Proportion of Candidates for Cardiac Resynchronization Therapy

ERDOGAN, A., et al. : Proportion of Candidates for Cardiac Resynchronization Therapy. Biventricular pacing has been used as an adjunct to standard heart failure therapy in symptomatic patients with left bundle branch block (LBBB). Estimates of the number of patients for whom this treatment is appropriate are unavailable, but are of clinical and socioeconomic importance. LBBB combined with a low (<0.35) ejection fraction was found in 7,121 consecutive patients referred for elective diagnostic angiography in 1996 through 2000 from a total population of about 125,000 residents. Patients with LBBB (n = 289, 4%) had lower ejection fractions (0.53 ± 0.23) in comparison with patients without LBBB (P < 0.0001). The ejection fraction was <0.35 in 558 (8%) patients. LBBB was combined with a low ejection fraction in 96 (1.4%) patients (i.e., 19 patients per year and about 15 patients per year per 100,000 residents). Of these 96 patients, 80 had normal sinus rhythm, 82 had mitral regurgitation (grade > II), 86 were <75 years of age, and 68 had coronary artery disease. Holter recordings performed in 47 of 96 patients showed nonsustained VT in 28 (60%). LBBB, low ejection fraction, sinus rhythm, and age <75 years were found in 71 (1%) patients (i.e., 11 patients per year per 100,000 residents). The prevalence of LBBB combined with severely impaired left ventricular ejection function is about 1–2% in patients who undergo cardiac catheterization. The authors estimate that biventricular pacing might be considered as an adjunct to standard heart failure therapy in five to ten patients per year per 100,000 residents in industrial countries. About half of these patients are potential candidates for implantation of cardioverter defibrillators combined with permanent pacing. (PACE 2003; 26[Pt. II]:152–154)     

A sensitive novel staining agent for the resolved proteins on PAGE

A more sensitive, stable and fast-reacting dye was isolated from the bark of Ratanjot by a simple solvent extraction procedure at high pH. The dye produced sharp, clear distinct stable bands of known proteins when resolved on polyacrylamide gel electrophoresis (PAGE) using sodium dodesyl sulfate (SDS), showing a rapid and strong affinity with protein molecules. Not only did proteins from peanut, separately stained with the new dye and Coomassie Brilliant Blue R-250, produce rapid comparable results, but also the protein bands were easily visualized and were less diffusible with clearer boundaries in the case of the new staining agent. © Munksgaard 1995.     

Relationship between semen characteristics, a-glucosidase and the capacity of spermatozoa to bind to the human zona pellucida

Unfertilized oocytes from an in-vitro fertilization programme were stored in different saline solutions and then utilized in a zona binding assay (ZBA). The four saline solutions tested were identical with regard to the capacity of the zona to bind sperniatozoa provided by healthy donors. Spermatozoa from 150 infertile patients were tested in the ZBA. The number of spermatozoa bound to the zona correlated positively with sperm concentration, the percentage sperm motility and the percentage of morphologically normal spermatozoa. The population was then divided into two groups according to the level of α-glucosidase activity, an epididymal marker. The average number of spermatozoa bound to the zona was diminished in the group with low α-glucosidase activity, even when considering strictly equivalent classes of sperm concentration, motility and morphology, respectively.     

Some Effects of Cassia italica on the Central Nervous System in Mice

This work examines some effects of the crude ethanolic extract of the medicinal plant Cassia italica, given at single oral doses of 0.25, 0.5 or 1 g kg^?1, on the central nervous system in mice. Several models of nociception have been used to examine the analgesic effect of the extract. HPLC fingerprinting of the extract was performed to ensure uniformity of the extract material used. In treated mice, the extract caused dose-related inhibition of acetic acid-induced abdominal constriction, and in the formalin test of antinociception the extract reduced formalin-induced pain in the second (late) but not in the first (early) phase of the pain. Treatment with the extract at doses of 0.5 and 1 g kg^?1 significantly increased the reaction time in the hot-plate and warm-water tail-flick tests. Naloxone was ineffective in antagonizing the analgesic effect of C. italica on tail-flick and abdominal constriction tests, possibly indicating that the effect occurs via non-opiate pathways. The C. italica extract caused slight dose-related impairment of motor control which was significant only at a dose of 1 g kg^?1. Treatment at the three doses used did not affect the rectal temperature of normothermic mice, but was effective in significantly reducing the rectal temperature of hyperthermic rats, 0.5 and 1 h (but not 6 h) after administration of the extract at doses of 0.5 and 1 g kg^?1. The extract also produced progressive diminution in the ambulatory and total activity of treated mice for up to 2 h after administration. It is concluded that the crude ethanolic extract of C. italica has CNS depressant properties, manifested as antinociception and sedation.     

Long-Term Survival and Complications in Patients With Malignant Ventricular Tachyarrhythmias: Treatment With a Nonthoracotomy Implantable Cardioverter Defibrillator With or Without a Subcutaneous Patch

The Endotak lead system and ICD has been used to treat patients with malignant ventricular arrhythmias. We analyzed The clinical characteristics of 1,053 patients who underwent implantation of The Endotak lead system with or without a subcutaneous patch. Group A consisted of 567 patients receiving The Endotak lead with a subcutaneous patch: group B consisted of 486 patients receiving The Endotak lead alone. The 2-year survivals from sudden death, cardiac death, and total death in groups A and B were 97.6%/98.2% (P = 0.38), 88.6%/92.7% (P = 0.09), and 84.7%/86.8% (P = 0.06). respectively. Minimum tested effective defibrillation energy at implantation was 17.2 ± 5.2 J for group A and 15.8 ±5.1 J for group B (P < 0.01). The operative mortality was 1.8% in group A and 0.6% in group B (P = 0.09). The incidence of lead dislodgment, malfunction, and infection was 6,7% for group A and 3.5% for group B (P < 0,01), Sudden death survival was excellent in both groups with less lead complications in group B. The Endotak lead alone may be The preferred choice of lead configuration in those patients who have adequate defibrillation thresholds at implant. (PACE 1997: 20[Pt. I]:1305-1311)     

IN VITRO EVALUATION OF GRISEOFULVIN, KETOCONAZOLE, AND ITRACONAZOLE AGAINST VARIOUS DERMATOPHYTES IN SINGAPORE

Background. Superficial cutaneous fungal infection, principally dermatophytosis, is an extremely common skin disease. Various in vitro test systems have been developed in recent years to determine the antifungal activity of various drugs. The minimum inhibitory concentration (mic ) obtained may give an indication of the in vivo potency of the drugs. Methods. One hundred patients (69 men and 31 women) with a clinical diagnosis of dermatophytosis were entered into the study. Direct microscopy and culture were done on all patients. The Mies were determined using the broth dilution method. Results. The age range was 1–76 years. The most common diagnosis was tinea corporis (36%), followed by tinea cruris (22%), and tinea pedis (19%). The most common fungus isolated was T. rubrum (58%), followed by E. floccosum (14%), and T. mentagrophytes (10%). The majority of the isolates was sensitive to the three drugs tested (griseofulvin, ketoconazole, and itraconazole). Of the isolates, 82% were sensitive to griseofulvin, 78% to ketoconazole, and 81% to itraconazole, all at a concentration of < 0.25 μg/mL. For T. rubrum, there were four isolates that had an mic of 64 μg/mL to griseofulvin, seven isolates and nine isolates with an mic > 64 g/mL to ketoconazole and itraconazole, respectively. T. interdigitale was relatively resistant to the three drugs in vitro with four of seven isolates having an mic 4 μg/mL with griseofulvin, one of seven isolate with an mic 64 μg/mL with ketoconazole, and three of seven isolates with an mic 32 μg/mL with itraconazole. Conclusions. The in vitro antifungal activity of griseofulvin, ketoconazole, and itraconazole are similar against dermatophytes in Singapore. Griseofulvin may be given as the first-line drug for treating such infections in Singapore.     

Ablation of Atrial Fibrillation at the Time of Cavotricuspid Isthmus Ablation in Patients With Atrial Flutter Without Documented Atrial Fibrillation Derives a Better Long‐Term Benefit

AF Ablation in Patients With Only Documentation of Atrial Flutter. Objectives: The aim of the study was to evaluate whether isolation of the pulmonary veins (PVs) at the time of cavotricuspid isthmus (CTI) ablation is beneficial in patients with lone atrial flutter (AFL). Background: A high proportion of patients with lone persistent AFL have recurrent episodes of atrial fibrillation (AF) after CTI ablation. However, the benefit of AF ablation in patients with only documentation of AFL has not been determined. Methods: Forty‐eight patients with typical lone persistent AFL (age 56 ± 6; 90% male) were randomized to CTI ablation (Group A; n = 25) or to CTI + PV isolation (PVI) (Group B; n = 23). In addition to PVI, some patients in group B underwent ablation of complex fractionated electrograms and/or creation of left atrial roof and mitral isthmus ablation line in a stepwise approach when AF was induced and sustained for more than 2 minutes. Mean follow‐up was 16 ± 4 months with a 48‐hour ambulatory monitor every 2 months. Results: There were no recurrences of AFL in either group. Six patients in group B (22%) underwent a stepwise ablation protocol. AF organized and terminated in 5 patients during ablation (83%). Complication rate was not significantly different among the groups. Twenty patients in group B (87%) and 11 patients in group A (44%) were free of arrhythmias on no medications at the end of follow‐up (P < 0.05). Conclusions: Ablation of AF at the time of CTI ablation results in a significantly better long‐term freedom from arrhythmias. (J Cardiovasc Electrophysiol, Vol. 22, pp. 34‐38, January 2011)     

神经内镜高血压脑出血手术3D打印训练模型及培训方法

目的 设计一款用于神经内镜下高血压脑出血手术血肿清除以及渗血止血操作训练的3D打印模型。方法 模型分为颅骨部、血肿部以及渗血部。使用猪血模拟血肿,用琼脂溶液模拟脑组织。学员在内镜下清除血肿,并进行渗血止血操作训练。记录下学员清除血肿的重量以及止血操作所用时间来计算训练得分。结果 共有32位学员完成清除血肿操作,15位学员完成止血操作。有内镜经验组相比于无内镜经验组,其清除血肿重量、止血操作所用时间和总得分均表现更好（P<0.05）。使用该模型进行训练和通过传统方式学习（手术视频讲解）的住培学员调查问卷结果显示,该模型在教学上的价值高于传统学习方式。结论 研发了首款可同时用于练习血肿清除以及渗血止血操作技术的3D打印模型。 [国际神经病学神经外科学杂志, 2023, 50(2): 40-43]