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Shih-Ann Chen,Chin-Yu Lin,Yenn-Jiang Lin,Fa-Po Chung 대한심장학회 2015 Korean Circulation Journal Vol.45 No.6
We describe the case of a patient with severe hypertensive left ventricular hypertrophy and sustained hemodynamically unstableventricular tachycardia (VT). Entrainment was demonstrated in the electrophysiological study. Activation mapping and pacemappingidentified the location of the intramural reentrant VT with the exit site close to the epicardium. However, VT persisted after ablation at theepicardial exit site. Successful ablation was performed endocardially at the corresponding position
Equine hyperimmune serum protects mice against Clostridium difficile spore challenge
Weiwei Yan,Kang-Soon Shin,Shih-Jon Wang,Hua Xiang,Thomas Divers,Sean McDonough,James Bowman,Anne Rowlands,Bruce Akey,Hussni Mohamed,Yung-Fu Chang 대한수의학회 2014 Journal of Veterinary Science Vol.15 No.2
Clostridium (C.) difficile is a common cause of nosocomialdiarrhea in horses. Vancomycin and metronidazole havebeen used as standard treatments but are only moderatelyeffective, which highlights the need for a novel alternativetherapy. In the current study, we prepared antiserum ofequine origin against both C. difficile toxins A and B as wellas whole-cell bacteria. The toxin-neutralizing activities of theantibodies were evaluated in vitro and the prophylacticeffects of in vivo passive immunotherapy were demonstratedusing a conventional mouse model. The data demonstratedthat immunized horses generated antibodies against bothtoxins A and B that possessed toxin-neutralizing activity. Additionally, mice treated with the antiserum lost less weightwithout any sign of illness and regained weight back to anormal range more rapidly compared to the control groupwhen challenged orally with 107 C. difficile spores 1 day afterserum injection. These results indicate that intravenousdelivery of hyperimmune serum can protect animals from C. difficile challenge in a dose-dependent manner. Hence,immunotherapy may be a promising prophylactic strategyfor preventing C. difficile infection in horses.
Fa-Po Chung,Yenn-Jiang Lin,Ling Kuo,Shih-Ann Chen 대한심장학회 2017 Korean Circulation Journal Vol.47 No.2
Differentiating arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) from other cardiomyopathies is clinically important but challenging. Although the modified Task Force Criteria can facilitate diagnosis of ARVD/C according to clinical manifestations, histopathological examination plays a pivotal role in excluding other diseases that can mimic ARVD/C. Here, we report a patient with amyloidosis that initially presented similarly to ARVD/C. The diagnosis was confirmed by endomyocardial biopsy, and catheter ablation eliminated the ventricular tachyarrhythmias through an epicardial approach.
Fa-Po Chung,Chin-Yu Lin,Yenn-Jiang Lin,Shih-Lin Chang,Li-Wei Lo,Yu-Feng Hu,Ta-Chuan Tuan,Tze-Fan Chao,Jo-Nan Liao,Ting-Yung Chang,Shih-Ann Chen 대한심장학회 2018 Korean Circulation Journal Vol.48 No.10
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is predominantly an inherited cardiomyopathy with typical histopathological characteristics of fibro-fatty infiltration mainly involving the right ventricular (RV) inflow tract, RV outflow tract, and RV apex in the majority of patients. The above pathologic evolution frequently brings patients with ARVD/C to medical attention owing to the manifestation of syncope, sudden cardiac death (SCD), ventricular arrhythmogenesis, or heart failure. To prevent future or recurrent SCD, an implantable cardiac defibrillator (ICD) is highly desirable in patients with ARVD/C who had experienced unexplained syncope, hemodynamically intolerable ventricular tachycardia (VT), ventricular fibrillation, and/or aborted SCD. Notably, the management of frequent ventricular tachyarrhythmias in ARVD/C is challenging, and the use of antiarrhythmic drugs could be unsatisfactory or limited by the unfavorable side effects. Therefore, radiofrequency catheter ablation (RFCA) has been implemented to treat the drug-refractory VT in ARVD/C for decades. However, the initial understanding of the link between fibro-fatty pathogenesis and ventricular arrhythmogenesis in ARVD/C is scarce, the efficacy and prognosis of endocardial RFCA alone were limited and disappointing. The electrophysiologists had broken through this frontier after better illustration of epicardial substrates and broadly application of epicardial approaches in ARVD/C. In recent works of literature, the application of epicardial ablation also successfully results in higher procedural success and decreases VT recurrences in patients with ARVD/C who are refractory to the endocardial approach during long-term follow-up. In this article, we review the important evolution on the delineation of arrhythmogenic substrates, ablation strategies, and ablation outcome of VT in patients with ARVD/C.
Stroke and Bleeding Risk Assessment in Atrial Fibrillation: Where Are We Now?
Ling Kuo,Yi-Hsin Chan,Jo-Nan Liao,Shih-Ann Chen,Tze-Fan Chao 대한심장학회 2021 Korean Circulation Journal Vol.51 No.8
Most important international guidelines recommend the use of CHA2DS2-VASc and HAS-BLED scores for stroke and bleeding risk assessments in atrial fibrillation (AF) patients, respectively. The 2020 AF guidelines of European Society of Cardiology have revised the definition of “C: congestive heart failure (HF)” component, and now patients with either HF with reduced ejection fraction or preserved ejection fraction should be assigned 1 point. Hypertrophic cardiomyopathy was also included. Besides, the revised “V: vascular diseases” component included both prior myocardial infarction and “angiographically significant coronary artery disease”. It is important to understand that the stroke and bleeding risks of AF patients were not static and should be re-assessed regularly. A high HAS-BLED score itself should not be the only reason to withhold or discontinue oral anticoagulants, but remind physicians for the corrections of modifiable bleeding risk factors and more regular follow up. In the future, the AF duration and left atrial function may play an important role for personalized evaluation of individual stroke risk while more studies are necessary.
Shinya Yamada,Li-Wei Lo,Yenn-Jiang Lin,Shih-Lin Chang,Fa-Po Chung,Yu-Feng Hu,Ta-Chuan Tuan,Tze-Fan Chao,Jo-Nan Liao,Chin-Yu Lin,Shih-Ann Chen 대한심장학회 2019 Korean Circulation Journal Vol.49 No.1
Background and Objectives: The differences between electromagnetic-based mapping (EM) and impedance-based mapping (IM) in 3D anatomical reconstruction have not been fully clarified. We aimed to investigate the anatomical accuracy between EM (MediGuide™) and IM (EnSite Velocity™) systems. Methods: We investigated 15 consecutive patients (10 males, mean age 58±9 years) who underwent pulmonary veins (PVs) isolation for paroxysmal atrial fibrillation (PAF). Contrast-enhanced computed tomography (CT) image of the left atrium (LA) was acquired before ablation and the 3D geometry of the LA was constructed using EM during ablation procedure. We measured the 4 PV angles between the main trunk of each PV and the posterior LA after field scaling. Additionally, the posterior LA surface area was measured. The variables were compared to those of CT-based geometry. A control group of 40 patients who underwent conventional PVs isolation using IM were also evaluated. Results: The actual and relative changes of EM and CT-based geometry in all PV angles and posterior LA were significantly smaller compared to those of IM and CT-based geometry. Intraclass correlation coefficient (ICC) between EM and CT-based geometry were 0.871 (right superior pulmonary vein [RSPV]), 0.887 (right inferior pulmonary vein [RIPV]), 0.853 (left superior pulmonary vein [LSPV]), 0.911 (left inferior pulmonary vein [LIPV]), and 0.833 (posterior LA). On the other hand, ICC between IM and CT-based geometry were 0.548 (RSPV), 0.639 (RIPV), 0.691 (LSPV), 0.706 (LIPV), and 0.568 (posterior LA). Conclusions: Image integration with EM enables high accurate visualization of cardiac anatomy compared to IM in PAF ablation.
Neutron and X-ray scattering on the monolayer structure of a lecithin fullerene-derivative.
Jeng, U-Ser,Lin, Tsang-Lang,Shin, Kwanwoo,Lee, Hsin-Yi,Hsu, Chia-Hung,Chi, Zau-Ann,Shih, Ming Chih,Torikai, Naoya American Scientific Publishers 2007 Journal of nanoscience and nanotechnology Vol.7 No.4
<P>Using neutron reflectivity with contrast variation, X-ray reflectivity, and grazing incident small-angle X-ray scattering (GISAXS), we have characterized the in-depth and in-plane structural characteristics of the Langmuir and Langmuir-Blodgett (LB) films formed by a novel lecithin C60-derivative, FPTL, of three phospholipids jointly bonded on one single olefinic moiety of a C60 cage. Based on the neutron reflectivity measured, we have proposed a monolayer structure, with the C60 cages of FPTL lifted into the air and hydrophilic phospholipid heads immersed in water, for the FPTL Langmuir layer formed on water. On the other hand, the LB film of FPTL prepared on mica exhibits clear Kiessig fringes in the X-ray reflectivity profile, indicating a 27 angstroms monolayer film with less molecular orientation. With GISAXS, we have extracted an in-plane correlation length of about 210 A for a possible in-plane aggregation of C60 of FPTL in the LB monolayer. We have also demonstrated the highly ordered monolayer structures of a lecithin lipid, in elucidating the positive effect of the attached functional group-phospholipids on the monolayer formation of the lecithin C60-derivative.</P>