Medical management is designed to decrease serum calcium levels b

Medical management is designed to decrease serum calcium levels by use of intravenous fluid diuresis with administration Selleckchem IPI 145 of furosemide and prednisolone. Biphosphate pamidronate

is used to inhibit calcium release from the bone. Phosphate binders aid in decreasing phosphate availability to interact with calcium. The prognosis is better if treatment is instituted early before development of hypercalcemia and hyperphosphatemia enables tissue mineralization to progress. (C) 2013 Published by Elsevier Inc.”
“The article reviews the current state and future of psychodynamic psychotherapies. In the past few decades psychodynamic psychotherapies have fallen into disrepute due to the fractious and dogmatic nature of different psychodynamic schools of thought and the lack of interest in validating some of its major premises or its effectiveness in comparison with other psychotherapy modalities. Despite these self-inflicted wounds, psychodynamic theory and treatment is staging a comeback. Many of the major premises that comprise the complex, layered model of the mind that are the basis

of psychodynamic treatments have again begun to be validated. A list of basic psychodynamic concepts is described. The evidence for each of these concepts varies, but as a whole the evidence is broad and deep for the model of the mind posited by psychoanalysis. This evidence is coming from many fields of knowledge that are not necessarily influenced by psychoanalysis. There have also been significant advances in developing methods and tools that can probe systematically into the complex nature of psychodynamic treatment APR-246 molecular weight processes. Finally, statistical tools-such as meta-analytic studies-that can aggregate and compare many different Studies at once are Pfizer Licensed Compound Library screening beginning to show the effectiveness of dynamic psychotherapies in comparison with other modalities of treatment.”
“The WAVE regulatory complex (WRC) controls actin cytoskeletal dynamics throughout the cell by stimulating the actin-nucleating activity of the Arp2/3 complex at distinct membrane sites. However, the factors that recruit

the WRC to specific locations remain poorly understood. Here, we have identified a large family of potential WRC ligands, consisting of similar to 120 diverse membrane proteins, including proto-cadherins, ROBOs, netrin receptors, neuroligins, GPCRs, and channels. Structural, biochemical, and cellular studies reveal that a sequence motif that defines these ligands binds to a highly conserved interaction surface of the WRC formed by the Sra and Abi subunits. Mutating this binding surface in flies resulted in defects in actin cytoskeletal organization and egg morphology during oogenesis, leading to female sterility. Our findings directly link diverse membrane proteins to the WRC and actin cytoskeleton and have broad physiological and pathological ramifications in metazoans.

Materials and Methods: The study was institutional review board a

Materials and Methods: The study was institutional review board approved. Participants gave informed consent.

Participants with at least one noncalcified, solid, indeterminate, intraparenchymal nodule (volume range, 50-500 mm(3)) at baseline were included (964 nodules in 750 participants). According to protocol, indeterminate nodules were re-examined at a 3-month follow-up CT examination. Repeat MK-8931 mouse screening was performed at years 2 and 4. A nodule was defined as resolving if it did not appear at a subsequent CT examination. Nodule resolution was regarded as spontaneous, not the effect of treatment. CT features of resolving and non-resolving (stable and malignant) nodules were compared by means of generalized estimating equations analysis. Results: At subsequent screening, 10.1% (97 of 964) of the nodules had disappeared, 77.3% (n = 75) of these at the 3-month follow-up CT and 94.8% (n = 92) at the second round of screening. Nonperipheral nodules were more likely to resolve than were peripheral nodules (odds ratio: 3.16; 95% confidence interval: 1.76, 5.70). Compared with smooth

nodules, nodules with spiculated margins showed the highest probability of disappearance (odds ratio: 4.36; 95% confidence interval: 2.24, 8.49). Conclusion: Approximately 10% of solid, intermediate-sized, intraparenchymal pulmonary nodules HIF-1 cancer found at baseline screening for lung cancer resolved during follow-up, three-quarters of which had disappeared at the 3-month follow-up CT examination. Resolving pulmonary nodules share CT features with malignant nodules. (c) RSNA, 2013″
“Engagement of the programmed death (PD)-1 receptor on activated cells by its ligand (PD-L1) is a mechanism for suppression of activated T-lymphocytes. Microglia, the resident inflammatory cells of the brain, are important for pathogen detection and initiation of innate immunity, however, a novel role for these cells as immune regulators has also emerged. AZD6244 mw PD-L1 on microglia has been shown to negatively regulate T-cell activation

in models of multiple sclerosis and acute viral encephalitis. In this study, we investigated the role of glial cell PD-L1 in controlling encephalitogenic CD8(+) T-lymphocytes, which infiltrate the brain to manage viral infection, but remain to produce chronic neuroinflammation. Using a model of chronic neuroinflammation following murine cytomegalovirus (MCMV)-induced encephalitis, we found that CD8(+) T-cells persisting within the brain expressed PD-1. Conversely, activated microglia expressed PD-L1. In vitro, primary murine microglia, which express low basal levels of PD-L1, upregulated the co-inhibitory ligand on IFN-gamma-treatment. Blockade of the PD-1: PD-L1 pathway in microglial: CD8(+) T-cell co-cultures increased T-cell IFN-gamma and interleukin (IL)-2 production.

Methods:The density and diameter of capillaries, as well

\n\nMethods:\n\nThe density and diameter of capillaries, as well as diameters of pial arteries, were measured by confocal laser-scanning microscopy and fluorescent microscopy, respectively. Possible angiogenesis was evaluated by detecting any outgrowth of endothelial cells from pre-existing vessels or intussusception in Tie2-GFP mice.\n\nResults:\n\nImmediately check details after unilateral CCA occlusion, cerebral blood flow (CBF) index, the reciprocal of mean transit time, reduced significantly and returned to the previous level after 14 days. Repeated observation of the cortical vessels did not reveal any angiogenesis, whereas the cortical capillary diameter increased by 74%

after 14 days. The anterior cerebral artery (ACA) and collateral vessels connecting ACA and middle cerebral artery also dilated significantly. The capillary dilatation to the size of arteriole in the settings of collateral growth and CBF restoration suggested capillary remodeling.\n\nConclusions:\n\nOur results indicate that capillary remodeling, pial artery dilatation and collateral growth without angiogenesis are sufficient mechanisms to restore normal cerebral blood flow after unilateral CCA occlusion.”
“Although the contraindications for thoracic epidural anesthesia (TEA) are PFTα cost well defined, the debate continues about whether TEA improves outcomes.

Pro and con trials and a metaanalysis in the past have PF-04929113 concentration yielded equivocal results; they did not deal with new vascular intervention or drugs. The benefit of TEA

in surgery is to provide analgesia. In subgroups, TEA can decrease the mortality and morbidity. In contrast, the cost can increase in the situation of a complication that is opposite to the side effects is rare, but the impairment caused by them is out of proportion to the benefits. Primary or secondary prophylaxis with antithrombotic drugs is increasing in developed countries because of the increasing cardiovascular interventions and aging of the population. The neuroaxial guidelines are useful, but the changing of the coagulation profile after hepatectomy is not included in them. The decision to use TEA in liver surgery must be individualized with steps planned from the beginning. TEA suitability is based on an evaluation of the contraindications, comorbidities, coagulation profiles, hepatic reserve, and balance of benefits and risks. The insertion or withdrawal of the epidural catheter should be made with care according to the neuroaxial guidelines and in the presence of a normal TEG. The decreasing level of prothrombin content and platelet counts after hepatectomy should be closely monitored every 2 to 5 days.”
“Background. Chronic kidney disease (CKD) is associated with increased risk for cardiovascular diseases (CVD).

(C) 2010 Elsevier B V All rights reserved “
“Eye loss in ch

(C) 2010 Elsevier B.V. All rights reserved.”
“Eye loss in children can be caused by trauma, glaucoma, or cancer, and may result in anxiety and depression. Recovery after eye loss involves a replacement with a custom-made eye

prosthesis, but, as the patient ages, changes in the size and shape of the eye socket can result in a sunken appearance of the child’s prosthetic eye. This article describes the fabrication of a custom-made eye and the necessity of changing ocular prostheses for a growing child, with a 5-year follow-up.”
“The AZD8931 manufacturer American Nurses Association mandates nursing informaticists to evaluate clinical system implementation processes. When implementing electronic documentation systems, the use of an evaluation tool aids in the identification of end-user concerns and recommendations, which leads to process improvement. At two community hospitals in South Florida, a Clinical Information System Implementation Evaluation Scale was used to evaluate nursing perceptions during the implementation of a new pediatric electronic documentation system (eDocumentation). The goals were to identify

barriers and resistance, as well as opportunities to improve PU-H71 the implementation process, and thus gain acceptance among end users.”
“The effects of feeding clinoptilolite on hematology, performance, and health of newborn Balouchi lambs were evaluated in this experiment. In a completely randomized design, 30 newborn lambs were allocated to three groups and fed by basal diet (C0; without clinoptilolite) and C1 and C2 (the basal diet plus 1.5% and 3% clinoptilolite, respectively, for 6 weeks (3 weeks before and 3 weeks after weaning)). Blood samples were taken from all lambs, at the time when the animals were

learn more allocated to the experimental diet and at the end of each week of experiment, and analyzed for hematology, plasma fibrinogen, and total protein. Performance and health of all lambs were measured. Fecal consistency score and diarrhea severity were evaluated. There was no difference between lambs in case of hematological parameters. Lambs fecal consistency score and severity of diarrhea were lowest (P < 0.05) for lambs on C1 and C2 and highest for lambs on C0. Dry matter intake and feed conservation ratio were similar between the groups of lambs fed by different diets, but daily gain of lambs differed significantly (P < 0.05) and was higher in C2. It was concluded that addition of 3% clinoptilolite to starter diet of newborn lamb can reduce incidence and severity of diarrhea, although its effect on hematology and performance was negligible.”
“Exposure to nonself red blood cell (RBC) antigens, either from transfusion or pregnancy, may result in alloimmunization and incompatible RBC clearance. First described as a pregnancy complication 80 years ago, hemolytic disease of the fetus and newborn (HDFN) is caused by alloimmunization to paternally derived RBC antigens.

NSBC has been exploited to obtain potable water free from pathoge

NSBC has been exploited to obtain potable water free from pathogens and pesticides in one step process. (C) 2012 Elsevier Ltd. All rights reserved.”
“Listeria monocytogenes poses a serious threat to public health, and the majority of cases of human listeriosis

are associated with contaminated food. Reliable microbiological testing is needed for effective pathogen control by food industry and competent authorities. The aims of this work were to estimate the prevalence and concentration of L. monocytogenes in minced pork meat by the application of a Bayesian modeling approach, and also to determine the performance of three culture media commonly used for detecting L. monocytogenes in foods from a deterministic and stochastic perspective. Samples (n = 100) collected from local markets were tested for L monocytogenes using in parallel SHP099 molecular weight the PALCAM, ALOA and RAPID’L.mono selective media according to ISO 11290-1:1996 and 11290-2:1998 methods. Presence of the pathogen was confirmed by conducting biochemical and molecular

tests. Independent experiments selleck compound (n = 10) for model validation purposes were performed. Performance attributes were calculated from the presence-absence microbiological test results by combining the results obtained from the culture media and confirmative tests. Dirichlet distribution, the multivariate learn more expression of a Beta distribution, was used to analyze the performance data from a stochastic perspective. No L. monocytogenes was enumerated by direct-plating (<10 CFU/g), though the pathogen was detected in 22% of the samples. L monocytogenes concentration was estimated at 14-17 CFU/kg. Validation showed good agreement between observed and predicted prevalence (error = -2.17%). The results showed that all media were best at ruling in L monocytogenes presence than ruling it out. Sensitivity and specificity varied depending on the culture-dependent method. None of the culture media was perfect

in detecting L monocytogenes in minced pork meat alone. The use of at least two culture media in parallel enhanced the efficiency of L. monocytogenes detection. Bayesian modeling may reduce the time needed to draw conclusions regarding L monocytogenes presence and the uncertainty of the results obtained. Furthermore, the problem of observing zero counts may be overcome by applying Bayesian analysis, making the determination of a test performance feasible. (C) 2013 Elsevier Ltd. All rights reserved.”
“Objective: We examined whether post-traumatic growth would moderate the impact of intrusive thoughts on a range of dimensions of well-being in a sample of younger adult survivors of various types of cancer.

In support of its effect on the NF-kappa B signaling pathway, Cuc

In support of its effect on the NF-kappa B signaling pathway, CucE decreased the phosphorylation levels of inhibitor of kappa B (I kappa B) and NF-kappa B/p65 in PDB + Ion-stimulated cells. Further supporting this, the nuclear translocation of NF-kappa B/p65 was significantly suppressed in

response to PDB plus Ion stimulation in the presence of CucE. The phosphorylation of p38MAPK, c-Jun N-terminal kinase (JNK), and Erk1/2, however, was not decreased or slightly increased at some time points by CucE treatment. Collectively, CBL0137 cost these data suggest that CucE may exhibit immunosuppressive effect by attenuating critical cytokine expression through down-regulating the NF-kappa B signaling pathway.”
“HBx is an oncogenic tumor-associated antigen and is dominantly expressed in hepatitis and hepatoma tissues, the induction of active cellular responses against HBx should be a promising approach for the treatment of hepatitis B virus-related hepatocellular carcinoma. The present study was designed to test whether a replication-defective adenovirus vaccine expressing HBx antigen could be effectively used in the immunotherapy of hepatocellular carcinoma. To validate the possibility, we developed a novel HBx-positive hepatocellular Selleck GDC-0068 carcinoma in mice by inoculated the pcDNA-HBx transfected Hepa1-6 cells subcutaneously

into the right flank of mice. We found that immunotherapy with Ad-HBx was effective at both protective and therapeutic antitumor immunity in the

hepatoma models in immune-competent mice. Histological examination revealed that Ad-HBx treatment led to significantly increased induction of apoptosis, tumor necrosis, MAPK inhibitor and elevated CD8(+) lymphocyte infiltration. In addition, the induction efficacy of the CTL response is dramatically enhanced by immunotherapy. Cytokine analysis comfirmed that the antitumor efficacy of Ad-HBx may mostly result from cellular immunity. Our findings may prove useful in development of adenovirus vaccine based on HBx antigen to the treatment of HBV-associated hepatocellular carcinoma.”
“Arboviral encephalitis is a potentially devastating human disease with no approved therapies that target virus replication. We previously discovered a novel class of thieno[3,2-b]pyrrole-based inhibitors active against neurotropic alphaviruses such as western equine encephalitis virus (WEEV) in cultured cells. In this report, we describe initial development of these novel antiviral compounds, including bioisosteric replacement of the 4H-thieno[3,2-b]pyrrole core with indole to improve metabolic stability and the introduction of chirality to assess target enantioselectivity. Selected modifications enhanced antiviral activity while maintaining low cytotoidcity, increased stability to microsomal metabolism, and also revealed striking enantiospecific activity in cultured cells.

“Satellite-based observations indicate that seasonal patte

“Satellite-based observations indicate that seasonal patterns in canopy greenness and productivity in the Amazon are negatively correlated with precipitation, with increased greenness

occurring during the dry months. Flux tower measurements indicate that the canopy greening that occurs during the dry season is associated with increases in net ecosystem productivity (NEP) and evapotranspiration (ET). Land surface and terrestrial biosphere model simulations for the region have predicted the opposite of these observed patterns, with significant declines in greenness, NEP, and ET during the dry season. In this study, we address this issue mainly by developing an empirically constrained, light-controlled phenology submodel within the Ecosystem Demography model version 2 (ED2). The constrained ED2 model with a suite of field observations shows markedly improved predictions selleck chemical of seasonal ecosystem dynamics, more accurately capturing the observed patterns of seasonality in water, carbon, and litter fluxes

seen at the Tapajos National Forest, Brazil (2.86 degrees S, 54.96 degrees W). Long-term simulations indicate that this light-controlled phenology increases the resilience of Amazon forest NEP to interannual Selleck LY2835219 variability in climate forcing.”
“Enteric duplication is a rare anomaly, which is common in pediatric population, and it is very rare in adults. Enteric duplication can occur anywhere from mouth to anus. Ileal duplication is the most common (30 %) followed by duodenum, stomach, jejunum, colon and rectum. Though most cases are presented within the first 2 years of life, some may present at later age. Here we report

a case of a 72-year-old male presented to us in emergency as acute abdomen, which was presumptively diagnosed as ca rectosigmoid, but later the patient developed perforative peritonitis. On exploratory laparotomy he was diagnosed as a case of perforated ileal duplication cyst. Though these lesions are very rare, the importance of enteric duplication cysts lies in the fact that they can mimic many disease conditions and may be KPT-8602 left untreated.”
“There is evidence to suggest that oxytocin is effective in stabilizing mood in humans. Lower plasma oxytocin levels have been reported in patients with major depression. The objective of this study was to investigate serum oxytocin levels during manic and depressive episodes and in the remission period in patients with bipolar disorder. Twenty-two patients in manic episode, 21 in depressive episode, and 24 in remission at the initial phase, ranging from 18 to 65 years of age, who were diagnosed with BD Type I and 24 healthy individuals were included in this study. Blood samples were collected from subjects in the morning at the beginning of the study. A second blood sampling was obtained from manic and depressive patients after response to treatment. MANCOVA was performed to compare the oxytocin values of the groups.

A small number of epidemiologic studies demonstrate that perinata

A small number of epidemiologic studies demonstrate that perinatal, sexual, household, and occupational transmission occurs, but our understanding of the risks of transmission in these settings has been limited. The therapy for chronic hepatitis C has evolved steadily

since alpha interferon was first approved for use. At present, the optimal regimen appears to be a 24- or 48-week course of a combined pegylated alpha interferon and ribavirin regimen. Currently, the combination of RNAi (LV-shIRES) with IFN-alpha has been proposed to prevent therapeutic resistance, and to promote enhanced antiviral activity against HCV. However, any RNAi based therapy may be years away due to off-target effects.”
“We have previously shown that elevated expression of Hairy enhancer of split 1 (Hes1) selleck chemicals llc Selleckchem VX-661 contributes to blast crisis transition in Bcr-Abl-positive chronic myelogenous leukemia. Here we investigate whether Hes1 is involved in the development of other myeloid neoplasms. Notably, Hes1 expression was elevated in only a few

cases of 65 samples with different types of myeloid neoplasms. Interestingly, elevated expression of Hes1 was found in two of five samples of Fip1-like1 platelet-derived growth factor receptor-alpha (FIP1L1-PDGFA)-positive myeloid neoplasms associated with eosinophilia. Whereas FIP1L1-PDGFR alpha alone induced acute T-cell leukemia or myeloproliferative neoplasms in mouse bone marrow transplantation models, mice transplanted with bone marrow cells expressing both Hes1 and FIP1L1-PDGFR alpha developed acute leukemia characterized by an expansion of myeloid blasts and leukemic cells without eosinophilic granules. FIP1L1-PDGFR alpha conferred cytokine-independent growth to Hes1-transduced common myeloid progenitors, interleukin-3 dependent cells. Imatinib inhibited the growth of common myeloid progenitors expressing Hes1 with FIP1L1-PDGFR alpha, but not with imatinib-resistant FIP1L1-PDGFR alpha mutants harboring T674I

or D842V. In contrast, ponatinib efficiently eradicated leukemic cells AZD1480 order expressing Hes1 and the imatinib-resistant FLP1L1-PDGFRA mutant in vitro and in vivo. Thus, we have established mouse models of FIP1L1-PDGFRA-positive leukemia in myeloid blast crisis, which will help elucidate the pathogenesis of the disease and develop a new treatment for it. (C) 2014 ISEH – Society for Hematology and Stem Cells. Published by Elsevier Inc.”
“AimThe aim of this study was to determine how socio-demographic and clinical variables affect quality of life (QoL) and to assess the validity of a 20-item scale in a sample of Italian subjects with colostomy, ileostomy and multiple stomata. MethodA cross-sectional multicentre survey was carried out in Italy between 2009 and 2010 in 73 stoma centres coordinated by the University of Padova. Patients aged 18years old and above with a history of nontemporary stoma were included in the study.

Here, a fast, simple direct method for microbial detection in blo

Here, a fast, simple direct method for microbial detection in blood plasma without using the spacer and blocking agent is reported. To compensate for the natural electrophoretic heterogeneity of microbes, a CTAB additive was used to sweep all microbial cells towards the plasma peak where a single sharp microbial peak is formed and detected. With the Mizoribine manufacturer use of BacLight (TM) Green bacterial stain, the microbial peak, generally, can be detected within 10 min in front of the plasma peak using capillary electrophoresis coupled with laser-induced florescence detection. The LOD of microbes detectable were 5 cells per injection. This technique provides a great

advantage over traditional, time-consuming microbial inoculation methods. (C) 2010 Published by Elsevier B.V.”
“The Hia autotransporter of Haemophilus infuenzae belongs to the trimeric autotransporter subfamily and mediates bacterial adherence to the respiratory epithelium.

In this report, we show that the structure of Hia is characterized by a modular architecture containing repeats of structurally distinct domains. Comparison of the structures of HiaBD1 and HiaBD2 adhesive repeats and a nonadhesive repeat (a novel fold) shed light on the structural CX-6258 determinants of Hia adhesive function. Examination of the structure of an extended version of the Hia translocator domain revealed the structural transition between the C-terminal translocator

domain and the N-terminal passenger domain, highlighting a highly intertwined domain that is ubiquitous among trimeric autotransporters. Overall, this study provides important insights into the mechanism of Hia adhesive activity and the overall structure of trimeric autotransporters. (C) 2008 Elsevier Ltd. All rights reserved.”
“Matrix metalloproteinase (MMP)-13 has a pivotal, rate-limiting function in cartilage remodeling and degradation due to its specificity for cleaving type II collagen. The proximal JQ-EZ-05 MMP13 promoter contains evolutionarily conserved E26 transformation-specific sequence binding sites that are closely flanked by AP-1 and Runx2 binding motifs, and interplay among these and other factors has been implicated in regulation by stress and inflammatory signals. Here we report that ELF3 directly controls MMP13 promoter activity by targeting an E26 transformation-specific sequence binding site at position -78 bp and by cooperating with AP-1. In addition, ELF3 binding to the proximal MMP13 promoter is enhanced by IL-1 beta stimulation in chondrocytes, and the IL-1 beta-induced MMP13 expression is inhibited in primary human chondrocytes by siRNA-ELF3 knockdown and in chondrocytes from Elf3(-/-) mice.

These results provide new insights into metazoan GST diversity an

These results provide new insights into metazoan GST diversity and the biochemical mechanisms used by marine organisms to cope with their chemically

defended prey. (c) 2008 Elsevier Inc. All rights reserved.”
“Austroplenckia populnea (Celastraceae), known as “marmelinho do campo”, is used in Brazilian folk medicine as antimicrobial, anti-inflammatory, and antitumoural agent. The aim of the present work was to evaluate the antimicrobial. antileishmanial and antimalarial activities of the crude hydroalcoholic extract of A. populnea (CHE) and some of its isolated compounds. The phytochemical study of the CHE was carried Out affording the isolation of methyl populnoate (1), populnoic acid (2), and stigmast-5-en-3-O-beta-(D-glucopyranoside) (3). This is the first time that the presence of compound 3 in A. populnea is reported. The results showed that the CHE presents antifungal and antibacterial activities, especially against Candida glabrata and Candida albicans, for which the CHE showed IC(50) values of 0.7 mu g mL(-1) and 5.5 mu g mL(-1), respectively, while amphotericin B showed an IC(50) value of 0.1 mu g mL(-1) against both microorganisms. Compounds 1-3 were inactive against all tested microorganisms. In the antileishmanial activity test against Leishmania donovani, the CHE showed an IC(50) value of 52 mu g mL(-1), while compounds 2 and 3 displayed an IC(50) value of 18 mu g mL(-1). In the antimalarial assay against Plasmodium falciparum (D6 and W2 clones), it was observed that all evaluated samples were inactive. In order to compare the effect on the parasites with the toxicity to mammalian cells, the cytotoxicity activity of the isolated compounds was

evaluated against Vero cells, showing that all evaluated samples exhibited no cytotoxicity at the maximum dose tested.”
“Gating of ion channels by ligands is fundamental to cellular function, and ATP serves as both an energy source and a signaling molecule that modulates Selleckchem Blebbistatin ion channel and transporter functions. The slowly activating K+ channel I-Ks in cardiac myocytes is formed by KCNQ1 and KCNE1 subunits that conduct K+ to repolarize the action potential. Here we show that intracellular ATP activates heterologously coexpressed KCNQ1 and KCNE1 as well as I-Ks in cardiac myocytes by directly binding to the C terminus of KCNQ1 to allow the pore to open. The channel is most sensitive to ATP near its physiological concentration, and lowering ATP concentration in cardiac myocytes results in I-Ks reduction and action potential prolongation. Multiple mutations that suppress I-Ks by decreasing the ATP sensitivity of the channel are associated with the long QT (interval between the Q and T waves in electrocardiogram) syndrome that predisposes afflicted individuals to cardiac arrhythmia and sudden death.