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Biomedical subjects

M S Chang

Publications and source records attributed to M S Chang.

At least 361 records · Page 20Linked to original sources

Arterial hemodynamics in human hypertension.

Differences in aortic impedance between normotensives and hypertensives are not well characterized. We examined impedance in 8 normotensive and 11 hypertensive (mean 96.7 vs. 122.2 mmHg) age-matched, Chinese patients undergoing cardiac catheterization at rest, during nitroprusside, and handgrip exercise before and after beta blockade (propranolol). Hypertensives had higher resistance (2,295 vs. 1713 dyn-s/cm5), characteristic impedance (145.7 vs. 93.9 dyn-s/cm5), total external power (1,579 vs. 1174 mW), peripheral reflections (ratio of backward to forward wave components of 0.54 vs. 0.44), and first zero crossing of impedance phase angle (4.15 vs. 2.97 Hz). These abnormalities were eliminated with vasodilatation. Differences between groups were not further exacerbated when pressure was increased during handgrip exercise. Beta blockade further increased resistance and reflections. Thus, hemodynamic abnormalities of essential hypertension (increased resistance, reflections, and pulse wave velocity, and decreased compliance) are compatible with an increased vasomotor tone that is further unmasked during generalized beta blockade.

Adult↗

Mechanisms of verapamil-induced conduction block in anomalous atrioventricular bypass tracts.

Verapamil, a calcium channel blocking agent, has been demonstrated to have depressive effects on the atrioventricular (AV) node but not anomalous AV bypass tracts. Of 39 patients with AV reciprocating tachycardia utilizing left-sided bypass tracts for retrograde conduction, intravenous infusion of verapamil (0.15 mg/kg) terminated the tachycardia in 31 patients. Verapamil interrupted the tachycardia circuit by inducing retrograde conduction block in the bypass tract rather than the AV node in 5 of these 31 patients. Electrophysiologic studies in these five patients revealed that verapamil-induced conduction block in the bypass tract could be accounted for by two distinctly different mechanisms. In three patients, verapamil induced alternating slow and fast AV nodal conduction resulting in alternating long and short cycle lengths during the tachycardia; consequently, development of the Ashman phenomenon in the bypass tract terminated the tachycardia. In the remaining two patients, the bypass tract exhibited properties similar to those of the AV node; verapamil prolonged the effective refractory period of the bypass tract, thereby terminating the tachycardia. Thus, depending on the functional properties of the bypass tract, verapamil may interrupt an AV reciprocating tachycardia circuit by exerting either a direct or indirect depressive action on the bypass tract.

Adult↗

Nadolol and supraventricular tachycardia: an electrophysiologic study.

To assess antiarrhythmic efficacy of oral nadolol, 15 patients with recurrent supraventricular tachycardia were studied. Eight patients had atrioventricular (AV) nodal reentrant tachycardia and seven had AV reciprocating tachycardia involving an accessory AV pathway. Electrophysiologic studies were performed before and after intravenous infusion of propranolol (0.20 mg/kg), and were repeated 5 to 8 days after oral nadolol therapy at a daily dose of 80 to 160 mg. Both intravenous propranolol and oral nadolol induced significant prolongation of the sinus cycle length from 741 +/- 73 ms to 834 +/- 97 and 1,029 +/- 95 ms, respectively (p less than 0.001 and p less than 0.0001, respectively). Both intravenous propranolol and oral nadolol depressed AV nodal but not accessory AV pathway conduction, and shifted the dual AV nodal pathway conduction curves (A1A2, A2H2; A1A2, H1H2) upward and to the right by prolonging the conduction time and increasing the refractory period. Ten patients (seven with AV nodal reentry and three with AV reciprocation) who responded to intravenous propranolol also responded to oral nadolol with loss of the inducibility of sustained tachycardia; the remaining five patients (one with AV nodal reentry and four with AV reciprocation) who did not respond to intravenous propranolol also failed to respond to oral nadolol with persistence of the inducibility of sustained tachycardia. Thus, in conclusion, intravenous propranolol testing predicts the therapeutic efficacy of oral nadolol therapy and oral nadolol in once-daily doses may be used for long-term prophylaxis of recurrent supraventricular tachycardia.

Adolescent↗

Clinical electrophysiology of supraventricular tachycardia.

In this comprehensive article, the authors examine the clinical and electrophysiologic aspects of supraventricular tachycardia. Included in this discussion are the various mechanisms that account for this arrhythmia, the types of supraventricular tachycardia, and the treatment for it.

Atrial Fibrillation↗

Effects of coronary arterial pressure on left ventricular end-systolic pressure-volume relation of isolated canine heart.

In the excised canine left ventricle, the end-systolic pressure-volume relationship (ESPVR) has been shown to be approximately linear over the working range of loading conditions when coronary arterial pressure (CAP) is maintained constant, independent of loading conditions. To investigate the ESPVR under the more intact physiological condition in which the CAP varies with loading on the left ventricle, we studied the effect of changes in CAP on the ESPVR in 10 excised cross-circulated canine ventricles which were contracting isovolumically. The ESPVR, determined from isovolumic contractions at four different volumes, was reasonably independent of CAP as long as CAP remained above a critical pressure (67.0 +/- 22.1 mm Hg). Below this pressure, the slope of ESPVR decreased although the volume axis intercept (V0) remained unaltered. These findings indicate that under physiological conditions, where there is a close coupling of CAP to systolic left ventricular pressure, the ESPVR should become nonlinear in the low preload or afterload regions. When CAP was varied with the left ventricular pressure in five ventricles, the ESPVR indeed became nonlinear in the low-load region. We conclude that the ESPVR in intact conditions is reasonably linear in the physiological load range, but it can be nonlinear in the low-load range.

Animals↗

Protection of rat liver 80 S ribosomes against ricin A chain inactivation by proteins extracted from rat liver and wheat germ ribosomal subunits with ammonium chloride/magnesium chloride.

Proteins extracted from wheat germ 60 S ribosomal subunits and rat liver 60 S and 40 S ribosomal subunits with 3 M NH4Cl/75 mM MgCl2 were able to prevent the ricin A chain-mediated inactivation of untreated 80 S rat liver ribosomes. The protection of polyphenylalanine synthetic capability of 80 S ribosomes was saturable and reached 100% protection in the presence of about 20 micrograms of extracted protein using a uniform set of assay conditions. No protection was observed using proteins extracted from wheat germ 40 S subunits or the core fraction of rat liver 60 S subunits or protein extracted from Escherichia coli ribosomes or ribosomal subunits. The conclusion that the protective effect of extracted 60 S subunit proteins was specific, was further strengthened by showing that unrelated proteins such as alpha-lactalbumin, bovine serum albumin and lysozyme, and polypeptides such as polylysine and poly(aspartic acid), also showed no protection. If 80 S ribosomes were first treated with ricin A chain and then incubated with proteins extracted from rat liver 60 S subunits, no protection was observed. Proteins extracted with NH4Cl/MgCl2 from 60 S rat liver subunits were applied to carboxymethylcellulose column equilibrated with 6 M urea. Stepwise elution with increasing concentrations of LiCl resulted in seven fractions. One fraction (D) contained most of the protective factor; one fraction (E) contained a lesser amount of the protective factor. Two-dimensional polyacrylamide gel electrophoresis of fraction D showed the presence of ten proteins. These data are consistent with the idea that the enzymatic target of ricin A chain is protein is nature and that fraction D contains one or more proteins that appear to act as a inhibitor against ricin A chain.

Ammonium Chloride↗

Parasitological and entomological studies on filariasis in seven villages, Serian District, Sarawak, East Malaysia.

A total of 82 persons have been found to be positive for microfilaria a sub-periodic Brugia malayi out of 1,613 examined in seven villages in Serian District. This represents an average microfilaria infection rate of 5.1% with a range of zero to 10.7%. It is found that males are more predominantly affected than females with a ratio of 3:1. It is also confirmed that Mansonia dives and M. bonneae are possible vectors for the transmission of the disease although Anopheles species cannot be ruled out owing to the small number of specimens examined. The study is confined to areas where indoor DDT spraying has been done since 1960 and only in two of the areas it has been terminated in 1966. Yet to be published data shows higher filaria infection rate than any of these villages.

Adolescent↗

Chronic tuberculous epididymitis: color Doppler US findings with histopathologic correlation.

BACKGROUND: The aim of this study was to determine the color Doppler features of tuberculous epididymitis and to correlate these findings with histopathologic findings. METHODS: Color Doppler ultrasound (US) findings of 12 histopathologically proven tuberculous epididymitis and tuberculous epididymo-orchitis in 11 consecutive patients were retrospectively analyzed. Color Doppler US findings of tuberculous epididymitis were correlated with histopathologic findings. RESULTS: Color Doppler US findings of tuberculous epididymitis demonstrated no blood flow in the epididymal lesions except for focal linear or spotty flow signals in the peripheral portion. These findings correlated well with pathologic findings; the central portion of the epididymal lesions demonstrated granulomas with caseation necrosis, and the peripheral portion of the epididymal lesions had several medium to small vessels. CONCLUSIONS: Color Doppler US may be helpful for differential diagnosis of tuberculous epididymitis and non-tuberculous epididymitis.

Adult↗

A small scale field trial with expanded polystyrene beads for mosquito control in septic tanks.

A field trial of the use of expanded polystyrene beads (EPSB) to control the breeding of mosquito larvae in household septic tanks was conducted in Sarawak. One week after treatment, the breeding of Culex quinquefasciatus and Aedes albopictus was reduced by 100% and 68.7% respectively. For both species combined, a 57.25% reduction in the adult emergence rate was achieved. No adult was caught in the emergence trap one month after treatment. A reduction in mosquito biting rates was reported by 87.3% of respondents. All households regarded the EPSB treatment as effective. This study has reduced the relatively high infestation rate of A. albopictus in the septic tanks to 16-20%. The EPSB treatment is feasible and practical. Post-treatment assessment using adult emergence traps and the implications for the vector control programme of the local authority are discussed.

Aedes↗

Changes in abundance and behaviour of vector mosquitoes induced by land use during the development of an oil palm plantation in Sarawak.

Surveys were conducted of adult and immature mosquitoes in an area undergoing oil palm development in north Sarawak. Point prevalence data from 2 sites were collected annually, coinciding with annual phases of forest clearing, burning/cultivation, and maintenance. Major habitat perturbation during the forest/clearing transition shifted the major mosquito faunal equilibrium in terms of species composition, relative density and occurrence. Analyses of variance showed that the mean numbers of 4 species of Anopheles decreased significantly after forest clearing. Relative densities of immature stages decreased after forest clearing, but A. letifer and Culex tritaeniorhynchus remained relatively unchanged after the second year. Comparisons with the pre-development forest stage showed that the reductions in person-biting rates, adult survival and combined entomological inoculation rates (EIR) of A. donaldi and A. letifer decreased the risk of malaria transmission by 90% over the 4 years period. Concomitant reductions in EIR and annual malaria incidence were also correlated. This study highlighted the 'law of unintended consequences', since 2 contrasting effects were observed: reduction of malaria vectors but concomitant increase of dengue vectors.

Animals↗