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Biomedical subjects

R Sutton

Publications and source records attributed to R Sutton.

At least 127 records · Page 7Linked to original sources
PubMed1983

Sustained improvement in exercise tolerance following physiological cardiac pacing.

Fifty-three patients have received 'physiological' pacemakers, 37 with atrioventricular (AV) block having atrial synchronous units (VAT or VDD) implanted and the remaining 16 patients with both AV block and sick sinus syndrome having 'universal' (DDD) pacemakers. Effort tolerance was assessed by serial bicycle ergometry and in 16 patients direct comparisons between ventricular pacing and atrial synchronous pacing could be made acutely. Physiological pacemakers were found to increase maximum effort tolerance by 43% compared to pre-pacing values (P less than 0.01). The increase was sustained over a mean of 33 months post pacing. The atrial synchronous mode increased maximum effort tolerance by 34% acutely compared to ventricular inhibited pacing. Dual chambered 'physiological' pacemakers represent a significant therapeutic advance over standard ventricular inhibited pacemakers.

Adult↗
PubMed1983

A comparison of once daily atenolol and metoprolol SA in mild to moderate hypertension.

Atenolol 100 mg once daily and metoprolol SA 200 mg once daily were compared in 20 patients with mild to moderate hypertension, in a randomised, double-blind cross-over trial. Blood pressure and heart rate were compared at rest and during maximal exercise on a bicycle ergometer at 2 and 24 h post-dose. Blood pressure control was similar with both drugs, except at 2 h when systolic blood pressure was significantly lower with atenolol. Blood pressure and heart rate were less well controlled at 24 h than at 2 h with both drugs, but the majority of patients were still considered adequately controlled at 24 h. Atenolol and metoprolol SA can be considered equally effective in the treatment of mild to moderate hypertension and can be recommended as a once daily regime.

Adult↗
PubMed1983

Physiological benefits of atrial synchrony in paced patients.

Over a five-year period, hemodynamic exercise capacity studies and a randomized controlled trial have been performed in a total of 50 patients. DVI vs. VVI pacing showed an increase in stroke work index (P less than 0.005) and a fall in left ventricular filling pressure (P less than 0.05) in 17 patients. VDD/DDD pacing vs. VVI showed an exercise capacity benefit in 44 patients (P less than 0.01) including 8 patients with sinus node disease and a lower peak heart rate (P less than 0.02). Maintenance of benefit was also shown of VDD/DDD pacing in the longer term (13 months) vs. acute (P - NS). The controlled trial VDD/DDD vs. VVI showed benefit in shortness of breath (P less than 0.01) and general well being (P less than 0.01). It is concluded that atrial synchronous ventricular pacing (VDD/DDD) is the mode of choice in suitable patients.

Bradycardia↗
PubMed1983

The role of rate hysteresis pacing in the hypersensitive carotid sinus syndrome.

The ability of rate hysteresis programming with the escape interval longer than the automatic interval to reduce the hypotensive response to carotid sinus massage at the onset of ventricular pacing was studied in six patients paced for carotid sinus syndrome. Rate hysteresis significantly reduced this hypotensive response and abolished spontaneous symptoms in two patients and symptoms reproduced by carotid sinus massage in four patients.

Adult↗
PubMed1983

Randomised controlled trial of physiological and ventricular pacing.

Thirteen patients have completed a randomised double blind cross over study to compare the effects of chronic ventricular and atrial synchronous pacing on exercise capacity and symptoms. Maximal symptom limited exercise was significantly increased after one month of atrial synchronous pacing compared with ventricular pacing. Symptomatic assessment (by diary card and monthly symptom scores) of "shortness of breath", "palpitation", and "general well-being" was significantly improved during the physiological pacing mode. Atrial synchronous pacing has been shown to be superior to ventricular pacing.

Adult↗
PubMed1982

Detection of IgE- and IgG-binding proteins after electrophoretic transfer from polyacrylamide gels.

An electrophoretic technique for transferring proteins to a nitrocellulose membrane has been applied to proteins separated in polyacrylamide gels by isoelectric focusing, and gradient, SDS and 2-dimensional electrophoresis. Allergenic proteins were then identified by successive incubation of the transfer membrane with serum from allergic individuals and with 125I-labelled anti-human IgE, followed by autoradiography. Alternatively, IgG binding proteins were detected using 125I-labelled protein A. The application of these methods was illustrated with cereal grain proteins and sera from individuals with bakers' asthma and coeliac disease. This approach allowed the easy comparison of allergens important for different patients in a single source, and of allergens present in different but cross-reacting sources.

Allergens↗
PubMed1982

Immunoglobulin E antibodies to ingested cereal flour components: studies with sera from subjects with asthma and eczema.

The specificity of immunoglobulin E for different cereal grain proteins was investigated using sera from twenty paediatric patients with asthma and/or eczema. Close correlations were observed between radioallergosorbent test values for grain extracts of wheat, rye and barley, and, to a lesser extent, oats. Of the different wheat four fractions tested, the globulins and glutenins consistently bound higher levels of IgE than the gliadins and albumins. This is in contrast both with bakers' asthma (an allergy to inhaled flour where the albumins are important allergens) and with coeliac disease (in which gliadin is the most toxic fraction). Partial digestion of the flour proteins largely removed their ability to bind IgE. An analytical technique of identifying allergens after gel isoelectric focusing demonstrated that many different flour proteins were involved.

Adolescent↗
PubMed1982

The import of carbamoyl-phosphate synthase into mitochondria from foetal rat liver.

A putative precursor of carbamoyl-phosphate synthase was isolated from a microsomal wash fraction and purified by high-pressure liquid chromatography. Autolytic degradation and limited proteolysis were used to characterize the putative precursor of carbamoyl-phosphate synthase and to show its similarity to the processed enzyme. The carbamoyl-phosphate synthase precursor underwent a time-dependent and concentration-dependent conversion into a dimeric or polymeric form. When labelled with 125I and incubated with foetal rat liver mitochondria the precursor was bound to the mitochondria and about 30% of the label was imported into the matrix space. This labelling required the presence of ATP and was time-dependent. Mitoplasts also imported the carbamoyl-phosphate synthase precursor. After import of the precursor, increases in carbamoyl-phosphate synthase activity could be demonstrated in foetal rat liver mitochondria.

Adenosine Triphosphate↗
PubMed1982

Carotid sinus syncope treated by pacing. Analysis of persistent symptoms and role of atrioventricular sequential pacing.

Seventy patients have been paced for carotid sinus syndrome over four years. Twelve patients had persistent symptoms despite adequate ventricular pacing. Patients with persistent symptoms were found to have a significant vasodepressor response, a significant hypotensive response to ventricular pacing (pacemaker effect), and a severe hypotensive response to carotid sinus massage with introduction of ventricular pacing, which reproduced symptoms in all patients. A group of 14 asymptomatic paced carotid sinus patients was found to have a significantly lower vasodepressor response, pacemaker effect, and combined vasodepressor response plus pacemaker effect than the group with persistent symptoms. Atrioventricular sequential pacing was shown to eliminate the hypotensive effect of ventricular pacing and is considered to be the treatment of choice for patients with carotid sinus syndrome who have both cardioinhibitory and significant vasodepressor responses.

Aged↗
PubMed1981

Modern atrial and ventricular leads for permanent cardiac pacing.

Three hundred and fifteen transvenous pacing leads of various modern designs have been assessed over a period of three years. Of these, 103 were implanted in the atrium and 212 in the ventricle. Screw-in leads in the right atrial appendage and short tined leads in the ventricle have resulted in the virtual elimination of lead displacement, and a very low incidence of other lead related problems. In two lead systems it has been found advantageous to have both leads constructed of urethane.

Electrodes, Implanted↗
PubMed1980

The transport and accumulation of adenine nucleotides during mitochondrial biogenesis.

The atractyloside-insensitive accumulation of adenine nucleotides by rat liver mitochondria (as opposed to the exchange-diffusion catalysed by the adenine nucleotide translocase) has been measured by using the luciferin/luciferase assay as well as by measuring [14C]ATP uptake. In foetal rat liver mitochondria ATP is accumulated more rapidly than ADP, whereas AMP is not taken up. The uptake of ATP occurs against a concentration gradient, and the rate of ATP uptake is greater in foetal than in adult rat liver mitochondria. The accumulated [14C]ATP is shown to be present within the mitochondrial matrix space and is freely available to the adenine nucleotide translocase for exchange with ATP present in the external medium. The uptake is specific for ATP and ADP and is not inhibited by adenosine 5'-[beta gamma-imido] triphosphate, GTP, CTP, cyclic AMP or Pi, whereas dATP and AMP do inhibit ATP accumulation. The ATP accumulation is also inhibited by carbonyl cyanide m-chlorophenylhydrazone, KCN and mersalyl but is insensitive to atractyloside. The ATP uptake is concentration-dependent and exhibits Michaelis-Menten kinetics. The divalent cations Mg2+ and Ca2+ greatly enhance ATP accumulation, and the presence of hexokinase inhibits the uptake of ATP by foetal rat liver mitochondria. These latter effects provide an explanation for the low adenine nucleotide content of foetal rat liver mitochondria and the rapid increase that occurs in the mitochondrial adenine nucleotide concentration in vivo immediately after birth.

Adenine Nucleotides↗