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PubMed1985

Influence of spinal cord stimulation upon myosin light chain and tropomyosin subunit expression in a fast muscle (posterior latissimus dorsi) of the chick embryo.

Latissimus dorsi muscles of the chick consist of a slow (ALD) and a fast (PLD) muscle. The influence of chronic spinal cord stimulation in the chick embryo upon the expression of myosin light chains and tropomyosin subunits was investigated. Early in development the two muscles exhibited the same ratio of alpha- and beta-tropomyosin subunits. Later, in the slow muscle the ratio beta:alpha decreased and in chicken the amounts of the two components were about the same. In the fast muscle, the alpha-subunit increased and reached 66% in young chicken. In the fast muscle, the alpha-subunit increased and reached 66% in young chicken. In the In the early stages of embryonic development, both muscles accumulated slow and fast light chains. However, in ALD the amount of slow light chains was greater than that of fast light chains and the reverse was observed in PLD muscle. Later during development, the slow components decreased in PLD while the fast components increased; the reverse was observed in ALD muscle. The fast myosin LC3f has been detected in 18-day-old embryonic PLD. Chronic spinal cord stimulation at a low rhythm was performed from day 10 of embryonic development to day 15 or 16. In both muscles from spinal cord-stimulated embryos, the beta-tropomyosin subunit was lower than in control embryos. In ALD, the pattern of light chains was unaffected by chronic stimulation while in PLD muscle the slow and fast components were modified. In particular the ratio LCs:LCf was increased in spinal cord-stimulated embryos with regard to controls.

Animals↗
PubMed1987

Patterns of troponin T expression in mammalian fast, slow and promiscuous muscle fibres.

The distribution of troponin T (TnT) species in typed single muscle fibres was analysed using one- and two-dimensional polyacrylamide gel electrophoresis (PAGE) and a monoclonal antibody specific for fast TnT. Fibres taken from erector spinae (Es), plantaris (Plt), diaphragm (Dia) and soleus (Sol) muscles of adult rabbits were pretyped as fast-twitch-glycolytic (FG), fast-twitch-oxidative-glycolytic (FOG), slow-twitch-oxidative (SO) or promiscuous (P) using a combination of histochemical staining and PAGE. Although none of the four size classes of TnT was either muscle or fibre type specific, their pattern of expression differed in each muscle and between the fibre types. FG fibres expressed TnT1f or TnT2f as predominant species, depending on the muscle; TnT3f and TnT4f were minor components. In contrast, all size classes of TnT were expressed in varying proportions in FOG fibres from Es and Plt, while those from Dia resembled FG fibres, expressing TnT1f as their major species. P fibres from Es, Plt, and Sol exhibited a distinctive pattern of fast TnT expression, TnT3f being the predominant species. Dia differed from the other muscles as TnT1f was the dominant fast TnT species in its P fibres as it is in the Dia fast fibres. Quantitative analysis of one- and two-dimensional gels revealed that the P fibres could be divided into two classes, those that exhibited discoordinate expression of fast and slow TnTs, myosin light chains and myosin heavy chains and those in which their expression was coordinate. In addition low levels of TnT4f were detected in SO fibres and of slow TnT in fast fibres.

Animals↗
PubMed2000

Diagnostic value of the fast-FLAIR sequence in MR imaging of intracranial tumors.

The aim of this study was to quantify imaging characteristics of fast fluid-attenuated inversion recovery (FLAIR) sequence in brain tumors compared with T1-postcontrast- and T2-sequences. Fast-FLAIR-, T2 fast spin echo (FSE)-, and T1 SE postcontrast images of 74 patients with intracranial neoplasms were analyzed. Four neuroradiologists rated signal intensity and inhomogeneity of the tumor, rendering of cystic parts, demarcation of the tumor vs brain, of the tumor vs edema and of brain vs edema, as well as the presence of motion and of other artifacts. Data analysis was performed for histologically proven astrocytomas, glioblastomas, and meningiomas, for tumors with poor contrast enhancement, and for all patients pooled. Only for tumors with poor contrast enhancement (n = 12) did fast FLAIR provide additional information about the lesion. In these cases, signal intensity, demarcation of the tumor vs brain, and differentiation of the tumor vs edema were best using fast FLAIR. In all cases, rendering of the tumor's inner structure was poor. For all other tumor types, fast FLAIR did not give clinically relevant information, the only exception being a better demarcation of the edema from brain tissue. Artifacts rarely interfered with evaluation of fast-FLAIR images. Thus, fast FLAIR cannot replace T2-weighted series. It provides additional information only in tumors with poor contrast enhancement. It is helpful for defining the exact extent of the edema of any tumor but gives little information about their inner structure.

Adolescent↗
PubMed2001

A normal ocular motor system model that simulates the dual-mode fast phases of latent/manifest latent nystagmus.

The fast phases of latent/manifest latent nystagmus (LMLN) may either cause the target image to fall within (foveating) or outside (defoveating) the foveal area. We previously verified that both types are generated by the same mechanism as voluntary saccades and propose a hypothetical, dual-mode mechanism (computer model) for LMLN that utilizes normal ocular-motor control functions. Fixation data recorded during the past 30 years from 97 subjects with LMLN using both infrared and magnetic search coil oculography were used as a basis for our simulations. The MATLAB/Simulink software was used to construct a robust, modular, ocular motor system model, capable of simulating LMLN. Fast-phase amplitude versus both peak velocity and duration of simulated saccades were equivalent to those of saccades in normal subjects. Based on our LMLN studies, we constructed a hypothetical model in which the slow-phase velocity acted to trigger the change between foveating and defoveating LMLN fast phases. Foveating fast phases were generated during lower slow-phase velocities whereas defoveating fast phases occurred during higher slow-phase velocities. The bidirectional model simulated Alexander's law behavior under all viewing and fixation conditions. Our ocular-motor model accurately simulates LMLN patient ocular motility data and provides a hypothetical explanation for the conditions that result in both foveating and defoveating fast phases. As is the case for normal physiological saccades, the position error determined the saccadic amplitudes for foveating fast phases. However, the final slow-phase velocity determined the amplitudes of defoveating fast phases. In addition, we suggest that individuals with LMLN use their fixation subsystem to further decrease the slow-phase velocity as the target image approaches the foveal center.

Adolescent↗
PubMed2007

Clinical outcomes and cost analysis of a "fast track" postoperative care pathway for ileal pouch-anal anastomosis: a case control study.

PURPOSE: Traditional length of hospital stay after ileal pouch-anal anastomosis is 8 to 15 days. Fast track rehabilitation programs reduce stay, but there are concerns that readmission and complication rates may be increased. This study evaluated a fast track pathway after ileoanal pouch surgery. METHODS: One hundred three consecutive patients underwent ileal pouch-anal anastomosis on two colorectal services using a fast track protocol with early ambulation, diet, and defined discharge criteria. Direct hospital costs and 30-day and long-term complication data were collected. Patients were matched to controls managed with traditional care pathways by other colorectal staff. RESULTS: Matching was established for 97 patients. Fast track patients had shorter hospital stay than controls (median 4 vs. 5 days; mean 5.0 vs. 5.9, P = 0.012). Readmission and recurrent operation rates were similar (24 vs. 20 percent, P = 0.49, and 9 vs. 10 percent, P = 0.8, fast track vs. control, respectively). Median direct costs per patient (US$) within 30 days were lower with fast track (5692 vs. 6672, P = 0.001), primarily because of reductions in postoperative management expenses. Complication rates, including pouch failure, bowel obstruction, pouchitis, and anastomotic stricture were comparable. Early discharge (< or = 5 days from surgery) occurred in 79 (77 percent) fast track patients. Failure with early discharge was associated with male gender, reoperations, and anastomotic complications. CONCLUSIONS: Fast track protocol after ileoanal pouch surgery reduces length of stay and hospital costs without increasing complication rates. Successful early discharge usually signals a benign postoperative course.

Adult↗
PubMed1994

Comparison of the effects of fluoride on the calcium pumps of cardiac and fast skeletal muscle sarcoplasmic reticulum: evidence for tissue-specific qualitative difference in calcium-induced pump conformation.

Comparison of the effects of fluoride (NaF, 1-10 mM) on the catalytic and ion transport functions of the Ca(2+)-ATPase in sarcoplasmic reticulum (SR) vesicles isolated from rabbit cardiac and fast-twitch skeletal muscles revealed similarities as well as striking tissue-specific differences depending on the experimental conditions employed. Short preincubation (3 min at 37 degrees C) of cardiac or fast muscle SR with fluoride in the absence of Ca2+ and ATP prior to initiating enzyme turnover by simultaneous addition of Ca2+ and ATP to the assay medium resulted in a strong inhibitory effect of fluoride on ATP-energized (oxalate-facilitated) Ca2+ uptake and Ca(2+)-ATPase activity. On the other hand, when turnover was initiated by the addition of ATP to SR preincubated with fluoride in the presence of Ca2+ but in the absence of ATP, fluoride caused concentration-dependent stimulation of active Ca2+ uptake by fast muscle SR with no appreciable change in Ca(2+)-dependent phosphoenzyme (EP) formation (from ATP) or Ca(2+)-ATPase activity but inhibition of active Ca2+ uptake by cardiac SR with concomitant inhibition of EP formation and Ca(2+)-ATPase activity. Exposure of cardiac or fast muscle SR to fluoride in the presence of both Ca2+ and ATP resulted in concentration-dependent stimulatory effect of fluoride on Ca2+ uptake with no change in EP formation or Ca(2+)-ATPase activity, this effect diminished substantially at saturating oxalate concentration in the assay. Assessment of the effects of deferoxamine (1 mM) and exogenous aluminum (10 microM) did not indicate a requirement for aluminum in the inhibitory or stimulatory effect of fluoride. These results suggest that (a) the Ca2+ and ATP-deprived (E1/E2) but not the Ca2+ plus ATP-liganded (CaE1ATP) conformation of the SR Ca(2+)-ATPase is susceptible to inhibition by fluoride in both cardiac and fast muscle; (b) the Ca(2+)-bound conformation (CaE1) of the SR Ca(2+)-ATPase is susceptible to inhibition in cardiac muscle but is refractory to fluoride in fast muscle; and (c) the stimulatory effect of fluoride is largely secondary to its ability to mimic the action of oxalate in intravesicular Ca2+ trapping when the fluoride-resistant enzyme is turning over normally. Fluoride inhibited phosphorylation of the Ca(2+)-free enzyme by Pi in cardiac and fast muscle SR indicating that fluoride sensitivity of the phosphorylation site of the SR Ca(2+)-ATPase is similar in cardiac and fast muscle.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphate↗
PubMed1985

Colchicine-induced differential sprouting of the endplates on fast and slow muscle fibers in rat extensor digitorum longus, soleus and tibialis anterior muscles.

The patterns of sprouting of motor endplates were examined in fast extensor digitorum longus and slow soleus muscles and in tibialis anterior muscles containing fast and slow muscle fiber types. A histochemical technique combining nerve silver impregnation and endplate cholinesterase staining was developed for this task. Temporal examination of the innervation was conducted 3, 7 and 10 days after either a 45 or 90 min application of the ipsilateral sciatic nerve with 5 mM colchicine. This dosage of drug did not cause detectable axon or muscle fiber degeneration, unlike 60 mM which was highly neurotoxic. At 3 days following treatment with the lower concentration, there were no significant differences in the percentages of intranodal, preterminal and ultraterminal sprouts between the normal (non-treated), sham-treated, contralateral systemic-control and drug-treated groups of muscles. By 7 and 10 days, the muscles on the drug-treated side exhibited significant increases in the 3 types of sprouts. Collateral sprouting was uncommon: most outgrowths remained on the muscle fibers innervated by the parent axons. Endplates in the tibialis anterior muscles of the control and drug-treated groups were classified Complex, Intermediate or Simple according to the relative degrees of branching of the terminal arbors. The occurrence of endplate classes and muscle fiber types was correlated in the superficial and deep regions of this muscle. Complex endplates innervated fast glycolytic fibers, Intermediate endplates supplied fast oxidative glycolytic fibers, and Simple endplates served slow oxidative fibers. In response to colchicine, the endplates of the slow muscles sprouted more than those of fast muscles while the innervation of slow fiber types sprouted less than that of fast fiber types. Furthermore, intranodal sprouts were more prevalent in slow muscles and ultraterminal sprouts more numerous in fast muscles whereas intranodal sprouts predominated on fast fiber types and ultraterminal sprouts were characteristic of slow fiber types. These apparently contradictory results were reconciled when it was noted that soleus endplates were mostly Complex and Intermediate, and the extensor digitorum longus contained more Simple endplates. Thus, consistency of sprouting patterns among endplate types of the 3 muscles was recognized when the pre-existing branching patterns were considered. This indicated that the patterns of sprouting were determined by the motor neurons rather than the muscle fibers. The observed sprouting responses supported the hypothesis that colchicine treatment of motor axons caused muscle fibers to elaborate a diffusible sprout-inducing factor.

Aging↗
PubMed1984

Changes in the distribution of fast and slow forms of troponin I in some neuromuscular disorders.

As judged from the atrophy of the muscle cells, the distribution of slow and fast troponin I in type I and type II cells in peripheral neuropathies in the adults (24-67 years of age) was unaffected for long periods after denervation. Reinnervation by fast or slow nerve in chronic neuropathies usually resulted in typical fibre type grouping with complete segregation of slow and fast troponin I in type I and type II cells, respectively. Intermediate fibres (slow and fast troponin I in the same cell) were present during the course of transformation. Unlike peripheral neuropathies, the number of cells staining for slow troponin I in the very atrophic fascicles in spinal muscular atrophy was considerably reduced. The synthesis of fast troponin I was stimulated in original type I cells containing slow troponin I. These observations support the experimental data (Dhoot and Perry 1982b) that the suppression of fast troponin I in type I or presumptive type I cells requires innervation by the slow nerve. Its absence results in an increased expression of fast troponin I in cells that originally contained only slow troponin I. Once suppressed, fast troponin I is absent in type I cells even after long periods of experimental denervation or cases of human peripheral neuropathies but not so in the cases of spinal muscular atrophy.

Adult↗
PubMed1987

Fast and slow depolarizing responses of guinea-pig coeliac ganglion cells to 5-hydroxytryptamine.

Responses to 5-hydroxytryptamine (5-HT) applied by pressure ejection to guinea-pig coeliac ganglion cells were recorded intracellularly in vitro. Three types of responses were observed: a fast depolarization (43% of cells), a slow depolarization (25%) and a biphasic response comprising an initial fast followed by a slow depolarization (30%). Fast depolarizations had a mean duration of 6.4 s and were associated with a decrease in membrane input resistance. On hyperpolarizing the membrane, responses increased in amplitude; the mean reversal potential was -23 mV. Fast responses were nearly eliminated in a Na-free medium but were unaffected by low Ca/high Mg solution or by low Cl medium. Fast responses were depressed by MDL 72222, quipazine, metoclopramide, and by relatively high concentrations of D-tubocurarine, but unaffected by methysergide. Slow responses had a mean duration of 62 s and were associated either with no change or a slight fall in membrane resistance. hyperpolarizing the membrane, slow responses were increased in most but not all cells tested. Slow depolarizations were depressed by methysergide but unaffected by agents that suppressed the fast responses. The biphasic response displayed electrophysiological and pharmacological characteristics of both the fast and slow depolarizations. It is concluded that guinea-pig coeliac ganglion cells display either a rapid depolarization, a slow depolarization or a biphasic response to 5-HT, that the fast depolarization appears to be mediated by a conductance increase to Na and K, while a different mechanism appears to underlie the slow depolarization, and that the two responses are mediated by different kinds of 5-HT receptor.

Animals↗
PubMed1992

Serum hormone and metabolite concentrations in fasted young bulls and steers.

The effect of dietary energy restriction on serum insulin, insulin-like growth factor I (IGF-I), growth hormone, (GH), cortisol, plasma urea nitrogen (PUN) and nonesterified fatty acid (NEFA) concentrations was examined. Angus bulls and steers (10 mo) were allotted to two groups of 12 animals and assigned a treatment order. In a switchback design, animals in order 1 were fed a high grain diet, then fasted, while order 2 animals were fasted, and then fed. Animals were allowed 60 hr to acclimate between treatments. Serum and plasma were obtained at 20 min intervals and 60 min, respectively, for 6 hr after feeding and for the last 6 hr of a 30 hr fast. Serum was assayed for insulin, IGF-I, GH, and cortisol (total and free). Plasma was assayed for PUN and NEFA. Mean insulin (ng/ml) differed between fed (.95 +/- .08) and fasted (.26 +/- .08) animals (P less than 01). Both mean total and free cortisol (ng/ml) were lower in fed (11.48 +/- .99) (1.06 +/- .12) than in fasted (17.10 +/- .93) (1.62 +/- .12) animals, respectively (P less than .01). Animals in order 1 differed in mean IGF-I (ng/ml) between fed (199.0 +/- 8.0) and fasted (116.5 +/- 7.2) treatments (P less than .01). Mean IGF-I for animals in order 2 was 146.7 +/- 7.2 in fed and 213.9 +/- 7.2 in fasted animals (P less than .01). Mean GH did not differ between treatments. Mean PUN and NEFA were higher in fasted than in fed animals (P less than .01). Except for % free cortisol (P less than .05), the hormones did not differ between bulls and steers.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

Fast food, race/ethnicity, and income: a geographic analysis.

BACKGROUND: Environmental factors may contribute to the increasing prevalence of obesity, especially in black and low-income populations. In this paper, the geographic distribution of fast food restaurants is examined relative to neighborhood sociodemographics. METHODS: Using geographic information system software, all fast-food restaurants within the city limits of New Orleans, Louisiana, in 2001 were mapped. Buffers around census tracts were generated to simulate 1-mile and 0.5-mile "shopping areas" around and including each tract, and fast food restaurant density (number of restaurants per square mile) was calculated for each area. Using multiple regression, the geographic association between fast food restaurant density and black and low-income neighborhoods was assessed, while controlling for environmental confounders that might also influence the placement of restaurants (commercial activity, presence of major highways, and median home values). RESULTS: In 156 census tracts, a total of 155 fast food restaurants were identified. In the regression analysis that included the environmental confounders, fast-food restaurant density in shopping areas with 1-mile buffers was independently correlated with median household income and percent of black residents in the census tract. Similar results were found for shopping areas with 0.5-mile buffers. Predominantly black neighborhoods have 2.4 fast-food restaurants per square mile compared to 1.5 restaurants in predominantly white neighborhoods. CONCLUSIONS: The link between fast food restaurants and black and low-income neighborhoods may contribute to the understanding of environmental causes of the obesity epidemic in these populations.

Eating↗
PubMed2006

Possible role of avian uncoupling protein in down-regulating mitochondrial superoxide production in skeletal muscle of fasted chickens.

Little is known about the precise physiological roles of uncoupling protein 1 (UCP1) homologs (UCP2, UCP3, avian UCP) whose levels are up-regulated during fasting. UCPs in skeletal muscle are thought to play a role in the regulation of lipids as fuel substrates, and/or in controlling the production of reactive oxygen species (ROS). The aim of this investigation, using skeletal muscle from fasted chickens, was to examine alterations in the expression of genes encoding for avian UCP and key enzymes relevant to lipid flux across the mitochondrial beta-oxidation pathway. We also clarified whether an increase in avUCP content could be associated with altered ROS production by mitochondria. Transcription levels of avUCP and CPT-I genes were increased 7.7- and 9.5-fold after a 24h fast and slightly diminished but remained about 5.0- and 7.7-fold higher than baseline levels, respectively, after 48h of fasting. In contrast, members of the beta-oxidation pathway, LCAD and 3HADH, were gradually up-regulated from 12 to 48h of fasting. This suggests that processes involved in the transfer and oxidation of fatty acids are up-regulated differently during the initial stage of fasting. Analysis of ROS production by lucigenin-derived chemiluminescence showed that the FFA-sensitive portion of carboxyatractyloside-upregulated ROS production was greater in skeletal muscle mitochondria from 24h-fasted chickens compared with control, which leads us to postulate that ROS production is potentially down-regulated by UCP. The possible involvement of a backlog of fatty acid for oxidation, observed in chickens after a 24h fast, in a transmembrane gradient of free non-oxidized fatty acids is also discussed.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed2005

Purkinje cell rhythmicity and synchronicity during modulation of fast cerebellar oscillation.

Fast (approximately 160 Hz) cerebellar oscillation has been recently described in different models of ataxic mice, such as mice lacking calcium-binding proteins and in a mouse model of Angelman syndrome. Among them, calretinin-calbindin double knockout mice constitute the best model for evaluating fast oscillations in vivo. The cerebellum of these mice may present long-lasting episodes of very strong and stable local field potential oscillation alternating with the normal non-oscillating state. Spontaneous firing of the Purkinje cells in wild type and double knockout mice largely differs. Indeed, the Purkinje cell firing of the oscillating mutant is characterized by an increased rate and rhythmicity and by the emergence of synchronicity along the parallel fiber axis. To better understand the driving role played by these different parameters on fast cerebellar oscillation, we simultaneously recorded Purkinje cells and local field potential during the induction of general anesthesia by ketamine or pentobarbitone. Both drugs significantly increased Purkinje cell rhythmicity in the absence of oscillation, but they did not lead to Purkinje cell synchronization or to the emergence of fast oscillation. During fast oscillation episodes, ketamine abolished Purkinje cell synchronicity and inhibited fast oscillation. In contrast, pentobarbitone facilitated fast oscillation, induced and increased Purkinje cell synchronicity. We propose that fast cerebellar oscillation is due to the synchronous rhythmic firing of Purkinje cell populations and is facilitated by positive feedback whereby the oscillating field further phase-locks recruited Purkinje cells onto the same rhythmic firing pattern.

Anesthetics, Dissociative↗
PubMed2005

Field evaluation of a fast anti-Leishmania antibody detection assay in Ethiopia.

A fast agglutination screening test (FAST) for the detection of Leishmania antibodies in human serum samples was evaluated under harsh field conditions in northern Ethiopia. Test performance was compared with a standard serological test, namely the direct agglutination test (DAT), and with parasitology. In total, 103 suspected cases were recruited for the study. Based on parasitological examination, 49 patients were confirmed of having visceral leishmaniasis (VL) and the other 54 suspected cases were parasitologically negative. Field evaluation of FAST was possible in blood samples of 89 patients. FAST had 4 false negative results and 13 false positive results. DAT had 2 false negative results and 20 false positive results. A good degree of agreement (86.9%) was observed between FAST and DAT (kappa value 0.73). In this field-based evalauation, the sensitivity and specificity of FAST were found to be 91.1% (95% CI 77.9-97.1) and 70.5% (95% CI 54.6-82.8), respectively, compared with 95.3% (95% CI 82.9-99.2) and 62.3% (95% CI 47.9-74.9) for DAT. FAST had a high predictive value of a negative test, demonstrating that FAST could be utilised to exclude rapidly non-VL patients from a large population of suspects with fever and splenomegaly in endemic areas.

Agglutination Tests↗
PubMed1997

Atrioventricular node reentrant tachycardia in patients with a long fast pathway effective refractory period: clinical features, electrophysiologic characteristics, and results of radiofrequency ablation.

Twenty-two patients (group 1) with AV node reentrant tachycardia and a baseline fast pathway effective refractory period (ERP) > or = 500 msec were compared with 30 consecutive patients (group 2) with AV node reentrant tachycardia and a fast pathway ERP < 500 msec. Both groups underwent slow pathway ablation. In the patients with complete elimination of slow pathway, the fast pathway ERP and shortest 1:1 conduction cycle length shortened significantly after ablation but was greater in group 1 (n = 14) than in group 2 (n = 21) (125 +/- 78 msec vs 48 +/- 29 msec, p < 0.001 and 103 +/- 72 msec vs 52 +/- 30 msec, p < 0.001, respectively). In group 1, the shortening of fast pathway ERP was correlated to baseline difference between anterograde fast and anterograde slow ERP (r = 0.806, p < 0.001, slope = 1.08), and the shortening of fast pathway shortest 1:1 conduction cycle length was correlated to baseline difference between anterograde fast and anterograde slow shortest 1:1 conduction cycle length (r = 0.885, p < 0.001, slope = 1.47). During follow-up bradycardia did not develop in any patient and no one required pacing. This shortening of the fast pathway ERP and shortest 1:1 conduction cycle length after complete elimination of slow pathway reduced the concern of subsequent impairment of AV node conduction.

Adrenergic beta-Agonists↗
PubMed1997

Safety of slow pathway ablation in patients with atrioventricular node reentrant tachycardia and a long fast pathway effective refractory period.

Radiofrequency catheter ablation is an accepted primary therapy for atrioventricular (AV) node reentrant tachycardia (AVNRT). There is concern that slow pathway ablation in patients with a long anterograde fast pathway effective refractory period (ERP) may potentially impair subsequent node conduction. Eighteen patients (14 women; age 53 +/- 20 years) with symptomatic AVNRT, whose fast pathway ERP at baseline was > or = 500 ms, underwent slow pathway ablation. Their outcome was compared with 24 consecutive control patients (17 women; age 42 +/- 17 years) who underwent ablation for AVNRT whose fast pathway ERP at baseline was <500 ms (controls). Slow pathway ablation was successful in 16 patients (90%). One patient had inadvertent fast pathway ablation. In a second patient the slow pathway could not be ablated because of recurrent transient AV block. Ablation was successful in all patients in the control group. Transient AV block related to current application occurred in 4 patients (22%) versus 1 control (4%) (p = 0.07). After ablation, the AV node refractory period increased in patients (368 +/- 68 to 428 +/- 92 ms, p = 0.02) and in controls (282 +/- 35 to 336 +/- 55 ms, p <0.0001), but the fast pathway ERP shortened in both groups (patients: 558 +/- 63 to 428 +/- 92 ms, p = 0.003; controls: 356 +/- 53 to 336 +/- 55 ms, p = 0.05). Furthermore, the slope of the regression line relating to shortening of the fast pathway ERP to the baseline ERP was markedly steeper in patients compared with controls (1.9 vs 0.4, p <0.0001). The shortening of the fast pathway ERP was greater in patients compared with controls (122 +/- 130 vs 21 +/- 50 ms, p = 0.001). During a mean follow-up of 18 +/- 11 months, 1 patient with severe coronary artery disease died suddenly 2 years after ablation. There was no recurrence of clinical tachycardia, and none of the patients developed symptoms of bradycardia or required permanent pacing. Thus, slow pathway ablation in patients with AVNRT and a long fast pathway ERP is safe and effective.

Adult↗
PubMed1998

Fast dynamic contrast enhanced MR imaging of cervical carcinoma.

The first pass phase of contrast material is most important to study vascularization and perfusion of tissue and can be studied using dynamic magnetic resonance (MR) imaging. The purpose of this prospective study was to evaluate the usefulness of pre-contrast vs. post-contrast and fast dynamic MR imaging in the pre-operative staging of cervical carcinomas. To assess the normal onset of enhancement of the uterus and cervix 15 volunteers underwent dynamic MR imaging. Forty-two consecutive patients with invasive cervical cancer underwent pre-operative evaluation using MR imaging. The results of the MR examinations were correlated with clinical (FIGO) staging under anaesthesia (n = 42) and with histopathological findings after operation (n = 26). The staging results of pre-contrast T1-weighted and T2-weighted turbo spin-echo (TSE) MR images, pre-contrast MR images plus post-contrast enhanced (two dimensional fast low angle shot (FLASH 2-D) post contrast), pre-contrast MR images plus post-contrast enhanced plus fast dynamic enhanced (single slice turbo fast low angle shot (turbo FLASH)) MR images compared to histopathology (n = 26) were 77%, 81% and 85% respectively. The improvement was statistically not significant. The result of MR staging compared to clinical staging (n = 42) with pre-contrast MR images was correct in 79% of the cases. Pre-contrast MR images combined with post-contrast MR images did not significantly improve staging accuracy (83%). Pre-contrast plus post-contrast plus fast dynamic MR imaging improved staging to 91%. However, the improvement was only statistically significant for one reader (P = 0.01), whereas the improvement of the second reader was not significant (P = 0.07). The single slice turbo FLASH images showed enhancement of all squamous cell carcinomas (n = 32) with an average onset of 5s (range 4-8s) during the first 45s of bolus injection of gadolinium. The normal cervix showed enhancement with an average of 10s (range 6-14 s). FLASH 2-D post-contrast images showed less intense enhancement of the cervical tumours with respect to the parametria and other surrounding structures. Fast dynamic MR imaging and to a lesser degree post-contrast MR imaging showed a higher level of confidence than pre-contrast MR. Fast dynamic MRI compared with clinical staging (n = 42) was correct in 91% (38/42) and to histopathology in 85% (22/26). Comparison of clinical staging with histopathology was 85% (22/26). In conclusion, fast dynamic MR imaging is superior to post-contrast and pre-contrast MR imaging and is at least as good as clinical staging in the evaluation of cervical carcinoma.

Adult↗
PubMed2003

Practical approaches to fast gas chromatography-mass spectrometry.

Fast gas chromatography-mass spectrometry (GC-MS) has the potential to be a powerful tool in routine analytical laboratories by increasing sample throughput and improving laboratory efficiency. However, this potential has rarely been met in practice because other laboratory operations and sample preparation typically limit sample throughput, not the GC-MS analysis. The intent of this article is to critically review current approaches to fast analysis using GC-MS and to discuss practical considerations in addressing their advantages and disadvantages to meet particular application needs. The practical ways to speed the analytical process in GC and MS individually and in combination are presented, and the trade-offs and compromises in terms of sensitivity and/or selectivity are discussed. Also, the five main current approaches to fast GC-MS are described, which involve the use of: (1) short, microbore capillary GC columns; (2) fast temperature programming; (3) low-pressure GC-MS; (4) supersonic molecular beam for MS at high GC carrier gas flow; and (5) pressure-tunable GC-GC. Aspects of the different fast GC-MS approaches can be combined in some cases, and different mass analyzers may be used depending on the analytical needs. Thus, the capabilities and costs of quadrupole, ion trap, time-of-flight, and magnetic sector instruments are discussed with emphasis placed on speed. Furthermore, applications of fast GC-MS that appear in the literature are compiled and reviewed. At this time, the future usefulness of fast GC-MS depends to some extent upon improvement of existing approaches and commercialization of interesting new techniques, but moreover, a greater emphasis is needed to streamline overall laboratory operations and sample preparation procedures if fast GC-MS is to become implemented in routine applications.

Gas Chromatography-Mass Spectrometry↗