Amiodarone blocks the inward rectifier potassium channel in isolated guinea pig ventricular cells

We examined the effects of amiodarone (5-20 microM) on both whole-cell inward rectifier potassium current (IK1) and single IK1 channel activity in isolated guinea pig ventricular myocytes using patch-clamp techniques. In whole-cell voltage-clamp experiments (n = 8), amiodarone (10-20 microM) caused only a small reduction of outward current at -50 mV (12 +/- 6%, no significant difference, N.S.). However, inward current was significantly reduced at -120 mV (21 +/- 7%; P < .05). When CdCl2 (100 microM) and tetrodotoxin (10 microM) were used to block inward Ca++ and Na+ current, respectively, amiodarone significantly reduced IK1 in both the inward (14 +/- 5% at -120 mV; P < .02) and outward (12 +/- 5% at -50 mV; P < .05; n = 11) directions. However, block required high drug concentrations (10-20 microM) and was slow in onset. In contrast, amiodarone did not affect membrane current when IK1 had been previously blocked by Ba++ (5 mM). In inside-out patch-clamp experiments, amiodarone (5 microM) reduced single IK1 channel open probability by increasing interburst interval (from 0.6 +/- 0.03 to 3.1 +/- 0.9 sec; n = 5; P < .05) with no significant difference in the duration of mean open and closed times or the number of shut events within a burst. The net result was that there was only a small change in both burst duration and single-channel kinetics within a burst. Complete channel block occurred after the increase in interburst interval (n = 6 of six cells).(ABSTRACT TRUNCATED AT 250 WORDS)

Computer-aided diagnosis in chest radiography. Preliminary experience

RATIONALE AND OBJECTIVES

Computer-aided diagnosis (CAD) schemes for chest radiography are being developed with which to alert radiologists to possible lesions, and thus potentially improve diagnostic accuracy. However, CAD schemes have not been tested on a large number of clinical cases. The authors identify design parameters that would be required for development of an intelligent workstation.

METHODS

Computer-aided diagnosis programs were applied for the automated detection of lung nodules, cardiomegaly, and interstitial infiltrates to 310 consecutive chest radiographs, and were analyzed for potential usefulness and limitations. Computer-aided diagnosis output was evaluated by radiologists and physicists for accuracy and technical problems, respectively.

RESULTS

Approximately 70% of the results were judged to be potentially acceptable; however, the number of false-positive findings was relatively high. Technical problems included failure to detect subtle abnormalities and the occurrence of false-positive detections caused by normal anatomical structures.

CONCLUSION

Computer-aided diagnosis has the potential to be a valuable aid to radiologists in clinical practice, if certain technical problems can be overcome and if optimal operating points can be defined for clinical use.

Sodium current in isolated human ventricular myocytes

Although fast sodium current (INa) plays a major role in the generation and conduction of the cardiac impulse, the electrophysiological characteristics of INa in isolated human ventricular myocytes have not yet been fully described. We characterized the human ventricular INa of enzymatically isolated myocytes using whole cell voltage-clamp techniques. Sixty myocytes were isolated from ventricular specimens obtained from 22 patients undergoing open-heart surgery. A low temperature (17 degrees C) and Na+ concentration in the external solution (5 or 10 mM) allowed good voltage control and facilitated the measurement of INa. Cs+ was substituted for K+ in both internal and external solutions to block K+ currents, and F- was added to the internal solution to block Ca2+ current. INa was activated at a voltage threshold of approximately -70 mV, and maximal inward current was obtained at approximately -30 mV (holding potential = -140 mV). The voltage dependence of steady-state INa availability (h infinity) was sigmoidal with half inactivation occurring at -97.3 +/- 1.1 mV and a slope factor of 5.77 +/- 0.10 mV (n = 60). We did not detect any significant differences in these parameters in cells from patients with a variety of disease states, with or without congestive heart failure. The overlap in voltage dependence of h infinity and Na+ conductance suggested the presence of a Na+ "window" current. An inactivation time course was voltage dependent and was fitted best by the sum of two exponentials. The rate of recovery from inactivation also was voltage dependent and fitted by the sum of two exponentials.(ABSTRACT TRUNCATED AT 250 WORDS)

An "intelligent" workstation for computer-aided diagnosis

Computer-aided diagnosis (CAD) involves a computerized analysis of radiographs that is used as a "second opinion" by the radiologist. The approach presented incorporates computer vision and artificial intelligence techniques and includes schemes for the analysis of lung nodules, interstitial infiltrates, and cardiomegaly seen on chest radiographs; masses and clustered microcalcifications on mammograms; and stenoses and blood flow on angiograms. The demonstration of various CAD schemes in chest radiography and mammography on a six-monitor workstation simulates one possible clinical implementation of CAD in radiology. Whether soft- or hard-copy display media are used, the radiologist can refer to the CAD results and still use the original radiograph for the final diagnosis. Although initial impressions of this simulated "intelligent" workstation are encouraging, CAD is still in a preliminary stage of development. Various methods for effectively and efficiently integrating CAD into a clinical radiology department are being investigated.

Combined therapy for carcinoma of the nasopharynx: a report of 49 cases

From April, 1986 to June 1989, 49 patients (29 male, 20 female) aged 20 to 70 years old who developed carcinoma of nasopharynx (included 15 with relapses) were treated with neoadjuvant regional chemotherapy, followed by radiotherapy, or cryosurgery and radiotherapy. Thirty-three of the patients had squamous cell carcinoma with poor differentiation, four with well differentiated squamous cell carcinoma were included. Tumours were treated with three modalities: (1) Induction regional chemotherapy with temporal artery catheterization as well as superselective intra-arterial chemotherapy of the femoral artery (chemotherapeutic agents: pingyangmycinum (P), Cisplatin (D), Vincristine (V), Methotrexate (M) and P.D.M. programmes); (2) Liquid nitrogen cryosurgery in 25 cases; (3) Radiotherapy was carried out for two weeks after cryosurgery or immediately applied to those without cryosurgery after chemotherapy. The data showed CR (complete response--all tumour gone) and PR (partial response--more than 50 per cent reduction) in 40 cases (81.6 per cent) and NR (no response--less than 50 per cent or no response) in nine cases (18.3 per cent) following regional chemotherapy. All of the patients were followed up for more than one year, and 48 of them survived (97.9 per cent). Thirty-five cases were followed up over two years and 28 of them survived (80 per cent). Twenty cases were followed up over three years, and 12 of them survived (60 per cent). The effect of regional chemotherapy and cryosurgery in combined treatment for carcinoma of the nasopharynx is discussed in this paper.

Characteristics of lidocaine block of sodium channels in single human atrial cells

Although lidocaine block of cardiac Na+ current (INa) has been extensively studied in animal tissues, very little is known about its actions on human cardiac INa. We studied the effects of lidocaine (0.01-10 mM) on human atrial INa in single myocytes using whole-cell patch-clamp techniques. The dose-response relationship for lidocaine block at a low frequency (0.2 Hz, "tonic" block) indicated that lidocaine blocked Na+ channels by one-to-one binding with an apparent Kd of 291 microM. Lidocaine (200 microM) shifted the steady-state INa availability curve by -11 mV, but did not change the slope factor (n = 5). Lidocaine also induced use-dependent block that increased directly with increases in drug concentration (0.01-1 mM) and pulse duration (3-100 msec) and inversely with interpulse interval (2-0.33 sec). The time constant for onset of lidocaine (200 microM) block of INa displayed both a fast (tau f = 3.6 +/- 0.4 msec) and a slow (tau s = 168 +/- 21 msec) exponential component (n = 10). In addition, lidocaine slowed the rate of INa recovery after a 1-sec conditioning pulse to -20 mV, recovery was biexponential at a low drug concentration (20 microM), but had only a single slow phase at a high drug concentration (200 microM). These characteristics of lidocaine block suggest that lidocaine binds to both inactivated and activated Na+ channels in human atrial cells and that use-dependent block of INa by lidocaine is dependent on drug concentration, interpulse interval and pulse duration, findings similar to those reported for other mammalian species. The similarity of these results to those obtained from atrial as well as ventricular cells from other species suggests that some source other than differential drug action on atrial and ventricular INa underlies differential drug efficacy against supraventricular and ventricular dysrhythmias.

Computerized radiographic analysis of osteoporosis: preliminary evaluation

Measurement of bone mass is important in determining the risk for fracture and in following the course of patients undergoing therapy for osteoporosis. Bone mineral densitometry (BMD) is a good predictor of fracture risk, but there is considerable overlap in BMD measurements between individuals with fracture risk and those without. In this study, computerized texture analysis of the trabecular pattern on conventional spine radiographs was used to evaluate bone structure as a determinant of fracture risk. Standard lumbar spine radiographs of 43 individuals were analyzed and compared with BMD measurements obtained with dual-photon absorptiometry. This method was more effective than BMD in differentiation of patients with fractures elsewhere in the spine from those with no fracture. These preliminary results suggest that this method of bone structure analysis, combined with BMD, may lead to a more sensitive and specific predictor of osteoporosis and risk of fracture.

Characterization of the sodium current in single human atrial myocytes

Patch-clamp recording techniques have permitted measurement of the fast Na+ current (INa) in isolated cardiac cells from a number of species in recent years. However, there is still only very little information concerning human cardiac INa. The purpose of this study was to describe the kinetics of INa in normal-appearing, Ca(2+)-tolerant, enzymatically isolated human atrial myocytes using whole-cell voltage-clamp techniques. Atrial specimens were obtained from 46 patients undergoing open heart surgery. Cs+ was substituted for K+ in both pipette and external solutions and F- was added to the former. The reversal potential of the rapid inward current varied approximately 57 mV at 17 +/- 1 degrees C with a 10-fold change in [Na+]o, and the current was completely blocked by 100 microM tetrodotoxin, findings typical of the fast cardiac Na+ current. The tetrodotoxin dose-response curve was best fitted by an equation describing binding to high- and low-affinity sites. INa was activated at a voltage threshold of -70 to -60 mV, and peak inward current was obtained at approximately -30 mV (holding potential, -140 mV). The inactivation time course was voltage dependent and was fitted best by the sum of two exponentials. The relation between voltage and steady-state availability (h infinity) was sigmoidal with the half-inactivation at -95.8 +/- 0.9 mV and a slope factor of 5.3 +/- 0.1 mV (n = 46), and we did not observe a significant difference with disease and age. The overlap of the h infinity and activation curves suggested the presence of a Na+ "window" current. Recovery from inactivation also was voltage dependent and best fitted by a model describing the sum of two exponentials. Recovery occurred after an initial delay at potentials positive to -140 mV, suggesting that inactivation of human atrial INa is a multistate process. We conclude that INa of normal-appearing, Ca(2+)-tolerant human atrial myocytes is similar to that of other mammalian cardiac cells with the possible exception of having two tetrodotoxin binding sites.

K-current mediation of prolactin-induced proliferation of malignant (Nb2) lymphocytes

The effects of different concentrations of various K-current blockers on prolactin-induced proliferation and membrane K-currents in malignant lymphocytes (Nb2 cells) were investigated. Membrane currents were measured with the whole cell patch-clamp technique, and lymphocyte density was quantified by both spectrophotometric and conventional methods. K-current blockers tested (quinidine, 4-aminopyridine, barium, and tetraethylammonium) exhibited similar rank order potency for K-current block and inhibition of prolactin-induced proliferation of malignant lymphocytes. Because Nb2 cells proliferate independently of a transmembrane Ca-influx, these results suggest that K-currents per se rather than K-current modulation of Ca-influx is an essential event for lymphocyte proliferation.

Responses of reticulospinal neurons in the lateral reticular nucleus area of the rat to cutaneous noxious and non-noxious stimulation

Response properties of reticulospinal neurons in the lateral reticular nucleus (LRN) area to natural cutaneous stimulation were investigated systematically in 45 urethane-anesthetized rats by using extracellular recording techniques. A total of 64 neurons were tested with peripheral stimuli, of which 19 were responsive only to noxious stimuli; 7 responsive to both noxious and non-noxious stimuli; 4 responsive only to non-noxious stimuli; and 34 not responsive to any cutaneous stimuli. Both the noxious and non-noxious receptive fields were large and bilateral. Among the neurons responding to noxious stimuli, the majority (72%) was excited. This study provides evidence that some reticulospinal neurons in the rat LRN area are involved in the mechanisms of nociception.

The detection of an antibody against IgA allotype A2M 2 and a study of the Am genetic marker among the Han Chinese population

The serum of a woman was found by the Ouchterlony double-diffusion and the hemagglutination inhibition (HAI) methods to have immunoglobulin A (IgA) deficiency. Further investigation using the hemagglutination (HA) test with red cells coated with IgA myeloma proteins of different specificities showed that the serum agglutinated only IgA2-, A2M-1, and A2M 2-coated cells. The patterns of the HAI test with a reference panel confirmed the presence of two specificities. One was anti-IgA2 and the other was a rare antibody against the allotype A2M 2. The anti-A2M 2 was used for population studies. Testing of the Han Chinese population, including family studies, confirms that A2M.1 and A2M.2 have an autosomal dominant mode of inheritance and are controlled by a codominant allele. The distribution of the two Am genetic markers among the Han Chinese population demonstrated A2M.1 with a gene frequency of 0.553 and A2M.2 with a gene frequency of 0.447 (chi 2 = 0.145, 0.80 greater than p greater than 0.70).