Host Immune Responses to Intradiscal Gene Transfer / 대한척추외과학회지

PURPOSE: To elucidate host immune responses to intradiscal gene transfer. MATERIALS AND METHODS: Twenty rabbits were utilized. Ad/luciferase (adenovirus construct) were injected into nucleus pulposus of lumbar vertebrae. Group 1 received intradiscal injection of Ad/luciferase only, Group 2 received subcutaneous and intradiscal injection simultaneously, Group 3 received subcutaneous injection then intradiscal injection with 2 weeks interval. Blood samples were obtained serially after injection. Animals were sacrificed at 7 weeks. Antibody to adenovirus in peripheral blood was measured with ELISA and transgene expression was measured with standard luciferase kits. RESULTS: All rabbits in the Group 2 and 3 exhibited increased production of neutralizing antibody. There were clearly two subgroups in Group 1, three rabbits exhibited production of antibody but remaining three rabbits showed little or no production of antibody. All rabbits showed robust increase in transgene expression regardless of titer of neutralizing antibody. CONCLUSION: The intervertebral disc is favorable site for adenovirus-mediated gene transfer escaping from systemic immunity.

Post-stress Measurements of Left Ventricular Function With Gated Perfusion SPECT: Comparison with Resting Measurements by using Exercise and Adenosine Stress

BACKGROUND AND OBJECTIVES: This study was designed to investigate the relationship between myocardial perfusion defect in single photon emission tomography(SPECT) and the difference in left ventricular functional parameters obtained after stress and at rest. MATERIALS AND METHODS: Eighty five patients known to have coronary artery disease (CAD) or suspected to have CAD underwent gated Tc-99m sestamibi SPECT using one or separate day rest/stress protocol. We compared post-stress left ventricular ejection fraction (LVEF-s) with that at rest (LVEF-r) in gated myocardial SPECT. We considered myocardial stunning was developed when LVEF was >5% lower than that at rest. METHODS: Forty one (48%) patients demonstrated reversible or irreversible perfusion defects in gated perfusion SPECT (group 1). Forty four (52%) patients demonstrated normal perfusion status (group 2). In group 1, LVEF-s was significantly lower than that at rest([mean+/-SD] 46+/-15.5 vs 48+/-16.0 respectively, p5% lower than LVEF-r. CONCLUSION: The LVEF obtained after stress with gated SPECT may not reflect true resting values. We recommend gated myocardial perfusion SPECT should be performed also at rest especially in patients with myocardial perfusion defects.

Arrhythmogenic Right Ventricular Cardiomyopathy as a Cause of Sudden Unexplained Death

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.