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C F Starmer

Publications and source records attributed to C F Starmer.

At least 109 records · Page 6Linked to original sources

The kinetics of intramolecular distribution of 15N in uric acid after administration of (15N) glycine. A reappraisal of the significance of preferential labeling of N-(3+9) of uric acid in primary gout.

THE CONCEPT OF AN ABNORMALITY OF GLUTAMINE METABOLISM IN PRIMARY GOUT WAS FIRST PROPOSED ON THE BASIS OF ISOTOPE DATA: when [(15)N]glycine was administered to gouty subjects, there was disproportionately great enrichment of N-(3 + 9) of uric acid, which derive from the amide-N of glutamine. An unduly high concentration of (15)N in glutamine was postulated, and attributed to a hypothetical defect in catabolism of glutamine. Excess glutamine was proposed as the driving force of uric acid overproduction. WE HAVE REEXAMINED THIS PROPOSITION IN FOUR GOUTY SUBJECTS: one mild overproducer of uric acid with "idiopathic gout," one marked overproducer with high-grade but "partial" hypoxanthine-guanine phosphoribosyl-transferase deficiency, and two extraordinary overproducers with superactive phosphoribosylpyrophosphate synthetases. In the last three, the driving force of excessive purine biosynthesis is a known surplus of alpha-5-phosphoribosyl-1-pyrophosphate. Disproportionately high labeling of N-(3 + 9) was present in all four gouty subjects, most marked in the most flamboyant overproducers. The precursor glucine pool was sampled by periodic administration of benzoic acid and isolation of urinary hippuric acid. Similarly, the precursor glutamine pool was sampled by periodic administration of phenylacetic acid and isolation of the amide-N of urinary phenylacetylglutamine. The time course of (15)N enrichment of hippurate differed from that of the amide-N of glutamine. Whereas initial enrichment values of hippurate were very high, those of glutamine-amide-N were low, increasing to a maximum at about 3 h, and then declining less rapidly than those of hippurate. However, enrichment values of hippurate and of phenacetyl glutamine were normal in all of the gouty subjects studied. Thus, preferential enrichment of N-(3 + 9) in gouty overproducers given [(15)N]glycine does not necessarily reflect a specific abnormality of glutamine metabolism, but rather appears to be a kinetic phenomenon associated with accelerated purine biosynthesis per se.In addition, greater enrichment of N-9 than of N-3 on days 1 and 2 provided suggestive evidence for a second pathway for synthesis of the initial precursor of purine biosynthesis, phosphoribosylamine, perhaps utilizing ammonia rather than the amide-N of glutamine as nitrogen donor. In this limited study, the activity of this potential second pathway did not appear to be selectively increased in gout.

Adenosine Triphosphate↗

Pressure-flow studies in man. An evaluation of the duration of the phases of systole.

This study was designed to assess the independent effects of stroke volume and heart rate on the phases of systole and other selected hemodynamic parameters. By means of the pressure gradient technique instantaneous blood pressure and flow were recorded in the ascending aorta at fixed ventricular rates in five patients with complete heart block and in four patients with atrio-ventricular dissociation induced by ventricular pacing. Because of the variable contribution of atrial systole to ventricular filling, a wide range of stroke volumes were observed at each heart rate. The results indicate that the duration of ejection bears a close direct linear relationship to stroke volume while heart rate has only a weak but independent relation. On the other hand, the duration of total systole is related chiefly to the heart rate but stroke volume exerts an important independent effect. In a given patient, both duration of ejection and pulse pressure reflect changes of stroke volume and the product of the duration of ejection and the pulse pressure shows a good correlation with the stroke volume.

Adult↗

[Slow excitation waves and mechanisms of polymorphic ventricular tachycardia in an experimental model: isolated walls of the right ventricle from rabbit and squirrel].

The mechanism of polymorphic disturbances of the heart rhythm is studied on an experimental model, isolated ventricular preparations of ground squirrel and rabbit. Polymorphic arrhythmias are identified from habitus of the isolated preparation pseudoECGs mathematically derived from electrograms registered simultaneously at 32 endocardial and 32 epicardial points. The same electrograms allow one to visualize the excitation wave propagation along each of the preparation surfaces. The comparison of excitation wave pictures and corresponding pseudoECGs enabled us to reveal the conditions necessary and sufficient for polymorphism in heart rhythm disturbances. Polymorphic arrhythmias are due to changes in wave pictures in the regions of retarded excitation propagation.

Animals↗

[Quantitative analysis of variability of electrocardiograms typical for polymorphic arrhythmias].

A new approach to the analysis of variability of electrocardiograms (ECGs) typical of polymorphic arrhythmias is developed. In these ECGs, separate QRS complexes can be often hardly identified. As a result, the mathematical methods that have been elaborated hitherto are not suitable for such arrhythmias. The approach presented here is based on the quantitative estimation of the variability of neighboring parts of the ECG. In this case, the necessity of the identification of separate QRS complexes ceases to be significant. Based on this approach, the analysis of normalized ECG variability is developed in the framework of which two indices that characterize the oscillation variability and its changes in time are related to a part of the ECG and/or the ECG as a whole. Variations of these indices allow both the polymorphism of a separate ECG to be estimated and different ECGs to be compared with each other. The method presented may be useful in studies of the mechanisms and in the diagnosis of polymorphic arrhythmias.

Arrhythmias, Cardiac↗