The Vanishing Defibrillator Syndrome: Incidence, Mechanism, and Clinical Relevance

Intraperitoneal migration of an abdominally implanted cardioverter defibrillator is a complication not yet fully described. In a consecutive series of 195 patients, migration occurred between I and 20 months in 5 (8%) of the 63 patients in whom a subrectus abdomini placement of the generator was chosen. It was unrelated to the patients'clinical characteristics or the defibrillator model. Dysuria and inability to interrogate the device were present in every subject, and the diagnosis was confirmed by the characteristic abdominal x-ray appearance and the findings at the time of surgery. Adhesions involving the omentum, and in one case, the small bowels, were present in three patients and seem to be related to the length of intraabdominal permanence of the generator. Because this complication may be due to specific anatomical characteristics of the aponeurosis of the abdominal muscles, it is likely that its incidence will be unchanged by the use of smaller devices. A close follow-up of the generators implanted deep to the rectus fascia is therefore advisable.     

哺乳类动物心室肌细胞的Luo-Rudy模型及计算机仿真研究的进展

在实验数据的基础上基于Hodgkin-Huxley方程建立的哺乳类动物心室肌细胞的Luo-Rudy模型及计算机仿真研究使得对心脏的认识从定性转入定量.本文简述了Luo-Rudy模型的发展过程及其应用研究,并给出了LR91模型的计算机仿真结果.心肌细胞模型在心脏电生理研究中起着重要的作用,随着对心肌细胞模型的进一步研究将在分子水平上揭开心源性猝死的原因.     

Procedural Effectiveness of a Novel 1.20 mm Diameter Angioplasty Catheter: Clinical and Angiographic Outcomes

Objective

To evaluate clinical and angiographic outcomes using a 1.20 mm diameter angioplasty catheter as part of a predilation strategy for coronary lesion treatment.

Background

Development of an angioplasty catheter with low crossing profile and small balloon diameter represents an opportunity to facilitate percutaneous revascularization of complex coronary disease.

Methods

Clinical and angiographic outcomes were evaluated following a predilation treatment strategy using a low profile, 1.20 mm angioplasty catheter. The primary end‐point of procedural success was defined as successful device delivery, performance and lesion treatment without occurrence of perforation, flow‐limiting dissection, reduction in baseline TIMI grade, or clinically significant arrhythmias, and with final achievement of TIMI 3 flow. In‐hospital major adverse events were also determined.

Results

Among 71 patients (83 lesions), angiographic characteristics included: de novo lesion, 75.9%; saphenous vein graft 9.6%; lesion length (mean ± standard deviation), 12.27 ± 5.96 mm; reference vessel diameter, 2.61 ± 0.57 mm; lesion classification B2/C, 59.0%; baseline TIMI 0/1 flow, 4.8%. Procedural success was achieved for 98.5% (66/67) of patients. Catheter delivery to the target lesion was achieved in all patients, and the rate of device success with luminal improvement after predilation was 96.2% (75/78). No acute procedural complications were observed, and in‐hospital target lesion failure occurred in 6 patients (8.5%) related to peri‐procedural non‐Q wave myocardial infarction.

Conclusions

Coronary lesion predilation with a low profile, 1.20 mm angioplasty catheter is associated with favorable procedural safety and efficacy and may represent an effective treatment for complex coronary anatomy. (J Interven Cardiol 2013;26:131–136)

     

Health Related Quality of Life (HRQoL) among Breast Cancer Patients Receiving Chemotherapy in Hospital Melaka: Single Centre Experience

Objective: To investigate the impact of chemotherapy on quality of life (QoL) among breast cancer patients and to evaluate the relationship with age, cancer stage and presence of any comorbidity. Methods: A prospective study was conducted among breast cancer patients receiving chemotherapy in Hospital Melaka from 1st January 2014 to 31st July 2014. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was given to patients to fill in prior chemotherapy (baseline) and after the third cycle of chemotherapy. Socio-demographic and clinical data were collected and analyzed using SPSS version 20. Result: Respondents were 32 female patients [mean age (SD): 49.7(9.93) years]. They reported a significant lower global health status (P < 0.01) and significant higher symptoms of nausea and vomiting (P < 0.01), loss of appetite (P = 0.028) and diarrhea (P = 0.026) after the third cycle of chemotherapy as compared to baseline. Compare to, this study showed significant better emotional functioning (P < 0.01) and social functioning (P < 0.01) than the EORTC QLQ-C30 Reference Values 2008 for breast cancer cases. Under symptom scales higher scores were noted for appetite loss (P = 0.017), nausea and vomiting (P < 0.01). Age, stage and comorbidity had no clear associations with global health status in our patients (P > 0.05). Conclusion: Chemotherapy did reduce the QoL of breast cancer patients. Management of chemotherapy-induced loss of appetite, diarrhea, nausea and vomiting should be improved for a better outcome.     

治疗血吸虫病药—盐酸奎宁锑的毒性及口服后锑在大鼠体内的吸收、分布及排洩

大白鼠口服盐酸奎宁锑后,锑自胃肠道消失得很慢,八小时后;仍有约90%的锑在胃肠道存留.如先将胃与小肠间以线结扎,再使动物口服本品,肠道的锑含量仍逐渐增加.大鼠口服盐酸奎宁锑后,锑很快进入胆汁中,锑的排洩以粪为主,自尿排出者,为量极微.大白鼠口服盐酸奎宁锑24小时后,各脏器均合有锑.除胃肠外,锑的浓度以肝脏为最高,肾和脾的浓度约为肝脏的一半,而肺、心、脑和血中的锑浓度极小.可见,口服盐酸奎宁锑后锑之所以自胃肠道消失得很少,并不一定由于锑的吸收很少,部分已吸收的锑经胆管又排洩至肠道.     

东北地区药用植物採集调查初步报告

本文目的旨在报導关于中國东北藥用植物分布情况,作为研究中藥的参考。作者以及在本組工作的前人从1938到1955年,經过多次調查采集獲得了約2000种本地植物,其中包括有300—400种藥用植物,并且还有156种著名的中藥例如:人参、甘帅、麻黄、細辛、烏头、龍胆及紫等。这些藥物都是量多而質优的。其中还有些已經在大量栽培。东北藥用植物資源非常丰富,尚有待于進一步地調查和研究。     

The highly specific platelet glycoprotein (GP) VI agonist trowaglerix impaired collagen-induced platelet aggregation ex vivo through matrix metalloproteinase-dependent GPVI shedding

Summary.  Background:  C-type lectin proteins (CLPs) have diverse targets including platelet GPIb, GPVI and integrin α₂β₁, and affect platelet function in a various way. In this study, we characterized a huge, heterodimeric venom protein, trowaglerix, which belongs to the CLP family. Methods:  We purified a potent platelet-aggregation inducer, trowaglerix, from the crude venom of Tropidolaemus wagleri . Biotinylated trowaglerix was used for binding assays, and immunoblotting was used to investigate the signal transduction involved. Results:  Two distinct subunits of trowaglerix with similar masses of around 16 kDa were eluted by high-performance liquid chromatography after reduction and alkylation. Trowaglerix induced platelet aggregation of washed human platelets and platelet-rich plasma (PRP) in a concentration-dependent manner. Biotinylated trowaglerix specifically bound to platelet membrane GPVI, but not to GPIb or α₂ integrin. Treatment with trowaglerix induced GPVI loss in human platelets in vitro and impaired the platelet aggregation of mouse PRP ex vivo in response to collagen but not in response to adenosine diphosphate (ADP). However, GM6001, a matrix metalloproteinase (MMP) inhibitor, inhibited trowaglerix-induced GPVI cleavage and restored the platelet responsiveness of PRP to collagen. Conclusions:  Trowaglerix activates platelets through specific binding to GPVI, leading to kinases-dependent exposure of functional α_IIbβ₃ and platelet aggregation, and also induces MMP-dependent GPVI shedding from platelets.