Lignocaine Therapy after Acute Myocardial Infarction

Thirty-five patients with ventricular dysrhythmias and seven with other dysrhythmias after acute myocardial infarction were treated with intravenous lignocaine.Satisfactory initial suppression of ventricular ectopic beats was achieved in 27 (82%) of 33 patients after either a 50-mg. bolus or a 50-mg. bolus followed by a 100-mg. bolus of intravenous 2% lignocaine. Continuous suppression of ventricular ectopic beats was accomplished in 21 (78%) of these 27 patients by continuous intravenous lignocaine infusions of 1 to 2 mg. per minute. Recurrence of ventricular ectopic beats occurred in four patients despite lignocaine infusion rates of up to 6 mg. per minute. Six patients with ventricular ectopic beats developed ventricular fibrillation despite satisfactory initial suppression of their dysrhythmia by lignocaine. In three of them ventricular fibrillation supervened while they were receiving a lignocaine infusion and two subsequently died. Unheralded ventricular fibrillation occurred in three other patients between four and seven days after completing the full course of lignocaine therapy.Toxic effects of lignocaine were minimal in patients receiving 1 to 2 mg. per minute.     

Practolol in Treatment of Supraventricular Cardiac Dysrhythmias

Practolol (I.C.I. 50172) was used to treat supraventricular dysrhythmias in 32 patients with a rapid ventricular rate and with heart disease of varied aetiology. In 26 patients the average reduction in ventricular rate was 75 per minute, while immediate reversion to sinus rhythm occurred in three patients. The slowing effect was mainly due to a direct action on the atrioventricular node. The effectiveness of practolol was unrelated to the type of dysrhythmia or its aetiology. No serious adverse clinical effects were noted.     

THEORETICAL DESIGN CONSIDERATIONS AND PHYSIOLOGIC PERFORMANCE CRITERIA FOR AN IMPROVED INTRACORPOREAL (ABDOMINAL) ELECTRICALLY ACTUATED LONG-TERM LEFT VENTRICULAR ASSIST DEVICE ("E-TYPE" ALVAD) OR PARTIAL ARTIFICIAL HEART

Our laboratories are engaged in the design of a clinically-oriented electrically actuated long-term intracorporeal (abdominal) left ventricular assist device ("E-type" ALVAD) or partial artificial heart. This infradiaphragmatic blood pump is designed to be powered by implantable electrical to mechanical energy converter systems. THE FOLLOWING ANALYSES WERE UNDERTAKEN TO: [List: see text] The proposed "E-type" ALVAD should be capable of pumping 4-7 liters per minute at heart rates of 75-100 beats per minute during rest, and 10 liters per minute at rates of 120 beats per minute during moderate exercise. These performance levels should be exceeded with a maximum device stroke volume of 85-90 ml and a mean pump inflow (filling) impedance of 相似文献   

Mouse heart rate in a human: diagnostic mystery of an extreme tachyarrhythmia

We report telemetry recording of an extreme non-fatal tachyarrhythmia noted in a hospitalized quadriplegic male with history of atrial fibrillation where the average ventricular conduction rate was found to be about 600 beats per minute and was associated with transient syncope. A medical literature review suggests that the fastest human ventricular conduction rate reported to date in a tachyarrhythmia is 480 beats per minute. We therefore report the fastest human heart rate noted in a tachyarrhythmia and the most probable mechanism of this arrhythmia being a rapid atrial fibrillation with 1:1 conduction in the setting of probable co-existing multiple bypass tracts.     

Influence of external periodic stimuli on heart rate variability in healthy subjects and in coronary heart disease patients

Frequency estimates of the heart rate variability (HRV) spectrum influenced by external periodic stimuli were studied in healthy subjects and patients with coronary heart disease (CHD). Sensory stimulation by periodic eye opening at a rate of 15, 10, 8, 6, or 5 times per minute, as well as spontaneous and controlled breathing at a rate of 15, 10, 8, 6, or 5 times per minute, was used. It was found that the spectral response to external periodic oscillations was determined by a frequency-dependent phenomenon, the maximal amplitude of heart rate variations being observed in the case of external stimuli at a frequency of 0.1 Hz. A resonance frequency in the 0.1-Hz range may be suggested to exist in the cardiovascular controls. Significant differences in the HRV frequency characteristics between CHD patients and healthy subjects were shown. CHD patients had a characteristic decline in HRV responses to external oscillations; the power of these responses did not depend on the frequency of external stimuli.     

Dynamics of milk ejection reflex during continuous rhythmic stimulation of areola-nipple complex of the mammary gland

In continuous 10-minute simultaneous action of the vacuum and compression stimuli at a 1 cycle/second frequency, the rate of the milk ejection from the breast was periodically changing in lactating women. The milk flow first peaks latency was 0.5-3.0 minutes, the number of peaks being 2-7 per minute with the inter-peak interval 2-4 minutes during a 10-minute milk ejection. The women revealed an individual pattern of the milk flow peaks. The findings suggest that a central gate mechanism intervenes to set the periodicity of the milk ejection.     

Atrial Pacing to Control Heart Rate and Rhythm in Acute Cardiac Conditions

Increasing the heart rate by a bedside atrial pacing technique was successfully utilized to treat serious cardiac arrhythmia or failure in 13 patients. Nine of these had ventricular arrhythmia refractory to drugs. Seven had evidence of sinus node depression or disease since their sinus pacemaker was below 70 beats per minute under decompensated conditions. In five, coronary artery disease was associated with the bradycardia and in two, digitalis toxicity was related to depression of the intrinsic pacemaker rate. Two patients in the coronary group required implantation of a permanent demand ventricular pacemaker. Hemodynamic studies were performed in seven patients. Only one patient had no increase in cardiac output with pacing rates above his resting rate. The other six patients showed an increase in cardiac output from 22 to 81% at paced rates between 70 and 125/minute. The duration of pacing ranged from one hour to 14 days and averaged five days.     

Survival of Plant Tissue at Super-Low Temperature VI. Effects of Cooling and Rewarming Rates on Survival

The survival rates of the cortical parenchymal cells of mulberry tree were determined as a function of cooling and rewarming rates. When cooling was carried out slowly at 1° to 15° per minute, all of the cells still remained viable even when rewarmed either rapidly or slowly. Survival rates gradually decreased to zero as the cooling rate increased from about 15° to 2000° per minute. In the intermediate cooling rates, when the cells were cooled at the rates lower than 14° per minute, from −2.2° to about −10°, these cells could survive subsequent rapid cooling and rewarming.

However, at cooling rates above 1000° per minute and with rapid rewarming, the effect of cooling rate reversed and survival increased, reaching a maximum at about 200,000° per minute. As the cooling rate increased above 15° per minute, survival rates became increasingly dependent on the rewarming rate, with rapid rewarming becoming less deleterious than slow rewarming.

The temperature range at which damage occurred during rewarming following removal from liquid nitrogen and in which growth rate of ice crystallization was greatest, was −30° to −40°. The survival rates even in the prefrozen cells at −30° decreased considerably by keeping them at −30° for 10 minutes after removal from liquid nitrogen. This fact indicates that intracellular freezable water remains to some degree even in the prefrozen cells at −30°. After removal from liquid nitrogen, all cells retained their viability, when they were passed rapidly through a temperature range between −50° and −2.5° within about 2 seconds, namely at the rates greater than 1000° per minute.

These observations are explained in terms of the size of the crystals formed within the cortical cells.

     

Thermal denaturation: is solid-state fermentation really a good technology for the production of enzymes?

The potential for thermal denaturation to cause enzyme losses during solid-state fermentation processes for the production of enzymes was examined, using the protease of Penicillium fellutanum as a model system. The frequency factor and activation energies for the first-order denaturation of this enzyme were determined as 3.447 x 10(59) h(-1) and 364,070 Jmol(-1), respectively. These values were incorporated into a mathematical model of enzyme deactivation, which was used to investigate the consequences of subjecting this protease to temporal temperature profiles reported in the literature for mid-height in a 34 cm high packed-bed bioreactor of 150 mm diameter. In this literature source, temperature profiles were measured for 5, 15 and 25 liters per minute of air and enzyme activities were measured as a function of time. The enzyme activity profiles predicted by the model were distributed similarly, one relative to the other, as had been found in the experimental study, with substantial amounts of denaturation being predicted when the substrate temperature exceeded 40 degrees C, which occurred at the lower two airflow rates. A mathematical model of a well-mixed bioreactor was used to explore the difficulties that would be faced at large scale. It suggests that even with airflows as high as one volume per volume per minute, up to 85% of the enzyme produced by the microorganism can be denatured by the end of the fermentation. This work highlights the extra care that must be taken in scaling up solid-state fermentation processes for the production of thermolabile products.     

The Prevalence of Ventricular Septal Defect in Elementary School Children in the City of Toronto

A knowledge of the prevalence of ventricular septal defect in different age groups is basic to the estimation of all complications of this disease. The Cardiac Registry in the City of Toronto has provided this information for elementary school children. Clinical diagnosis of ventricular septal defect was made if the child had a pansystolic murmur in the 3rd or 4th left intercostal space with a palpable thrill and/or electrocardiographic evidence of ventricular hypertrophy and/or radiologic evidence of pulmonary plethora at one or more examinations. When possible, the diagnosis was confirmed by cardiac catheterization. Children with the same murmur, no thrill and normal electrocardiogram and radiograph were labelled “probable” and presumed to have a minute or disappearing defect.The prevalence rate of ventricular septal defect in elementary school children varied betwen 0.44 and 0.48 per 1000 in four successive years of study. The rate of “probable” ventricular septal defect varied between 0.27 and 0.37 per 1000 children.     

Purification and degradation of ribulose bisphosphate carboxylase from soybean leaves

A rapid method is described for the preparation of up to 500 milligrams of pure ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBP carboxylase) from 250 grams of field-grown soybean leaves. Leaves were extracted in 20 millimolar phosphate (pH 6.9) at 4°C, containing 4% (w/v) polyvinylpolypyrrolidone, 10 micromolar leupeptin, 1 millimolar phenylmethyl sulfonylfluoride, 1 millimolar diethyldithiocarbamate, 5 millimolar MgCl₂, 1 millimolar dithiothreitol, 0.2 millimolar ethylene-diaminetetraacetic acid, 50 millimolar 2-mercaptoethanol. The extract was incubated in the presence of 5 millimolar ATP at 58°C for 9 minutes, then centrifuged and concentrated. Sucrose gradient centrifugation into 8 to 28% (w/v) sucrose on a vertical rotor for 2.5 hours yielded pure enzyme with a specific activity of 1.1 to 1.3 micromoles per minute per milligram protein at pH 8.0, 25°C. Soybean plants of the same line grown (at 400 microeinsteins per square meter per second) in growth chambers yielded enzyme with a specific activity of 0.6 to 0.7 micromoles per minute per milligram protein. During prolonged purification procedures a proteolytic degradation of RuBP carboxylase caused complete loss of catalytic activity. Without destroying the quaternary structure of the enzyme, a 3 kilodalton peptide was removed from all large subunits before further breakdown (removal of a 5 kilodalton peptide) occurred. Catalytic competence of the enzyme was abolished with the loss of the first (3 kilodalton) peptide.     

The effects of specific respiratory rates on heart rate and heart rate variability

In this study respiratory rates of 3, 4, 6, 8, 10, 12, and 14 breaths per minute were employed to investigate the effects of these rates on heart rate variability (HRV). Data were collected 16 times at each respiratory rate on 3 female volunteers, and 12 times on 2 female volunteers. Although mean heart rates did not differ among these respiratory rates, respiratory-induced trough heart rates at 4 and 6 breaths per minute were significantly lower than those at 14 breaths per minute. Slower respiratory rates usually produced higher amplitudes of HRV than did faster respiratory rates. However, the highest amplitudes were at 4 breaths per minute. HRV amplitude decreased at 3 breaths per minute. The results are interpreted as reflecting the possible effects of the slow rate of acetylcholine metabolism and the effect of negative resonance at 3 cycles per minute.     

The relationship between the thermogenic response of brown adipose tissue and age during noradrenaline infusion in the young rabbit

This work was undertaken to determine if the thermogenic activity of brown fat decreased with age in young rabbits despite the morphological evidence indicating persistence of the brown adipocytes at 4 weeks of age. Data obtained by infusing five doses of noradrenaline and measuring oxygen consumption were used to construct cumulative dose-response curves for five age groups between 3 and 32 days of age. Blood flow to brown fat and other tissues was measured by the microsphere method at 1 and 3 weeks of age. The noradrenaline-induced increase in oxygen consumption when expressed as a percentage of resting oxygen consumption in millilitres per 100 g of body weight decreased (p less than 0.05) with age. However, the absolute noradrenaline-induced increase in metabolic rate (millilitres per minute) increased with age. Total blood flow to brown fat (millilitres per minute) during noradrenaline infusion was unchanged between 1 and 3 weeks of age, but when the blood flow was expressed in millilitres per minute per gram of tissue flow decreased significantly (p less than 0.05) probably because of infiltration of brown fat with white fat. These data suggest that the amount of brown fat and its thermogenic capacity remain relatively constant between 1 and 3 weeks of age, but as a thermogenic organ, brown fat becomes proportionally less effective with age because of the large increase in body mass.     

Quantitative study of the importance of water permeability in plant cold hardiness

The rate of ice formation was measured for Hedera helix L. cv. Thorndale (English ivy) bark exposed to -10 C. The cooling rate of bark exposed to -10 C was 31 C per minute. The water efflux rate required for ice formation to occur extracellularly was calculated from the rate of ice formation and the average cell diameter. The water potential difference driving the efflux of water to sites of extracellular ice was calculated from the sample temperature, osmotic water potential, and fraction of water frozen at a given freezing temperature. From the water efflux rate and water potential difference, the resistance of the barrier controlling movement of intracellular water to sites of extracellular ice was calculated. Comparison of the resistance of this barrier to water movement with the resistance of the cell membrane revealed that the membrane represented only 0.5% of the barrier resistance. Thus, membrane resistance can have little influence on the rate of water efflux and ice formation when bark is cooled at a rate of 31 C per minute. If ice formation occurred at the same rate in ivy bark as it occurred in a 10 mm MnCl(2) solution, the membrane resistance would still have represented only 1% of the resistance of the barrier to ice formation. Therefore, at a cooling rate of 31 C/minute, heat removal plays a large part in determining the rate of ice formation. At slower cooling rates experienced under natural freezing conditions the ability to remove heat would play an even larger role. It is concluded that under natural freezing conditions membrane resistance does not limit water efflux.     

The Lens Effect and Phototropism of Phycomyces

Normally, the dioptrics in air of the cylindrical sporangiophore of Phycomyces blakesleeanus confer on the distal side a focusing advantage of about 30 per cent for unilateral stimuli of parallel light. This advantage can be nullified or reversed to produce negative curvatures by means of diverging light stimuli. A thin cylindrical glass lens was positioned 0.15 mm from the light-adapted growing zone with its long axis parallel to the long axis of the sporangiophore. A 3 minute blue stimulus was given and the lens removed. Reproducible negative curvatures were observed with a maximum of 13 degrees occurring within 8 minutes after the beginning of the stimulus. Experiments in air were done in a water-saturated atmosphere to minimize avoidance responses due to the proximity of the lens. The data support Buder's conclusion that the focusing advantage is the principal mechanism which produces the response differential necessary for phototropism. When the lens advantage is small, the attenuation becomes important in determining the direction of the response. Data obtained from sporangiophores immersed in inert liquids indicate that the attenuation is about 14 per cent. Therefore, whenever the focusing advantage is less than 14 per cent, negative curvatures are produced by unilateral stimuli.     

A retrospective study of 932 second trimester terminations using gemeprost (16,16 dimethyl-trans delta 2 PGE1 methyl ester).

A retrospective study of 932 second trimester terminations between 12-27 weeks gestation was carried out to determine the efficacy of gemeprost for second trimester termination. A single course of 5 x 1 mg gemeprost pessaries was administered every three hours. If abortion had not occurred after the first course of pessaries, a further course of 5 x 1 mg pessaries was administered. Intravenous oxytocin was administered after 36 hours if abortion had not occurred. Eighty per cent and ninety five per cent of patients aborted within 24 and 48 hours respectively. Of the remaining 5 per cent of women, 3 per cent aborted with escalating doses of oxytocin. In the remaining 18 (2 per cent) women, the pregnancies were electively terminated with an alternative method. The median induction-abortion interval was 18.0 hours and 15.0 hours in nulliparous and parous women respectively (P less than 0.0001). The number of pessaries required to induce abortion was not influenced by parity. Significantly more parous women bled more than 500 ml. The incidence of pelvic sepsis (0.1 per cent) and cervical tear (0.1 per cent) was low. Twenty six per cent of women had diarrhoea and 23 per cent vomited following administration of prostaglandin. This study confirmed the efficacy of gemeprost for second trimester termination of pregnancy. This method of termination is safe, non-invasive, simple and has a low complication rate.     

Cytochrome P-450-mediated denitrification of 2-nitropropane in mouse liver microsomes

Enzymatic denitrification of 2-nitropropane (2NP) was investigated in an NADPH-dependent hepatic microsomal system from male CD1 mice. The involvement of cytochrome P-450 (P-450) as the catalyst in 2NP denitrification was revealed by the induction of nitrite-releasing activity following phenobarbital (PB) pretreatment, by a decrease in activity with carbon tetrachloride pretreatment, by the inhibition of the reaction with classical P-450 inhibitors, and by the observation of a type I binding spectrum. Under optimal conditions, two pH-dependent peaks of activity were observed at pH 7.6 and pH 8.8, each with its own optimal substrate concentration. Inhibition of the reaction by metyrapone and carbon monoxide (CO) (among others) produced differential responses dependent on pH. These results, along with two pH optima and two substrate optima, suggested the involvement of multiple P-450 isozymes. Average specific activities were 8.05 nmoles of nitrite released per minute per milligram microsomal protein at pH 7.6 and 6.44 nmoles of nitrite released per minute per milligram microsomal protein at pH 8.8. Acetone was identified as the second product of the reaction by gas chromatography/mass spectrometry (GC/MS). Stoichiometry studies indicated that the acetone production was slightly less than expected (about 70%) from nitrite release. Up to 25% residual activity was observed under anaerobic conditions. These results suggested that though the predominant reaction mechanism was oxidative, oxygen-independent metabolism of 2NP also occurred to some extent. In contrast to the reported lack of activity in untreated rat, the observed denitrification in uninduced mouse liver microsomes was significant and suggested that major species-specific differences exist in the in vitro metabolism of 2NP.     

A plastic property in the change of rat muscle potentials clarified in the presence of neostigmine: a conjecture on the recycling process of ACh]

Released acetylcholine (ACh) is rapidly hydrolyzed, and choline is recaptured and re-used as available ACh for release. This elaborated recycling process of ACh was evaluated in terms of muscle potentials evoked by a set of 10 stimuli in the presence and the absence of neostigmine using Wistar rats anesthetized with urethane. All potentials evoked by a set of 10 stimuli before the injection of neostigmine were similar in amplitude. The first potential recorded 8 min after it was as large as that before it. The second potential was greatly depressed, and others were gradually recovered to the control level. The recovery was attained in the 5th-7th potential in some rats while a slight depression of the 10th potential was still seen in other animals. This time course was a general pattern in the change of muscle potentials evoked by a set of 10 stimuli in the presence of neostigmine. When 10 stimuli were given 9 min after it, all potentials showed rather comparable amplitudes to the control level. Thus, another pattern was found. The two patterns were repeatedly observed within individuals: A striking contrast in the changing pattern was noted between successive two sets of 10 stimuli with an interval of one minute. The former set exerted an influence upon those muscle potentials evoked by the latter one beyond one minute or so, but this effect disappeared during the elapse of two minutes or more. This plastic property and other findings were discussed in conjunction with those evidences recently accumulated on the recycling process of ACh. A conjecture was made on the recycling process of ACh: The process would be activated following impulse transmission, and this activation would be maintained for one minute or so. In that sense, this process would be controlled in a 'short-term memory' manner and endocytosis of synaptic vesicles coupled with their exocytosis should be emphasized. In addition, releasable ACh would be restored during repetitive stimulation even if it was once depleted notably.     

一套研究机械电反馈的心室压力钳系统

在心脏机械电反馈的研究中准确控制机械刺激是非常重要的。本研究室构建了一套适用于离体家兔心脏的心室压力钳系统。该系统通过计算机控制压力钳,不仅能模拟正常生理条件下左心室的压力波形,还能在心室活动周期的特定时相、以适当波形对心室施加机械刺激。该系统集心脏灌流与起搏、表面心电图记录、单相动作电位记录、心室压力钳制与测定等多种功能于一体,特别适用于器官水平上观察机械电反馈现象并探讨其机制。     

Nitrogen Starvation and the Regulation of Glutamine Synthetase in Agmenellum quadruplicatum

The level of glutamine synthetase activity in Agmenellum quadruplicatum strain PR-6 was dependent on the nitrogen source used for growth and on the nutritional status of the cells. During exponential growth, glutamine synthetase activity was low in cells grown on ammonia, urea, or nitrate. During the transition from nitrogen replete to nitrogen starved growth, glutamine synthetase activity began to rise. With ammonia as a nitrogen source, glutamine synthetase activity as determined in whole cells increased from 1 nanomole per minute per milliliter during exponential growth to 22 nanomoles per minute per milliliter during severe nitrogen starvation. In cells grown on nitrate the increase was from 5 to 39 nanomoles per minute per milliliter, and in cells grown on urea the increase was from 4 to 31 nanomoles per minute per milliliter.