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Biomedical subjects

R Warner

Publications and source records attributed to R Warner.

At least 91 records · Page 5Linked to original sources
PubMed1982

Improved electrocardiographic criteria for the diagnosis of inferior myocardial infarction.

New electrocardiographic (ECG) criteria for the diagnosis of inferior myocardial infarction (IMI) are proposed. The criteria are based upon the relationships between portions of the vectorcardiographic (VCG) QRS loop in the frontal plane and the corresponding portions of the ECG QRS complexes recorded in leads II and III. The application of the proposed criteria requires that the tracings be obtained with three-channel ECG machines so that the temporal relationships between the QRS complexes in lead II and those in simultaneously recorded lead III can be inspected. This type of analysis of the ECG permits important features of the contour of the VCG QRS loop to be predicted. The proposed ECG criteria for the diagnosis of IMI are: in the absence of counterclockwise rotation in the frontal plane, (1) Q waves of 30 msec or longer in lead II or (2) regression of initial inferior forces from lead III to lead II. The proposed ECG criteria were evaluated in an initial series of 333 patients and, using a blind experimental design, in a confirmatory series of 94 patients. The performance of the proposed criteria was statistically superior to that of two sets of ECG Q-wave criteria and comparable to that of the VCG criteria of Starr et al.

Adult↗
PubMed1982

Oral theophylline disposition in cystic fibrosis.

Theophylline absorption and disposition of CF patients have not been systematically studied. To evaluate these factors in CF subjects, seven CF patients were fasted overnight and administered a dose of aminophylline liquid equivalent to 4 mg/kg of anhydrous theophylline. Liver function tests (SGOT, GGT, alkaline phosphatase) were normal in all seven patients. maximum serum theophylline concentrations occurred between 30 and 60 minutes post-dose in all subjects and ranged from 4.8 to 8.6 mcg/ml. These values are similar to those reported in non-CF subjects for a single 4 mg/kg oral dose. The mean serum half-life of 3.5 hours with a range of 1.2 to 5.0 hours is similar to that reported in non-CF populations. The authors conclude that theophylline elimination (half-lives) in CF patients with normal liver function is similar to those of normal and asthmatic patients. CF patients with clinical liver disease may have a decreased clearance and should be carefully monitored.

Administration, Oral↗
PubMed1982

Depletion of phenylalanine in the blood of phenylketonuric patients using a PAL-enzyme reactor. An in vitro study.

Blood samples obtained from eight adult phenylketonuric individuals had a mean phenylalanine level of 25 mg/dl. When these samples were circulated through multitubular enzyme-reactors prepared with immobilized phenylalanine ammonia lyase an average of 77% of phenylalanine was metabolized within 30 minutes. We conclude that phenylalanine in human phenylketonuric blood is just as susceptible to metabolism by PAL-enzyme reactors as phenylalanine that is added to normal blood, or that is circulating in dogs and monkeys made hyperphenylalaninemic by experimental means.

Adult↗
PubMed1980

Deception and self-deception in shamanism and psychiatry.

The author argues that both shaman and psychiatrist are obliged to use a degree of self-deception in assuming their roles. The shaman must rationalize his use of trickery to impress his patients, and the psychiatrist deceives himself that his psychotherapeutic techniques have specific healing properties in the face of evidence which suggests that he often merely mobilizes the general effects of placebo and suggestion. Shaman and psychiatrist appear to use the same mental mechanisms in deceiving themselves. Inadequate method and theory may be supported by reference to personal experience and unrelated data or defended by circular reasoning or comparison with an even more inadequate system. The practitioner may also allow his perception of his abilities to be moulded by social consensus.

Alaska↗
PubMed1980

Gas chromatographic detection of the mycotoxin zearalenone in blood serum.

A sensitive gas chromatographic method for the quantitative analysis of zearalenone in blood serum is described. Zearalenone is eluted from blood serum by column chromatography followed by base-acid extraction with dichloromethane as the organic phase. After epicoprostanol (internal standard) is added, the sample is evaporated to dryness, derivatized, and injected onto the gas chromatographic column. A number of silylating agents and reaction conditions were investigated. Derivatizing zearalenone with N-methyl-N-trimethylsilyltrifluoroacetamide in the presence of acetone at room temperature for at least 2 hr gave best results. Sensitivity limit is < 0.5 ng injected, equivalent to 100 ng zearalenone/mL blood serum. A linear standard curve is observed when 0.5-30 ng zearalenone derivative is injected onto the Perkin-Elmer gas chromatograph. For quantitation, a standard curve is prepared by plotting amounts of zearalenone (ng) injected vs. ratios for peak areas of zearalenone and epicoprostanol derivatives. The internal standard procedure improves the precision by minimizing variations in sample injections and detector response. Percent recovery from blood serum is 68-75 in the range of 1.6-8.0 micrograms zearalenone/mL blood.

Animals↗
PubMed1980

G6PD San Francisco: a new variant of glucose-6-phosphate dehydrogenase associated with congenital nonspherocytic hemolytic anemia.

Congenital nonspherocytic hemolytic anemia in an adult male of Scandinavian ancestry was associated with virtual absence of G6PD activity in red cells. Characterization of G6PD purified from leukocytes using standard WHO techniques revealed diminished electrophoretic mobility, marked lability on heating at 46 degrees C, normal pH optimum and utilization of alternate substrates (2-deoxy G6P, D-amino NADP), elevated Km NADP, and striking susceptibility to NADPH inhibition. The variant G6PD, which appears to be unique, has been designated G6PD San Francisco. An unusual feature of the variant enzyme, susceptibility to inactivation by brief periods of dialysis, could be prevented by addition of 200 microM NADP to the dialysis solution. In red cells, where G6PD activity was essentially absent, regeneration of reduced glutathione was totally curtailed in vitro, while in leukocytes, where residual G6PD activity was approximately 60% of normal, hexose monophosphate shunt activity, oxygen consumption during phagocytosis, and bacterial killing were unimpaired. Thus, instability of the variant enzyme rather than its unfavorable kinetics appeared to be an important determinant of abnormal cell function.

Adult↗
PubMed1980

Sinusoidal heart rate pattern and fetal distress secondary to severe anemia.

A case of sinusoidal fetal heart rate (FHR) pattern with fetal anemia is described. The etiology of the pattern appears to have been fetal anemia from an umbilical cord knot, abruptio placentae and fetal asphyxia. The poor neonatal outcome in our case and a review of the literature suggest that a sinusoidal pattern is an ominous sign demanding complete evaluation of fetal well-being and often prompt obstetric intervention. The use of scalp capillary hematocrit is suggested.

Adolescent↗
PubMed1979

Racial and sexual bias in psychiatric diagnosis: psychiatrists and other mental health professionals compared by race, sex, and discipline.

In a study designed to test for sex- and race-related bias in psychiatric diagnosis, the responses of 173 mental health professionals to four hypothetical patient profiles were analyzed. Minimal racial bias was observed. In some instances, therapists appeared more likely to make judgments biased against patients who were of the same race and sex as themselves. The results support the contention that hysterical and antisocial personality disorders are sex-biased diagnoses. The race of the therapist strongly influenced diagnosis. It is argued that this finding reflects resistance of nonwhite therapists to a majority-group-dominated diagnostic theory. Professional discipline rarely affected diagnosis with the exception that psychiatrists were more prone to diagnose psychosis.

Adult↗
PubMed1979

Echo- and phonocardiographic studies in patients with Lillehei-Kaster aortic valve prostheses.

Simultaneous echo- and phonocardiographic studies were performed in 17 patients with normally functioning Lillehei-Kaster (LK) tilting disc prosthesis in the aortic position. The LK aortic valve prosthesis was well recorded by echocardiography with a disc excursion of 14 to 25 mm and very fast opening and closing velocities, too rapid for quantitative assessment. On phonocardiography the opening click of the prosthesis was only rarely observed (2 out of 17 cases), while the closing sound was consistently present in all patients, occurring within 5 msec of the point of complete closure of aortic disc prosthesis by echocardiography. Systolic time intervals (STI) measured by combined echo-and phonocardiography were similar to the predicted values in 15 patients who had no evidence of residual cardiac dysfunction. In the remaining 2 patients, one or more components of the STI differed by more than 2 standard deviations from the predicted values, and in these there were associated findings to explain the discrepancies. This study illustrates the echo- and phonocardiographic features of the normally functioning LK aortic valve prosthesis. In addition, precise measurements of the isometric contraction and relaxation periods as well as standard systolic time intervals are possible with these techniques.

Adult↗
PubMed1978

Sodium nitroprusside therapy in congestive cardiomyopathy-variability in hemodynamic response.

Twelve of 17 patients (group A) with congestive cardiomyopathy improved hemodynamically during sodium nitroprusside (NP) infusion. Five patients (group B) failed to increase their cardiac output. The two groups were identical in clinical presentation and had comparable cardiomegaly and left ventricular filling pressure (LVFP). However, group A had a baseline cardiac index (CI) lower than 2.5 L/min/m2 and high peripheral systemic (PSR) and total pulmonary vascular resistance (PR). In contrast, group B had a control of CI of higher than 2.5 L/min/m2 and near normal PSR and PR. Furthermore, a highly significant correlation was observed between the calculated levels of control PSR and their subsequent reduction during NP infusion. The higher the initial resistance, the more marked was its fall on NP as documented in group A. In group B, the PSR was probably not high enough for NP to be effective in increasing the cardiac output further by vasodilatation. We conclude that NP infusion may not increase cardiac output in congestive cardiomyopathy, in spite of a high LVFP, if the PSR is near normal.

Adult↗
PubMed1978

Systemic and pulmonary hemodynamic effects of saralasin infusion in hypertension. Predictability of plasma renin status from hemodynamic changes.

Hemodynamic measurements were obtained before and after 30 minutes of saralasin infusion in 26 fasting adults with hypertension (25 men and 1 woman). Nine showed a depressor response with a decrease in mean intaarterial pressure greater than 20 mm Hg. Ten were nonresponders and seven had an agonistic response with an increase in mean arterial pressure of greater than 10 mm Hg. Heart rate, pulmonary arterial and wedge pressures and pulmonary vascular resistance were nearly identical in the three groups and remained unchanged. Cardiac index decreased from a mean of 2.76 +/- 0.14 (standard error of the mean) to 2.48 +/- 0.1 liters/min per m2 in the nonresponders (P less than 0.02) but remained unchanged in the groups with a depressor or an agonistic response. The mean systemic vascular resistance decreased from 2,406 +/- 303 to 1,839 +/- 265 dynes sec/cm5 in the group with a depressor response (P less than 0.001) and increased in nonresponders (less than 0.02) and those with an agonistic response (P less than 0.01). However, regardless of the response of mean arterial pressure, systemic vascular resistance decreased only in the 10 patients with a plasma renin activity greater than 5 ng/ml per hour (8 from the depressor response group and 1 each from the nonresponse and agonistic response groups). It is concluded that (1) classification based soley on the response of aterial pressure to saralasin ignores important hemodynamic changes; (2) the response of cardiac index--no change in the patients with a depressor response and a reduction in nonresponders--suggests that endogenous angiotension II supports cardiac output in these groups; (3) a decrease in systemic vascular resistance is better than a decrease in mean arteiral pressure as a predictor of the status of the plasma renin activity; and (4) lack of change in pulmonary vascular resistance suggests that endogenous angiotension II plays an insignificant role in maintaining the resistance of the pulmonary vasculature.

Adult↗