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Deceleratory growth by a rat glial tumor line in culture.

Tumors in vivo usually exhibit deceleratory rather than exponential growth kinetics. Deceleration results from a negative feedback inhibition of growth the effectiveness of which increases progressively with tumor size. A major obstacle to understanding the fine mechanisms of deceleratory growth has been the lack of a tissue culture system proven to exhibit these kinetics. Rat C6 glioma cells in culture enter a prolonged phase of deceleratory growth about 72 hr after subculture. As with tumor growth in vivo, the kinetics of the C6 deceleratory phase can be described with high accuracy by Gompertz, logistic, inverse cube root, and power functions. The least-squares correlation coefficients for the linearized forms of the rate equations for these functions were typically in the range of 0.75 to 0.90. During the deceleratory phase, the equilibrium growth rate of C6 cells is a monotonically decreasing function of population density at all observable densities, whether sub- or supraconfluent. Any change in density produces a compensatory change of opposite direction in the growth rate. To account for these relationships, a density-equilibrium hypothesis of C6 growth regulation is presented. The fine mechanisms responsible for this regulation do not involve medium or substratum depletion, production of conditioned medium factors, or the extracellular matrix. The development of growth deceleration appears to correlate with the extent of contact interactions between cells and their neighbors, indicating that deceleratory growth regulation is probably mediated by contact interactions. However, these interactions are fundamentally different from those postulated by the traditional contact inhibition theory. Confluency is irrelevant to the contact modulation which produces C6 growth deceleration. Any degree of contact, even at very sparse subconfluent densities, appears capable of exerting some degree of growth inhibition.

Animals↗

The nature of torque "overshoot" in Cybex isokinetic dynamometry.

Transient peaks or "spikes" frequently appear in the initial segments of torque curves recorded with the Cybex isokinetic dynamometer. The purpose of this investigation was to determine whether these spikes represent artifact or transient initial surges of true muscular force output. Cinematographic analysis using both inert weights and a human subject as the source of torque input to the Cybex revealed that the dynamometer's input lever initially exceeded the pre-set angular velocity by an amount ranging from 11% (inert weight; pre-set Cybex velocity = 180 degrees/s) to 200% (human hip abduction; pre-set velocity = 30 degrees/s). The majority of this "overspeeding" occurred in the latter part of the free acceleration period, prior to the engagement of the dynamometer's resistance mechanism. The remainder occurred in the initial part of the elastic loading phase, just after resistance had engaged. A sharp deceleration of the overspeeding lever and the affixed weight or limb then followed in response to the dynamometer's continuing build-up of resistance. Simultaneous with this deceleration, a prominent torque spike was recorded that superseded the correct (mechanical equilibrium) torque value. Within our error of measurement, the deceleration observed in the film quantitatively accounted for all of the "overshoot" torque, i.e., that amount of the spike that exceeded the correct value. It was concluded that such prominent, initial torque spikes represent inertial forces and should not be confused with true muscular tension development.

Biomechanical Phenomena↗

[Estimate of lung capillary pressure and identification of the "pseudonormal" transmitral flow pattern in patients with severe systolic dysfunction of the left ventricle].

OBJECTIVES: Aim of this study was to investigate whether Doppler-derived transmitral flow velocity variables would allow a reliable estimate of pulmonary capillary wedge pressure in patients with left ventricular systolic dysfunction and normal mitral flow velocity pattern, and would then predict the presence of a "pseudonormal" transmitral flow velocity profile. BACKGROUND: Abnormal relaxation and increased chamber stiffness have opposing effects on the left ventricular filling pattern. When both abnormalities are present at the same time, as often occurs in patients with systolic dysfunction, the mitral pattern may appear to be normal: in this case the ability of Doppler recording to assess diastolic function and predict left ventricular filling pressure may be significantly compromised. METHOD: Pulmonary capillary wedge pressure (PWP) and Doppler transmitral flow velocity profile were simultaneously recorded in 70 postinfarction patients with ejection fraction < or = 35% and mitral flow velocity pattern apparently normal (E/A ratio between 1 and 2). Doppler traces were analyzed using a microcomputer-based digitizing system, and the following variables were measured: peak flow velocity in early diastole (E) and during atrial contraction (A), peak E/A wave velocity ratio and the deceleration time (Dec T) of early diastolic flow. RESULTS: Mean E/A ratio was 1.3 +/- 0.2 and mean PWP was 17 +/- 7 mm Hg. Forty-two patients had a PWP < 20 mm Hg and the remaining 28 patients (40%) had PWP > or = 20 mm Hg. Peak E, peak A and E/A ratio were similar in the two groups, whereas Dec T was significantly (p < 0.001) lower in patients with > or = 20 mm Hg PWP (93 +/- 15 vs 146 +/- 19 msec). A very weak correlation was found between PWP and both E and A velocity (r = 0.14 and r = 0.09, respectively). Furthermore, no correlation was found between E/A ratio and PWP (r = 0.08). Conversely, a very close negative correlation was observed between Dec T of early filling and PWP (r = -0.96). Sensitivity and specificity of < or = 120 ms in Dec T in predicting > or = 20 mm Hg in PWP were 100% and 99%, respectively. CONCLUSIONS: These data point out the relevant role of Doppler-derived deceleration time of early diastole in predicting left ventricular filling pressure. In patients with left ventricular systolic dysfunction an apparently normal diastolic filling pattern is often associated with elevated PWP. Through the estimate of increased PWP, early deceleration time seems to provide an important means of differentiating a real normal from a pseudonormal or masked abnormal filling pattern caused by increased left ventricular filling pressure.

Adult↗

The influence of age on injury severity of restrained front seat occupants in head-on collisions.

This excerpt is part of a large-scale retrospective study on the interrelationship between accident severity and injury severity. A multivariate analysis of 319 cases of restrained front seat occupants involved in car-to-car head-on collisions showed the significant influence of the energy equivalent speed (EES) and age of the occupants on the number of rib fractures and sternum fractures. Three hundred occupants sustained no rib fractures, nine occupants one to 16 rib fractures, and ten occupants 17 to 32 rib fractures. In these three groups the EES increased from 35 km/h (no rib fractures) to 55 km/h (one to 16 rib fractures) and to then to 67 km/h (17 to 32 rib fractures). The average age in these groups was 34, 55 and 57 years respectively. Twenty-four occupants sustained sternum fractures. The average values of the EES and the average age were: in the group with sternum fractures: 56 km/h; 50 years old; in the group without sternum fractures: 35 km/h; 34 years old. The probability of sustaining fatal injuries in a head-on collision depended on the EES as well as the age of the occupant. At an EES of 60 km/h the probability of fatal injuries was 0.05% in the group < 30 years and 35% in the group > 59 years. Fifty-eight per cent of the occupants with sternal fractures had rib fractures as well; 46% of the occupants with rib fractures also had sternal fractures. The results were compared to the results of 185 post-mortem simulations of head-on collisions from the year 1973 to 1978. In post-mortem simulations the number of rib fractures and sternum fractures was influenced by vehicle decelerations and the age of the test subjects. The number of rib fractures increased at higher collision speeds, higher decelerations and increased age; the number of sternum fractures increased at higher deceleration and increased age of the test subjects. Seventy-two per cent of the test subjects with sternal fractures had rib fractures; 91% of the subjects with rib fractures had sternal fractures.

Accidents, Traffic↗

[Variations of blood flow in pulmonary veins caused by electric stimulation in total atrioventricular block].

It was suggested that Doppler study of pulmonary venous flow (PVF) in combination with mitral flow is useful to evaluate ventricular function. In order to investigate the utility of PVF study in patients with total A-V block treated with pacemaker DDD, we performed transesophageal echocardiography pulsed Doppler of PVF and mitral flow in 12 patients. We measured the following parameters in PVF: peak systolic velocities (S1 and S2), peak diastolic velocity (D) reversal atrial flow diastolic deceleration time. In mitral flow we measured: E wave, A wave and deceleration time of E. We compared our results with the same patients with pacemaker inhibited. In patients with total A-V block with pacemaker inhibited we reported one systolic wave of PVF, a larger D wave with a shortened deceleration time. The PVA seems to disappear. Transmitral flow slowed a higher E wave in patients A-V block with pacemaker inhibited. In patients with total A-V block stimulated by DDD pacemaker we restored the atrioventricular sequentialty; therefore electric stimulation determines the onset of S1 peak and the reduction of S2 peak and the systematic presence of the atrial-pulmonary regurgitant wave.

Cardiac Pacing, Artificial↗

Comparative Gompertzian analysis of alterations of tumor growth patterns.

We have shown previously that different patterns of growth (including classical Gompertzian, exponential, and hyperexponential) can be described based on the Gompertzian difference equation, In G(t+s) = a+b In G(t) [G(t), tumor size at time t; s, constant time interval of a stroboscopic set of tumor size measurements], by the initial or intrinsic growth rate, a, and the exponential rate of growth deceleration, b (I. D. Bassukas and B. Maurer-Schultze, Growth Dev. Aging, 52: 113-122, 1988). Particularly, the possible effects of antineoplastic treatments on this latter factor have not been adequately appreciated to date. In the present study a new method of comparison of growth process is introduced, which consists of two steps. (a) The corresponding growth patterns are compared with each other on the basis of the Gompertzian difference equation using an analysis of variance algorithm. The result indicates whether or not there is an alteration of the growth pattern and, if there is one, whether it refers to alterations of the a and/or b values for the growth patterns. (b) The ultimate effect of any perturbation is assessed by using the limit (for t-->infinity) of the quotient of the tumor sizes after and before perturbation to characterize it as stimulation or inhibition. The present approach introduces a new quality of tumor growth perturbations; tumor growth may be altered although being neither inhibited nor stimulated, a phenomenon with biological significance still to be evaluated. The application of this method to the treatment with suramin of a human renal cell carcinoma xenograft in nude mice reveals a complex alteration of its growth pattern. Suramin simultaneously inhibits both the initial or intrinsic growth rate and the exponential rate of growth deceleration of this tumor. Consequently, this tumor starts with a lower growth rate in the presence of suramin; however, this rate also decelerates more slowly as a function of tumor growth, so that treated tumors, although initially inhibited, grow larger than controls.

Animals↗

Transmitral Doppler assessment of left ventricular diastolic function during coronary artery bypass surgery.

OBJECTIVE: To evaluate which Doppler transmitral velocity indices of left ventricular diastolic function change with alteration of left ventricular filling pressure. METHODS: Twenty-two patients undergoing coronary artery bypass surgery. The effect of fluid loading on indices derived from the transmitral Doppler waveform, recorded by a trans-oesophageal echocardiography, was evaluated using a generalised linear statistical model. RESULTS: E-wave maximum velocity, E-wave acceleration time and slope, E-wave deceleration slope, A-wave maximum velocity and E/A wave maximum velocity ratio showed significant changes after alterations in left ventricular filling pressure. E-wave deceleration time and E-wave maximum velocity/time velocity integral showed no significant change after fluid loading. CONCLUSION: Several commonly used Doppler derived indices of left ventricular diastolic function are significantly affected by changes in filling pressure of the left ventricle. This may limit the usefulness of the Doppler method for serial assessment of diastolic function when the left ventricular filling pressure has changed between assessments. Only the E-wave deceleration time did not show significant changes and might be a useful Doppler index for the serial measurement of left ventricular compliance but this needs to be confirmed with haemodynamic measurements.

Adult↗

Kinematic description of variability of fast movements: analytical and experimental approaches.

Analysis of variability of fast aimed movements predicts the properties of trajectory variance. The analysis is based on a kinematic model with nonlinear changes in "internal time". The purpose of the work was to identify different sources of variability and their influence on the trajectory variance. An analytical expression for the speed-accuracy trade-off is introduced. Experiments were performed with subjects making single-joint elbow flexion movements over different distances as fast as possible with their eyes closed to memorized targets. Standard deviation of movement trajectory increased during the first part of the movement and subsequently decreased. The variance peaked after the time of peak velocity, close to the time of peak deceleration. A dependence of the trajectory variance on movement distance (speed-accuracy trade-off) was seen during the movement (at times of peak velocity and peak deceleration) but not after the movement termination. We conclude that the previously reported drop in the variability of movement trajectory during the deceleration phase does not necessarily mean a compensation by the control system but may result from purely kinematic properties of the movement. The importance of the time of measurement for analysis of the speed-accuracy trade-offs is emphasized.

Biomechanical Phenomena↗

[MR evaluation of common femoral arterial flow: age-related changes and characteristics in obstructive arterial disease of lower extremities].

Flow velocity measurements of the common femoral arteries in 60 lower extremities of 30 healthy subjects and 12 lower extremities of 7 patients with arteriosclerosis obliterans (ASO) were performed by means of magnetic resonance imaging with a use of presaturation bolus tracking (PBT) method. Our PBT method can provide both precise determination of flow velocity and evaluation of flow patterns within 30 minutes in the clinical setting. In phantom study, MR flow velocity had good correlation with actual flow velocity (r = 0.997). 30 healthy volunteers were classified into three groups; group I (20-40 years), group II (41-60 years) and group III (61-80 years). Starting time of acceleration (STA) were shortened as the age progressed. Peak reverse velocity (PRV), maximum deceleration rate (MDR), peak forward velocity/mean velocity ratio (PFV/MV) and pulsatility index (PI) were significantly decreased in group III as compared to group I and group II. Although intraluminal flow profile showed almost uniform during acceleration time on MR images, flow profile became disproportioned and reverse flow was observed in the medial portion during deceleration time. These characteristic hemodynamics were recognized in all healthy subjects regardless to the different age group. In ASO, STA was prolonged and PFV, PRV, Maximum acceleration rate, MDR, PFV/MV, PI, Vascular sectional area, flow volume were significantly decreased (p < 0.001) as compared to the control healthy group III. As the result we obtained marked characteristics such as flattening of curves and disappearance of reverse flow in MR flow waveform. On MR images, disproportion of intraluminal flow profile, decreased flow velocities during acceleration time and disappearance of reverse flow (11 of 12 extremities) during deceleration time were observed.

Adult↗

Ground reaction force patterns of Dutch Warmbloods at the canter.

Ground reaction force (GRF) patterns from 20 clinically sound Dutch Warmbloods were recorded at the right fore-leading canter, and a standard horse was composed. These GRF data for the standard can be used for evaluation of jumping horses. The GRF patterns were asymmetric for all 4 limbs. The leading right forelimb decelerated the body. The trailing left forelimb propelled the body and decelerated it slightly. The trailing left hind limb propelled, and the leading right hind limb contributed to deceleration and propulsion. Referred to the maximal vertical load of the leading right forelimb, the load of the trailing left forelimb was 25% more; the load of the right hind limb was slightly less, whereas the load of the left hind limb was about 80% of that value.

Analysis of Variance↗

Vestibulo-ocular response of human subjects seated in a pivoting support system during 3 Gz centrifuge stimulation.

The vestibulo-ocular reflex (VOR) and spatial orientation perceptions were recorded in 15 subjects during 3 Gz centrifuge runs. These data were obtained to study two issues: (1) to gain insight into reports of asymmetrical disorientation and disturbance during acceleration and deceleration of centrifuge runs like those used to train pilots on the procedures to counteract G-induced loss of consciousness (G-LOC); (2) to study the effects of sustained vertical linear acceleration on the vestibular system. The centrifuge angular velocity profile consisted of a 19 s angular acceleration to 3 Gz that was sustained for 5 min during a period of constant angular velocity, and a 19 s deceleration to 1 Gz. The runs were repeated three times with the subject facing the motion and three times with the subject's back to the motion. The VOR and spatial orientation perceptions from the eight subjects who completed all six runs were analyzed. The total VOR response during acceleration and deceleration was composed of interacting angular (AVOR) and linear components (LVOR). Asymmetries in pitch orientation perception between centrifuge acceleration and decleration were not matched by asymmetries in the total VOR slow phase velocity. During the constant velocity high-G phase of the run, sustained up-beating LVOR (Lz nystagmus) was present in 14 of the 15 subjects. Significant individual differences in Lz nystagmus were found, but the maximum Lz response in our 15 subjects was probably of insufficient magnitude to degrade visual scan of cockpit instruments. Mean magnitudes ranged from 0 to 10 deg/s at 90 s from onset of centrifuge run.

Adult↗

[Morphophysiological analysis of the formation of mechanisms of the activity-rest cycle in human ontogenesis].

The natural behavior of normal and anencephalic fetuses at 20 to 41 weeks of the development was studied by ultrasound monitoring and continuous recording of heart rate (HR) and motor activity (MA), followed by processing and presentation on [symbol: see text]CM computer. The statistical characteristics of HR and MA changes in the anencephalic fetuses were corrected by the degree of CNS deficiency. The comparative study of 20 normal and 34 anencephalic fetuses showed: 1) when the spinal cord was present, stable HR (about 150 bpm) seems to be due to cardiac automatism and sharp decelerations unaccompanied by MA were recorded; 2) in fetuses with the medulla oblongata present showed a decrease in baseline HR up to 140 bpm, repeated pronounced decelerations and spontaneous single motor acts dissociated with the latter; 3) when a rudiment of the midbrain was present, some reductions in the amplitude of decelerations and manifestation of weak accelerations, cluster motor acts, brief episodes of the active state were revealed; 4) the quiet state was observed in fetuses with the cerebral cortex; 5) the rest-activity cycle formed with further differentiation of the cerebral cortex.

Anencephaly↗

Analysis of heart rate patterns preceding fetal death.

An analysis of fetal heart rate patterns preceding death is presented in 7 patients. The intrapartum deaths were not predictable on the basis of clinical evaluation. Predeath recording time varied from 11 minutes to 7.75 hours. An atypical deceleration pattern was observed in 3 patients terminally with associated loss of beat-to-beat variability. These occurred with uterine contractions, but had the characteristic appearance of variable decelerations (CC). This pattern was characterized by short contraction to deceleration intervals, and by large drops in the rate (62-102 beats/min). In 6 of the 7 patients, there was either absent (0-5 beats/min) or diminished (5-10 beats/min) beat-to-beat variability. In 1 the terminal recording showed an absolutely fixed rate with a progressive loss of beats and an increased amount of electrical noise.

Adolescent↗

Tricuspid inflow and regurgitant flow dynamics after mitral valve replacement: differences relating to surgical repair of the tricuspid valve.

BACKGROUND AND AIMS OF THE STUDY: Changes in tricuspid inflow and regurgitant flow dynamics were evaluated in patients with functional tricuspid regurgitation (TR) who underwent mitral valve replacement (MVR) with and without tricuspid annuloplasty (TAP). METHODS: In a group of 30 patients, all with atrial fibrillation, 15 underwent TAP performed according to the modified De Vega technique; the remaining 15 did not undergo TAP. Patients were studied before and serially after surgery, using pulsed and color Doppler echocardiography. The mean follow up was 4.7 years in the TAP group and 5.1 years in the non-TAP group. RESULTS: In the TAP group, immediately after surgery, the area of the TR jet decreased markedly, and the deceleration time of the tricuspid inflow velocity wave was significantly prolonged compared with that before surgery. By contrast, in the non-TAP group, both the area of the TR jet and deceleration time of tricuspid inflow velocity were virtually unchanged. The area of the TR jet remained small for a long period in the TAP group, but in non-TAP patients was increased in four cases over seven years, with two patients developing right-sided heart failure. Recent data showed the area of the TR jet to be significantly smaller, with maximum tricuspid inflow velocity significantly increased, and deceleration time of the tricuspid inflow velocity wave significantly prolonged in the TAP group compared with the non-TAP group. CONCLUSIONS: In patients with functional tricuspid regurgitation undergoing MVR, concomitant TAP may cause mild tricuspid stenosis, but produces sustained preventive effects against TR. Careful follow up is needed in patients who have not undergone TAP, as TR is not markedly decreased and may even be exacerbated. Aggressive TAP is recommended in patients showing dilatation of the tricuspid annulus, even if TR is mild.

Adult↗

[Interpretation of pulse oximetry and near infrared spectroscopy values sub partu].

Pulse oximetry and Near Infrared Spectroscopy (NIRS) are both optical methods which have been made applicable to the fetus during labour in order to improve the assessment of fetal oxygen supply and well being. 317 pulse oximetry measurements showed that postpartum pH, Base Excess, PO2 are significantly negatively resp. pCO2 is positively correlated to the time, during which arterial oxygen saturation (SpO2) is below a critical threshold of 30%. The 1' APGAR-score is also influenced by the duration of SpO2 values below 30%. Near Infrared Spectroscopy semiquantitatively measures cerebral concentration changes of oxygenized, desoxygenized and total hemoglobin as well as that of cytochrome aa3 which is the key enzyme of the intracellular respiratory chain. In an analysis of 1350 contractions during 42 deliveries decelerations type 1 and 2 differed from normal CTG by a significantly deeper drop of oxygenized and total hemoglobin in the brain on top of contractions. Until the following contraction oxygenized and total hemoglobin remained deeper below their original levels in case of decelerations type 2 than in case of normal CTG or type 1 decelerations. Simultaneous registration of pulse oximetry and NIRS revealed an increase of cerebral blood volume in case of low arterial oxygen saturation (SpO2 < 30%) which may be interpreted as "brain sparing effect".

Asphyxia Neonatorum↗

Fetal Heart Rate Observations in 300 Term Brain-damaged Infants

>Objective: To describe the fetal heart rate (FHR) patterns of 300 term brain-damaged infants.Methods: The fetal monitor strips of 300 singleton term neurologically impaired neonates were retrospectively analyzed.Results: Of the 300 infants, the admission FHR patterns were: reactive, 152 (51%); nonreactive, 135 (45%); bradycardia, 9 (3%); or unclassifiable, 4 (1%). In the reactive group, the FHR did the following: 1) remained reactive throughout labor [24 (16%)]; 2) developed an elevated baseline FHR in association with repetitive FHR decelerations and, in most instances, a loss of variability [67 (22%)]; or 3) developed a sudden prolonged FHR deceleration that lasted until delivery [61 (20%)]. Finally, the nonreactive admission group exhibited the following: 1) a persistent fixed baseline rate from admission (149 +/- 16 beats/min) [97 (72%)]; 2) a prolonged FHR deceleration that lasted until delivery [12 (9%)]; or 3) a stair steps to death pattern [26 (19%)].Conclusions: While term infants later found to be neurologically impaired do not manifest a uniform FHR pattern, these fetuses do manifest distinct FHR patterns intrapartum that can be easily categorized and identified on the basis of the fetal admission test and subsequent changes in the baseline heart rate. This distinction should prove helpful in the management of obstetrical patients in labor.

Journal Article↗

[Effect of reduced arterial compliance on the diastolic function of the heart].

BACKGROUND AND OBJECTIVE: Reduced arterial compliance is associated with age, hypertension and left ventricular hypertrophy. It is unclear if and how reduced arterial compliance affects the diastolic properties of the heart. PATIENT POPULATION: We examined 64 normotensive and 27 hypertensive individuals, (31 females, 60 males). Their ages ranged from 19 to 78 years (mean 43 +/- 14.7 y), BP ranged from 80/50 to 180/110 mmHg. Exclusion criteria were atrial fibrillation, coronary or peripheral vascular disease, diabetes, anemia, hypercholesterolaemia, as well as antihypertensive drug therapy. METHODS: Diastolic function was assessed by Doppler measurement of E and A wave velocities of Mitral flow. E acceleration and deceleration slopes and times. LV mass was calculated from an M- mode echocardiogram. Arterial compliance was assessed by an automatic pulse wave velocity (PWV) measurement. RESULTS: Age and PWV correlated significantly with the mitral E and A waves, the E acceleration time. E deceleration and E deceleration time. No significant correlations were found between SBP, DBP or LV mass and the parameters of diastolic function (see table).

Adult↗

Nystagmus slow-phase velocity during vestibular, optokinetic, and combined stimulation in the monkey.

In Rhesus monkeys the slow-phase velocity of nystagmus was measured during optokinetic, vestibular, and combined stimulation. Accelerations and decelerations of 2.5--40 degrees/s2, and rotation at constant velocities of 70-160 degrees/s were applied. During combined visual-vestibular stimulation, nystagmus slow-phase velocity is a function only of the instantaneous stimulus velocity: It has a gain near unity and is independent of the duration and value of the acceleration. The limited linear working range of the vestibular or optokinetic system is thus extended. During deceleration an inappropriate nystagmus response is elicited only when the previous constant velocity rotation was above the saturation velocity of optokinetic nystagmus (OKN). These results are related to single neuron activity recorded in the vestibular nuclei and the flocculus under identical stimulus conditions.

Acceleration↗