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Biomedical subjects

R Weiss

Publications and source records attributed to R Weiss.

At least 163 records · Page 9Linked to original sources
PubMed1996

Effect of coupling interval and pacing cycle length on morphology of paced ventricular complexes. Implications for pace mapping.

BACKGROUND: Ventricular pace mapping is performed by comparing the QRS morphology of ventricular paced complexes to that of a template arrhythmia, either a premature ventricular depolarization or a QRS complex during ventricular tachycardia. The objective of this study was to evaluate the effect of coupling interval and pacing cycle length on QRS morphology. METHODS AND RESULTS: The study population consisted of 20 patients (mean age, 38 +/- 16 years) undergoing a clinically indicated electrophysiology procedure. In the first 10 patients, the effect of coupling interval on the morphology of single paced ventricular complexes was evaluated visually and by signal processing techniques. Visually apparent differences in QRS morphology occurred in a mean of 4/12 electrocardiographic leads with a change in coupling interval of > or = 100 ms. In the next 10 patients, the QRS complex morphology during ventricular overdrive pacing at cycle lengths of 600 and 300 ms was found to differ significantly in a mean of 4/12 leads. The QRS morphology during overdrive pacing differed significantly from that of a single paced complex whenever the pacing cycle length differed from the coupling interval of the single paced complex by > 80 ms. CONCLUSIONS: The morphology of single paced QRS complexes may vary, depending on coupling interval, and the QRS morphology during overdrive pacing is affected by the pacing cycle length. During ventricular pace mapping, the coupling interval or cycle length of the template arrhythmia should be matched during pacing. If not, rate-dependent changes in QRS morphology that are independent of the pacing site may confound the results of pace mapping.

Adult↗
PubMed1996

Ventricular rate during atrial fibrillation before and after slow-pathway ablation. Effects of autonomic blockade and beta-adrenergic stimulation.

BACKGROUND: Radiofrequency catheter modification of AV conduction can be used to control the ventricular rate during atrial fibrillation both in the baseline state and during exercise. Slow-pathway ablation has been suggested to be the mechanism for this response. The purpose of this study was to determine the effect of slow-pathway ablation on the ventricular rate in atrial fibrillation during autonomic blockade and sympathetic stimulation in patients with AV nodal reentrant tachycardia (AVNRT). METHODS AND RESULTS: Thirty-five patients undergoing slow-pathway radiofrequency ablation for AVNRT were assigned to autonomic blockade (0.2 mg/kg propranolol and 0.04 mg/kg atropine; n = 14) or isoproterenol (2 micrograms/min; n = 21). Atrial fibrillation was induced before and after slow-pathway radiofrequency ablation. During autonomic blockade, the mean ventricular cycle length (448 +/- 34 versus 525 +/- 103 ms, P < .01) and maximum ventricular cycle length (640 +/- 105 versus 798 +/- 226 ms, P = .04) were prolonged after ablation, whereas the minimum ventricular cycle length did not change significantly (361 +/- 42 versus 403 +/- 83 ms, P = .05). During isoproterenol infusion, the mean ventricular cycle length (375 +/- 52 versus 390 +/- 61 ms, P = .2), maximum ventricular cycle length (520 +/- 88 versus 537 +/- 106 ms, P = .3), and minimum ventricular cycle length (307 +/- 59 versus 298 +/- 33 ms, P = .4) did not change significantly after slow-pathway ablation. CONCLUSION: Slow-pathway ablation slows the ventricular rate during atrial fibrillation under conditions of autonomic blockade but not during sympathetic stimulation. Therefore, slow-pathway ablation alone cannot account for the clinical results obtained with radiofrequency modification of AV conduction in patients with atrial fibrillation.

Adult↗
PubMed1996

Binding of biotinylated DNA to streptavidin-coated polystyrene latex: effects of chain length and particle size.

The binding of 5'-end biotinylated DNA, ranging in size from 100 to 5000 base pairs, was studied using streptavidin-coated polystyrene latex particles with diameters between 0.944 and 0.090 micron. The experimental binding constants and forward rate constants of this solid-phase reaction were determined to be several orders of magnitude lower than values for the biotin-streptavidin interaction in solution as expected and were shown to depend on the size of both ligand and substrate. An observed inflection in the binding constant of the biotinylated DNA appeared around 1000 base pairs, possibly indicating different surface orientations of the macroligand above and below this critical size. This effect was more pronounced for the smaller latex particles used in this study and highlighted possible differences in the surface arrangement of streptavidin on the differently sized particles. Diffusion limitation to the binding reaction was found to be significant in all cases. In this present work, an exponential relationship was established between the experimental binding constant and the number of base pairs in the biotinylated DNA. This relationship possibly provides a means to predict capacity and binding speed in cases where adsorption, purification, and release of larger DNA chains are required.

Bacterial Proteins↗
PubMed1996

[Medication group for noncompliant patients in a psychiatric day unit--experiences during a one year period].

A group of noncompliant psychiatric patients was treated on a weekly basis over a 6-month period; 13 started but 3 dropped out. Results indicated greater feeling of security with medication; increased desire to maintain follow-up treatment in the outpatient clinic; greater likelihood of patients accepting their illness; and strong desire to discuss medication-related topics with staff. Our medication group appears to offer a convenient and organized method for addressing issues of psychiatric medication, especially for chronic patients, which we recommend to clinicians in other medical disciplines.

Adult↗
PubMed1996

Interaction between the substrate and the high-valent-iron-oxo porphyrin cofactor as a possible factor influencing the regioselectivity of cytochrome P450 catalysed aromatic ring hydroxylation of 3-fluoro(methyl)anilines.

In the present study the in vitro and in vivo aromatic ring hydroxylation of a series of amino and/or methyl containing fluorobenzenes, i.e. 3-fluoro(methyl)anilines, was investigated and compared to the calculated density distribution of the reactive frontier pi-electrons of the aromatic substrate. This was done (1) to study to what extent the regioselectivity of the aromatic ring hydroxylation of the 3-fluoro(methyl)anilines could be predicted on the basis of the calculated chemical reactivity, as was previously observed for a series of fluorinated benzenes and monofluoroanilines, and (2) to investigate which factors contribute to possible deviations from the predictions on the basis of the calculated chemical reactivity. Results obtained show that the in vitro and in vivo aromatic ring hydroxylation of the series of 3-fluoro(methyl)anilines correlates qualitatively with the calculated frontier orbital density distribution for electrophilic attack by the cytochrome P450(FeO)3+ species. These results indicate that the HOMO/HOMO-1 frontier orbital densities, i.e. the chemical reactivity of the carbon centres for an electrophilic attack, predict the preferential as well as the non-reactive sites for cytochrome P450 catalysed aromatic ring hydroxylation of the tested model compounds. The absolute values, however, deviated in a systematic way; C4 para hydroxylation being observed to a higher extent than expected on the basis of chemical reactivity and C2/C6 ortho hydroxylation being observed to a lower extent than expected. Additional experiments were performed using different microsomal preparations and microperoxidase-8. The latter is a mini-heme protein of eight amino acids without a substrate binding site. In incubations of the model compounds with different types of microsomal preparations, as well as with MP-8 and purified reconstructed cytochrome P4502B1, similar systematic deviations between the predicted and observed regioselectivity of aromatic hydroxylation were observed. These results show that the regioselectivity of aromatic ring hydroxylation of the 3-fluoro(methyl)anilines cannot be predominantly ascribed to an interaction between the substrate and the substrate binding site of the cytochromes P450 dictating a specific stereoselective positioning of the substrate in the active site. More likely, the systematic deviations between the observed and predicted regioselectivity of hydroxylation of the tested model substrates should be ascribed to an (orienting) interaction between the substrate and the activated cytochrome P450(FeO)3+ cofactor.

Aniline Compounds↗
PubMed1996

Comparison of atrial-His intervals in patients with and without dual atrioventricular nodal physiology and atrioventricular nodal reentrant tachycardia.

The purpose of this study was to compare the atrial-His intervals generated during programmed atrial stimulation in patients with and without dual atrioventricular nodal physiology and with and without inducible atrioventricular nodal reentrant tachycardia. Programmed atrial stimulation at a basic-drive cycle length of 500 to 600 msec was performed in 180 patients. The minimum atrial-His interval was defined as the atrial-His interval of the basic-drive beats. The maximum atrial-His interval was defined as the longest A2H2 interval. The criterion for dual atrioventricular nodal physiology was an increment of 50 msec in the A2H2 interval in association with a 10 msec decrement in the A1A2 interval. The minimum atrial-His interval was significantly shorter (106 +/- 34 msec vs 116 +/- 29 msec; p < 0.05) and the maximum atrial-His interval significantly longer (304 +/- 101 msec vs 222 +/- 56 msec; p < 0.001) in the 87 patients who had atrioventricular nodal reentry than in the 93 patients who did not. Among the 87 patients who had atrioventricular nodal reentry, the maximum atrial-His interval was significantly longer in 53 patients who had dual atrioventricular nodal physiology than in 34 patients who did not (340 +/- 105 msec vs 249 +/- 62 msec; p < 0.001). Among the 66 patients who had dual atrioventricular nodal physiology, the maximum atrial-His interval was significantly longer in 53 patients who had atrioventricular nodal reentry than in 13 patients who did not (340 +/- 105 msec vs 268 +/- 61 msec; p < 0.01). The insensitivity of the conventional dual atrioventricular nodal physiology criterion for the detection of dual atrioventricular nodal pathways is in part attributable to a lesser degree of slowing of conduction in the slow pathway relative to the fast pathway in some patients who have atrioventricular nodal reentry. The inability to demonstrate atrioventricular nodal reentry despite the presence of dual atrioventricular nodal physiology in some persons may be attributable in part to an inadequate degree of conduction delay in the slow pathway.

Atrioventricular Node↗
PubMed1996

In vivo detection of Trypanosoma cruzi antigens in hearts of patients with chronic Chagas' heart disease.

The heart is the most commonly affected organ in chronic Chagas' disease, and lymphocytic myocarditis is often observed. However, the pathogenesis of chronic Chagas' heart disease is controversial. The purpose of this study was to determine whether in vivo T. cruzi antigens could be detected in hearts from patients with chronic Chagas' disease and to investigate whether a correlation between these antigens and the intensity of myocardial inflammation exists. We studied 16 patients with chronic Chagas' heart disease. Ten patients had severely impaired left ventricular function and refractory heart failure, and six had episodes of sustained ventricular tachycardia without severe left ventricular dysfunction. Eight patients underwent magnetic resonance imaging with gadolinium enhancement to guide endomyocardial and surgical biopsies to sites with more intense inflammatory processes. Myocardial specimens were studied with immunohistochemical techniques by using rabbit anti-T. cruzi immune serum to detect the presence of T. cruzi antigen. All patients had evidence of some myocarditis in at least one myocardial fragment. T. cruzi antigen was detected in 11 (69%) patients. T. cruzi antigens were detected in 10 (71%) of 14 regions with histopathologic evidence of moderate or severe myocarditis. In contrast, T. cruzi antigens were detected in 3 of 18 regions with only mild or absent myocarditis. There was a statistically significant correlation between the presence of T. cruzi antigens and moderate or severe myocarditis (chi-square = 5.169, p = 0.023). The results of this in vivo study demonstrate that T. cruzi antigens are frequently detected in chronic Chagas' heart disease. In addition, there is an association between the intensity of the inflammatory process and the presence of T. cruzi antigens. The presence of the T. cruzi antigen and its correlation with the severity of myocardial inflammatory process provide strong supportive evidence for the role of T. cruzi even in the chronic forms of Chagas' heart disease.

Adult↗
PubMed1996

Balloon dilation of esophageal strictures in children.

Esophageal strictures in children may develop as a primary constriction, secondary to a surgically repaired esophageal atresia (with or without tracheoesophageal fistula), as a result of chemical injury after caustic ingestion, or following esophageal surgery. Traditional treatment of esophageal strictures has been limited to dilation (using bougie dilators) with esophagoscopy under general anesthesia. Recent reports have shown success with fluoroscopically guided balloon catheter dilation. Eight children (aged 2 months to 14 years) were treated with balloon catheter dilation for focal strictures of the esophagus. In six of the eight cases, complete resolution of the strictures was achieved after an average of 7.5 dilations (range, 1 to 14). Two of the eight patients moved to another part of the country and did not complete treatment. There has been no morbidity or mortality. In selected centers, balloon catheter dilation under fluoroscopic guidance has become a safe treatment of benign esophageal strictures in children. It should be considered the treatment of choice in the initial management of esophageal narrowing and appears to be safer than the more traditional methods of esophageal dilation.

Adolescent↗
PubMed1996

Slow pathway ablation in patients with documented but noninducible paroxysmal supraventricular tachycardia.

OBJECTIVES: The purpose of this study was to assess the clinical efficacy of radiofrequency ablation of the slow pathway in patients with documented but noninducible paroxysmal supraventricular tachycardia (PSVT) who have evidence of dual atrioventricular (AV) node pathways. BACKGROUND: Patients with a documented history of PSVT at times do not have inducible PSVT in the electrophysiology laboratory. Because dual AV node pathways serve as the substrate for AV node reentrant tachycardia (AVNRT), ablation of the slow pathway potentially may be useful in these patients. METHODS: The subjects in this prospective study were seven consecutive patients who underwent an electrophysiologic procedure because of documented PSVT and were found to have dual AV node physiology or inducible single AV node echo beats, but no inducible PSVT despite the administration of isoproterenol and atropine. Their mean (+/- SD) age was 33 +/- 13 years, and they had been symptomatic for 12 +/- 12 years. The frequency of the episodes of PSVT ranged from > or = 1/day to 1/month. The rate of the documented episodes ranged from 170 to 260 beats/min, and discrete P waves were not apparent. Slow pathway ablation was performed with 9 +/- 4 applications of radiofrequency energy using a combined anatomic and electrogram mapping approach. RESULTS: All evidence of dual AV node pathways was eliminated in six patients, and dual AV node physiology remained present in one patient. During a mean follow-up period of 15 +/- 10 months (range 8 to 27), no patient had a recurrence of symptomatic tachycardia (success rate 95% confidence interval 65% to 100%). CONCLUSIONS: Slow pathway ablation may be clinically useful in patients with documented but noinducible PSVT who have evidence of dual AV node pathways.

Adult↗
PubMed1996

2:1 atrioventricular block during atrioventricular node reentrant tachycardia.

OBJECTIVES: The purpose of this study was to determine the incidence and to clarify the mechanism of 2:1 atrioventricular (AV) block during AV node reentrant tachycardia induced in the electrophysiology laboratory. BACKGROUND: In patients with 2:1 AV block during AV node reentrant tachycardia, the absence of a His bundle potential in the blocked beats has been considered evidence of intranodal, lower common pathway block. METHODS: In consecutive patients with AV node reentrant tachycardia, the incidence of 2:1 AV block and the response to atropine and a single ventricular extrastimulus was observed. RESULTS: Persistent 2:1 AV block occurred in 13 of 139 patients with AV node reentrant tachycardia. A His bundle deflection was present in the blocked beats in eight patients and absent in five. Patients with 2:1 AV block had a shorter tachycardia cycle length than did patients without such block (mean +/- SD 312 +/- 32 vs. 353 +/- 55 ms, p < 0.01). Atropine did not alter the 2:1 block in any patient. In every patient, a single ventricular extrastimulus introduced during the tachycardia converted the 2:1 block to 1:1 conduction. CONCLUSIONS: The incidence of induced 2:1 AV block during AV node reentrant tachycardia is approximately 10%. The lack of a response to atropine and the consistent conversion of 2:1 block to 1:1 conduction by a ventricular extrastimulus indicate that, regardless of the presence or absence of a His bundle potential in blocked beats, 2:1 block during AV node reentrant tachycardia is due to functional infranodal block.

Adult↗
PubMed1996

Randomized comparison of two techniques for titrating power during radiofrequency ablation of accessory pathways.

INTRODUCTION: The purpose of this study was to prospectively compare the value of impedance and temperature monitoring during accessory pathway ablation. Temperature and impedance monitoring can be used during radiofrequency ablation of accessory pathways to titrate power to achieve adequate but not excessive tissue heating. METHODS AND RESULTS: One hundred thirty-two patients with a single accessory pathway were randomly assigned to undergo ablation using either impedance monitoring or temperature monitoring. During impedance monitoring, the endpoint for titration of power was a 5- to 10-omega decrease in the measured impedance while for temperature monitoring the endpoint was to achieve a temperature of 58 degrees to 62 degrees C. Two protocols were used. In protocol 1 (90 patients), impedance monitoring was performed with a nonthermistor catheter and temperature monitoring was performed with a thermistor catheter. In protocol 2 (42 patients), a thermistor catheter was used in all patients. In protocol 1, the success rate (93% vs 93%; P = 1.0), ablation procedure duration (57 +/- 56 vs 41 +/- 41 min), fluoroscopy time (48 +/- 29 vs 41 +/- 23 min; P = 0.3), number of applications (6.2 +/- 4.7 vs 5.7 +/- 4.6; P = 0.8), and the number of applications associated with coagulum formation (0.1 +/- 0.3 vs 0.3 +/- 0.6; P = 0.1) were similar in the two groups. In protocol 2, as in protocol 1, there were no differences in the success rate (91% vs 95%; P = 1.0), ablation procedure duration (49 +/- 37 vs 62 +/- 55 min; P = 0.4), fluoroscopy time (46 +/- 24 vs 49 +/- 36 min; P = 0.8), number of applications (6.8 +/- 7.0 vs 7.8 +/- 12.1; P = 0.7), or number of applications associated with coagulum formation (0.3 +/- 0.6 vs 0.2 +/- 0.7; P = 0.6), between the impedance and temperature monitoring groups. CONCLUSION: Temperature and impedance monitoring are equally effective in optimizing the results of accessory pathway ablation.

Adult↗
PubMed1996

Molecular characterization of Mycobacterium paratuberculosis isolates from sheep, goats, and cattle by hybridization with a DNA probe to insertion element IS900.

Mycobactin J-dependent mycobacterial isolates from sheep, goat, and cattle herds with Johne's disease in Morocco, South Africa, the United States, and Germany were tested for the repetitive insertion sequence IS900 of Mycobacterium paratuberculosis by PCR. The IS900 PCR target sequence was detected in 90 of 93 fecal culture isolates tested (96.8%). Restriction fragment length polymorphisms (RFLPs) and in vitro growth characteristics were studied in 46 of the IS900-positive isolates and in two bovine vaccine strains of M. paratuberculosis. Five different RFLP types were identified in PvuII digests of genomic DNA by Southern hybridization with a DNA probe specific for IS900. All isolates of M. paratuberculosis could be classified into two major clusters by their growth rates as well as the relatedness of their PvuII-RFLP hybridization patterns. All of the sheep isolates were classified into cluster I (extremely slow growth), while all cattle and goat isolates were members of cluster II (moderately slow growth). Different PvuII-RFLP patterns were detected in different sheep flocks from Morocco and South Africa. Our results demonstrate that genetically and phenotypically different strains of M. paratuberculosis were present in ruminant populations. The strains from sheep in Morocco and South Africa tested in the study appeared to belong to a unique group of M. paratuberculosis strains that might have adapted to this host species. The presence of several genetically distinct strains in different sheep flocks suggested that analysis of IS900-specific RFLP patterns may provide a useful tool for the epidemiologic investigation of ovine paratuberculosis outbreaks.

Animals↗
PubMed1996

New ideas for affordable space missions

In September 1995, NASA-Goddard held a workshop on low-cost access to space for science missions. The workshop provided briefings on balloons, sounding rockets, Shuttle payloads, and low-cost free-flyer concepts, to provide options of getting experiments into space. This report is the result of a panel session organized with the aim of generating new ideas beyond those presented in the workshop. In addition to the authors, Orlando Figueroa and Paul Ondrus of NASA-Goddard and Richard Zwirnbaum of Computer Sciences Corp. participated in the discussions. The ideas presented do not necessarily reflect the current thinking of NASA managers. Although the panel discussion was focused on the kinds of science missions usually funded by NASA, most of the ideas that were generated are relevant to military and commercial missions as well.

Computer Communication Networks↗
PubMed1996

[Demonstration of activity of two potentiated sulfonamides in feces of horses after oral or intravenous administration].

Both, the oral and intravenous application of two trimethoprim-potentiated sulfonamides induced measurable antibacterial activities in the feces of horses. With regard to the risk of antibiotic-induced alterations of the gastrointestinal flora, the route of application of potentiated sulfonamides seems to be of minor importance. The antibiotics used were Sulfadimethoxine/Trimethoprim (Trafigal 30% ad us. vet.) for oral and Sulfadoxine/Trimethoprim (Borgal 24% ad us. vet., both Hoechst AG, Frankfurt) for intravenous application. As recommended, both drugs were given in a dose of 20 mg per kg bodyweight. The detection method is based on a procedure layed down in German laws for sulfonamide residues in meat-samples and has undergone some modifications for the examination of feces.

Administration, Oral↗
PubMed1995

Antianginal and antiischemic efficacy of monotherapy extended-release nisoldipine (Coat Core) in chronic stable angina.

A double-blind, randomized, placebo-controlled study was conducted to test the peak and trough antianginal and antiischemic monotherapy efficacy and safety of a new extended-release formulation of nisoldipine (nisoldipine Coat Core [Bayer Corporation], 20 mg, 40 mg, and 60 mg once daily compared to placebo). Study patients had a history of chronic, stable angina pectoris, exercise-induced angina in association with ST segment depression, and exercise test reproducibility. Of the 483 patients enrolled in the study, results were valid for safety analysis for 312 and for efficacy analysis for 284. There was a statistically significant improvement in total exercise time at both peak and trough for patients taking 20 mg and 60 mg of nisoldipine compared with patients taking placebo, but the group taking 60 mg was not better than the group taking 20 mg (33.9 and 33.7 seconds, respectively, at trough). The results were similar for the secondary endpoints (time to onset of angina and time to 1 mm ST segment depression). No correlation was evident between plasma nisoldipine levels and total exercise duration. Headache and peripheral edema were the most frequently reported adverse events and were dose related. There were no discontinuations due to adverse events in patients randomized to the 20-mg nisoldipine group. No deaths occurred while patients were receiving active nisoldipine therapy. Therapy with this extended-release formulation of nisoldipine is an effective once-daily treatment for chronic stable angina pectoris. It represents one of the few dihydropyridine calcium channel antagonists that has shown efficacy when administered as monotherapy to patients with angina.

Adult↗
PubMed1995

Synthesis and evaluation of a non-radioactive gene probe for the detection of C.perfringens alpha toxin.

The synthesis and evaluation of a non-radioactive hybridization probe is described, specific detecting the Clostridium perfringens alphatoxin gene (plc) by colony blot hybridization assay. A vector free digoxigenin-dUTP-labelled probe was generated by polymerase chain reaction (PCR) targeting the cloned plc gene of C.perfringens strain ATCC 13124. In a colony blot hybridization assay 296 strains of C.perfringens were tested for plc. None of the strains failed in hybridization. Presence of plc was even demonstrated in C.perfringens strains reported to lack lecithinase activity. Specificity of the probe was shown with various strains of other bacterial species. None different Clostridia sp. tested, e.g. C.bifermentans, C.tertium, C.novyi, C.chauvoei, C.sporogenes, C.difficile, C.putrifucum, C.sordellii, C.botulinum, C. septicum and C.histolyticum, hybridized with the plc specific probe. Strains expressing an enzymatically related phospholipase like Bacillus cereus, Listeria monocytogenes and Staphylococcus aureus gave also negative results. Comparing the results of conventionally used egg yolk turbidity assay and those gained with DNA hybridization, the plc probe proved to be a much more sensitive and specific diagnostic tool for the detection of C.perfringens plc.

Bacillus cereus↗
PubMed1995

Nontoxigenic Vibrio cholerae O1 intestinal pathology in adult mice.

The intestinal pathology caused by nontoxigenic Vibrio cholerae O1 was examined in the sealed adult mouse (SAM) model. Histologic examination demonstrated that a nontoxigenic V. cholerae O1 strain that elicited maximum fluid accumulation (FA) in the small intestine of adult mice caused damages to the villi and necrosis of lymphoid elements within solitary submucosal lymphoid nodules in the Peyer's patches. Challenge of mice with a strain that did not elicit intestinal FA produced none of the above tissue responses. Increased FA activity, intestinal alterations, and tissue pathology caused by the nontoxigenic V. cholerae O1 indicate its pathogenic potential.

Animals↗