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Biomedical subjects

J Jung

Publications and source records attributed to J Jung.

At least 91 records · Page 5Linked to original sources

Response of retinal ganglion cell axons to striped linear gradients of repellent guidance molecules.

Although molecular gradients have long been postulated to play a role in the development of topographic projections in the nervous system, relatively little is known about how axons evaluate gradients. Do growth cones respond to concentration or to slope? Do they react suddenly or gradually? Is there adaptation? In the developing retinotectal system, temporal retinal ganglion cell axons have previously been shown to avoid repellent cell-surface activities distributed in gradients across the optic tectum. We confronted temporal retinal axons with precisely formed striped linear gradients of repellent tectal membranes and of two candidate repellent molecules, ephrin-A2 and -A5. Axons entered gradient stripes independently of their slope and extended unhindered in the uphill direction until they suddenly avoided an apparent threshold concentration of repellent material that was independent of slope. This critical concentration was similar in both linear and nonlinear gradients, and hence independent of gradient shape. When gradients of identical slope were formed on different basal levels of repellent material, axons grew uphill for a fixed increment of concentration, possibly measured from the lowest point of the gradient, rather than up to a fixed absolute concentration. The speed of growth cones was not affected by repellent unstriped gradients below the critical concentration level. Similar results were found with membranes from cell lines stably transfected with either ephrin-A5 or ephrin-A2, two previously identified growth cone repellent cell-surface proteins. These data suggest that growth cones or axons can integrate guidance information over large distances, probably by a combined memory and adaptation mechanism.

Adaptation, Physiological↗

Antitachycardia pacing in patients with implantable cardioverter-defibrillators: inverse circadian variation of therapy success and acceleration.

We analyzed spontaneous ventricular tachycardias treated by antitachycardia pacing during long-term follow-up in 138 recipients of an implantable cardioverter-defibrillator. An inverse circadian variation of the antitachycardia pacing termination and acceleration rates with the worst antitachycardia pacing success during the time period with the highest episode frequency (morning hours) was demonstrated.

Circadian Rhythm↗

Tolerability of internal low-energy shock strengths currently needed for endocardial atrial cardioversion.

There seems to be no relation between shock strength and patient's tolerability using energy levels currently needed for low-energy internal atrial cardioversion. Every patient felt that the second delivered shock, independent of the amount of energy, was more uncomfortable than the first one, which indicates that psychological conditioning may also play an important role in determining discomfort.

Atrial Fibrillation↗

Retinal axon growth cone responses to different environmental cues are mediated by different second-messenger systems.

Numerous studies have shown that the developing tip of a neurite, the growth cone, can respond to environmental cues with behaviors such as guidance or collapse. To assess whether a given cell type can use more than one second-messenger pathway for a single behavior, we compared the influence of two well-characterized guidance cues on growth cones of chick temporal retinal ganglion cells. The first cue was the repulsive activity derived from the posterior optic tectum (p-membranes), and the second was the collapse-inducing activity derived from oligodendrocytes known as NI35/NI250. p-Membranes caused permanent growth cone collapse with no recovery after several hours, while NI35 caused transient collapse followed by recovery after about 10 min. The p-membrane-induced collapse was found to be Ca2+ independent, as shown using the Ca2+-sensitive dye Fura-2 and by the persistence of collapse in Ca2+-free medium. Dantrolene, a blocker of the ryanodine receptor, had only a minor effect on the collapse frequency caused by p-membranes. In contrast, the NI35-induced collapse was clearly Ca2+ dependent. [Ca2+]i increased sevenfold preceding collapse, and both dantrolene and antibodies against NI35 significantly reduced both the Ca2+ increase and the collapse frequency. Thus, even in a single cell type, growth cone collapse induced by two different signals can be mediated by two different second-messenger systems.

Animals↗

Involvement of soluble proteinous factors in auxin-induced modulation of P-type ATPase in rice (Oryza sativa L.) seedlings.

The marked difference in auxin sensitivity between plant roots and shoots was studied in terms of auxin-induced stimulation of membrane P-type ATPase. The results suggest the existence in rice seedlings of, at least, two isoforms of soluble proteinous factors (SPF), SPF(I) and SPF(II), which are involved in the stimulatory action of auxin on the enzyme. It also is indicated that SPF(I) which mediates the auxin effect in low hormone concentration range (10(-10)-10(-7) M IAA) is the dominant isoform in roots, whereas SPF(II) which does in high hormone concentration range (10(-7)-10(-4) M IAA) is that in shoots.

Adenosine Triphosphatases↗

Incidence and clinical significance of short-term recurrent ventricular tachyarrhythmias in patients with implantable cardioverter-defibrillator.

Aims of the present study were (1) to investigate the clinical significance of short-term recurrent tachyarrhythmias (STRTs) in ICD recipient, (2) to identify basic characteristics of the subgroup of patients with STRTs and (3) to compare the frequency and circadian pattern of single arrhythmic events and STRTs. We reviewed data from 119 consecutive patients with late generation ICD. All registered spontaneous ventricular tachyarrhythmias were divided into STRTs (defined as two or more consecutive episodes separated by < or =1 h of sinus rhythm) and single events. During a mean follow up of 36+/-18 months (range 2-67 months) 1849 ventricular arrhythmic events were detected in 57 out of 119 ICD recipients (48%). 202 STRTs consisting of 1128 single detection (6+/-7/STRT, range 2-52) occurred in 34/57 patients (60%; 6+/-6 per patient, range 1-21). Recurrent ventricular tachycardias before device implantation and a high number of single arrhythmic events during follow-up distinguished patients with STRTs. Cardiac mortality was significantly higher in patients with STRTs (26 vs. 4%, P<0.05). The majority of both single episodes and STRTs were registered between 8 a.m. and noon and in the evening. This study reveals a high incidence of STRTs in ICD recipients with spontaneous tachyarrhythmias during follow-up and identifies STRTs as prognostic significant events. Comparable circadian variations suggest that similar triggering factors may be involved in the genesis of STRTs and single tachyarrhythmias.

Adult↗

Factors influencing heart rate variability in patients with severe aortic valve disease.

BACKGROUND AND HYPOTHESIS: Heart rate variability (HRV) is an accepted tool for the assessment of cardiovascular autonomic tone. There are no sufficient data concerning its application to patients with severe aortic valve disease (AVD) requiring cardiac surgery. METHODS: It was the aim of this study to examine HRV and its physiologic correlates in patients with severe aortic valve disease requiring cardiac surgery. The correlates of time domain indices of HRV obtained from 24-h Holter electrocardiographic recordings were analyzed in 36 consecutive patients (23 men and 13 women, mean age 62 +/- 11 years) with AVD prior to cardiac surgery (aortic stenosis: 17 patients, aortic valve regurgitation: 3 patients, combined aortic valve disease: 16 patients). RESULTS: Low values of HRV were found in the entire study group: SDNN 96.8 +/- 30.9 ms, SDNNI 39.3 +/- 14.4 ms, SDANN 86 +/- 28.9 ms, and RMSSD 30 +/- 18.1 ms. In a univariate analysis, there was no significant correlation between the time domain measures of HRV and age, gender, medication, left ventricular ejection fraction, peak aortic pressure gradient, fraction of aortic valve regurgitation, and left ventricular mass assessed by echocardiography. Patients in advanced functional classes of heart failure [New York Heart Association (NYHA) III or IV] had significantly lower values for SDNN (83.8 +/- 33.6 vs. 107.3 +/- 24.7 ms; p < 0.05) and SDANN (72.7 +/- 29.4 vs. 96.6 +/- 24.3 ms; p < 0.05) than patients in NYHA class I or II. Reassessment of HRV 1 week after aortic valve replacement was performed in 17 patients and showed a significant further decrease of SDNN (102.4 +/- 29.7 vs. 61.5 +/- 23.5 ms; p < 0.001), SDNNI (40.7 +/- 13.6 vs. 23.4 +/- 12.4 ms; p < 0.001) and SDANN (91.8 +/- 29.2 vs. 54.2 +/- 22.8 ms; p < 0.001). CONCLUSION: Patients with AVD requiring cardiac surgery reveal reduced time domain indices of HRV. This observation is pronounced in patients with a progressed clinical class of heart failure, whereas hemodynamic and echocardiographic parameters seem to have no significant influence on HRV parameters in this population. In addition, there is evidence of a further reduction of HRV time domain indices 1 week after uncomplicated aortic valve replacement.

Aortic Valve↗

Derivation of herpesvirus saimiri-transformed CD8+ T cell lines with noncytotoxic anti-HIV activity.

Herpesvirus saimiri (HVS), strain 488-77, was used to derive continuously growing transformed human CD8+ T cell lines that can suppress HIV replication in CD4+ cells via the production of an antiviral factor(s). Transformed CD8+ cell lines were obtained by HVS infection of peripheral blood mononuclear cells or purified CD8- T cells from HIV-infected or uninfected individuals. Suppression of primary or laboratory isolates of HIV was mediated by factor permeation of a transwell membrane or by cell-free culture supernatants. Suppressing and nonsuppressing cell lines were IL-2-dependent for good growth and showed a similar activated cell surface phenotype. The cell lines produced varying amounts of the cytokines IL-8, IL-10, TNF-alpha, TNF-beta, RANTES, MIP-1 alpha, and MIP-1 beta, but not IFN-alpha. No correlation was observed between the level of any of these cytokines and the presence or absence of antiviral activity in cell line culture supernatants. These cell lines have become an important resource for studying antiviral factors produced by CD8+ T cells from HIV-infected individuals.

Anti-HIV Agents↗

[Biatrial stimulation in therapy of paroxysmal atrial tachycardia: a case report].

A biatrial pacemaker was inserted in a 68-year-old female with paroxysmal atrial fibrillation and atrial flutter refractory to antiarrhythmic drugs based on a sick-sinus-syndrome and concomitant interatrial conduction delay. One electrode positioned in the right atrium and another electrode located in the coronary sinus were connected to a dual-chamber pacemaker. The electrode in the right atrium was connected to the atrial channel, the electrode in the coronary sinus to the ventricular channel. The pacemaker was programmed in DDD-mode with an AV-delay of 30 ms. Under a chronic antiarrhythmic medication with 160 mg sotalol per day there was no evidence for recurrent episodes of atrial tachyarrhythmias in the patient's history, 24-h-Holter-ECG, nor in the memory of the pacemaker during a follow-up of 8 months.

Aged↗

Implantable cardioverter-defibrillator therapy: influence of left ventricular function on long-term results.

The degree of left ventricular impairment in an acknowledged important prognostic marker of long-term outcome for patients being evaluated for implantation of cardioverter-defibrillators. Just how left ventricular function impacts freedom from all-cause mortality, as well as from sudden death and cardiac death, is a subject of current major debate, and is analyzed hereunder from a large, recent multicenter ICD patient cohort. The multicenter database consists of data from 361 patients receiving implantable cardioverter-defibrillators for standard indications, that is, documented episodes of ventricular fibrillation or sustained ventricular tachycardias with poor hemodynamic toleration. Data were collected from 1988 to 1995 at three centers in Germany. Two-hundred and three patients (56%) had a left ventricular ejection fraction (LVEF) > 0.30 (group I), and 158 patients (44%) had a LVEF < or = 0.30 respectively (group II). The mean follow-up was 23.9 months (range 3-98 months). Overall survival at 5 years for group II patients was lower, as expected, at 74.1% versus 94.2%, respectively (P < 0.0001). Mortality was higher for each different cause of death in group II patients than in Group I: sudden arrhythmic deaths, 5 versus 1 (P < 0.048); nonsudden cardiac deaths, 16 versus 5 (P < 0.002); noncardiac deaths, 7 versus 2 (P < 0.03). Group II patients received a higher rate of at least one presumably appropriate shock at 86 (54.4%) versus 89 (43.8%) in group I (P < 0.05). However (and somewhat surprisingly), neither the time from ICD implantation to death, comparing only the patients who died, nor the event-free probability of appropriate shocks due to very rapid, sustained ventricular arrhythmias (> 230 beats/min), including a presumed risk of sudden arrhythmogenic death, differed between groups I and II. Sudden cardiac death was only marginally affected by LVEF (group I, 1.5% actuarial, 5-year survival 99.5%; group II, 3.1% and 95.8%, respectively). Therefore, the lower overall survival in ICD patients with LVEF < or = 0.30 resulted mainly from causes of death that cannot be directly influenced by cardioverter-defibrillator therapy. However, because group II patients had a far higher incidence of at least one ventricular tachyarrhythmia terminated by ICD shocks than group I patients, they also probably derived benefit from ICD therapy.

Cohort Studies↗

Balance and source of social support in relation to well-being.

Well-being was examined as a function of the balance of provided and received levels of four types of social support shared by 165 college students and their support networks over 1 semester. Prospective hierarchical regressions of balance of support exchange, after controlling for Time 1 level of the dependent variable, showed some interactions between hassles level and balance of support receipt and provision for symptomatology, but not for depression. These effects were stronger for low than for high hassle levels at Time 1 for men, whereas the opposite held for women. Men who provided more informational support than they received reported more symptoms at Time 2 than did net recipients, if Time 1 hassles were low. In contrast, women who received more tangible or more informational support than they provided at Time 1 reported more symptoms at Time 2 than did net providers, but only at high hassle levels. Results are interpreted in terms of both the costs and the benefits of receiving and providing support.

Adaptation, Psychological↗

Facilitating influence of procainamide on conversion of atrial flutter by rapid atrial pacing.

In a prospective, double-blind, randomized, placebocontrolled study we investigated the facilitating influence of intravenous procainamide on conversion of atrial flutter by rapid atrial pacing. Fifty consecutive patients with spontaneous sustained atrial flutter were 1:1 randomized into two homogenous groups: group A received 10 mg.kg-1 procainamide intravenously, group B placebo. After infusion there was a significant (P < 0.01) lengthening of the flutter cycle with respect to baseline in group A, exceeding the flutter cycle length of the control group (P < 0.05). The overall success rate of rapid atrial pacing in restoring sinus rhythm was significantly higher after pre-treatment with procainamide compared to placebo (100% vs 76%; P < 0.05): 20 patients of group A reverted immediately after pacing to sinus rhythm, the remaining five after a brief episode of atrial fibrillation. In the placebo group, 16 patients showed a prompt conversion to sinus rhythm and three after transient atrial fibrillation. In the remaining six patients, due to sustained pacing-induced atrial fibrillation, direct current cardioversion was necessary. After administration of procainamide a less aggressive stimulation protocol with significantly (P < 0.01) longer paced cycles to interrupt atrial flutter was achievable. In conclusion, intravenous procainamide augments the efficacy of atrial pacing to convert atrial flutter to sinus rhythm.

Adult↗

Low energy transvenous cardioversion of short duration atrial tachyarrhythmias in humans using a single lead system.

The purpose of this study was to investigate the efficacy and safety of atrial cardioversion using an endocardial single lead system presently used for ventricular defibrillation. The study population consisted of 26 recipients of an ICD in combination with a conventional endocardial single lead system with the proximal spring electrode as anode in the SVC and the distal as cathode in the apex of the RV. Atrial tachyarrhythmias were induced by right atrial burst pacing. If the arrhythmia sustained > 1 minute, biphasic shocks synchronized with the R wave were delivered using the implanted device, beginning with an energy of 4 J. If 4 J failed to terminate the arrhythmia, energy was increased stepwise, if the first shock was successful, a step-down testing was performed after reinduction of atrial tachyarrhythmias. The mean atrial defibrillation threshold was 2.3 +/- 1.2 J (range, 0.5-5 J). A total of 154 shocks were delivered and no adverse effects were observed. The mean defibrillation threshold for atrial flutter was somewhat lower than that for AF (1.8 +/- 1 J vs 2.7 +/- 1.4 J, P = 0.08). There was no correlation between the atrial defibrillation threshold and a history of previously occurring atrial tachyarrhythmias, the kind of the underlying heart disease, a prescription of antiarrhythmic drugs, the dimension of the LA, the LVEF, or the ventricular DFT. Internal atrial cardioversion of short duration atrial tachyarrhythmias using a transvenous single lead system designed for ventricular defibrillation is feasible and safe at low energies, and may have important clinical applications.

Adult↗

Antitachycardia pacing in patients with implantable cardioverter defibrillators: how many attempts are useful?

The purpose of this study was to determine the termination and acceleration rates for 1 to 6 attempts of antitachycardia pacing [ATP] delivered by ICD in order to terminate spontaneously occurring VTs. Twenty-four ICD recipients with active ATP programs, including a maximum of six ATP sequences and spontaneously occurring VTs during follow-up, were investigated. During a mean follow-up of 42 +/- 15 months (range, 17-63 months) 413 spontaneous VT episodes (17 +/- 14; range, 1-49 per patient) resulting in appropriate ATP delivery by the ICD occurred. ATP successfully terminated 328 episodes (80%) with a mean number of 1.6 +/- 1.1 pacing sequences. Eighty episodes (19%) were accelerated by ATP and 5 (1%) were unresponsive to ATP. The ATP success decreased until the third ATP sequence (59%-->31%-->24%), but increased again in the fourth to sixth attempt (46%-->46%-->29%). The acceleration rate increased from sequence one to sequence three (8%-->13%-->28%), but decreased significantly in further ATP attempts (19%-->0%-->0%). The mean time delays until redetection or termination after 4, 5, and 6 attempts of ATP were 22 +/- 5 seconds, 37 +/- 2 seconds, and 41 +/- 9 seconds, respectively. Nine patients (37%) used > or = 3 ATP attempts during follow-up and all of them had a therapeutic benefit from it. Five out of 13 VTs (38%) treated with > or = 4 attempts could ultimately be terminated by ATP. The results of this study demonstrate that the first ATP sequence is the most effective and that > 4 ATP attempts may be useful in a minority of patients. There seems to be a low risk of VT acceleration by the fourth to sixth ATP sequence. Because of the associated time delay, a high number of ATP attempts should only be programmed in patients with hemodynamically well-tolerated stable VTs.

Acceleration↗

Low-energy transvenous cardioversion of atrial fibrillation using a single atrial lead system.

INTRODUCTION: Clinical studies have shown that electrical conversion of atrial fibrillation (AF) is feasible with transvenous catheter electrodes at low energies. We developed a single atrial lead system that allows atrial pacing, sensing, and defibrillation to improve and facilitate this new therapeutic option. METHODS AND RESULTS: The lead consists of a tripolar sensing, pacing, and defibrillation system. Two defibrillation coil electrodes are positioned on a stylet-guided lead. A ring electrode located between the two coils serves as the cathode for atrial sensing and pacing. We used this lead to cardiovert patients with acute or chronic AF. The distal coil was positioned in the coronary sinus, and the proximal coil and the ring electrode in the right atrium. R wave synchronized biphasic shocks were delivered between the two coils. Atrial signal detection and pacing were performed using the proximal coil and the ring electrode. Eight patients with acute AF (38 +/- 9 min) and eight patients with chronic AF (6.6 +/- 5 months) were included. The fluoroscopy time for lead placement was 3.5 +/- 4.3 minutes. The atrial defibrillation threshold was 2.0 +/- 1.4 J for patients with acute AF and 9.2 +/- 5.9 J for patients with chronic AF (P < 0.01). The signal amplitude detected was 1.7 +/- 1.1 mV during AF and 4.0 +/- 2.9 mV after restoration of sinus rhythm (P < 0.001). Atrial pacing was feasible at a threshold of 4.4 +/- 3.3 V (0.5-msec pulse width). CONCLUSIONS: Atrial signal detection, atrial pacing, and low-energy atrial defibrillation using this single atrial lead system is feasible in various clinical settings. This system might lead to a simpler, less invasive approach for internal atrial cardioversion.

Acute Disease↗

Chemical suppression of gravitropic bending response in flower stalks of snapdragon (Antirrhinum majus L.).

Numbers of chemical agents which have been shown to inhibit either auxin signal transduction pathway or ethylene formation in plant cells were applied to cut flower stems of snapdragon (Antirrhinum majus L.) and their effects on the postharvest gravitropic response were studied. The chemical treatments were done by submerging either the stem base or the top part of cut flower, which involves the gravistimulus-sensitive region, for 1 h at 25 degrees C. When the chemicals were supplied from the cut stem base, the gravitropic upward bending of flower stalks kept horizontally after the treatments with 20 mM CDTA or 10 mM CoCl2 was comparable to that of the untreated control, but o-vanadate showed a certain degree of effectiveness for suppressing the bending response. In contrast, the direct application of those agents to the gravitropically sensitive region of cut flowers in the presence of 0.01% Triton X-100 resulted in a substantial reduction of the gravitropic response. In the case of 20 mM CoCl2 treatment, almost total elimination of gravitropism without any significant deterioration of flower quality was observed. The results indicate the possibility of preparation of a protocol involving CoCl2 and a proper surfactant for commercial use to suppress the gravitropic response of cut flowers during postharvest storage and transportation.

Chelating Agents↗

Increased variability in motor output with brain-spinal cord interaction.

Spinal cord neural circuitry of the lamprey that forms a central pattern generator for locomotion interacts with reticular neurons forming a reticulo-spino-reticular loop. We examine the hypothesis that increased variability exists in the locomotor output in the presence of this loop. Fictive locomotion (rhythmic activity recorded from ventral roots (VR)) was induced in in-vitro brain-spinal cord preparations of adult lampreys, by bathing the spinal cord with excitatory amino acids. In the control conditions the brain was bathed with physiological saline. Subsequently, synaptic reticular neuron communication was suppressed by application of a zero Ca2+ saline or, the brain was detached. The mean value of the predominant period was given by the lag to the first peak in the autocorrelation of the full wave rectified, moving averaged VR activity (zero mean, normalized). Variability in signal amplitude and burst duration or cycle period is indicated by attenuation of the peak values at lags > zero and the rate of decay of the autocorrelation. Also, power spectral density calculations were used to determine the dominant frequencies. Increased variability is indicated by wider peaks and higher power in a broader frequency band. Each index indicated the presence of increased variability when the reticular-spinal loop was functional.

Animals↗

Atrial defibrillation: can modifications in current implantable cardioverter-defibrillators achieve this?

Atrial fibrillation (AF), the most common arrhythmia resulting in hospital admission, is a major health problem. The limited efficacy of antiarrhythmic drugs to control this rhythm disorder and their potential proarrhythmic risk led to the development of new techniques to ameliorate the treatment of AF. Transvenous atrial defibrillation using endocardial electrodes has been shown to be effective at low energy levels. An implantable atrial defibrillator could be a potentially valuable treatment option for patients with paroxysmal AF that is medically refractory. Research is currently under way to investigate several critical issues concerning this new therapeutic concept: long-term efficacy, safety, patient's tolerance, and an acceptable cost/benefit ratio. It is well known that AF often complicates the use of the implantable cardioverter-defibrillator (ICD) for ventricular tachyarrhythmias. Therefore, it would seem desirable to implement the capability for atrial defibrillation into current ICD systems. It has been shown that atrial defibrillation, using endocardial lead configurations specifically designed for ventricular defibrillation, is feasible at energies well within the capabilities of current ICD technology. Further research is needed to evaluate if some enhancement of the lead configuration in combination with possible advanced technology could reduce the atrial defibrillation threshold to a well tolerated level as a prerequisite for automated atrial defibrillation, in ICD recipients with concomitant paroxysmal AF.

Animals↗