Precordial QT dispersion and inducible ventricular tachycardia

We compared the performance of precordial QT dispersion, late potentials on the signal-averaged electrocardiogram (ECG), and reduced left ventricular ejection fraction for identification of inducible ventricular tachycardia (VT) in 162 patients undergoing electrophysiologic study (EPS). QT(apex) dispersion in 56 patients with inducible VT (72 +/- 55 msec) was greater than that in 106 patients without inducible VT (55 +/- 36 msec, p < 0.01); dispersion was greater in both groups than in 144 normal subjects (33 +/- 19 msec). A QT(apex) dispersion partition of more than 68 msec, the upper ninety-fifth percentile in normal subjects, identified inducible VT with a specificity of 75% and a sensitivity of 45%. Although the performances of late potentials (specificity 82%, sensitivity 59%) and reduced ejection fraction (specificity 86%, sensitivity 54%) were each stronger than QT dispersion alone for identification of inducible VT, abnormal QT(apex) dispersion remained a significant additional predictor of inducible VT in a logistic regression model that included the three variables (specificity 78%, sensitivity 75%).     

Genetic distribution of Bare-1-like retrotransposable elements in the barley genome revealed by sequence-specific amplification polymorphisms (S-SAP)

Acid anhydrides are highly reactive, low molecular weight compounds that are used widely in industry. Work-related exposure to this group of substances may cause occupational asthma. Because of low molecular weight, these compounds are not able to induce antibody responses without conjugating with human proteins. Acid anhydrides may act as haptens when conjugated with human serum albumin (HSA). The induction mechanism of immediate and late bronchial hyperresponsiveness to acid anhydrides appears to be at least partly mediated by IgE antibodies. Other clinical syndromes, which may be caused by acid anhydrides such as pulmonary disease-anemia (PDA), and late respiratory systemic syndrome (LRSS) associated with TMA exposure, appear to be associated with IgG antibodies to TMA as well as with IgE. Significant cross-reaction occurs between different compounds of this group, particularly regarding IgE antibodies. As inhalational exposure to acid anhydrides may result in serious pulmonary disease, adequate protection of potentially exposed workers or their removal, if affected, from exposure is essential.     

Ehrlichiosis: findings on chest radiographs in three pediatric patients

OBJECTIVES: Ehrlichiosis is a newly recognized tick-borne infection affecting both children and adults. The disease is usually mild, with flulike symptoms, but can be fatal. We present the chest radiographs and, in one case, the chest CT scan of all recognized pediatric cases of ehrlichiosis to date from our institution. CONCLUSION: Ehrlichiosis should be included in the differential diagnosis of acutely ill pediatric patients with a history of possible tick exposure and radiographic patterns of interstitial prominence, alveolar opacities, or consolidation that may be associated with pleural effusion.     

Psychosocial stressors and well-being in health care workers. The impact of an intervention program

There have been few prospective studies of the impact of workplace interventions on employee and organizational well-being within health care settings. This study was conducted at a large regional hospital in Sweden in 1994 with a follow-up in 1995. Effects of a structured organizational and staff intervention program on perceived psychosocial work quality, supporting resources and self-reported health and well-being were evaluated. Based on department-specific results from the baseline assessment in 1994, each department formulated their own improvement goals. They also made their own decisions on relevant improvement activities. Since there was no formal reference group in this study, departments with high and low rating levels, respectively, with regard to intervention activities were compared. Despite an overall worsening in most of the measures most likely due to a notice of 20% staff reduction prior to the follow-up assessment, the intervention appeared to have attenuated negative changes in the high as compared with the low activity group. Manager-rated impact of the program as well as positive staff attitudes and staff involvement in the enhancement process were identified as important determinants for more favourable changes. The study points out the relevance of structured workplace interventions for organizational and employee well-being especially in times of cut-backs and organizational turmoil. Department-specific factors will determine the impact of such programs. The study indicates that the psychosocial impact of personnel cut-backs in health care may be attenuated through management initiatives.     

Rapid disappearance of zinc positive terminals in focal brain ischemia

The study was undertaken to determine if the levels of vesicular zinc in neuronal terminals would decrease in response to focal brain ischemia. The middle cerebral artery was occluded distal to the striatal branches in male spontaneously hypertensive rats. At 7, 15, 30, 45, 60, 90, 120 min; 3, 6, 12, 24, 48 h and 7 days later the animals were sacrificed and the brains were stained for zinc-sulfides, cell bodies and AChE-positive cholinergic fibers. The density of zinc positive terminals significantly decreased in the neocortical ischemic zone 7 min after middle cerebral artery occlusion (MCAO). In the neocortical layers II and III most zinc positive neuronal terminals disappeared at 7 min after MCAO whereas the zinc positive terminals in layers V and VI remained positive at least 2 h. Beginning at 1 h after MCAO and progressing to 24 h a significant decrease in the density of zinc positive terminals was observed in the dorsolateral striatum, and ventrobasal thalamic nucleus, both major projection areas of the sensorimotor cortex. The disappearance of zinc positive neuronal terminals in the ischemic neocortex and related areas, is most likely due to a neuronal release of vesicular zinc in response to hypoxia. The high extracellular concentration of zinc is thought to be both neuroprotective by blocking the NMDA receptor and neurotoxic by activating neuronal influx of Ca2+ through voltage gated calcium channels. It seems evident that the latter effect of zinc is contributing to the neuronal death in focal brain ischemia.     

Technique of lymphatic mapping and sentinel node biopsy for melanoma

AIM: To evaluate the effect of PD Plus on weekly Kt/Vurea and creatinine clearance (Kcr) among patients undergoing CAPD/CCPD (continuous ambulatory peritoneal dialysis/continuous cyclic peritoneal dialysis). METHODS: The kinetic studies of 92 CAPD and 18 CCPD patients who transferred to PD Plus were analyzed. All patients underwent CAPD/CCPD and PD Plus for a minimum of 3 months. Standard collection methods were used and kinetic indices calculated with the Pack PD Kinetic Modeling program. 57 patients had transport data and were modeled for a target weekly Kt/Vurea >/=2.1 using PD Plus with /=2.1 and 47% a Kcr >/=60 liters/1.73 m2 with PD Plus, but only 20% did so with CAPD/CCPD. A close correlation between the supervised patients and modeled therapy was observed. CONCLUSIONS: Adequate dialysis is possible by using higher fill volumes, the supine position, and optimal dwell times (PD Plus) in most patients. The discrepancy between modeled and achieved dose is likely due to poor compliance with therapy, inadequate training, or poor specimen collection.