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Biomedical subjects

C K Ng

Publications and source records attributed to C K Ng.

At least 73 records · Page 4Linked to original sources
PubMed1984

Tachycardia caused by an accessory nodoventricular tract: a clinico-pathologic correlation.

Paroxysmal tachycardia with widened QRS complexes was recorded in an eleven-year old boy who had suffered from brain damage, which had resulted from an episode of ventricular fibrillation. Atrial stimulation produced an increased AV conduction, sudden disappearance of the His bundle deflection and a complete left bundle branch block pattern. Tachycardias of this morphology were initiated by early atrial and ventricular premature beats. The findings suggested the presence of a macro re-entry circuit, utilizing a slow AV node- nodoventricular bypass tract as the anterograde limb and the His-Purkinje system--fast AV node as the retrograde limb. This supposition found further support by serial sectioning of the AV junctional area of the heart, which revealed a nodoventricular tract, which originated from the posterior extension of the compact part of the atrioventricular node and inserted into the crest of the ventricular septum.

Brain Damage, Chronic↗
PubMed1984

Validation of 3-deoxy-3-fluoro-D-glucose as a glucose transport analogue in rat heart.

Four aspects of the behavior of 3-deoxy-3-fluoro-D-glucose (D-3FDG) were studied. The distribution of label in rat tissues after intravenous administration of [18F]D-3FDG was compared with that seen with labeled 3-deoxy-3-fluoro-L-glucose (L-3FDG). Results were consistent with a larger volume of distribution for the physiological D-isomer coupled with some degree of reabsorption by the kidneys. L-3FDG, but not its D-isomer, was excluded from the brain. D-3FDG competitively inhibited uptake of glucose by isolated perfused rat hearts. The inhibition constant was 12.8 +/- 1.6 mM compared with 6.1 +/- 1.1 mM for 3-O-methyl-D-glucose. Residue curves obtained after bolus administration of [18F]D-3FDG to isolated hearts indicated phosphorylation of the tracer at a lower rate than for 2-deoxy-2-fluoro-D-glucose but with subsequent dephosphorylation at a faster rate. Chromatographic analysis of 18F remaining in tissues after administration of [18F]D-3FDG revealed in addition to free D-3FDG three other peaks. These disappeared after treatment with alkaline phosphatase and were thus assigned as phosphates. The principal metabolite had the same retention time as D-3FDG-6-phosphate prepared with hexokinase. No phosphorylated metabolites were detected in blood. D-3FDG labeled with 18F may be a useful tracer in studies of glucose transport and metabolism.

3-O-Methylglucose↗
PubMed1983

Effects of 2[5(4-chlorophenyl)pentyl]oxirane-2-carboxylate on fatty acid and glucose metabolism in perfused rat hearts determined using iodine-125 16-iodohexadecanoate.

Long-chain fatty acid oxidation by the isolated perfused rat heart was assayed by external counting using [125I]16-iodohexadecanoic acid as substrate after administration of the hypoketonemic and hypoglycemic compound 2[5(4-chlorophenyl)pentyl]oxirane-2-carboxylate to rats. Glucose metabolism was also assessed by measuring release of tritium from [2-T]glucose. The oxidation of long chain fatty acids was virtually suppressed in hearts from fed or starved rats given 2[5(4-chlorophenyl)pentyl]oxirane-2-carboxylate while glucose utilization was increased 2-2.5 fold.

Animals↗
PubMed1983

Alveolar size as a determinant of pulmonary distensibility in mammalian lungs.

Pulmonary distensibility depends on surface tension and tissue elastic forces, but the relative contribution of each to total lung recoil remains incompletely defined. By applying an exponential analysis to static pressure-volume curves obtained from the excised lungs of cats, dogs, and rats with air and saline filling, the exponential constant K (an index of lung distensibility) was related to the mean linear intercept Lm (a morphometric estimate of the mean size of peripheral air spaces at maximal inflation). K for air filling (Ka) was unrelated to K for saline filling (Ks), and Ks was unrelated to Lm, but similar highly significant regressions of Ka on Lm were found in each species, and the common regression was similar to that described previously for human lungs. Approximately 86% of the variance in lung distensibility (Ka) within and between species was explained by Lm. Because Lm determines the size of air spaces, and therefore the alveolar surface-to-volume ratio, the findings indicate that the density of surface forces is the major determinant of lung distensibility in the air-filled state.

Animals↗
PubMed1982

[Clinical and electrophysiological observations in a case of Romano-Ward syndrome ].

Syncope associated with atypical ventricular tachycardia of the "torsades de pointes" type was observed in a 16 year-old girl with hereditary QT prolongation. The arrhythmia occurred only during maximal prolongation of the QTc to 0.77 sec, which had possibly been aggravated by exercise and hypokalaemia. Electrophysiological studies were performed when the QTc was 0.59 sec. Incremental as well as premature ventricular pacing with single or double premature ventricular beats did not initiate ventricular arrhythmias, but revealed AV nodal and bundle branch reentry. It is postulated that these types of macroreentry are involved in the twisting of the QRS complexes in the surface ECG in torsades de pointes.

Adolescent↗
PubMed1982

Electrophysiology of tiapamil in concealed accessory pathways.

The effect of 2 mg/kg intravenous tiapamil was studied by programmed stimulation of the heart in 6 patients. Before tiapamil, sustained tachycardias were initiated in 5, and only atrial echoes in 1. In all patients, the reentrant circuit involved an accessory pathway conducting only in the ventriculoatrial direction. When administered during tachycardia, tiapamil promptly terminated the arrhythmia in 5 cases. Tiapamil lengthened the atrio-His (A-H) interval and the effective refractory period of the A-V node. As a result of these changes, it was not possible to initiate the tachycardia in 1 patient. In 1 case, tiapamil permitted the induction of sustained tachycardia, while only echoes had been initiated before the drug. In 2 cases, the tachycardia zone narrowed, in 2 others it widened following tiapamil. The ability to sustain the arrhythmia was lost in 1 patient. Tiapamil may be useful for the termination of reentrant supraventricular tachycardia involving concealed accessory pathways. Whether tiapamil prevents or favors the initiation of tachycardia in these patients depends on the interplay between the prolongation of the effective A-V nodal refractory period and the prolongation of the transnodal conduction time in individual patients.

Adult↗
PubMed1982

Effect of tiapamil in the preexcitation syndrome.

The effects of tiapamil were studied in 10 patients with antegrade preexcitation using programmed stimulation of the heart. Before administration of the drug, it was possible to initiate sustained orthodromic tachycardia in 7 patients, antidromic tachycardia in 2 and atrial echoes in 1 case by premature atrial and/or ventricular stimulation. An intravenous bolus of 2 mg/kg tiapamil terminated the tachycardia in 7 out of 8 cases by blocking the A-V node. The tachycardia continued at a reduced heart rate in 1 case with a nodoventricular bypass. Tiapamil lengthened the effective A-V nodal refractory period in 1 patient in whom it could be measured and the atrial effective refractory period in 1 case but did not prolong the antegrade or retrograde refractory periods of the accessory pathway. Only in 1 case was the antegrade effective refractory period of the accessory pathway shortened by tiapamil. The A-V nodal conduction time (A-H interval) was prolonged. Following tiapamil it was not possible to initiate the tachycardia in 4 cases and atrial echoes in 1 case; in 2 patients the tachycardia zone widened and in 3 it was not altered. In the latter, the cycle length of the tachycardia increased. Tiapamil appears to be of therapeutic value for the termination of tachycardia and also for its prevention in some cases. In others, it may facilitate the initiation of tachycardia. The delayed A-V nodal conduction during sinus rhythm augments the area of ventricular preexcitation which may facilitate the electrocardiographic localization of the accessory pathway.

Adolescent↗
PubMed1981

Demonstration of multiple antegrade and retrograde atrioventricular pathways.

A patient with paroxysmal supraventricular tachycardia had discontinuous antegrade (1a-A2, H1-H2) and retrograde (V1-V2, A1-A2) conduction curves suggesting dual A-V nodal pathways in both directions. Atrial echoes occurred with premature atrial pacing only at short A1-A2 coupling intervals after long antegrade (A2-H2) and retrograde (H2-A3) conduction intervals. Premature ventricular stimulation revealed ventricular echoes simultaneously with a sudden increase in the V2-A2 interval. The echo zone coincided with the slow pathway curve. Following atropine the echo zone was extended over the slow and fast pathway curves. Slow pathway conduction was observed at long and sort V1-V2 coupling intervals. Following isoproterenol ventricular stimulation initiated two cycles of ventricular echoes with relatively long retrograde (V2-A2, Ve-Ae) and short antegrade (A2-He, Ae-He) conduction times, the earliest atrial activation being observed in the low right atrium before the left atrium and the high right atrium. Antegrade fast and slow pathways as well as retrograde fast pathway conduction appeared to be confined to the A-V node. Retrograde slow pathway conduction may progress through a slow or fast A-V nodal pathway slowed by antegrade concealed conduction. However, an accessory pathway with long conduction times located near the septum cannot be ruled out entirely.

Atrioventricular Node↗
PubMed1979

Intracardiac electrophysiological effects of lorcainide in man.

The electrophysiological effects of lorcainide 1.25 or 2.5 mg/kg given iv over 2 or 4 min, were studied in 21 patients with normal and diseased impulse formation and conduction, by means of intracardiac recording and stimulation. Sinus rate and the effective atrial refractory period rose following both doses of lorcainide. The corrected sinus node recovery time rose only after lorcainide 2.5 mg/kg and then most markedly in patients with sinus node dysfunction. The P-A interval remained unchanged following the drug. The A-H interval during sinus rhythm, and the pooled A-H intervals during atrial pacing, increased slightly, and the functional and effective A-V nodal refactory period changed variably. Wenckebach periods above the bundle of His occurred at lower atrial pacing rates following both doses of lorcainide in 7 patients, at the same atrial pacing rate in 9 and at higher rates in 3. H-V intervals, pooled H-V intervals and QRS-width lengthened in all patients, most markedly in cases with a conduction delay below the His bundle, who had received lorcainide 2.5 mg/kg. Thus, lorcainide shares some electrophysiological properties with procainamide and aprindine. Higher doses should be used with caution in patients with pre-existing conduction delay below the bundle His.

Acetanilides↗
PubMed1979

Concealed accessory pathway and dual AV conduction: drug-dependent reentrant tachycardia.

Electrophysiological studies were performed in a patient with paroxysmal supraventricular tachycardia and a normal surface ECG at the time of the study. Premature atrial stimulation revealed dual AV conduction and an echo zone during AV conduction over the fast and the slow pathway. The prolongation of the AV conduction time by a calcium antagonist, Ro 11-1781, permitted the induction of tachycardias via both pathways. Premature ventricular stimulation yielded constant VA conduction times with activation of the low right atrium before the high right atrium before the left atrium. During the tachycardia, premature right ventricular beats conducted to the atrium at a time when the AV node and the His bundle would be refractory. The study suggests the simultaneous occurrence of an occult accessory bundle connecting the right ventricle to the right atrium and dual AV conduction.

Adult↗
PubMed1979

Effect on paroxysmal re-entrant supraventricular tachycardia of a drug affecting calcium transport (Ro 11-1781).

The effect of Ro 11-1781, a drug that affects calcium transport, in 10 patients with paroxysmal supraventricular tachycardia (PSVT), was studied by intracardiac recording and stimulation. The re-entry circuit involved an accessory pathway that conducted only in the ventriculo-atrial direction in 5 patients, and was confined to the A-V node in 5 cases. Prior to administration of Ro 11-1781 tachycardia could be initiated in all patients. An intravenous bolus of 2 mg/kg during PSVT terminated the tachycardia in all cases by blockade in the A-V node. Ro 11-1781 lengthened the A-V nodal conduction time as well as the functional and effective refractory period of the A-V node. The effective refractory period of the "fast" pathway was variably changed. After Ro 11-1781 the tachycardia zone was abolished in 3 cases, reduced in 3, increased in 3 and was converted to an echo zone in 1. The ability to sustain the PSVT was lost in one subject. The heart rate during PSVT was slowed following Ro 11-1781. Ro 11-1781 appears to be useful for the termination of PSVT, but its ability to prevent PSVT varies. Beneficial effects include abolition or narrowing of the tachycardia zone, loss of the ability to sustain PSVT and a reduction in heart rate during PSVT. The widening of the tachycardia zone may be harmful.

Adult↗
PubMed1979

Use of an exponential function for elastic recoil.

To improve the quantitative representation of elastic recoil, an exponential function (V = A - B exp (-KP), where V is the lung volume, P is the recoil pressure, and A, B, and K are constants), has been fitted to static pressure-volume (PV) data by a least-squares technique using a digital computer. The PV points below about 50% total lung capacity (TLC) usually deviate from an exponential expression. Increasing the lower volume limit to which the exponential was fitted from 40 to 75% of TLC in 20 subjects, increased K and B/A significantly. Residual variance was lowest (approx 1.0 +/- 0.5%) when the lower volume limit was between 50 and 60% TLC. The PV points in the lower volume range deviated significantly less from exponential in a group of older subjects than for young subjects. The coefficient of variation of K and B/A for duplicate studies in 10 subjects was 9 and 14%, respectively. For inflation PV data, K was significantly lower and A significantly higher than for deflation. For PV data obtained after a submaximal inspiration, K did not change significantly. From this exponential function, the PV curve above 50% TLC can be satisfactorily described by K, B/A, and recoil pressure at TLC; other conventional parameters may be derived.

Adult↗
PubMed1979

Exponential analysis of elastic recoil and aging in healthy males and females.

To examine the effects of aging on the elasticity of the lungs a single exponential function (V = A - B exp (-KP)), where V is lung volume, P is recoil pressure, and A, B, and K are constants) and a fourth-order polynomial were fitted to the static pressure-volume data from 124 healthy nonsmokers (83 males). K, the index of compliance, was independent of sex and increased with age. B/A and recoil pressures at various lung volumes were higher in males than females, but decreases with age were similar in both sexes. Static compliance (expressed as percent of total lung capacity/cmH2O), derived from the polynomial expression, was the same in males and females and increased with age. The results show that the lungs of males and females have the same intrinsic elasticity, and differences in recoil pressure depend on differences in lung size and in maximum distending forces. Loss of elasticity with age is consistent with an increase in the unstressed dimensions of alveoli and a decrease in their elastic fibers.

Adolescent↗
PubMed1979

The effect of a new calcium antagonist (Ro 11-1781) on the cardiac conduction system in man.

Using His bundle electrograms and atrial pacing the effects of Ro 11-1781, a new calcium antagonist, was studied in 13 patients with normal A--V conduction. Following an intravenous bolus of 2 mg/kg Ro 11-1781 the A--V nodal conduction time (A--H interval) was prolonged in all patients during sinus rhythm, atrial incremental and premature pacing. Wenckebach periods above the bundle of His occurred at lower atrial driving rates following the drug. The functional and effective refractory period of the A--V node were prolonged after the administration of Ro 11-1781. No significant effect of Ro 11-1781 on the remainder of the conduction system was observed. Heart rate and the corrected sinus node recovery time changed variably. The increase of the A--H time in response to Ro 11-1781 was completely reversed by Atropine.

Adolescent↗
PubMed1978

Computerized measurement of pulmonary conductance and elastic recoil.

A system devloped for on-line measurement of transpulmonary pressure, gas flow at the mouth, change in expired volume and plethysmograph volume uses a minicomputer to control a multiplexed analog to digital converter. The computer identified samples as static or dynamic values by monitoring a voltage activating a solenoid valve, used to close the airway. Analysis of these samples by other task-specific programs yielded the static deflation pressure-volume (PV) curve, the conductance-recoil pressure, GL-Pst(L), relationship and the maximum expiratory flow-volume (MEFV) curve; the MEF-Pst(L) curve and conductance upstream from the equal pressure point were derived. The PV relationship was represented by a fourth-order polynomial and the GL-Pst(L) relationship by linear regression. In 11 subjects the results obtained using on-line data collection, compared with manual analysis of oscillograph recordings, showed small differences in static compliance and in the maximum Pst(L); but overall the two methods showed excellent agreement. Besides advantages of speed and objectivity, this system facilitates a more rigorous analytical treatment of elastic recoil and conductance.

Asthma↗
PubMed1978

[Lorcainid--electrophysiologic examinations of a new anti-arrhythmia agent].

The electrophysiologic properties of Lorcainide (1.25 and 2.5 mg/kg) were studied on 21 patients by intracardiac electrograms and atrial stimulation. A prolongation of the H-V interval, widening of QRS duration but only minor changes in A-H interval were found. The effective refractory period of the atria increased, the effective and functional refractory periods of the A-V node changed variable following Lorcainide. There was a slight increase in heart rate and the sinus node recovery time was longer after 2.5 mg/kg of the drug. The major site of action of Lorcainide in man appears to be the His-Purkinje system. In electrophysiologic terms the new antiarrhythmic agent closely resembles Aprindine.

Acetanilides↗