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N K Roberts

Publications and source records attributed to N K Roberts.

14 recordsLinked to original sources

Morphology of the atrioventricular node, bundle and proximal bundle branches: a study employing computerized reconstruction.

The morphology of the human atrioventricular node, atrioventricular bundle and bundle branches is described. A block of tissue bounded by the ostium of the coronary sinus, the pars membranacea, the septal leaflet of the tricuspid valve and the atrial and ventricular septa is removed. The block is then sectioned serially from the right endocardial surface in the frontal plane of the heart. Sectioning in this way produces fewer sections than from techniques previously described. Outlines of the atrioventricular node, atrioventricular bundle and proximal bundle branches are digitally registered and stored in a computer. Three dimensional reconstructions of the structures are then generated by computer and displayed on an oscilloscope so that the entire three dimensional image can be rotated in any plane. Stereoscopic image pairs are produced to assist perception of the shape of the atrioventricular node, bundle and branching patterns of the bundles. This technique is unique in that it describes a method from which a relatively small number of histologic sections are generated permitting not only a complete histologic examination, but also a study of the morphology of the area.

Adult

Left axis deviation: a reassessment.

This report deals with the ramifications of the concept of left axis deviation. In early life, the leftward shift of the frontal plane QRS axis is determined chiefly, if not solely, by the relative weights of the ventricles. Once adult ventricular weight ratios are reached, there is a long period of axis stability, then a gradual leftward drift of the QRS, governed principally by left anterior fascicular conduction. Thus, the normal QRS axis is age-dependent, and left axis deviation must be considered accordingly.

Adult

Adaptation of the rat myocardium to endurance training.

The purpose of this study was to assess cardiac adaptation to endurance training in rats. After 11 wk of progressive treadmill exercise (1 h/day), gastrocnemius cytochrome c oxidase activity was 38% higher (P less than 0.01) in the trained (n = 20) as compared to control (n = 20) rats. Cardiac Mg2+-stimulated myofibril ATPase activity (0.308 +/- 0.012 vs. 0.324 +/- 0.006 micrometer.mg-1.min-1) did not change nor was there any change in myofibril protein concentration (60.0 +/- 1.12 vs. 59.9 +/- 0.85 mg.g-1). The isolated left ventricular papillary muscle showed no significant change in time-to-peak tension (TPT) or half-relaxation time. Tension output, however, was significantly increased with training, 2.2 +/- 0.3 vs. 1.5 +/- 0.1 g.mm-2 (P less than 0.025). Furthermore, when the papillary preparations were perfused with 0.5 mM lanthanum (La3+) to displace membrane-bound Ca2+, the time course for tension decay was significantly prolonged in the trained muscles (P less than 0.001). We conclude that endurance running of this type does not necessarily increase myofibril ATPase activity or the time course of the isometric twitch of rat papillary muscle. However, tension output per unit area does increase and this appears to be due to a greater amount of Ca2+ being made available to the contractile apparatus.

Adaptation, Physiological

Diagnosis of trifasicular damage following tetralogy of fallot and ventricular septal defect repair.

We evaluated the usefulness of the surface electrocardiogram to predict the presence of postoperative trifascicular damage. We used the pre and postoperative electrocardiograms and postoperative His bundle electrograms from 50 patients an average of 3.8 years following tetralogy of Fallot (TF) and ventricular septal defect (VSD) repair. Right bundle branch block (RBBB) and RBBB with left anterior hemiblock (LAH) developed in 88% and 18% respectively, and 22% had transient postoperative complete heart block (CHB). Mean P-A and A-H conduction times were 16.6 and 84.9 msec and were not different from 37 are-matched normal patients and 61 patients with unoperated TF and VSD. The mean H-V conduction time of 48.5 msec was significantly increased compared to the other two groups. Ten postoperative patients had H-V times of 55 msec or greater, indicating trifasicular damage. Of these, five had electrocardiographic bifascicular block (RBBB with LAH) with or without additional 1 degrees A-V block. The remaining five patients' electrocardiograms did not suggest trifascicular damage. Since postsurgical trifascicular damage may progress to late onset CHB, conduction studies are indicated to identify patients at risk, despite surface electrocardiographic findings.

Adolescent

The atrioventricular node, His bundle and bundle branches-a new histologic technique.

A technique for examination of the conducting system of the heart is described. A block of tissue embracing the ostium of the coronary sinus, the pars membranacea, the septal leaflet of the tricuspid valve, and appropriate amounts of interatrial and interventricular septum is flattened and fixed in a Kaiserling I solution. Blocks are subsequently cleared in methyl salicylate and trimmed. Sections are cut from the blocks after paraffin embedding beginning from the endocardial surfaces of the right heart chambers. The sections are mounted and stained on 35 mm unperforated leader film and covered with an acrylic preservative. For examination of the conducting system many fewer sections are required than with previous techniques.

Atrioventricular Node

Electrophysiologic study of the condition system in normal children.

Values for cardiac conduction intervals obtained from normal children are reported so that the data will be available for comparison with patients who are suspected of having abnormalities. Sinus node recovery time correlated linearly with the resting PP interval. The mean intra-atrial conduction was considerably shorter in children (less than 25 msec) than in adults (42 msec). The atrioventricular node had similar electrophysiologic properties in the child and adult. With aging, the His bundle to Purkinje fiber time increased significantly (P less than .01).

Adolescent

Sinus node function in children. Factors influencing its evaluation.

Overdrive atrial stimulation was performed in 20 electrophysiologically normal children at the time of routine diagnostic cardiac catheterization, for the determination of the sinus node recovery time (SNRT). Measurements were made at pacing rates of 120, 150, 180, and 200 beats/min. The absolute recovery times demonstrated wide range of values (420-1280 msec). Expressed as a percent of the resting P-P interval, values at pacing rates of 120 and 150 beats/min were 109-166%, with significantly less overdrive suppression (P less than 0.001) occurring at the two faster pacing rates. Atropine diminished the maximum SNRT in all patients tested. This study reports normal values for the SNRT in children. Factors which influence the SNRT are the resting heart rate, the rate of overdrive, and the autonomic tone. In children, the sinus node recovery time should be expressed in terms of the resting sinus interval.

Adolescent

Circadian changes in salivary constituents and conductivity in women and men.

Circadian rhythms in salivary [glucose], [Na+], [K+] and conductivity were measured in 2 age groups of men (men A, 20-45 years and men B, 46-60 years) and 8 different states of fertility in women (normally menstruating, taking oral contraceptives, pregnant, lactational amenorrhea, lactational amenorrhea and taking oral contraceptives, lactating and menstruating, menopausal, and post-menopausal). Unstimulated whole saliva (2-3 ml) was collected every 3 h over a 48 h span. Analysis of Spearman Rank Correlations indicated significant circadian rhythms (significant positive coefficients) for all groups of [Na+] (mean = 0.577 +/- 0.040) and conductivity (mean = 0.410 +/- 0.050). There was no evidence of differences in prominence of rhythm across groups for [Na+] and conductivity. [K+] showed less evidence of rhythms and much greater variability between groups (mean correlation coefficient = 0.198 +/- 0.055). Rhythms in [glucose] (mean correlation coefficient = 0.409 +/- 0.051) were evident in all groups except men B (0.016), menopausal women (0.151) and post-menopausal women (0.310). Model analysis of the data showed no discernible rhythmic trend with age for either conductivity, [Na+] or [K+], where any differences were explainable by the group characteristics. The rhythm in [glucose] showed a significant weakening with age over all groups (F-ratio = 7.46**), and was different between men A and men B (F-ratio = 6.95**). It was concluded that circadian rhythms were present in whole unstimulated saliva for conductivity and [Na+] and that these rhythms were independent of reproductive state, whereas circadian rhythms in [K+] were dependent on reproductive state. Circadian rhythms for [glucose] were dependent on age. The loss of a rhythm in [glucose] with age indicates that glucose, Na+ and K+ are not linked in their entry into saliva. The influence of entry and reabsorption on the final concentrations of glucose, Na+ and K+ in saliva is discussed.

Adult