29 aged patients of transvenous endocardial pacemaker implantation have been performed during 1981-1988. Elderly group consisted of 29 cases with 19 males and 10 females with age ranging from 60-86 years. The indications for permanent pacing in this series included. (1) Sinus bradycardia (2 cases), (2) Sinus bradycardia, sinus arrest and/or sinoatrial block (2. cases), (3) Brady-tachyarrhythmia (It cases), (4) Bifaseicular block (2 cases), (5) Trifascicu lar block (3 cases), and (6) Complete AV block (9 cases). All 29 cases were symptomatic (syncopal attacks). They required permanent pacing. They have been followed up for 2 to 90 (average 39) months. The incidence of complications has been relatively low. A pacing mortality during the follow-up period was not seen in this series.A clinical assessment was made with emphasis on some special features in elderly individuals. In the elderly bradyarrbythmia was usually due to fibrosis and sclerosis of the conduc-tion system rather than to ischaemic heart disease. In the elderly the implantation of a pacemaker was indicated for any symptomatic bradycardia. Age was not a contraindication for permanent pacing

Objective:To study cardiomyocyte apoptosis of viral myocarditis (VMC) mice,study the effect and significance of Tumor Necrosis Factor-? (TNF-?) to cardiomyocyte apoptosis in VMC.Methods:Our experiments studied cardiomyocyte apoptosis at 3、5、7、9、15、35 days after virus inoculation in VMC mice by ways of TUNEL and electron microscope.We studied the effect of TNF-? to cardiomyocyte apoptosis in VMC by the way of intervention with TNF-? and TNF-? mAb.Results:Apoptotic cardiomyocyte of VMC mice increased appaently compared with control mice.Cardiomyocyte apoptosis increased after TNF-? intervention,cardiomyocyte apoptosis reduced after TNF-? mAb intervention.Conclusion:Abnormal cardiomyocyte apoptosis was observed in VMC,cardiomyocyte apoptosis may has relation with the Pathogenesis of VMC.TNF-? can induce cardiomyocyte apoptosis in VMC.TNF-? induces cardiomyocyte apoptosis may has relation with its role in VMC.

Objective:To study the effect and clinical significance of tumor necrosis factor-?(TNF-?) in viral myocarditis(VMC).Methods:Animal model was established by serum TNF-? in VMC mice was assayed by the way of ELISA.In addition,VMC mice were treated by TNF-? mAb and rTNF-?,death rate andmyocardial change of intervention group were compared with control group.Results:Serum TNF-? in VMC mice increased apparently.Inflammatory cell infiltration and myocardial necrosis had ralations with TNF-? in VMC.Inflammatory cell infiltration and myocardial necrosis in the mice of exogenous TNF-? intervention group were more serious than simple VMC group apparently,death rate of mice was also higher than simple VMC group.Inflammatory cell infiltration and myocardial necrosis in the mice of TNF-? mAb intervention group were milder than simple VMC group apparently,death rate of mice was also lower.Conclusion:TNF-? take part in the immunoreaction and pathogenesis of VMC,it has important significance to the therapy of VMC.

Objective To study ultrastructure changes of myocardium and morphic change of cardiomyocyte apoptosis in mice with viral myocarditis(VMC).Methods Our experiment established animal model of VMC by the way of coxsackie virus B3(CVB3) inoculation,then we studied the changes and apoptosis of cardiomyocyte by ways of microscope and electron microscope.Results The myocardial changes and inflammatory cell infiltration were found by ways of microscope and electron microscope from 5 days after virus inoculation in experimental mice,the peak changes were at 7-9 days,and were almost recoverd at 35 days.Apoptotic changes and apoptotic bodies were found by eletron microscope at 7-9 days after virus inoculation in mice with VMC.Conclusions VMC can be caused in mice after CVB3 inoculation,abnormal cardiomyocyte apoptosis can be found in VMC.

OBJECTIVETo study the change of serum tumor necrosis factor-alpha (TNF-alpha) and its mRNA in viral myocarditis (VMC) and its role in VMC.

METHODSThe expression of TNF-alpha mRNA in VMC mice was studied by the way of RT-PCR. Changes of serum TNF-alpha on day 3, 5, 7, 9, 15 and 35 after virus inoculation in VMC mice were assayed using ELISA. The possible relationship of TNF-alpha and VMC was analysed.

RESULTSThe expression of TNF-alpha mRNA in VMC mice increased apparently. The level of TNF-alpha mRNA expressed on the 7th day after virus inoculation (1.94) was higher than that on the 3rd day (1.09). Serum TNF-alpha of the VMC mice was higher than that of the control mice (127.2 +/- 13.8) from the 3rd to 35th day after virus inoculation (3rd day group 159.7 +/- 40.8, 5th day group 212.7 +/- 40.0, 7th day group 296.7 +/- 34.3, 9th day group 267.3 +/- 41.4, 15th day groups 187.8 +/- 49.6, and 35th day groups 155.4 +/- 35.9) and the peak expression was on the 7th day after the inoculation (P < 0.01 compared with the control group).

CONCLUSIONSBoth serum TNF-alpha and its mRNA increased in murine VMC, which may take part in the pathogenesis of VMC.

Animals ; Coxsackievirus Infections ; Mice ; Mice, Inbred BALB C ; Myocarditis ; Myocardium ; RNA, Messenger ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism