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Hwang D, Liu X, Kote A, Reaso J, Andersson T, Shehata MM, Ehdaie A, Wang X, Cingolani E, Ramireddy A, Braunstein ED, Chen LS, Li X, Goldhaber J, Chen PS. Sympathetic toggled paroxysmal atrial fibrillation and recurrent premature atrial contractions in ambulatory patients. Heart Rhythm 2024:S1547-5271(24)02571-2. [PMID: 38762134 DOI: 10.1016/j.hrthm.2024.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/01/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Autonomic nerve activity is important in the mechanisms of paroxysmal atrial fibrillation (PAF). OBJECTIVE To test the hypothesis that a single burst of skin sympathetic nerve activity (SKNA) can toggle on and off PAF or premature atrial contraction (PAC) clusters. METHODS We performed neuECG recording over 7 days in patients with PAF. RESULTS In Study 1, we found 8 patients (7 men, 1 woman, 62±8 years) had 124 episodes of PAF. An SKNA burst toggled both on and off PAF in 8 (6.5%) episodes (Type 1), toggled on but not off in 12 (9.7%) episodes (Type 2), and toggled on a PAC cluster, followed by PAF in 4 (3.2%) episodes (Type 3). The duration of these PAF episodes was < 10 min. The remaining 100 (80.6%) episodes were associated with active SKNA bursts throughout PAF (Type 4) and lasted longer than Type 1 (p=0.0185) and Type 2 (p=0.0027) PAF. There were 47 PAC clusters. Among them, 24 (51.1%) were toggled on and off, and 23 (48.9%) were toggled on but not off by an SKNA burst. In Study 2, we found 17 patients (9 men, 8 women, 58±12 years) with < 10 min PAF (4, 8, 0, and 31 of Types 1-4, respectively). There were significant circadian variations of all types of PAF. CONCLUSIONS A single SKNA burst can toggle short-duration PAF and PAC cluster episodes on and off. The absence of continued SKNA after the onset might have affected the maintenance of these arrhythmias.
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Affiliation(s)
- Daerin Hwang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Xiao Liu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Anxhela Kote
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Jewel Reaso
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Taiga Andersson
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Michael M Shehata
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Ashkan Ehdaie
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Xunzhang Wang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Eugenio Cingolani
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Archana Ramireddy
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Eric D Braunstein
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Lan S Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Xiaochun Li
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN
| | - Joshua Goldhaber
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California 90095
| | - Peng-Sheng Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
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Wang B, Fei X, Yin HF, Xu XN, Zhu JJ, Guo ZY, Wu JW, Zhu XS, Zhang Y, Xu Y, Yang Y, Chen LS. Photothermal-Controllable Microneedles with Antitumor, Antioxidant, Angiogenic, and Chondrogenic Activities to Sequential Eliminate Tracheal Neoplasm and Reconstruct Tracheal Cartilage. Small 2024; 20:e2309454. [PMID: 38098368 DOI: 10.1002/smll.202309454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Indexed: 03/16/2024]
Abstract
The optimal treatment for tracheal tumors necessitates sequential tumor elimination and tracheal cartilage reconstruction. This study introduces an innovative inorganic nanosheet, MnO2 /PDA@Cu, comprising manganese dioxide (MnO2 ) loaded with copper ions (Cu) through in situ polymerization using polydopamine (PDA) as an intermediary. Additionally, a specialized methacrylic anhydride modified decellularized cartilage matrix (MDC) hydrogel with chondrogenic effects is developed by modifying a decellularized cartilage matrix with methacrylic anhydride. The MnO2 /PDA@Cu nanosheet is encapsulated within MDC-derived microneedles, creating a photothermal-controllable MnO2 /PDA@Cu-MDC microneedle. Effectiveness evaluation involved deep insertion of the MnO2 /PDA@Cu-MDC microneedle into tracheal orthotopic tumor in a murine model. Under 808 nm near-infrared irradiation, facilitated by PDA, the microneedle exhibited rapid overheating, efficiently eliminating tumors. PDA's photothermal effects triggered controlled MnO2 and Cu release. The MnO2 nanosheet acted as a potent inorganic nanoenzyme, scavenging reactive oxygen species for an antioxidant effect, while Cu facilitated angiogenesis. This intervention enhanced blood supply at the tumor excision site, promoting stem cell enrichment and nutrient provision. The MDC hydrogel played a pivotal role in creating a chondrogenic niche, fostering stem cells to secrete cartilaginous matrix. In conclusion, the MnO2 /PDA@Cu-MDC microneedle is a versatile platform with photothermal control, sequentially combining antitumor, antioxidant, pro-angiogenic, and chondrogenic activities to orchestrate precise tracheal tumor eradication and cartilage regeneration.
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Affiliation(s)
- B Wang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - X Fei
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - H F Yin
- Department of Infection Management, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - X N Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - J J Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Z Y Guo
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - J W Wu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - X S Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Y Zhang
- Department of Orthopedics, Shanghai Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Y Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Y Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
- Central Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
- School of Materials Science and Engineering, Tongji University, Shanghai, 201804, China
| | - L S Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
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Tsai W, Hung TC, Kusayama T, Han S, Fishbein MC, Chen LS, Chen PS. Autonomic Modulation of Atrial Fibrillation. JACC Basic Transl Sci 2023; 8:1398-1410. [PMID: 38094692 PMCID: PMC10714180 DOI: 10.1016/j.jacbts.2023.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 01/13/2024]
Abstract
The autonomic nervous system plays a vital role in cardiac arrhythmias, including atrial fibrillation (AF). Therefore, reducing the sympathetic tone via neuromodulation methods may be helpful in AF control. Myocardial ischemia is associated with increased sympathetic tone and incidence of AF. It is an excellent disease model to understand the neural mechanisms of AF and the effects of neuromodulation. This review summarizes the relationship between autonomic nervous system and AF and reviews methods and mechanisms of neuromodulation. This review proposes that noninvasive or minimally invasive neuromodulation methods will be most useful in the future management of AF.
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Affiliation(s)
- Wei–Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tien-Chi Hung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Takashi Kusayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences Kanazawa, Kanazawa, Japan
| | - Seongwook Han
- Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Michael C. Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA
| | - Lan S. Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Peng-Sheng Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Liu X, Rosenberg C, Reaso JN, Lee AM, Ricafrente J, Ebinger JE, Chen LS, Li X, Bairey Merz CN, Rader F, Chen PS. Skin sympathetic nerve activity and nocturnal blood pressure nondipping in patients with postural orthostatic tachycardia syndrome. J Hypertens 2023; 41:1290-1297. [PMID: 37195245 PMCID: PMC10330228 DOI: 10.1097/hjh.0000000000003465] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Postural orthostatic tachycardia syndrome (POTS) is associated with abnormal blood pressure (BP) regulation and increased prevalence of nocturnal nondipping. We hypothesized that nocturnal nondipping of BP is associated with elevated skin sympathetic nerve activity (SKNA) in POTS. METHOD We used an ambulatory monitor to record SKNA and electrocardiogram from 79 participants with POTS (36 ± 11 years, 72 women), including 67 with simultaneous 24-h ambulatory BP monitoring. RESULTS Nocturnal nondipping of BP was present in 19 of 67 (28%) participants. The nondipping group had a higher average SKNA (aSKNA) from midnight of day 1 to 0100 h on day 2 than the dipping group ( P = 0.016, P = 0.030, respectively). The differences (Δ) of aSKNA and mean BP between daytime and night-time were more significant in the dipping group compared with the nondipping group (ΔaSKNA 0.160 ± 0.103 vs. 0.095 ± 0.099 μV, P = 0.021, and Δmean BP 15.0 ± 5.2 vs. 4.9 ± 4.2 mmHg, P < 0.001, respectively). There were positive correlations between ΔaSKNA and standing norepinephrine (NE) (r = 0.421, P = 0.013) and the differences between standing and supine NE levels ( r = 0.411, P = 0.016). There were 53 (79%) patients with SBP less than 90 mmHg and 61 patients (91%) with DBP less than 60 mmHg. These hypotensive episodes were associated with aSKNA of 0.936 ± 0.081 and 0.936 ± 0.080 μV, respectively, which were both significantly lower than the nonhypotensive aSKNA (1.034 ± 0.087 μV, P < 0.001 for both) in the same patient. CONCLUSION POTS patients with nocturnal nondipping have elevated nocturnal sympathetic tone and blunted reduction of SKNA between day and night. Hypotensive episodes were associated with reduced aSKNA.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Carine Rosenberg
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jewel N. Reaso
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Andrew M. Lee
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Joselyn Ricafrente
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Joseph E. Ebinger
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Lan S. Chen
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Xiaochun Li
- Biostatistics and Health Data Science, Indiana University
School of Medicine, Indianapolis, IN
| | - C. Noel Bairey Merz
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
- Barbra Streisand Women’s Heart Center, Smidt Heart
Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Florian Rader
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Peng-Sheng Chen
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
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5
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Xu MM, Chen LS, Peng YQ, Sheng XL, Liang L, Gong XX, Huang SL, Zhang B. [Asymptomatic pyriform sinus fistula misdiagnosed as thyroid cancer: report of 3 cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:492-495. [PMID: 37150997 DOI: 10.3760/cma.j.cn115330-20230111-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Affiliation(s)
- M M Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - L S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Y Q Peng
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - X L Sheng
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - L Liang
- Department of Otorhinolaryngology, Guangzhou First People's Hospital, Guangzhou 510515, China
| | - X X Gong
- Department of Otorhinolaryngology Head and Neck Surgery, People's Hospital of Yuxi City, Yuxi 653100, China
| | - S L Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - B Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
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6
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Hwang D, Liu X, Rosenberg C, Lee A, Borle S, Ricafrente JQ, Wei J, Shufelt C, Chen LS, Li X, Goldhaber JI, Bairey Merz CN, Chen PS. Sympathetic toggled sinus rate acceleration as a mechanism of sustained sinus tachycardia in chronic orthostatic intolerance syndrome. Heart Rhythm 2022; 19:2086-2094. [PMID: 35995322 DOI: 10.1016/j.hrthm.2022.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of sympathetic nerve activity to maintain sinus rate acceleration remains unclear. OBJECTIVE The purpose of this study was to test the hypothesis that sustained (>30 seconds) sinus rate acceleration can be associated with either a sympathetic driven or a sympathetic toggled mechanism. METHODS We used a patch monitor to record skin sympathetic nerve activity (SKNA) and electrocardiogram over 24 hours. Study 1 included chronic orthostatic intolerance (OI) (n = 18), atrial fibrillation (n = 7), and asymptomatic normal control (n = 19) groups. Study 2 included 17 participants with chronic OI not treated with ivabradine, pyridostigmine, or β-blockers. RESULTS While a majority of sinus rate acceleration was driven by persistent SKNA in study 1, some episodes were toggled on and off by SKNA bursts without persistent SKNA elevation. The sympathetic toggled sinus rate acceleration episodes were found in 7 of 18 participants with chronic OI (39%), 2 of 7 participants with atrial fibrillation (29%), and 6 of 19 normal control participants (32%) (P = .847) and were faster and longer in the chronic OI group than in other groups. In study 2, there were a total of 11 episodes of sinus rate acceleration that persisted for >200 seconds. Among these episodes, 6 (35%) were toggled on and off by SKNA bursts. CONCLUSION Sustained sinus rate acceleration (may be toggled on or off) is associated with SKNA bursts in participants with chronic OI, participants with atrial fibrillation, and normal controls. Patients with OI had more frequent and longer episodes than did other groups.
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Affiliation(s)
- Daerin Hwang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Xiao Liu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Carine Rosenberg
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Andrew Lee
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Sanjana Borle
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Joselyn Q Ricafrente
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Janet Wei
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Chrisandra Shufelt
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida
| | - Lan S Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Xiaochun Li
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Joshua I Goldhaber
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - C Noel Bairey Merz
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Peng-Sheng Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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7
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Jin KQ, Shen YR, Wu YM, Dai J, Liu XG, Li JQ, Chen LS, Jiang GN. [Association between the presence of solid or micropapillary components and survival outcome in stage ⅠA lung adenocarcinoma cases: a retrospective cohort study]. Zhonghua Wai Ke Za Zhi 2022; 60:587-592. [PMID: 35658347 DOI: 10.3760/cma.j.cn112139-20220225-00084] [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: 06/15/2023]
Abstract
Objectives: To examine the influence of the proportion of pathological subtypes on the prognosis of stage ⅠA lung adenocarcinoma cases, and to explore the association between the presence/absence of solid or micropapillary (S/M) components and survival outcome. Methods: Totally 321 patients with stage ⅠA lung adenocarcinoma who received complete surgical resection at Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital from January 2011 to December 2013 were retrospectively analyzed. There were 130 males and 191 females, aging 59(11) years (M(IQR)) (range: 55 to 66 years). The diagnostic value of the proportion of each pathological growth subtype on relapse-free survival (RFS) and overall survival (OS) were analyzed by using receiver operator characteristic curve. Patients were firstly divided into two groups according to the presence or absence of S/M components. And patients without S/M components were farther divided into two groups according to predominant growth pattern. There were three groups in total: with S/M components (group S/M+), without S/M components and lepidic growth pattern predominant (group S/M-LPA), without S/M components and papillary or acinar growth pattern predominant (group S/M-P/A). Kaplan-Meier method were used to draw the survival curves of the three groups, and Log-rank test were used to compare RFS and OS among the three groups. Cox proportional risk model was used to verify whether the presence of S/M components was a prognostic factor on RFS. Results: The proportion of S/M components had no diagnostic value for recurrence (solid: area under curve (AUC)=0.588, P=0.095; micropapillary: AUC=0.566, P=0.106) and death (AUC=0.589, P=0.104; AUC=0.607, P=0.056). The 5-year RFS rate of group S/M-LPA, S/M-P/A and S/M+ were 92.4%, 82.3% and 77.3%, respectively (all P<0.05), while the 5-year OS rate were 97.4%, 94.5% and 83.2%, respectively (all P<0.05). Multivariable analysis showed that the 3 groups were independent predictors of recurrence (S/M-P/A vs. S/M- LPA: HR=2.691, 95%CI: 1.249 to 5.799, P=0.011; S/M+ vs. S/M-LPA, HR=6.763, 95%CI: 3.050 to 14.996, P<0.01). Conclusions: The proportion of S/M components in stage ⅠA lung adenocarcinoma with complete resection cases did not affect survival outcome. New grouping method based on the presence or absence of S/M components were significantly associated with patient survival outcomes: S/M+ patients had the worst prognosis and S/M-LPA patients had the best prognosis.
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Affiliation(s)
- K Q Jin
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Y R Shen
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Y M Wu
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - J Dai
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - X G Liu
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - J Q Li
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - L S Chen
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - G N Jiang
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, China
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Bhavnani CD, Fong AYY, Koh KT, Oon YY, Tan CT, Chen LS, Pang IX, Said AB, Ho KH, Shu FEP, Ling HS, Cham YL, Thien LK, Chung BK, Ong TK. Performance and 12 month outcomes of a wire free fractional flow reserve system for assessment of coronary artery disease, first experience in south east asia. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Fractional flow reserve (FFR) using an invasive pressure wire has a Class 1A recommendation for guiding coronary revascularization in stable coronary artery disease (CAD). Angiography based ‘wire free’ FFR is an emerging technique which determines the physiological significance of a coronary lesion without requirement of a pressure wire or induction of hyperemia. It also eliminates potential complications associated with introduction of wires into the coronary arteries.
Objective
To assess the 12-month clinical outcomes of PCI deferral, guided by an angiography based fractional flow reserve (CAFFR) system. The primary end point was a composite of death from any cause, myocardial infarction (MI) or target vessel revascularization (TVR)
Methods
This was a prospective, single center study involving 69 patients (93 vessels) with angiographic stenosis of 30%-90%. Patients with CAFFR of <0.80 or poor image quality were excluded leaving 29 patients (31 vessels) for analysis. All recruited patients had a CAFFR >0.80 and thus, PCI deferral.
Wired FFR was done for comparison on 14 patients (48%) at the operator’s discretion.
Results
The mean age was 59 ± 12.6 years old. Majority of patients (83%) were male. 12 (42%) patients were diabetic, 18 (62%) were hypertensive, 17 (59%) had dyslipidemia and 18 (62%) had a smoking history. The mean LVEF was 52+/-11.4%. 72% of the patients had a recent acute coronary syndrome. We assessed the LAD artery in 15 (52%) vessels. The mean CAFFR and FFR was 0.87 ± 0.04 and 0.89 ± 0.05 respectively. The values showed agreement with each other with no statistically significant proportional bias on the Bland Altman plot (linear regression t test: t=-1.19, p = 0.257). CAFFR values >0.80 showed 100% correspondence to negative FFR values (>0.80). There were zero procedural complications from CAFFR measurement.
At 12 months, all 29 patients were alive. Only 1 patient (3.4%) met the primary end point (TVR for angina). 89.6% (26) patients remained in CCS class 1 on follow up.
Conclusion
CAFFR shows good agreement with wired FFR. The 12-month outcome data shows that CAFFR guided PCI deferral is safe and comparable to the gold standard of wired FFR guided PCI deferral. Further analysis with a larger patient pool and longer follow-up is warranted. Abstract Figure. Bland-Altman plot of FFR and CAFFR
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Affiliation(s)
| | | | - K T Koh
- Sarawak Heart Center, Kuching, Malaysia
| | - Y Y Oon
- Sarawak Heart Center, Kuching, Malaysia
| | - C T Tan
- Sarawak Heart Center, Kuching, Malaysia
| | - L S Chen
- Sarawak Heart Center, Kuching, Malaysia
| | - I X Pang
- Sarawak Heart Center, Kuching, Malaysia
| | - A B Said
- University Malaysia Sarawak (UNIMAS), Kuching, Malaysia
| | - K H Ho
- Sarawak Heart Center, Kuching, Malaysia
| | - F E P Shu
- Sarawak Heart Center, Kuching, Malaysia
| | - H S Ling
- University Malaysia Sarawak (UNIMAS), Kuching, Malaysia
| | - Y L Cham
- Sarawak Heart Center, Kuching, Malaysia
| | - L K Thien
- Sarawak Heart Center, Kuching, Malaysia
| | - B K Chung
- Sarawak Heart Center, Kuching, Malaysia
| | - T K Ong
- Sarawak Heart Center, Kuching, Malaysia
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Bhavnani CD, Koh KT, Oon YY, Pang IX, Tan CT, Chen LS, Shu FEP, Ho KH, Cham YL, Ling HS, Said A, Thien LK, Chung BK, Fong AYY, Ong TK. Three year clinical outcomes of fractional flow reserve guided coronary revascularization using a monorail pressure sensor microcatheter. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Fractional flow reserve (FFR) has a Class 1A recommendation for guiding coronary revascularization in stable coronary artery disease. Deferral of revascularization for coronary stenosis of FFR >0.80 has shown favorable long-term outcomes, yet the adoption in real-world practice is limited. To date, there is no study on FFR guided PCI in the Malaysian population.
Objective
(1) To explore the 3-year clinical outcome of FFR guided coronary revascularization.
(2) To compare the clinical outcome of FFR guided deferral of coronary revascularization versus FFR guided revascularization. The primary outcome was a composite of all cause mortality, non fatal myocardial infarction (MI) and ischemia driven target vessel revascularization (TVR)
Results
Thirty-five patients were lost to follow up leaving 78 patients (95 vessels) for final analysis. The mean age was 59.3 ± 9.4 years old. 69 (88.5%) patients were male, 24 (30.7%) had diabetes mellitus, 58 (74.3%) had dyslipidemia, 61 (78.2%) had hypertension and 45 (57.7%) were smokers. The mean LVEF was 56.7 ± 14.7%. FFR to the LAD artery was performed in 64 (82%) patients. Based on the FFR value of 0.80, 47 (60.2%) patients had FFR guided deferral of coronary revascularization and 31 (39.7%) patients had FFR guided revascularization.
At 3 years, 11 (14.1%) patients met the primary outcome, mainly driven by all-cause mortality (11.5%). The primary outcome was met in 14.9% of FFR guided deferral versus 12.9% of FFR guided revascularization (p = 0.828). All-cause mortality was 12.7% in patients with FFR guided deferral compared to 9.7% in patients with FFR guided revascularization at 3 years (p = 0.712).
Cox proportional hazards model did not demonstrate any independent predictors associated with the primary outcome or all cause mortality.
Conclusion
FFR guided deferral of revascularization was safe and had comparable long-term clinical outcomes to FFR guided PCI. To our knowledge, this is the first study on long-term clinical outcome on FFR guided revascularization in Malaysia. Abstract Figure. Kaplan-Meier curve primary end point Abstract Figure. Kaplan-Meier curve all cause mortality
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Affiliation(s)
| | - K T Koh
- Sarawak Heart Center, Kuching, Malaysia
| | - Y Y Oon
- Sarawak Heart Center, Kuching, Malaysia
| | - I X Pang
- Sarawak Heart Center, Kuching, Malaysia
| | - C T Tan
- Sarawak Heart Center, Kuching, Malaysia
| | - L S Chen
- Sarawak Heart Center, Kuching, Malaysia
| | - F E P Shu
- Sarawak Heart Center, Kuching, Malaysia
| | - K H Ho
- Sarawak Heart Center, Kuching, Malaysia
| | - Y L Cham
- Sarawak Heart Center, Kuching, Malaysia
| | - H S Ling
- University Malaysia Sarawak (UNIMAS), Kuching, Malaysia
| | - A Said
- University Malaysia Sarawak (UNIMAS), Kuching, Malaysia
| | - L K Thien
- Sarawak Heart Center, Kuching, Malaysia
| | - B K Chung
- Sarawak Heart Center, Kuching, Malaysia
| | | | - T K Ong
- Sarawak Heart Center, Kuching, Malaysia
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Huang SL, Chen LS, Xu MM, Gong XX, Zhang B, Liang L, Sheng XL, Zhan JD, Luo XN, Lu ZM, Zhang SY. [A comparison between endoscopic CO 2 laser cauterization and open neck surgery in the treatment of congenital piriform fistula]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:619-625. [PMID: 34256487 DOI: 10.3760/cma.j.cn115330-20200805-00647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the efficacy, advantages and disadvantages of endoscopic CO2 laser cauterization (ECLC) and open neck surgery in the treatment of congenital pyriform sinus fistula (CPSF). Methods: From September 2014 to March 2017, 80 cases with confirmed diagnosis of CPSF received initial treatment at Guangdong Provincial People's Hospital were prospectively analyzed, including 34 males and 46 females, aged 18 to 672 (194.17±141.18) months. They were consecutively divided into endoscopic group and open-surgery group, with 40 cases in each group. Both groups of patients received surgical treatment under general anesthesia. The endoscopic group was treated by endoscopic CO2 laser cauterization, and the open-surgery group underwent the following surgery: first, we performed suspension laryngoscopy examination to confirm the presence of fistula in the bottom of the piriform fossa, then open-neck resection of congenital piriform sinus fistula with recurrent laryngeal nerve and/or lateral branch of superior laryngeal nerve anatomy plus partial thyroidectomy were performed. The data between the two groups were compared, including the operative time, intraoperative blood loss, postoperative pain, average length of stay, neck cosmetic scores, complications and cure rates. All patients were followed up in outpatient clinics. Statistical analysis was performed using SPSS 20.0 software. P<0.05 indicates that the difference is statistically significant. Results: All patients were successfully completed the operation. The operative time, intraoperative blood loss, postoperative pain and average length of hospital stay in the endoscopic group were significantly less than those in the open group [(27.4±5.5) min to (105.8±52.5) min, (0.6±0.5) ml to (33.6±41.5) ml, (1.7±0.9) points to (4.6±0.7) points, (5.9±2.9)d to(8.9±3.3)d, t values were-9.400, -5.031, -16.199, -4.293, P values were all<0.01]; The neck cosmetic score in the endoscopy group was significantly greater than that of the open group [(9.9±0.4) against (5.8±0.9) points, t=25.847, P<0.01]. Compared with the open group (15.0%, 6/40), the complication rate of the endoscopic group (7.5%, 3/40) was not statistically significant (χ²=0.50, P>0.05). Three months after the first treatment, the cure rate in the endoscopic group (82.5%, 33/40) was significantly lower than that in the open-neck group (100.0%, 40/40), χ²=5.64, P<0.05. The follow-up time was 12 months after the last treatment. Eighty cases were followed up and none was lost to follow-up. During the follow-up period, the cure rate of the endoscopy group (97.5%, 39/40) was compared with that of the open group (100.0%, 40/40), and the difference was not statistically significant. Conclusions: In the treatment of CPSF, the two-surgical method each has their advantages. Compared with open-neck surgery, ECLC is simpler, repeatable. ECLC has shorter time in operation and hospital stay, less complications, and less postoperative pain and more precise cosmetic results. It could be preferred for the initial treatment of CPSF and relapsed cases after cauterization. But subject to relatively low cure rate of one-time cauterization and uncertain long-term efficacy, it cannot completely replace the open-neck surgery at present.
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Affiliation(s)
- S L Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - L S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - M M Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - X X Gong
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - B Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
| | - L Liang
- Department of Otorhinolaryngology, Nansha Hospital of Guangzhou First People's Hospital, Guangzhou 510515, China
| | - X L Sheng
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - J D Zhan
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - X N Luo
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Z M Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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11
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Li XB, Zhao F, Ding CL, Li LL, Chen LS. Application of Chrysomya rufifacies (Diptera, Calliphoridae) to Postmortem Interval Estimation in Southwest China: A Case Report. Fa Yi Xue Za Zhi 2021; 37:338-343. [PMID: 34379902 DOI: 10.12116/j.issn.1004-5619.2020.400314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Indexed: 06/13/2023]
Abstract
Insect samples found on human corpses can provide the information important to estimating the minimum postmortem interval (PMImin). A female cadaver, found in a deserted factory in Chongqing of China, was confirmed as a homicide case after the forensic investigation and autopsy. Determining the time of death was difficult due to the inconsistent degree of decomposition in different parts of the decedent. The insect specimens found on the cadaver were identified to be Chrysomya rufifacies (C. rufifacies, Macquart) by morphology and mitochondrial DNA sequence analysis. The PMImin was estimated to be 452 h, based on the developmental rate of C. rufifacies. The PMImin was estimated successfully to be almost precise, which provided an important entomological evidence for case investigation and suspect prosecution. In so doing, this highlights the usefulness of entomological evidence of specific species in the geographic area for PMI accurate estimation, especially in the case of advanced decomposed corpses.
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Affiliation(s)
- X B Li
- Key Laboratory of Evidence Identification in Universities of Shandong Province, Shandong University of Political Science and Law, Jinan 250014, China
- Institute of Forensic Science, Chongqing Municipal Public Security Bureau, Chongqing 400021, China
| | - F Zhao
- Key Laboratory of Evidence Identification in Universities of Shandong Province, Shandong University of Political Science and Law, Jinan 250014, China
| | - C L Ding
- Key Laboratory of Evidence Identification in Universities of Shandong Province, Shandong University of Political Science and Law, Jinan 250014, China
| | - L L Li
- Key Laboratory of Evidence Identification in Universities of Shandong Province, Shandong University of Political Science and Law, Jinan 250014, China
| | - L S Chen
- Guizhou Police College, Guiyang 550005, China
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Andy Ko TY, Chen LS, Pang IX, Ling HS, Wong TC, Sia Tonnii LL, Koh KT. Smartphone electrocardiogram for QT interval monitoring in Coronavirus Disease 2019 (COVID-19) patients treated with Hydroxychloroquine. Med J Malaysia 2021; 76:125-130. [PMID: 33742617] [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: 06/12/2023]
Abstract
INTRODUCTION The global pandemic of Corona Virus Disease 2019 (COVID-19) has led to the re-purposing of medications, such as hydroxychloroquine and lopinavir-ritonavir in the treatment of the earlier phase of COVID-19 before the recognized benefit of steroids and antiviral. We aim to explore the corrected QT (QTc) interval and 'torsadogenic' potential of hydroxychloroquine and lopinavir-ritonavir utilising a combination of smartphone electrocardiogram and 12-lead electrocardiogram monitoring. MATERIALS AND METHODS Between 16-April-2020 to 30-April- 2020, patients with suspected or confirmed for COVID-19 indicated for in-patient treatment with hydroxychloroquine with or without lopinavir-ritonavir to the Sarawak General Hospital were monitored with KardiaMobile smartphone electrocardiogram (AliveCor®, Mountain View, CA) or standard 12-lead electrocardiogram. The baseline and serial QTc intervals were monitored till the last dose of medications or until the normalization of the QTc interval. RESULTS Thirty patients were treated with hydroxychloroquine, and 20 (66.7%) patients received a combination of hydroxychloroquine and lopinavir-ritonavir therapy. The maximum QTc interval was significantly prolonged compared to baseline (434.6±28.2msec vs. 458.6±47.1msec, p=0.001). The maximum QTc interval (456.1±45.7msec vs. 464.6±45.2msec, p=0.635) and the delta QTc (32.6±38.5msec vs. 26.3±35.8msec, p=0.658) were not significantly different between patients on hydroxychloroquine or a combination of hydroxychloroquine and lopinavir-ritonavir. Five (16.7%) patients had QTc of 500msec or more. Four (13.3%) patients required discontinuation of hydroxychloroquine and 3 (10.0%) patients required discontinuation of lopinavirritonavir due to QTc prolongation. However, no torsade de pointes was observed. CONCLUSIONS QTc monitoring using smartphone electrocardiogram was feasible in COVID-19 patients treated with hydroxychloroquine with or without lopinavir-ritonavir. The usage of hydroxychloroquine and lopinavir-ritonavir resulted in QTc prolongation, but no torsade de pointes or arrhythmogenic death was observed.
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Affiliation(s)
- T Y Andy Ko
- Sarawak General Hospital, Department of Medicine, Kuching, Sarawak, Malaysia.
| | - L S Chen
- Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia
| | - I X Pang
- Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia
| | - H S Ling
- Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia
| | - T C Wong
- Sarawak General Hospital, Department of Medicine, Kuching, Sarawak, Malaysia
| | - L L Sia Tonnii
- Sarawak General Hospital, Department of Medicine, Kuching, Sarawak, Malaysia
| | - K T Koh
- Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia
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Liu X, Yuan Y, Wong J, Meng G, Ueoka A, Woiewodski LM, Chen LS, Shen C, Li X, Lin SF, Everett TH, Chen PS. The frequency spectrum of sympathetic nerve activity and arrhythmogenicity in ambulatory dogs. Heart Rhythm 2020; 18:465-472. [PMID: 33246037 DOI: 10.1016/j.hrthm.2020.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/02/2020] [Accepted: 11/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sympathetic nerve activity, heart rate (HR), and blood pressure (BP) all have very low frequency (VLF), low frequency (LF), and high frequency (HF) oscillations. OBJECTIVE The purpose of this study was to test the hypothesis that the frequency spectra of subcutaneous nerve activity (ScNA), stellate ganglion nerve activity (SGNA), HR, and BP are important to cardiac arrhythmogenesis. METHODS We used radiotransmitters to record SGNA, ScNA, HR, and BP in 6 ambulatory dogs and determined the dominant frequency and paroxysmal atrial tachyarrhythmias (PATs) episodes in 3-minute windows over a 24-hour period. RESULTS The frequency spectra determined in ScNA reflected that in SGNA. HF oscillations were present in both ScNA and SGNA at all time but could be overshadowed by the much larger LF and VLF burst activities. The dominant frequency could occur in any of the 3 frequency bands. There were circadian variations with more frequent occurrences of HF oscillations at night. HF oscillations in HR and BP matched HF oscillations in SGNA and ScNA. PATs occurred only when dominant frequencies of SGNA and ScNA were in the LF and VLF bands. CONCLUSION HF oscillations in BP and HR correlate with HF oscillations in sympathetic nerve activity and are present at all time. HF oscillations can be overshadowed by the much larger LF and VLF burst activities. PATs occur only when LF or VLF, but not when HF, is the dominant frequency. The frequency spectra determined in ScNA reflect that in SGNA.
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Affiliation(s)
- Xiao Liu
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cedars-Sinai Medical Center, Los Angeles, California
| | - Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Johnson Wong
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Guannan Meng
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Akira Ueoka
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Leanne M Woiewodski
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Xiaochun Li
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cedars-Sinai Medical Center, Los Angeles, California.
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Chen YQ, Chen LS, Yang YH. [Using of autostainer for dual stain of EBER in situ hybridization and immunohistochemistry]. Zhonghua Bing Li Xue Za Zhi 2020; 49:623-624. [PMID: 32486544 DOI: 10.3760/cma.j.cn112151-20190910-00491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y Q Chen
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - L S Chen
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Y H Yang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Kusayama T, Wong J, Liu X, He W, Doytchinova A, Robinson EA, Adams DE, Chen LS, Lin SF, Davoren K, Victor RG, Cai C, Dai MY, Tian Y, Zhang P, Ernst D, Rho RH, Chen M, Cha YM, Walega DR, Everett TH, Chen PS. Simultaneous noninvasive recording of electrocardiogram and skin sympathetic nerve activity (neuECG). Nat Protoc 2020; 15:1853-1877. [DOI: 10.1038/s41596-020-0316-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/28/2020] [Indexed: 11/09/2022]
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Kusayama T, Wong J, Liu X, He W, Doytchinova A, Adams DE, Chen LS, Everett TH, Chen PS. Simultaneous Non‐invasive Recording of Skin Sympathetic Nerve Activity. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.03440] [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: 11/11/2022]
Affiliation(s)
| | | | - Xiao Liu
- Indiana University School of Medicine
| | - Wenbo He
- Indiana University School of Medicine
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17
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Chen YH, Meng GQ, Chen LS. [A case report of migratory foreign body in the neck]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:168-170. [PMID: 32074759 DOI: 10.3760/cma.j.issn.1673-0860.2020.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y H Chen
- Department of Otorhinolaryngology, Nanning Red Cross Hospital, Nanning 530012, China
| | - G Q Meng
- Department of Otorhinolaryngology, Nanning Red Cross Hospital, Nanning 530012, China
| | - L S Chen
- Department of Otorhinolaryngology, Guangdong General Hospital, Cuangzhou 510080, China
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18
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Yuan Y, Zhao Y, Wong J, Tsai WC, Jiang Z, Kabir RA, Han S, Shen C, Fishbein MC, Chen LS, Chen Z, Everett TH, Chen PS. Subcutaneous nerve stimulation reduces sympathetic nerve activity in ambulatory dogs with myocardial infarction. Heart Rhythm 2020; 17:1167-1175. [PMID: 32068184 DOI: 10.1016/j.hrthm.2020.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/04/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Subcutaneous nerve stimulation (ScNS) remodels the stellate ganglion and reduces stellate ganglion nerve activity (SGNA) in dogs. Acute myocardial infarction (MI) increases SGNA through nerve sprouting. OBJECTIVE The purpose of this study was to test the hypothesis that ScNS remodels the stellate ganglion and reduces SGNA in ambulatory dogs with acute MI. METHODS In the experimental group, a radio transmitter was implanted during the first sterile surgery to record nerve activity and an electrocardiogram, followed by a second sterile surgery to create MI. Dogs then underwent ScNS for 2 months. The average SGNA (aSGNA) was compared with that in a historical control group (n = 9), with acute MI monitored for 2 months without ScNS. RESULTS In the experimental group, the baseline aSGNA and heart rate were 4.08±0.35 μV and 98±12 beats/min, respectively. They increased within 1 week after MI to 6.91±1.91 μV (P=.007) and 107±10 beats/min (P=.028), respectively. ScNS reduced aSGNA to 3.46±0.44 μV (P<.039) and 2.14±0.50 μV (P<.001) at 4 and 8 weeks, respectively, after MI. In comparison, aSGNA at 4 and 8 weeks in dogs with MI but no ScNS was 8.26±6.31 μV (P=.005) and 10.82±7.86 μV (P=0002), respectively. Immunostaining showed confluent areas of remodeling in bilateral stellate ganglia and a high percentage of tyrosine hydroxylase-negative ganglion cells. Terminal deoxynucleotidyl transferase dUTP nick end labeling was positive in 26.61%±11.54% of ganglion cells in the left stellate ganglion and 15.94%±3.62% of ganglion cells in the right stellate ganglion. CONCLUSION ScNS remodels the stellate ganglion, reduces SGNA, and suppresses cardiac nerve sprouting after acute MI.
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Affiliation(s)
- Yuan Yuan
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ye Zhao
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Johnson Wong
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Wei-Chung Tsai
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Zhaolei Jiang
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ryan A Kabir
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Seongwook Han
- Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
| | - Changyu Shen
- Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Zhenhui Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Zhu J, Lian DS, Yin YQ, Hu D, Wang N, Chen LS, Wang B. [HIV prevalence and correlated factors on male clients of female sex workers in Hekou Yao autonomous county of Yunnan province, 2014-2015]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:440-445. [PMID: 31006205 DOI: 10.3760/cma.j.issn.0254-6450.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the prevalence and related factors of HIV infection among male clients of the female sex workers in Hekou Yao autonomous county of Honghe Hani Yi autonomous prefecture (Hekou county) in Yunnan province in China, 2014-2015. Methods: Serial cross-sectional survey was conducted during June 2014 to November 2015. Convenience sampling methods were used to recruit the male clients for this study. Self-reported information on social-demographic characteristics, with sexual and drug behavior patterns, was gathered. Both blood and urine samples were collected for HIV, with for opiate testing. Multivariate logistic regression and Exhaustive CHAID method were used to determine the correlated factors associated with HIV infection. Statistical analysis was used by SPSS 22.0 software and Clementine 12.0 software. Results: The overall HIV prevalence of male clients was 2.06% (16/776). Male clients who keep using condom with female sex worker was estimated as 68.81% (534/776). The last commercial sexual partner of Vietnamese male clients was all Vietnamese female sex workers. Compared with Chinese male clients, Vietnamese male clients have a higher rate of morphine positive. Factors as: age ≥50 years vs. age <30 years (OR=8.11, 95%CI: 1.26-52.16) and testing for morphine positive vs. morphine negative (OR=7.35, 95%CI: 1.42-38.06) were significantly associated with HIV infection through multiple logistic regression analysis. Through Exhaustive CHAID, it confirmed that age was the primary factor that associated with HIV infection of male clients. Conclusions: Relationship between morphine and HIV infection indicated that HIV prevalence of male clients in Hekou county was influenced by the combined effect of both illegal drug use and commercial sexual behavior. Special attention should be paid to male clients over 50 years of age, on HIV intervention.
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Affiliation(s)
- J Zhu
- School of Public Health, Southeast University, Nanjing 210009, China
| | - D S Lian
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Y Q Yin
- School of Public Health, Southeast University, Nanjing 210009, China
| | - D Hu
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211116, China
| | - N Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L S Chen
- School of Public Health, Southeast University, Nanjing 210009, China
| | - B Wang
- School of Public Health, Southeast University, Nanjing 210009, China
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Yuan Y, Liu X, Wan J, Wong J, Bedwell AA, Persohn SA, Shen C, Fishbein MC, Chen LS, Chen Z, Everett TH, Territo PR, Chen PS. Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation. Heart Rhythm 2019; 16:1383-1391. [PMID: 31150819 DOI: 10.1016/j.hrthm.2019.05.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Subcutaneous nerve stimulation (ScNS) damages the stellate ganglion and improves rhythm control of atrial fibrillation (AF) in ambulatory dogs. OBJECTIVE The purpose of this study was to test the hypothesis that thoracic ScNS can improve rate control in persistent AF. METHODS We created persistent AF in 13 dogs and randomly assigned them to ScNS (n = 6) and sham control (n = 7) groups. 18F-2-Fluoro-2-deoxyglucose positron emission tomography/magnetic resonance imaging of the brain stem was performed at baseline and at the end of the study. RESULTS The average stellate ganglion nerve activity reduced from 4.00 ± 1.68 μV after the induction of persistent AF to 1.72 ± 0.42 μV (P = .032) after ScNS. In contrast, the average stellate ganglion nerve activity increased from 3.01 ± 1.26 μV during AF to 5.52 ± 2.69 μV after sham stimulation (P = .023). The mean ventricular rate during persistent AF reduced from 149 ± 36 to 84 ± 16 beats/min (P = .011) in the ScNS group, but no changes were observed in the sham control group. The left ventricular ejection fraction remained unchanged in the ScNS group but reduced significantly in the sham control group. Immunostaining showed damaged ganglion cells in bilateral stellate ganglia and increased brain stem glial cell reaction in the ScNS group but not in the control group. The 18F-2-fluoro-2-deoxyglucose uptake in the pons and medulla was significantly (P = .011) higher in the ScNS group than the sham control group at the end of the study. CONCLUSION Thoracic ScNS causes neural remodeling in the brain stem and stellate ganglia, controls the ventricular rate, and preserves the left ventricular ejection fraction in ambulatory dogs with persistent AF.
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Affiliation(s)
- Yuan Yuan
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao Liu
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Juyi Wan
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Johnson Wong
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Amanda A Bedwell
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Scott A Persohn
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Zhenhui Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Paul R Territo
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Huang SL, Chen LS, Zhang B, Liang L, Gong XX, Zhou ZG, Zhang SX, Luo XN, Lu ZM, Zhang SY. [Value of modified Killian's method in diagnosis of congenital pyriform sinus fistula]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 52:744-748. [PMID: 29050091 DOI: 10.3760/cma.j.issn.1673-0860.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the feasibility and significance of modified Killian(MK) method in the clinical diagnosis of congenital pyriform sinus fistula(CPSF) by electronic laryngoscopy. Methods: The following examinations were performed for 30 suspected cases of CPSF, including the traditional electronic laryngoscopy, MK examination(modified Killian position+ head rotation+ the Valsalva maneuver), barium swallow X-ray(BSX) and CT , and a prospective comparison among them were done. Patients were divided into two groups according to their age: young age group(≤14 years old) and older age group (>14 years old). The results of MK examination from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ(2) tests. Results: Sinuses in 20 of 30 patients were depicted from pyriform sinus in BSX, and the PDR was 66.7%(20/30). The PRD of CT was 83.3%(25/30). The presence of air bubbles around the upper lobe of the thyroid gland or at the inferomedial edge of cricothyroid joints, morphological changes of thyroid grand as well as pseudo-fistula formation on lower neck were detected clearly on CT. Comparing to the traditional electronic laryngoscopy, the effect of exposing piriform fossa fistula by MK examination is significant(χ(2)=17.05, P<0.05), with the PDR of 13.3%(4/30) and 76.7%(23/30) respectively. Nevertheless, comparing to BSX and CT, there were no statistically significant differences in the effect to diagnose CPSF (χ(2)=0.31, χ(2)=0.10 respectively, P>0.05). The PDR of MK in older group is significantly higher than younger group(χ(2)=6.68, P<0.05). Conclusions: MK examination can clearly reveal the hypopharyngeal anatomical structure and detect the sinus of CPSF .It could be a safe, feasible, convenient and economical method as an application in preoperative diagnosis and follow-up examination of clinical suspected CPSF.
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Affiliation(s)
- S L Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - L S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - B Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - L Liang
- Department of Otorhinolaryngology, Nansha Hospital of Guangzhou First People's Hospital, Guangzhou 510515, China
| | - X X Gong
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Z G Zhou
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S X Zhang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - X N Luo
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Z M Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Jiang Z, Zhao Y, Tsai WC, Yuan Y, Chinda K, Tan J, Onkka P, Shen C, Chen LS, Fishbein MC, Lin SF, Chen PS, Everett TH. Effects of Vagal Nerve Stimulation on Ganglionated Plexi Nerve Activity and Ventricular Rate in Ambulatory Dogs With Persistent Atrial Fibrillation. JACC Clin Electrophysiol 2018; 4:1106-1114. [PMID: 30139493 DOI: 10.1016/j.jacep.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study was designed to test the hypothesis that low-level vagal nerve stimulation (VNS) reduces the ventricular rate (VR) during atrial fibrillation (AF) through the activation of the inferior vena cava (IVC)-inferior atrial ganglionated plexus nerve activity (IAGPNA). BACKGROUND Increased IVC-IAGPNA can suppress atrioventricular node conduction and slow VR in canine models of AF. METHODS Persistent AF was induced in 6 dogs and the IVC-IAGPNA, right vagal nerve activity, left vagal nerve activity, and an electrocardiogram were recorded. After persistent AF was documented, VNS was programed to 14 s "on" and 1.1 min "off." After 1 week, the VNS was reprogramed to 3 min off and stimulation continued for another week. Neural remodeling of the stellate ganglion (SG) was assessed with tyrosine hydroxylase staining and terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling staining. RESULTS Average IVC-IAGPNA was increased during both VNS 1.1 min off (8.20 ± 2.25 μV [95% confidence interval (CI): 6.33 to 9.53 μV]; p = 0.002) and 3 min off (7.96 ± 2.03 μV [95% CI: 6.30 to 9.27 μV]; p = 0.001) versus baseline (7.14 ± 2.20 μV [95% CI: 5.35 to 8.52 μV]). VR was reduced during both VNS 1.1 min off (123.29 ± 6.29 beats/min [95% CI: 116.69 to 129.89 beats/min]; p = 0.001) and 3 min off (120.01 ± 4.93 beats/min [95% CI: 114.84 to 125.18 beats/min]; p = 0.001) compared to baseline (142.04 ± 7.93 bpm [95% CI: 133.72 to 150.37]). Abnormal regions were observed in the left SG, but not in the right SG. Terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling-positive neurons were found in 22.2 ± 17.2% [95% CI: 0.9% to 43.5%] of left SG cells and 12.8 ± 8.4% [95% CI: 2.4% to 23.2%] of right SG cells. CONCLUSIONS Chronic low-level VNS increases IVC-IAGPNA and damages bilateral stellate ganglia. Both mechanisms could contribute to the underlying mechanism of VR control during AF.
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Affiliation(s)
- Zhaolei Jiang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ye Zhao
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wei-Chung Tsai
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kroekkiat Chinda
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Physiology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - Jian Tan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Patrick Onkka
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Shien-Fong Lin
- Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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23
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Liang L, Chen LQ, Chen LS, Zhang B, Huang SL, Gong XX, Zhang SY, Luo XN, Xie JH. [Pathological analysis and treatments of neck infection induced by congenital pyriform sinus fistula]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:514-518. [PMID: 29798081 DOI: 10.13201/j.issn.1001-1781.2018.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Indexed: 11/12/2022]
Abstract
Objective:To identify the pathogenic bacteria of CPSF and their resistance to antibiotics,and guide the rational use of antibiotics therapy.Method:One hundred and thirty cases of deep neck infection whose imaging finding depicted patients with suspected as CPSF were enrolled in the study from January 2010 to June 2017.Specimens were collected from abscesses or other inflammatory lesions from all patients through a small incision or the external orifice on the skin of the neck.Result:A total of 108 strains of pathogens have been isolated from 88 patients (positive rate: 67.7%), among which the gram-positive bacteria accounted for 56.5%, gram-negative bacteria accounted for 43.5%. Streptococcus and Staphylococcus aureus (22.2%) were the most common pathogens among young patients (≤14 years old) (17.7%);Klebsiellapneumoniae (15.7%) were the most common pathogens among the patients over 14 years old. Separation of pathogenic bacteria have maintained a low resistance to most antibiotics. G+ bacteria is totally sensitive to quinupristin/dalfopristin and vancomycin; G-bacteria is totally sensitive to cefoperazone/Batan, piperacillin/tazobactam,imipenem.Conclusion:Most of pathogens come from upper respiratory tract in CPSF cases, and are mostly sensitive to βlactamase.
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Affiliation(s)
- L Liang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People' Hospital, Guangzhou,510180,China
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Gong XX, Xu MM, Chen LS, Huang SL, Zhang B, Liang L. [Reoccurrence of congenital piriform sinus fistula after the internal opening obliteration with CO(2) laser cauterization: one case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 53:61-63. [PMID: 29365385 DOI: 10.3760/cma.j.issn.1673-0860.2018.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X X Gong
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - M M Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - L S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - S L Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - B Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The University of Hong Kong-Shenzhen Hospital, 518053 Shenzhan, China
| | - L Liang
- Department of Otorhinolaryngology, Guangzhou First People's Hospital-Nansha Hospital, 510515 Guangzhou, China
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Kabir RA, Doytchinova A, Liu X, Adams D, Straka S, Chen LS, Shen C, Lin SF, Everett TH, Chen PS. Crescendo Skin Sympathetic Nerve Activity and Ventricular Arrhythmia. J Am Coll Cardiol 2017; 70:3201-3202. [DOI: 10.1016/j.jacc.2017.10.065] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/01/2017] [Accepted: 10/22/2017] [Indexed: 11/15/2022]
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Yuan Y, Jiang Z, Zhao Y, Tsai WC, Patel J, Chen LS, Shen C, Lin SF, Chen HSV, Everett TH, Fishbein MC, Chen Z, Chen PS. Long-term intermittent high-amplitude subcutaneous nerve stimulation reduces sympathetic tone in ambulatory dogs. Heart Rhythm 2017; 15:451-459. [PMID: 29081397 DOI: 10.1016/j.hrthm.2017.10.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Reducing sympathetic efferent outflow from the stellate ganglia (SG) may be antiarrhythmic. OBJECTIVE The purpose of this study was to test the hypothesis that chronic thoracic subcutaneous nerve stimulation (ScNS) could reduce SG nerve activity (SGNA) and control paroxysmal atrial tachycardia (PAT). METHODS Thoracic ScNS was performed in 8 dogs while SGNA, vagal nerve activity (VNA), and subcutaneous nerve activity (ScNA) were monitored. An additional 3 dogs were used for sham stimulation as controls. RESULTS Xinshu ScNS and left lateral thoracic nerve ScNS reduced heart rate (HR). Xinshu ScNS at 3.5 mA for 2 weeks reduced mean average SGNA from 5.32 μV (95% confidence interval [CI] 3.89-6.75) at baseline to 3.24 μV (95% CI 2.16-4.31; P = .015) and mean HR from 89 bpm (95% CI 80-98) at baseline to 83 bpm (95% CI 76-90; P = .007). Bilateral SG showed regions of decreased tyrosine hydroxylase staining with increased terminal deoxynucleotidyl transferase dUTP nick-end labeling-positive nuclei in 18.47% (95% CI 9.68-46.62) of all ganglion cells, indicating cell death. Spontaneous PAT episodes were reduced from 9.83 per day (95% CI 5.77-13.89) in controls to 3.00 per day (95% CI 0.11-5.89) after ScNS (P = .027). Left lateral thoracic nerve ScNS also led to significant bilateral SG neuronal death and significantly reduced average SGNA and HR in dogs. CONCLUSION ScNS at 2 different sites in the thorax led to SG cell death, reduced SGNA, and suppressed PAT in ambulatory dogs.
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Affiliation(s)
- Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zhaolei Jiang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ye Zhao
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiac Surgery, First Affiliated Hospital of China Medical University, Shen Yang, China
| | - Wei-Chung Tsai
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jheel Patel
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Huei-Sheng Vincent Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Zhenhui Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Xu ZJ, Chen LS, Zhan JD, Xu MM, Zhang B, Huang SL, Lu ZM, Luo XN, Zhang SY. [Modified rhytidectomy incision and modified Blair incision contrast research in superficial parotid gland tumor resection]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:1684-1687. [PMID: 29798128 DOI: 10.13201/j.issn.1001-1781.2017.21.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Indexed: 11/12/2022]
Abstract
Objective:Evaluate the application value of modified rhytidectomy incision in superficial parotid gland tumor resection.Method:Seventy-one patients with tumor in the superficial parotid were included in this study from January 2012 to January 2015. They all accepted superficial parotidectomy or subtotal superficial parotidectomy. Thirty-six cases used modified rhytidectomy incision and 35 cases used modified blair incision. The data of operative field exposure, operating time, bleeding, the rate of complication, score of patients's satisfaction were recorded and compared between the two groups.Result:There was no statistically significant difference between the two groups in the operative field exposure, operating time and bleeding (P > 0.05). No difference was found between the two groups in the rate of facioplegia, while the rate of insensible earlobe in the modified rhytidectomy incision group was significantly lower than the modified blair incision group (P < 0.05). The score of patient's satisfaction in the modified rhytidectomy incision group was significantly higher than the other group (P < 0.05).Conclusion:The modified rhytidectomy incision provides good exposure and has the advantage of less complication and better cosmetic outcome. It is worthy of wide clinical application.
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Affiliation(s)
- Z J Xu
- Department of Otolaryngology Head and Neck Surgery, Huizhou Municipal Central People's Hospital, Huizhou, 516001,China
| | - L S Chen
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - J D Zhan
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - M M Xu
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - B Zhang
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - S L Huang
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - Z M Lu
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - X N Luo
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
| | - S Y Zhang
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital
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Yuan Y, Hassel JL, Doytchinova A, Adams D, Wright KC, Meshberger C, Chen LS, Guerra MP, Shen C, Lin SF, Everett TH, Salanova V, Chen PS. Left cervical vagal nerve stimulation reduces skin sympathetic nerve activity in patients with drug resistant epilepsy. Heart Rhythm 2017; 14:1771-1778. [PMID: 28778733 DOI: 10.1016/j.hrthm.2017.07.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND We recently reported that skin sympathetic nerve activity (SKNA) can be used to estimate sympathetic tone in humans. In animal models, vagal nerve stimulation (VNS) can damage the stellate ganglion, reduce stellate ganglion nerve activity, and suppress cardiac arrhythmia. Whether VNS can suppress sympathetic tone in humans remains unclear. OBJECTIVE The purpose of this study was to test the hypothesis that VNS suppresses SKNA in patients with drug-resistant epilepsy. METHODS ECG patch electrodes were used to continuously record SKNA in 26 patients with drug-resistant epilepsy who were admitted for video electroencephalographic monitoring. Among them, 6 (2 men, age 40 ± 11 years) were previously treated with VNS and 20 (7 men, age 37 ± 8 years) were not. The signals from ECG leads I and II were filtered to detect SKNA. RESULTS VNS had an on-time of 30 seconds and off-time of 158 ± 72 seconds, with output of 1.92 ± 0.42 mA at 24.17 ± 2.01 Hz. Average SKNA during VNS off-time was 1.06 μV (95% confidence interval [CI] 0.93-1.18) in lead I and 1.13 μV (95% CI 0.99-1.27) in lead II, which was significantly lower than 1.38 μV (95% CI 1.01-1.75; P = .036) and 1.38 μV (95% CI 0.98-1.78; P = .035) in the control group, respectively. Heart rate was 65 bpm (95% CI 59-71) in the VNS group, which was significantly lower than 77 bpm (95% CI 71-83) in the control group. CONCLUSION Patients with VNS had significantly lower SKNA than those without VNS.
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Affiliation(s)
- Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jonathan L Hassel
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Anisiia Doytchinova
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - David Adams
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Keith C Wright
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Chad Meshberger
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Maria P Guerra
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Vicenta Salanova
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Shen MJ, Coffey AC, Straka S, Adams DE, Wagner DB, Kovacs RJ, Clark M, Shen C, Chen LS, Everett TH, Lin SF, Chen PS. Simultaneous recordings of intrinsic cardiac nerve activity and skin sympathetic nerve activity from human patients during the postoperative period. Heart Rhythm 2017. [PMID: 28648667 DOI: 10.1016/j.hrthm.2017.06.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Intrinsic cardiac nerve activity (ICNA) and skin nerve activity (SKNA) are both associated with cardiac arrhythmias in dogs. OBJECTIVE The purpose of this study was to test the hypothesis that ICNA and SKNA correlate with postoperative cardiac arrhythmias in humans. METHODS Eleven patients (mean age 60 ± 13 years; 4 women) were enrolled in this study. Electrical signals were simultaneously recorded from electrocardiogram (ECG) patch electrodes on the chest wall and from 2 temporary pacing wires placed during open heart surgery on the left atrial epicardial fat pad. The signals were filtered to display SKNA and ICNA. Premature atrial contractions (PACs) and premature ventricular contractions were determined manually. The SKNA and ICNA of the first 300 minutes of each patient were calculated minute by minute to determine baseline average amplitudes of nerve activities and to determine their correlation with arrhythmia burden. RESULTS We processed 1365 ± 973 minutes of recording per patient. Low-amplitude SKNA and ICNA were present at all time, while the burst discharges were observed much less frequently. Both SKNA and burst ICNA were significantly associated with the onset of PACs and premature ventricular contractions. Baseline average ICNA (aICNA), but not average SKNA, had a significant association with PAC burden. The correlation coefficient (r) between aICNA and PAC burden was 0.78 (P < .01). A patient with the greatest aICNA developed postoperative atrial fibrillation. CONCLUSION ICNA and SKNA can be recorded from human patients in the postoperative period. The baseline magnitude of ICNA correlates with PAC burden and development of postoperative atrial fibrillation.
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Affiliation(s)
- Mark J Shen
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Arthur C Coffey
- Department of Medicine, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana; Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Susan Straka
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - David E Adams
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - David B Wagner
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Richard J Kovacs
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Michael Clark
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Changyu Shen
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and the Division of Cardiology, Indiana University School of Medicine and Indiana University Health Physicians, Indianapolis, Indiana.
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Chen LS, Zhu GH. [Investigation of the Necrophagous Flies in Beijing]. Fa Yi Xue Za Zhi 2017; 33:267-270. [PMID: 29230992 DOI: 10.3969/j.issn.1004-5619.2017.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To explore the number of necrophagous flies and seasonal distribution of common necrophagous flies at present in Beijing. METHODS The specimens of necrophagous flies were collected by the methods of animal carcass, trapping and feeding. And the specimens were observed and counted after the classification and preservation. RESULTS The necrophagous flies in Beijing belonged to 4 families, 9 subfamilies, 21 genera and 46 species, and 12 species of them were the first records in Beijing. The necrophagous flies had the characteristics of regional and seasonal distribution. CONCLUSIONS The data of seasonal distribution of necrophagous flies and common necrophagous flies in Beijing can provide reference for related research.
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Affiliation(s)
- L S Chen
- Guizhou Police College, Guiyang 550005, China
| | - G H Zhu
- Shantou University Medical College, Shantou 515041, China
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Chen LS, Wong PS, Leong KN, Chow TS. Filariasis in axillary lymph node. Trop Biomed 2017; 34:461-463. [PMID: 33593029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A case of adult filarial worms detected in an axillary lymph node of an asymptomatic patient. A 64 year-old Indian female underwent a mammogram and was incidentally found to have punctate microcalcifications in the upper outer quadrant of the left breast with left axillary lymphadenopathy. She has underlying hypertension and diabetes mellitus on oral medications. She has no family history of breast malignancy. Fine needle aspiration of the left axillary lymph node was suggestive of reactive lympha-denitis. Histopathological examination of excisional biopsy of left breast lump showed fibrocystic disease; no evidence of malignancy was detected whereas excisional biopsy of left axillary lymph node showed reactive lymphoid hyperplasia, featuring variably sized lymphoid follicles with intact mantle zone. No expansion of marginal zone was noted. Occasional pigment-laden macrophages were seen. One of the lymph node showed presence of calcified serpinginous tubular bodies, in keeping with non viable parasite organisms with intact outlines of the structures. There were no eosinophilic infiltrates. The possibility of filarial infestation was suspected. Histopathological sample was sent for further identification and confirmed the presence of adult filarial worm.
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Affiliation(s)
- L S Chen
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - P S Wong
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - K N Leong
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - T S Chow
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
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Uradu A, Wan J, Doytchinova A, Wright KC, Lin AYT, Chen LS, Shen C, Lin SF, Everett TH, Chen PS. Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation. Heart Rhythm 2017; 14:964-971. [PMID: 28347833 DOI: 10.1016/j.hrthm.2017.03.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Skin sympathetic nerve activity (SKNA) is useful for estimating sympathetic tone in humans. OBJECTIVE The purpose of this study was to test the hypotheses that (1) increased SKNA is associated with the onset and termination of paroxysmal atrial tachycardia (AT) and atrial fibrillation (AF) and (2) sinoatrial node response to SKNA is reduced in patients with more frequent AT or AF episodes. METHODS SKNA and electrocardiogram were recorded in 11 patients (4 men and 7 women; average age 66 ± 10 years), including 3 patients with AT (11 ± 18 episodes per patient) and 8 patients with AF (24 ± 26 episodes per patient). RESULTS The average SKNA (aSKNA) 10 seconds before AT onset was 1.07 ± 0.10 μV and 10 seconds after termination was 1.27 ± 0.10 μV; both were significantly (P = .032 and P < .0001) higher than that during sinus rhythm (0.97 ± 0.09 μV). The aSKNA 10 seconds before AF onset was 1.34 ± 0.07 μV and 10 seconds after termination was 1.31 ± 0.07 μV; both were significantly (P < .0001) higher than that during sinus rhythm (1.04 ± 0.07 μV). The aSKNA before onset (P < .0001) and after termination (P = .0011) was higher in AF than in AT. The sinus rate correlated (P < .0001) with aSKNA in each patient (average r = 0.74; 95% confidence interval 0.65-0.84). The r value in each patient negatively correlated with the number of AT and AF episodes (r = -0.6493; 95% confidence interval -0.8990 to -0.08073; P = .0306). CONCLUSION Increased SKNA was observed both at the onset and termination of AT and AF. Patients with more frequent AT and AF episodes had a weak correlation between sinus rate and aSKNA, suggesting sinoatrial node remodeling by tachycardia.
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Affiliation(s)
- Andrea Uradu
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
| | - Juyi Wan
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana; Department of Cardiothoracic Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Anisiia Doytchinova
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
| | - Keith C Wright
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
| | - Andrew Y T Lin
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
| | - Lan S Chen
- Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Shien-Fong Lin
- Institute of Biomedical Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Thomas H Everett
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana.
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Huang SL, Zhang B, Chen LS, Liang L, Luo XN, Lu ZM, Zhang SY. [Fourth branchial cleft deformity with skin orifice: a series of 10 cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 51:776-779. [PMID: 27765110 DOI: 10.3760/cma.j.issn.1673-0860.2016.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To report rare cases of congenital neck cutaneous sinus with an orifice near the sternoclavicular joint and to investigate their origins and managements. Methods: A total of ten patients with congenital neck cutaneous sinus having an orifice near the sternoclavicular joint treated in the Guangdong General Hospital from January 2010 to June 2015 were retrospectively analyzed. Results: There four boys and six girls, aging from 11 months to 96 months with an average of 33.4 months, and they had a common feature showing a congenital cutaneous sinus with an orifice near sternoclavicular joint. Discharge of pus from the orifice or abscess formation was commonly seen soon after infection. With bacteriological study, staphylococcus aureus was positive in five cases and klebsiella pneumonia in a case. Another orifice of fistula/sinus was not depicted in pyriform with barium swallow X-ray in five cases Ultrasound studies of three cases demonstrated anechoic (i.e., nearly black) and solid-cystic lesion near sternoclavicular joint with posterior acoustic enhancement. Magnetic resonance imaging (MRI) showed isointensity of the lesion on T1 and T2 weighted images with heterogeneous enhancement and a close relationship with sternoclavicular joint. All patients underwent laryngoscopic examination, which showed no orifice of sinus in pyriform at same side. Surgical resection of fistula/sinus was performed in all cases. The lengths of the fistula varied from 5 mm to 22 mm with an average of 11 mm. Postoperative pathological examination showed all specimens were accordance with fistula. No complications were noticed. Recurrence was not observed in the cases by following-up of 6 months to 70 months (median: 33 months). Conclusion: Congenital neck cutaneous sinus with orifice near the sternoclavicular joint maybe a special clinical phenotype of the fourth branchial cleft sinus with skin orifice in cervicothoracic junction. Differential diagnoses between low cervical diseases are required. The curative treatment is a complete excision during inflammatory quiescent period.
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Affiliation(s)
- S L Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - B Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - L S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - L Liang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - X N Luo
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - Z M Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - S Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
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Tsai WC, Chan YH, Chinda K, Chen Z, Patel J, Shen C, Zhao Y, Jiang Z, Yuan Y, Ye M, Chen LS, Riley AA, Persohn SA, Territo PR, Everett TH, Lin SF, Vinters HV, Fishbein MC, Chen PS. Effects of renal sympathetic denervation on the stellate ganglion and brain stem in dogs. Heart Rhythm 2016; 14:255-262. [PMID: 27720832 DOI: 10.1016/j.hrthm.2016.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Renal sympathetic denervation (RD) is a promising method of neuromodulation for the management of cardiac arrhythmia. OBJECTIVE We tested the hypothesis that RD is antiarrhythmic in ambulatory dogs because it reduces the stellate ganglion nerve activity (SGNA) by remodeling the stellate ganglion (SG) and brain stem. METHODS We implanted a radiotransmitter to record SGNA and electrocardiogram in 9 ambulatory dogs for 2 weeks, followed by a second surgery for RD and 2 months SGNA recording. Cell death was probed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. RESULTS Integrated SGNA at baseline and 1 and 2 months after RD were 14.0 ± 4.0, 9.3 ± 2.8, and 9.6 ± 2.0 μV, respectively (P = .042). The SG from RD but not normal control dogs (n = 5) showed confluent damage. An average of 41% ± 10% and 40% ± 16% of ganglion cells in the left and right SG, respectively, were TUNEL positive in RD dogs compared with 0% in controls dogs (P = .005 for both). The left and right SG from RD dogs had more tyrosine hydroxylase-negative ganglion cells than did the left SG of control dogs (P = .028 and P = .047, respectively). Extensive TUNEL-positive neurons and glial cells were also noted in the medulla, associated with strongly positive glial fibrillary acidic protein staining. The distribution was heterogeneous, with more cell death in the medial than lateral aspects of the medulla. CONCLUSION Bilateral RD caused significant central and peripheral sympathetic nerve remodeling and reduced SGNA in ambulatory dogs. These findings may in part explain the antiarrhythmic effects of RD.
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Affiliation(s)
- Wei-Chung Tsai
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Chan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Kroekkiat Chinda
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Physiology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - Zhenhui Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Jheel Patel
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Department of Biostatistics, Indiana University School of Medicine and the Fairbanks School of Public Health, Indianapolis, Indiana
| | - Ye Zhao
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiac Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhaolei Jiang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Michael Ye
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Amanda A Riley
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Scott A Persohn
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Paul R Territo
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Harry V Vinters
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Yao DM, Chen LS, Liang L, Zhang B, Luo XN, Zhang SY, Lu ZM. [The selective anterior neck dissection for treating children's recurrent thyroglossal duct cysts]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016. [PMID: 29871137 DOI: 10.13201/j.issn.1001-1781.2016.19.010.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective:To evaluate the therapeutic effect of selective anterior neck dissection on the treatment of children's recurrent thyroglossal duct cysts. Method: The clinical data of 28 patients with recurrent thyroglossal duct cysts were retrospectively analyzed. In accordance with the embryologic and anatomic features of thyroglossal duct cysts, different types of selective neck dissection were applied. Enbloc resection principles were applied to extirpate thyroglossal duct cysts,scarrings and inflammatory granuloma during the operation. Result:All the wounds of 28 patients healed primarily without significant complications including dysphagia, paragammacism, injury of hypoglossal nerve and superior laryngeal nerve. No recurrences were found in all 28 cases with a follow-up period of 24 to 72 months(average 46 months). Conclusion:Selective anterior neck dissection is a safe and effective surgical procedure for the radical treatment of children's recurrent thyroglossal duct cysts.
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Affiliation(s)
- D M Yao
- Department of Otolaryngology Head and Neck Surgery,Shantou Central Hospital,Affiliated Shantou Hospital of Sun Yat-sen University,Shantou,515000,China
| | - L S Chen
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - L Liang
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - B Zhang
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - X N Luo
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - S Y Zhang
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - Z M Lu
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
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Yao DM, Chen LS, Liang L, Zhang B, Luo XN, Zhang SY, Lu ZM. [The selective anterior neck dissection for treating children's recurrent thyroglossal duct cysts]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1545-1547. [PMID: 29871137 DOI: 10.13201/j.issn.1001-1781.2016.19.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Indexed: 11/12/2022]
Abstract
Objective:To evaluate the therapeutic effect of selective anterior neck dissection on the treatment of children's recurrent thyroglossal duct cysts. Method: The clinical data of 28 patients with recurrent thyroglossal duct cysts were retrospectively analyzed. In accordance with the embryologic and anatomic features of thyroglossal duct cysts, different types of selective neck dissection were applied. Enbloc resection principles were applied to extirpate thyroglossal duct cysts,scarrings and inflammatory granuloma during the operation. Result:All the wounds of 28 patients healed primarily without significant complications including dysphagia, paragammacism, injury of hypoglossal nerve and superior laryngeal nerve. No recurrences were found in all 28 cases with a follow-up period of 24 to 72 months(average 46 months). Conclusion:Selective anterior neck dissection is a safe and effective surgical procedure for the radical treatment of children's recurrent thyroglossal duct cysts.
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Affiliation(s)
- D M Yao
- Department of Otolaryngology Head and Neck Surgery,Shantou Central Hospital,Affiliated Shantou Hospital of Sun Yat-sen University,Shantou,515000,China
| | - L S Chen
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - L Liang
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - B Zhang
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - X N Luo
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - S Y Zhang
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - Z M Lu
- Department of Otolaryngology Head and Neck Surgery,Guangdong General Hospital,Guangdong Academy of Medical Science
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Doytchinova A, Hassel JL, Yuan Y, Lin H, Yin D, Adams D, Straka S, Wright K, Smith K, Wagner D, Shen C, Salanova V, Meshberger C, Chen LS, Kincaid JC, Coffey AC, Wu G, Li Y, Kovacs RJ, Everett TH, Victor R, Cha YM, Lin SF, Chen PS. Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram. Heart Rhythm 2016; 14:25-33. [PMID: 27670627 DOI: 10.1016/j.hrthm.2016.09.019] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sympathetic nerve activity is important to cardiac arrhythmogenesis. OBJECTIVE The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. METHODS We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. RESULTS In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1-V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P < .001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P < .05) and shortening of QT interval (P < .001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. CONCLUSION SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.
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Affiliation(s)
- Anisiia Doytchinova
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Jonathan L Hassel
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongbo Lin
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Dechun Yin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - David Adams
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Susan Straka
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Keith Wright
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Kimberly Smith
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - David Wagner
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Vicenta Salanova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Chad Meshberger
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - John C Kincaid
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Arthur C Coffey
- Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Gang Wu
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Geriatrics, Shengjing Hospital, China Medical University, Shenyang, China
| | - Richard J Kovacs
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ronald Victor
- Cedars-Sinai Heart Institute/Hypertension Center(,) Los Angeles, California
| | - Yong-Mei Cha
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Huang SL, Liang L, Chen LS. [Progress in surgery treatment of congenital pyriform sinus fistula]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1491-1494. [PMID: 29871125 DOI: 10.13201/j.issn.1001-1781.2016.18.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Indexed: 11/12/2022]
Abstract
Congenital pyriform sinus fistula(CPSF) is a rare brancial cleft deformity in neck, characterized by acute suppurative thyroiditis, recurrent cervical abscesses and cellulitis. At present, surgical treatment of CPSF include traditional surgery and endoscopic cauterization. In the past,en block resection of the fistula by surgery is the only cure method. The late 90, relatively safe and effective endoscopic and minimally invasive aesthetic surgery is applied in treatment of CPSF, and was recommended as the preferred treatment for congenital pyriform sinus fistula. From the long term efficacy, which method is more dominant, yet to be elegant. Through the analysis of embryo principles and anatomy of CPSF,we introduce and summarize the indications, complications and prevention in conventional surgical treatment and endoscopic cauterization, and briefly descript the factors influencing the efficacy of the treatment of CPSF.
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Zhang B, Chen LS, Huang SL, Liang L, Wu PN, Zhang SY, L ZM, Liang L. [Manifestation of first branchial anomaly:56 cases reportrhinitis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1359-1362. [PMID: 29798457 DOI: 10.13201/j.issn.1001-1781.2016.17.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Indexed: 06/08/2023]
Abstract
Objective:To sum up and conclude manifestation of congenital first branchial anomaly(CFBCA).Method:The clinical data of 56 patients from 2005 to 2015 in our hospital were retrospective reviewed.Result:Manifestation:mass without pain(26.8%),repeated sore and discharge(71.4%),otological symptom(external auditory discharge、hearing loss,28.6%).Eleven cases bacterial sample showed positive result,and most of them show pseudomonas aeruginosa and staphylococcus aureus.Auricular endoscopy typically performed stricture of external auditory canal,cholesteatoma samples accumulated in ear canal,fistula at the conjunction of the bone and cartilage and tympanic membranous attachment.Typical performance of CT(MRI)was that there were cystic,lobulated or tubular abnormal shadow related with ear canal in Pochet's triangle area whose cyst wall or pipe wall could been enhanced in enhanced CT(MRI) scans,and part of that could be connected with skin.The statistical difference between type Oslen and Work and clinical characteristics(P<0.01),and the relationship between type Oslen and Work(P<0.01).Most of Work Ⅰ were cyst type,and these two type often had no infected symptom.Most of them were young patients.Most of Work Ⅱ were sinus and fistula type ,and these two type often had infected symptom.Most of them were teenagers.Part of patients of type Work Ⅱ showed tympanic membranous attachment.Conclusion:CFBCA was rare,and it is more common in young patients and often in left part.It always performed as mass without pain、repeated sore and discharge、external auditory discharge.Most of Work Ⅰ were cyst type,and these two type often had no infected symptom and most of them were young patients .Most of Work Ⅱ were sinus and fistula type,and these two type often had infected symptom and most of them were teenagers.Auricular endoscopy,CT,MRI could help make diagnose.Doctors clinical need to differentiate it with related diseases according to different manifestations.
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Affiliation(s)
- B Zhang
- Southern Medical University,Guangzhou,510515,China
- Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - L S Chen
- Southern Medical University,Guangzhou,510515,China
- Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - S L Huang
- Department of Otolaryngology,the First People's Hospital of Guangzhou
| | - L Liang
- Department of Otolaryngology,the First People's Hospital of Guangzhou
| | - P N Wu
- Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - S Y Zhang
- Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - Z M L
- Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science
| | - L Liang
- Department of Otolaryngology,Guangdong General Hospital,Guangdong Academy of Medical Science
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Zhong W, Jiang ZY, Zhong SB, Zhang LC, Huang JH, Zhang S, Chen LS, Cao YF. [Phenotypic characteristics of LAP(+) CD4(+) T lymphocytes in colorectal cancer tissues]. Zhonghua Zhong Liu Za Zhi 2016; 38:596-601. [PMID: 27531479 DOI: 10.3760/cma.j.issn.0253-3766.2016.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To analyze the phenotypic characteristics of LAP(+) CD4(+) T lymphocytes and investigate their molecular mechanisms in colorectal cancer (CRC) microenvironment. METHODS Fifty colorectal cancer patients treated in our two hospitals from January 2014 to May 2014 were included in this study. Their tumor tissues and adjacent normal tissues, peripheral blood samples, and peripheral blood samples of 25 healthy donors (HD) were collected to isolate the lymphocytes. The different expressions of CCR7, CD45RA, Foxp3, CTLA-4, CCR4 and CCR5 in LAP(+) CD4(+) T and LAP(-)CD4(+) T lymphocytes were analyzed by flow cytometry (FCM). RESULTS The FCM assay detected that the percentage of LAP(+) CD4(+) T cells in peripheral blood of the CRC patients were significantly higher than that of HD [(9.44±3.18)% versus (1.49±1.00)%, P<0.001]. In addition, significantly more LAP(+) CD4(+) T cells were also recruited into tumor tissue than those in the tumor-adjacent normal tissue [(11.76±3.74)% versus (3.87±1.64)%, P<0.001]. LAP(+) CD4(+) T cells in the tumor-adjacent normal tissue and peripheral blood of both HDs and CRC patients mainly displayed a central memory phenotype. However, effector memory lymphocytes were predominant in the tumor tissue.In the tumor tissue, the expression of Foxp3 in the LAP(+) CD4(+) T cells was (3.87±1.12)%, significantly lower than that in the LAP(-)CD4(+) T cells (16.70±2.61)%, (P<0.001); the expression of CTLA-4 in the LAP(+) CD4(+) T cells was (36.36±19.14)%, significantly higher than the (19.60±8.91)% in the LAP(-)CD4(+) T cells (P<0.001); the expression of CCR4 in the LAP(+) CD4(+) T cells was (37.72±11.14)%, significantly higher than the (30.06±9.14)% in the LAP(-)CD4(+) T cells (P<0.001); and the expression of CCR5 in the LAP(+) CD4(+) T cells was (18.86±7.10)%, significantly higher than the (13.92±3.31)% in the LAP(-)CD4(+) T cells (P<0.001). CONCLUSIONS LAP(+) CD4(+) T cells with low expression of Foxp3 and high expressions of CTLA-4, CCR4 and CCR5 are tend to be enriched and accumulated in the tumor tissue. The unique phenotypic characteristics make these cells a distinct subset of lymphocytes, apparently different from the traditional CD4(+) CD25(+) Treg cells.
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Affiliation(s)
- W Zhong
- Gastrointestinal Surgery Department, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, China
| | - Z Y Jiang
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - S B Zhong
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - L C Zhang
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - J H Huang
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - S Zhang
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - L S Chen
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Y F Cao
- Colorectal and Anal Surgery Department, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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Huang SL, Chen LS, Zhang B, Liang L, Wu PN, Luo XN, Lu ZM, Zhang SY. [Bilateral congenital second branchial cleft deformity: report of four cases and literature review]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 51:464-5. [PMID: 27345889 DOI: 10.3760/cma.j.issn.1673-0860.2016.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- S L Huang
- Shantou University Medical College, Shantou 515041, China
| | - L S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - B Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - L Liang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - P N Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - X N Luo
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - Z M Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
| | - S Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China
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Chen LS, Shi SJ, Zou PS, Ma M, Chen XH, Cao DH. Identification of novel DYNC2H1 mutations associated with short rib-polydactyly syndrome type III using next-generation panel sequencing. Genet Mol Res 2016; 15:gmr8134. [PMID: 27323140 DOI: 10.4238/gmr.15028134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Short rib-polydactyly syndrome type III (SRPS3) is a perinatal lethal skeletal disorder with polydactyly and multisystem organ abnormalities. While ultrasound of the fetus can detect skeletal abnormalities characteristic of SRPS3, the syndrome is often difficult to diagnose before birth. As SRPS3 is an autosomal recessive disorder, identification of the gene mutations involved could lead to the development of prenatal genetic testing as an accurate method of diagnosis. In this study, we describe genetic screening approaches to identify potential abnormalities associated with SRPS3. Karyotype analysis, array comparative genomic hybridization (aCGH), and next-generation panel sequencing were each performed on a fetus showing signs of the disorder, as well as on the mother and father. Karyotype and aCGH results revealed no abnormalities. However, next-generation panel sequencing identified novel mutations in the DYNC2H1 gene. The fetus was compound heterozygous for both a missense mutation c.8313A > T and a frameshift mutation c.10711_10714delTTTA in the DYNC2H1 gene, which were inherited from the mother and father, respectively. These variants were further confirmed using Sanger sequencing and have not been previously reported. Our study indicates the utility of using next-generation panel sequencing in screening for novel disease-associated mutations.
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Affiliation(s)
- L S Chen
- Aristogenesis Center, Hospital of PLA, Shenyang, China
| | - S J Shi
- Aristogenesis Center, Hospital of PLA, Shenyang, China
| | - P S Zou
- Aristogenesis Center, Hospital of PLA, Shenyang, China
| | - M Ma
- Aristogenesis Center, Hospital of PLA, Shenyang, China
| | - X H Chen
- Aristogenesis Center, Hospital of PLA, Shenyang, China
| | - D H Cao
- Aristogenesis Center, Hospital of PLA, Shenyang, China
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Chinda K, Tsai WC, Chan YH, Lin AYT, Patel J, Zhao Y, Tan AY, Shen MJ, Lin H, Shen C, Chattipakorn N, Rubart-von der Lohe M, Chen LS, Fishbein MC, Lin SF, Chen Z, Chen PS. Intermittent left cervical vagal nerve stimulation damages the stellate ganglia and reduces the ventricular rate during sustained atrial fibrillation in ambulatory dogs. Heart Rhythm 2015; 13:771-80. [PMID: 26607063 DOI: 10.1016/j.hrthm.2015.11.031] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND The effects of intermittent open-loop vagal nerve stimulation (VNS) on the ventricular rate (VR) during atrial fibrillation (AF) remain unclear. OBJECTIVE The purpose of this study was to test the hypothesis that VNS damages the stellate ganglion (SG) and improves VR control during persistent AF. METHODS We performed left cervical VNS in ambulatory dogs while recording the left SG nerve activity (SGNA) and vagal nerve activity. Tyrosine hydroxylase (TH) staining and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining were used to assess neuronal cell death in the SG. RESULTS We induced persistent AF by atrial pacing in 6 dogs, followed by intermittent VNS with short ON-time (14 seconds) and long OFF-time (66 seconds). The integrated SGNA and VR during AF were 4.84 mV·s (95% confidence interval [CI] 3.08-6.60 mV·s) and 142 beats/min (95% CI 116-168 beats/min), respectively. During AF, VNS reduced the integrated SGNA and VR, respectively, to 3.74 mV·s (95% CI 2.27-5.20 mV·s; P = .021) and 115 beats/min (95% CI 96-134 beats/min; P = .016) during 66-second OFF-time and to 4.07 mV·s (95% CI 2.42-5.72 mV·s; P = .037) and 114 beats/min (95% CI 83-146 beats/min; P = .039) during 3-minute OFF-time. VNS increased the frequencies of prolonged (>3 seconds) pauses during AF. TH staining showed large confluent areas of damage in the left SG, characterized by pyknotic nuclei, reduced TH staining, increased percentage of TH-negative ganglion cells, and positive TUNEL staining. Occasional TUNEL-positive ganglion cells were also observed in the right SG. CONCLUSION VNS damaged the SG, leading to reduced SGNA and better rate control during persistent AF.
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Affiliation(s)
- Kroekkiat Chinda
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Department of Physiology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - Wei-Chung Tsai
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Chan
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, The First Department of Medicine, Chang-Gung Memorial Hospital, Taipei, Taiwan
| | - Andrew Y-T Lin
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Jheel Patel
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ye Zhao
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiac Surgery, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Alex Y Tan
- Division of Cardiology, Hunter Holmes McGuire VA Medical Center, Virginia Commonwealth University, Richmond, Virginia
| | - Mark J Shen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Hongbo Lin
- Department of Biostatistics, Indiana University School of Medicine and the Fairbanks School of Public Health, Indianapolis, Indiana
| | - Changyu Shen
- Department of Biostatistics, Indiana University School of Medicine and the Fairbanks School of Public Health, Indianapolis, Indiana
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Lan S Chen
- The Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Shien-Fong Lin
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Zhenhui Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Rhee KS, Hsueh CH, Hellyer JA, Park HW, Lee YS, Garlie J, Onkka P, Doytchinova AT, Garner JB, Patel J, Chen LS, Fishbein MC, Everett T, Lin SF, Chen PS. Cervical vagal nerve stimulation activates the stellate ganglion in ambulatory dogs. Korean Circ J 2015; 45:149-57. [PMID: 25810737 PMCID: PMC4372981 DOI: 10.4070/kcj.2015.45.2.149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 11/12/2014] [Accepted: 01/08/2015] [Indexed: 12/04/2022] Open
Abstract
Background and Objectives Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. Materials and Methods We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. Results Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (ΔSGNA) increased progressively from 5.2 mV-s {95% confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (ΔHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. Conclusion Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.
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Affiliation(s)
- Kyoung-Suk Rhee
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. ; Department of Internal Medicine, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Chia-Hsiang Hsueh
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jessica A Hellyer
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hyung Wook Park
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. ; Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young Soo Lee
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. ; Division of Cardiology, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Jason Garlie
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick Onkka
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anisiia T Doytchinova
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John B Garner
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jheel Patel
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, The David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Thomas Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Chan YH, Tsai WC, Shen C, Han S, Chen LS, Lin SF, Chen PS. Subcutaneous nerve activity is more accurate than heart rate variability in estimating cardiac sympathetic tone in ambulatory dogs with myocardial infarction. Heart Rhythm 2015; 12:1619-27. [PMID: 25778433 DOI: 10.1016/j.hrthm.2015.03.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND We recently reported that subcutaneous nerve activity (SCNA) can be used to estimate sympathetic tone. OBJECTIVE The purpose of this study was to test the hypothesis that left thoracic SCNA is more accurate than heart rate variability (HRV) in estimating cardiac sympathetic tone in ambulatory dogs with myocardial infarction (MI). METHODS We used an implanted radiotransmitter to study left stellate ganglion nerve activity (SGNA), vagal nerve activity (VNA), and thoracic SCNA in 9 dogs at baseline and up to 8 weeks after MI. HRV was determined based on time-domain, frequency-domain, and nonlinear analyses. RESULTS The correlation coefficients between integrated SGNA and SCNA averaged 0.74 (95% confidence interval [CI] 0.41-1.06) at baseline and 0.82 (95% CI, 0.63-1.01) after MI (P <.05 for both). The absolute values of the correlation coefficients were significantly larger than that between SGNA and HRV analysis based on time-domain, frequency-domain, and nonlinear analyses, respectively, at baseline (P <.05 for all) and after MI (P <.05 for all). There was a clear increment of SGNA and SCNA at 2, 4, 6, and 8 weeks after MI, whereas HRV parameters showed no significant changes. Significant circadian variations were noted in SCNA, SGNA, and all HRV parameters at baseline and after MI, respectively. Atrial tachycardia (AT) episodes were invariably preceded by SCNA and SGNA, which were progressively increased from 120th, 90th, 60th, to 30th seconds before AT onset. No such changes of HRV parameters were observed before AT onset. CONCLUSION SCNA is more accurate than HRV in estimating cardiac sympathetic tone in ambulatory dogs with MI.
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Affiliation(s)
- Yi-Hsin Chan
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou, Taoyuan, Taiwan
| | - Wei-Chung Tsai
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung University College of Medicine, Kaohsiung, Taiwan
| | - Changyu Shen
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana; Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Seongwook Han
- Division of Cardiology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shien-Fong Lin
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Peng-Sheng Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Hsu CY, Yen AMF, Chen LS, Chen HH. Analysis of household data on influenza epidemic with Bayesian hierarchical model. Math Biosci 2015; 261:13-26. [PMID: 25484132 PMCID: PMC7094348 DOI: 10.1016/j.mbs.2014.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 11/14/2014] [Accepted: 11/22/2014] [Indexed: 11/25/2022]
Abstract
Data used for modelling the household transmission of infectious diseases, such as influenza, have inherent multilevel structures and correlated property, which make the widely used conventional infectious disease transmission models (including the Greenwood model and the Reed-Frost model) not directly applicable within the context of a household (due to the crowded domestic condition or socioeconomic status of the household). Thus, at the household level, the effects resulting from individual-level factors, such as vaccination, may be confounded or modified in some way. We proposed the Bayesian hierarchical random-effects (random intercepts and random slopes) model under the context of generalised linear model to capture heterogeneity and variation on the individual, generation, and household levels. It was applied to empirical surveillance data on the influenza epidemic in Taiwan. The parameters of interest were estimated by using the Markov chain Monte Carlo method in conjunction with the Bayesian directed acyclic graphical models. Comparisons between models were made using the deviance information criterion. Based on the result of the random-slope Bayesian hierarchical method under the context of the Reed-Frost transmission model, the regression coefficient regarding the protective effect of vaccination varied statistically significantly from household to household. The result of such a heterogeneity was robust to the use of different prior distributions (including non-informative, sceptical, and enthusiastic ones). By integrating out the uncertainty of the parameters of the posterior distribution, the predictive distribution was computed to forecast the number of influenza cases allowing for random-household effect.
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Affiliation(s)
- C Y Hsu
- Department of Emergency Medicine, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan ; Division of Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - A M F Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - L S Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - H H Chen
- Division of Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Jiang Z, Zhao Y, Doytchinova A, Kamp NJ, Tsai WC, Yuan Y, Adams D, Wagner D, Shen C, Chen LS, Everett TH, Lin SF, Chen PS. Using skin sympathetic nerve activity to estimate stellate ganglion nerve activity in dogs. Heart Rhythm 2015; 12:1324-32. [PMID: 25681792 DOI: 10.1016/j.hrthm.2015.02.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Stellate ganglion nerve activity (SGNA) is important in cardiac arrhythmogenesis. However, direct recording of SGNA requires access to the thoracic cavity. Skin of upper thorax is innervated by sympathetic nerve fibers originating from the stellate ganglia and is easily accessible. OBJECTIVE The purpose of this study was to test the hypothesis that thoracic skin nerve activity (SKNA) can be used to estimate SGNA. METHODS We recorded SGNA and SKNAs using surface electrocardiogram leads in 5 anesthetized and 4 ambulatory dogs. Apamin injected into the right stellate ganglion abruptly increased both right SGNA and SKNA in 5 anesthetized dogs. We integrated nerve activities and averaged heart rate in each 1-minure window over 10 minutes. We implanted a radiotransmitter to record left SGNA in 4 ambulatory dogs (2 normal, 1 with myocardial infarction, 1 with intermittent rapid atrial pacing). After 2 weeks of recovery, we simultaneously recorded the SKNA and left SGNA continuously for 30 minutes when the dogs were ambulatory. RESULTS There was a positive correlation [average r = 0.877, 95% confidence interval (CI) 0.732-1.000, P <.05 for each dog] between integrated skin nerve activity (iSKNA) and SGNA (iSGNA) and between iSKNA and heart rate (average r = 0.837, 95% CI 0.752-0.923, P <.05). Similar to that found in the anesthetized dogs, there was a positive correlation (average r = 0.746, 95% CI 0.527-0.964, P <.05) between iSKNA and iSGNA and between iSKNA and heart rate (average r = 0.706, 95% CI 0.484-0.927, P <.05). CONCLUSION SKNAs can be used to estimate SGNA in dogs.
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Affiliation(s)
- Zhaolei Jiang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ye Zhao
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Anisiia Doytchinova
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nicholas J Kamp
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Wei-Chung Tsai
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University
| | - Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - David Adams
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - David Wagner
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Department of Biostatistics, Indiana University School of Medicine and the Fairbanks School of Public Health, Indianapolis, Indiana
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana,.
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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Doytchinova A, Patel J, Zhou S, Chen LS, Lin H, Shen C, Everett TH, Lin SF, Chen PS. Subcutaneous nerve activity and spontaneous ventricular arrhythmias in ambulatory dogs. Heart Rhythm 2014; 12:612-620. [PMID: 25460171 DOI: 10.1016/j.hrthm.2014.11.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Stellate ganglion nerve activity (SGNA) is important in ventricular arrhythmogenesis. However, because thoracotomy is needed to access the stellate ganglion, it is difficult to use SGNA for risk stratification. OBJECTIVE The purpose of this study was to test the hypothesis that subcutaneous nerve activity (SCNA) in canines can be used to estimate SGNA and predict ventricular arrhythmia. METHODS We implanted radiotransmitters to continuously monitor left stellate ganglion and subcutaneous electrical activities in 7 ambulatory dogs with myocardial infarction, complete heart block, and nerve growth factor infusion to the left stellate ganglion. RESULTS Spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) was documented in each dog. SCNA preceded a combined 61 episodes of VT and VF, 61 frequent bigeminy or couplets, and 61 premature ventricular contractions within 15 seconds in 70%, 59%, and 61% of arrhythmias, respectively. Similar incidence of 75%, 69%, and 62% was noted for SGNA. Progressive increase in SCNA [48.9 (95% confidence interval [CI] 39.3-58.5) vs 61.8 (95% CI 45.9-77.6) vs 75.1 (95% CI 57.5-92.7) mV-s] and SGNA [48.6 (95% CI 40.9-56.3) vs 58.5 (95% CI 47.5-69.4) vs 69.0 (95% CI 53.8-84.2) mV-s] integrated over 20-second intervals was demonstrated 60 seconds, 40 seconds, and 20 seconds before VT/VF (P <.05), respectively. The Pearson correlation coefficient for integrated SCNA and SGNA was 0.73 ± 0.18 (P <.0001 for all dogs, n = 5). Both SCNA and SGNA exhibited circadian variation. CONCLUSION SCNA can be used as an estimate of SGNA to predict susceptibility to VT and VF in a canine model of ventricular arrhythmia and sudden cardiac death.
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Affiliation(s)
- Anisiia Doytchinova
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Jheel Patel
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shengmei Zhou
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Hongbo Lin
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana; Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Changyu Shen
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana; Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Chen LS, Xu L, Dhar SU, Li M, Talwar D, Jung E. Autism spectrum disorders: a qualitative study of attitudes toward prenatal genetic testing and termination decisions of affected pregnancies. Clin Genet 2014; 88:122-8. [PMID: 25251361 DOI: 10.1111/cge.12504] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 12/25/2022]
Abstract
In the United States, prenatal genetic testing (PGT) for Autism Spectrum Disorders (ASD) is currently available via clinical genetic services. Such testing may inform parents about their unborn child's risk for ASD, prepare parents for the birth of an affected infant, and allow them to arrange for early interventions. Although PGT for autism has potential benefits, the associated ethical, legal, and social implications (ELSI) should be considered. This first qualitative study employed a hypothetical scenario to explore the attitudes toward PGT and termination decisions of 42 parents of children with ASD. Over half of the participants expressed willingness to undergo PGT for autism. Reasons included better preparation for birth, early and better treatment, termination of affected pregnancy, contribution to research, and curiosity. Of the 31 parents who were either willing or unsure about undergoing the PGT, approximately three-fourths would continue their hypothetical affected pregnancies. Explanations included preparation for birth of the child, bonding or acceptance of existing ASD-affected children, apprehensions about test limitations, and religious concerns. Parents who reported they would terminate the affected pregnancy in this hypothetical situation were primarily Asians. This study contributes to the growing understanding of the ELSI aspects of PGT in clinical practice.
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Affiliation(s)
- L S Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - L Xu
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - S U Dhar
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - M Li
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - D Talwar
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - E Jung
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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Chen LS, Li C, Wang CH, Amuta A, Li M, Huang TY, Dhar SU, Talwar D, Jung E. Autism spectrum disorders: perceptions of genetic etiology and recurrence risk among Taiwanese parents of affected children. Clin Genet 2014; 88:129-34. [PMID: 25267333 DOI: 10.1111/cge.12514] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/11/2014] [Accepted: 09/26/2014] [Indexed: 11/29/2022]
Abstract
In Taiwan, autism spectrum disorders (ASDs) are an emerging public health concern. The ongoing scientific progress for understanding the genetic etiology of ASD makes it increasingly important to examine how parents of children with ASD perceive the causes and recurrence risk of having another child with ASD. These perceptions may influence their family planning, attitudes toward genetic services, and willingness to take their children for ASD genetic testing. However, previous studies addressing this issue were conducted primarily in Western countries. As culture might shape an individual's views of genetic/genomic disorders, this first-of-its-kind study examined the perceptions of the genetic etiology for ASD and the recurrence risk among Taiwanese parents of children affected with ASD. In-depth, semi-structured interviews were conducted among 39 parents having at least one child with ASD. Although the majority of participants believed that ASD has a genetic link, less than half perceived genetic factors as the cause of their own child's ASD. Moreover, most participants articulated their recurrence risk incorrectly. Some parents were concerned about their doctors' limited genomic competencies. To provide parents with better education, counseling, and support for making reproductive decisions, ASD-related genomic education among Taiwanese physicians is needed.
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Affiliation(s)
- L S Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - C Li
- Department of Foreign Languages, WeiFang Medical University, Shandong, China
| | - C H Wang
- Department of Special Education, National HsinChu University of Education, HsinChu, Taiwan
| | - A Amuta
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - M Li
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - T Y Huang
- Department of Special Education, National HsinChu University of Education, HsinChu, Taiwan
| | - S U Dhar
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - D Talwar
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - E Jung
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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