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PubMed1990

Clinical predictors of myocardial damage after high voltage electrical injury.

Myocardial damage after high voltage electrical body injury is a serious and often life-threatening situation. The purpose of this pilot study was to identify early clinical predictors of myocardial damage in patients with high voltage electrical injury. Twenty-four patients with high voltage electrical injuries and no evidence of arc burns were evaluated. In 13/24 patients the diagnosis of myocardial damage was confirmed by total creatine kinase (CK) and creatine kinase MB (CK-MB) isoenzyme elevation (group A). In these patients the total CK range was 1373 to 52,544 mU/ml. In 11/24 patients CK-MB was negative (group B) indicating absence of myocardial damage. ECG changes occurred in 10/13 group A and 4/11 group B patients (p less than .095). No patient in either group gave a history suggestive of myocardial ischemia after the electrical injury. The pathways of electricity through the body, as mapped by a line drawn between the wound(s) of entrance and exit, were vertical in all group A patients, i.e., from upper to lower body segment, vs. 5/11 group B patients with evidence of a vertical pathway (p less than .003). Group A patients also had greater body surface burns (16.0 +/- 2.7%) vs. group B patients (4.0 +/- 1.6%, p less than .001). The presence of a vertical pathway and the magnitude of percent surface burns were found to be the most significant clinical predictors of myocardial damage in multiple logistic regression analysis (p less than .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[High-voltage therapy of prostate cancer].

High-voltage therapy is becoming increasingly important as a form of individual differential therapy of carcinoma of the prostate. Around 40% of all patients with a diagnosis of carcinoma of the prostate can be treated with high-voltage therapy. The precondition is the absence of bone and soft-tissue metastases and of juxtaregional lymph-node metastases. Individual carcinoma therapy is based on pre-therapeutic tumor classification according to the TNM system. The 5-year survival rates are presented from a retrospective study carried out using primary radiation monotherapy and a combined hormone and radiation therapy; these figures were calculated by the life-table method. The study revealed no significant differences between the two forms of therapy as regards 5-year survival rates. The 5-year survival rates of all patients of the classifications T0-T3Nx-N2M0 irradiated (n: 198) (72% +/- 11% for hormone plus radiation therapy and 74% +/- 11% for radiation monotherapy) did not differ greatly from those of a normal male population of the same age (77%). High-voltage therapy of carcinoma of the prostate can thus be classified as a curative method of treatment.

Aged↗
PubMed2004

Influence of low frequency electric fields on anti- and pro-coagulability of the vascular endothelium: new insights into high-voltage electrical injury.

After high-voltage electric injury, patients often show tissue necrosis and thrombosis of blood vessels even remote from entry and exit site of electrical current. In this study, plasma levels of TAT, F(1+2), PAI-1, and t-PA were determined in vivo in three patients with high-voltage injury for 96 hours after trauma. In order to analyse a possible effect on haemostasis related to endothelial cell damage, protein S, TF, ET-1, PGI(2), NO, t-PA, and PAI-1 were determined for 72 hours in vitro in cell culture supernatant of HUVECs that had been exposed to 1, 10, 30, and 50 electric field periods of 50 Hz with field strength of 60 V/cm and duration of 20 ms. Furthermore, expression of thrombomodulin was immunohistochemically analysed. Clotting activation could be observed in our patients by increased levels of F(1+2) and TAT between 12 and 72 hours after injury, whereas fibrinolysis was disturbed due to high PAI-1. One patient presented thrombosis of vessels by day 3. In vitro, PAI-1 increased significantly (p<0.05) in medium of cells with an application of 30 and 50 periods between 2 and 48 hours. Between 4 and 72 hours, the concentration of t-PA was significantly lower (p<0.05) in the medium of HUVECs exposed to 10, 30, and 50 periods, whereas there was a significant increase (p<0.05) in the concentration of TF in the cell groups with an application of 30 and 50 periods. 24, 48, and 72 hours after injury, there was just weak or no staining for thrombomodulin in HUVECs with an application of 30 and 50 periods. The disturbed balance between clotting system and fibrinolysis seen in vitro after electric injury might explain the clinical observation of a progressive thrombosis of blood vessels after electric injury leading to tissue loss.

Adolescent↗
PubMed1994

Low- and high-voltage-activated calcium channel currents and their modulation in the dorsal root ganglion cell line ND7-23.

The dorsal root ganglion-neuroblastoma cell line ND7-23 expresses low-voltage-activated calcium channel currents, and also expresses high-voltage-activated currents in about 50% of differentiated cells. Calcium channel currents were recorded with Ba2+ as the charge carrier. Low-voltage-activated currents were maximally activated at -30 mV and completely inactivated at holding potentials of -60 to -50 mV. omega-Conotoxin GVIA produced a reversible inhibition of low-voltage-activated currents, whereas the inhibition of high-voltage-activated current was largely irreversible. Dihydropyridine antagonists did not inhibit low-voltage-activated currents, whereas they inhibited a sustained, high-voltage-activated current. Low-voltage-activated currents were inhibited to a greater extent than high-voltage-activated currents by Ni2+ (100 microM) and by phenytoin (10 microM). Bradykinin (0.1 microM), baclofen (2 microM) and internal guanosine-5'-O-3-thiotriphosphate (100 microM) inhibited low-voltage-activated currents without affecting their kinetics of activation. Two classes of low-voltage-activated current were distinguished by their kinetics of inactivation. In the majority of cells, currents were slowly inactivating with a time-constant of inactivation of about 50 ms. They also exhibited a sustained component to the current, representing about 20% of the peak current. This component could be distinguished pharmacologically from high-voltage-activated current. The remainder of cells expressed a rapidly and completely inactivating current, with a time-constant of inactivation of about 20 ms. Two distinct single channel currents were observed in these cells, from cell-attached patch measurements, one had a single channel conductance of 7.9 pS, and the ensemble average current showed some inactivation. It is likely that this channel subtype underlies the low-voltage-activated current. The other showed long openings in the presence of a dihydropyridine agonist, had a conductance of 23.1 pS, and was non-inactivating.

Ammonium Chloride↗
PubMed1977

Skull injuries caused by high voltage electricity.

Four cases by high voltage electricity are reported. Particular interest is taken in describing initial conservative treatment of injuries where the entrance of the current has been through the head, followed by surgical excision and flap surgery. This procedure had an uneventful postoperative course. Other methods comprising an earlier excision and revitalizing flap coverage over the necrotic bone thereby avoiding later bone grafting are being discussed and may be preferable. A decrease in high voltage injuries has been noticed during the last ten-year period compared to earlier data (5.5% down to 1.4%). This may well be partially explained by improved precautionary measures, but children are still prominent among the injured. All the children were injured while playing around railroad areas.

Electric Injuries↗
PubMedDate not supplied

One hundred ninety-five cases of high-voltage electric injury.

High-voltage electric injury (HVEI) is associated with a high incidence of extremity compartment syndrome and of major amputation. The purpose of this study was to review our experience with HVEI and to attempt to develop predictors of the need for fasciotomy and amputation in patients with HVEI. The records of the 195 patients with HVEI who were admitted to a single burn center during a 19-year period were reviewed. Evidence for muscle necrosis, to include myoglobinuria and elevated creatine phosphokinase (CPK) levels, was noted. A total 187 patients (95.9%) survived to hospital discharge. A total of 56 underwent fasciotomy within 24 h of injury; 80 patients underwent an amputation during the hospitalization. Fasciotomy was predicted by presence of myoglobinuria with an overall accuracy of 72.8%. Amputation was predicted by a logistic model incorporating myoglobinuria, undergoing a previous fasciotomy, and age, with an overall accuracy of 73.3%. HVEI was associated with high amputation risk and a low rate of mortality in patients admitted to our burn center. Patients with gross myoglobinuria are at higher risk of requiring fasciotomy and/or amputation.

Accidents, Occupational↗
PubMed1993

Effects of muscarinic receptor agonists and anticholinesterase drugs on high voltage spindles and slow waves.

The effects of muscarinic agonists (AF102B, pilocarpine, oxotremorine) and anticholinesterases (physostigmine, tetrahydroaminoacridine) were investigated on the incidence of thalamically generated rhythmic high voltage spindles and on scopolamine (0.2 mg/kg)-induced neocortical slow wave activity (i.e. increased sum amplitude value of the 1-20 Hz band in a quantitative electroencephalography (qEEG) analysis). AF102B and pilocarpine decreased high voltage spindles and scopolamine increased sum amplitude values at 3 and 9 mg/kg, but not at 1 mg/kg. Oxotremorine was less potent than AF102B or pilocarpine in suppressing high voltage spindles. Oxotremorine had no effect on the scopolamine-induced qEEG changes. Tetrahydroaminoacridine decreased high voltage spindles at 1, 3 and 9 mg/kg and slow waves at 9 mg/kg. Physostigmine decreased high voltage spindles and slow waves at 0.12 and 0.36 mg/kg. Based on the present results we propose that agonists possessing muscarinic M1 receptor activity are effective in decreasing high voltage spindles and scopolamine-induced slow wave activity, but agonists showing predominant muscarinic M2 receptor activity may be less effective in decreasing high voltage spindles and slow waves. Furthermore, tetrahydroaminoacridine decreased high voltage spindles at doses lower than those required to decrease scopolamine-induced slow waves. Physostigmine decreased high voltage spindles and slow waves over the same dose range. This result may indicate that non-cholinergic mechanisms are involved in the tetrahydroaminoacridine-induced decrease in high voltage spindles.

Alzheimer Disease↗
PubMed1990

[Anticancer effect of high voltage pulses combined with concentration dependent anticancer drugs on Lewis lung carcinoma, in vivo].

Using high voltage pulse (initial electric field strength 3kV/cm, duration 4 msec, applied energy 14.9 joule) as a local load, and concentration dependent anticancer drugs such as peplomycin (PEP) 20 mg/kg, cyclophosphamide (CPA) 100 mg/kg, mitomycin C (MMC) 3 mg/kg and cisplatin (CDDP) 5 mg/kg administrated intraperitoneally, the effects on the suppression of primary lesions and on formation of pulmonary metastasis in the spontaneous pulmonary metastatic system of Lewis lung carcinoma were investigated. Though only CPA among single administrated anticancer drugs showed a suppressive effect against tumor growth, remarkable reduction in the size of primary lesions was obtained with a combination of high voltage pulse and an anticancer drug, regardless of various kinds of drug. A maximal ratio of size before and after treatment was 0.05 in PEP, 0.2 in CPA, 0.38 in MMC and 0.14 in CDDP. A combination of PEP or CPA with high voltage pulse had a particularly good effect, reducing the volume of the primary tumor after treatment less than levels before treatment throughout 2 weeks. The use of high voltage pulse alone did not affect any growth kinetics of the primary lesion. The number of pulmonary metastatic nodules was significantly reduced only by CPA among various kinds of single administrated drugs, whereas it was reduced by all treatments with a combination of high voltage pulse and each anticancer drug. The use of high voltage pulse alone did not result in any increase of the number of pulmonary metastatic nodules.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Structure of the colcemid-treated PtK1 kinetochore outer plate as determined by high voltage electron microscopic tomography.

High voltage electron microscopic tomography was used to determine the organization of the kinetochore plate and its attachment to the underlying chromosome. Six reconstructions were computed from thick sections of Colcemid-treated PtK1 cells and analyzed by a number of computer graphics methods including extensive thin slicing, three-dimensional masking, and volume rendering. When viewed en-face the kinetochore plate appeared to be constructed from a scaffold of numerous 10-20-nm thick fibers or rods. Although the fibers exhibited regions of parallel alignment and hints of a lattice, they were highly variable in length, orientation and spacing. When viewed in stereo, groups of these fibers were often seen oriented in different directions at different depths to give an overall matted appearance to the structure. When viewed "on edge," the plate was 35-40 nm thick, and in thin slices many regions were tripartite with electron-opaque domains, separated by a more translucent middle layer, forming the inner and outer plate boundaries. These domains were joined at irregular intervals. In some slices, each domain appeared as a linear array of 10-20-nm dots or rods embedded in a less electron-opaque matrix, and adjacent dots within or between domains often appeared fused to form larger blocks. The plate was connected to the underlying chromosome by less densely arrayed 10-20-nm thick fibers that contacted the chromosome-facing (i.e., inner) surface of the plate in numerous patches. These patches tended to be arrayed in parallel rows perpendicular to the long axis of the chromosome. In contrast to connecting fibers, corona fibers were more uniformly distributed over the cytoplasmic-facing (i.e., outer) surface of the plate. When large portions of the reconstructions were viewed, either en-face or in successive slices parallel to the long axis of the chromosome, the edges of the plate appeared splayed into multiple "fingers" that partly encircled the primary constriction. Together these observations reveal that regions of the kinetochore outer plate contain separate structural domains, which we hypothesize to serve separate functional roles. Our three-dimensional images of the kinetochore are largely consistent with the hypothesis that the outer plate is composed of multiple identical subunits (Zinkowski, R. P., J. Meyne, and B. R. Brinkley. 1991. J. Cell Biol. 113:1091-1110).

Animals↗
PubMed1978

Comparison of active zones in spinal cord of anesthetized and unanesthetized rats: a high voltage electron microscope study.

High voltage electronmicroscopy was applied to the study of presynaptic nerve terminals and specifically the arrangement and staining properties of synaptic vesicles in and around the active zone. The zinc iodideosmium tetroxide technique was used for the impregnation of neuropil derived from the spinal cord of anesthetized (40 mg/kg pentobarbital sodium) and unanesthetized rats. Under optimal conditions of section thickness and tilt angles stereoscopic views of a paracrystalline lattice arrangement of synaptic vesicles could be ascertained. The ZIO affinity was significantly higher in synaptic vesicles of the anesthetized as compared with the unanesthetized preparations.

Animals↗
PubMed1988

DNA cleavage based on high voltage electric pulse.

A high voltage electric pulse was applied to DNA cleavage. The DNA cleavage reaction was dependent on the voltage amplitude, pulse number and pulse width. Radical scavengers and ESR data indicated the possibility that active species such as OH radical were strongly related to DNA cleavage.

DNA↗
PubMed1996

Proximal and segmental motor nerve conduction in the sciatic nerve produced by percutaneous high voltage electrical stimulation.

Percutaneous high voltage electrical stimulation was applied to the proximal sciatic nerve at the hip in 18 normal subjects to evaluate motor conduction in the proximal sciatic nerve, and short-segment stimulation of the sciatic and posterior tibial nerves was given in 6 normal subjects. Compound muscle action potentials (CMAPs) were recorded from the abductor hallucis (AH) and extensor digitorum brevis (EDB) muscles. Supramaximal stimulation was easily obtained at the proximal sciatic nerve and all the sites in the short-segment stimulation. The motor nerve conduction velocity of the sciatic nerve between the hip and the popliteal fossa was 49.2 +/- 4.24 m/sec in the tibial division and 54.1 +/- 6.48 m/sec in the peroneal division. The respective peak-to-peak amplitude and negative-peak areas of the CMAPs at the hip were reduced to 86.8 +/- 5.65% and 97.3 +/- 5.36% for the tibial division, and 93.4 +/- 7.06% and 96.8 +/- 5.09% for the peroneal division as compared to the values for the popliteal fossa. The negative-peak duration of the CMAPs at the hip point were increased to 109.2 +/- 7.2% for the tibial nerve and 107.1 +/- 5.68% for the peroneal nerve as compared with the duration at the popliteal fossa. This method is non-invasive and useful for evaluating motor nerve conduction in the lower limb.

Adult↗
PubMed1991

Quantitative determination of the mineral distribution in different collagen zones of calcifying tendon using high voltage electron microscopic tomography.

High voltage electron microscopic tomography was used to make the first quantitative determination of the distribution of mineral between different regions of collagen fibrils undergoing early calcification in normal leg tendons of the domestic turkey, Meleagris gallopavo. The tomographic 3-D reconstruction was computed from a tilt series of 61 different views spanning an angular range of +/- 60 degrees in 2 degrees intervals. Successive applications of an interactive computer operation were used to mask the collagen banding pattern of either hole or overlap zones into separate versions of the reconstruction. In such 3-D volumes, regions specified by the mask retained their original image density while the remaining volume was set to background levels. This approach was also applied to the mineral crystals present in the same volumes to yield versions of the 3-D reconstructions that were masked for both the crystal mass and the respective collagen zones. Density profiles from these volumes contained a distinct peak corresponding only to the crystal mass. A comparison of the integrated density of this peak from each profile established that 64% of the crystals observed were located in the collagen hole zones and 36% were found in the overlap zones. If no changes in crystal stability occur once crystals are formed, this result suggests the possibilities that nucleation of mineral is preferentially and initially associated with the hole zones, nucleation occurs more frequently in the hole zones, the rate of crystal growth is more rapid in the hole zones, or a combination of these alternatives. All lead to the conclusion that the overall accumulation of mineral mass is predominant in the collagen hole zones compared to overlap zones during early collagen fibril calcification.

Achilles Tendon↗
PubMedDate not supplied

Antibiotic identification by high voltage electrophoresis bioautography.

The high voltage electrophoresis bioautography method is applicable to meat, milk, and animal feeds. Meat is freeze-dried, powdered, and extracted with acetonitrile-water (9 + 1), and the extract is concentrated by evaporation at room temperature. Milk is examined directly or following acetonitrile-water extraction. Feed is extracted with acetonitrile-water. Samples or extracts are applied to preliminary assay plates of antibiotic medium No. 1 at pH 6 and 8, seeded with Micrococcus luteus (ATCC 9341), M. luteus DHSR (ATCC 9341A), Bacillus cereus (ATCC 11778), or B. cereus K250 TR (NCIB 11183), and nutrient agar at pH 7 seeded with B. subtilis BGA. Inactivation of penicillinase indicates beta-lactam antibiotics. Addition of trimethoprim increases sensitivity to sulfonamides. After 18-24 h incubation at 30 degrees C, plates yielding clear inhibition zones guide selection of conditions for subsequent electrophoresis bioautography. Extracts are applied (5-100 microL) to 10 mm diameter wells on electrophoresis plates 60 cm long and 40 cm wide, with a gel depth of 1.6 mm. The support medium is 1% agar and 1% agarose in Tris/succinic acid buffers pH 6 and pH 8. A potential of 1500 V is applied for 1.5 h at 15 degrees C. Following electrophoresis, the migrated antibiotics are visualized by over-layering with antibiotic medium No. 1, pH 6 or 8, seeded with M. luteus or B. cereus spore suspension; plates are incubated for 18-24 h at 30 degrees C. Identification is based on results of preliminary screening together with electrophoretic migration distances and inhibition zone appearances compared with standards.

Animal Feed↗
PubMed1999

Comparison of the effects of short, high-voltage and long, medium-voltage pulses on skin electrical and transport properties.

High-voltage pulses have been shown to increase rates of transport across skin by several orders of magnitude on a time scale of minutes to seconds. Two main pulse protocols have been employed to promote transport: the intermittent application of short ( approximately 1 ms) high-voltage (approximately 100 V across skin) pulses and a few applications of long (=100 ms) medium-voltage (>30 V across skin) pulses. In order to better evaluate the benefits of each protocol for transdermal drug delivery, we compared these two protocols in vitro in terms of changes in skin electrical properties and transport of sulforhodamine, a fluorescent polar molecule of 607 g/mol and a charge of -1. Whereas both protocols induced similar alterations and recovery processes of skin electrical resistance, long pulses of medium-voltage appeared to be more efficient in transporting molecules across skin. Skin resistance decreased by three (short pulses) and two (long pulses) orders of magnitude, followed by incomplete recovery in both cases. For the same total transported charge, long pulses induced faster and greater molecular transport across skin than short pulses. In addition, a greater fraction of the aqueous pathways created by the electric field was involved in molecular transport when using long pulse protocols. Transport was concentrated in localized transport regions (LTRs) for both protocols but LTRs created by long pulses were an order of magnitude larger than those formed by short pulses and the short pulses created an order of magnitude more LTRs. Overall, this study is consistent with the creation of fewer, but larger aqueous pathways by long, medium-voltage pulses in comparison to short, high-voltage pulses.

Adult↗
PubMed1997

99Tcm-MDP scintigraphy in high-voltage electrical burn patients.

In high-voltage electrical burn injuries (> 1000 V), it is difficult to identify the site and extent of non-viable deep tissue damage for debridement to avoid further tissue injury from wound infection and the risk of sepsis. This prospective study was designed to evaluate the usefulness of 99Tcm-methylene di-phosphonate (99Tcm-MDP) scintigraphy in detecting the extent of tissue injury and determining the level of amputation required for electrical burn patients. Over a 5 year period, 33 high-voltage electrical burn patients were studied. Blood flow and blood pool studies revealed absent perfusion in 37 limbs, all of which eventually were amputated. In addition to a routine three-phase bone scan, images were obtained at 30-60 min (early images) to evaluate whether soft tissue injury could be detected better at that time. For comparison of the detection rate from the early images and bone (delayed) images, 164 corresponding spot views of both images were reviewed. Eighty-three and 125 tissue necrotic lesions were demonstrated by the early images and bone images respectively. All of the 83 lesions found by the early images were more clearly identified by the bone images. All but one of the 125 lesions underwent surgical debridement or amputation. We concluded that the blood flow and blood pool images correlated well with the level of amputation required. The site and extent of tissue necrotic lesions can be clearly identified on 99Tcm-MDP bone scans. Because the early images were less sensitive in detecting tissue necrosis, we suggest that early imaging is not necessary.

Adolescent↗