The cyclic nature of the Phanerozoic sedimentary rock distribution, carbonsulphur coupling, and material transfer among sedimentary reservoirs appears to be controlled by tectonic factors. The distribution of preserved sedimentary mass in terms of rock mass remaining U. geologic age shows a minimum c. 300-350 Ma ago, which separates two subcycles of erosion and deposition of sedimentary rocks. The older subcycle was interrupted because of the major continental collisions of the Devonian and late Carboniferous. These collisions resulted in a reduction of outcrop areas of rocks of the older cycle relative to their masses, leading to a decline in the probability of destruction and an increase in half-life of these older sediments.A strong correlation exists between the long-term cyclicity in the Phanerozoic global sea level curve and the distribution of carbon and sulphur among their major exogenic reservoirs. This correlation is related to two principal tectonic modes of the Phanerozoic: oscillatory and submergent.It is postulated that the submergent mode of active plate convergence, obduction and subduction of sediments, large ridge volume, and high sea level gave rise to low erosion and sedimentation rates, less restricted environments of carbonate deposition, and relatively high atmospheric CO, levels (high temperatures ?), resulting from an increased rate of production of CO, from diagenetic and metamorphic reactions at subduction zones. As sea level rose carbon was transferred from the sedimentary reservoir of reduced organic carbon to that of oxidized inorganic carbon in limestones, whereas sulphur moved from the oxidized sulphate reservoir to the reduced sulphide reservoir. As sea level fell, reservoir transfers were opposite to those above culminating in the oscillatory mode of generally elevated continental interiors. These reservoir transfers are consistent with secular changes observed in the distribution of 6 13C and S34S in Sedimentary materials during the Phanerozoic.Petrographic examination of Phanerozoic oolite formations shows that ooids with preserved calcitic relict textures are characteristic of pre-Carboniferous carbonate rocks, whereas ooids with relict textures indicative of initial aragonite mineralogy are dominant in rocks of younger age. These changes in ooid mineralogy may be interpreted as reflecting changes in CO, levels of the ocean-atmosphere system consistent with the above tectonic considerations. Atmospheric CO, levels were higher prior to Carboniferous time, favouring formation of calcitic ooids and skeletal parts; after the Carboniferous, CO, levels fell and aragonite and Mg-calcites of greater than 8 mol % Mg increased in abundance as precipitates.
Late survival and freedom from myocardial infarction were determined for 192 patients with coronary artery disease and depressed left ventricular ejection fraction at rest (less than or equal to 35%) determined by biplane angiography who were evaluated between 1970 and 1977. Seventy-seven patients had coronary artery bypass grafting and 115 patients were treated medically and were considered surgical candidates. The medical and surgical groups were comparable in all baseline characteristics examined except frequency of three vessel disease and angina pectoris, which occurred in a significantly greater percent of the surgically treated patients (p less than 0.01). Only three medically treated patients (2.6%) underwent coronary bypass grafting in the follow-up period. Seven year actuarial survival was 63% in the surgical and 34% in the medical group (p less than 0.001). Ninety-three percent of patients in the surgical group and 81% of those in the medical group were free of nonfatal myocardial infarction (p = 0.01), and 62 and 33%, respectively, were alive and free of myocardial infarction (p less than 0.001) at 7 years. Significant differences in survival favoring surgical treatment were observed for the subsets of patients with an ejection fraction of 25% or less (p = 0.0002) and 26 to 35% (p = 0.01), and for the subsets with three vessel coronary disease (p less than 0.001), normal left ventricular end-diastolic volume (less than or equal to 100 ml/m2) (p = 0.005) and elevated end-diastolic volume (greater than 100 ml/m2)(p = 0.001). After adjustment for other important prognostic variables, the type of treatment remained significant in predicting the relative risk (medical to surgical) of mortality at 5 and 7 years (2.58 and 2.12, respectively). These data corroborate the trends observed in several randomized trials of medical and surgical therapy in patients with abnormal left ventricular function. If hospital mortality for coronary artery bypass grafting is less than 5%, substantial benefit can be anticipated for the majority of patients with depressed ventricular function.
In an effort to understand the ionic basis for the developmental changes that have been reported to occur in the configuration of the human atrial action potential, we characterized the transient outward current (Ito) and the inward rectifier current in atrial myocytes isolated from 20 young (ages 1 day-2.5 yr) and 8 adult (11-68 yr) human hearts using the whole cell patch-clamp technique. We found evidence for statistically significant (P < 0.05) age-related changes in the Ito, including 1) the presence of an Ito in only 67% of the cells isolated from young hearts vs. 100% of the cells isolated from adult hearts, 2) an almost twofold increase in the current density of Ito in adult cells vs. young cells, and 3) recovery kinetics that are approximately twofold slower in young myocytes relative to adult myocytes. In contrast, there were no age-related changes found in the current density of the inward rectifier current or the sustained current measured after the decay of Ito. These results suggest important current-dependent changes that occur with age in human atria.
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