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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 1319-1321 
    ISSN: 1432-1440
    Keywords: Demand-Schrittmacher ; Sensing-Anomalität ; akuter Myocardinfarkt ; Demand pacemaker ; Sensing abnormality ; Acute myocardial infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Trasient asynchronous pacing due to abnormal sensing function is reported in two patients with inserted demand pacemakers during the early phase of acute myocardial infarction. The hazards of the pacemaker induced parasystole with R on T phenomenon in conditions of enhanced electrical instability could be successfully overcome applying overdrive suppression of the inserted pacing system by external chest wall stimulation
    Notes: Zusammenfassung Bei 2 Patienten mit implantiertem Demand-Schrittmacher wurde in der Frühphase eines Myokardinfarktes vorübergehend asynchrone Schrittmachertätigkeit infolge gestörter Detektion beobachtet. Die Gefährdung durch schrittmacherinduzierte Parasystolie mit R auf T Phänomen unter Bedingungen erhöhter elektrischer Instabilität konnte erfolgreich unter Anwendung externer Overdrive-Stimulation beseitigt werden.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 264 (1969), S. 281-282 
    ISSN: 1432-1912
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 265 (1969), S. 131-148 
    ISSN: 1432-1912
    Keywords: Ca-Influx and Manganese ; Adrenaline ; Theophylline ; Digitoxigenin ; Isolated Guinea Pig Auricle ; Ca-Einstrom und Mangan ; Adrenalin ; Theophyllin ; Digitoxigenin ; Isolierter Meersehweinchenvorhof
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The influence of bivalent manganese ions (Mn++) on the positive inotropic effect of adrenaline, theophylline, and digitoxigenin was studied in isolated, electrically driven left guinea-pig auricles in phosphate-free Tyrode's solutions with different extracellular calcium concentrations ([Ca]e; 0.45; 1.8; 7.2 mM). Mn++ (0.1–50 mM) exerted a dose-dependent negative inotropic effect which was dependent on [Ca]e: Raising [Ca]e decreased the inhibitory action of Mn++. The negative inotropic effect of Mn++ was exclusively due to a decrease in the rate of tension development; the time to peak tension and the duration of contraction remained unchanged. In a solution containing 0.45 mM Ca, pretreatment with 0.1 mM Mn+ significantly diminished the positive inotropic effect of adrenaline (10−9-10−5 g/ml) and theophylline (5×10−6-10−3 g/ml), but did not influence the effect of digitoxigenin (2×10−7-2×10−6 g/ml). The depression of the positive inotropic effect of adrenaline and theophylline with higher concentrations of Mn+ (0.35–2.25 mM, producing a negative inotropic effect of about 50%) was influenced by the [Ca]e. The effect of Mn+ was most evident at 0.45 mM Ca, less pronounced (but significant) at 1.8 mM Ca and was not observed at 7.2 mM Ca. With the same concentrations of Mn+, however, the positive inotropic effect of digitoxigenin was only slightly decreased at 0.45 mM Ca, was not changed at 1.8 mM Ca and was increased at 7.2 mM Ca. As Mn+ selectively blocks the inward movement of Ca ions across the membrane of the myocardial cell during depolarisation, it is tentatively concluded from these experiments that the positive inotropic effect of adrenaline and theophylline may be due at least partially to an increase of the Ca influx during the excitation process, whereas the positive inotropic effect of digitoxigenin seems to be independent of this mechanism.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 278 (1973), S. 165-178 
    ISSN: 1432-1912
    Keywords: Inotropic Effect ; Butyryl Derivatives of c-AMP ; Non-Cyclic Tributyryl-AMP ; Isolated Rat Auricles
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This study was designed to further elucidate relevance and mechanism of the positive inotropic action of cyclic N6-2′-O-dibutyryl-AMP (DB-c-AMP). For this purpose the effects of cyclic N6-monobutyryl-AMP (N6-MB-c-AMP), noncyclic N6-2′-O-3′-O-tributyryl-5′-AMP (TB-AMP), c-AMP, adenosine and various adenine nucleotides (ATP, ADP, AMP) on myocardial contractile force (CF) were investigated and compared to that of DB-c-AMP. The experiments were performed on isolated, electrically driven (frequency 2 Hz) rat left auricles, i.e. on a preparation in which DB-c-AMP consistently produced positive inotropic effects. The following results were obtained: 1. N6-MB-c-AMP (2×10−4–5×10−3 M) produced a concentration-dependent positive inotropic effect (Fig. 2). This effect began 5.5 to 1.8 min after addition of the drug (Table 2), developed gradually (Fig.2), and was maximal within 44.5 to 9.5 min (Table 2). It was preceded by a transitory decrease in CF which was also concentration-dependent (Fig.2, Table 1). 2. The inotropic effects of cyclic N6-MB-AMP and cyclic DB-AMP were qualitatively similar. Quantitatively, the positive inotropic effect of N6-MB-c-AMP developed more slowly (Table 2) and was smaller in magnitude than that of DB-c-AMP (Fig.2). The initial negative inotropic effect, however, was more pronounced (Table 1) and longer in duration (Table 2) with N6-MB-c-AMP than with DB-c-AMP. 3. The time course of the reversal of the positive inotropic effects during washout in drug-free solution was practically not different with both drugs (Fig.3). Predrug levels were reached within 50–60 min. 4. No positive inotropic effects were found with the non-cyclic but butyryl substituted adenine nucleotide, TB-AMP. In contrast, this compound (10−7 to 10−3 M) produced a concentration-dependent decrease in CF (Fig.4). 5. c-AMP, ATP, ADP, AMP and adenosine depressed CF. No secondary positive inotropic effects could be detected within 60 min (Fig.5; Fig.6). From the failure of non-cyclic TB-AMP to increase contractile force it is concluded that the positive inotropic effects seen with cyclic DB-AMP and cyclic N6-MB-AMP are due to both acyl substitution and the intact cyclophosphate structure. In so far we probably have ruled out one of the objections to the view that the positive inotropic responses to acyl substituted derivatives of c-AMP are “representative” for c-AMP itself. Since the effects of cyclic DB-AMP and cyclic N6-MB-AMP were qualitatively similar and since the time course of the loss of the positive inotropic effects during washout were practically not differen with both drugs, one may further conclude that within the cell both drugs are likely to act via the same compound. This agent could be c-AMP. However, cyclic N6-MB-AMP as the active intracellular compound cannot be ruled out.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1912
    Keywords: Dibutyryl-c-AMP ; Adrenaline ; Isolated Rat Auricles ; Positive Inotropic Effect ; 45Ca Exchange
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of adrenaline (2.2×10−6 M) and cyclic N6-2′-O-dibutyryl-adenosine-3′,5′-monophosphate (DB-c-AMP; 10−3 M) on mechanical performance, 45Ca uptake and total tissue calcium concentration were investigated in electrically stimulated left auricles isolated from female rats weighing 180–220 g. The experiments were performed at reduced [Ca]e of 0.45 mM and at various frequencies of stimulation (0–120 beats/min). In the first series of experiments 45Ca incubation time was 5 min. Under these conditions DB-c-AMP as well as adrenaline enhanced contractile force to 300–450% of the control values at all frequencies tested (Fig.1). This increase in contractile force was accompanied by a significant enhancement in 45Ca exchange (Fig.2) while the total tissue calcium concentration remained unchanged (Table 1). In resting auricles 45Ca exchange was not altered under the influence of both drugs. At long periods of 45Ca exposure (40–90 min) both drugs augmented contractile force in a way similar to that of the first series of experiments (Fig.4) but no influence of DB-c-AMP or adrenaline on 45Ca exchange could be detected (Fig.3). It is concluded that DB-c-AMP can mimic the wellknown effects of adrenaline on myocardial calcium movements. Under the assumption that DB-c-AMP is representative for c-AMP, the results thus provide experimental support for the view that the positive inotropic effect of adrenaline is mediated by primary changes in the intracellular level of c-AMP which secondarily might enhance calcium fluxes across the cardiac cell membrane.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 282 (1974), S. 143-153 
    ISSN: 1432-1912
    Keywords: DB-c-AMP ; Positive Inotropic Action ; Isometric Contraction Curve ; Isolated Ventricular and Atrial Preparations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Conflicting results exist about the influence of cyclic N6-2′-O-dibutyryl-AMP (DB-c-AMP) on myocardial contractile force. The present study was designed to examine whether the positive inotropic action of DB-c-AMP is restricted to certain model preparations or whether it can be assumed to represent a more general effect of the drug. Therefore, the effects of DB-c-AMP on myocardial force and on various parameters of the isometric contraction curve were examined in isolated electrically driven (0.5–2Hz) ventricular and atrial preparations of several mammalian species (cat, rabbit, calf, sheep, rat and guinea-pig). The following results were obtained: 1. At concentrations above 3×10−4M, DB-c-AMP exerted concentrationdependent positive inotropic effects in all ventricular preparations studied. These effects were accompanied by increases in the rates of force development and relaxation and by decreases in time to peak force and relaxation time. 2. Positive inotropic responses to DB-c-AMP were also obtained in atrial preparations of cats, rabbits, calves, sheep and rats. In guinea-pig auricles, similar effects were seen when the preparations were treated with the phosphodiesterase inhibitor papaverine. The results suggest that the positive inotropic action of DB-c-AMP is not restricted to certain model preparations and can be obtained in all cases under suitable experimental conditions.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 279 (1973), S. 313-325 
    ISSN: 1432-1912
    Keywords: Dibutyryl-c-AMP ; Adrenaline ; Isolated Rat and Guinea-Pig Auricles ; Positive Inotropic Effect ; 45Ca Exchange
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The positive inotropic effect of adrenaline has been assumed to result from an increase in the intracellular level of c-AMP which, in turn, might enhance the permeability of the cardiac cell membrane to Ca2+. In order to further test this hypothesis, the effects of cyclic N6-2′-O-dibutyryl-adenosine-3′,5′-monophosphate (DB-c-AMP; 10−3 M) on mechanical performance, 45Ca uptake and total tissue calcium concentration were investigated in electrically stimulated (120 beats/min) left auricles isolated from female rats weighing 180–220 g. The experiments were performed in Tyrode solution containing 0.9 mM CaCl2; the duration of 45Ca exposure was 3–60 min. In this study, DB-c-AMP markedly enhanced contractile force but the drug failed to detectably increase 45Ca exchange (Figs. 1 and 2). This finding seemed to indicate that the effects of DB-c-AMP on myocardial 45Ca exchange were completely different from those of adrenaline which previously (and in this study; Fig. 4) has been shown to accelerate 45Ca exchange in auricles obtained from guinea-pigs of “normal” size. However, under the conditions used, adrenaline (2.2–5.5×10−6 M) also failed to significantly enhance 45Ca exchange not only in rat auricles (Fig. 3) but also in small auricles isolated from very light guinea-pigs (body-weight 75–150 g; Fig. 4). From these findings it is concluded that druginduced changes in membrane calcium fluxes, which possibly occur, only might have escaped detection under the present experimental conditions. The “pool saturation phenomenon” previously described by Grossman and Furchgott (1964b; 1964c) is discussed to be the underlying mechanism. Thus, substantial conclusions on the effects of DB-c-AMP on myocardial Ca fluxes can as yet not be drawn. They must await experiments in which an adrenaline induced increase in cardiac 45Ca exchange becomes detectable.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 52 (1974), S. 701-703 
    ISSN: 1432-1440
    Keywords: Isolated human ventricular myocardium ; c-AMP ; DB-c-AMP ; Positive inotropic effect ; Isoliertes menschliches Ventrikelmyokard ; c-AMP ; DB-c-AMP ; Positiv inotroper Effekt
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Am isolierten menschlichen Ventrikelmyokard hatte c-AMP (10−4–10−3 M) keinen Einfluß auf die Kontraktionskraft. Im Gegensatz dazu wirkte DB-c-AMP (10−4−5·10−3 M) konzentrationsabhängig und reversibel positiv inotrop. Dieser Effekt ging einher mit einer Verkürzung von Anstiegzeit und Erschlaffungszeit der Kontraktion und wurde durch Vorbehandlung mit Propranolol nicht beeinflußt.
    Notes: Summary The contractile responses to c-AMP and DB-c-AMP were studied in isolated electrically stimulated human papillary muscle strips. C-AMP (1×10−4 to 1×10−3 M) had no effect on contractile force in all of 6 human papillary muscle preparations studied. In contrast, DB-c-AMP (10−4 to 5×10−3 M) produced a concentration-dependent and reversible positive inotropic effect which was associated by a decrease in time to peak force and in relaxation time and which was not inhibited by 10−6 M propranolol. The possibility of a clinical applicability of DB-c-AMP is discussed.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 63 (1985), S. 193-204 
    ISSN: 1432-1440
    Keywords: Suprasternal M-mode echocardiography ; Cardiovascular diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The suprasternal approach can be used to image the aortic arch, the right pulmonary artery and the left atrium. Dilatation or dissections involving the aortic arch were detected echocardiographically from the suprasternal notch. The echocardiogram of the right pulmonary artery is altered in cases of acute and chronic pulmonary hypertension. Intrapulmonary thrombi in patients with acute pulmonary embolism were visualized with this technique. A volume overloading of the pulmonary circulation due to a congenital left to right shunt, as well as a decreased pulmonary blood flow due to a congenital right to left shunt causes characteristic changes in the wall motion pattern of the right pulmonary artery. Hypoplasia or aplasia of the central pulmonary arteries can be diagnosed as well. Imaging of the left atrium from the suprasternal notch may help to differentiate between supraventricular and ventricular rhythm disturbances. The suprasternal approach is therefore recommended to be used as a routine part of each echocardiographic examination.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 64 (1986), S. 301-306 
    ISSN: 1432-1440
    Keywords: Myocardial infarction ; Fibrinolysis ; Plasminogen activators
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The early treatment of acute myocardial infarction has changed rapidly in recent years. Given the fact that an occlusive coronary thrombus can be found in most infarct patients within 4 h after clinical symptoms, the idea of instituting medical or mechanical recanalization of the occluded vessel is intriguing. However, invasive measures are time consuming, expensive and not freely available to a great number of patients. Thus, only i.v. fibrinolytic therapy of acute myocardial infarction will gain wider application in the near future. Several concepts have been worked out, one of which uses a high-dosage streptokinase or urokinase regimen. A different therapeutic alternative has been made possible by the development of selective fibrinolytic substances, such as the tissue-type plasminogen activator (t-PA) or the anisoylated plasminogen-streptokinase activator complex (APSAC). Preliminary clinical data have shown that the coronary artery patency rate achieved after i.v. administration of t-PA or APSAC is higher than that after conventional treatment with streptokinase or urokinase. The incidence of severe bleeding complications is low and comparable in these studies. However, until myocardial salvage has been demonstrated with early i.v. fibrinolytic therapy in acute myocardial infarction in a placebo-controlled randomized trial, this therapeutic concept will still be unsettled.
    Type of Medium: Electronic Resource
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