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Biomedical subjects

J Myers

Publications and source records attributed to J Myers.

At least 181 records · Page 10Linked to original sources
PubMed1989

Reproducibility of treadmill exercise data in patients with atrial fibrillation.

Serial submaximal treadmill tests are often used to evaluate the efficacy of therapy in patients with atrial fibrillation. Since the response to serial tests can be influenced by a 'learning phenomenon', we performed maximal exercise tests on 9 patients (mean age 63 +/- 4 years) with chronic atrial fibrillation. Points of analysis for the initial and follow-up treadmill exercise tests were 3 mph/0% grade, the gas exchange anaerobic threshold, and maximal exertion. Significant (p less than 0.05) reductions in ventilation (l/min) and oxygen uptake (ml/kg/min) were observed on follow-up at a standard submaximal work load of 3.0 mph/0% grade and at the gas exchange anaerobic threshold. There was no significant alteration in these variables at maximal exertion. A reduction in heart rate was observed throughout exercise during the follow-up test with the most marked reduction (21 beats/min) occurring at 3.0 mph/0% grade. There were no differences in respiratory exchange ratio or systolic blood pressure at any point. The reduction in submaximal heart rate and gas exchange variables without a significant change in these variables at maximal exertion is consistent with a learning effect. Therefore, studies comparing consecutive submaximal exercise test responses in patients with atrial fibrillation can be misleading.

Aged↗
PubMed1989

Can maximal cardiopulmonary capacity be recognized by a plateau in oxygen uptake?

The failure of oxygen uptake to increase with increasing work has been considered a marker of the limits of the cardiopulmonary system for many years. However, the concept has suffered from inconsistencies in definition, criteria, and data sampling, all of which affect the interpretation of the relation between changes in work and oxygen uptake. To evaluate the response and reproducibility of the slope in oxygen uptake at peak exercise, six subjects (mean age, 33 +/- 6 years) performed two individualized ramp treadmill tests on separate days. During exercise, oxygen uptake (for a given sample of 30 eight-breath running averages) was regressed with time and the slope was calculated. Maximal oxygen uptake, maximal heart rate and maximal perceived exertion were reproducible from day 1 to day 2 (mean difference, 0.4 ml/kg/min, 1.0 beats per minute, and 0.2 for maximal oxygen uptake, heart rate, and maximal perceived exertion, respectively [not significant]). Considerable variability in the slopes was observed during each test and from day to day. This occurred despite the use of large gas exchange samples, averaging techniques, and constant, consistent changes in external work. A plateau, defined as the slope of an oxygen uptake sample at peak exercise that did not differ significantly from a slope of zero, was not a consistent finding within subjects between days. We conclude that marked variability in the slope of the change in oxygen uptake occurs throughout progressive exercise, despite the use of large samples and a linear change in external work. These findings appear to preclude the determination of a plateau by common definitions.

Exercise Test↗
PubMed1989

Preventing staff-patient sexual relationships.

Just as the awareness of incest and childhood sexual abuse has grown in recent years, so too has knowledge of sexual exploitation of patients by psychotherapists and other mental health professionals. Almost no one, however, has discussed the prevalence of this problem in the hospital setting. The authors were members of a study group that thoroughly reviewed reported incidents in their own institution, leading to the recommendation that education is the best preventive measure currently available. The authors discuss fundamental issues involved in such a study, summarize profiles of patients and staff members who may be vulnerable to sexual involvement, and describe the main components of a preventive educational approach.

Antisocial Personality Disorder↗
PubMed1988

Molecular crowding on the cell surface.

Strong steric interactions among proteins on crowded living cell surfaces were revealed by measurements of the equilibrium spatial distributions of proteins in applied potential gradients. The fraction of accessible surface occupied by mobile surface proteins can be accurately represented by including steric exclusion in the statistical thermodynamic analysis of the data. The analyses revealed enhanced, concentration-dependent activity coefficients, implying unanticipated thermodynamic activity even at typical cell surface receptor concentrations.

Animals↗
PubMed1988

Cytopathologic detection of Chlamydia trachomatis in vaginopancervical (Fast) smears.

The value of the Papanicolaou-stained vaginopancervical (Fast) smear in the detection of chlamydial infection has been disputed. We examined 116 satisfactory Fast smears from 203 women enrolled in the Johns Hopkins Fertility Control Clinic and compared tissue-culture results with cytopathologic detection using various published morphologic criteria. All Chlamydia culture-positive cases were reviewed, and certain cytologic features considered helpful in the detection of chlamydial infection in cervical smears obtained from this selected high-risk population were identified. The changes that had the highest correlation with tissue culture included fine vacuolation of metaplastic endocervical cells, giving their cytoplasm a rarefied "moth-eaten" appearance. Using these criteria, cytopathologic changes of chlamydial infection were observed in 24 of 28 cases of tissue-culture-positive cases and in 8 of 88 tissue-culture-negative cases. The sensitivity and specificity of the Fast-smear cytodiagnosis of Chlamydia infection utilizing these morphologic changes and compared with tissue culture were 86% and 91%, respectively. Other cytologic features, including inflammatory background and intracytoplasmic structures consistent with initial and intermediate chlamydial bodies within the metaplastic cells, were found to be useful although less specific and less sensitive. The implications of these diagnostic features, the conditions to be considered in their differential diagnosis, and the pitfalls of chlamydial cytodiagnosis and the chlamydia culture studies have been critically reviewed. Study design and the high unsatisfactory cervical smear rate are discussed.

Cervix Uteri↗
PubMed1988

Lung water measurements with iodo-antipyrine.

131I labeled iodo-antipyrine and 99mTc labeled erythrocytes were used to measure water content in lungs. These radioactive tracers were injected into 10 rabbits with normal lungs and 11 rabbits with injured lungs. Blood samples were drawn and the subjects were killed. The lungs were removed, weighed and homogenized. Samples of blood and lung homogenate were assayed for 131I and 99mTc. Samples were also weighed before and after drying to a constant weight at 70-75 degrees C. Extravascular lung water was determined by the dual isotope technique and again by gravimetric analysis. The average ratio of the results from the 2 different methods is 1.03 +/- 0.15. The 2 methods were compared by regression analysis and the correlation coefficient was 0.92 +/- 0.09. Our investigation suggests the possibility of measurement of lung water with equilibrium distribution of iodo-antipyrine.

Animals↗
PubMed1988

Effects of iron, copper, zinc, calcium, and magnesium on human lymphocytes in culture.

The effects of simultaneous changes of calcium, magnesium, iron, copper, and zinc concentrations were evaluated in normal human T and B lymphocytes, cultured in cation-depleted media. Optimal concentrations for thymidine incorporation (TI) in both cell populations were Fe and Zn 15 microM and Cu 5 microM; for T cells Ca 2 mM and Mg 4 mM; for B cells Ca 4 mM and Mg 6 mM. TI decreased with increasing molarity of cations and the decrease was particularly apparent with Cu. Minimal amounts of Ca and Mg (0.5 mM) were necessary for growth, even in presence of optimal concentrations of Fe, Cu, and Zn. Fe and Cu showed synergistic stimulatory effects at low concentrations and synergistic inhibitory effects at high concentrations. Antagonism between Fe and Zn, Cu and Zn, and Ca and Zn was also demonstrated. CD4/CD8 increased with PHA stimulation in presence of Zn, and decreased with ConA stimulation in presence of Zn or Fe. The results demonstrate: (1) the relationship and interdependence of Fe, Cu, and Zn concentrations in modulating the growth of normal lymphocytes; (2) the stimulatory effects of Fe on B cells and Zn on CD8 positive cells; (3) the inhibitory effect of Cu at concentrations lower than those of Fe and Zn; (4) the requirement of Ca and Mg in certain concentration and ratio for the action of the other cations; and (5) the Ca and Mg requirement for the growth of B cells higher than T cells.

B-Lymphocytes↗
PubMed1988

High-frequency electrocardiography: an evaluation of lead placement and measurements.

Before there is widespread clinical application of the high-frequency ECG, differences resulting from the leads used and the measurement criteria for late potentials must be resolved. Therefore 113 consecutive patients without resting QRS conduction abnormalities referred for Holter monitoring were studied. Four different lead systems were used: a standard bipolar orthogonal lead system and three bipolar lead systems mapping the left ventricle. Measurements made of late potentials included normal and high-frequency QRS duration, their difference, the duration of low-amplitude signals (less than 40 uV) in the terminal QRS, and the root mean square of the last 40 msec of the high-frequency QRS duration. We found that the left ventricular leads tended to give more abnormal measurements than the orthogonal system and that the various measurements failed to agree with each other. In addition, even in this population in which abnormalities of QRS conduction were excluded, the late potential measurements tended to be more abnormal as QRS duration lengthened. These differences in lead systems and measurement criteria must be considered when clinically applying information regarding late potentials measured from the high-frequency ECG.

Adult↗
PubMed1988

A clinical and pathologic study of chronic sinusitis: the role of the eosinophil.

Evidence exists that the eosinophil plays an important role in mediating injury to bronchial epithelium in chronic asthma. Here, the role of the eosinophil in chronic inflammatory disease of the paranasal sinuses was studied with tissue from patients who underwent surgery for chronic sinusitis. Paranasal tissue from patients with chronic asthma and/or allergic rhinitis was extensively infiltrated with eosinophils. Immunofluorescent studies demonstrated a striking association between the presence of extracellular deposition of major basic protein and damage to sinus mucosa. The histopathology of paranasal respiratory epithelium appeared similar to that described in bronchial asthma. These findings suggest that the eosinophil acts as an effector cell in chronic inflammatory disease of paranasal respiratory epithelium. Thus, sinus disease in patients with asthma may be due to the same mechanisms that cause damage to bronchial epithelium.

Adolescent↗
PubMed1988

Maximal exercise testing and gas exchange in patients with chronic atrial fibrillation.

To evaluate the response of patients with chronic atrial fibrillation to exercise, 50 men (mean age 65 +/- 8 years) with atrial fibrillation underwent a maximal exercise test using respiratory gas exchange techniques. Patients were classified by the presence (n = 29) or absence ("lone atrial fibrillation," n = 21) of underlying heart disease. Responses were evaluated at a standard submaximal work load (3.0 mph, [4.8 km/h] 0% grade), at the gas exchange anaerobic threshold and at maximal exercise. For all 50 patients, the mean maximal oxygen uptake was 20.6 ml/kg per min, which approximates 85% of the aerobic capacity predicted for age-matched normal individuals. Patients with lone atrial fibrillation demonstrated normal exercise capacity in contrast to patients with atrial fibrillation and known heart disease (22.7 +/- 5 versus 19.1 +/- 5.0 ml/kg per min, p less than 0.05). The mean maximal heart rate (176 +/- 30 beats/min) was approximately 20 beats/min higher than that expected for age, was extremely variable and accounted for only 8% of the variance in maximal oxygen uptake. Maximal heart rate in subjects with lone atrial fibrillation was higher than that of subjects with atrial fibrillation and known heart disease (189 +/- 32 versus 166 +/- 24 beats/min, p less than 0.01). Stepwise regression analysis revealed that maximal systolic blood pressure accounted for 19% of the variance in maximal oxygen uptake (VO2 max), suggesting that systolic function is an important determinant of exercise performance in atrial fibrillation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Immunohistochemical demonstration of Chlamydial antigens in association with prostatitis.

The occurrence of Chlamydia trachomatis in association with histologically proven prostatitis was investigated. We used the immunoperoxidase technique with a monoclonal antibody against Chlamydia and evaluated formalin-fixed, paraffin-embedded sections from 16 cases of histologically proven prostatitis. Chlamydial antigens were detected within the prostate glands in 5 (31%) of these 16 cases. In contrast, none of 19 cases of prostatic hyperplasia without significant inflammation used as a control group showed staining for Chlamydia in the prostatic glands (P less than 0.03). Chlamydial antigens were, however, detected in the urothelium of the prostatic urethra in one of these control cases. Staining for Chlamydia occurred focally in atrophic glands and was associated with a predominantly chronic nonspecific inflammation. No cytoplasmic inclusions or other specific morphologic features of chlamydial infection could be identified on routine hematoxylin-eosin- or Giemsa-stained tissue sections from these specimens. Our results demonstrate that Chlamydia can infect the prostatic glands, and that its presence is statistically associated with marked nonspecific inflammation. We suggest that C. trachomatis may have an etiologic role in nonbacterial prostatitis.

Antibodies, Monoclonal↗
PubMed1987

The role of a Ca2+/calmodulin dependent plasma membrane Ca2+ channel during concanavalin A activation of MC9 mast cells.

The effects of Con A on free cytoplasmic calcium concentrations in the cloned murine mast cell, MC9, have been measured using the fluorescent calcium indicator quin 2. Con A causes a rapid, small yet sustained rise in free cytosolic calcium (up to 245 nM) followed closely by increased 45calcium uptake and more slowly by histamine release. The increases in 45calcium uptake and histamine release require extracellular calcium. However, the Ca2+ influx blockers, nifedipine and verapamil inhibit these responses only at concentrations significantly higher than those used in smooth muscle to oppose potential-dependent events, and diltiazem is inactive. These observations suggest that, in these mast cells, other types of channels control Ca2+ entry. In contrast, the intracellular Ca2+ blocker, TMB-8, inhibits both the Con A-induced histamine release and the Ca2+ changes. The calmodulin antagonists calmidazolium, trifluoperazine and W-7 are also highly effective inhibitors of both the Ca2+ changes and histamine release in direct proportion to their potency against calmodulin-dependent phosphodiesterase, implicating calmodulin in the regulation of stimulus-secretion in MC9 cells. These data imply that histamine release follows increases in intracellular Ca2+ concentration. Free intracellular Ca2+ results from rapid release from internal stores and is followed by a slower but more sustained influx of extracellular Ca2+.

Animals↗
PubMed1987

Observations on the use of a cation exchange resin for the preparation of metal-depleted media for lymphocyte culture.

A chelating resin specific for divalent cations (Chelex) was used to prepare metal-depleted media for lymphocyte culture. A batch procedure (resin in pH 7.4 phosphate buffer/specimen, 1:1) removed 70-80% of iron, 77-87% of copper and 88-98% of zinc, calcium and magnesium. At variance with other reports, when a resin/specimen ratio of 1:4 was used, iron chelation decreased to 40%, whereas other cation chelation remained unchanged. Best chelation for iron and calcium was obtained at pH 5-6.4; for copper, zinc and magnesium, at pH 7.4-8.0. During the procedure protein content decreased by 8-10%; arginine and lysine by 80%; asparagine, cystine, tyrosine and phenylalanine by 60%, other amino acids by 35%. These new data suggest that cation-depleted media prepared with Chelex may be used to study the effects of cations on lymphocytes in culture, provided that the most appropriate pH and resin/specimen ratio are selected and adequate amino acid replacement is performed. Results on normal human lymphocytes are reported.

Cation Exchange Resins↗
PubMed1987

Effect of beta-adrenergic blockade on exercise performance in patients with chronic atrial fibrillation.

Beta-adrenergic blocking agents are commonly used in combination with digitalis to control excessive heart rate during exercise in patients with chronic atrial fibrillation. However, little is known about the effect of beta-adrenergic blockade on exercise capacity in these patients. Accordingly, a randomized, double-blind, cross-over placebo-controlled study was performed to assess the efficacy of celiprolol, a new cardioselective beta-blocker with partial intrinsic sympathomimetic activity, on exercise performance in nine men with chronic atrial fibrillation. All but one patient was receiving maintenance digitalis during the study. Heart rate, blood pressure and gas exchange variables were measured at rest and during treadmill exercise testing while the patients were receiving maintenance celiprolol or placebo. Significant reductions in heart rate and systolic blood pressure compared with control values were observed at submaximal exercise, at the gas exchange anaerobic threshold and at maximal exertion while the patients were taking celiprolol. However, oxygen uptake at the gas exchange anaerobic threshold during celiprolol therapy was 12.3 versus 14.0 ml oxygen/kg per min during placebo administration (a 12% difference, p less than 0.01). Similarly, oxygen uptake at maximal exertion during celiprolol therapy was 17.6 versus 21.0 ml/kg per min during placebo administration (a 16% difference, p less than 0.01). Treadmill time was also reduced during the celiprolol phase compared with placebo (11.3 versus 10.3 minutes; a 19% difference, p less than 0.01). These results indicate that in patients with atrial fibrillation the major beneficial effects of beta-adrenergic blockade--reduced submaximal and maximal exercise heart rate and blood pressure--must be weighed against the decrease in exercise capacity.

Adrenergic beta-Antagonists↗
PubMed1987

Influence of exercise training on spatial R-wave amplitude in patients with coronary artery disease.

To evaluate the influence of an exercise program on spatial and left precordial R-wave amplitude among patients with coronary artery disease, computerized electrocardiogram (ECG) data were acquired during maximal treadmill testing before and after 1 yr in 89 patients randomized to either exercise (n = 40) or control (n = 49) groups. Spatial and lateral R-wave amplitudes were derived from the orthogonal Frank (XYZ) lead system. The exercise group significantly increased maximal O2 consumption (0.17 l/min), whereas controls decreased significantly (0.12 l/min, P less than 0.01 between groups). No significant changes in electrocardiographic R-wave voltage measurements occurred within or between groups during the year. It is concluded that exercise training does not result in increases in R-wave voltage in patients with coronary artery disease.

Angina Pectoris↗