OBJECTIVETo describe the clinical features of 6 patients with catecholaminergic polymorphic ventricular tachycardia.

METHODSClinical data including signs and symptoms, electrocardiograms, Holter monitoring electrocardiograms and echocardiography was analyzed. Definite diagnosis was made based on the mutations of RYR2 and CASQ2.

RESULTSFrom July 2002 to March 2010, 6 consecutive patients referred to our center because of syncope [4 males, mean age (13.0 ± 4.2) years] were diagnosed with CPVT by clinical evaluation and genetic testing. Their electrocardiograms showed T waves with notch or bimodal and tall U waves in right chest leads. There was no J wave, no ST-segment deviation, no prolongation or shortening of QT interval. We captured the so-called "bidirectional and(or) polymorphic ventricular tachycardia (bVT and pVT)" in 2 out of 6 patients by ECG, in 5 out of 6 patients by 24-hours Holter monitor, in 3 out of 6 patients by exercise test. All patients received β blockers and no syncope occurred during the 3 months follow-up after discharge from hospital.

CONCLUSIONSCPVT is an inherited cardiac channelopathy characterized by syncope and(or) sudden death relatived to motion. The ECG shows T wave alteration and tall U wave in right chest leads. The mode of its onset is bVT and(or) pVT, and can be captured by Holter easily. β blocker is a safe and effective remedy for suppressing its attack.

Adolescent ; Catecholamines ; adverse effects ; Child ; Electrocardiography ; Female ; Humans ; Male ; Tachycardia, Ventricular ; diagnosis ; physiopathology ; Young Adult

The data obtained from present experiments demonstrated that among several inhalation anesthetics, ether was the most irritable, resulting in marked irregularity of respiratory movement, and halothane depressed respiratory rate more than the other. The pulse rate and blood pressure were decreased marked1y in ether and the halothane anesthesia. the rate of beat of the isolated atria was not greately altered after anesthesia with ether or trichlore-thylene, while it was reduced after chloroform or halothane inhalation. The response of isolated atria to exogeneous norepinephrine was most prominent in the atria isolated from halothane anesthetized rabbits. Myocardial catecholamine contents were reduced uniformly after anesthesia with each anesthetics and most significantly with the halothane inhalation. From the above results, it may be concluded that the increasing cardiac activity with general inhalation anesthetics is closely related to the quantitative changes of the endogenous myocardial catecholamine contents.
Anesthesia, Inhalation/adverse effects ; Anesthetics/*toxicity ; Animals ; Catecholamines/*metabolism ; Heart/*drug effects ; Myocardium/*metabolism ; Norepinephrine/*pharmacology ; Rabbits

OBJECTIVETo investigate the effects of neoadjuvant chemotherapy on the response of surgical stress during perioperative period.

METHODSFrom July 2005 to June 2006, 30 SD rats with the same age were distributed into 3 experimental groups and 1 control group randomly. Each experimental group included 8 rats, and the control group included 6 rats. The rats in experimental groups received intravenous infusion of cyclophosphamide, while the rats in control group received IV infusion of normal sodium. The blood of rats from experimental groups was taken 30 min before and during the stimulation of abdominal surgery which was given at the end of the first, the second and the third week after receiving IV infusion cyclophosphamide. Then the plasma concentration of noradrenaline was measured respectively.

RESULTSThe IV infusion of cyclophosphamide before operation could greatly improve the plasma level of norepinephrine, and it reached peak at the end of the second week. When surgeries were given at that time, the stress response became much more seriously. The response induced by neoadjuvant chemotherapy disappeared 3 weeks later.

CONCLUSIONSNeoadjuvant chemotherapy with cyclophosphamide can induce significant stress response which is characterized by the increase of plasma level of norepinephrine. It indicates that the best time of surgery for patients who have received neoadjuvant chemotherapy with cyclophosphamide is 2 weeks later.

Animals ; Catecholamines ; blood ; Chemotherapy, Adjuvant ; Cyclophosphamide ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Infusions, Intravenous ; Male ; Perioperative Care ; adverse effects ; methods ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological ; etiology

Hypertrophic cardiomyopathy (HCM) with hypertrophy of the basal septum is the most common etiology of left ventricular outflow tract (LVOT) obstruction. In this article, we report the case of a patient with a structurally normal heart who developed hemodynamic deterioration due to severe LVOT obstruction following treatment with catecholamines. Hypovolemia accompanied with a hyperdynamic condition, resulting from catecholamine treatment, may cause dynamic LVOT obstruction due to the systolic anterior motion of the mitral valve leaflet. The solution for this is early recognition and correction of aggravating factors such as, withdrawal of catecholamine therapy and volume replacement.
Catecholamines/*adverse effects ; Heart Septum ; Humans ; Hypertrophy ; Hypovolemia/chemically induced/*complications ; Male ; Middle Aged ; *Plasma Volume ; Ventricular Outflow Obstruction/*chemically induced/etiology

OBJECTIVETo study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.

METHODSSix pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes, which maintained the blood gas value at the fetal physiological level. The fetal blood pressure, heart rate, pH value and blood lactate levels were monitored. The levels of catecholamine, cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.

RESULTSThere were no changes before and during the bypass in fetal blood pressure, heart rate and blood gas. However, pH values decreased and blood lactate levels increased (P < 0.05). The fetal catecholamine and cortisol levels increased significantly (P < 0.01), while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass (P < 0.01), and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass, the fetal lamb would not survive more than 1 hour.

CONCLUSIONThe fetal lamb has a strong negative reaction to cardiopulmonary bypass.

Animals ; Blood Gas Analysis ; Blood Glucose ; analysis ; Cardiopulmonary Bypass ; adverse effects ; Catecholamines ; blood ; Fatty Acids, Nonesterified ; blood ; Fetus ; physiology ; Hemodynamics ; physiology ; Hydrocortisone ; blood ; Lactates ; blood ; Sheep

Pheochromocytoma is a rare disorder and functioning tumor composed of chromaffin cells that secrete catecholamines. Patients with a pheochromocytoma 'crisis' have a high mortality in spite of aggressive therapy. We present a case with a severe acute catecholamine cardiomyopathy presenting ST segment elevation with cardiogenic shock after hemorrhage into a left suprarenal tumor. Intra-aortic balloon pump (IABP) support, combined with inotropic therapy, was performed. However, the patient deteriorated rapidly and was unresponsive to a full dose of inotropics and IABP. We decided to apply extracorporeal membrane oxygenation (ECMO) device for the patient. His clinical state began to improve 3 days after ECMO. After achieving hemodynamic stabilization, he underwent successful laparoscopic left adrenalectomy. He needed no further cardiac medication after discharge.
Adrenal Glands/pathology ; Adult ; Cardiomyopathies/*diagnosis/*etiology ; Catecholamines/*adverse effects ; Coronary Angiography/methods ; Diagnosis, Differential ; Electrocardiography/methods ; Extracorporeal Membrane Oxygenation/*methods ; Humans ; Intra-Aortic Balloon Pumping ; Male ; Myocardial Infarction/*diagnosis ; Pheochromocytoma/*therapy ; Time Factors ; Tomography, X-Ray Computed/methods

The use of PCs can cause health problems, including musculoskeletal disorders (MSDs) of the upper limbs. This study was performed to investigate whether using PCs in PC game rooms may induce MSDs of the upper limbs. 284 young male Koreans were included. A self-administered, structured questionnaire was used to gather information about game room use, perceived subjective stress, and the symptoms related to MSDs. Urinary concentrations of epinephrine, norepinephrine, and dopamine were measured in spot urine. The symptom prevalence of MSDs of the upper limbs increased according to the increase of the duration of game room use. The intensity of perceived subjective stress showed a significant dose-response relationship with the frequency of MSDs symptoms in neck and shoulder areas. However, the urinary level of catecholamines was not significantly correlated with the symptom prevalence of MSDs in the upper limbs. These findings suggest that using PCs in game rooms produce physical stress on the upper limbs, strong enough to induce MSDs.
Adolescent ; Adult ; Arm ; Catecholamines/*urine ; Dopamine/urine ; Epinephrine/urine ; Human ; Male ; Musculoskeletal Diseases/*epidemiology/etiology/urine ; Norepinephrine/urine ; Prevalence ; Risk Factors ; Stress, Psychological/complications/*epidemiology/urine ; Video Games/*adverse effects