Mechanism of cardiac arrhythmias induced by epinephrine in dogs with hypokalemia

To investigate the mechanism of ventricular arrhythmias induced by epinephrine in dogs with hypokalemia, 30 adult mongrel dogs were separated into a control group (n = 13) and a hypokalemia group (n = 17). In the hypokalemia group, sodium polystyrene sulfonate (5 g/kg body weight) was infused into the colon. In both groups, the serum concentrations of sodium, potassium and calcium were measured every 15 minutes for 60 minutes. The mean ( ± standard deviation) serum potassium level of the hypokalemia group decreased significantly from 3.81 ± 0.21 to 2.92 ± 0.36 mEq/liter; there were no significant changes in other electrolytes. After 60 minutes, epinephrine (10 μg/kg) was injected intravenously in the hypokalemia and control groups, and the arrhythmia ratio (the number of ventricular ectopic beats divided by the total heart rate) was calculated for 5 minutes. Each group was further classified into subgroups of dogs with an arrhythmia ratio higher or lower than 10%. An arrhythmia ratio over 10% was observed in 7.7% of the control group and 53% of the hypokalemia group.Immediately after 5 minutes of epinephrine injection, myocardial mitochondria and plasma membrane fraction were prepared from each group. Mitochondrial calcium content and phospholipase activity of plasma membrane fraction were determined. Significant increases in both mitochondrial calcium content and phospholipase activity were observed in the dogs with hypokalemia and an arrhythmia ratio greater than 10%. In the hypokalemia group, there was a clear reciprocal correlation (r = − 0.79) between serum potassium concentration at 60 minutes and mitochondrial calcium content, and a clear correlation (r = 0.80) between mitochondrial calcium content and phospholipase activity. It was also demonstrated that the dogs with a higher than 10% arrhythmia ratio had a low serum potassium concentration, high mitochondrial calcium content and high phospholipase activity. These results suggest that hypokalemia enhances the calcium influx induced by epinephrine, resulting in activation of phospholipase, which is responsible for the development of ventricular arrhythmias

Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer

Background/Aims Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety. Methods Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed. Conclusions Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis (clinical trial number, UMIN000037567)

Manipulation of charge carrier flow in Bi₄NbO₈Cl nanoplate photocatalyst with metal loading

Separation of photoexcited charge carriers in semiconductors is important for efficient solar energy conversion and yet the control strategies and underlying mechanisms are not fully established. Although layered compounds have been widely studied as photocatalysts, spatial separation between oxidation and reduction reaction sites is a challenging issue due to the parallel flow of photoexcited carriers along the layers. Here we demonstrate orthogonal carrier flow in layered Bi₄NbO₈Cl by depositing a Rh cocatalyst at the edges of nanoplates, resulting in spatial charge separation and significant enhancement of the photocatalytic activity. Combined experimental and theoretical studies revealed that lighter photogenerated electrons, due to a greater in-plane dispersion of the conduction band (vs. valence band), can travel along the plane and are readily trapped by the cocatalyst, whereas the remaining holes hop perpendicular to the plane because of the anisotropic crystal geometry. Our results propose manipulating carrier flow via cocatalyst deposition to achieve desirable carrier dynamics for photocatalytic reactions in layered compounds

Comparative study of the work load between one-man buses and two-man buses.

The differences in physiological and safety conditions of one-man buses and two-man buses were examined from the view point of occupational fatigue. This survey consisted of a work load study which included a time study, study of subsidiary behavior, auditory task, memory test, Galvanic Skin Response (GSR) and physiological function tests and a self-administered questionnaire which involved items concerning safety and subjective fatigue complaints. The visual and postural restrictions in the one-man bus were greater than in the two-man bus. The mental capacity of the one-man bus drivers was found to be less. Greater mental fatigue and stress were observed in the one-man bus. More subjective fatigue complaints were observed in the one-man bus. More cases of near accidents were observed in the one-man bus. From these results it was concluded that the one-man bus caused bus drivers a greater mental and physical work load.</p