Showing papers by "University of Alabama published in 1978"
TL;DR: The results indicate that patients with unstable angina pectoris can be managed acutely with intensive medical therapy, including the administration of propranolol and long-acting nitrates in pharmacologic doses, with adequate control of pain in most patients and no increase in early mortality or myocardial infarction rates.
Abstract: A prospective randomized study comparing intensive medical therapy with urgent coronary bypass surgery for the acute management of patients with unstable angina pectoris was carried out by nine cooperating medical centers under the auspices of the National Heart, Lung, and Blood Institute. Between 1972 and 1976, a total of 288 patients were entered into the study. All patients had transient S-T or T wave changes, or both, in the electrocardiogram during pain; 90 percent had pain at rest in the hospital, and 76 percent had multivessel coronary disease. The medically and surgically treated patients were comparable with respect to clinical, electrocardiographic and angiographic characteristics and left ventricular function. During the total study period, the hospital mortality rate was 5 percent in the surgical group and 3 percent in the medical group (difference not significant). The rate of in-hospital myocardial infarction was 17 and 8 percent in the respective groups (P In the 1st year after hospital discharge class III or IV angina (New York Heart Association criteria) was more common in medically than in surgically treated patients with one vessel disease (22 percent versus 3 percent, P The results indicate that patients with unstable angina pectoris can be managed acutely with intensive medical therapy, including the administration of propranolol and long-acting nitrates in pharmacologic doses, with adequate control of pain in most patients and no increase in early mortality or myocardial infarction rates. Later, elective surgery can be performed with a low risk and good clinical results if the patient's angina fails to respond to intensive medical therapy.
311 citations
TL;DR: All published autopsy cases of patients with tetralogy of Fallot who died without surgical treatment were studied to determine the life expectancy of such persons, indicating that the chance of survival is significantly less when pulmonary atresia, rather than stenosis, is present.
Abstract: All published autopsy cases of patients with tetralogy of Fallot who died without surgical treatment were studied to determine the life expectancy of such persons. In addition, the data from a study of persons with tetralogy alive in Denmark in 1949 were reanalyzed. The survival data from these two sources were remarkably similar, indicating that 66 percent of persons with tetralogy of Fallot not treated surgically live to age 1 year, 49 percent to age 3 years and 24 percent to age 10 years; thereafter, the hazard function (or Instantaneous risk of death) remains constant. The chance of survival is significantly less when pulmonary atresia, rather than stenosis, is present.
298 citations
TL;DR: The nature of localized atrial activation during atrial fibrillation was characterized in 34 patients following open heart surgery and an atrial flutter‐fibrillation pattern in the ECG was associated with a relatively ordered atrialactivation pattern and a relatively slow atrial rate.
Abstract: The nature of localized atrial activation during atrial fibrillation was characterized in 34 patients following open heart surgery. Bipolar atrial electrograms (AEG) recorded in each patient with atrial fibrillation exhibited a myriad of sizes, shapes, polarities, amplitudes, and beat-to-beat intervals. On the basis of the AEG morphology and the nature of its baseline, we have classified the recordings into four Types. Type I was characterized by discrete AEG complexes separated by an isoelectric baseline free of perturbation, Type II by discrete AEG complexes but with perturbations of the baseline between complexes, Type III by AEGs which failed to demonstrate either discrete complexes or isoelectric intervals, and Type IV in which AEGs of Type III alternated with periods characteristic of Type I and/or Type II. In 22 patients, the AEGs were recorded a second time, and in 11 of these patients the type of atrial fibrillation changed between the first and second recording period. An atrial flutter-fibrillation pattern in the ECG was associated with a relatively ordered atrial activation pattern and a relatively slow atrial rate. Human atrial fibrillation is not an electrophysiologically homogeneous process when compared among different patients or ad seriatim in the same patient.
287 citations
TL;DR: Card-ac function early postoperatively was good in both groups clinically and according to measurements, but only in the cold cardioplegic group (A) was cardiac index not adversely affected by longer cross-clamp time.
212 citations
TL;DR: The presence of HA0 in smooth membranes of TM-treated cells suggests that neither glycosylation nor sulfation is essential for membrane association or migration of HA from rough to smooth membranes.
148 citations
TL;DR: The deiodinative pathways of T4 and the production of T3 and rT3 were compared in two groups of normal volunteers on physiological T4 replacement and changes were most marked during the fifth to seventh day of fasting, but recovered partly toward the baseline values during the second week of fasting.
Abstract: The deiodinative pathways of T4 and the production of T3 and rT3 were compared in two groups of normal volunteers on physiological T4 replacement. One group was given a normal diet and the second group was fasted up to 15 days. After 1 week of fasting, the mean serum T3 level fell from 140 to 93 ng/dl, and the mean serum rT3 level rose from 51 to 106 ng/dl. No significant change occurred in the group mean serum concentration of TSH or total or free T4. These changes were most marked during the fifth to seventh day of fasting, but recovered partly toward the baseline values during the second week of fasting. The ratio of mean serum T3 to mean serum rT3 was 2.8 before fasting. It diminished to 0.9 after 1 week of fasting and increased to 1.5 after 2 weeks of fasting. In seven control subjects, the MCRs of T4, T3, and rT3 were 1.27 ± 0.24, 24.0 ± 3.6, and 105 ± 13 liters/day · 70 kg, respectively (mean ± sd). The disposal rates of T4, T3, and rT3 were 140 ± 16, 41 ± 5, and 49 ± 12 μg/day·70 kg, respectively....
147 citations
TL;DR: It is concluded that routine placement of atrial wire electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure or the preoperative rhythm.
127 citations
TL;DR: Ro 21-3981 is a promising anaesthetic induction drug that merits further human study and to compare it with diazepam for induction of anaesthesia.
Abstract: Ro 21-3981 is a newly synthesized water soluble benzodiazepine derivative. Its pharmacological properties are similar to diazepam. This investigation was designed to establish the effective induction dosage of Ro 21-3981 and to compare it with diazepam for induction of anaesthesia. The ED50 for Ro 21-3981 induction is 0.15 mg/kg and ED100 is 0.2 mg/kg. Ro 21-3981 is one and one-half times as potent as diazepam (0.3 rng/kg) and more rapid in action. There is significantly less pain on injection with Ro 21-3981 as compared to diazepam. Cardiovascular stability and apnoea were observed with both drugs. Ro 21-3981 is a promising anaesthetic induction drug that merits further human study.
124 citations
TL;DR: The mutagenic effects of fiteen mycotoxins on Salmonella typhimurium strains TA1535, TA1537 and TA1538 and Saccharomyces cerevisiae strain D-3 were tested and only aflatoxin B1 and sterigmatocystin were Mutagenic.
Abstract: The mutagenic effects of fifteen mycotoxins on Salmonella typhimurium strains TA1535, TA1537 and TA1538 and Saccharomyces cerevisiae strain D-3 were tested. Only aflatoxin B1 and sterigmatocystin were mutagenic. Both were active against S. typhimurium strain TA1538 and S. cerevisiae strain D-3; however, both required activation by the hepatic S-9 enzyme preparation. A positive correlation between the other mycotoxins reported to be carcinogenic and the two in vitro test systems employed was not demonstrated in our hands.
108 citations
TL;DR: The crystal structure of [LiN(SiMe3)2]3 has been determined from single-crystal X-ray diffraction data collected by counter methods as mentioned in this paper.
105 citations
TL;DR: Cardiac performance after repair was better in those in whom a transannular patch was used rather than a valved external conduit and important pulmonary dysfunction postoperatively occurred more often in patients with large "bronchial" arteries than in those without them.
TL;DR: The labelling of benzodiazepine receptors in vivo permits studies of receptor occupancy in various pharmacological and physiological conditions as well as autoradiographic localisation of the receptor in situ.
Abstract: THE presence of benzodiazepine receptors has been demonstrated using isolated membrane preparations from the mammalian central nervous system1–3. Specific binding of 3H-diazepam to synaptosomal membranes is maximal at temperatures of 0–4 °C, but reduced by more than 95% at physiological temperatures4. Although the inhibition of 3H-diazepam binding by other benzodiazepines in vitro closely parallels their pharmacological potencies in vivo, failure to demonstrate specific binding in physiological conditions raises questions as to whether receptor binding occurs in vivo. We report here that benzodiazepine receptors can be demonstrated in the intact animal following intravenous administration of 3H-diazepam. The labelling of benzodiazepine receptors in vivo permits studies of receptor occupancy in various pharmacological and physiological conditions as well as autoradiographic localisation of the receptor in situ.
TL;DR: Several months after infarction, the graded exercise test can be performed safely and can be utilized to predict the extent of coronary artery disease and left ventricular dysfunction in selected groups of patients.
Abstract: To evaluate the effectiveness of the graded exercise test in predicting the extent of coronary artery disease and the degree of left ventricular dysfunction in patients with prior myocardial infarction, 100 consecutive patients underwent both graded exercise testing and coronary and left ventricular angiography at a median of 4 months after infarction. The studies caused no complications. An equal number of patients had anterior and inferior infarction. Coronary artery disease, defined as 70 percent or greater stenosis of luminal diameter, was present in three vessels in 31 patients, in two vessels in 35 patients, in one vessel in 33 patients and in no vessel in one patient. With “diagnostic” electrocardiographic criteria of 1 mm or greater J point depression plus a flat or downsloping S-T segment, 31 patients had an electrocardiographically positive exercise test; 27 of these (87 percent) had two or three vessel coronary artery disease. Of the 21 patients with a negative exercise test, 62 percent had coronary artery disease in no more than one vessel, 33 percent in two vessels and 5 percent in three vessels. Fourteen patients had S-T segment elevation during exercise; these patients had a lower ejection fraction and larger angiographic scar size than the remaining 86 patients. Patients terminating exercise because of symptoms of left ventricular dysfunction (fatigue or dyspnea) showed correlation between duration of exercise and ejection fraction ( r = 0.65) and between duration of exercise and angiographic scar size ( r = −0.62). Thus, several months after infarction, the graded exercise test can be performed safely and can be utilized to predict the extent of coronary artery disease and left ventricular dysfunction in selected groups of patients.
TL;DR: In another study as mentioned in this paper, mothers of school-aged male stutterers were found to perceive their children as being more insecure, sensitive, anxious, withdrawn, fearful, and introverted than did mothers of nonstutterers.
TL;DR: Determinants of hosptal mortality and controversies in surgical management are reviewed and examples of current experience with repair of TAPVC are given.
TL;DR: In this article, an observation of a train of hydromagnetic waves with a period of about 150 sec seen at synchronous orbit by the ATS 6 spacecraft on June 27, 1974 is discussed.
Abstract: The observation is discussed of a train of hydromagnetic waves with a period of about 150 sec seen at synchronous orbit by the ATS 6 spacecraft on June 27, 1974. The critical observation is a phase shift of 90 deg between east-west oscillations of the particle flow and the east-west component of magnetic field oscillations. This phase shift alone suggests a standing rather than a propagating hydromagnetic wave. Careful processing of the particle data makes it possible to determine the drift velocity and hence the electric field of the wave. The wave electric field together with the time-varying magnetic field reveals an oscillating Poynting vector with zero mean component aligned with the ambient magnetic field and nonzero azimuthal (westward) component.
TL;DR: In this paper, a systematic study of the inner solar corona is made within the context of two-dimensional, time-dependent plane hydromagnetics, and numerical solutions are obtained by introducing an impulsive temperature enhancement within a rectangular region (i.e., "box") in an initially isothermal corona in magnetohydrostatic equilibrium.
Abstract: A systematic study of dynamic response of the inner solar corona is made within the context of two-dimensional, time-dependent plane hydromagnetics. The governing equations are written in r-phi coordinates (i.e., in the solar equatorial plane), and numerical solutions are obtained by introducing an impulsive temperature enhancement within a rectangular region (i.e., 'box') in an initially isothermal corona in magnetohydrostatic equilibrium. Effects of the magnetic field configuration are illustrated for initially open (radial) and closed (azimuthal) magnetic fields by comparison with the nonmagnetic response. The channeling or blocking effects by the magnetic fields on the mass motion of solar plasma as the consequence of the evolution of fast and slow mode MHD shock waves are demonstrated. Some physically significant applications of the results, useful for the interpretation of observations, are discussed. It is noted, for example, that coronal transients observed in white light probably occur within essentially radial field topologies.
TL;DR: Estimates of the carbohydrate content of the HA glycoprotein, together with previous estimates of the oligosaccharide components, suggest that in the case of virions grown in MDBK cells HA2 contains a single type I oligosACcharide group, whereas HA, contains two types I oligOSaccharides plus one or two type II oligosAccharides.
TL;DR: The geologic history of Africa can be described in terms of three types of assemblages: (1) migmatites formed largely by remobilization of pre-existing sialic crust during Pan-African time; (2) calcalkaline batholithic suites formed in association with subduction of oceanic crust; and (3) alkali-rich, post-tectonic granites.
TL;DR: Spontaneous fasting hypoglycemia developed in four nondiabetic patients with end-stage renal failure and appeared to result from several mechanisms, including impaired hepatic gluconeogenesis in association with impaired or absent renal glucose production.
Abstract: Spontaneous fasting hypoglycemia developed in four nondiabetic patients with end-stage renal failure. All were undergoing long-term maintenance hemodialysis and three patients were anephric. Hypoglycemia was generally accompanied by severe metabolic acidosis and, in three patients, lactic acidemia. Abnormalities of hepatic structure and/or function were present in three patients. In one patient, hypoglycemia was refractory to exogenous glucagon, failed to respond to alanine, glycerol, or galactose, and was associated with suppressed plasma insulin and elevated plasma glucagon levels. Fasting hypoglycemia appeared to result from several mechanisms. In at least two patients, fasting hypoglycemia and lactic acidosis resulted from impaired hepatic gluconeogenesis in association with impaired or absent renal glucose production. Additionally, substrate limitation probably contributed to hypoglycemia in several patients. (Arch Intern Med138:1364-1368, 1978)
TL;DR: In this paper, a modified random walk production-inventory heuristic for the aggregate planning problem is proposed. But, the proposed approach is contrasted with linear programming, parametric programming, and linear decision rule optimal and near optimal solutions for several well known production situations.
Abstract: A number of approaches to the aggregate planning problem have been proposed in the literature, yet experience suggests that industrial concerns seldom use these models in actual planning situations. This paper describes a modified random walk production-inventory heuristic for the problem which should appeal to managers on the basis of simplicity as well as efficiency. The proposed approach is contrasted with linear programming, parametric programming, and linear decision rule optimal and near optimal solutions for several well known production situations. The simple production switching heuristic produces schedules which exceed optimal schedules by only 1 to 2 percent of total production costs in all cases.
TL;DR: The results and the natural history of patients with this malformation indicate that there should be no change in the policy of performing elective intracardiac repair before age 2 years and primary repair rather than pulmonary arterial banding when operation is required in the early months of life.
Abstract: Twenty-seven consecutive patients less than 2 years of age underwent primary intracardiac repair of complete atrioventricular (A-V) canal. Three (19 percent) of the 16 operated on after January 1, 1975 died in the hospital, a smaller proportion than the 8 of 11 patients who died in the hospital after operation between 1972 and 1975 (P = 0.005). The date of operation as a continuous variable is also related to the probability of hospital death (P = 0.016). Age at operation was not related to hospital mortality among the total group of 27 infants, nor were the anatomic characteristics of the anterior and posterior bridging leaflets, the location and size of the interventricular communications or the duration or technique of profound hypothermia (total circulatory arrest versus low perfusion flow rate). The improved results in the 16 patients operated on since January 1, 1975 are believed to be primarily the result of an improved ability to construct "mitral" and "tricuspid" valves from the common A-V valve. Fourteen of the 16 hospital survivors are alive and well 5 to 60 months after operation. These results and the natural history of patients with this malformation indicate that there should be no change in the policy of performing elective intracardiac repair before age 2 years and primary repair rather than pulmonary arterial banding when operation is required in the early months of life.
TL;DR: It is concluded take-home methadone can be a powerful reinforcer of rehabilitation behaviors in methamphetamineadone programs, and significant decreases in drug-seeking and increases in productivity were associated with the contingency.
Journal Article•
TL;DR: Improved 1-year patency rates for grafts in period II and a low incidence of late failure and development of late stenosis for up to 61 months following operation appear justified.
Abstract: The patency of 871 aortocoronary saphenous vein grafts in 438 patients was evaluated for a mean (+/- SEM) of 12.1 +/- 0.3 months after operation. Second studies were performed in 62 patients (134 grafts) at a mean of 42 +/- 1.3 months postoperatively (range, 13 to 61 months). The 1-year patency rate was 79.4% and increased from 76% for 546 grafts placed in 1970-1973 (Period I) to 85% for 325 grafts in 1974-1976 (period II) (P = 0.001). Overall patency was highest (82%) for grafts to the anterior descending system and lowest (76%) for the right system. These patency rates also increased between periods I and II from 79 to 88% (P 50%) stenoses were present in three of the five grafts at initial study. Development of late stenosis was observed in two grafts (1.7%). These data document improved 1-year patency rates for grafts in period II and a low incidence of late failure and development of late stenosis for up to 61 months following operation. Continued use of saphenous vein grafts to all three coronary arterial systems appears justified.
TL;DR: In this article, the propagation of coronal transients through the lower corona in the meridional plane is studied on the basis of numerical solutions of the time-dependent MHD equations of motion.
Abstract: The propagation of coronal transients through the lower corona in the meridional plane is studied on the basis of numerical solutions of the time-dependent MHD equations of motion. The importance of the topology of the initial coronal magnetic field is demonstrated by considering two configurations: one which is essentially radial (open), and another which is essentially parallel to the solar surface (closed). The effect of coronal field magnitude is investigated by using values for the beta parameter of 1 and 0.1 at the coronal base. The consequences of including radiative losses and of varying the polytropic index are also considered. The solar event is simulated by a step-function increase in the pressure at the base of an initially hydrostatic atmosphere by a factor of 5, lasting for a period of 5 min.
TL;DR: The arthritis of MCTD may be both erosive and deforming and this disease should be considered in patients presenting as rheumatoid arthritis with unusual features.
Abstract: Seventeen of 19 patients with mixed connective tissue disease (MCTD) had arthritis as a significant initial feature of their disease; 8 were given an initial diagnosis of rheumatoid arthritis (RA) and 4 received chrysotherapy. RA-like hand deformities were present in 35% and contractures and/or persistent loss of joint motion in 47%. Joint radiographs showed abnormalities in 41% and included erosions and/or cysts in 30%. The arthritis of MCTD may be both erosive and deforming and this disease should be considered in patients presenting as RA with unusual features.
TL;DR: A follow-up study of two attitude change experiments examined the effects of a fear appeal, that is, increasing smokers' awareness and appreciation of the highly noxious consequences of smoking.
Abstract: Despite the research interest in modifying smoking behavior, therapeutic treatments that can produce long-term cessation have not been demonstrated rigorously. A follow-up study of two attitude change experiments (N = 173) examined the effects of a fear appeal, that is, increasing smokers' awareness and appreciation of the highly noxious consequences of smoking. Although this familiar type of information may be an integral component of many smoking treatment programs, its long-term suppressive effect has not been demonstrated in well-controlled experiments. The results disclosed that 3 months and also 1 year after treatment, a high-fear manipulation had increased significantly the percentage of smokers who were able to stop smoking completely.
TL;DR: In this paper, a review of two-dimensional gas chromatography is presented, with a focus on technology which is capable of dealing with samples of extreme complexity, and instrumentation for trace-and ultratrace analysis.
Abstract: Basic methodology to effect the separation of complex samples by gas chromatography is discussed from an experimental point of view. Several possibilities are presented which are commonly used to enhance the information content of a gas chromatographic run. These include incorporation of more than one set of retention data, multiple detectors, and special column switching techniques. These and other techniques have sometimes been labeled “multidimensional” in the literature. An attempt is made to define the term “two-dimensional chromatography”.
The review is divided into sections which point out the different directions which have been taken to deconvolute chromatographically unresolved components. Particular emphasis is placed on technology which is capable of dealing with samples of extreme complexity, and instrumentation for trace- and ultratrace analysis is dicussed with specific examples. The future of two-dimensional techniques in gas chromatography is looked into.
TL;DR: In this paper, the authors investigated the dynamic behavior of transients in a stratified atmosphere in the presence of a magnetic field with the two-dimensional plane formulation, i.e., the formulation in which variations of the flow and magnetic field are confined within a plane.
Abstract: The dynamic behavior of transients in a stratified atmosphere in the presence of a magnetic field is investigated with the two-dimensional plane formulation, i.e., the formulation in which variations of the flow and magnetic field are confined within a plane. It is pointed out that, in the plane formulation, the noncompressible transverse waves (often called the Alfven waves) are excluded. The compressible responses of the atmosphere are then examined with a temperature perturbation (simulating a sudden local release of energy by a flare) as functions of the configuration of magnetic field and field strength. It is shown that (1) in the open (mostly radial) magnetic field, the propagation of 'bubble-like' density enhancements, the coronal transients, result; while (2) in the closed (mostly azimuthal) field, the density enhancement forms a pair of 'horns' near the foot points of field lines similar to that often observed by coronagraphs after flares. Discussions in interpreting the results in terms of the anisotropic propagation of the fast and slow waves (or shocks) are presented together with consideration of possible consequences with the inclusion of the transverse waves.