Asthenospermia in hay fever patients improved by stopping treatment with histamine H1 receptor antagonists

We report two cases of asthenospermia, which appeared to be associated with exposure to histamine H1 receptor antagonists. A 44-year-old man and a 35-year-old man had continued the treatment with fexofenadine hydrochloride and cetirizine hydrochloride, respectively, under the diagnosis of hay fever. They and their wives had been examined as infertile couples. Infertility evaluations revealed no problems with their wives; the patients, however, were found to have a low sperm motility (<10%). On suspicion of adverse effects of the histamine H1 receptor antagonists, they stopped treatment with these drugs, which resulted in a complete reversal of spermatic dysfunction. Current information identifies the potential fertility hazards of histamine H1 receptor antagonists.     

Anomalies of Cartilaginous and Ossified Axial Skeleton in Rat Fetuses Treated with Cyclophosphamide: Type, Frequency, and Stage Specificity

The purpose of the present study was to assess the type, frequency and stage specificity of axial skeletal anomalies induced by cyclophosphamide (CP). Female Crj: Wistar rats were mated with male rats (vaginal sperm = gestation day 0, GDO). They were then injected intravenously with 5 mg/kg of CP in a saline solution on GD7, 8, 9, 10, 11, 12, 13, or 14, or with saline on GD8 for controls. Dams were sacrificed on GD20. Fetuses were stained with alcian blue and alizarin red S. Eighteen types of axial skeletal anomaly were detected, e. g., shifted ventral lamina, cervical rib, cleft arch of the atlas, axis fused to atlas, sternebral misalignment, bipartite sternum, fused ribs, change in pre-sacral vertebral number, supernumerary rib, misdirected transverse process, anteriorly-shifted spinous process, short spinous process, fused vertebral bodies, cartilaginous short rib at Th.7, short or absent rib at Th.12 or 13, dumbbell-shaped vertebral body, wavy rib, and rib cartilage not attached to the sternal cartilage. The present experimental study indicates that: 1) observations of cartilaginous skeletons can provide more information than observations of ossified skeletons; 2) the pattern of CP-induced anomalies along the anterior–posterior axis may depend on the sequence of development progression among structures, spinous process, vertebral arch, vertebral body, rib/transverse process; and 3) in more cranial vertebrae, anteriorly-shifted anomalies, such as anteriorly-shifted ventral lamina and anteriorly-shifted spinous processes, rather than posteriorly-shifted anomalies, may be the primary indicators for detecting developmental toxicity, since CP injection increased the frequencies of these anomalies.     

Defibrillation Effects of Intravenous Nifekalant in Patients with Out-of-Hospital Ventricular Fibrillation

Nifekalant (NF), a pure K⁺ channel blocker developed in Japan, has been reported to be effective in the treatment of life-threatening ventricular arrhythmias. We studied its efficacy in 18 men and 4 women with out-of-hospital ventricular fibrillation (VF) admitted to our emergency department between August 2001 and March 2004. The number of DC shocks delivered for out-of-hospital VF, serum Na⁺ and K⁺, arterial blood pH, and base excess were compared in 8 patients treated with NF, 0.3 mg/kg i.v. followed by a continuous intravenous (group N) versus 14 patients treated with lidocaine, 2 mg/kg, i.v. (group C). The two groups were similar with respect to their baseline characteristics. Sinus rhythm returned in 5 of 8 patients in group N versus 2 of 14 patients in group C (P < 0.05). These seven patients were admitted to the intensive care unit, though all died within 1 month. The results of this study suggest that NF may be effective in defibrillation of out-of-hospital VF, though controlled studies are needed to confirm our observations.     

Recovery of high speed memory scanning after transient global amnesia: A case report

Abstract We described the case of a 59 year old female with transient global amnesia (TGA) who had been examined neuropsychologically using Sternberg's paradigm and a random number generation (RNG) task on the following day, 1 week and 4 weeks after a TGA episode. The slope value of the linear function, a measure of cognitive memory scanning speed, decreased with time and showed a marked decrease 1 week after TGA, suggesting that the stage of serial and exhaustive scanning recovered within 1 week. The zero-intercept value, on the other hand, increased during 1 week but decreased 4 weeks later and was not related directly to recovery from TGA. The performance in RNG task improved 1 week later, but deteriorated 4 weeks after the episode. Such a change in RNG was in accordance with that of the zero-intercept value, predicting a relationship. It is concluded that the subclinical memory deficit, detected with these tasks, persisted longer than clinical recovery from TGA.     

Catheter Ablation of Atrial Fibrillation in the Elderly

The incidence and prevalence of atrial fibrillation (AF) increase with age. Catheter ablation has been suggested to improve the quality of life of patients with AF. However, in order to expand the indications for AF ablation to the elderly, several important questions should be answered as to whether safety and efficacy of AF ablation in elderly patients are similar to those in younger populations, whether the AF mechanisms in elderly patients are similar to those in younger patients so that the same ablation techniques can be used in both groups, and whether anticoagulation strategies should be the same for elderly patients as for younger patients after AF ablation. Recent studies reported that the risk of complications from AF ablation did not vary with age, nor was the AF recurrence rate age-dependent for any type of AF, suggesting that the AF mechanisms in elderly patients were similar to those in younger patients. On the other hand, the feasibility of discontinuation of anticoagulation in the elderly after successful AF ablation has not been established since it is difficult to be certain whether AF has been truly cured and since many elderly people are likely to be considered as high-risk based on their CHADS₂ score. In addition, the elderly patients who have been included in published trials of AF ablation may not represent an unselected population of individuals in this age group. Randomized trials of catheter ablation will be necessary before this procedure can be promoted for wider use in the elderly.     

Premature Ventricular Contractions Arising from the Intramural Ventricular Septum

A 68-year-old man with symptomatic idiopathic premature ventricular contractions (PVCs) underwent electrophysiological testing. Radiofrequency catheter ablation was unsuccessful at the earliest endocardial ventricular activation site in the left coronary cusp. Epicardial mapping via the cardiac veins was then performed. Balloon-occluded coronary sinus venography revealed the small branches of the anterior interventricular vein. Mapping with a microcatheter revealed the earliest ventricular activation and perfect pace map at the distal portion of the septal perforating branch, suggesting an intramural ventricular septal PVC origin. Catheter ablation was abandoned because of the inaccessibility of the ablation catheter to that site via the venous system.     

Age-Related Increase in Atrial Fibrillation Induced by Transvenous Catheter-Based Atrial Burst Pacing: An In Vivo Rat Model of Inducible Atrial Fibrillation

AF Rat Model Induced by Transvenous Catheter Pacing.   Introduction: Large animal models of atrial fibrillation (AF) are well established, but limited experimental reports exist on small animal models. We sought to develop an in vivo rat model of AF using a transvenous catheter and to evaluate the model's underlying characteristics.
Methods and Results: Echocardiogram, surface electrocardiogram (ECG), and atrial effective refractory period (AERP) were recorded at baseline in young (3 months) and middle-aged (9 months) Wistar rats. AF inducibility and duration were measured through transvenous electrode catheter in young (n = 11) and middle-aged rats (n = 11) and middle-aged rats treated with either pilsicainide (1 mg/kg iv, n = 7) or amiodarone (10 mg/kg iv, n = 9). Degrees of interstitial fibrosis and cellular hypertrophy in the atria were assessed histologically. The P-wave duration and AERP were significantly longer and echocardiographic left atrial dimension significantly larger in middle-aged versus young rats. AF was inducible in >90% of all procedures in both untreated rat groups, whereas AF inducibility was reduced by the antiarrhythmic drugs. The AF duration was significantly longer in middle-aged than in young rats and was significantly shortened by treatment with either pilsicainide or amiodarone. Histologic analysis revealed significant increases in atrial interstitial fibrosis and cellular diameter in middle-aged versus young rats.
Conclusions: Transvenous catheter-based AF is significantly longer in middle-aged than in young rats and is markedly reduced by treatment with antiarrhythmic drugs. This rat model of AF is simple, reproducible, and reliable for examining pharmacologic effects on AF and studying the process of atrial remodeling. (J Cardiovasc Electrophysiol, Vol. 21, pp. 88–93, January 2010)