Does delayed loss of preexcitation after unsuccessful radiofrequency catheter ablation of accessory pathways result in permanent cure?
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Adult↗
Biomedical subjects
Y H Kim
Publications and source records attributed to Y H Kim.
Expression of the murine homologue of the cell cycle control protein p34cdc2 in T lymphocytes.
The mammalian homologue of the cdc2 gene of the fission yeast Schizosaccharomyces pombe encodes a p34cdc2 cyclin-dependent kinase that regulates the cell cycle of a wide variety of cell types. Resting murine T lymphocytes contained no detectable p34cdc2 protein, histone kinase activity, or specific mRNA for the cdc2 gene. Activation of the T cells by immobilized anti-CD3 resulted in the expression of specific mRNA late in the G1 phase of the cell cycle, and p34cdc2 protein was detectable at or near G1/S. At this point in the cell cycle, the protein was phosphorylated at tyrosine and displayed no H1 histone kinase activity. As the cells progressed through the cycle, the amount of specific mRNA and p34cdc2 increased, and H1 histone kinase activity was detectable when the cells were blocked at G2/M by nocodazole. The activation of T cells by phorbol dibutyrate induced the expression of IL-2R but failed to induce the synthesis of IL-2 or the expression of cdc2-specific mRNA. Under these conditions, the activated cells failed to enter the S phase of the cell cycle. Because the presence of IL-2 added exogenously during activation by phorbol dibutyrate resulted in the expression of cdc2-specific mRNA and progression through the cell cycle, either IL-2 or the interaction with IL-2R may be involved in the expression of cdc2 and regulation of the G1/S transition.
Amino Acid Sequence↗
Effects of acute and prolonged administration of propafenone on internal defibrillation in the pig.
Some antiarrhythmic sodium channel blocking drugs have been found to increase the energy necessary for internal defibrillation. Propafenone is a new drug that has been shown to be efficacious in the therapy of supraventricular and ventricular arrhythmias, and is of potential use in patients with defibrillators. The effects of short-term and prolonged propafenone administration on the internal defibrillation threshold (DFT) were determined in 43 pigs randomized to one of four groups: saline infusion (n = 10); propafenone infusion (n = 10); placebo administration for 8 days (n = 10); or propafenone administration for 8 days (n = 13). Two mesh electrodes were sutured on the right lateral and left lateral epicardial surface and current was delivered from the right electrode to the left electrode. Triplicate DFTs were obtained before and at 40 and 80 minutes after infusion of drug or placebo. In pigs receiving long-term administration, after baseline DFTs were obtained the electrodes were removed and the chest was closed. Following 8 days of drug or placebo administration, DFTs were redetermined. No changes were observed in the short- or long-term control groups. DFTs were lower after propafenone administration: either short-term infusion (20 +/- 6.2 joules at baseline; 15.6 +/- 5 joules at 40 minutes, p less than 0.05; 10.2 +/- 6 joules at 80 minutes, p less than 0.001) or long-term administration (17.8 +/- 2.6 joules at baseline versus 12 +/- 3.2 joules on drug, p less than 0.002). Decreased ventricular cycle lengths were found with acute administration of propafenone. Three pigs died during long-term administration of propafenone.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Total nodal radiation in progressive sarcoidosis. Case report.
The subject of this article is a patient with sarcoidosis with neurological involvement, who failed to respond to high dose steroid therapy and cyclophosphamide. Low doses (20 Gy) of total nodal and craniospinal irradiation resulted in an excellent response, the patient being alive and in good health 3 years after irradiation without any further steroid therapy.
Adult↗
Recessive dystrophic epidermolysis bullosa phenotype is preserved in xenografts using SCID mice: development of an experimental in vivo model.
Recessive dystrophic epidermolysis bullosa (RDEB) is a subgroup of hereditary blistering diseases characterized by repetitive wounding and healing with subsequent extensive scarring. The purpose of this study was to establish a xenograft model that retains the RDEB phenotype and thus might be used as an experimental in vivo model to explore the molecular and biochemical mechanisms of the chronically wounded phenotype of RDEB. Full-thickness, tumor-free RDEB skin tissues were grafted onto the dorsum of severe combined immunodeficiency (SCID) mice. At 4, 8, 12, and 24 weeks after grafting, the xenografts were removed for examination. Immunofluorescence studies were performed using species-specific antibodies to human class I antigen, mouse class I antigen, human type IV and VII collagens and with cross-reacting antibody against bullous pemphigoid antigen (BPA). Staining with the antibody to human class I antigen, W6/32, and with the antibody to mouse class I antigen, 20.8.4s, confirmed the species-specific results obtained with the type IV and type VII collagen and laminin antibodies. The RDEB grafts showed essentially no staining with the type VII collagen antibody. Antibodies against laminin and BPA showed normal staining patterns in RDEB grafts. There was an overall paucity of anchoring fibrils in the grafts when examined with electron microscopy. Blisters could be induced in these grafts with minor trauma and showed a sublamina densa separation by immunomapping and electron microscopy. As late as 24 weeks post-transplantation, the RDEB grafts remain human, are not significantly replaced by mouse cells, and retain the RDEB disease phenotype.
Adolescent↗
Molluscum contagiosum occurring in an epidermal cyst--report of 3 cases.
We present three unusual cases of molluscum contagiosum occurring in epidermal cysts. All of them are asymptomatic, elevated, oval nodules diagnosed clinically as epidermal inclusion cyst or prurigo nodularis. Histology showed true epidermal cysts containing molluscum bodies throughout the cyst wall and some type of laminated material within the cyst itself. The lesion, in all three cases developed in the pubic area of young adult men.
Adult↗
Effects of higher-order harmonics on phase determination in an ultrasonic interferometer.
The effect of higher-order harmonic components on phase determination were analyzed to improve the accuracy of transient time measurement in an ultrasonic interferometer with a quadrature detector system. Under ideal conditions the locus of output signals of the phase sensitive detector forms a circle on the phase plane as the frequency changes and any nonideal factor would distort the circle, leading to erratic phase determination. This analysis has shown that the nth-order contribution to the phase is mostly determined by the product of the amplitudes of corresponding components of the reference and echo signals fed to the phase detector. The distortion parameters were obtained by least-squares fitting of the data to the distorted circle in the phase plane, and compared with those roughly estimated from the frequency components of the reference and echo signals. The exemplary numerical phase corrections for the third-order harmonics were carried out, so as to illustrate the improvement in the accuracy of the ultrasonic interferometer.
Acoustics↗
Syncope associated with supraventricular tachycardia. An expression of tachycardia rate or vasomotor response?
BACKGROUND: Syncope in patients with supraventricular tachycardia has been suggested to be an ominous finding, predictive of rapid rates during tachycardia. METHODS AND RESULTS: To explore the mechanism of syncope during supraventricular tachycardia, tachycardia was induced in the supine position and after passive head-up tilting to 60 degrees in 13 patients with atrioventricular (AV) node reentry, eight patients with AV reentry, and one patient with atrial tachycardia. Tilt testing was also performed in sinus rhythm for 30 minutes (the last 15 minutes with isoproterenol infusion). Mean +/- SEM age was 38 +/- 3 years, and 11 patients had a history of syncope (median number of syncopal episodes, three; range, one to 30). The cycle length of tachycardia when upright was shorter than when supine (297 +/- 9 compared with 357 +/- 10 msec, p less than 0.001), and mean blood pressure fell to a greater extent after the onset of tachycardia (fall in mean blood pressure, 53 +/- 6 compared with 24 +/- 3 mm Hg, p less than 0.001). Mean blood pressure correlated significantly with tachycardia cycle length when supine (r = 0.58, p = 0.005) but not when tilted upright (r = 0.18, p = 0.45). Syncope occurred in seven patients during upright tachycardia. These seven patients had a greater fall in mean blood pressure with upright tachycardia than the 15 patients without syncope (fall in mean blood pressure, 70 +/- 4 compared with 45 +/- 5 mm Hg, p = 0.01), but there was no difference in the tachycardia cycle length (311 +/- 10 compared with 290 +/- 11 msec, p = 0.29). Six of the seven patients with tachycardia-induced syncope also had syncope with tilt testing in sinus rhythm compared with four of the 15 patients without tachycardia-induced syncope (p = 0.02). CONCLUSIONS: These data support the view that syncope during supraventricular tachycardia is related to vasomotor factors and does not predict a more rapid tachycardia rate.
Adult↗
Surface characteristics and blood compatibility of polyurethanes grafted by perfluoroalkyl chains.
Polyurethane (PU) surface was chemically modified by grafting of perfluorodecanoic acid (PFDA) to produce a highly hydrophobic surface to compare the blood compatability with hydrophilic poly(ethylene oxide) (PEO) grafted PUs. The advancing contact angle of modified PU-PFDA was increased up to 115 deg, while that of untreated PU was 86 deg. The PFDA grafted PU exhibited less adhesion and shape change of platelets than untreated PU, and the activated partial thromboplastin time (APTT) of PU-PFDA was considerably extended. The ex vivo occlusion time of untreated PU was only 50 min, but that of PFDA grafted PU was extended to 130 min, indicating that this hydrophobic surface is significantly blood compatible. It is interesting to find that the enhanced blood compatibility of very hydrophobic PU-PFDA was equivalent to hydrophilic PU-PEO.
Biocompatible Materials↗
Results of the Harris-Galante cementless hip prosthesis.
We reviewed 82 primary arthroplasties (in 71 patients) in which cementless porous-coated hip prostheses were used. The mean age of the patients at operation was 52 years (24 to 86); they were followed up for an average of 62.1 months (60 to 66). The diagnosis was avascular necrosis of the femoral head in 35%, fracture of the femoral neck in 24%, primary osteoarthritis in 16% and miscellaneous in 25%. The average preoperative Harris hip score was 56.7 points and the average postoperative score was 83.3 points. Eight hips (10%) had component loosening; four had been revised and four were awaiting revision. In 27 hips (33%) there was a radiolucent line wider than 2 mm in zones 1 and 7. In 55 hips (67%) there was calcar resorption of more than 10 mm. Twenty patients (28%) complained of thigh pain although they had no radiographic evidence of loosening of a component. Factors that may have contributed to the poor clinical and radiographic results were: 1) inadequate surface area for bone ingrowth, particularly on the lateral aspect of the upper part of the prosthesis, 2) poor initial fit of the stem in the metaphysis, which resulted in cantilever motion of the proximal part of the stem about the well-fixed distal stem, and 3) the collar of the prosthesis, which prevented it from subsiding to a naturally stable position and caused damage to the calcar.
Bone Cements↗
Influence of the stopcock on the efficiency of percutaneous drainage catheters: laboratory evaluation.
The effects of stopcocks on percutaneous fluid drainage were tested in a laboratory model by using a standard stopcock (6-French inner diameter) and a prototype stopcock (9-French inner diameter) connected to 8-, 10-, 12-, 14-, and 16-French catheters. Catheters were immersed in water alone or in viscous fluid with particulate matter, and the system was connected to low wall suction or gravity drainage. The average volume of fluid aspirated in a given period with and without a stopcock was compared for each catheter. The standard stopcock decreased drainage efficiency for these catheters by 13-42%. This decreased drainage efficiency was worse with the larger catheters. Particulate fluid blocked the stopcock connection for all catheters. With the prototype stopcock, drainage of water alone was reduced by 0-9% for the catheters of different sizes. Particulate fluid did not obstruct the prototype stopcock with any size catheter. With gravity drainage, the volume of water aspirated was reduced by 12-42% with the standard stopcock and by 3-6% with the prototype stopcock. These data suggest that stopcock connections greatly influence the efficiency of the percutaneous drainage systems. Stopcocks with larger inner diameters may improve drainage over that achievable with the stopcocks that are currently available.
Catheterization↗
Effects of Na+, K(+)-pump inhibitors on acetylcholine-induced relaxation in the rabbit aorta.
The purpose of this study was to investigate the effects of inhibitors of the Na+, K(+)-pump and membrane depolarizing agents on endothelium-dependent acetylcholine-induced relaxation in the rabbit thoracic aorta. Aortic rings were prepared from the rabbit descending thoracic aorta and the contractility of the ring was measured in various conditions such as application of ouabain, exposure to K(+)-free Krebs-Henseleit solution and high K+. Ouabain or exposure to K(+)-free Krebs-Henseleit solution inhibited acetylcholine or sodium nitroprusside-induced relaxation. KCl also inhibited the acetylcholine or sodium nitroprusside-induced relaxation. These results suggest that the Na+, K(+)-pump may play a role in endothelium-dependent acetylcholine-induced relaxation.
Acetylcholine↗
Effect of peripheral nerve stimulation on the dorsal horn cell activity in cats with cutaneous inflammation.
There are some reports showing that an experience of long-enduring pain causes a change in the pain transmission system, suggesting a plastic nature of the nociceptive system. However, most of the studies concerning the analgesic effect of peripheral nerve stimulation dealt with normal animal or human subjects. So, the present study was undertaken to investigate the effect of peripheral nerve stimulation on the dorsal horn cell activity using a tonic pain model, which was made by producing a cutaneous inflammation. The main results are summarized as follows. 1) The evoked activity by electrical or natural stimulation as well as spontaneous activity was enhanced, and the receptive field size was also expanded by the inflammation. 2) Peripheral nerve conditioning stimulation reduced the C-response of the dorsal horn cell in the normal and inflamed group, and the degree of inhibition between the two groups showed no significant difference. 3) Inhibition of the C-response of the dorsal horn cells by peripheral conditioning stimulation was completely reversed by naloxone in the inflamed group whereas there was a partial block in the normal group.
Analgesia↗
Network analysis of Korean health insurance policy-making process.
This study examines how the decision-making process evolved in Korea during the initial phases of introduction and implementation of National Health Insurance. This study analyses the official documents and interviews views made with government officials and related personnel. We used the method of network analysis and multidimensional scaling in order to demonstrate how the major participants in the decision-making process developed and changed under the contemporary political situations. In the pre-implementation stage around 1976, major concerns were concentrated around the issues of financial support for social insurance, the fee schedule and who ought to be covered first. The total number of participants of the health or health-related organization was 61, which included the President, the Minister of Health and Social Affairs, representatives of special interest groups, etc. In the actual implementation period of 1982, different issues were brought up by the major participants. The number of participants in this period declined to 44 with the deletion of 19 and with the addition of two newly formed health insurance organizations. By 1988, as the implementation reached its final decision period, disagreements were centered on progressive premium rating and the administration of National Health Insurance. The number of participants increased to 60 after the addition of 16 participants. The analysis of this paper may provide some insight for other countries which wish to establish National Health Insurance; as reference to the policy-making process, it may provide some suggestions for when to initiate and how to formulate National Health Insurance policies.
Humans↗
Pulmonary embolism as the initial manifestation of large cell lung cancer--a case report with review.
Lung cancer is known as a risk factor of pulmonary embolism. We experienced a case of pulmonary embolism combined with pleural effusion and pleuritic chest pain as the initial manifestation of large cell lung cancer, which is a relatively rare cell type of lung cancer in Korea. We report it with a review of the literature.
Adult↗
Avascular necrosis after fracture-separation of the distal end of the humerus in children.
Fracture-separation of the distal end of the humerus in children has been reported infrequently, and may be misdiagnosed as a fracture of the condyle or a traumatic dislocation of the elbow. We discuss eight cases of a seldom reported complication following fracture-separation of the distal end of the humerus. This complication consists of dissolution of the trochlea within three to six weeks postinjury and a defect of the medial or central part of the condyle that develops later. The fractures were severely displaced fracture-separation of the distal end of the humerus with large medial or lateral metaphyseal fragment, but initially misdiagnosed as a fracture of the medial, lateral condyle or a traumatic dislocation of the elbow in six of eight cases. We performed open reduction in six cases because of initial misdiagnosis or because of difficulty in satisfactory closed reduction. We speculated that this complication is due to avascular necrosis of the distal end of the humerus, and that fracture-separation of the distal end of the humerus is more common than reported.
Child↗
A double-blind comparison of adhesive bandages with the use of uniform suction blister wounds.
BACKGROUND AND DESIGN: The assessment of cutaneous wound healing in humans has been hampered by the inability to evaluate multiple wounds with identical origins, treatment histories, and sizes. There have been no double-blind wound healing studies in humans that compared one wound dressing with another. The purpose of this study was to determine if identical suction blister wounds could serve as a model to evaluate and compare wound healing and overall cosmetic appearance of wounds treated with commercially available adhesive bandages. In a double-blind study, we compared superficial skin wounds of identical depth and diameter, created on the forearms of five human subjects by means of a suction blister device. The wounds were covered by two common, commercially available adhesive bandages or a copolymer of polyurethane membrane type of wound dressing. We compared the degree of reepithelialization, erythema, skin depression, and overall cosmetic appearance of wounds with respect to the specific adhesive bandages used. RESULTS: The wounds covered with the copolymer of polyurethane membrane were judged to have better overall appearance and advanced reepithelialization compared with identical wounds covered by the other wound dressings. With the use of x5 magnification for viewing the wounds on the final day of evaluation (between days 18 and 22), the wounds treated with the copolymer of polyurethane membrane were judged to be the least depressed wounds in fields of identical wounds in the three subjects studied. Concordance between the evaluators' "blinded" assessments was uniform, and no discrepancy between the evaluators' assessments occurred at any of the time points. CONCLUSION: Identical wounds created with a suction blistering device can be used reliably to detect differences between the performances of wound dressings in healing superficial wounds. Superficial cutaneous wounds covered with a copolymer of polyurethane dressing demonstrated a superior rate of reepithelialization, less depression, and a better overall cosmetic appearance than wounds covered with two commercially available adhesive bandages.
Adhesives↗
Effect of atropine and isoproterenol on tachycardia induction in asymptomatic patients with Wolff-Parkinson-White electrocardiographic pattern.
OBJECTIVE: To determine if pharmacological interventions aimed at altering autonomic tone would allow induction of orthodromic atrioventricular reentrant tachycardia in asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern. DESIGN: Prospective interventional protocol in consecutive eligible patients. SETTINGS: University hospital. PATIENTS: Eighteen asymptomatic patients (13 male and five female) with the Wolff-Parkinson-White electrocardiographic pattern without inducible tachycardia in the drug-free state. INTERVENTION: Electrophysiological assessment was performed at baseline, after intravenous administration of atropine (0.03 mg/kg) and during isoproterenol infusion (0.5 to 2 micrograms/min). RESULTS: Orthodromic reciprocating tachycardia was not inducible at baseline because of absent retrograde accessory pathway conduction in seven patients. In five patients, orthodromic atrial echo beats could be induced (which blocked retrogradely in the accessory pathway in three patients and anterogradely in the atrioventricular node in two). In the remaining six patients, neither orthodromic echo beats nor reciprocating tachycardia could be induced despite intact retrograde accessory pathway conduction. Following atropine administration (mean dose 1.9 +/- 0.3 mg), anterograde and retrograde accessory pathway effective refractory periods decreased from 360 +/- 172 to 284 +/- 62 ms and from 340 +/- 38 to 296 +/- 32 ms, respectively (both P < 0.05 versus control). Orthodromic reciprocating tachycardia was induced in two patients (nonsustained in one). During isoproterenol infusion (mean dose 1.0 +/- 0.3 micrograms/min), anterograde and retrograde accessory pathway effective refractory periods decreased further to 243 +/- 23 and 248 +/- 22 ms, respectively (both P < 0.05 versus after atropine); two further patients had inducible orthodromic reciprocating tachycardia (nonsustained in one). No patient with absent retrograde accessory pathway conduction developed retrograde accessory pathway conduction or reciprocating tachycardia with isoproterenol and/or atropine. CONCLUSIONS: Isoproterenol and/or atropine allowed tachycardia induction in four of 18 asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern. In the majority of these patients, tachycardia is not inducible because of deficient retrograde accessory pathway conduction which does not improve with autonomic facilitation.
Adolescent↗