Transvenous catheter–based microwave ablation for atrial flutter

We report a case of successful transvenous, catheter-based, cavotricuspid isthmus ablation for treatment of atrial flutter using microwave energy. Microwave energy was delivered at 900–930 MHz using 21 W of power. Bidirectional cavotricuspid isthmus conduction block was achieved by microwave ablation without any patient discomfort or complication during the procedure. Our initial experience suggests that transcatheter microwave ablation is feasible for the cure of typical atrial flutter.     

Rice varieties with similar amylose content differ in starch digestibility and glycemic response in humans

Three high-amylose rice varieties, IR42, IR36, and IR62, with similar chemical composition including amylose content (26.7-27.0%), were cooked under the same conditions and tested for in vitro digestibility as well as blood glucose and insulin responses in healthy human volunteers. The starch-digestion rate and the glycemic and insulin responses were the highest in IR42, followed by IR36 and, then IR62. The differences were not due to unabsorbed carbohydrate but were related to their physicochemical properties, such as gelatinization temperature, minimum cooking time, amylograph consistency, and volume expansion upon cooking. When the three varieties were cooked for their minimum cooking time, they had the same degree of gelatinization and their starch-digestion rates and glycemic responses were similar. We conclude that amylose content alone is not a good predictor of starch-digestion rate or glycemic response. Rice varieties with similar high-amylose contents can differ in physicochemical (gelatinization) properties and this, in turn, can influence starch digestibility and blood glucose response.     

Paired kidney analysis of tacrolimus and cyclosporine microemulsion-based therapy in Chinese cadaveric renal transplant recipients

Few studies used paired kidneys for comparison between tacrolimus and cyclosporine in renal transplantation. Most of the published data used whole blood trough levels for drug monitoring. However, the use of limited sampling strategy and abbreviated formula to estimate the 12-h area under concentration-time curve (AUC(0-12)) allowed better prediction of drug exposure. Sixty-six first cadaveric renal transplant recipients receiving paired kidneys were randomized to receive either tacrolimus-based (n = 33) or cyclosporine microemulsion (Neoral)-based therapies (n = 33). Abbreviated AUC(0-12) was used for drug monitoring and dose titration. Mean follow-up duration was 2.8 +/- 2 years. The patient and graft survival were comparable. Fewer incidence of acute rejection was observed in tacrolimus group (15% vs. 27.3%) though the difference was not significant (P = 0.23). The absolute value and the rate of decline of creatinine clearance were both significantly better in tacrolimus-treated patients. Prevalence of hypertension, post-transplant diabetes mellitus, infection, and malignancy were similar in both groups. Prevalence of hypercholesterolemia (11/33 vs. 4/33) and gum hypertrophy (6/33 vs. 1/33) was more common in cyclosporine-treated patients (P = 0.04 in both parameters). This was the first prospective, randomized study with paired kidney analysis showing the renal function was significantly better in tacrolimus-treated patients than in cyclosporine-treated patients.     

Low peripheral plasma renin activity as a critical marker in pediatric hypertension

In evaluating hypertensive children and adolescents, the etiological considerations should include a set of inherited disorders that share very low plasma renin activity (PRA) as a common feature. In particular among these disorders, glucocorticoid remediable aldosteronism (GRA) appears to be emerging as an important etiology of hypertension in the pediatric population. We report the evaluation of a 9-year-old Caucasian girl who presented with severe hypertension and a strong family history of early-onset hypertension. Her suppressed PRA, her family history, and her failure to respond to conventional antihypertensive therapy raised GRA as a potential etiology. The diagnosis was confirmed by an elevated ratio of urinary 18-oxotetrahydrocortisol to urinary tetrahydroaldosterone and genetic testing, which demonstrated the chimeric gene duplication. The molecular pathogenesis of GRA and the clinical implications are reviewed. Received May 15, 1996; received in revised form and accepted September 16, 1996     

Effect of resin hydrophilicity and water storage on resin strength

This study evaluated the change in the ultimate tensile strength (UTS) of five polymerised resin blends of increasing hydrophilicity, after ageing in distilled water or silicon oil. Resin blocks were prepared from each resin blend by dispensing the uncured resin into a flexible, embedding mould, containing multiple cavities. The resins were polymerised in the moulds under nitrogen at 551.6 kPa and light-activated at 125 degrees C for 10 min. After dry ageing for 24 h at 37 degrees C, the middle third of each resin specimen was trimmed into an 'I' shape. Fifteen control specimens were randomly selected from each resin blend for baseline UTS evaluation. The UTS of the experimental specimens were determined after 1, 3, 6 and 12 months of ageing in water or oil. The UTS of each group of resins at different storage periods in water or oil were analysed using the Friedman multiple ANOVA on ranks and Dunn's multiple comparison tests at 95% confidence level. Significant reduction (p < 0.01) in UTS was observed in Groups II-V resins after 12-month storage in water, while the most hydrophobic Group I resin showed no significant change (p > 0.05) in the same period. The percentage reduction in UTS increased with the hydrophilicity of the resin blends. Long-term water storage of hydrophilic resin blends such as those employed in dentine adhesives, resulted in a marked reduction in their mechanical strength that may compromise the durability of resin-dentine bonds.     

Immunotactoid glomerulopathy with fingerprint immune deposits

Summary Immunotactoid glomerulopathy is a distinct clinico-pathological entity which has recently been defined. The term immunotactoid refers to highly organized immune depositions appearing as rod-like microtubular structures in ultrastructural examination. We describe a patient with mixed connective tissue disease who demonstrates characteristic features of immunotactoid glomerulopathy. The diagnosis was made after excluding amyloidosis, cryoglobulinaemia and lupus nephritis. In addition to immunotactoid microtubules, ultrastructural examination also demonstrated presence of fingerprint depositions which were intimately mixed with immunotactoid structures. Fingerprint deposits have been described in lupus nephritis and cryoglobulin-related nephropathy, but rarely in other glomerulonephritis. These unique findings in our patient may suggest a previously unsuspected relationship between the syndrome of immunotactoid glomerulopathy and systemic lupus erythematosus.     

CGRP对缺氧缺血新生鼠脑细胞内游离Ca2+的影响

目的探讨降钙素基因相关肽(CGRP)对缺氧缺血新生鼠脑细胞内游离Ca2+的影响及对脑损伤的保护作用.方法 7日龄SD大鼠制成HIE模型.⑴药物治疗组于模型后即给CGRP 3μg*kg-1*d-1,腹腔内注射,共3d;⑵生理盐水组每天给予同剂量生理盐水腹腔内注射;⑶正常对照组(假手术组).各组于3d后断头取脑,采用钙荧光指标剂Fura-2AM法测定脑细胞胞浆游离钙浓度[(Ca2+)].结果生理盐水组脑细胞内钙含量最高,(129.47±17.21nmol/L)与正常对照组(93.72±24.16nmol/L)比较有显著差异P＜0.01,而药物治疗组(103.35±12.46nmol/L)与正常对照组比较无显著差异.结论 CGRP能阻止新生鼠缺氧缺血脑损伤后细胞钙内流,降低细胞膜对Ca2+通透性可能是CGRP对脑缺氧缺血保护作用的重要机制.