Ventriculoatrial Block During Atrioventricular Nodal Reentrant Tachycardia Utilizing Multiple Retrograde Pathways

VA Block During Multiple AVNRT. A rare case of narrow QRS tachycardia continuing despite the occurrence of VA block is reported. Right ventricular stimulation suggested dual AV nodal physiology. The tachycardia was induced by ventricular premature stimulation, which failed to depolarize the atrium. Two types of tachycardia that had different retrograde conduction sequences, HA intervals, and cycle lengths were induced. The occurrence of VA block did not terminate the tachycardia but transiently prolonged the tachycardia cycle length. These findings suggest the mechanism is AV nodal reentry utilizing multiple retrograde pathways with intranodal reentry bridging the VA block and maintaining the tachycardia.     

Differences of LAK-activity and IL-2 responsiveness between α/β and γ/δ T cells which developed after thymus transplantation

A patient with severe combined immunodeficiency was transplanted with T cell depleted haploidentical bone marrow from his father and was later given a thymic graft from an unrelated donor, α/β and γ/δ T cells of bone marrow donor origin appeared only after the thymus transplantation procedure. Among the peripheral blood lymphocytes (PBL), γ/δ T cells comprised 10–20% and most of them were δTCS1⁺. The α/β T cells were single positive cells, either CD4⁺ or CD8⁺. Expression of CD5, CD7 and CD8α,β molecules on α/β T cells was reduced. Functional studies showed that γ/δ T cells proliferated slightly in response to anti-CD3 stimulation, and proliferated well with exogenous IL-2 stimulation, while α/β T cells did not proliferate following mitogenic stimulation even in the presence of IL-2. γ/δ T cells but not α/β T cells exhibited some LAK activity after culturing with IL-2. Since α/β T cells expressed IL-2R α and β chains after mitogenic stimulation and bound IL-2, the deficit(s) in these cells was considered to occur after IL-2 binding to the IL-2R. These results indicate thymic dependency of both types of T cells and that two types of T cells differed in the acquisition of IL-2 responsiveness during development.     

Factors affecting turnover of Japanese novice nurses in university hospitals in early and later periods of employment

suzuki e ., tagaya a ., ota K ., nagasawa Y ., matsuura r . & sato c . (2010) Journal of Nursing Management 18, 194–204
Factors affecting turnover of Japanese novice nurses in university hospitals in early and later periods of employment Aim To explore the factors affecting turnover of novice nurses during the 10th–15th months of employment in comparison with those during the preceding 6 months. Background The early turnover of novice nurses is a serious issue. Our previous study showed that 4.0% (37/923) of novice nurses quit their jobs in the initial 3rd–9th months of employment. The major determinants of their turnover were education (i.e. graduation from vocational nursing schools), undesired ward assignment and lack of peer support. Methods The cohort of 762 novice nurses from our previous study was followed up during the next 10th–15th months of employment. Their turnover in this period was predicted using variables from baseline data such as demographic attributes, burnout (J-MBI), assertiveness (J-RAS) and perceptions about the workplace. Results The findings showed that 4.6% (35/762) of novice nurses quitted their jobs during the first 15-month period. The factors affecting the turnover were: burnout, dissatisfaction with the workplace and hospital location being in Tokyo. All these factors were different from those observed for the preceding follow-up period. Conclusion Burnout was revealed to be the most significant factor affecting the turnover of novice nurses. Implications for nursing management Nurse managers should be vigilant and exercise care in the prevention of burnout among novice nurses.     

Asystole Caused by Vegetation and Abscess of Right Ventricle Attached to a Tip of Pacemaker Lead

A 69-year-old man with pacemaker was referred to our center for cerebral infarction. He had a high fever for 10 days during his hospitalization. Pacing failures deteriorating to asystole were observed responsible for bacterial vegetation around the tip of the pacemaker lead, which is rare but important for the cause of pacing failure.     

Cross-correlation between 1/f-like fluctuations in heartbeat and diurnal changes in the sleep-waking stage

Abstract The cross-correlation function between diurnal changes in /f-like fluctuations of the R-R interval and those of the sleep-waking stage was calculated based on the data from six normal subjects in order to investigate the interactions among circadian components. Sleep stage was scored according to the standard criteria and waking stage was scored with criteria developed for the present study. Polysomnography was performed for 11 h during the daytime. The equation for 1/f was approximated using the power spectra of the R-R interval every 10 min. Cross-correlation analysis between sleep-waking stage and 1/f fluctuation of the R-R interval suggested that the neural network for 1/f fluctuation in heartbeat is influenced by the Sleep-wake cycle with a time lag in the order of tens of minutes.     

Sex difference of electromyogram of masticatory muscles and mandibular movement during chewing of food

summary The aim of this study was to investigate whether there were sex differences in the electro-myograms (EMG) of the masticatory muscles and in the mandibular movement of young adults when chewing food. Twenty subjects with normal dentitions were selected. The II test foods selected were all easily available in Japan. The results showed firstly that although there were no significant differences of chewing frequency between males and females, females chew food more slowly with less masticatory force and narrower mouth opening width than males; and secondly it appears that the chewing function in females is lower than in males.     

C5b-8 Step Lysis of Swine Endothelial Cells by Human Complement and Functional Feature of Transfected CD59

The authors established several swine endothelial cell (SEC) lines expressing human CD59 by transfection of cDNA, and assessed the function of the transfectant molecules in comparison with those of membrane cofactor protein (MCP) and decay-accelerating factor (DAF) in an in vitro hyperacute rejection model of swine to human discordant xenograft. At the usual expression rate, DAF and MCP protected SEC from human complement mediated cell lysis, but CD59 did not block human complement attack on SEC. However, CD59 protects SEC from cell lysis when sufficiently expressed as in human umbilical vein (HUVEC). The authors examined why CD59 needed so many molecules to protect human complement-mediated SEC lysis and found that SEC underwent lysis by human C5b-8. The degree of C5b-8 step lysis of SEC was approximately 70% of the total activity (C5b-9). Additionally, CD59 protected human complement activation less efficiently at the C5b-8 step than at the C9-step. Therefore, to overcome human complement mediated SEC lysis, C8 activity must be inhibited by dense expression of CD59.