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Biomedical subjects

E Hahn

Publications and source records attributed to E Hahn.

At least 19 recordsLinked to original sources
PubMed1992

Superiority of a vertical sternal lead for detection of arrhythmias during ambulatory electrocardiographic monitoring.

In a preliminary study comparing 7 sets of bipolar leads with standard modified V1 and V5 leads, a vertical sternal lead system with the negative lead just below the suprasternal notch, and the positive lead over the xiphoid had the greatest P-wave area. In the current study, the vertical sternal and modified V1 leads were obtained simultaneously using 2-channel ambulatory electrocardiographic recorders in 50 consecutive patients undergoing diagnostic ambulatory electrocardiography for suspected arrhythmias. The vertical sternal lead provided tracings with a larger P-wave area compared with that of the modified V1 (0.58 +/- 0.44 vs 1.23 +/- 0.69 mm2; p less than 0.0001), and a greater QRS complex (9.23 +/- 4.16 vs 11.78 +/- 4.90 mm; p = 0.006). During premature atrial contractions and supraventricular tachycardia, P-wave visibility was significantly better in the sternal lead than in V1 (p less than 0.001). Furthermore, sternal lead tracings were superior with regard to overall quality and noise level. It is suggested that the vertical sternal lead replace the currently used modified V1 during ambulatory electrocardiographic monitoring. This lead system in conjunction with the standard modified V5 lead should be useful in the differential diagnosis of atrial arrhythmias.

Adolescent↗
PubMed1992

Dissociation of atrioventricular conduction and refractoriness following application of radiofrequency energy to the canine atrioventricular node: acute and chronic observations.

The electrophysiology of AV nodal modification induced by radiofrequency energy (n = 5) or a sham procedure (n = 5) was studied in ten dogs. The five dogs that received radiofrequency energy had an AH prolongation > 100% from baseline values and this prolongation persisted throughout the 2-month study. The AV nodal functional refractory period was prolonged only acutely. These data indicate a dissociation between the effects on AV nodal conduction and refractoriness that was induced by this procedure. The five sham treated controls showed no acute or chronic electrophysiological changes. In the dogs that received radiofrequency energy, there was fibrosis of the approaches to the AV node and the region of the AV node itself. It is concluded that chronic modification of AV nodal conduction without concomitant changes in refractoriness can be induced by radiofrequency energy delivered in the proximal portion of the AV node. It would be anticipated that this procedure would not decrease the ventricular response to atrial fibrillation or flutter, may be effective in preventing AV nodal reentrant tachycardia by interfering with conduction either in the AV node or perinodal region. Since the AV node itself suffers at least moderate pathological damage, there may be an appreciable incidence of the late development of complete heart block after this procedure.

Animals↗
PubMed1992

Evaluation of electrocardiographic leads for detection of atrial activity (P wave) in ambulatory ECG monitoring: a pilot study.

The usual lead systems for ambulatory ECG monitoring (AECG) used in the evaluation of arrhythmias is a modified bipolar V-1 and V-5. A comparison of various lead systems to enhance the detection of atrial activity (p waves) has not been reported. We evaluated various surface lead systems in 12 subjects comparing p waves recorded at 20 mm/mV and 50 mm/sec. We compared p wave area, amplitude, and duration from modified bipolar V1 and V5 as well as seven nonstandard leads recorded on a AECG monitor. Of the seven nonstandard leads, a vertical sternal lead, with the negative pole just below the suprasternal notch and the positive pole at the xiphoid process, had the largest area (1.46 +/- 0.65 mm2), and also had a greater area than the standard V1 (0.88 +/- 0.45 mm) and V5 (1.06 +/- 0.49 mm2) lead system (P less than 0.01). We conclude that the bipolar vertical sternal lead system provides a larger p wave area than seven nonstandard bipolar lead systems and the two standard lead systems currently used in AECG monitoring. Replacement of the modified bipolar V1 lead with a vertical sternal lead should improve the recognition of atrial activity and, therefore, enhance the diagnosis of cardiac arrhythmias.

Adult↗
PubMed1991

Comorbidities and perioperative complications among patients with surgically treated benign prostatic hyperplasia.

We address the question of whether or not age and comorbidity are related to intra- and postoperative complications after a transurethral resection. The data are derived from a retrospective, population-based study conducted in Hagen, Germany, which included all patients with an initial prostatectomy for benign prostatic hyperplasia (N = 621) during the five-year period 1984-1988. Seventy-seven percent of the patients had at least one of the following preoperative risk factors: heart disease, hypertension, smoking, chronic obstructive lung disease, and diabetes. There was no intraoperative death. The risk of intraoperative circulatory complications was found to be related to age only for patients without a history of heart diseases or hypertension. The incidence of major complications was 3.1 percent and was significantly higher in the oldest age group. Three patients (0.54%) died postoperatively in the hospital. Infections were the most frequent postoperative complications. The relationship of age and overall postoperative complications was not statistically significant either for patients with (p = 0.121) or without any comorbidity (p = 0.651). Based on this study it seems reasonable to conclude that age is not a clinically relevant risk factor for perioperative complications in patients who have a transurethral resection for benign prostatic hyperplasia.

Age Factors↗
PubMed1991

Factors associated with binocular single vision in microtropia/monofixation syndrome.

We reviewed the charts of 398 patients with microtropia/monofixation syndrome to determine what factors influence the level of binocularity attained. Most patients (82%) exhibited some degree of stereoacuity. Patients with a later age at presentation of the initial deviation were more likely to exhibit stereoacuity (p less than 0.001). Patients with smaller initial deviations were also more likely to exhibit stereoacuity (p = 0.016), as were those with smaller manifest deviations on final testing (p less than 0.001). Patients with amblyopia on final testing were less likely to demonstrate stereoacuity (p = 0.0001). Generally, the more intervention required in the form of optical or surgical correction, the poorer the level of binocularity.

Adolescent↗
PubMed1990

Age-related prognosis after acute myocardial infarction (the Multicenter Diltiazem Postinfarction Trial).

The basis for the excess mortality with age after acute myocardial infarction (AMI) is not clear, nor is it known whether the mode of death is altered with age. Age-related factors predictive of mortality and age-related mechanisms of the 333 deaths were examined in 2,466 patients who were enrolled in a placebo-controlled trial to determine the effect of diltiazem on mortality and reinfarction after AMI. There were 3 age groups with increasing mortality rates: ages 25 to 49 (n = 499), 50 to 64 (n = 1,228) and 65 to 75 years (n = 739). There was a significant age-related increase in the proportion of patients with baseline risk factors. These baseline characteristics did not differ by treatment (placebo vs diltiazem). However, multivariate survivorship analysis still identified age as an independent risk factor for cardiac death. The proportion of arrhythmic and myocardial failure deaths did not differ by treatment or age group.

Adult↗
PubMed1990

The prognostic significance of first myocardial infarction type (Q wave versus non-Q wave) and Q wave location. The Multicenter Diltiazem Post-Infarction Research Group.

The prognostic significance of the type of first acute myocardial infarction (Q wave versus non-Q wave) and Q wave location (anterior versus inferoposterior) was determined from a multicenter data base involving 777 placebo-treated patients who were participants in the Multicenter Diltiazem Post-Infarction Trial. There were 224 patients (29%) with a non-Q wave infarction, 326 (42%) with an inferoposterior Q wave infarction and 227 (29%) with an anterior Q wave infarction. Mean left ventricular ejection fraction was significantly (p less than 0.001) lower in patients with an anterior Q wave infarction than in the other two groups (anterior Q wave 0.39; inferior Q wave 0.52; non-Q wave 0.53). Nevertheless, the total cardiac mortality rate during the follow-up period (average 25 months per patient) was only marginally higher (p = 0.42) in the anterior Q wave group (8.4%) than in the other two groups (inferoposterior Q wave 7.1%; non-Q wave 6.3%). The total first recurrent cardiac event was somewhat higher (p = 0.08) in the anterior Q wave group (18.1%) than in the other two groups (inferoposterior Q wave 11.7%; non-Q wave 15.6%). Survivorship analyses extending over 3 years revealed that electrocardiographic classification of the type of first infarction and Q wave location did not make significant independent contributions to the risk of postinfarction cardiac death or first recurrent cardiac event, either before or after adjustment for baseline clinical variables.

Adult↗
PubMed1990

[Statistical evaluation of 60,000 blood alcohol values from 1964 to 1983. III. Multiple convictions].

Between the years 1964 and 1983, 59,226 blood samples with appropriate blood-alcohol concentrations (BAC greater than 0.1 g/kg) were investigated at the Institute for Forensic Medicine at the University of Tübingen. These originated from 47,416 different "culprits", of whom 38,851 (81.9%) were first offenders and 8,565 (18.1%) multiple offenders. The total number of crimes committed by the latter group reached as many as 13. There were fewer women amongst the recurring offenders, the maximum number of offences in this group was 4. The age of the multiple offenders at the time of their first brush with the law was lower than that of single culprits. Their blood-alcohol level at the first offence was similar to that of single offenders, however it increased slightly with each subsequent time. Homotropic traffic offenders were mainly only represented in the group with the lower crime rate. Most multiple offenders proved to be criminal delinquents who were frequently conspicuous not only for criminal--but also for criminal--and traffic violations. In about half the cases the time intervals between 2 offences was under 3 years.

Accidents, Traffic↗
PubMed1989

Energy metabolism in children with newly diagnosed acute lymphoblastic leukemia.

The effect of tumor burden in acute lymphoblastic leukemia on resting energy expenditure, thermic effect of food, and substrate utilization was investigated with open-circuit indirect calorimetry after an overnight fast. Nine patients (six females, three males) ages 6.5 to 15.8 y were studied. Patients were divided into two groups according to their tumor burden at diagnosis (i.e. white cell count, presence or absence of mediastinal mass, or massive organomegaly). The patients with a greater tumor burden had increased energy expenditure. Their resting energy expenditure returned to normal in response to chemotherapy. These results must be interpreted with caution due to the small patients numbers (high tumor burden n = 3; low tumor burden n = 6). Substrate utilization was altered by chemotherapy with an increase in carbohydrate utilization and a decrease in fat oxidation (p less than 0.009). The magnitude of the thermic effect of food tended to increase on treatment (p less than 0.016). Inasmuch as most chemotherapy programs for children last up to 3 y, we believe it is important that the effects of chemotherapy on intermediary metabolism be studied, particularly in relationship to any possible permanent effects on growth and development.

Adolescent↗
PubMed1988

Discontinuous buffer systems optimized for the agarose gel electrophoresis of subcellular particles.

Discontinuous buffer systems operative between pH 5.7 and 7.4, 0 degrees C, were generated, which are characterized by more rapidly displaced moving boundaries than applied previously. These allow one to resolve subcellular particles relatively rapidly and at relatively low agarose gel concentrations. A commercial mixture of DNA restriction fragments pre-stained with ethidium bromide was found to be a suitable tracking dye for these boundaries.

Buffers↗
PubMed1988

Linear Ferguson plots of polystyrene sulfate size standards for the quantitative agarose gel electrophoresis of subcellular particles.

Accurately standardized commercial polystyrene sulfate particles in agarose gel electrophoresis yield linear Ferguson plots at pH 7.4 over a gel concentration range up to 0.9% agarose which do not exhibit any significant sigmoidal curve elements, using either a discontinuous buffer system or a continuous buffer. Ferguson plots of these standard-sized particles were evaluated using alternatively a linear or convex model, by means of a newly developed set of programs (to be used in conjunction with program M-LAB) which (i) is sufficiently user-friendly to allow for quantitative agarose gel electrophoresis of subcellular-sized spherical particles based on their convex Ferguson plots with the same operational simplicity previously available for linear Ferguson plots only; (ii) simultaneously and interactively analyzes the Ferguson plots of all particles under consideration on the basis of an extended Ogston model.

Electronic Data Processing↗
PubMed1988

Evidence that a decrease in opioid tone on proestrus changes the episodic pattern of luteinizing hormone (LH) secretion: implications in the preovulatory LH hypersecretion.

We have studied the LH secretion pattern evoked by diminution in the opioid tone produced by iv naloxone (NAL) infusion between 1100-1400 h on proestrus, the LH secretion pattern occurring spontaneously between 1430-1730 h on proestrus and the LH secretion pattern produced by exogenous LHRH administered either as a 10 ng/pulse at 20-, 30-, or 60-min intervals or infused continuously at a rate of 30 ng/h between 1200-1700 h in rats given pentobarbital at 1100 h on proestrus. Infusion of 0.5 ng NAL/h raised plasma NAL levels to 200-300 ng/ml and augmented LH secretion, as evident by increments in pulse amplitude and frequency discharge to one every 37.5 min from an average of one every 75 min in saline-infused control rats. A 4-fold increase in circulating NAL levels, produced by 2 mg/h NAL infusion, further augmented the frequency of LH episodes to 30-33 min and induced a surge-like LH secretion pattern which resembled that seen on the afternoon of proestrus. Further analysis of the secretory pattern of the preovulatory LH surge (n = 7) showed LH pulses of increased amplitude during the basal phase (n = 4), ascending phase (n = 2), and plateau and descending phases (n = 3); in two rats the LH rise was steep, and no LH pulses were identified. A LHRH pulse (10 ng/pulse) delivered at 20- or 30-min intervals or continuous infusion of LHRH at a rate of 30 ng/h produced LH surges, with peak levels reaching the range seen on the afternoon of proestrus. Further, despite the fact that 10 ng LHRH/pulse at 20-min intervals reproduced a proestrous-type LH surge, only 40% of the LHRH pulses were followed by identifiable LH pulses. Surprisingly, despite the observations that NAL evoked robust LH episodes, the basal pattern of FSH secretion in these rats was not altered. These findings show that a decrease in opioid tone on proestrus accelerates episodic LH discharge to the range that occurs after gonadectomy. A quantitative relationship between the degree of restraint on the opioid tone imposed by NAL and the magnitude of the LH response can be demonstrated. The evidence suggests that the preovulatory LH surge may occur in an episodic fashion and that it can be reproduced by LHRH delivered at a frequency rate of LH pulses seen in ovariectomized rats.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1987

Energy expenditure of patients with cystic fibrosis.

Resting energy expenditure was measured by open-circuit indirect calorimetry in 71 patients, aged 8.9 to 35.5 years, with cystic fibrosis who had no recent history of acute lung infection. Pulmonary function and nutritional status were studied simultaneously. In most patients, resting energy expenditure was above normal (range 95% to 153% of predicted values for age, sex, and weight as derived from the Harris Benedict equations), and was negatively correlated with pulmonary function (P less than 0.01) and nutritional status (P less than 0.01) when expressed as a percentage of body fat. Pulmonary status was positively correlated with nutritional status (P less than 0.01). We conclude that resting energy expenditure in patients with cystic fibrosis exceeds normal values and that the increase correlates with a deterioration in lung function and nutritional status.

Adolescent↗
PubMed1985

Basement membrane proteins and type III procollagen in murine schistosomiasis.

The livers of female CBA mice were examined 9 to 10 weeks after subcutaneous infection with Schistosoma mansoni. Cryostat liver sections and isolated liver cells were examined by indirect immunofluorescence using specific antibodies against basement membrane proteins (laminin, fibronectin and type IV collagen and type III collagen precursor. Liver cells were isolated by collagenase digestion, purification on Percoll density gradients and centrifugal elutriation to yield enriched fractions of hepatocytes, endothelial and Kupffer cells (Fractions I, II, III respectively). Infected animals yielded more than three times the control number of non-parenchymal cells; electron microscopy revealed that the increase in Fraction II was due mainly to eosinophilic leucocytes and in Fraction III due to Kupffer cells and macrophages from the schistosomal granulomata. Studies of cryostat liver sections showed that the schistosomal granulomata contained dense deposits of type III collagen precursor and fibronectin in the distribution of the reticulin fibres but laminin and type IV collagen were conspicuous only in new vessels in the periphery of the granuloma. Isolated liver cells showed fibronectin on their surface. Immunofluorescence studies could not be performed on Kupffer and endothelial cell fractions because of marked non-specific fluorescence. These experiments indicate that centrifugal elutriation is a useful method for isolating the constituent cells of murine schistosomal granulomata.

Animals↗