Potassium status of Northeast Thai constructors in three different geographic locations.

Sudden and unexpected death of young adults during sleep is a phenomenon among Southeast Asians and particularly young Northeast (NE) Thailand constructors in Singapore. Survivor of sudden unexplained death syndrome (SUDS) without structural heart disease with idopathic ventricular fibrillation (VF) has been documented. Low plasma potassium (K) and depletion of K can occur simply through a reduction of K intake and are associated with increased risk of VF. The K-status of the populations was evaluated in the NE (Group 1, n=30), Bangkok (Group 2, n=48) and Singapore (Group 3, n=46). Groups 2 and 3 were further subdivided into Group 2A (worked in Bangkok < or = 1 year, n=8), Group 2B (worked in Bangkok > 1 year, n=40), Group 3A (consumed self-prepared or ready-to-buy meals, n=25) and Group 3B (regularly consumed foods provided free-of-charge by construction companies, n=21). Thirty-four male healthy university personnels from the NE and Bangkok served as the control--Group 4. Two 24-h urine samples and a fasting blood sample were collected from each subject. Dietary-K from food was determined by duplicated meal analysis. All these samples were then analyzed for their K-content. Group 3A had the lowest K-status: their K-intake, serum-K, and urinary-K level were 29 +/- 5.8 mmol/day (% low K-intake=100), 3.43 +/- 0.34 mmol/L (% hypokalemia=48) and 19.23 +/- 8.2 mmol/day (% hypokaliuria=87.5), respectively. Among the construction workers, average K-intake, serum-K and urinary-K levels were 45.5 +/- 6.1 mmol/day (% low K-intake = 37.5), 3.93 +/- 0.2 mmol/L (% hypokalemia = 2.5) and 39.6 +/- 9.2 mmol/day (% hypokaliuria = 12.5), respectively. The values of Group 2B were similar to Group 4. In addition, when the data from all of the groups were compared, there was a positive correlation between dietary-K (intake) and urinary-K (excretion) (r=0.881, p<0.001). In conclusion, NE Thailand constructors from various locations exhibited low K status with low dietary-K, high incidence of hypokalemia, and low urinary-K. From the present study, this low K status may be an important trigger factor for VF in construction workers and associated with increase risk of SUDS.

Pattern of inheritance in three sudden unexplained death syndrome ("Lai-tai") families.

Sudden Unexplained Death Syndrome (SUDS) (or Lai-tai) is sudden death in previously healthy young adults without any structural cause of death from autopsy findings. Our previous data showed that familial SUDS is not X-linked recessive. The objective of this study was to determine the pattern of inheritance in familial SUDS using the ECG markers of Brugada syndrome (RBBB and ST-segment elevation in V1 to V3), SUDS and presumptive SUDS as phenotypes. We employed the standard 12-lead ECG and higher intercostal space (ICS) V1 to V3 (-V1 to -V3 and -2V1 to -2V3) leads ECG in SUDS relatives after procainamide and drew the pedigree. We studied 62 relatives of 9 SUDS victims who died in Singapore and selected 3 families (n = 34) for the procainamide test and ECG. The mean age was 36.4 +/- 23.6 years (4-78 years). Three SUDS families showed the same pattern of inheritance of autosomal dominant.

Safety and acceptable initial outcomes of reused balloon catheters for percutaneous transluminal coronary angioplasty.

OBJECTIVES: This study was conducted to compare the safety and initial outcomes applying reused balloon (RB) catheters with those of attained new balloon (NB) catheters when performing percutaneous transluminal coronary angioplasty. BACKGROUND: Recently, PTCA procedures have been used increasingly for the treatment of patients with coronary heart disease. In the era of national economic constraint, reused balloon catheters will reduce the cost of expensive, imported coronary angioplasty devices. Hence, data concerning the safety and success rate of RB catheters compared with NB catheters are urgently required. METHODS: Prospective comparative study between reused and new balloon catheters for coronary angioplasty. Data forms were completed after each procedure and before the patient was discharged after an 18-month period. RESULTS: From July 1996 to December 1997, 221 cases (121-RB, 100-NB) were enrolled. Mean age, ejection fraction, diseased vessel and lesion characteristics were similar in both groups. The number of lesions was much higher performed in the RB than in the NB group (1.7 +/- 0.9 vs 1.4 +/- 0.8, p = 0.02). The RB group had more cases of acute myocardial infarction than the NB group (7.4% vs 1%, p = 0.003), however, the angiographic and case success rate were the same (99.5% vs 97.9% and 98.3% vs 97% respectively). Major adverse cardiac events in RB amounted to 1.7 per cent and for NB to 1.0 per cent (p = ns). The total amount of balloons used in RB was much higher than in the NB group (1.5 +/- 0.6 vs 1.1 +/- 0.3, p = <0.0001). There were neither infection nor positive blood cultures in either group. CONCLUSIONS: Reused balloon catheters can be safely used for percutaneous transluminal coronary angioplasty with a high success rate. The total cost of angioplasty can be reduced without a decline in efficacy.

Efficacy of rapid infusion of streptokinase in patients with acute myocardial infarction.

The early use of thrombolytic agents is now the most important treatment in acute myocardial infarction (AMI). The earlier reperfusion should result in a higher survival rate. To determine whether the faster infusion of streptokinase (SK) will produce earlier reperfusion, 40 patients were enrolled to the trial. Half of them received 1.5 mu. of SK in one hour while the others received 1.5 mu. in half an hour. The rapid infusion group tended to have earlier reperfusion but there was no statistically significant difference in the reperfusion time. Hypotension was observed in both groups but more in the conventional group and responded to intravenous fluid replacement. Bleeding complication was low in both groups. Four patients died, one from re-occlusion and developed severe bradycardia, the remainder had cardiogenic shock which did not respond to treatment. It can be concluded that SK infusion in half an hour is safe but the beneficial effect remains to be seen in a large scale study.