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Biomedical subjects

K Fox

Publications and source records attributed to K Fox.

At least 235 records · Page 13Linked to original sources
PubMed1985

Threshold effects of N-methyl D-aspartate (NMDA) and 2-amino 5-phosphono valeric acid (2APV) on the spontaneous activity of neocortical single neurones in the urethane anaesthetised rat.

Spontaneous activity of single neurones in neocortex was sampled using pairs of microelectrodes in rats anaesthetised with urethane. In confirmation of previous studies, many cells recorded from middle layers characteristically fired in bursts, the onset times of which were synchronous both unilaterally and bilaterally. Iontophoresis of 2APV onto such cells either caused an abolition of bursts or a reduction in spikes per burst. In the latter case action potentials which occurred later in the burst were preferentially abolished. Iontophoresis of NMDA onto the same cells caused a prolongation of bursts with minimal effect on intraburst interspike interval. In interactive trials with the two drugs the effect of NMDA could be abolished by 2APV, and NMDA counteracted the effect of 2APV. It is concluded that spontaneous burst generation in neocortex during urethane anaesthesia is generated through a cortical NMDA/2APV-sensitive receptor mechanism.

Action Potentials↗
PubMed1984

Cigarette smoking and the treatment of angina with propranolol, atenolol, and nifedipine.

To determine whether cigarette smoking affects the results of drug treatment for angina, we studied 10 cigarette smokers with angina who were given placebo, nifedipine (60 mg per day), propranolol (240 mg per day), and atenolol (100 mg per day), each for one week. The four-week double-blind study was repeated with the same randomly determined order of drug sequences, after all 10 subjects had stopped smoking. Before and after the subjects stopped smoking, all three drugs significantly reduced the frequency of angina, as measured with angina diaries, and improved the results of maximal exercise testing and 48-hour ambulatory monitoring of ST segments (P less than 0.01). However, during the nonsmoking phase of the study, there was an overall decline in the frequency of angina and an improvement in performance on exercise testing (P less than 0.05) as compared with the smoking period, although the results of 48-hour ambulatory monitoring remained unchanged. The improvement after patients stopped smoking was greater during treatment with nifedipine than during administration of the other two drugs or placebo. Blood levels of propranolol were increased when patients stopped smoking; levels of nifedipine and atenolol were unchanged. Our data show that smoking had direct and adverse effects on the heart and interfered with the efficacy of all three anti-anginal drugs, but with nifedipine the most.

Angina Pectoris↗
PubMed1984

Central cyanosis following coronary artery bypass graft surgery.

A case of central cyanosis occurring after coronary artery bypass graft surgery is described. This was due to the development of a right ventricular infarction which facilitated shunting from right to left through a previously undiagnosed patent foramen ovale or small atrial septal defect.

Coronary Artery Bypass↗
PubMed1984

Effect of nitroglycerin on the electrical changes of early or subendocardial ischaemia evaluated by monophasic action potential recordings.

Intracavitary recording of monophasic action potentials (MAP) is a sensitive means of detecting the electrophysiological effects of early or subendocardial ischaemia. The effects of nitroglycerin (NTG) on the MAP was evaluated during pacing-induced angina in seven patients with localised, reversible ischaemia. Recordings from the ischaemic zone demonstrated a decrease in MAP amplitude and an abnormal rate-corrected shortening of MAP repolarisation. The "control" right ventricular MAP showed only the expected rate-dependent decrease in duration throughout the pacing stress test. The ischaemic MAP were unchanged following the intracoronary administration of NTG (100 micrograms). In contrast, intravenous NTG (200 to 300 micrograms) produced a normalisation of MAP amplitude and duration in spite of continuous pacing at the angina-provoking rate. These changes were preceded by a fall in aortic pressure (from mean 123/84 to 96/62) and subsequent lowering of the rate-pressure product. The major beneficial effects of NTG on the early electrical changes of pacing-induced ischaemia are thus related to decreased oxygen demand due to reduction in cardiac preload.

Action Potentials↗
PubMed1984

The interaction of cigarette smoking and beta-adrenoceptor blockade.

The importance of the interaction between smoking and propranolol (metabolised in the liver) and atenolol (excreted almost entirely in the urine) was investigated in a double-blind placebo-controlled trial. Resting and exercise heart rates were significantly greater during smoking than no-smoking phases. Atenolol and propranolol significantly improved ST segment response after exercise whether or not the patients were smoking. Plasma propranolol significantly increased when patients stopped smoking whereas there was no such change in atenolol levels.

Adrenergic beta-Antagonists↗
PubMed1984

Retinal telangiectasia, retinoschisis and retinal detachment.

A 32-year-old woman had progressive bilateral peripheral and central retinal telangiectasis with secondary exudative, nonrhegmatogenous, retinal detachment, and secondary retinoschisis. This is unique constellation of clinical findings, retinal telangiectasis itself being an uncommon disease, and usually occurring in young males, unilaterally. Theories for the etiology of this disease process are presented. The disease was successfully treated bilaterally with retinal cryopexy extensively applied to the retinal telangiectasis, both peripheral and paracentral, with both scleral buckling and drainage of copious amounts of thick subretinal exudation.

Adult↗
PubMed1983

Treatment of angina pectoris with nifedipine: importance of dose titration.

The effects of different doses of nifedipine on frequency of angina and objective measurements of myocardial ischaemia during exercise were studied in 10 patients with stable angina pectoris. In a single blind trial over nine weeks patients received one week's treatment each with placebo, nifedipine 10 mg, 20 mg, 30 mg, 40 mg, 30 mg, 20 mg, 10 mg, then placebo three times a day. The response to the different doses of nifedipine was highly variable. On exercising, three patients achieved a consistent improvement in workload attained before onset of ST segment depression and maximum ST depression during exercise testing during all active phases. Four patients improved with 10 mg three times a day but deteriorated at higher doses. In two patients there was no objective or subjective improvement with any dose of the drug, while in one patient anginal frequency increased and there was objective deterioration during exercise testing at doses above 10 mg three times a day. Thus a dose of nifedipine that is beneficial in one patient may have minimal or opposite effects in another. These results indicate the importance of careful titration of doses for individual patients if the maximum benefit from nifedipine is to be obtained in patients with exertional angina.

Adult↗
PubMed1983

Initial experience with a physiological, rate responsive pacemaker.

A new pacemaker that can adapt the heart rate in response to the patient's metabolic requirements has been developed. This pacemaker uses the QT interval as the indicator of physiological demand. Experience in five patients showed the rate response to exercise to be smooth and progressive and to return gradually to the basic paced rate after activity stopped. Physiological rate responsive pacing resulted in a 45% increase in cardiac output when compared with fixed rate pacing. Similarly, a 57% increase in maximal exercise capacity was noted when rate responsive pacing was compared with conventional pacing at 70 beats/min. This study showed that physiological rate responsive pacing using the QT interval provides a simple means of increasing the heart rate in accordance with the body's requirements.

Adult↗
PubMed1983

Effects of ionophoresed noradrenaline on the spontaneous activity of neurones in rat primary somatosensory cortex.

Changes in spontaneous activity of rat S1 cortical neurones with identified receptive fields were investigated in reply to ionophoresed noradrenaline (NA). Extracellular levels of NA were maintained constant by continuous electrochemical analysis at the carbon fibre recording tip of the multibarrel micro-electrode. In the absence of NA there were clear differences in spike amplitude, firing rate and pattern of firing of deep (800-1400 micron) and superficial (0-800 micron) cells. Superficial cells responded to low (5 X 10(-8) to 5 X 10(-7) M) NA concentrations with simple inhibition. Recovery occurred within a minute or so of extracellular NA concentrations falling below detectable (10(-8) M) levels. Increases in local concentration merely stopped cells firing. In contrast, cells located in the deep zone could often be excited by very low NA concentrations (less than 10(-8) M), with inhibition occurring at levels 10-100 times greater. Most cells, however, were inhibited, with threshold doses for a 50% change in firing rate much higher than for superficial cells. Some cells in the deep zone showed sustained increases in firing rate following an ionophoretic trial. This could occur for periods of up to 1 h after ceasing a trial. Such effects could be produced by levels as low as 10(-7) M-NA. Interspike interval analysis for deep cells suggested that their spontaneous activity resembled that established for slow-wave sleep. During and after excitation by NA the pattern of firing of small groups of these cells changed to that established for the waking state. The effect could persist for up to 1 h following a short (2-5 min) ionophoretic trial.

Action Potentials↗
PubMed1983

Intracardiac electrode detection of early ischaemia in man.

We have evaluated an intracardiac technique for the study of the electrophysiological patterns of early or subendocardial ischaemia in man. Simultaneous recordings of the paced endocardial evoked response and monophasic action potentials were obtained during pacing stress testing in 10 patients with reversible myocardial ischaemia. Early patterns of change occurred in both these recordings in response to regional ischaemia. Abnormal rate corrected shortening of the local repolarisation time in the paced endocardial evoked response from the left ventricular ischaemic zone diverging from control non-ischaemic values by a mean of 10.6% was paralleled by decreases in the simultaneous paced monophasic action potentials duration. A differential delay in the local activation time and conduction was also documented by the paced endocardial evoked response and monophasic action potential electrodes. Non-ischaemic control zones showed no changes in the pattern of activation and repolarisation. Disparate repolarisation times and asynchronous activation within the myocardium were thus consistently demonstrated during regional ischaemia. These changes in the endocardial paced evoked response and monophasic action potentials always preceded the appearance and regression of the clinical ischaemia. Intracavitary recordings may thus provide earlier and more sensitive detection of regional ischaemia during cardiac catheterisation or coronary artery surgery. The study of the patterns of activation and response could permit the assessment of interventions on the early electrical changes of ischaemia, and may bridge the gap between in vitro studies and the electrophysiological studies performed upon the intact heart.

Action Potentials↗
PubMed1983

Ambulatory electrocardiographic ST segment changes in healthy volunteers.

Twenty four hour ambulatory monitoring was performed on 120 healthy volunteers using a frequency modulated recorder: 50 men and 50 women below 40 years and 20 men between 40 and 60 years were studied. Twenty eight subjects had episodes of ST segment elevation (range 1-3 mm), which occurred almost invariably at night with a slow heart rate 62.4 +/- 10.4 beats/min). ST segment elevation occurred most often in men, and was not found in subjects over the age of 37. Also in 10 subjects horizontal or downsloping ST segment depression (range 1-2 mm) was recorded, usually in association with tachycardia (135 +/- 10.5 beats/min). Nine of these exercised on a bicycle ergometer, and widespread ST segment depression was observed in eight. Thus ST segment changes, which are often interpreted as myocardial ischaemia in patients with ischaemic heart disease, are commonly seen in 24 hour electrocardiographic monitoring of healthy volunteers.

Adult↗
PubMed1983

The role of nitrates on regional subendocardial ischaemia--studies with endocardial monophasic action potentials during pacing-induced angina.

Intracavitary recording of monophasic action potentials (MAP) is a sensitive means of detecting the electrophysiological effects of early or subendocardial ischaemia. The effect of nitroglycerin on the MAP was evaluated during pacing-induced angina in seven patients with localized, reversible ischaemia. Recordings from the ischaemic zone demonstrated a decrease in MAP amplitude and an abnormal rate-corrected shortening of MAP repolarization. The "control" right ventricular MAP showed only the expected rate-dependent decrease in duration throughout the pacing stress test. The ischaemic MAP were unchanged following the intracoronary administration of 100 micrograms nitroglycerin. In contrast, 200-300 micrograms intravenous nitroglycerin produced a normalization of MAP amplitude and duration in spite of continuous pacing at the angina-provoking rate. These changes were preceded by a fall in aortic pressure (from mean 123/84 to 96/62) and subsequent lowering of the rate-pressure product. The major beneficial effects of nitroglycerin on the early electrical changes of pacing-induced ischaemia are thus related to decreased oxygen demand due to cardiac unloading.

Action Potentials↗
PubMed1982

Inability of exercise-induced R wave changes to predict coronary artery disease.

To determine the value of exercise-induced R wave changes in diagnosing coronary disease 200 patients undergoing coronary angiography were studied with 16 lead precordial exercise mapping. R wave amplitude was calculated before and immediately after exercise as the sum of R in all 16 leads, the sum of the R waves in the left plus the S waves in the right precordial leads, as well as the sum of the R waves only in those leads that manifested S-T depression. Coronary artery disease was found in 154 patients, S-T depression developed in 122 (sensitivity 79 percent); the sum of R increased or remained unchanged in 61 and decreased in 93 (sensitivity 40 percent). Forty-six patients did not have coronary artery disease; S-T depression developed in 5 (specificity 89 percent); the sum of R increased or was unchanged in 30 and decreased in 16 (specificity 35 percent). Similar results were obtained using the other criteria for calculating R wave amplitude. Exercise-induced S-T depression was identified in 5. 1 +/- 2.6 (mean +/- standard deviation) of the 16 precordial leads and in 2.0 +/- 1. 1 of the chest leads of the standard electrocardiogram (p less than 0.01). Thus, electrocardiographic alterations found in the standard chest leads represent only a small variable proportion of the total projection. When the whole precordial area was analyzed, R wave changes were so unpredictable that they could not be used in the diagnosis of coronary disease.

Adult↗
PubMed1982

A survey of the anemia status of preschool age children and pregnant and lactating women in Jamaica.

An island-wide anemia survey was conducted in Jamaica on pregnant and lactating women and preschool age children. The results indicate that anemia is a serious public health problem in Jamaica. Of pregnant women, 61.6% had Hb levels below 11.0 g/dl. Of lactating women 58.7% had Hb levels below 12.0 g/dl. Of preschool age children 69.1% had Hb levels below 11.0 g/dl. Public health and fortification programs for the control of anemia have been implemented by the government and are currently being reviewed.

Anemia↗
PubMed1981

Pericardial complications of endocardial and epicardial pacing.

A patient with complete atrioventricular block was fitted with a temporary endocardial pacing wire via a right subclavian percutaneous approach. The result was initially satisfactory, but within a few days radiography for left-sided chest pain showed pneumopericardium. A permanent epicardial pacing system was therefore substituted and she remained well for three months. She was then admitted for syncope: the pacemaker was failing to capture, and radiography showed pericardial and pleural effusion. A new permanent endocardial pacing system using a wedged electrode was inserted and she made an uncomplicated recovery. Pneumopericardium complicating endocardial pacing has apparently not been reported before. Presumably the electrode had penetrated both the right ventricle and the pericardium into the adjacent lung.

Adult↗
PubMed1981

Quantitative ionophoresis of catecholamines using multibarrel carbon fibre microelectrodes.

Carbon fibre microelectrodes can be used to measure the local concentration of ionophoretically ejected catecholamines in vitro or in vivo. The method can also be used to measure the transport number for the materials. The concentration measurement takes about 20 ms and can be repeated at up to about 10 Hz without electrode poisoning or deterioration. This paper describes in detail the methodology of the technique and the apparatus required.

Animals↗