A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953-1989

BACKGROUND: Virtually all natural history studies of Wolff-Parkinson-White (WPW) syndrome have been case series and, as such, have been constrained by referral biases, skewed age and sex distributions, or brief follow-up periods. The purpose of our study was to examine the natural history, the development of arrhythmias, and the incidence of sudden death in an entire cohort of pediatric and adult WPW patients from a community-based local population. METHODS AND RESULTS: We identified 113 residents of Olmsted County, Minnesota, during the period 1953-1989 using the centralized records-linkage system provided by the Mayo Clinic and the Rochester Epidemiology Program Project. Medical records and ECGs were reviewed to confirm the diagnosis and to establish pathway location by ECG criteria. Follow-up, via record review and telephone interview, was complete in 95% of subjects through 1990. The incidence of newly diagnosed cases was approximately four per 100,000 per year. Preexcitation was not present on the initial ECG of 22% of the cohort. Approximately 50% of the population was asymptomatic at diagnosis, with 30% subsequently having symptoms related to arrhythmia at follow-up. Two sudden cardiac deaths (SCD) occurred over 1,338 patient-years of follow-up, yielding an overall SCD rate of 0.0015 (95% confidence interval, 0.0002-0.0054) per patient-year. No SCD occurred in patients asymptomatic at diagnosis. CONCLUSIONS: The incidence of sudden death in a local community-based population is low and suggests that electrophysiological testing should not be performed routinely in asymptomatic patients with WPW syndrome. Nevertheless, young, asymptomatic patients, particularly those < 40 years old, should return for medical follow-up should symptoms develop.     

Comparative severity of respiratory lesions of sialodacryoadenitis virus and Sendai virus infections in LEW and F344 rats

In several chronic diseases, lesions are more severe in LEW rats than in F344 rats. To determine whether or not acute viral diseases also are more severe in LEW rats than in F344 rats, we inoculated 6-7-week-old LEW and F344 rats with 10(7.2) cell culture infective units of sialodacryoadenitis virus or 10(4.7) infective units of Sendai virus. Twenty-four rats of each strain were given each virus. Lesions in nasal passages, tracheas, intrapulmonary airways, and pulmonary alveoli in 6 or 12 rats inoculated with each virus were assessed by scoring 5, 10, and 14 days after inoculation. Both viruses caused typical patchy necrotizing rhinitis, tracheitis, bronchitis, and bronchiolitis, with multifocal pneumonitis, in rats of both strains. Mean lesion indices for LEW rats given sialodacryoadenitis virus were significantly different from those for F344 rats for nasal passages on days 10 (0.999 vs. 0.680) and 14 (0.736 vs. 0.278), bronchi on day 5 (0.479 vs. 0.361), and alveoli on day 5 (0.677 vs. 0.275). Lesion indices for LEW rats given Sendai virus were significantly different from those for F344 rats for nasal passages on days 10 (1.000 vs. 0.611) and 14 (0.778 vs. 0.583); trachea on day 10 (0.625 vs. 0.028); bronchi on days 5 (0.476 vs. 0.331), 10 (0.123 vs. 0.013), and 14 (0.038 vs. 0); and alveoli on days 5 (0.413 vs. 0.114) and 10 (0.185 vs. 0.020). Thus, at the tested doses, both viruses caused more severe respiratory tract lesions in LEW rats than in F344 rats.     

Low RF noise and power loss for ion-implanted Si having an improved implantation process

Very-low-transmission line noise of <0.25 dB at 18 GHz and low power loss /spl les/0.6 dB at 110 GHz have been measured on transmission lines fabricated on proton-implanted Si. In contrast, a standard Si substrate gave much higher noise of 2.5 dB and worse power loss of 5 dB. The good RF integrity of proton-implanted Si results from the high isolation impedance to ground, as analyzed by an equivalent circuit model. The proton implantation is also done after forming the transmission lines at a reduced implantation energy of /spl sim/4 MeV. This enables easier process integration into current VLSI technology.     

Inhibition of monocyte leukotriene B4 production after aspirin desensitization

Aspirin-sensitive patients may be desensitized through a graded series of exposures to aspirin. We investigated the underlying mechanism of aspirin desensitization by measuring the release of leukotrienes B4 and C4 from calcium ionophore-stimulated peripheral blood monocytes. Compared with monocytes from normal volunteers (n = 5), monocytes from patients with aspirin-sensitive asthma (n = 10) released increased amounts of thromboxane B2 (1060 +/- 245 pg/ml vs 456 +/- 62 pg/ml), leukotriene B4 (861 +/- 139 pg/ml vs 341 +/- 44 pg/ml), and leukotriene C4 (147 +/- 31 pg/ml vs 56 +/- 6 pg/ml) at baseline. After aspirin desensitization, thromboxane B2 release was almost completely suppressed in both groups. Leukotriene B4 release was significantly decreased in the aspirin-sensitive group (484 +/- 85 pg/ml) but not in the normal subject group (466 +/- 55 pg/ml). The need for prednisone decreased significantly after patients were desensitized to aspirin (10.4 +/- 2.2 mg/day to 1.6 +/- 2.8 mg/day). These results demonstrate that desensitization to aspirin results in decreased monocyte leukotriene B4 release. On the basis of the bronchospastic and inflammatory potential of leukotrienes, the decrease in leukotriene release may contribute to the clinical improvement seen after aspirin desensitization.     

Characterization of in Vitro Transdermal Iontophoretic Delivery of Insulin

In-vitro studies were conducted to characterize the transdermal iontophoretic delivery of insulin, thus avoiding potential complications from various biological variations, which may be encountered during in-vivo studies. The proteolytic degradation of insulin in skin homogenates and degradation under the experimental conditions used was investigated. Appropriate adjuvants were incorporated to minimize the potential degradation problems of insulin. ¹²⁵I-Insulin was observed to penetrate into and accumulate in the skin during the iontophoresis period. It was then released gradually from this depot, as a mixture of intact and ¹²⁵-I labelled fragments, into the receptor medium. Drug desorption studies supported the theory of skin depot or reservoir formation. It was found that an electric field could be used to facilitate the desorption of drug from the depot. The post-application flux of insulin (or its fragments) from the skin depot formed during iontophoresis was monitored to study the factors affecting the iontophoretic delivery of insulin. Stripping and delipidization of the skin were noted to increase the skin permeation rate of insulin. The cumulative radioactivity permeated and accumulated in the skin was higher at pH 3.6 than at pH 7.4. The iontophoresis-facilitated transdermal delivery was observed to increase with increasing duration of current application and increasing donor concentration of insulin. Modulation of drug delivery by multiple applications was also found to be feasible.     

Effects of α‐form or β‐form nuclei on polymorphic crystalline morphology of poly(butylene adipate)

The effects of α‐form and β‐form nuclei on polymorphic morphology of poly(butylene adipate) (PBA) upon recrystallization from the molten state up to various T_max values were examined by differential scanning calorimetry (DSC), wide‐angle X‐ray diffraction (WAXD) and polarized light microscopy (PLM). In this study, PBA with complex melting and polymorphism behaviour was used as a model for examining different types and extents of residual nuclei. As the PBA initially containing the sole α‐crystal was brought to a molten state of various T_max, the extents of trace α‐form crystal nuclei varied and were dependent on T_max. Furthermore, it did not matter whether, initially, the PBA contained α‐ or β‐form crystals (or both) because only a single type of α‐nuclei could be left upon treatment to the molten liquid state at T_max. Therefore, only the α‐crystal in PBA had ‘memory capacity’ in the molten liquid state while the β‐crystal did not. This was so because the latter had been completely transformed into the solid state prior to being heated into a liquid. PBA crystallized before α‐nuclei could be packed into α‐crystal, regardless of the crystallization temperature (T_c). For recrystallization from molten PBA without any nuclei, the crystalline polymorphism was correspondingly influenced by T_c. Copyright © 2005 Society of Chemical Industry     

Methylaluminoxane/haloalkane as initiator system for styrene polymerization

Summary Styrene polymerization was initiated by methylaluminoxane in the presence of haloalkane. The propagating species are shown by trapping experiments and electron paramagnetic resonance to be both radicals and cations.     

Structure Development Study of Pb (Zr, Ti)O3 Thin Films by an Optical Method

Lead zirconate titanates (Pb (Zr_xTi_1–x)O₃ or PZT) are well-known materials with useful ferroelectric properties for nonvolatile memory applications. The device applications usually require processes which form the ferroelectric perovskite phase at low temperatures. Understanding the various aspects of structure development of PZT films is the key to develop low-temperature processes. An effective, versatile, and nondestructive optical method was developed for the study of the structure development in PZT films. Also, models for the structure development were proposed and were verified by this optical method. Using this method, the characteristic temperatures at which both pyrochlore phase and perovskite phase are initiated and completed were identified. The pyrochloreperovskite transformation was initiated at lower temperature and completed faster for the films on the titanium-rich side than those on the zirconium-rich side. In addition, the volume fractions of the perovskite phase were obtained as a function of annealing temperature by this optical method.