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Hsieh SW, Hung KC. Trachway(®) stylet: a perfect tool for nasotracheal intubation? Anaesthesia 2016; 71:724. [PMID: 27158992 DOI: 10.1111/anae.13449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - K C Hung
- E-DA Hospital, Kaohsiung, Taiwan
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Li HK, Tsai PY, Hung KC, Kasai T, Lin KC. Communication: Photodissociation of CH3CHO at 308 nm: Observation of H-roaming, CH3-roaming, and transition state pathways together along the ground state surface. J Chem Phys 2015; 142:041101. [DOI: 10.1063/1.4906457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hou-Kuan Li
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - Po-Yu Tsai
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - Kai-Chan Hung
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - Toshio Kasai
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - King-Chuen Lin
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
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Hung KC, Tsai PY, Li HK, Lin KC. Photodissociation of CH3CHO at 248 nm by time-resolved Fourier-transform infrared emission spectroscopy: Verification of roaming and triple fragmentation. J Chem Phys 2014; 140:064313. [DOI: 10.1063/1.4862266] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Tsai PY, Hung KC, Li HK, Lin KC. Photodissociation of Propionaldehyde at 248 nm: Roaming Pathway as an Increasingly Important Role in Large Aliphatic Aldehydes. J Phys Chem Lett 2014; 5:190-195. [PMID: 26276201 DOI: 10.1021/jz402329g] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Time-resolved Fourier transform infrared emission spectroscopy is employed in the photolysis of propionaldehyde (CH3CH2CHO) at 248 nm to characterize the role of the roaming pathway. High-resolution spectra of CO are analyzed to yield a single Boltzmann rotational distribution for each vibrational level (ν = 1-4) with small rotational and large vibrational energy disposals. A roaming saddle point is found containing two far separated moieties of HCO and CH3CH2 with a weak interaction between them. Quasiclassical trajectory calculations on this configuration yield the CO energy flow behavior, consistent with the findings. The rate constant along the roaming pathway is evaluated to be larger by >1-2 orders of magnitude than those along tight transition state or three-body dissociation pathways. This work implies that the roaming mechanism plays an increasingly important role in aliphatic aldehydes as the molecular size becomes larger.
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Affiliation(s)
- Po-Yu Tsai
- Department of Chemistry, National Taiwan University and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - Kai-Chan Hung
- Department of Chemistry, National Taiwan University and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - Hou-Kuan Li
- Department of Chemistry, National Taiwan University and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
| | - King-Chuen Lin
- Department of Chemistry, National Taiwan University and Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei 106, Taiwan
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Jiang JC, Lin KH, Li SC, Shih PM, Hung KC, Lin SH, Chang HC. Association structures of ionic liquid/DMSO mixtures studied by high-pressure infrared spectroscopy. J Chem Phys 2011; 134:044506. [DOI: 10.1063/1.3526485] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jyh-Chiang Jiang
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan
| | - Kuan-Hung Lin
- Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974, Taiwan
| | - Sz-Chi Li
- Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974, Taiwan
| | - Pao-Ming Shih
- Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974, Taiwan
| | - Kai-Chan Hung
- Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974, Taiwan
| | - Sheng Hsien Lin
- Department of Applied Chemistry, National Chiao Tung University, Hsinchu 30010, Taiwan
- Institute of Atomic and Molecular Sciences, Academia Sinica, P.O. Box 23-166, Taipei 106, Taiwan
| | - Hai-Chou Chang
- Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974, Taiwan
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Chang ST, Chen CL, Chen CC, Hung KC. Clinical events occurrence and the changes of quality of life in chronic haemodialysis patients with dry weight determined by echocardiographic method. Int J Clin Pract 2004; 58:1101-7. [PMID: 15646404 DOI: 10.1111/j.1742-1241.2004.00124.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The maintenance of circulating blood volume within an optimal range is necessary for haemodialysis patients to avoid circulating complications, including over-hydration and dehydration. Inferior vena cava diameter (IVCD) estimation is a non-invasive method to obtain a well correlation with the intravascular fluid status, and it may get a reliable ideal dry weight (DW) for chronic haemodialysis patients. We try to analysis the life quality changes and circulating complication in chronic haemodialysis patients who adjust DW with this tool in comparing with the traditional method. A total of 100 chronic haemodialysis patients, ranging from 26 to 77 years old, were involved in this study. They are randomly divided into study (n = 50) and control group (n= 50). All of them received the IVCD estimation by echocardiography every month for 3 months. The patients in the study group adjusted the DW with the IVCD estimated by echocardiographic method, however, patients in the control group with the traditional method. The quality of life (QOL) was evaluated with the short form 36 questionnaire (SF-36) in the beginning and the end of the study. The scores of physical functioning (PF), role limitation-physical (RP), general health (GH) and role limitation-emotional (RE) have much improvement in the patients of the study group than those in the control group. Besides, the occurrence of clinical events due to circulating complications during the study period showed significant reduction in the extents of hypotension, gastrointestinal upset, discontinuation of haemodialysis, muscular cramps, tinnitus, headache and chest discomforts with electrocardiographic changes; and these effects, especially, are significant in the patients with over-dehydrated status, which with the IVCD < 8 mm/m2 detected by echocardiographic method. The study demonstrated that ideal DW estimated by echocardiographic method not only improved the QOL but also reduced the circulating complications during haemodialysis for chronic haemodialysis patients.
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Affiliation(s)
- S T Chang
- The Divisions of Cardiology, Chia-yi Chang Gung Memorial Hospital, Tauyuan, Taiwan, P.R. China
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Wu HE, Hung KC, Mizoguchi H, Fujimoto JM, Tseng LF. Acute antinociceptive tolerance and asymmetric cross-tolerance between endomorphin-1 and endomorphin-2 given intracerebroventricularly in the mouse. J Pharmacol Exp Ther 2001; 299:1120-5. [PMID: 11714902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Development of tolerance in mice pretreated intracerebroventricularly with mu-opioid receptor agonist endomorphin-1, endomorphin-2, or [D-Ala(2),N-Me-Phe(4),Gly-ol(5)]-enkephalin (DAMGO) was compared between endomorphin-1- and endomorphin-2-induced antinociception with the tail-flick test. A 2-h pretreatment with endomorphin-1 (30 nmol) produced a 3-fold shift to the right in the dose-response curve for endomorphin-1. Similarly, a 1-h pretreatment with endomorphin-2 (70 nmol) caused a 3.9-fold shift to the right for endomorphin-2. In cross-tolerance experiments, pretreatment with endomorphin-2 (70 nmol) caused a 2.3-fold shift of the dose-response curve for endomorphin-1, whereas pretreatment with endomorphin-1 (30 nmol) caused no change of the endomorphin-2 dose-response curve. Thus, mice acutely tolerant to endomorphin-1 were not cross-tolerant to endomorphin-2, although mice made tolerant to endomorphin-2 were partially cross-tolerant to endomorphin-1; an asymmetric cross-tolerance occurred. Pretreatment with DAMGO 3 h before intracerebroventricular injection of endomorphin-1, endomorphin-2, or DAMGO attenuated markedly the antinociception induced by endomorphin-1 and DAMGO but not endomorphin-2. It is proposed that two separate subtypes of mu-opioid receptors are involved in antinociceptive effects induced by endomorphin-1 and endomorphin-2. One subtype of opioid mu-receptors is stimulated by DAMGO, endomorphin-1, and endomorphin-2, and another subtype of mu-opioid receptors is stimulated solely by endomorphin-2.
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Affiliation(s)
- H E Wu
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA
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Hung KC, Su BH, Lin TW, Peng CT, Tsai CH. Glucose-insulin infusion for the early treatment of non-oliguric hyperkalemia in extremely-low-birth-weight infants. Acta Paediatr Taiwan 2001; 42:282-6. [PMID: 11729704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
In order to investigate the status of non-oliguric hyperkalemia and to evaluate glucose-insulin infusion treatment among extremely-low-birth-weight (ELBW) infants, 161 infants weighting less than 1000 gm at birth were enrolled for this study. They were divided into two groups: a hyperkalemic group and a non-hyperkalemic group. Hyperkalemia was defined here as a serum potassium level of greater than 6 mEq/L in a non-hemolyzed arterial blood sample. A glucose-insulin infusion was administered to the patients when hyperkalemia was detected in them during the first few days after birth. The infusion was discontinued when the serum potassium levels had been less than 6 mEq/L and stabilized for 6 hours. The incidence of non-oliguric hyperkalemia among ELBW infants in this study was 58% (93/161). The mean gestational age of neonates was 25.7 +/- 1.8 weeks (hyperkalemic) and 26.6 +/- 1.7 weeks (non-hyperkalemic). The mean rate of increases in serum potassium levels was 0.32 +/- 0.29 mEq/L/hr (hyperkalemic) and 0.13 +/- 0.12 mEq/L/hr (non-hyperkalemic). The incidence of severe intraventricular hemorrhage (IVH) was 19% (18/93) (hyperkalemic) and 4.4% (3/68) (non-hyperkalemic). The incidence of cardiac arrhythmia was 12% (11/93) (hyperkalemic) and 0% (non-hyperkalemic) respectively. Neonates with fewer weeks of gestation at birth and faster increases in serum potassium levels were associated with a more prominent tendency toward hyperkalemia. Hyperkalemia markedly increases the risk of severe IVH and arrhythmia for ELBW infants. A higher glucose infusion rate should be maintained to prevent hypoglycemia following insulin treatment.
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Affiliation(s)
- K C Hung
- Department of Pediatrics, China Medical College Hospital, 2, Yuh Der Road, Taichung 404, Taiwan
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Hsieh IC, Chien CC, Chang HJ, Chern MS, Hung KC, Lin FC, Wu D. Acute and long-term outcomes of stenting in coronary vessel > 3.0 mm, 3.0-2.5 mm, and < 2.5 mm. Catheter Cardiovasc Interv 2001; 53:314-22. [PMID: 11458407 DOI: 10.1002/ccd.1174] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We compared the acute and long-term outcomes of stentings in coronary vessels > 3.0 mm, 3.0-2.5 mm, and < 2.5 mm. A total of 1,152 patients underwent coronary stenting was divided into three groups based on the reference vessel size. Group A consisted of 598 patients (667 lesions) with a reference vessel diameter > 3.0 mm, group B 485 patients (544 lesions) with a reference vessel diameter of 3.0-2.5 mm, and group C 114 patients (119 lesions) with a reference vessel diameter < 2.5 mm. The procedural success, stent thrombosis, and in-hospital cardiac event rate were similar in the three groups. At 6-month angiographic follow-up, the lesion restenotic rate was significantly higher in the small-vessel group (14%, 22%, and 26% in groups A, B, and C, respectively; P = 0.011). These differences appeared to result from a lesser acute gain and a lesser net gain in small-vessel group; the late luminal loss was similar in the three groups. During a follow-up duration of 28 +/- 3 months, group C patients had a significantly lower rate of event-free survival than the group A and B patients (71% vs. 85% and 82%; P = 0.002). Stepwise regression analysis demonstrated that complex lesion (P = 0.032) and long lesion (P = 0.046) are independent predictors of restenosis in very-small-vessel (< 2.5 mm) stenting. In conclusion, the acute results of stenting in small coronary arteries appear safe and feasible with a high procedural success rate and a low incidence of stent thrombosis. Stenting in patients with a small coronary artery appears to have a similar in-hospital cardiac event rate, but a higher angiographic restenosis rate and a lower event-free survival rate, compared to stenting in patients with a larger coronary artery. The predictors of restenosis in very-small-vessel stenting are complex lesions and long lesions. Cathet Cardiovasc Intervent 2001;53:314-322.
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Affiliation(s)
- I C Hsieh
- Second Section of Cardiology, Chang Gung University College of Medicine and Hospital, 199 Tung-Hwa North Road, Tao-Yuan, Taipei, Taiwan
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Abstract
Five new suberosane sesquiterpenes, suberosenol A (1), suberosenol B (2), suberosanone (3), suberosenol A acetate (4), and suberosenol B acetate (5), along with the known sesquiterpene subergorgic acid (6), have been isolated from the gorgonian Isis hippuris. The structures of these metabolites were established by spectroscopic and chemical methods. Metabolites 1 and 3-5 were found to exhibit potent cytotoxicity toward P-388, A549, and HT-29 cancer cell lines.
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Affiliation(s)
- J H Sheu
- Department of Marine Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan 804, Republic of China.
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Hsieh IC, Chang HJ, Chern MS, Hung KC, Lin FC, Wu D. Benefits of late coronary artery stenting in patients with acute myocardial infarction with and without thrombolytic therapy. Chang Gung Med J 2000; 23:738-46. [PMID: 11416894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND There are no added benefits when balloon angioplasty is conducted in conjunction with thrombolytic therapy in patients with acute myocardial infarction. The purpose of this study was to determine whether or not thrombolysis has an impact on the outcome of late coronary artery stenting following acute myocardial infarction. METHODS The outcome of late coronary artery stenting in the infarct-related artery following acute infarction was compared in patients with (68 patients, group A) and without (118 patients, group B) prior thrombolytic therapy. RESULTS The baseline characteristics were similar in the 2 groups except that total occlusion of the infarct-related artery was more common in group B. The angiographic characteristics of the target lesion were similar in the 2 groups; the procedural success rate was 98% in both groups. There was no subacute thrombosis or other complications in either group. The 6-month follow-up coronary angiography and the restenosis rate was 18% in both groups; the reocclusion rate was 2% in group A and 4% in group B. The increment of the left ventricular ejection fraction was similar in both groups (6% versus 7%). During a follow-up duration of 18 +/- 3 months, the mortality rate was 3% versus 2%, reinfarction 0% versus 1%, recurrent angina 6% versus 4%, and target lesion revascularization by angioplasty 13% versus 13% in group A and B patients, respectively. CONCLUSION The outcome of late coronary artery stenting following acute myocardial infarction in patients with and without prior thrombolytic therapy was comparable. Significant improvement of left ventricular function was noted in both groups.
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Affiliation(s)
- I C Hsieh
- Second Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, R.O.C
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Abstract
Tissue plasminogen activator (t-PA) was administered to three patients with newly developed intracardiac thrombi. Cases 1 and 2 developed right heart thrombi after radiofrequency ablation for atrioventricular nodal reentrant tachycardia and case 3 had tachycardia-related cardiomyopathy and a left ventricular thrombus. In all three patients, the intracardiac thrombi were successfully eliminated following t-PA therapy without major bleeding complications. These observations suggest that t-PA is effective in lysing new thrombus complicating radiofrequency ablation or heart failure and may be the therapy of choice in these conditions. Cathet. Cardiovasc. Intervent. 49:91-96, 2000.
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Affiliation(s)
- K H Yeh
- Second Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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Abstract
In the problem of specifying a well-defined wavelet description of a planar closed curve, defining a unique start point on the curve is crucial for wavelet representation. In this paper, a generalized uniqueness property inherent in the one-dimensional (1-D) discrete periodized wavelet transformation (DPWT) is derived. The uniqueness property facilitates a quantitative analysis of the one-to-one mapping between the variation of 1-D DPWT coefficients and the starting point shift of the originally sampled curve data. By employing the uniqueness property, a new shape descriptor called the uniqueness wavelet descriptor (UWD) by which the starting point is fixed entirely within the context of the wavelet representation is proposed. The robustness of the UWD against input noise is analyzed. On the basis of local shape characteristic enhancement, several experiments were conducted to illustrate the adaptability property of the UWD for desirable starting point determination. Our experiments of pattern recognition show that the UWD can provide a supervised pattern classifier with optimal features to obtain the best matching performance in the presence of heavy noise. In addition, the generalized uniqueness property can be used for the shape regularity measurement. The UWD does not have local support and therefore it can not be applied to contour segments.
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Affiliation(s)
- K C Hung
- Department of Electronic Engineering, I-Shou University, Kaohsiung County, Taiwan 84008, ROC.
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Hsieh IC, Chern MS, Chang HJ, Hung KC, Lin FC, Wu D. Clinical and angiographic outcomes are similar with half, single, or multiple contiguous Palmaz-Schatz stent implantations for a single coronary stenosis. Am J Cardiol 1999; 84:970-5. [PMID: 10569648 DOI: 10.1016/s0002-9149(99)00482-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We compared the immediate and 6-month clinical and angiographic outcomes in patients undergoing a half, a single, or multiple contiguous stent implantations for a single coronary stenosis. Four hundred forty-three consecutive patients, who underwent elective Palmaz-Schatz stent implantations for 542 stenoses between November 1995 and July 1998, were analyzed. Sixty-three patients with 78 stenoses received a half stent (group A), 346 patients with 395 stenoses received a single stent (group B), and 68 patients with 69 stenoses received multiple overlapping stents (group C) for a single coronary stenosis. Seventy-eight half stents were implanted in 78 stenoses in group A, 395 stents in 395 stenoses in group B, and 141 stents in 69 stenoses in group C. The baseline characteristics were similar in the 3 groups. There were no deaths, no subacute thrombosis, and no vascular complications. Forty-nine patients with 57 stenoses in group A, 280 patients with 326 stenoses in group B, and 59 patients with 60 stenosis in group C underwent 6-month follow-up coronary angiography; the restenotic rate per patient was 10% in group A, 20% in group B, and 24% in group C (NS); the restenotic rate per stenosis was 9% in group A, 18% in group B, and 23% in group C (NS). Follow-up of 18 +/- 3 months revealed no differences in mortality, reinfarction, recurrent angina, target narrowing angioplasty, and elective coronary artery bypass surgery among the 3 groups. The overall cardiac event-free survival was 90%, 82%, and 83% in groups A, B, and C, respectively (p = 0.275). Thus, the procedural success rate, the in-hospital morbidity, and the long-term outcome are similar with coronary stenting using a half, a single, or multiple overlapping Palmaz-Schatz stents for a single stenosis.
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Affiliation(s)
- I C Hsieh
- Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
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Hung KC, Lin FC, Chern MS, Chang HJ, Hsieh IC, Wu D. Mechanisms and clinical significance of transient atrioventricular block during dobutamine stress echocardiography. J Am Coll Cardiol 1999; 34:998-1004. [PMID: 10520781 DOI: 10.1016/s0735-1097(99)00306-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the possible mechanism and the clinical significance of transient atrioventricular block (AVB) during dobutamine stress echocardiography (DSE). BACKGROUND Transient AVB occurs rarely during DSE; however, the mechanisms responsible for blocks are unclear. METHODS A retrospective analysis of clinical, echocardiographic, catheterization, revascularization and head-up tilting test data was conducted in patients who developed transient AVB during DSE. RESULTS A total of 302 patients with known or suspected coronary artery disease (CAD) underwent DSE before coronary angiography between November 1997 and August 1998. Transient AVB developed in 12 patients during the test. Mobitz I block was noted in six patients and Mobitz II block in the other six patients. Nine of these 12 patients were subsequently shown to have CAD and three had no significant coronary artery stenosis. Mobitz II block was observed only in patients with CAD, while Mobitz I block occurred in three patients with and three patients without CAD (p < 0.05). Eight of the nine patients with CAD underwent a successful coronary angioplasty with or without stenting and a repeat DSE revealed no recurrence of heart block except in one patient. Head-up tilting test in the 12 patients revealed a positive response in three of the nine patients with and all three patients without CAD. A negative head-up tilting test was likely to be observed in patients with, as compared with those without, CAD in this study population (p < 0.05). CONCLUSIONS Transient AVB is not an infrequent manifestation during DSE. Both myocardial ischemia and neurally mediated vagal reflex may be responsible for this phenomenon. The development of Mobitz II block during DSE is indicative of the presence of CAD. A successful revascularization in patients with CAD who develop transient AVB may abolish this phenomenon.
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Affiliation(s)
- K C Hung
- Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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Hung MJ, Lin FC, Cherng WJ, Wang CH, Hung KC, Hsieh IC, Wen MS, Wu D. Comparison of antihypertensive efficacy and tolerability of losartan and extended-release felodipine in patients with mild to moderate hypertension. J Formos Med Assoc 1999; 98:403-9. [PMID: 10443063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
Appropriate control of blood pressure has been shown to reduce morbidity and mortality in patients with hypertension. Losartan potassium, a selective antagonist of the angiotensin II type 1 (AT1) receptor, has been shown to lower blood pressure in patients with hypertension. The purpose of this study was to compare the efficacy and tolerability of losartan and extended-release (ER) felodipine in Taiwanese patients with mild to moderate hypertension. Patients with mild to moderate hypertension (sitting diastolic blood pressure, 95-115 mm Hg) were enrolled in this prospective, randomized, parallel study. Sitting blood pressure, heart rate, adverse reactions, and serum biochemistry values were assessed during 2 weeks of placebo and 12 weeks of active treatment. Each patient received 50 mg of losartan or 5 mg of felodipine ER once daily, and the dosage was adjusted to double the initial level at week 6 if necessary. Of the 44 patients randomly allocated to receive losartan (n = 23) or felodipine (n = 21) therapy, 37 completed the study; three patients in the losartan group and four in the felodipine group withdrew because of adverse experiences, or were lost to follow-up. The mean reductions in sitting diastolic blood pressure at 6 and 12 weeks were significant with both losartan (-8.6 and -11.38 mm Hg, respectively) and felodipine (-9.2 and -10.69 mm Hg, respectively), and did not differ significantly between the two groups. Both losartan and ER felodipine were well tolerated by patients. However, the ER felodipine group had a significantly higher rate of drug-related flushing than the losartan group (24% vs 0%, p = 0.022). The results indicate that once-daily administration of losartan is as effective and well tolerated as once-daily ER felodipine in blood pressure reduction.
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Affiliation(s)
- M J Hung
- Department of Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
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Huang HL, Lin FC, Hung KC, Wang PN, WU D. Hemolytic anemia in native valve infective endocarditis: a case report and literature review. Jpn Circ J 1999; 63:400-3. [PMID: 10943622 DOI: 10.1253/jcj.63.400] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hemolytic anemia is a rare manifestation of infective endocarditis. A 19-year-old man with a small ventricular septal defect developed right-sided infective endocarditis with huge vegetations involving the tricuspid valve, the ventricular septal defect, and the pulmonary valve. Intravascular hemolysis was suggested by the presence of numerous fragmented erythrocytes, giant platelets and polychromasia of the red blood cells. The direct Coombs test was positive, and there were spherocytes and splenomegaly, findings that suggested an immune-mediated mechanism also played a role in the hemolysis. The hematological picture persisted despite antibiotic therapy and recovered only after surgical removal of the vegetations, tricuspid and pulmonary valvectomy, and patch closure of the ventricular septal defect.
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Affiliation(s)
- H L Huang
- Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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Abstract
Matrix-assisted laser desorption/ionization mass spectrometry of DNA and proteins, directly deposited on the poly(tetrafluoroethylene) (Teflon) surface, is demonstrated. For DNA analysis, this technique apparently produces a more homogeneous coverage of the matrix/DNA over the sample surface. Moreover, it enhances the sensitivity and salt tolerance. As described here, this technique can also achieve an excellent mass resolution, similar to that observed using a metal probe for DNA up to 62mer. We also examined the use of Teflon as a sample support for protein analysis since Teflon has been used as a transfer membrane. Less than 25 fmol of myoglobin has been detected with this technique. In addition, effective MALDI-TOF analysis of salt-contaminated protein samples can also be accomplished by loading the protein sample onto Teflon, followed by steps of washing away salts, adding the matrix, and desorbing sample directly from Teflon.
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Affiliation(s)
- K C Hung
- Department of Chemistry, Cleveland State University, Ohio 44115, USA
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20
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Abstract
BACKGROUND The safety and efficacy of late coronary artery stenting of the infarct-related artery after acute infarction has not been evaluated previously. METHODS AND RESULTS Coronary artery stenting was performed in 117 consecutive patients with acute infarction who were receiving ticlopidine/aspirin regimen without coumarin. There were 97 men and 18 women, aged 58+/-11 (mean +/- SD) years. A total of 136 Palmaz-Schatz stents were successfully implanted in 130 lesions 15+/-8 days after acute myocardial infarction (median 9 days) in 115 of 117 (98%) patients. The minimal luminal diameter (MLD) increased from 0.66+/-0.46 to 3.14+/-0.53 mm (P< .001), with an acute gain of 2.49+/-0.61 mm. One patient had acute thrombosis requiring further stenting and another patient received emergency bypass surgery. There was no subacute thrombosis or other complications. During a follow-up duration of 14+/-3 months, 2 patients had angina pectoris develop and 1 died suddenly. Sixty-two patients underwent a follow-up coronary angiography 195+/-36 days after stenting. Restenosis was noted in 8 patients (13%); the MLD was 2.19+/-0.73 mm, the late loss was 0.96+/-0.65 mm (P< .001), the loss index was 0.39+/-0.28, and the net gain was 1.56+/-0.79 mm (P< .001). The angiographic left ventricular ejection fraction increased from 47%+/-12% to 55%+/-12% (P< .001). CONCLUSIONS Late coronary stenting of the infarct-related artery in patients with acute myocardial infarction is a safe and effective late reperfusion therapy and may be beneficial to the patients.
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Affiliation(s)
- I C Hsieh
- Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan, Republic of China
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21
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Abstract
Poor detection limits and strong salt effects are two of the main problems encountered in the matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometric analysis of DNA. This work demonstrates that a probe tip with a paraffin wax film (Parafilm) surface improves the MALDI performance in DNA analysis compared to the commonly used metal surface. First, the use of Parafilm increases the detection sensitivity. It was found that the detection limit achieved with Parafilm was 5 times better than that obtained using stainless steel for a 85mer. More importantly, the Parafilm method could improve detection of larger DNA components in the presence of a large excess of a smaller DNA component or in a DNA mixture. This feature is important to analyses of PCR and sequencing products. Second, we found that the use of Parafilm increased the salt tolerance limits for the 17-, 41-, and 85mers studied in this work and that the salt effect was less sensitive to the DNA size. Third, this method offers other analytical benefits, including producing a more homogeneous coverage of matrix/DNA, adding no extra cost and time to sample preparation, and eliminating the commonly required step for cleaning the probe after analysis. In this paper, we will also present our perspectives on why the use of Parafilm can improve the MALDI-TOF performance in DNA analysis.
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Affiliation(s)
- K C Hung
- Department of Chemistry, Cleveland State University, Ohio 44115, USA
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22
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Abstract
A forty-eight-year-old man with a history of pulmonary tuberculosis and scarring of both hila and upper lobes was noted to have bilateral pulmonary pseudosequestration, in which the blood supply originated from a coronary artery fistulous vessel arising from the left circumflex artery and draining into the pulmonary artery. This is the first reported patient with the source of blood supply to the pulmonary pseudosequestration arising from a coronary artery fistula.
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Affiliation(s)
- K C Hung
- Department of Medicine, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan
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