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10,004,300 | Chemical carcinogens from several diverse chemical classes i.e.; aromatic amines, polycyclic hydrocarbons, nitrosamines, hormonal derivatives, metals and direct alkylating agents cause a 6.2-60.5-fold increase in the frequency of murine sarcoma virus (MSV)-induced transformation in a normal rat kidney (NRK) cell system. Exogenous metabolic activation with a rat liver S-9 homogenate is required for expression of this activity by procarcinogens. Non-carcinogenic analogs of these compounds fail to cause significant increases in the transformation frequency either with or without prior metabolic activation. Iododeoxyuridine, a mutagen also does not cause enhancement of transformation. This system may serve as the basis for a rapid and quantifiable means of identifying chemical carcinogens while introducing a new model for the understanding of the interactions between oncornaviruses and chemical carcinogens. | [
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10,004,301 | The functional role of structural complexities in the propagation of depolarization in the atrium of the dog. Cardiac conduction disturbances due to discontinuities of effective axial resistivity. | [
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10,004,302 | Effects of the discrete pattern of electrical coupling on propagation through an electrical syncytium. | [
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10,004,303 | We used numerical integration techniques to simulate action potential propagation along one-dimensional strands of cells coupled with electrical junctions. We considered the standard case to be a series of cardiac cells (20 micrometer in diameter, 50 micrometers long) with intercellular coupling such that the effective longitudinal resistance was 200 omega cm. The membrane properties were represented by the model of Beeler and Reuter (1977) (Sharp and Joyner, 1980). By increasing Ri (and thus decreasing the space constant, L), we showed that effects due to the discrete cell length, delta X, became apparent when delta X/L was greater than about 0.2, producing an increased maximal dV/dt but a decrease in peak inward current. We also simulated the effects of a periodic spatial variation in Ri, representing a structure with groups of well-coupled cells but with minimal coupling between the groups. Even with a constant membrane model and cell size, variations in the spatial pattern of interconnection produced significant changes in action potential shape and velocity, with some patterns producing decremental conduction or propagation failure. | [
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10,004,304 | PH-Dependent effects of quinidine on the kinetics of dV/dtmax in guinea pig ventricular myocardium. | [
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10,004,305 | Altered left ventricular diastolic properties during pacing-induced ischemia in dogs with coronary stenoses. Potentiation by caffeine. | [
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10,004,306 | Electrophysiological and electron microscopic correlations concerning the effects of neuraminidase on canine heart cells. | [
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10,004,307 | Microcirculation of left atrial muscle, cerebral cortex and mesentery of the cat. A comparative analysis. | [
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10,004,308 | By means of transillumination (microtransilluminator and light pipe), comparative analyses were carried out on geometry, topography, and morphometry of microcirculation in the cerebral cortex, left atrial muscle, and mesentery of the cat using computer analysis. In addition, specific types of capillary distribution (concurrent, countercurrent, and asymmetric distribution) in these three organs were ascertained from images visualized on films. These parameters were related to their role in tissue oxygen supply. It was found that mean capillary diameter, mean intercapillary distance, total capillary length, and total capillary surface area differed significantly among the three organs. Differences in mean capillary tortuosity between cerebral and left atrial muscle and between left atrial muscle and mesentery also were significant. Mean capillary tortuosity in mesentery and cerebral cortex was of equal magnitude. In the cerebral cortex, a high degree of tortuosity and asymmetric capillary distribution favor tissue oxygenation. A similar situation exists in left atrial muscle, although some concurrent and countercurrent distribution could be detected. In the mesentery, the combination of high capillary tortuosity and concurrent capillary arrangement is unfavorable for tissue oxygenation. | [
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10,004,309 | Effects of pH on Na+-Ca2+ exchange in canine cardiac sarcolemmal vesicles. | [
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10,004,310 | Using highly purified sarcolemmal vesicles isolated from dog ventricles, we examined the effects of pH on Na+-Ca2+ exchange. The initial rate of Nai+-dependent Ca2+ uptake is a sigmoid function of pH. The Ca2+ uptake is inhibited at pH 6 and stimulated at pH 9 (as compared with uptake at pH 7.4). This dependence on pH suggests that the ionization state of a histidine residue may be important in Na+-Ca2+ exchange. The effects of H+ on Nai+-dependent Ca2+ uptake are partially competitive with Ca2+, although this relationship is complex. Nao+-dependent Ca2+ efflux is also sensitive to H+ and increases monotonically with pH. These effects of pH appear to be due to intrinsic interactions with the Na+-Ca2+ exchange system and are not due to an alteration of Na+-H+ exchange or membrane permeability. The effects of pH on vesicular Na+-Ca2+ exchange are apparent only at low Ca2+ and Na+ concentrations. Thus modulation of vesicular Na+-Ca2+ exchange by pH is manifest only under ionic conditions which exist intracellularly in intact myocardium. Since the negative inotropy caused by acidosis is thought to reflect a fall in internal pH, these results suggest that alteration of sarcolemmal Ca2+ transport (medicated by Na+-Ca2+ exchange) by internal pH may contribute to the regulation of myocardial contractility by pH. | [
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10,004,311 | Role of renal nerves, angiotensin II, and prostaglandins in the antinatriuretic response to acute hypercapnic acidosis in the dog. | [
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10,004,312 | Although clinical studies suggest that chronic hypercapnic acidosis may be associated with renal sodium retention, little information is available on the effect of acute hypercapnic acidosis on renal sodium excretion. We, therefore, increased PCO2 from 23 to 74 mm Hg in anesthetized dogs and observed a marked antinatriuresis as absolute sodium excretion (235 to 60 muEq/min, P less than 0.001) and fractional excretion of sodium (4.0 to 1.2 %, P less than 0.02) decreased significantly. This decrease in sodium excretion occurred independent of consistent changes in renal perfusion pressure, PO2, glomerular filtration rate, renal blood flow, extraction of P-aminohippuric acid, and filtration fraction. The antinatriuretic response to acute hypercapnic acidosis could be attenuated significantly by surgical renal denervation, intrarenal phenoxybenzamine, and by intrarenal infusion of 1-sarcosine,8-glycine angiotensin II. Administration of 10 mg/kg indomethacin enhanced the antinatriuretic response to hypercapnic acidosis in denervated kidneys. These results suggest that renal alpha-adrenergic nerves and the renal angiotensin system result in an antinatriuretic effect during acute hypercapnic acidosis. Renal prostaglandins or related substances may serve to attenuate this antinatriuretic response. | [
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10,004,313 | Non-hydrostatic pulmonary edema after coronary artery ligation in dogs. Protective effect of indomethacin. | [
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10,004,314 | Pulmonary edema which develops during acute myocardial infarction is generally believed to result solely from pulmonary microvascular hypertension. However, patient with myocardial infarction and pulmonary edema occasionally are found to have normal pulmonary wedge pressure. We report data indicating that pulmonary edema develops after coronary artery ligation despite stable microvascular pressure. Four groups of open-chest dogs were studied: (1) nine dogs with left anterior descending coronary artery ligation, (2) seven dogs with sham coronary ligation, (3) seven dogs ligated after beginning an infusion of indomethacin (5 mg/kg per hr), and (4) five dogs ligated after an infusion of the drug's vehicle was begun. Extravascular lung water and pulmonary blood volume were measured at hourly intervals during the 2 hours before and after coronary ligation or sham ligation. Gravimetric lung water was measured immediately thereafter. Changes of net pulmonary intravascular driving force (the difference of microvascular hydrostatic and oncotic pressure) after ligation or sham ligation were small and comparable in all groups. Pulmonary blood volume did not change in any group. Pulmonary extravascular water volume remained constant in the sham group but rose significantly in the ligated group. Gravimetric lung water also was significantly higher in the latter group. We interpret these results to indicate that factors other than microvascular pressure can mediate the formation of these results to indicated that factors other than microvascular pressure can mediate the formation of edema during acute myocardial infarction; increased pulmonary microvascular permeability may be responsible. Indomethacin infusion blocked the formation of edema after coronary ligation, even though net microvascular driving force was highest in this group. Infusion of the vehicle alone did not prevent edema. The mechanism by which indomethacin exerts this protective effect is unclear but is probably a result of its inhibition of cyclo-oxygenase or cyclic nucleotide phosphodiesterase. | [
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10,004,315 | Intracardiac extrastimulation studies: How to? Where? By whom? | [
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10,004,316 | Prolongation of atrioventricular conduction time by electrical stimulation of the carotid sinus nerves in man. | [
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10,004,317 | Electrical stimulation of the carotid sinus nerves was applied during diagnostic catheterization of two patients who had coronary artery disease. The immediate reflex prolongation of the atrioventricular (AV) interval was due to prolongation of the AH interval only and was roughly parallel to the reflex RR interval prolongation evoked without atrial pacing. After cholinergic block, the reduced prolongation of both the RR interval and the AV interval caused by reflex inhibition of sympathetic tone followed a time course similar to the arterial pressure decrease. This is the first demonstration in man of the parallel baroreflex effects on the sinoatrial node and the AV node. | [
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10,004,318 | Influence of heart rate and inhibition of autonomic tone on the QT interval. | [
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10,004,319 | To evaluate whether heart-rate-induced changes of the QT interval are dependent on autonomic tone, we studied 13 healthy subjects, mean age 67.5 years. The maximal uncorrected QT from leads I, II, V1 and V6 was determined during atrial pacing at 90 beats/min and 130 beats/min before and after i.v. administration of propranolol, 0.1 mg/kg, and atropine, 0.02 mg/kg. Significant reductions (p less than 0.01) of QT were induced by the paced increases in heart rate before drugs (10%), after propranolol (10%) and after the combination of atropine and propranolol (9%). Propranolol caused no significant change in the QT interval when heart rate was held constant by pacing. In contrast, atropine produced rate-independent reductions of QT interval (5%) in subjects with beta-adrenergic blockade (p less than 0.05). Bazett's formula for heart-rate correction of the QT interval (QTc) was not applicable for atrial overdrive pacing, as it gave proportionately longer QTc values at higher heart rates. These results show that heart rate is a major determinant of the duration of the QT interval and that paced changes in heart rate induce QT-interval responses that are essentially uninfluenced by autonomic tone. The rate-dependent effect of the QT interval produced by elimination of cholinergic tone suggests a direct influence of cholinergic activity on the repolarization of ventricular myocardium. | [
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10,004,320 | The effect of high lung conductivity on electrocardiographic potentials. Results from human subjects undergoing bronchopulmonary lavage. | [
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10,004,321 | The effect of increased lung conductivity on ECG potentials was studied in human subjects undergoing pulmonary lavage of a whole lung. In this procedure, the air in the lung is replaced by physiologic saline solution, which is a highly conductive fluid. The same situation was simulated theoretically with an eccentric spherical model of the heart and torso. Both the experimental results and theoretical simulations show a decrease in body-surface potentials as the lung conductivity increases. In particular, a large decrease was observed in the posterior vector and the scalar Z lead both experimentally and theoretically. The model simulation shows that the scalar Z lead is maximal at a conductivity value that is very close to the typical normal lung conductivity, so that low voltages are predicted for low lung conductivities as well. | [
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10,004,322 | Survival of patients with a strongly positive exercise electrocardiogram. | [
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10,004,323 | To assess the prognosis of patients with a strongly positive exercise ECG, the 5-year cumulative survival rate was computed for 220 medically treated patients. Of these patients, 107 had coronary angiograms (group A) and 113 did not (group B). All had horizontal or downsloping ST depression greater than or equal to 2 mm during a multistage Bruce protocol treadmill exercise test. In group A, the overall 5-year survival rate was 74 +/- 5%. Survival decreased with decreasing duration of exercise: All patients who achieved stage IV (541 seconds or more) survived, whereas the survival rate was 86 +/- 6% when the patients terminated their exercise during stage III (361 - 540 seconds), 73 +/- 7% when during stage II (181 - 360 seconds) and only 52 +/- 13% when during stage I (180 seconds or less). The mortality was associated with more severe coronary artery disease, and sudden death was the main cause of death. Patients in group B had a longer mean exercise duration than those in group A and, as expected, a higher survival rate (91 +/- 3%, p less than 0.01), which also varied according to the exercise duration. Among patients with a strongly positive exercise ECG, the duration of exercise identifies subsets that have different survival rates. | [
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10,004,324 | Clinical classification of cardiac deaths. | [
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10,004,325 | One hundred forty-two deaths among 743 men ages 50 - 65 years who had been examined and followed 5 - 10 years were investigated and classified on the basis of clinical information from medical and non-medical observers, ECGs and autopsies. A classification based on the condition of the circulation immediately before death appears to be most relevant to studies of sudden death. In 58% of the cases, the subjects collapsed abruptly and his pulse ceased without prior circulatory collapse (arrhythmic death); in 42%, the pulse ceased only after the peripheral circulation had collapsed (deaths in circulatory failure). Thirty-three percent of arrhythmic deaths and 10% of deaths in circulatory failure occurred in a setting of clinical evidence of acute ischemic heart disease (p less than 0.005). Forty-five percent of arrhythmic deaths were preceded by chronic congestive heart failure without circulatory collapse. Ninety-three percent of final illnesses that lasted less than 1 hour ended in arrhythmic deaths; 74% lasted more than 1 day ended in deaths in circulatory failure (p less than 0.001). Eighty-eight percent of deaths that occurred outside of the hospital were arrhythmic; 71% of deaths that occurred in the hospital were deaths in circulatory failure (p less than 0.001). Ninety percent of deaths in which the primary cause of the final illness was heart disease were arrhythmic; 86% of deaths in which the primary cause was other than heart disease were deaths in circulatory failure (p less than 0.001). Ninety-one percent of deaths precipitated by an acute cardiac event were arrhythmic; 98% precipitated by acute respiratory obstruction, hemorrhage, infection, stroke or other noncardiac events were deaths in circulatory failure (p less than 0.001). | [
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10,004,326 | The effects of cigarette smoke and nicotine on platelet thrombus formation in stenosed dog coronary arteries: inhibition with phentolamine. | [
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10,004,327 | This study was undertaken to examine in vivo the effects of cigarette smoke on cyclic reductions in coronary flow due to platelet thrombus formation in the stenosed coronary arteries of anesthetized dogs. The circumflex coronary artery of 21 mongrel dogs was stenosed 60 - 80%, with blood flow measured with an electromagnetic flow probe. After the administration of cigarette smoke, plasma epinephrine was elevated nine times the control level (p less than 0.001) and peak mean blood pressure was elevated one and one-half times control (p less than 0.01). The hematocrit increased several percent (p less than 0.01) with cigarette smoke, although blood gases and pH remained unchanged. In all 21 dogs, spontaneous reductions in coronary blood flow were greatly exacerbated in the stenosed circumflex artery as evidenced by the number of flow reductions, the increased size of the reductions and the rate of flow reduction. Nicotine administered intravenously in doses comparable to those achieved through absorption of cigarette smoke by the lungs provoked similar responses of alpha-adrenergic stimulation and potentiation of the platelet thrombus formation. An alpha-adrenergic antagonist, phentolamine, was given (3 mg/kg) intravenously to inhibit the exacerbated platelet thrombus formation due to cigarette smoke or infused nicotine. In 18 of 21 dogs, an acute occlusive platelet thrombus was prevented 15 minutes after phentolamine and after phentolamine and after a cigarette smoke or nicotine challenge. This study confirms a link between cigarette smoking, platelet formation, and the potential for humans to develop an acute occlusive platelet thrombus in a diseased and stenotic coronary artery. | [
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10,004,328 | Changes in plasma lipid and lipoprotein levels in men and women after a program of moderate exercise. | [
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10,004,329 | Levels of high-density lipoprotein (HDL) cholesterol and other lipids and lipoproteins of 24 men and 37 women were measured before and after a 10-week exercise program. The program involved three sessions of aerobic exercise each week, with 15-20 minutes of activity at 70% of maximal heart rate. Men and women had significantly different lipid patterns in response to exercise, despite equivalent increases in maximal oxygen uptake. Men showed a 5.1% increase in HDL cholesterol, a 6% decrease in low-density lipoprotein (LDL) cholesterol, and a 12.4% increase in the HDL/LDL ratio. In contrast, women showed a 1% decrease in HDL cholesterol, a 4.3% decrease in LDL cholesterol, and no significant change in HDL/LDL ratio. The number of sessions attended correlated positively with HDL/LDL changes in men and correlated negatively with HDL/LDL changes in women. These findings suggest that moderate exercise may have different effects on men and women. | [
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10,004,330 | Left ventricular function in trained and untrained healthy subjects. | [
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10,004,331 | Left ventricular function was compared in 18 normal sedentary controls (mean age 28 years, range 22 - 34 years) and nine endurance-trained athletes (mean age 19 years, range 15 - 25 years) at rest and during supine bicycle exercise. Gated radionuclide angiocardiograms were performed at rest and at each level of graded maximal supine bicycle exercise. Heart rate, blood pressure, left ventricular ejection fraction and the relative changes in left ventricular end-diastolic and end-systolic volumes were assessed. Athletes attained a much greater work load than controls (mean 22.1 kpm/kg body weight vs 13 kpm/Kg body weight). Both groups achieved similar increased in heart rate, blood pressure and ejection fractions. In the controls, the mean end-diastolic volume increased to 124% of that at rest (p less than 0.02) during exercise and the mean end-systolic volume decreased to 81% of the rest level (p less than 0.02). In contrast, the mean end-diastolic volume did not significantly change during exercise in the athletes, and the mean end-systolic volume decreased to 64% of rest (p less than 0.05). Thus, although trained and untrained healthy subjects had similar increases in the left ventricular ejection fraction during exercise, different mechanisms were used to achieve these increases. Untrained subjects increased end-diastolic volumes, whereas trained subjects decreased the end-systolic volumes. The ability of athletes to exercise without increasing preload may be an effect of training amd might have important implications in reducing myocardial oxygen demand during exercise. | [
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10,004,332 | Acute hemodynamic responses to sublingual nifedipine: dependence on left ventricular function. | [
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10,004,333 | Studies of amiodarone during experimental myocardial infarction: beneficial effects on hemodynamics and infarct size. | [
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10,004,334 | The effect of amiodarone was investigated in a canine model of myocardial infarction. The left anterior descending coronary artery was occluded in 24 anesthetized dogs. After 15 minutes of coronary artery occlusion, the ischemic myocardium at risk of necrosis was determined by labeling the heart with technetium-99m-labeled human albumin microspheres injected into the systemic circulation through the left atrium, and the dogs were than randomized to either a saline-treated control group (n = 13) or an amiodarone-treated group (n = 11) that received i.v. amiodarone, 10 mg/kg, administered in a single bolus 30 minutes after coronary artery occlusion. Myocardial infarct size was determined directly after 6 hours of coronary occlusion by incubation of sections of myocardium in triphenyltetrazolium chloride, a dehydrogenase stain, and expressed as a percentage of left ventricle below occlusion. Autoradiography of the stained myocardial sections was performed to determine the ischemic myocardium at risk of necrosis, which was similar in the control and amiodarone-treated groups (31.8 +/- 2.8% vs 32.5 +/- 3.3% of the left ventricle, respectively). In the amiodarone-treated group, only 67.1 +/- 8.4% of the myocardium at risk became necrotic; in the control group, 97.5 +/- 7.7% of the myocardium at risk became necrotic (p less than 0.01), representing 21.8 +/- 3.5% vs 31.1 +/- 2.8% of the left ventricle below occlusion, respectively (p less than 0.025). Amiodarone decreased heart rate, contractility and afterload. Its beneficial action on infarct size is related presumably to reduced myocardial oxygen demand. | [
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10,004,335 | The role of right ventricular systolic dysfunction and elevated intrapericardial pressure in the genesis of low output in experimental right ventricular infarction. | [
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10,004,336 | To elucidate the pathophysiology of severe right ventricular infarction (RVI), isolated RVI was produced in 15 dogs with the pericardium intact or open. After RVI in dogs with the pericardium intact, RV systolic pressure decreased by 27%, aortic pressure by 29% and cardiac output by 34%. RV transmural pressure, RV end-diastolic size and intrapericardial pressure increased, left ventricular transmural pressure and end-diastolic size decreased and the diastolic pressures equalized. Pericardiotomy after RVI resulted in increased ventricular transmural pressures and diastolic size, improved cardiac output and resolution of equalized diastolic pressures. RVI in dogs with the pericardium open resulted in similar changes, but of lesser magnitude and without equalization of diastolic pressures. These results indicate that reduced left ventricular preload due to impaired RV systolic function contributes to low cardiac output in RVI. Elevated intra-pericardial pressure further reduced left ventricular preload and produces equal diastolic pressures. | [
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10,004,337 | Effects of hydralazine on coronary blood flow and myocardial energetics in congestive heart failure. | [
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10,004,338 | The acute effects of oral hydralazine, 1 mg/kg, on coronary vascular resistance, coronary blood flow (estimated using the coronary sinus thermodilution technique), and myocardial oxygen consumption were evaluated in 10 patients with chronic (New York Heart Association class III and IV) nonischemic congestive heart failure. Central hemodynamic responses demonstrated a modest decrease in mean arterial pressure, pulmonary capillary wedge pressure and systemic vascular resistance (12%, 15% and 29%, respectively), while the cardiac index increased from 2.3 +/- 0.1 to 3.1 +/- 0.3 and left ventricular stroke work index from 24 +/- 3.7 to 28 +/- 3.4 (p less than 0.01). Heart rate and diastolic filling time did not change. Coronary blood flow increased approximately 50%, from 144 +/- 17 to 218 +/- 30 ml/min, and coronary vascular resistance decreased from 0.55 +/- 0.09 to 0.36 +/- 0.08 mm Hg/ml/min (both p less than 0.01). Oral hydralazine increased myocardial oxygen consumption by 33%, from 15 +/- 1.6 to 20 +/- 2.7 ml/min. Despite this moderate augmentation in myocardial oxygen consumption, the arterial-coronary sinus oxygen difference decreased from 104 +/- 6.2 to 94 +/- 7.5 and the myocardial oxygen extraction ratio decreased from 71% to 64% (both p less than 0.05). The ratio of coronary vascular resistance to systemic vascular resistance decreased with hydralazine therapy, while coronary blood flow increased from 3.5% to 4.3 % of total cardiac output. In this group of patients with nonischemic cardiomyopathy, hydralazine had a favorable effect on the coronary circulation and improved the critical myocardial oxygen supply-demand ratio. | [
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10,004,339 | Effect of coronary blood flow on thallium-201 uptake and washout. | [
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10,004,340 | Myocardial uptake and washout of thallium-201 (201TI) were studied in an experimental dog model in which regional blood flow to the posterior wall was varied by transient 2-minute occlusion of the circumflex coronary artery to produce transient ischemia and reactive hyperemia. Thallium-201 myocardial activity in a region of interest was determined continuously after i.v. administration by a gamma camera and computer program. Activity in the posterior wall was compared with that in the anterior wall in the same dog and the posterior wall of control dogs. Thallium-201 uptake was directly related to blood flow. With reactive hyperemia, there was a rapid and absolute increase in uptake followed by rapid washout; with ischemia, there was slow and decreased uptake followed by a slow washout. The calculated myocardial activity during washout in both ischemic and hyperemic areas approached values in control dogs long after blood flow had returned to baseline levels. Significant differences in washout slopes were found between the three groups of dogs (-0.156%/min in control dogs, -0.244%/min after reactive hyperemia, and -0.076%/min after transient ischemia, with half-washout times of 5.3 hours, 3.4 hours and 11.0 hours, respectively). These data suggest that both the initial decrease in activity in the ischemic area and the initial excess in the hyperemic area are corrected by different washout rates of ischemic and hyperemic cells during redistribution. | [
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10,004,341 | Gamma camera quantitation of thallium-210 redistribution at rest in a dog model. | [
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10,004,342 | Defects seen at rest on thallium-201 (201TI) scintigraphy can disappear over time. We obtained sequential 5-minute scans over 127 +/- 9.4 minutes in seven open-chest dogs with fixed, stable regional flow reductions (normal zone flow 0.76 +/- 0.09 ml g-1/min, ischemic zone flow 0.49 +/- 0.04 ml g-1 min [mean +/- SEM], p less than 0.05) as determined by microsphere injection. Sequential 5-minute scans were obtained after i.v. injection of 1.5 mCi of 201TI. Data were stored in a 64 x 64 pixel computer matrix. Qualitatively, defects that showed redistribution were seen in all dogs. Quantitatively, greater count loss from peak activity distinguished the normal zone, but overlap was great. Alternate quantitative methods using background subtraction altered the characteristics of the time-activity curves, but did not enhance the separation of ischemic from normal zones. Patterns of 201TI redistribution from gamma camera imaging are profoundly influenced by the method of quantitation. No single method of quantitative analysis separated ischemic from normal zones in all dogs. The clinical significance of patterns at rest requires redefinition. | [
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10,004,343 | The phase image: its relationship to patterns of contraction and conduction. | [
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10,004,344 | To determine the relationship of phase changes and abnormalities of ventricular contraction and conduction, we performed phase image analysis of blood pool scintigrams in 29 patients. Eleven patients had no evidence of blood pool contraction or ECG conduction abnormalities, four had contraction abnormalities, seven had abnormal conduction and seven had abnormalities of both variables. The phase delay generally related to the degree of contraction abnormality. The mean phase delay in hypokinetic segments differed from that in normokinetic segments in the same patient (p less than 0.025), the phase delay of akinetic and dyskinetic segments differed from that in normokinetic segments (p less than 0.001) and the phase delay in dyskinetic segments differed from that in akinetic segments (p less than 0.005), but there was a significant overlap in the phase delay in normal and hypokinetic segments. Also, in patients with conduction abnormalities, the minimal associated regional phase delay presented a phase dispersion and a pattern of contraction consistent with the pattern of conduction and different from normal. A single study performed both at rest and with stress demonstrated the effect of heart rate on phase assessment and confirmed the independent effects of contraction and conduction on phase delay. Acquisition and analytic methods should add significantly to the resolution of the phase method. | [
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10,004,345 | Comparative value of the cold-pressor test and supine bicycle exercise to detect subjects with coronary artery disease using radionuclide ventriculography. | [
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10,004,346 | Quantitative analysis of segmental wall motion throughout systole and diastole in the normal human left ventricle. | [
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10,004,347 | We traced left ventricular contours, frame-by-frame throughout systole and diastole, of normal sinus beats from 30 degrees right anterior oblique ventriculograms from 32 normal patients. We separated both systole and diastole into 19 equal time intervals each and calculated regional lengths (R), normalized by both end-diastole length and relative time interval (T) in systole and diastole and diastole, for the middle inferior wall, distal inferior wall, apex, distal anterior wall, middle anterior wall, and proximal anterior wall. We also computed the relative velocities of R, delta R/ delta T, over each quarter of systole and diastole. Comparing systole with diastole, we found significant differences between paired values of R at all regions except the distal inferior wall, but these differences were not the same between regions. Between regions, mean R and delta R/ delta T values were significantly different as early as the first quarter of systole. Within a region, there were significant differences between mean R and delta R/ delta T values over intervals as short as one-fourth of systole or diastole. Thus, there is no homogeneity between regions in normal wall motion in both systole and diastole. This normal lack of homogeneity has important clinical implications for identifying abnormal wall motion in individual patients from ventriculographic measurements, and for using the information present in the diastole portion of the ventriculogram to characterize normal segmental function. | [
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10,004,348 | Noninvasive visualization of the dilated main coronary arteries in coronary artery fistulas by cross-sectional echocardiography. | [
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10,004,349 | Real-time cross-sectional echocardiographic studies of the main coronary arteries were performed in 20 normal subjects, 12 patients with patent ductus arteriosus and 14 patients with coronary artery fistula in whom the diagnosis was established by angiography. In 12 patients, the coronary artery that formed the fistula was dilated: The right coronary artery was involved in eight and the left coronary artery in four. The dilated coronary artery appeared as two dominant parallel echoes of wide lumen originating from the aorta in the region of the involved artery. Th echo diameter of the coronary artery correlated well with the angiographically estimated diameter of the artery. In the normal subjects and the patients with patent ductus arteriosus, we found no echocardiographic findings of coronary artery dilatation. This study demonstrates that cross-sectional echocardiography is useful in identifying the dilated coronary artery in coronary artery fistula and distinguishing this entity from patent ductus arteriosus. | [
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10,004,350 | Effect of cough on coronary perfusion pressure: Does coughing help clear the coronary arteries of angiographic contrast medium? | [
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10,004,351 | Pulsus alternans determined by biventricular simultaneous systolic time intervals. | [
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10,004,352 | This investigation was performed to determine the presence of unilateral or bilateral pulsus alternans in the systemic and pulmonary circulations in heart failure and to estimate the prevalence of pulsus alternans in congestive cardiomyopathy. The subjects were 36 adult patients in heart failure due to a variety of cardiopulmonary diseases. We measured left- and right-sided systolic time intervals from simultaneous dual echocardiograms of both semilunar valves. The alternans was left-sided in seven patients, right-sided in one patient and bilateral in six patients. Pulsus alternans was induced by ventricular premature complexes (VPCs), except in one patient with bilateral and persistent alternans. For a VPC to precipitate alternans, the early beat itself must be associated with an abbreviated ejection time. Echophonocardiographic records of 100 patients with congestive cardiomyopathy were reviewed for evidence of pulsus alternans. We found persistent alternans in 10 patients and VPC-induced alternans in seven patients. We could not measure any difference in severity of disease in patients with pulsus alternans compared with those without. | [
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10,004,353 | Termination of ventricular tachycardia by carotid sinus massage. | [
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10,004,354 | Intracardiac electrophysiologic studies were performed in two patients who had recurrent sustained ventricular tachycardia. In both, the tachycardia was repeatedly terminated by carotid massage. In one patient, intracardiac electrophysiologic studies revealed ventricular tachycardia with 2:1 retrograde ventriculoatrial (VA) block. Carotid massage resulted in alternate Wenckebach retrograde VA conduction terminated by ventricular echo beats. When ventricular echo beats occurred at a coupling interval of 340 - 400 msec, the tachycardia was terminated. Similarly, induced atrial depolarizations (during ventricular tachycardia) produced ventricular capture and terminated the tachycardia when the resultant ventricular coupling interval was 330 - 395 msec. In the second patient, progressively premature atrial or ventricular depolarizations did not terminate the tachycardia. carotid massage had no consistent effect on retrograde VA conduction during ventricular tachycardia, but usually resulted in gradual increases in the tachycardia cycle length (50 - 100 msec) before abrupt termination of the tachycardia. This is the first report documenting termination of ventricular tachycardia by carotid massage alone (i.e., without prior drug intervention); hence, tachycardia termination by simple carotid sinus massage does not prove a supraventricular origin. The mechanism of tachycardia termination was due to ventricular echo beats from retrograde atrioventricular nodal reentry in one patient and to direct vagal effects on either the ventricular muscle or the ventricular specialized conduction system in the other. | [
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10,004,355 | Ejection performance in AS. | [
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10,004,356 | Irreversible coronary occlusion and ergonovine. | [
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10,004,357 | First-pass technique and diastolic phenomena. | [
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10,004,358 | Probability of CAD. | [
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10,004,359 | Can myocardial ischemia be imaged with technetium-99m-Sn-2+-pyrophosphate? | [
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10,004,360 | Manual for evaluation of lung function by spirometry. Prepared by the Cardiopulmonary Council of the American Heart Association. | [
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10,004,361 | Laboratory evaluation of the Boehringer Mannheim "Diagnostic M" automated discrete analyzer. | [
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10,004,362 | We evaluated a new multiple-channel chemistry analyzer, the Boehringer Mannheim "Diagnostic M." This instrument can perform 25 tests at the rate of 120 1.3-mL serum samples per hour. The instrument may be run in either a profile mode or single-test mode. In the single-test mode only the necessary reagent is pumped. the instrument is computer controlled. We compared it with the Technicon SMAC, SMA 12/60, and SMA 6/60. It demonstrated excellent precision, linearity, lack of interference, ease of operation, and satisfactory comparison with values obtained by the Technicon methods. | [
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10,004,363 | Assays of serum lipase by the "BALB-DTNB method" mechanized for use with discrete and continuous-flow analyzers. | [
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10,004,364 | We successfully adapted the dimercaprol (BAL) tributyrate-5,5'-dithiobis(2-nitrobenzoic acid) method (J. Biochem. 81: 361, 1977) for assay of lipase in human serum to a discrete analyzer (the TBA 880) (I) or a continuous-flow analyzer (AutoAnalyzer, Type II) (II). In both, BAL-tributyrate is used as substrate, in combination with serum esterase inhibitors and a chromogenic reagent for the SH group of the liberated BAL. Serum lipase activities of patients with pancreatic diseases, measured at 90 or 40 samples per hour by I or II, respectively, correlated well with those measured by the corresponding manual method or by Kaplan's radioassay (Anal. Biochem. 33: 213, 1970). The correlation coefficients were all greater than 0.95, and the coefficients of variation were less than 8%, showing the practical usefulness of these procedures. | [
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10,004,365 | An enzymic, reaction-rate assay for serum creatinine with a centrifugal analyzer. | [
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10,004,366 | We describe a procedure for specific, rapid, kinetic determination of creatinine, in which a manual coupled-enzyme micro-scale assay is adapted to a centrifugal analyzer. The creatinine reaction is ultimately linked to NADH utilization, which is measured by the absorbance change at 340 nm. This procedure requires 15 microL of serum and the standard curve is linear to a creatinine concentration of 200 mg/L. A four-point kinetic algorithm allows the dynamic range of the assay to be extended without sacrificing sensitivity, and makes a separate serum blank unnecessary. The within-run precision (CV) for samples with a creatinine concentration of 11 and 52 mg/L was 5.6 and 2.4%, respectively; day-to-day CV for a creatinine concentration of 11 mg/L was 7.7% (n = 21). We compared this procedure with a kinetic Jaffé procedure, with excellent agreement (r = 0.996; y = 0.96x + 2.4 mg/L). Bilirubin, non-esterified fatty acids, and ketone bodies do not affect creatinine determinations by this method; thus the method is especially useful for monitoring the renal function of diabetics. | [
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10,004,367 | Detergent activation of the binding protein in the folate radioassay. | [
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10,004,368 | A minor cow's whey protein associated with beta-lactoglobulin is used as binding protein in the competitive radioassay for serum and erythrocyte folate. Seeking to optimize the assay, we tested the performance of binder solutions of increasing purity. The folate binding protein was isolated from cow's whey by means of CM-Sepharose CL-6B cation-exchange chromatography, and further purified on a methotrexate-AH-Sepharose 4B affinity matrix. In contrast to beta-lactoglobulin, the purified protein did not bind folate unless the detergents cetyltrimethylammonium (10 mmol/L) or Triton X-100 (1 g/L) were present. Such detergent activation was not needed in the presence of serum. There seems to be a striking analogy between these phenomena and the well-known reactivation of certain purified membrane-derived enzymes by surfactants (lipids/detergents). | [
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10,004,369 | Evaluation of a commercially available radioimmunoassay kit for measurement of doxorubicin in plasma. | [
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10,004,370 | We evaluated a commercially available (Diagnostic Biochemistry Inc.) doxorubicin 125I radioimmunoassay kit. This kit gave a high apparent doxorubicin concentration (greater than 12 micrograms/L), which was not linearly related to dilution, for two pools of normal human serum and plasma and also for samples collected from patients before they received the drug. In contrast, a doxorubicin 3H radioimmunoassay developed by us gave a low blank (2 micrograms/L), which was linearly related to dilution, for the same pools and patients' samples. Doxorubicin concentrations in the plasma of patients receiving the drug were compared by the two methods; the kit gave results five- to 10-fold those obtained with our assay. High nonspecific interference by serum and plasma as measured by the 125I radioimmunoassay must therefore be borne in mind by users of the kit, and we suggest that results should be corrected for these nonspecific effects. | [
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10,004,371 | Reference intervals for serum IgG, IgA, IgM, C3, and C4 as determined by rate nephelometry. | [
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10,004,372 | We report reference intervals for IgG, IgA, IgM, C3, and C4 for a population of 750 well children and 120 healthy adults. Ranges were established by rate nephelometry (previous studies have been based on immunodiffusion). Our results generally agree with previously established immunoglobulin ranges, except for some disagreement as to ages when adult values are attained. | [
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10,004,373 | Comparative evaluation of two calcium ion-selective electrode systems, and their utility for monitoring steady-state changes in [Ca2+]. | [
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10,004,374 | We compared ionized calcium concentrations ([Ca2+]) as measured with two ionized-calcium analyzers: the NOVA 2 and the Orion SS-20. Samples were obtained from 43 human volunteers, 213 patients, and five dogs (106 samples). In the [Ca2+] range of 0.85 to 1.8 mmol/L, [Ca2+] measurements in whole blood with the NOVA 2 consistently exceeded those measured with the Orion SS-20. However, in the normal range, this difference appeared to be smaller when we compared values for plasma or serum, and was absent over the entire range when we compared aqueous solutions. The normal human [Ca2+] in whole blood as measured with the NOVA 2 is 1.22 +/- 0.01 mmol/L (mean +/- SEM) and that with the Orion SS-20 is 1.12 +/- 0.01 mmol/L (p less than 0.0001 by paired t-test); the 95% confidence intervals were from 1.14 to 1.30 and from 1.02 to 1.22 mmol/L, respectively. Using dogs, we also tested the usefulness of the ionized-calcium electrode for monitoring [Ca2+] during infusion of either citrate or calcium chloride solutions, to produce steady-state alterations in [Ca2+] equilibrium. Frequent successive [Ca2+] measurements were essential to appropriately adjust the infusion rates of these solutions to achieve steady-state [Ca2+]. | [
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10,004,375 | Gas-chromatographic/mass spectrometric detection of 3-hydroxy-3-methylglutaryl-CoA lyase deficiency in double first cousins. | [
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10,004,376 | Gas chromatography/mass spectrometry was used for the detection of 3-hydroxy-3-methylglutaryl-CoA lyase (EC 4.1.3.4) deficiency in double first cousins. This enzyme is in the last step of leucine catabolism and is also involved in ketogenesis. Quantitation of urinary organic acids as their cyclohexyl esters demonstrated increased concentrations of 3-hydroxy-3-methylglutaric acid, 3-methylglutaconic acid, 3-methylglutaric acid, and 3-hydroxyisovaleric acid. The procedure is more rapid, sensitive, and specific than previously reported gas-chromatographic methods for acid quantitation. The affected children initially presented with symptoms similar to Reye's syndrome; the acids were quantitated during periods of altered intake of protein and fat. Both leucine and fat intake contributed to increased acid excretion. These studies suggest that life-threatening episodes of hypoglycemia are best prevented with a low-protein, low-fat diet. | [
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10,004,377 | Measurements of serum colloid osmotic pressure are of limited usefulness. | [
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10,004,378 | We examined the usefulness of serum colloid osmotic pressure measurement in patients with chronic rather than acutely occurring low serum protein concentrations. We used two oncometers, the IL 186 Weil Oncometer and the Wescor Model 4100; results from the two instruments were interchangeable. Values for the colloid osmotic pressure were compared with those for serum total protein (r = 0.783) and albumin concentrations (r = 0.882), which were similar to previously published values. Our day-to-day CV was 2.8%. In studying over 100 patients we found that the previously reported occurrence of pulmonary edema in almost all patients whose colloid osmotic pressure was less than 12.5 mmHg was not seen in the chronic hypoproteinemic patients. We noted only one fatality in our patients whose colloid osmotic pressure was less than 10.5 mmHg, a value found to be associated with fatality in one previous study of acutely ill patients. Factors such as ambulation, fasting, dehydration, and the nature of the blood sample can markedly affect the value for colloid osmotic pressure value, and this, coupled with the good correlation with the serum albumin in several studies, leads us to question the usefulness of measuring colloid osmotic pressure in a non-specialist hospital environment, either as an adjunct to the measurement of serum protein or albumin, or as an independent test. | [
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10,004,379 | Two serum pancreatic isoamylase determinations compared. | [
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10,004,380 | Serum pancreatic isoamylase activity was measured by a method involving inhibition of salivary isoamylase and by a well-known agarose electrophoretic method, modified by us. We saw changes in electrophoretic patterns of pancreatic isoamylase fractions after storage of serum samples for three weeks at 4-8 degrees C, but with the inhibition method no alterations in activities were found. Within-assay and between-assay imprecisions of both methods were about the same. Serum pancreatic amylase activities as measured by the inhibition method exceeded by about 10% those obtained by the electrophoretic method. The inhibition method seems to be a reasonable candidate for routine application, whereas the electrophoretic method is still time-consuming and requires special skill to perform. Some suggestions are given for improving the calibration of the inhibition method recommended by the manufacturer. | [
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10,004,381 | Turnover rate of skeletal alkaline phosphatase in humans. | [
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0.032096780836582184,
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... |
10,004,382 | Two patients with Paget's disease of bone were subjected to plasmapheresis. Alkaline phosphatase activities of serum declined sharply, but returned to preplasmapheresis values within eight to 10 days. The biological half-life of circulating skeletal alkaline phosphatase, as calculated from these experiments, is between 1.12 and 2.15 days. | [
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0.034083154052495956,
0.0410916... |
10,004,383 | Stability of frozen liquid control sera for assay of cholesterol in high-density lipoprotein. | [
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10,004,384 | Liquid serum pools with low-, normal-, or above-normal concentration of high-density lipoprotein cholesterol were prepared by selection and dilution of sera having low lipoprotein content or by enrichment with concentrated high-density lipoprotein. Stability of the serum pools depended on storage conditions. On storage between -2 and -12 degrees C, the high-density lipoprotein cholesterol content decreased. At a constant temperature of -19 to -21 degrees C the concentrations remained stable for more than 18 months. The imprecision (CV) of the high-density lipoprotein cholesterol assay during this period as established with enzymic cholesterol analysis (Clin. Chem. 26: 1780-1786, 1980) of these serum pools was between 2.7 and 4.8% (n = 51). Serum pools prepared and stored as described are suitable for internal quality-control procedures. In external quality-control trials these sera may be superior to the commercially available lyophilized lipid control sera. | [
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... |
10,004,385 | Evaluation of a new serum separator. | [
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0.0... |
10,004,386 | We tested the Centri-Sep filter (DADE) for its effectiveness in separating serum from clotted blood samples used for chemical analysis. Although statistical analysis by paired t-test showed differences in results for some analytes with the use of this device as compared with use of no separator or of a serum-decanting device, we concluded from the small bias of the paired means that the new separator device did not interfere with the clinical usefulness of reported values for the analytes studied. The separator is not an effective barrier for long-term storage of serum on its clot; however, we could obtain about 10% more serum with the separator than with decanting devices. | [
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0.05... |
10,004,387 | Proteins of human urine. II. Identification by two-dimensional electrophoresis of a new candidate marker for prostatic cancer. | [
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0.1065... |
10,004,388 | A protein series common to the urine and prostatic tissue of 16 of 17 patients with prostatic adenocarcinoma has been identified by high-resolution two-dimensional gel electrophoresis. These proteins, designated PCA-1, have a relative molecular mass in sodium dodecyl sulfate of about 40000. Analyses of urines from eight age-matched controls, seven patients with other ty pes of urogenital malignancies, two patients with benign prostatic hyperplasia, and five patients with malignancies not associated with the urogenital system failed to show PCA-1 in the patterns. These preliminary findings suggest that this protein should be systematically investigated as a candidate marker for prostatic adenocarcinoma in man. | [
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-0.010816802270710468,
0.07499... |
10,004,389 | Immunoinhibition and automated column chromatography compared for assay of creatine kinase isoenzyme MB in serum. | [
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10,004,390 | We examined sera from six different groups of patients for CK-MB activity by means of two commercially available tests, an immunoinhibition method (E. Merck) and the CK-MB test as used with the aca (Du Pont). In the first group of patients (suspicion of myocardial infarction) the correlation between the two methods was good: r = 0.9191, y = 1.068x -- 0.888, x = 18.7 U/L, y = 19.0 U/L. In the second group, patients with high adenylate kinase activity, no interference was detectable on the aca, whereas the immunoinhibition method yielded falsely high CK-MB values. The third group consisted of persons with macro-CK-BB in their serum. In the immunoinhibition test these patients usually showed a high CK-MB:total CK ratio, whereas such results were rarely found for the aca. The fourth group, patients with a different electrophoretic mobility of their CK-isoenzymes (migration of an active band towards the cathode), were detected by the immunoinhibition method (high ratio of CK-MB to total CK), but not with the aca. In the presence of free CK-BB (group five) the immunoinhibition test resulted in "falsely" high CK-MB values, whereas CK-BB was retained on the column of the aca. In skeletal muscle diseases (group six) results by the two methods differed, values for CK-MB on the aca being much higher. It was demonstrated experimentally that this was due to CK-MM with altered surface charge. | [
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0.04179241880774498,
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10,004,391 | Potentiometric analysis for sodium and potassium in biological fluids. | [
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0.06... |
10,004,392 | Results obtained with a potentiometric analyzer, NOVA 1, specific for sodium and potassium, were compared with those by flame photometry. Both instruments showed linearity within a physiological range of sodium and potassium concentrations and had similar precisions. Volume displacements from addition of albumin or Intralipid to aqueous samples yielded the predicted lower flame-photometric results because of the relative decrease in sample water. There may be a small interaction between sodium and albumin. Physiological measurements on plasma from uremic patients showed no change after dialysis that could be ascribed to a decrease in interaction of these ions with creatinine and urea. Potentiometric values for sodium and potassium did not differ significantly, whether measured in cerebrospinal fluid or in the corresponding plasma. Results for urine were the same potentiometrically and by flame photometry. | [
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10,004,393 | Fluorometry of selenium in serum or urine. | [
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0.06398167461156845,
0.0198... |
10,004,394 | This fluorometric procedure for determining selenium in human serum or urine is sensitive (requiring only 0.4 mL of sample), accurate, simple, and can be performed on several samples concurrently. Using this technique, we found a mean selenium concentration in the serum of normal Canadian men of 142.9 (SD 16.1) micrograms/L. The mean urinary excretion rate was 124.5 (SD 76.0) micrograms/day. | [
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0.016... |
10,004,395 | Radioimmunoassay and chemical ionization/mass spectrometry compared for plasma cortisol determination. | [
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0.0548... |
10,004,396 | We describe a method for determination of cortisol in plasma and urine, based on chemical ionization/mass spectrometry with deuterium-labeled cortisol as the internal standard. The within-run precision (CV) was 2.5-5.7%, the between-run precision 4.6%. Results by this method were compared with those by a radioimmunological method (RIANEN Cortisol, New England Nuclear) for 395 plasma samples. The latter method gave significantly higher (approx. 25%) cortisol values. | [
0.05662253126502037,
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0.0... |
10,004,397 | Comparison of enzyme-linked immunosorbent assay and radioimmunoassay for prostate-specific acid phosphatase in prostatic disease. | [
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0.1065857... |
10,004,398 | We compared results by an enzyme-linked immunosorbent assay (ELISA) with those by a standard radioimmunoassay (RIA) for detection and quantitation of prostate-specific acid phosphatase (EC 3.1.3.2) in serum. Control subjects, patients with benign prostatic hyperplasia, and patients in all four clinical stages of prostatic adenocarcinoma were tested. The upper limit of normal (95% of the population) by the ELISA was 2.0 micrograms/L, and by the RIA was 2.2 micrograms/L. In prostatic adenocarcinoma stage I (not detectable by digital rectal examination), ELISA was slightly more sensitive than RIA, but sensitivity was still relatively low (20%). As tumor mass increased (stages II through IV), the frequency of increased concentrations of prostatic acid phosphatase in serum also increased. We confirmed this increase in circulating enzyme in some cases of benign prostatic hyperplasia and suggest that this finding is related to either acinar cytolysis or an increase in acini size and number. Although prostate-specific acid phosphatase is not a cancer-specific enzyme, we conclude that its measurement may be of considerable value in monitoring prostatic disease. | [
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0.0820... |
10,004,399 | Colorimetry of serum acetaminophen (paracetamol) in uremia. | [
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0.024930814281105995,
0.04887... |
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