Analysis of abnormal signals within the QRS complex of thehigh-resolution electrocardiogram

Presents a new, quantitative approach to measuring abnormal intra-QRS signals, using the high-resolution electrocardiogram (HRECG). These signals are conventionally known as QRS “notches and slurs.” They are measured qualitatively and form the basis for the ECG identification of myocardial infarction. The HRECG is used for detection of ventricular late potentials (LP), which are linked with the presence of a reentry substrate for ventricular tachycardia (VT) after a myocardial infarction. LP's are defined as signals from areas of delayed conduction which outlast the normal QRS period. The authors' objective is to quantify very low-level abnormal signals that may not outlast the normal QRS period. In this work, abnormal intra-QRS potentials (AIQP) were characterized by removing the predictable, smooth part of the QRS from the original waveform. This was represented as the impulse response of an ARX parametric model, with model order selected empirically from a training data set. AIQP were estimated using the residual of the modeling procedure. Critical AIQP parameters to separate VT and non-VT subjects were obtained using discriminant functions. Results suggest that AIQP indexes are a new predictive index of the HRECG for VT. The concept of abnormal intra-QRS potentials permits the characterization of pathophysiological signals contained wholly within the normal QRS period, but related to arrhythmogenesis. The new method may have other applications, such as detection of myocardial ischemia and improved ECG identification of the site of myocardial infarction, particularly in the absence of Q waves     

Long-term results in the treatment of femoral-shaft fractures in young children by immediate spica immobilization

Manual traction reduction without anesthesia and immediate immobilization in a spica cast were used to treat eighty-five children ranging in age from birth to ten years old who had closed femoral-shaft fractures and no associated injuries. Up to two centimeters of overriding, 30 degrees of anterior angulation, and 15 degrees of medial angulation were accepted. Any angulation in excess of these amounts, or lateral or posterior angulation, was corrected by wedging the cast at the fracture site. Further telescoping of the fracture fragments in the case was attributed to the child pressing the foot against the bottom of the cast and was prevented by removing the sole of the cast. Of the seventy-five children examined two to eighteen years after fracture, none had any residual skeletal deformity or joint stiffness. The length discrepancies of the fractured limbs ranged from 1.7 centimeters of shortening to 0.9 centimeter of overgrowth.     

Fibrous myopathy. A rheumatic complication of drug abuse

A progressive fibrous myopathy may result from chronic intramuscular drug abuse. This complication may mimic other rheumatic disorders and early recognition may prevent disability. The patient described here presented with fixed flexion and extension contracture of hips and knees, respectively, after abusing meperidine and other agents for 3 years. Soft tissues of thighs and buttocks were "wood hard," EMG showed absence of action potentials in affected muscles, and biopsy revealed extensive replacement of muscle with dense, acellular fibrous tissue. Possible mechanisms are discussed.     

Cutaneous leishmaniasis in the Libyan Arab Republic: distribution of the disease and identity of the parasite

When mammalian sperm cells are exposed to solutions of albumin there are changes in the membranes of some species that resemble those that normally occur in the uterus prior to fertilization. We have shown that albumin molecules absorb on to the membranes of ejaculated rabbit sperm cells, and that the equilibrium binding constant, K, (1) varies inversely with the albumin concentration, (2) is independent of the sperm cell concentration in the range of 10(6)--10(7) per ml, (3) is independent of the time of exposure of the sperm cells to the albumin solution, and (4) decreases in the presence of Ca++ and Mg++ ions. An unusual aspect of the adsorption is that if the albumin concentration is given the symbol [A], K[A] is a constant in our measurements. This means that for virtually the entire range of [A] studied, the sperm cells bind albumin so that half of the available surface is coated and half remains uncoated. This situation is rather remarkable and it suggests a role that adsorption could play in the physical processes preceding fertilization. In purely physical systems, the optimum for the bridging and flocculation of particles that are coated with adsorbed macromolecular films occurs when half of the available surface is covered. The sperm cell appears to provide the optimal situation for interacting with itself or with another surface.     

Performance of isolated rat hearts perfused with helium- or nitrogen-containing, gas-saturated solutions

Effects of helium on the isolated perfused rat heart were studied employing the Langendorff technique. The perfusate consisted of Krebs-Henseleit solution saturated with one of three gas mixtures: 1) 95% O2-5% CO2, 2) 50% O2-45% He-5% CO2, and 3) 50% o2-45% N2-5% CO2. Contractile indices measured revealed the performance of hearts with the helium mixture to be equivalent to those perfused with the 95% O2-5% CO2 mixture. Those perfused with the nitrogen gas mixture exhibited contractile activity lower than that in the other two groups. It was concluded that helium exerts a direct effect on the coronary vasculature of the isolated rat heart by reducing its resistance to flow. A greater oxygen delivery to hearts perfused with the He-saturated solution compared to the N2-perfused hearts may account for the difference in performance.     

Effects of zinc and vitamin A deficient diets on the hepatic mobilization and urinary excretion of vitamin A in rats

Weanling rats were fed diets deficient in zinc (ZD), vitamin A (AD), or both (ZAD) for 3 weeks. Each then received 20 mug of 11,12-3H-retinyl acetate. Plasma retinol was monitored for radioactivity for 5 hours and urine for 6 days. Rats were killed and measurements made of plasma and liver vitamin A and plasma zinc. Plasma vitamin A was depressed but growth was not affected in AD rats compared to pair-fed controls. Radioactivity appeared most rapidly in the plasma retinol fractions of the two vitamin A-depleted groups (AD and ZAD) and was excreted most rapidly in the urine of these same groups. Zinc-deficient diets (ZD and ZAD) caused depressed plasma levels of zinc and vitamin A and growth retardation greater than in pair-fed controls. However zinc deficiency had no effect on mobilization of newly-ingested vitamin A or urinary excretion of labeled metabolites. Liver stores of vitamin A were lower for ZD rats than for controls. The data indicate that zinc deficiency is not a limiting factor in hepatic vitamin A release except as it influences growth and body demand for the vitamin. The data also suggest that newly-absorbed vitamin A is mobilized and utilized in preference to that previously stored in the liver.