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R A Frankel

Publications and source records attributed to R A Frankel.

7 recordsLinked to original sources
PubMed1996

Visual outcome in bilateral nonarteritic anterior ischemic optic neuropathy.

BACKGROUND: Nonarteritic anterior ischemic optic neuropathy (NAION) is a common cause of visual loss in the older population. Bilateral NAION is a well-documented entity; however, no study to date has compared the visual outcome between affected eyes. METHODS: The authors retrospectively reviewed the charts of 99 patients with diagnoses of NAION over 3 1/2 years. In the 23 patients with bilateral involvement, 16 were included in the study for analysis of final visual outcome between affected eyes. Snellen acuity, Ishihara color plates, and Humphrey automated perimetry were evaluated as the parameters of visual function. Descriptive analysis of the outcome between affected eyes for each parameter is presented as a frequency distribution of pre-defined groups. Statistical significance is established using nonparametric tests. RESULTS: Bilateral NAION was found in 23% (23/99) of the patients studied. The authors identified a high percent agreement between eyes with regard to visual acuity (81% within 3 Snellen lines), color vision (69% within 3 plates), and Humphrey visual field (75% within 5 decibels of mean deviation). Additionally, there was a statistically significant correlation between affected eyes for all three visual parameters: visual acuity (P = 0.043), color vision (P = 0.001), and Humphrey visual field (P = 0.039). CONCLUSION: The authors found a high percent agreement and statistically significant correlation in final outcome between affected eyes of patients with bilateral NAION for visual acuity, color vision, and visual field loss. With a larger series, it may be possible to predict the visual outcome of the second affected eye based on the parameters of the first eye.

Adult↗
PubMed1993

Evaluation of spontaneous baroreflex sensitivity in conscious dogs.

1. We evaluated a method of measuring cardiac baroreflex sensitivity (BRS) derived from spontaneous changes in systolic pressure (SP). SP was measured from the ECG signal in seven conscious, resting dogs. 2. Beat-to-beat changes in PI (dPI) were positively correlated with beat-to-beat changes in SP (dSP) in all dogs tested, suggesting spontaneous baroreflex function. The slope of the regression of dPI on dSP was used as an index of spontaneous BRS. 3. The spontaneous BRS was abolished by hexamethonium, atropine and bilateral carotid sinus denervation. Low dose atropine sulphate produced a paradoxical increase in spontaneous BRS, which has been observed in other studies. The spontaneous BRS was positively correlated with the average pulse interval in resting dogs. 4. Random modulation of heart rate after vagotomy failed to reproduce the strong positive correlation between dSP and dPI; this demonstrated that the correlation was not the result of mechanical coupling between heart rate and arterial blood pressure. 5. The BRS was measured pharmacologically in six dogs using a bolus injection of a vasoconstrictor. The pharmacological BRS was positively correlated with the spontaneous BRS measured after the bolus injection. 6. Finally, the spontaneous BRS was negatively correlated with the average arterial pressure in resting dogs. We conclude that the spontaneous BRS is a useful quantitative indicator of baroreflex function in conscious resting dogs.

Animals↗
PubMed1993

Spontaneous pressure-flow relationships in renal circulation of conscious dogs.

Renal pressure-flow (P-F) relationships are usually evaluated by measuring effects of mechanically induced changes in renal arterial pressure (AP) on renal blood flow (RBF). We devised a method allowing evaluation of renal P-F relationships during normal changes in AP occurring spontaneously in a conscious animal rather than during artificially induced changes in AP. In 18 trials in 6 dogs standing at rest, we measured average AP and RBF for each cardiac cycle over periods of approximately 35 min (approximately 3,100 cardiac cycles/trial). AP and RBF values for each cardiac cycle were expressed as percent change (%delta) from the 35-min average (beat-to-beat changes). Slope and angle of each consecutive beat-to-beat P-F change were calculated and collated into one of eight zones representing the possible physiological mechanisms responsible for concurrent, spontaneous changes in RBF and AP. In a predominance of the cardiac cycles (approximately 43%), the spontaneous AP-RBF relationship was consistent with being mediated by arterial baroreflexes (i.e., increases in AP were accompanied by proportionately greater increases in RBF during 44.4% of cardiac cycles in which AP increased, and decreases in AP were accompanied by proportionately greater decreases in RBF during 41.4% of cardiac cycles in which AP decreased). Blockade of autonomic ganglionic transmission with hexamethonium markedly attenuated this pattern. Our results indicate that renal circulation participates in moment-to-moment control of AP via a predominant baroreflex-like pattern.

Animals↗
PubMed1991

A filter to suppress ECG baseline wander and preserve ST-segment accuracy in a real-time environment.

Accurate monitoring of the ST-segment displacements in real-time environments can be distorted by the nonlinear phase response of a baseline filter such as the single-pole, high-pass (0.5 Hz) filter that is standard in the industry today. The authors have previously constructed a four-pole null phase (1.0 Hz) filter that is nearly ideal in suppressing baseline wander while preserving ST-segment accuracy; however, this foreward/backward filter requires capture of a large ECG segment before filtering, thereby producing a delay that is unacceptable in a real-time environment. As a practical compromise, a two-pole, phase-compensated (1.0 Hz) filter was constructed while introducing a small time delay (160 ms). It performs much better than the "standard filter" and almost as well as the "ideal" filter in several tests, namely (1) suppression of baseline wander in a series of ECGs, (2) suppression of artificial baseline, (3) response to a triangular impulse wave (American Heart Association test), and (4) J-point displacement in several ECGs.

Cardiomegaly↗
PubMed1969

Kyphoscoliosis.

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Abnormalities, Multiple↗