Frequency analysis of ventricular fibrillation in Swine ventricles

It has been suggested from frequency analysis that cardiac fibrillation is driven by stable intramural reentry, with wavebreak occurring due to failure of 1:1 propagation. We tested this hypothesis with a combined experimental and theoretical approach. Optical mapping was performed on epicardial, endocardial, and transmural cut surfaces of fibrillating swine ventricles. Wavelets were characterized, the frequency content of optical signals analyzed, and space-time plots (STPs) constructed to detect Wenckebach-like conduction. The findings were compared with simulations in 2D and 3D cardiac tissue using the Luo-Rudy action potential model. The incidence of reentry in the cut transmural surface (11.8% in right ventricle, 14.3% in left ventricle) was similar to that on the endocardial surface (13.1%, P=NS) but greater than on the epicardial surface (7.7%, P<0.01). Frequency spectra of optically recorded membrane voltage were organized into spatial domains with the same dominant frequency, but these domains were nonstationary. In STPs, pseudo-2:1 conduction block was caused by double potentials arising when reentry occurred on the recording site rather than true Wenckebach conduction. The latter was observed in 11 of 166 STPs but did not occur at borders of high-to-low frequency domains. In simulations, similar findings were obtained when action potential duration (APD) restitution slope was steep. Stationary dominant frequency domains with Wenckebach conduction patterns were observed only in the presence of shallow APD restitution slope and marked nonuniform tissue heterogeneity. In conclusion, stable intramural reentry as the engine of fibrillation was not observed. Our findings support the idea that dynamic wavebreak plays a fundamental role in the generation and maintenance of ventricular fibrillation.     

Inhibition of COX-2 activity and proinflammatory cytokines (TNF-α and IL-1β) production by water-soluble sub-fractionated parts from bee (<Emphasis Type="Italic">Apis mellifera</Emphasis>) venom

Bee venom is used as a traditional medicine for treatment of arthritis. The anti-inflammatory activity of the n-hexane, ethyl acetate, and aqueous partitions from bee venom (Apis mellifera) was studied using cyclooxygenase (COX) activity and pro-inflammatory cytokines (TNF-alpha and IL-1beta) production, in vitro. COX-2 is involved in the production of prostaglandins that mediate pain and support the inflammatory process. The aqueous partition of bee venom showed strong dose-dependent inhibitory effects on COX-2 activity (IC50 = 13.1 microg/mL), but did not inhibit COX-1 activity. The aqueous partition was subfractionated into three parts by molecular weight differences, namely, B-F1 (above 20 KDa), B-F2 (between 10 KDa and 20 KDa) and B-F3 (below 10 KDa). B-F2 and B-F3 strongly inhibited COX-2 activity and COX-2 mRNA expression in a dose-dependent manner, without revealing cytotoxic effects. TNF-alpha and IL-1beta, are potent pro-inflammatory cytokines and are early indicators of the inflammatory process. We also investigated the effects of three subfractions on TNF-alpha and IL-1beta production using ELISA method. All three subfractions, B-F1, B-F2 and B-F3, inhibited TNF-alpha and IL-1beta production. These results suggest the pharmacological activities of bee venom on anti-inflammatory process include the inhibition of COX-2 expression and the blocking of pro-inflammatory cytokines (TNF-alpha, and IL-1beta) production.     

The effect of lidocaine on the globule size distribution of propofol emulsions

In this study, we sought to determine the globule size distribution of a propofol/lidocaine mixture as a function of lidocaine concentration and time elapsed after mixing in a standard formulation of propofol emulsion (Diprivan) and in a new formulation containing L-lysine to improve stability. The globule size was measured with a laser diffraction technique. The median diameter of the globule size in 20 mL of Diprivan immediately after the addition of 0, 10, 20, 30, 40, and 50 mg of lidocaine was similar to that of chylomicrons, ranging from 0.28 +/- 0.01 micro m to 0.30 +/- 0.02 micro m, over the whole range of lidocaine concentration. However, the maximum diameter increased slightly (from 0.97 +/- 0.01 micro m to 2.90 +/- 0.07 micro m) as the concentration of lidocaine increased. At 6 h after adding lidocaine, the maximum globule size had increased slightly (to 2.98 +/- 0.04 micro m) with 20 mg of lidocaine and increased considerably (to 51.76 +/- 0.62 micro m) when 30 mg of lidocaine was added. At 2 h after the addition of 50 mg of lidocaine, the maximum globule diameter had increased to 52.2 +/- 1.92 micro m. The maximum globule diameter in the propofol emulsion to which L-lysine was added as a stabilizer did not exceed 3.0 micro m even when the largest amount of lidocaine was added. This study demonstrated that when 30 mg of lidocaine was added to 20 mL of Diprivan and the solution was left for a period of time, the globule size increased. Its increase was minimized by the addition of L-lysine to the propofol emulsion.     

Effects of morphine on mechanical allodynia in a rat model of central neuropathic pain

We examined whether morphine reduced the behavioral signs of neuropathic pain below level induced by T13 spinal hemisection in rats. In order to examine the effect of morphine on the mechanical allodynia, morphine alone, morphine with naloxone and saline were administered intraperitoneally and intrathecally and behavioral tests were conducted. In systemic injection, mechanical allodynia was reduced only when a higher concentration of morphine (5 mg/kg) was used. Intrathecally injected morphine (0.5, 1, 2, 5 microg) reduced mechanical allodynia dose-dependently. It is suggested that systemic morphine has limited effect on mechanical allodynia but direct spinal administration of morphine is more effective in controlling central pain following spinal cord injury.     

Comparison of IY81149 with omeprazole in rat reflux oesophagitis

1. This study was aimed at evaluating the effects of IY81149[2-[[(4methoxy-3-methyl)-2-pyridinyl]methylsulfinyl]-5-(1H-pyrrol-1-yl)-1H-benzimidazole], a new proton pump inhibitor, on the development of the surgically induced reflux oesophagitis, on gastric secretion and on lipid peroxidation which is a marker of oxidative stress. Omeprazole was used as a reference drug. We furthermore investigated the influence of quercetin and desferrioxamine (DFO) on the development of the surgically induced reflux oesophagitis in rats on gastric secretion and on lipid peroxidation. 2. IY81149 and omeprazole significantly prevented the development of reflux oesophagitis and gastric secretion in a dose-dependent manner. The ED50 values of IY81149 for inhibition of oesophagitis and volume of gastric secretion were lower than of omeprazole (5.7 vs. 14.2 micromol, 15.3 vs. 24.0 micromol, respectively). IY81149 was also more potent in the acid output inhibition with an ED50 of 6.8 micromol compared with 20.8 micromol of omeprazole. 3. Malonyldialdehyde (MDA) content, the end product of lipid peroxidation, increased significantly in the oesophageal mucosa after the induction of reflux oesophagitis. IY81149 and omeprazole significantly and dose-dependently prevented lipid peroxidation. Quercetin (200 mg kg-1, p.o.) and DFO (800 mg kg-1, i.d.) significantly prevented the development of reflux oesophagitis and inhibited the lipid peroxidation independent of their actions on gastric secretion. 4. This result suggests that IY81149 is comparable with omeprazole in the treatment of reflux oesophagitis.     

Suction–curettage with combination of two different cannulae in the treatment of axillary osmidrosis and hyperhidrosis

Objective  To investigate the efficacy and safety of suction–curettage with a combination of two different cannulae for treatment of axillary osmidrosis and hyperhidrosis.
Design  Retrospective analysis of patients who underwent surgery from September 2004 to September 2006.
Setting  Outpatient clinic for hyperhidrosis at a university-affiliated hospital.
Subjects  Sixty-five patients who were treated for axillary malodor and hyperhidrosis.
Interventions  Patients were sequentially treated with Fatemi and Cassio cannulae.
Main outcome measures  Demographic data, severity data (assessment of malodor), degree of satisfaction, sweating, hair growth, scarring, recurrence and complications.
Results  Sixty of the 65 patients (96.9%) had excellent to fair results, and only 2 patients (3.1%) had poor results. Complications occurred in 4 patients (6.2%). Recurrence occurred in 3 patients (4.6%).
Conclusions  This simplified and inexpensive method resulted in a high success rate with low complications and high satisfaction with minimal scarring and rapid recovery.     

Idiopathic bronchiolitis obliterans with organizing pneumonia presenting with spontaneous hydropneumothorax and solitary pulmonary nodule

The first case of idiopathic bronchiolitis obliterans with organizing pneumonia (BOOP) presenting as solitary pulmonary nodule with spontaneous hydropneumothorax is reported in a 54-year-old man. A wedge resection of the right lower lobe was performed to show typical histological features of BOOP. This case report demonstrates that BOOP has a very diverse clinical manifestation and stresses the need to include solitary pulmonary nodule with hydropneumothorax in the spectrum of BOOP.     

Variations in treatment policies and outcome for bladder cancer in the Netherlands

AimTo describe the population-based variation in treatment policies and outcome for bladder cancer in the Netherlands.MethodsAll newly diagnosed patients with primary bladder cancers during 2001–2006 were selected from the Netherlands Cancer Registry (n = 29,206). Type of primary treatment was analysed according to Comprehensive Cancer Centre region, hospital type (academic, non-academic teaching or other hospitals) and volume (≤5, 6–10 or >10 cystectomies yearly). For stage II–III patients undergoing cystectomy we analyzed the proportion of lymph node dissections and 30-days mortality.Results44% of patients with stage II–III bladder cancer underwent cystectomy, while 26% were not treated with curative intent. Cystectomy was the preferred option in three of nine regions, radiotherapy in two, and two regions waived curative treatment more often. Between 2001 and 2006 the number of cystectomies increased with 20% (n = 108). Twenty-one percent (n = 663) of these procedures were performed in 44 low-volume hospitals. In 79% of the cystectomies lymph node dissections were performed, more often in high and medium-volume centers (82% and 81% respectively) than in low-volume hospitals (71%, the odds ratio being 1.5). The overall 30-days post-operative mortality rate was 3.4% and increased with older age. It was significantly lower in high-volume centers (1.2%).ConclusionTreatment policies for muscle-invasive bladder cancer in the Netherlands showed regional preferences and a gradual increase of cystectomy. Cystectomy albeit considered as golden standard, was performed in a minority of the muscle-invasive cases. In high-volume institutions, lymph node dissection rates were higher and post-operative mortality rates were lower.     

Summation or Axial Slab Average Intensity Projection of Abdominal Thin-section CT Datasets: Can They Substitute for the Primary Reconstruction from Raw Projection Data?

We hypothesized that that the summation or axial slab average intensity projection (AIP) techniques can substitute for the primary reconstruction (PR) from a raw projection data for abdominal applications. To compare with PR datasets (5-mm thick, 20% overlap) in 150 abdominal studies, corresponding summation and AIP datasets were calculated from 2-mm thick images (50% overlap). The root-mean-square error between PR and summation images was significantly greater than that between PR and AIP images (9.55 [median] vs. 7.12, p < 0.0001, Wilcoxon signed-ranks test). Four radiologists independently compared 2,000 test images (PR [as control], summation, or AIP) and their corresponding PR images to prove that the identicalness of summation or AIP images to PR images was not 1% less than the assessed identicalness of PR images to themselves (Wald-type test for clustered matched-pair data in a non-inferiority design). For each reader, both summation and AIP images were not inferior to PR images in terms of being rated identical to PR (p < 0.05). Although summation and AIP techniques produce images that differ from PR images, these differences are not easily perceived by radiologists. Thus, the summation or AIP techniques can substitute for PR for the primary interpretation of abdominal CT.     

Divided Countries, Divided Mind 1: Psycho-Social Issues in Adaptation Problems of North Korean Defectors

A review of studies on the adaptation problems of North Korean defectors in South Korean society and studies of people''s adaptation to political and cultural changes in other countries suggests that similar adaptation problems may occur in the process of and after unification. Defectors have various adaptation problems and some of them have psychiatric disorders such as depression and post-traumatic stress disorder (PTSD). The reasons for this were revealed to be the difference in the culture and personality between South and North Korea, which have developed for the last 60 years without any communication with each other, in spite of their common racial and cultural heritage. Economic factors including the lack of skills and knowledge for working at industrialized and competitive society like South Korean society, also aggravate the severity of such adaptation problems. Research on defectors'' adaptation problems and on the differences in the culture and mentality between North and South Korea can provide useful information on what kinds of problems may arise during the process of and after unification and what should be done to achieve mutual adaptation and harmonious and peaceful unification.