The applicability of the signal averaging technique in clinical cardiology.
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Biomedical subjects
Publications and source records attributed to V Braun.
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1 In 46 patients (16 female and 30 male), aged between 18 and 73 years and effect of acute beta-adrenoceptor blockade with i.v. pindolol, acebutolol and atenolol has been studied at rest and during ergometric exercise, during routine intracardiac His bundle investigations. 2 At rest the functional parameters of the sinus node were impaired most markedly by atenolol. A-V nodal conduction was more depressed with acebutolol and atenolol than with pindolol. The His-Purkinje system conduction remained unaffected by all three beta-adrenoceptor blocking agents. 3 During ergometric exercise the depressant action of beta-adrenoceptor blockade on sinus nodal function with lower heart rates and on A-V nodal conduction with slower conduction velocities was equieffective with pindolol, acebutolol and atenolol. His-Purkinje system conduction again remained unchanged with one exception that after administration of pindolol, conduction rate during exercise was faster than before beta-adrenoceptor blockade. 4 It may be concluded that, in patients with low heart rates, an antagonist such as pindolol with relatively pronounced intrinsic sympathomimetic activity can be considered to be the drug of choice. In contrast, patients with higher heart rates at rest should be treated with a cardioselective betablocker without ISA. Patients with overt Sick Sinus Syndrome should not be given beta-adrenoceptor blockers at all. 5 Physical activity may change (improve or impair) the antiarrhythmic potency of beta-adrenoceptor blockers used in the treatment of supraventricular tachycardias or tachyarrhythmias.
Escherichia coli strains which contain the Fe3+-aerobactin transport system specified by the ColV plasmid became deficient in aerobactin-dependent iron transport when they were converted to cloacin-resistant derivatives. An outer membrane protein with a molecular mass of 74,000 daltons was overproduced under iron-limiting growth conditions and was absent in cloacin-resistant mutants. Fe3+-aerobactin protected cells against cloacin. These results suggest that the cloacin receptor protein, controlled by the colV plasmid, also participates in Fe3+-aerobactin transport.
Four chromosomal genes, tonA (fhuA), fhuB, tonB, and exbB, were required for the transport of iron(III)-aerobactin specified by the plasmids ColV-K311, ColV-K229, ColV-K328, and ColV-K30. These genes also determine the transport system in Escherichia coli for the iron ionophore ferrichrome. Aerobactin and ferrichrome are both iron ligands of the hydroxamate type, but they are of different structure. The ColV plasmids determine an outer membrane protein that serves as a receptor for cloacin. Cloacin-resistant mutants were devoid of iron(III)-aerobactin transport but were unimpaired in ferrichrome transport. We conclude that for iron(III)-aerobactin transport two outer membrane proteins, the TonA and the cloacin receptor protein, have to interact functionally or structurally or both.
Regulation by iron was studied in Escherichia coli strains whose iron supply was entirely dependent on the iron(III)-aerobactin system determined by the ColV plasmid. By the insertion of phage Mu (Ap lac) into the ColV plasmid, mutants were selected that could no longer grow in iron-limited media. The inserted Mu (Ap lac) strongly reduced the amount of aerobactin and he cloacin receptor protein formed by the cells. Their production was no longer subject to regulation by iron. The Mu (Ap lac) insertion apparently led to a polar effect on the expression of the presumably closely linked genes that control the synthesis of aerobactin and the cloacin receptor protein. The expression of the beta-galactosidase gene on the inserted phage genome came under the control of the iron state of the cells. Under iron-limited growth conditions, the amount of beta-galactosidase synthesized was, depending on the strain studied, 6 to 30 times higher than under iron-sufficient growth conditions. In fur mutants with an impaired iron regulation of ll iron supply systems studied so far, high amounts of beta-galactosidase were synthesized independent of the cells' iron supply. The results demonstrate an iron-controlled promoter on the ColV plasmid which is subject to regulation by the chromosomal fur gene.
Colicin M inhibited the incorporation of DL + meso-2,6-diamino[3,4,5-3H]pimelic acid into the murein (peptidoglycan) of growing cells of Escherichia coli W7 dap lys. The inhibition of the UDP-N-acetylmuramyl pentapeptide-dependent incorporation of UDP-N-acetyl-D-[U-14C]glucosamine into isolated cell envelopes indicated interference with a late step of murein biosynthesis. After the inhibition of murein biosynthesis, cells lysed, and they released lysis products of murein. In vitro, the murein biosynthesis of colicin M-tolerant mutants (tolM) was inhibited by colicin M. Therefore, tolerance is probably conferred by an impaired uptake of an altered fixation close to the target site and not by a mutation of the target itself. Preliminary studies with beta-lactam antibiotics and with mutants in penicillin-binding proteins did not reveal a specific enzymatic step inhibited by colicin M. The unique action among the colicins renders colicin M a potentially useful tool for studying murein biosynthesis.
A study of the adsorption kinetics of T5+ and the tail fiber-less mutant hd-2 to lipopolysaccharides of various Escherichia coli strains demonstrated T5+ binding to the O-antigen of th O8 and O9 types. Incorporation of radioactive mannose into the phosphomannose isomerase-deficient strain E. coli F860 O9 pmi allowed the derivation of the number of O-antigens per cell required to increase T5 adsorption. With more than 500 O-antigen molecules, acceleration of T5+ adsorption was observed. The highest adsorption rate was obtained when nearly all lipopolysaccharide molecules were substituted with a polymannose O-antigen. Inhibition studies with purified components of an enzymatically degraded lipopolysaccharide of the O8 type showed that among the mannosides tested the smallest unit, the trimannoside, was the strongest inhibitor of T5+ binding. We conclude that the reversible preadsorption to the O8 and O9 polymannose antigens increases the rate of infection via the cellular receptor protein encoded by the fhuA (formerly tonA) gene.
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Cells of Escherichia coli K-12 could grow aerobically at an iron concentration as low as 0.05 micrometer without any of the known iron ionophores present. The growth rate increased between 0.05 and 2 micrometer iron. Supplementation with the iron ligands ferrichrome and citrate resulted in optimal growth already at 0.05 micrometer iron. Under certain conditions iron uptake preceded growth of cells by more than an hour. During logarithmic growth the rate of iron uptake matched the growth rate. The radioactive tracer method revealed a cellular iron content of 4 nmol/mg dry weight. After consumption of the iron in the medium cells continued to grow with high rate for 1-2 generations. The iron uptake activity was increased during iron starvation.
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In a total of 18 patients, 7 females and 11 male patients with ages ranging from 23 to 70 years (mean: 45.5 +/- 14.5) diagnostic His bundle studies incorporating programmed atrial and ventricular pacing for the induction of tachycardias was performed before and after betablockade with the cardioselective betablocking agent atenolol, in a dose of 5 mg given iv. over 3 to 5 minutes. In 7 patients the pacing procedure could be repeated following ergometric exercise in order to evaluate the influence of a raised sympathetic tone on the conditions initiating paroxysmal tachycardias. At rest, atenolol prevented the pacing induced tachycardias (20 dysrhythmias in 18 patients) in 3/5 individuals with Wolff-Parkinson-White (WPW)-syndrome, in 4/6 cases with atrial tachycardias, in 4/6 patients presenting atrial flutter, in 2/2 cases developing AV-nodal tachycardias and in 1/1 individual with ventricular tachycardia. Thus, in 13 out of 19 (68%) supraventricular dysrhythmias patients benefitted from atenolol by preventing or controlling the tachycardia. Ergometric exercise changed the tachycardia or echo zone in 5/8 arrhythmias after betablockade when compared to the controls before administration of atenolol (3/5 improvement by narrowing of the tach- or echo zone, 1/5 prevention of tachycardia, 1/5 impairment due to widening of the tachycardia zone). Considering only the prevention of tachycardias, the antiarrhythmic potency of atenolol was improved in one patient with pacing induced flutter and impaired in one individual with a WPW syndrome, by ergometric exercise. These results suggest that atenolol seems to provide a good antiarrhythmic action, especially in supraventricular tachycardias, and that an increased sympathetic tone during exercise may modify the antidysrhythmic strength of betablockade.
In 17 of the 28 patients a surface potential of the bundle of His could be differentiated. Pharmacological tests with verapamil and ajmaline raised the number of positive body surface recordings of the bundle of His to 22 out of 30 (=73%). In 11 of the 30 subjects (=37%) depolarizations of the Tawara bundle branches were recorded in addition. Two possible applications of this method are discussed: follow-up of patients with AV-block and supervision of negative dromotropic cardiac medication.
Induction of the citrate-dependent iron transport system of Escherichia coli K-12 required 0.1 mM citrate and 0.1 micrometer iron in the growth medium. Five--ten-times more iron than citrate was taken up into the cells which suggests that citrate was largely excluded from the transport. Fluorocitrate and phosphocitrate induced the citrate-dependent iron transport system although they supported iron uptake only very poorly. An outer membrane protein (FecA), belonging to the transport system, was induced in fecB mutants which were devoid of citrate-dependent iron transport. The intracellular citrate and iron concentrations were 10--100-times higher than the external concentrations required for induction of the transport system. It is concluded that only exogenous ferric citrate induced the transport system, and that citrate did not have to enter the cytoplasm. The Tn10 transposon, conferring tetracycline resistance, was inserted near the fec gene region which controls the expression of the citrate-dependent iron transport system. The determination of the cotransduction frequencies of Tn10 with the fecA and fecB markers suggested the gene order fecA fecB Tn10.
Mutants of Escherichia coli K-12 AB2847 and of E. coli K-12 AN92 were isolated which were unable to grow on ferric citrate as the sole iron source. Of 22 mutants, 6 lacked an outer membrane protein, designated FecA protein, which was expressed by growing cells in the presence of 1 mM citrate. Outer membranes showed an enhanced binding of radioactive iron, supplied as a citrate complex, depending on the amount of FecA protein. The FecA protein was the most resistant of the proteins involved in ferric irion iron translocation across the outer membrane (FhuA = TonA, FepA, Cir, or 83K proteins) to the action of pronase P. It is also shown that previously isolated fec mutants (G. C. Woodrow et al., J. Bacteriol. 133:1524-1526, 1978) which are cotransducible with argF all lack the FecA protein. They were termed fecA to distinguish them from the other ferric citrate transport mutants, now designated fecB, which mapped in the same gene region at 7 min but were not cotransducible with ArgF. E. coli W83-24 and Salmonella typhimurium, which are devoid of a citrate-dependent iron transport system, lacked the FecA protein. It is proposed that the FecA protein participates in the transport of ferric citrate.
Colicin M of Escherichia coli Cl139 was isolated in pure form. It consisted of a single polypeptide with a molecular weight of 27,000 +/- 2,000. Colicin M lysed sensitive cells of E. coli but had to act continuously up to the point when lysis commenced (after 20 min). Colicin M was largely resistant to hydrolysis by trypsin except when adsorbed to cells. Within 4 to 5 min after addition of colicin M, cells could be rescued by trypsin or sodium dodecyl sulfate. Later, colicin M was apparently inaccessible to these inactivating agents. Killing of cells by colicin M required Ca2+ ions. Cells could be rescued with ethylene glycol-bis(beta-aminoethyl ether)-N,N'-tetraacetate (EGTA) immediately before the onset of lysis. Under these conditions, colicin M remained bound to the cells, and it became again sensitive to trypsin. We conclude that under the influence of EGTA colicin M is removed from its site of action and becomes again accessible to trypsin at the cell surface.
Mutants of the fhuA gene of Escherichia coli K-12, which encodes a receptor protein in the outer membrane, took up ferrichrome after exposure to pronase, whereas fhuB mutants remained transport negative. The latter finding supports our previous proposal that fhuB mutants are defective in a function that residues in the cytoplasmic membrane. Cells remained completely viable after treatment with pronase, although they became sensitive to the antibiotic actinomycin.
A mutant sensitive to colicin M at 30 degrees C and tolerant at 42 degrees C to high concentrations of colicin M was isolated from Escherichia coli K-12. A temperature shift from 30 to 42 degrees C rescued all cells up to the time they started to lyse at 30 degrees C (25 min after addition of colicin M). The growth rate at 42 degrees C remained unaffected by colicin M. AT 42 degrees C the cell-bound colicin M was inactivated by trypsin, sodium dodecyl sulfate, and antiserum against colicin M. Ferrichrome competed with colicin M at 42 degrees C only during the initial adsorption to the common receptor protein in the outer membrane. Since cells lysed earlier at 30 degrees C when they had been preincubated with colicin M at 42 degrees C, we conclude that the process leading finally to cell lysis is initiated at 42 degrees C and stops at a later stage of colicin M trypsin, dodecyl sulfate, and antiserum when cells were transferred from 30 to 42 degrees C, we assume that colicin M is translocated from its target site towards the cell surface. The mutation conferring tolerance was mapped close to the rpsL gene.