Alternation of QRS Morphology and Effect of Radiofrequency Ablation in Idiopathic Ventricular Tachycardia

We performed electrophysiological studies in 13 patients with idiopathic VT and attempted radiofrequency (RF) catheter ablation in 4 of them.Results: VT was induced by programmed stimulation in all patients and the mean cycle length was 363 ± 58 msec. In 8 of 13 patients (62%), alternation of either the cycle length and/or morphology of VT was observed. Transient entrainment was achieved in all patients by rapid pacing from the right ventricular outflow tract so reentry was considered the underlying mechanism of VT. The site of earliest activation (EAS) during VT was located at the apicoposterior portion of the left ventricular septum and used as the target site for RF catheter ablation. Spikelike presystolic activity was detected 20–40 msec prior to the large deflection of the local electrogram in four patients. VT was terminated by a few seconds of RF current in all four patients, but subsequently new VTs with a slightly different morphology were induced in three of them and re-mapping showed a shift of the EAS. After additional RF ablation at the new EAS, VT was no longer induced. No complication was noted and VT did not recur during a follow-up period for a mean of 9.3 ± 5.2 months.Conclusion: RF catheter ablation seems useful and safe for idiopathic VT. The alternation of QRS morphology and the findings at the time of catheter ablation suggest that an alternative pathway or multiple exits may be present in some patients with idiopathic VT, because the change in VT morphology was associated with a shift of the EAS.     

Human parvovirus B19-induced aplastic crisis in iron deficiency anemia

Human parvovirus B19 (HPVB19) infects and replicates in erythroid progenitor cells. Its specific cytotoxic effect on these cells results in aplastic crises in patients with congenital hemolytic anemias. Aplastic crisis due to HPVB19 infection in a healthy girl revealed occult iron deficiency anemia. The condition is characterized by a high serum iron level in the aplastic phase and rapid recovery after administration of iron. Temporary HPVB19-induced red blood cell aplasia could occur in patients with other anemias, particularly those with non-inherited form of hemolysis.     

On the Fine Structure of Ito's Fat-Storing Cells in the Liver of the Mouse Fetus after Maternal Treatment with Vitamin A

ABSTRACT The purpose of this study is to ascertain possible cytological effects of vitamin A administration to pregnant mice on the fat-storing cells (Ito cell) in the fetus liver. Though many external anomalies were occurred in the fetus when vitamin A was given once on day 8 of gestation, it is conceivable that the appearance of these teratogenicity may not be concerned in Ito cell because liver had not yet developed at this stage. When vitamin A was given once a day for four days consecutively from day 14 to day 17 of gestation little external anomalies were appeared. By electron microscopy, cytological changes were found in Ito cell, especially the number of lipid droplets in the cytoplasm conspicuously increased. This proved that vitamin A administered to the mothers was carried into the fetuses through the placenta and Ito cells of the fetus liver had an ability to absorb vitamin A at the late stage of pregnancy.     

Serum regulated upon activation, normal T cell expressed and presumably secreted concentrations and eosinophils in respiratory syncytial virus infection

BACKGROUND: The aim of this study was to characterize respiratory syncytial virus (RSV) infection. To do this, the authors evaluated eosinophil counts and chemokines including regulated upon activation, normal T cell expressed and presumably secreted (RANTES) in children with RSV, adenoviral, and influenza virus infections. METHODS: The authors enrolled 80 patients who had been diagnosed with acute viral respiratory infection caused by RSV, adenoviral, or influenza viruses. In total, 35 patients (Group A) had RSV infection, 18 (Group B) had adenoviral infection, and 27 (Group C) had influenza virus infection. The authors evaluated clinical manifestations, white blood cell and eosinophil counts, and serum chemokines including RANTES concentrations in the acute and recovery phases in each group. RESULTS: In recovery phase, eosinophil counts were higher in Group A than Groups B and C. In Group A, eosinophil counts were higher in recovery phase than in the acute phase. In Group A, serum RANTES concentration was significantly higher in the recovery phase than in the acute phase (132+/-76 pg/mL vs 52+/-25 pg/mL, P<0.05). CONCLUSION: The findings suggest that high values of RANTES in children with RSV infection may be associated with the presence of eosinophils and be an important mediator of inflammatory response.     

不同养生功法对2型糖尿病患者MMPI的影响

目的 观察不同养生功法对2型糖尿病的辅助治疗作用以及心理影响.方法 将108例2型糖尿病患者随机分为动功组、动静组、静功组和对照组4组,动功采用八段锦,静功采用放松功.动功组在常规治疗基础上练习1 h八段锦:动静组在常规治疗基础上前半小时练习八段锦,后半小时练习放松功;静功组在常规治疗基础上练习1 h放松功;对照组按常规治疗,不加干预.所有入组患者在练功前、练功2个月、练功4个月测量明尼苏达多项人格测验量表(MMPI),得到完整病例94例,动功组24例、动静组25例、静功组22例和对照组23例.结果 前3组练功两个月时,与对照组差别不明显,练功4个月时,静功组MMPI中的社会内向因子显著优于对照组(P=0.029);动静组MMPI中的精神病态、精神衰弱、精神分裂因子明显改善(分别为P=0.010、P=0.020、P=0.017);静功组MMPI中的癔病、精神病态、偏执因子显著改善(P=0.026、P=0.033、P=0.035).结论 动功、动静结合、静功,功法不同,效果有一定差异.静功和动静功结合训练可能对部分人格倾向具有一定改善作用.     

Mean power frequency during speech in myalgia patients

Summary The purpose of this study was to clarify a difference of mean power frequency (MPF) during speech between control and myalgia patients groups. The control group consisted of 20 asymptomatic volunteers and the myalgia patients group consisted of 19 patients. A bilateral electromyogram (EMG) of masseter muscles during speech movement was recorded using surface electrodes, and the EMG data were stored and analysed with a computer‐based EMG analyzer. The MPF during the entire duration of EMG burst during speech was compared between the control and myalgia group. The average (SD) MPFs during speech in the myalgia and control groups were 214·06 (17·23) and 183·39 (22·35) Hz, respectively, significantly higher in the former (P < 0.001). In myalgia patients, firing rates or recruitment of motor units innervated by high threshold motoneurons might decrease and lead to a higher MPF. The result suggests the possibility that muscle pain, that is a subjective experience, could be evaluated by objective data that is calculated from electromyographic activities which is recorded during speech.     

Evaluation of Dabigatran- and Warfarin-Associated Hemorrhagic Events Using the FDA-Adverse Event Reporting System Database Stratified by Age

Dabigatran and warfarin are oral anticoagulant drugs widely used for the prevention of stroke in patients with atrial fibrillation. The objective of this study was to evaluate the interaction between aging and dabigatran- and warfarin-induced gastrointestinal (GI) and nervous system hemorrhage using data available in the FDA Adverse Event Reporting System (FAERS) database.We analyzed reports of hemorrhagic events in the GI and nervous system recorded in the FAERS database between 2004 and 2014 using an adjusted reporting odds ratio (ROR).We demonstrated that dabigatran-associated GI hemorrhage was significantly increased in patients over the age of 80 years. The RORs of dabigatran increased with increasing age, although aging had little effect on warfarin-associated GI hemorrhage. The ROR for anticoagulant-associated nervous system hemorrhage was not significantly affected by aging, as compared to GI hemorrhage.Our results indicate that the excretion of dabigatran may be affected by aging, as compared to warfarin, likely due to renal function decline. Our results emphasize the need for physicians to closely monitor GI bleeding in aging patients, because it is closely related to renal function deterioration.     

Polymorphisms of DNA repair genes, XRCC1 and XRCC3, and susceptibility to familial prostate cancer in a Japanese population

Aim: DNA repair systems play an important role in protecting the genome damaged by endogeneous and exogeneous mutagens. Deficiency in these systems has been reported to increase the risk of various types of cancer. We investigated two DNA repair genes, X‐ray repair cross‐complementing group 1 (XRCC1) and X‐ray repair cross‐complementing group 3 (XRCC3), to assess the association between DNA repair genes and familial prostate cancer susceptibility in the Japanese population. Methods: We performed a case‐control study consisting of 142 familial prostate cancer cases and 119 normal control subjects. The genetic polymorphism was analyzed by the polymerase chain reaction‐restriction fragment length polymorphism method. Results: Of the three polymorphisms investigated, the frequency of the XRCC1 codon 194 Arg/Trp genotype, was significantly observed in cases (odds ratio [OR] = 2.19, 95% confidence interval [CI] = 1.28–3.73, P = 0.0058) and the Arg/Trp and Trp/Trp genotypes were also significantly observed in cases (OR = 2.03, 95% CI = 1.23–3.36, P = 0.0080). For the Arg399Gln genotype in XRCC1 and the Thr241Met genotype in XRCC3, no significant differences were observed between cases and controls. Stratification of cases according to clinical stages and pathological grades showed no significant difference among clinical parameters and genotypes. Conclusion: The Trp allele in the XRCC1 codon 194 was significantly associated with individuals in the Japanese population with a family history of prostate cancer.     

Bronchoscopic practice in Japan: A survey by the Japan Society for Respiratory Endoscopy in 2010

Background and objective: To ensure the safety of bronchoscopic practice, the Japan Society for Respiratory Endoscopy conducted a national survey to investigate the current state of procedure for this technique. Methods: A questionnaire survey about procedures carried out during the whole of the year 2010 was mailed to 538 facilities accredited by the society. Results: Responses were obtained from 511 facilities (95.0%). Rigid bronchoscopes were used in only 18.5% of the facilities, while mobile/thin bronchoscopes were used in ≥50%, and fluoroscopy systems were used in 99.8%. Biopsies were performed after discontinuation of therapy in patients receiving antiplatelet drugs and anticoagulants in 96.7% and 97.4% of the facilities, respectively. Atropine was administered for premedication in 67.5% of the facilities, a decrease from previous surveys. Intravenous sedation was given in 36.1% of the facilities. In 21.9% of these, the procedure was conducted in the outpatient clinic for ≥70% of patients. A bronchoscope was orally inserted in ≥70% of patients in 95.7% of the facilities. Intravenous access was maintained during the examination in 92.5% of the facilities, oxygen saturation was monitored during examinations in 99.0%, oxygen was administered in 97.6% and resuscitation equipment was available in 96%. In 98.6% of the facilities, bronchoscopes were disinfected using an automatic washing machine, with glutaraldehyde used in 42.2%. Conclusions: Japan‐specific characteristics of bronchoscopic practice were identified. Whether procedures used in Japan meet international guidelines with respect to safety should be monitored continuously. In addition, a Japanese evidence‐based consensus is needed.