A perspective on the ESVEM trial and current knowledge: Catheter ablation for ventricular tachyarrhythmias

Although an effective and potentially curative technique for treating idiopathic ventricular tachycardia, map-guided transcatheter radiofrequency ablation is far from optimal for ventricular tachyarrhythmias in patients with advanced ischemic or other types of organic heart disease. First, this technique can be applied only to a minority of patients with structural heart disease, who can tolerate relatively long episodes of induced ventricular tachycardia necessary for mapping and successful ablation. Second, the success rate is lower and recurrence higher in patients with organic heart disease. Finally, for patients who lose consciousness during tachycardia or who present with prehospital cardiac arrest, transcatheter radiofrequency ablation is inappropriate as definitive treatment. At best, it is palliative and may be used to suppress relatively slow, frequent, or incessant ventricular tachycardias but does not obviate the need for other therpaies such as cardioverter-defibrillator implantation or antiarrhythmic drug therapy.     

Bilateral sequential lung transplantation for end stage septic lung disease.

BACKGROUND-- Bilateral sequential lung transplantation (BSLT) has been widely adopted as an alternative to combined heart and lung transplantation for the management of end stage septic lung disease in many transplant centres. METHODS-- A retrospective review was undertaken of the first 32 consecutive patients with septic lung disease to undergo BSLT at the Freeman Hospital. RESULTS-- Between April 1988 and October 1994 32 patients underwent BSLT. Survival at 30 days was 85% and actuarial survival at one year was 70%. Improved pulmonary function was seen in all surviving patients. CONCLUSION-- BSLT for septic lung disease offers comparable survival to heart-lung transplantation, with excellent functional results. Long term results may be superior because the disadvantages of transplanting the heart are avoided.     

Acrylamide induced inhibition of hepatic glutathione-S-transferase activity in rats

Rats injected i.p. with acrylamide (50 mg/kg/day) for 5 days showed a significant inhibition of hepatic glutathione-S-transferase (GST) activity; maximum inhibition occurred in 15-day-old rats in which early development of hind limb paralysis was noted. Addition of acrylamide in vitro to the assay system also inhibited GST activity. No changes were observed in oxidized and reduced glutathione contents.     

Anticollagen antibody responses in DBA/1 (H-2q) mice associated with type II collagen-induced arthritis and the effect of pregnancy

We have previously shown that DBA/1 mice immunized with heterologous type II collagen showed remission of the subsequent collagen-induced arthritis (CIA) when pregnant, but experienced exacerbation postpartum. Measurement of anticollagen antibody (aCa) responses by ELISA in primiparous mice immunized at day 1 of pregnancy revealed no significant difference compared to aCa titres in virgin animals, apart from slightly increased titres following the primary immunisation. When mice received collagen challenge during early pregnancy, however, the date at which maximal antibody titres was reached was delayed by 5 days. Pregnancy initiated following the intraperitoneal boost caused a ten-fold suppression in aCa titres with a rise post-partum. Measurements of aCa levels in individuals which showed fetal resorption indicated that suppression of humoral responses was dependent on the presence of a viable conceptus. Antibody titres declined in all animals after a period of time, which was more prolonged in multigravidae where aCa titres were higher than in nulliparous and primiparous mice. The results show that although pregnancy alters aCa responses during the course of gestation, no long-term modification of humoral immunity occurs, an observation in agreement with the clinical findings in these mice and in humans.     

Diagnosis of asymptomatic atrial septal aneurysms using two-dimensional color Doppler and contrast transthoracic echocardiography

Atrialseptalaneurysm (ASA ) ,alocalizedsacculardeformity ,iscausedbyexcessiveseptaltissuecoveringthefossaovalis 1,2 　Itoftenoccursconcomitantlywithcongenitaloracquiredheartdiseases ,butisolatedcaseshavealsobeenreported 3　ASAmustbeconsideredinthedifferentialdiagnosisofatrialcystsandtumors ,anditisapotentialriskfactorfortransientarrhythmiaandparadoxicalembolism 4 6　Aneurysmmaybelocatedintherightatrium ,theleftatriumoritmaymoveintobothatria 1,7　Dependingonthebulgingofthearea ,itmaybelargee…