Transmural and endocardial Purkinje activation in pigs before local myocardial activation after defibrillation shocks.

BACKGROUND: Earliest recorded postshock myocardial activations in pigs originate in the subepicardium of the apex and lateral free wall of the left ventricle (LV) 30-90 ms after the shock. OBJECTIVE: The purpose of this study was to determine whether the Purkinje system is a candidate for the source of postshock activations by performing endocardial and transmural postshock activation mapping. METHODS: In five pigs, 32 plunge needles with 12 electrodes (1-mm spacing) were inserted into the LV apex and lateral free wall. Up to 70 plunge needles with six electrodes (2-mm spacing) were spread throughout the remainder of the LV, while 9-12 plunge needles with four electrodes (2-mm spacing) were inserted into the right ventricle. A basket catheter with 32 bipolar recording sites was inserted into the LV. Defibrillation-threshold (DFT)-level shocks were delivered during 10 episodes of electrically induced ventricular fibrillation. Electrograms of postshock activation cycles were analyzed for Purkinje and myocardial activations. RESULTS: Purkinje activations were recorded before local myocardial activation in 9% of basket electrograms and in 15% of plunge needles during the first postshock activation cycle. Purkinje activations were identified during the first and subsequent several postshock activation cycles in at least one basket and one needle electrogram in 96% and 98% of defibrillation episodes, respectively. CONCLUSIONS: The Purkinje system is active during the early postshock activation cycles after DFT-level shocks. Further studies are required to determine whether activation initiates in the Purkinje system or whether it is activated by the myocardium or by Purkinje-myocardial junctional cells.     

腹部外科常见感染性疾病的病原菌及药敏试验研究

为了了解本地区本医院腹部外科感染性疾病病原菌的构成比和药物敏感率的变化,指导临床用药,我们采用美国BD公司生产的6B和7D两种增菌瓶采集标本和培养细菌,并用该公司生产的生化板和药敏板,对1994～1996年269例常见的普外科感染性疾病患者的手术标本进行前瞻性的细菌培养和药敏试验研究.     

Neuroticism,symptom reports,and Type A behavior: Interpretive cautions for the Framingham scale

The Framingham Type A Scale (FTAS) is one of three primary measures of Type A behavior. Unlike the structured interview (SI) and Jenkins Activity Survey (JAS), the FTAS is correlated with neuroticism. Further, neuroticism and FTAS scores predict angina-like chest pain complaints but not more definitive coronary heart disease (CHD) end points. Thus, the FTAS may be unique among Type A measures in its susceptibility to the neuroticism-symptom reporting confound. The present study examined associations of the SI, JAS, and FTAS with neuroticism and symptom reporting in two independent samples of undergraduate males. Unlike the SI and JAS, the FTAS was correlated with neuroticism and symptom reporting. Further, the correlations of FTAS scores and symptoms were due to shared variance with neuroticism. The findings are discussed in terms of a possible alternative interpretation of the Framingham Study and the need to consider neuroticism in studies of personality and health.     

Increased fluidity of Plasmodium berghei-infected mouse red blood cell membranes detected by electron spin resonance spectroscopy

The fluidity of Plasmodium berghei-infected mouse red cell membranes is increased over that of uninfected cells at both 24°C and 37°C. This was demonstrated by electron spin resonance spectroscopy using the hydrocarbon spin labels 2-dodecyl-2′,5,5′-trimethyloxazolidine-N-oxyl and 2-heptyl-2′ -hexyl-5,5′-dimethyloxazolidine-N-oxyl to label regions of the bilayer near its surface, and deeper within the hydrocarbon region, respectively. Arrhenius plots of the ‘empirical motion parameter’ (R_i) obtained from 2-heptyl-2′-hexyl-5,5′-dimethyloxazolidine-N-oxyl-labeled cells versus temperature over the range from 0 to 45°C showed an hysteretic behavior of the spin labels in the membranes of both mature and immature uninfected cells. Such hysteretic behavior was consistently lacking in membranes of infected cells. These differences in membrane fluidity and spin label behavior are interpreted to reflect biochemical modifications of the red cell membrane which occur with infection by the malarial parasite.     

Molecular genetic studies of early breast cancer evolution

Summary In the past few years there has been an explosion in the number of patients diagnosed with hyperplastic breast disease andin situ breast cancer. Based on epidemiological data, these morphologically defined lesions may be categorized as those with little malignant potential (e.g. typical hyperplasia or proliferative disease without atypia [PDWA]), those with significant malignant potential which may already be initiated (e.g. atypical ductal hyperplasia [ADH]), and early transformed lesions which are malignant but not yet invasive (e.g. ductal carcinomain situ [DCIS]). They may represent sequential evolutionary stages in the ontogeny of invasive breast cancer, with each morphologically defined stage resulting from accumulating genetic changes culminating in a transformed clonal lineage capable of invasion and metastasis. Using loss-of-heterozygosity (LOH) analysis, we are studying the genetic changes associated with these lesions in archival tissue samples. 50% (6/12) of the proliferative lesions (PDWA and ADH) and 80% of the DCIS shared their LOH patterns with more advanced lesions from the same breast, strongly supporting a precursor/product relationship between these lesions and the cancers they accompany.     

Treatment of infected left ventricular assist device using antibiotic-impregnated beads

There is no well-established therapy for treating infections of heart-assist or artificial heart devices, a serious problem with life-threatening consequences. We used a promising new approach in which antibiotic-impregnated polymethylmethacrylate beads were placed around an implanted left ventricular assist device to control an external blood pump infection in a bridge-to-transplant patient. In this case report, we describe the potential of antimicrobial-impregnated polymethylmethacrylate beads for in situ control of infections involving external surfaces of cardiovascular devices.