Four patients with chronic ventricular arrhythmias, shown to respond over the short term to N‐acetylprocainamide (NAPA), were treated for between 3 and 4 yr with NAPA, and 24‐hr ambulatory ECGs were ...obtained monthly to monitor their responses. When the patients were ambulatory and receiving NAPA, the mean frequency of premature ventricular complexes averaged 70% (range 60% to 82%) below that recorded at 6‐mo intervals when the patients were hospitalized and receiving placebo. Analysis of variance showed that NAPA exerted an antiarrhythmic effect in these patients and that tolerance to this effect did not develop with long‐term therapy. Plasma NAPA concentrations required to achieve this level of response averaged 21 µg/ml (12 to 35 µg/ml) and were roughly twice as high as those which appeared to be maximally effective when the patients were hospitalized for their initial evaluation. NAPA therapy was associated with positive antinuclear antibody titers in only one patient and seems less prone to cause drug‐induced lupus erythematosus than procainamide, but NAPA shares the gastrointestinal and other side effects of procainamide.
Clinical Pharmacology and Therapeutics (1983) 33, 565–576; doi:10.1038/clpt.1983.77
AIM: To investigate the incidence, characteristics, and risk factors for hepatocellular carcinoma(HCC) in Chinese patients with primary biliary cirrhosis(PBC).METHODS: We reviewed the data of 52 PB ...Cassociated HCC patients treated at Beijing 302 Hospital from January 2002 to December 2013 and analyzed its incidence and characteristics between the two genders. The risk factors for PBC-associated HCC were analyzed via a case-control study comprising 20 PBC patients with HCC and 77 matched controls without HCC. The matched factors included gender, age, follow-up period and Child-Pugh scores. Conditional logistic regression was used to evaluate the odds ratios of potential risk factors for HCC development. A P < 0.05 was considered statistically significant. RESULTS: The incidence of HCC in Chinese PBC patients was 4.13%(52/1255) and was significantly higher in the males(9.52%) than in the females(3.31%). Among the 52 PBC patients with HCC, 55.76%(29/52) were diagnosed with HCC and PBC simultaneously, and 5.76%(3/52) were diagnosed with HCC before PBC. The males with PBC-associated HCCwere more likely than the females to have undergone blood transfusion(18.75% vs 8.33%, P = 0.043), consumed alcohol(31.25% vs 8.33%, P = 0.010), smoked(31.25% vs 8.33%, P = 0.010), had a family history of malignancy(25% vs 5.56%, P = 0.012), and had serious liver inflammation, as indicated by the elevated levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase(P < 0.05). Conditional logistic regression analysis revealed that body mass index(BMI) ≥ 25 adjusted odds ratio(AOR) = 1.116, 95%CI: 1.002-1.244, P = 0.045 and history of alcohol intake(AOR = 10.294, 95%CI: 1.108-95.680, P = 0.040) were significantly associated with increased odds of HCC development in PBC patients. CONCLUSION: HCC is not rare in Chinese PBC patients. Risk factors for PBC-associated HCC include BMI ≥ 25 and a history of alcohol intake. In addition to regular monitoring, PBC patients may benefit from abstinence from alcohol and body weight control.
The hypotensive effects of N-acetylprocainamide (NAPA) were studied in anesthetized dogs and in a normal subject. In dogs, intravenous NAPA infusions reduced mean arterial pressure and the pressor ...response of the isolated, perfused gracilis muscle vascular bed to preganglionic, but not postganglionic, sympathetic stimulation. The kinetics of these effects were correlated with NAPA pharmacokinetics. The time course of NAPA concentrations in a hypothetical biophase was characterized, and the relationship between NAPA biophase concentrations and the intensity of the effects was determined. From these results, it was estimated that peak effects would occur in dogs 6.6 min after intravenous bolus injection of NAPA, and that biophase NAPA concentration would lower mean arterial pressure 0.39 mm Hg/microgram/ml and would attenuate by 0.224 mm Hg/microgram/ml the gracilis muscle vascular bed pressor response to preganglionic stimulation. In the normal subject, a similar analysis indicated that maximal hypotension would occur 8.0 min after intravenous NAPA injection, and that blood pressure would fall 0.40 mm Hg/microgram/ml relative to biophase NAPA concentrations. These results suggest that blood pressure should be monitored for at least 10 min after patients receive and intravenous NAPA injection, and that repeated NAPA doses probably should not be administered more frequently.
To differentiate spontaneous variability from proarrhythmia in patients with benign or potentially lethal ventricular arrhythmias, 495 patients with 2 or more Holter tracings during placebo therapy ...were evaluated. The Holter session with the highest frequency of ventricular premature complexes (VPCs) and ventricular tachycardia was compared with the first placebo recording. Patients were segregated by their baseline frequency of VPCs. The percent of patients taking placebo in this trial who had the same increase in VPC frequency as has been ascribed to those with proarrhythmia varied from 0 of 470 patients with a baseline frequency of ventricular arrhythmia of 10 to 50 VPCs/hour, 3 of 44 (7%) with 51 to 100 VPCs/hour, 1 of 139 (0.7%) with 101 to 300 VPCs/hour and 1 of 265 (0.04%) with more than 300 VPCs/hour. Overall, 5 of 496 (1%) patients would have been classified as having proarrhythmia using the algorithm although only placebo was given. A 10-fold or greater increase in ventricular tachycardia beats in patients taking placebo occurred in 9 of 274 patients (3%). Thus, a simple algorithm to define proarrhythmia in patients with mixed cardiac disease and chronic ventricular arrhythmias can be defined and differentiated from spontaneous variability. This arbitrary algorithm defines proarrhythmia as an increase of more than 3 times when baseline VPC frequency is more than 100 VPCs/hour and more than 10 times when that frequency is less than 100 VPCs/hour with a false-positive rate of only 1%.
博士
國立臺灣大學
食品科技研究所
91
This dissertation was attempted to investigate the effects of extrusion condition, milling method, and particle size of rice flour on the rheological properties of glutinous rice ...extrudates. From the results, feasible conditions to prepare mochi by using single screw extrusion cooking (SSEC) have been identified.
First, the influence of screw configuration and die opening area were studied. Among three screw configurations, forward, mixing bar & disc, and mixing disc and three die diameters of 10, 20, and 40 mm, the combination of mixing disc and 10-mm die exhibited longest mean residence time and good mixing effect. The extrudate prepared using these conditions yielded high degree of gelatinization with smooth texture. The flow patterns of material in the single extruder were analyzed using three models, including Wolf-White, Simplified, and Complete model. The Complete model was the best one among the three models.
The barrel temperature and water content were also important factors on
The strength limit state of American Association of State Highway and Transportation Officials (AASHTO) Load and Resistance Factor Design (LRFD) Bridge Design Specifications is developed based on the ...failure probabilities of the combination of non-extreme loads. The proposed design limit state equation (DLSE) has been fully calibrated for dead load and live load by using the reliability-based approach. On the other hand, most of DLSEs in other limit states, including the extreme events Ⅰ and Ⅱ, have not been developed and calibrated though taking certain probability-based concepts into account. This paper presents an assessment procedure of highway bridge reliabilities under the limit state of extreme event Ⅰ, i. e., the combination of dead load, live load and earthquake load. A force-based approach and a displacement-based approach are proposed and implemented on a set of nine simplified bridge models. Results show that the displacement-based approach comes up with more convergent and accurate reliabilities for selected models, which can be applied to other hazards.
This dissertation is concerned with diagnostic studies of steel structures using modal analysis. First, a model structure is built under a US-China joint research project on structural dynamic ...research. The dynamic properties of the model are obtained by experimental system identification. Secondly, a damage diagnosis theory applicable to civil engineering structures is presented. It is found that a new vibrational signature can be sensitive to the presence of structural damage, providing a means of damage detection. A 0.4 scale model of a prototype single-bay and five-story high steel building is designed and manufactured to simulate the dynamic properties of the prototype. Component tests, such as coupon tests and residual stress tests, are used to determine the material and member properties of the model. Dynamic structural tests for system identification are conducted to investigate the overall structural behavior of the model. The results show that the relationship between the prototype and model has been established satisfactorily. Experimental techniques in modal analysis to determine vibrational signatures of the structure are also described. A new vibrational signature called Strain Mode Shape (SMS) is obtained from the system identification results and presented for damage diagnosis. The theory and physical meaning of SMS is mathematically derived and explained. Two experiments are designed to verify the sensitivity of the proposed diagnostic approach. One is tested on the five-story model, the other is on a simply supported beam. On the former, several types of geometric damage such as reduction in the member cross section and loosening of bolts are introduced. New structural signatures, SMS 's, experimentally obtained for different degrees of structural integrity are compared to the baseline values. The changes of SMS reflects the magnitude of force redistribution and can indicate the location of damage. On the latter, a bridge component with fatigue cracks is simulated. The SMS change obtained shows the stress concentration effect and flexural strength reduction of a beam with flange cracks, although it fails to detect effects of web cracks.
Twenty-four growth hormone-deficient children were treated with growth hormone releasing hormone-40 (GHRH) for 6 months or longer. GHRH (1 to 4 micrograms/kg of body weight per dose) was administered ...subcutaneously every 3 h (n = 10); or every 3 h overnight only (n = 10); or by twice daily injections (n = 4). Twenty-one children had an increase in growth rate during GHRH treatment. The growth velocities (mean +/- SD; cm/yr) before and during treatment were, respectively: every 3 h 3.5 +/- 1.4 versus 10.0 +/- 2.2, p = 0.0001; overnight only 3.4 +/- 1.0 versus 6.2 +/- 2.1, p = 0.008; twice daily injections 3.2 +/- 1.8 versus 7.9 +/- 2.4, p = 0.06. Using these three modes of GHRH administration, different total daily amounts of GHRH were administered. Regression analysis of average daily dose versus growth velocity revealed a correlation coefficient (r) value of 0.57, p = 0.004. Sixteen children received extended treatment for periods varying from 9 to 30 months. Of these, seven children were treated continuously for 9 months with pump overnight only and 5 for 12 months with pump every 3 h. Their growth velocities were sustained at a similar rate as those observed at 6 months. Six children received both twice daily and three hourly treatments consecutively. The growth velocities were similar during both treatments. Eleven children developed circulating antibodies to GHRH during treatment, however, all 11 had accelerated growth rates during GHRH therapy.
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