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Biomedical subjects

A S Thornton

Publications and source records attributed to A S Thornton.

17 recordsLinked to original sources
PubMed2006

Magnetic assisted navigation in electrophysiology and cardiac resynchronisation: a review.

Magnetic assisted navigation is a new innovation that may prove useful in catheter ablation of cardiac arrhythmias and cardiac resynchronization therapy. The ability to steer extremely floppy catheters and guidewires may allow for these to be positioned safely in previously inaccessible areas of the heart. The integration of other new technology, such as image integration and electroanatomic mapping systems, should advance our abilities further. Although studies have shown the technology to be feasible, with the advantage to the physician of decreased radiation exposure, studies need to be performed to show additional benefit over standard techniques.

Journal Article↗
PubMed2006

Magnetic navigation in AV nodal re-entrant tachycardia study: early results of ablation with one- and three-magnet catheters.

AIMS: Steering soft, flexible catheters using an external magnetic field could have advantages for heart catheterization, especially for therapy of tachyarrhythmias. Our aims were to assess the feasibility of magnetic navigation to Koch's triangle and reliable ablation of atrioventricular nodal re-entry tachycardia (AVNRT) with a magnetic catheter. METHODS AND RESULTS: Consecutive patients with AVNRT were mapped and ablated with a magnetically enabled catheter (Helios I or II), with, respectively, one and three magnets at the tip. The catheter was remotely advanced with the Cardiodrive system and orientated with the Navigant control system. After initial positioning with the external magnets, adjustment was made in 5 degrees steps. Success rates, procedure, and fluoroscopy times were analysed, and compared with a local contemporary series of conventional AVNRT ablations. Magnetic navigation was feasible in all 20 patients. Targets were easily reached. Catheters remained stable in position during accelerated junctional rhythms. Ablation was successful in 18/20 procedures (90%). No significant complications occurred. Median patient fluoroscopy time was 12 min, median physician fluoroscopy time was 4 min. Fluoroscopy times tended to be shorter than that in the conventionally treated group. Procedure duration decreased significantly over time, median procedure time was similar to that in the conventional group. CONCLUSION: AVNRT can be successfully mapped and ablated using magnetic navigation. A learning curve was evident, unrelated to catheter type, but to increasing operator experience. Physician radiation times were one-third of patient times. No complications occurred. Procedure time is comparable with that of conventional ablation.

Cardiac Catheterization↗
PubMed2005

Anticoagulation in atrial fibrillation and flutter.

Atrial fibrillation and atrial flutter are important risk factors for stroke. Based on a literature search, pathogenesis of thromboembolism, risk assessment in patients, efficacy of anticoagulation therapy and its alternatives are discussed. Special emphasis is put on issues like paroxysmal atrial fibrillation, atrial flutter and anticoagulation surrounding catheter ablation and cardioversion. A strategy for anticoagulation around the time of pulmonary vein ablation is suggested.

Administration, Oral↗
PubMed2004

The dioxin TCDD protects against aflatoxin-induced mutation in female rats, but not in male rats.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is an environmental contaminant and a potent carcinogen in laboratory rodents. When combined with other environmental toxins, it has been shown to increase the (geno)toxicity of some compounds. In this study, the effect of TCDD on the mutagenicity of aflatoxin-B1 (AFB1) was examined in the rat liver using a lacI transgenic rodent mutation assay. AFB1 induces GC-->TA transversions. Since TCDD is known to have a differential effect in male and female rodents, both sexes were studied. The data showed that a 6-week pre-exposure to TCDD had no significant effect on the frequency of aflatoxin-induced mutation in the liver of male rats. However, the TCDD treatment completely prevented the aflatoxin-induced transversion mutations in female animals.

Aflatoxin B1↗
PubMed2004

Visualization of a coronary sinus valve using intracardiac echocardiography.

Cannulation of the coronary sinus (CS) is sometimes difficult due to the presence of anatomical anomalies. Fluoroscopy is of limited value in visualizing these variations. This case is the first to demonstrate how intracardiac echocardiography (ICE) allows visualization of a valve, which is one of the causes of problematic cannulation of the CS. Based on information obtained by ICE an appropriate catheter could be selected.

Cardiac Catheterization↗
PubMed2001

Mutagenicity of TCDD in Big Blue transgenic rats.

The compound 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a significant environmental contaminant resulting from such industrial processes as pulp and paper production. TCDD is a suspected human carcinogen and its ability to induce cancer in laboratory rodents is well documented. Its mechanism of tumor initiation, however, is not well understood and in vitro mutagenicity studies have yielded inconsistent results. In this study, Big Blue lacI transgenic rats were used to assess the mutagenicity of TCDD in both male and female animals. After 6 weeks of exposure to 2 microg/kg TCDD neither an increase in mutation frequency nor any change in mutation spectrum was observed in either male or female animals.

Animals↗
PubMed2000

Landau-level spectroscopy of a two-dimensional electron system by tunneling through a quantum dot.

A single InAs self-assembled quantum dot is incorporated in the barrier of a tunnel diode and used as a spectroscopic probe of an adjacent two-dimensional electron system from the Fermi energy to the subband edge. We obtain quantitative information about the energy dependence of the quasiparticle lifetime. For magnetic field B, applied parallel to the current, we observe peaks in the current-voltage characteristics I(V) corresponding to the formation of Landau levels. Close to filling factor nu=1 we observe directly the exchange enhancement of the Lande g factor.

Journal Article↗
PubMed1993

Determinants of near fatality in acute severe asthma.

PURPOSE: The data extrapolated from cases of acute severe asthma that narrowly miss being fatal may prove valuable in the identification of the factors implicated in mortality. The purpose of this study was, therefore, to identify determinants of near fatality in patients with acute severe asthma. PATIENTS AND METHODS: We studied 81 patients with acute severe asthma in whom mechanical ventilation was required. Near fatality was defined as the occurrence of respiratory arrest and/or coma necessitating emergency tracheal intubation and resuscitation. In the cases that were not regarded as near fatal, tracheal intubation was performed electively because of deteriorating arterial blood gas values and/or the anticipation of exhaustion. Various continuous and categorical variables were compared in these two groups of patients. Patients with a hyperacute attack (period from onset of attack to mechanical ventilation less than 3 hours) were specifically sought and studied to determine the impact of such a course on near fatality. RESULTS: The "attack duration" (period from onset of attack to mechanical ventilation) was an important determinant of near fatality and of the subsequent clinical course. It was shorter in the group with a near-fatal episode (p < 0.03), and hyperacute attacks were uniformly near fatal. The attack duration correlated positively with the duration of the requirement for mechanical ventilation (p < 0.01). A longer attack duration was associated with an increased likelihood of the occurrence of major atelectasis (p < 0.01). There was no evidence of a relationship between near fatality and the side effects of bronchodilators as regards hypokalemia, arrhythmias, or cardiotoxicity. There was evidence of considerable under-treatment in the patient population as a whole, particularly in regard to the use of corticosteroids. CONCLUSIONS: A short attack duration is associated with an increased risk of near fatality in acute severe asthma. This is particularly evident in hyperacute attacks. Hyperacute attacks resolve rapidly once bronchodilator therapy has been instituted, suggesting that smooth muscle spasm is the predominant pathogenetic mechanism. The importance of routine anti-inflammatory therapy in mild to moderate asthma requires re-emphasis but, in addition, all patients should be provided with, and educated in the use of, bronchodilator rescue therapy, which should be available at all times. Despite current trends, the use of regular, prophylactic bronchodilator therapy in strict conjunction with anti-inflammatory agents may still be indicated. There is little evidence in the present data obtained from near-fatal cases to support the concept that cardiotoxicity related to bronchodilators contributes significantly to mortality from asthma.

Acute Disease↗
PubMed1990

Budget holding.

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Budgets↗
PubMed1987

Significance of tomographic signs in the diagnosis of bronchial carcinoma.

In a previous study the value of conventional tomography was assessed in the diagnosis of 100 potentially malignant opacities on the chest radiograph. To determine which of the radiological signs were most useful the radiologists reviewed 82 of the original 100 radiographs independently, searching for the presence or absence of 36 signs. The five commonest signs of bronchial carcinoma were a mass, coarse linear shadows contiguous to a mass, unilateral hilar enlargement, linear shadows from mass to periphery, and an irregular margin to a mass. The combination of either two or three of these signs was highly sensitive, 95% and 89% respectively, in detecting carcinoma. The most useful specific signs were lobulation of the mass and cavitation with thick or irregular walls.

Bronchography↗
PubMed1984

Assessment of conventional tomography and fibreoptic bronchoscopy in the diagnosis of potentially malignant chest opacities.

Conventional chest tomography and fibreoptic bronchoscopy were performed in 100 patients with a localised chest abnormality on their chest radiographs who had been referred with a possible diagnosis of bronchial carcinoma. Carcinoma was eventually confirmed in 74 cases and in 26 the lesion proved to be benign. The accuracy of tomography in the overall series was 83%, with a sensitivity of 92% and a specificity of 58%. These figures compare favourably with the results of other imaging techniques used in the diagnosis of bronchial carcinoma. In 50 patients bronchoscopy did not suggest carcinoma and in this group of patients 24 had a carcinoma and 26 a benign lesion. The accuracy of tomography in the bronchoscopy negative patients was 74%, the major source of error being the false positive category. The lesion eventually proved to be benign in 33% of the cases where tomography suggested malignancy, but when the tomograms suggested that the lesion was benign a tumour was found to be present in only 12% of cases.

Aged↗
PubMedDate not supplied

Imaging of a coronary artery bypass graft during coronary sinus venography.

Retrograde coronary sinus perfusion to maintain viability during cardiac surgery means that a connection via the capillary system to the coronary arteries, and potentially bypass grafts, may be possible. Coronary sinus (CS) venography prior to resynchronisation therapy in this patient with previous bypass grafting was associated with visualisation of these grafts.

Aged↗