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Biomedical subjects

E Warman

Publications and source records attributed to E Warman.

18 recordsLinked to original sources

Comparison of the effects on drug concentrations, electrophysiologic parameters, and termination of atrial fibrillation in dogs when procainamide and ibutilide are delivered into the right atrium versus intravenously.

INTRODUCTION: We tested the hypothesis that right intra-atrial (i.a.) administration of antiarrhythmic drugs resulted in higher peak serum drug concentrations, greater electrophysiologic effects, and greater efficacy for termination of atrial fibrillation (AF) than intravenous (i.v.) drug delivery. METHODS AND RESULTS: Eight dogs were treated with 9.7 mg/kg procainamide infusion and eight dogs with 0.02 mg/kg ibutilide infusion, injected over 5 minutes. Each dog had both an electrophysiologic (EP) and an AF termination study during i.a. and i.v. drug administration at > or = 2-day intervals (total four studies each). Right atrial pacing capture threshold, right atrial effective refractory period (ERP), right atrial and right ventricular monophasic action potential (MAP) durations at 70% and 90% of repolarization (MAPD70, MAPD90), AH, HV, and QT intervals, QRS width, intra-arterial systolic and diastolic blood pressures, and cardiac output were measured at different time-points. Blood samples were drawn from the coronary sinus and femoral vein for drug level determination. The right atrium was paced at 400-msec cycle length throughout the study. AF was induced by rapid right atrial pacing and maintained by methacholine infusion at 1.5 to 3 microg/kg/min. The sustained AF was allowed to persist for 10 minutes before starting the antiarrhythmic drug infusion. We found no significant difference between the procainamide concentrations in the coronary sinus and femoral vein during i.a. and i.v. drug delivery. The time course and extent of increase in right atrial ERP, MAPD70, MAPD90, and all the other measured EP parameters did not differ between the two routes of drug administration. No significant difference was found in termination of AF between i.v. (5/7 procainamide; 4/8 ibutilide) or i.a. (3/8 procainamide; 3/8 ibutilide) drug delivery or between drugs (8/15 procainamide; 7/16 ibutilide). CONCLUSION: Our data do not support any beneficial effect of i.a. versus i.v. procainamide or ibutilide delivery.

Animals↗

Wave front-obstacle interactions in cardiac tissue: a computational study.

An understanding of wave front-obstacle interactions will greatly enhance our knowledge of the mechanisms involved in cardiac arrhythmias and their therapy. The goal of this computational study is to examine the interactions between wave fronts and various obstacles in a two-dimensional sheet of myocardium. The myocardium is modeled as an isotropic sheet with Luo-Rudy I membrane kinetics. An examination is conducted of wave front interactions with nonconductive and passive-tissue obstacles. Simulations were performed either in environments of reduced myocardial excitability, or with rapid stimulation via a line electrode. The shape of the obstacles and their ability to withdraw current from the active tissue greatly influence wave front-obstacle interactions in each of these environments. The likelihood of wave front detachment from an obstacle corner increases as the curvature of the obstacle corner is increased. A passive-tissue obstacle promotes wave front-obstacle separation in regions of depressed excitability. Under rapid pacing, the presence of the passive obstacle results in wave fragmentation, while the insulator obstacle promotes wave front detachment. The results of this study reveal the importance of obstacle composition and geometry in wave front interactions with cardiac obstacles.

Animals↗

Oral herpetic lesions in an edentulous patient.

This article reports a case of oral herpetic lesions that recurred several times over 1 1/2 years in an edentulous 65-year-old woman. The patient was under treatment for complete dentures at the New Jersey Dental School. A differential diagnosis of mucosal ulcerative lesions is described, along with the laboratory methodology for confirmation of herpes simplex virus type 1 (HSV-1) infection.

Aged↗

Radiopacity with vertical indentations.

An elliptical radiopacity with vertical indentations at its border was seen in the radiograph of an edentulous patient. Interpretation of the image was based on a correlation of the clinical findings with a review of the image projection that occurs during exposure of a maxillary posterior periapical radiograph.

Aged↗

Manipulating the intracellular environment of hippocampal slices: pH and high-energy phosphates.

The intracellular energetic environment of rat hippocampal slices was manipulated by bolstering ATP levels following the addition of adenosine to the incubation medium, or by manipulating intracellular pH. Addition of 8 mM adenosine to the incubation medium increased total tissue adenylate and ATP content, but did not prolong electrical function during anoxia. Further, it resulted in long-lasting alterations in normoxic evoked responses. Intracellular pH (pHi) was changed by manipulating the bicarbonate/CO2 ratio of the incubation medium, or by adding amiloride, a hydrogen/sodium antiport blocker. Estimates of intracellular pH using the creatine kinase equilibrium agree with those obtained by Neutral red scanning spectrophotometry in control conditions. However, only Neutral red indicated an acidification with amiloride treatment, while the creatine kinase equilibrium was preferentially affected by hypercapnia, suggesting the presence of at least two pH compartments in hippocampal brain slices. These manipulations cannot be carried out easily in vivo, and provide a means of determining the importance of metabolic changes on neural function during anoxia.

Action Potentials↗