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Biomedical subjects

J Hummel

Publications and source records attributed to J Hummel.

At least 19 recordsLinked to original sources
PubMed2006

Evaluation of a new electromagnetic tracking system using a standardized assessment protocol.

This note uses a published protocol to evaluate a newly released 6 degrees of freedom electromagnetic tracking system (Aurora, Northern Digital Inc.). A practice for performance monitoring over time is also proposed. The protocol uses a machined base plate to measure relative error in position and orientation as well as the influence of metallic objects in the operating volume. Positional jitter (E(RMS)) was found to be 0.17 mm +/- 0.19 mm. A relative positional error of 0.25 mm +/- 0.22 mm at 50 mm offsets and 0.97 mm +/- 1.01 mm at 300 mm offsets was found. The mean of the relative rotation error was found to be 0.20 degrees +/- 0.14 degrees with respect to the axial and 0.91 degrees +/- 0.68 degrees for the longitudinal rotation. The most significant distortion caused by metallic objects is caused by 400-series stainless steel. A 9.4 mm maximum error occurred when the rod was closest to the emitter, 10 mm away. The improvement compared to older generations of the Aurora with respect to accuracy is substantial.

Austria↗
PubMed2006

Digestion studies in captive Hippopotamidae: a group of large ungulates with an unusually low metabolic rate.

We performed intake and digestibility studies in four common (Hippopotamus amphibius) and four pygmy (Hexaprotodon liberiensis) hippos from two zoological institutions, using acid detergent lignin as an internal marker for the quantification of faecal output. In the case of one pygmy hippo, where total faecal collection was also possible, there was no distinct difference between the two methods of faecal output quantification. Two animals from each species were tested on a conventional zoo diet of hay and concentrates (diet HC) and on hay only (diet H). The other two animals received fresh grass at two different levels of intake (diets G1 and G2). Dry matter (DM) intake was higher on HC than on H or G diets, and averaged 37 +/- 11 for common and 35 +/- 14 g/kg(0.75) for pygmy hippos. There were no species differences in the average digestibility (aD) coefficients. Non-dietary faecal nitrogen averaged 65 +/- 4% of total faecal nitrogen, aD of crude protein (CP) averaged 67 +/- 9% and true protein digestibility 89 +/- 3%. Average digestibility of DM and crude fibre averaged 54 +/- 11% and 45 +/- 17%, respectively. In comparison with ruminants, hippos generally achieve lower aD for DM, organic matter and fibre parameters, but equal or higher aD CP coefficients. This is most likely due to the absence of significant fermentative activity in the hindgut and the corresponding low metabolic faecal nitrogen losses. Digestible energy intake was higher on HC than on H or G diets and averaged 0.30 +/- 0.11 MJ/kg(0.75) metabolic body mass. This value is extremely low for ungulates, supporting earlier suspicions that hippos have particularly low metabolic rates, and explains the proneness of this species to obesity in captivity when fed energy-dense pelleted feeds.

Animal Feed↗
PubMed2006

Digestion coefficients achieved by the black rhinoceros (Diceros bicornis), a large browsing hindgut fermenter.

In contrast to the grazing white (C. simum) and Indian (R. unicornis) rhinoceros, the black rhinoceros (D. bicornis) is an exclusive browser. Due to the particular fermentation characteristics of browse, one would expect browsers to display both shorter ingesta retention times and lower digestion coefficients on comparable diets than grazers. In order to generate a database to test this hypothesis, we performed digestibility studies in eight black rhinoceroses (D. bicornis) from three zoological institutions, using total faecal collection for the quantification of faecal output. One to three regularly fed zoo rations of roughage, concentrates and varying proportions of browse material were used per animal. Additional data was taken from three hitherto unpublished studies as well as several published sources. When compared with horses on similar rations, black rhinoceroses achieved lower digestion coefficients for organic matter and CF. In general, an increase in dietary CF content led to a steeper decrease in organic matter and GE digestibility in black rhinoceroses than in horses. When comparing available data for rhinoceroses, browsing species showed a steeper decrease in organic matter digestibility than grazing species with increasing dietary cell wall content. Endogenous losses as determined by linear regression analysis were within the range reported for horses and Indian rhinoceroses. The results suggest that the horse is not a useful model animal for evaluating diets for black rhinoceroses energetically. In general, diets fed to captive black rhinoceroses seem to include higher proportions of concentrates than diets for other rhinoceros species, and an increase in browse or roughage would reduce digestion coefficients to levels observed in animals fed natural forage.

Animal Feed↗
PubMed2006

Antioxidant status of faeces of captive black rhinoceros (Diceros bicornis) in relation to dietary tannin supplementation.

In context with the frequent observations of excessive iron (Fe) storage in captive black rhinoceroses (Diceros bicornis), it has been suggested that both an excessive dietary Fe content and a lack of dietary Fe-chelating substances, such as tannins, is the underlying cause. Therefore, studies on the effects of tannin supplementation to captive diet are warranted. Six captive rhinoceroses were fed their normal zoo diet (N), and a similar diet supplemented with either tannic acid (T, hydrolysable tannin) or quebracho (Q, condensed tannins), and the total antioxidant capacity (TAC) was measured as mmol Trolox equivalents per kg fresh faeces. The TAC values on diets N (1.24 +/- 0.39 mmol/kg fresh faeces) and T (1.34 +/- 0.33 mmol/kg fresh faeces) were similar, but significantly higher on diet Q (2.32 +/- 0.61 mmol/kg fresh faeces). In contrast to expectations, faecal TAC increased with increasing faecal Fe, possibly as a result of the fact that the faecal Fe content was positively correlated to the proportion of concentrate feeds in the diet, which also contain antioxidants, such as vitamin E, in addition to Fe. Increased antioxidant status caused by the use of tannin substances could have a beneficial effect on animal health, but if tannins should be incorporated in designed diets, other tannin sources, such as grape pomace should be tested.

Animals↗
PubMed2005

Fast DRR generation for 2D/3D registration.

We present a simple and rapid method for generation of perspective digitally rendered radiographs (DRR) for 2D/3D registration based on splat rendering. Suppression of discretization artefacts by means of computation of Gaussian footprints--which is a considerable computational burden in classical splat rendering--is replaced by stochastic motion of either the voxels in the volume to be rendered, or by simulation of a X-ray tube focal spot of finite size. The result is a simple and fast perspective rendering algorithm using only a small subset of voxels. Our method generates slightly blurred DRRs suitable for registration purposes at framerates of approximately 10 Hz when rendering volume images with a size of 30 MB on a standard PC.

Algorithms↗
PubMed2005

Observations on the macroscopic digestive anatomy of the Himalayan tahr (Hemitragus jemlahicus).

We measured macroscopic anatomical parameters of the digestive tract of 12 female Himalayan tahrs. According to morphological criteria used sensu Hofmann for the classification of ruminants into feeding types - in particular the reticuloruminal capacity measured as wet content weights, the ruminal pillar thickness, the reticular honeycomb structure, the size of the omasum and the size of the parotid glands - tahrs can be classified as predominantly grazing ruminants. As reported in other ruminant species, the length of the large intestine was a more constant parameter over a range of body weights than that of the small intestine. The weight of the parotid glands scaled to metabolic body weight.

Animals↗
PubMed2005

Energy and fibre intake in a group of captive giraffe (Giraffa camelopardalis) offered increasing amounts of browse.

We investigated the effect of diet on intake of energy and fibre in a group of three captive adult giraffe by weighing offered diet items and leftovers for 7 days after an adaptation period of 7 days. Digestion coefficients were calculated using, as internal marker, the acid detergent lignin content of a faecal sample pooled from subsamples taken during the last 5 days of intake measurement. Two lucerne hay-only diets of differing quality (L1, L2) were fed, as well as the regular diet of lucerne hay and concentrates (L2C), and the regular diet supplemented with 3 or 6 kg of edible, fresh browse material (L2CB3, L2CB6). The proportion of roughage in the ingested diets L2CB6 (45 +/- 5% dry matter), L2CB3 (35 +/- 3%) and L2C (37 +/- 10%) did not differ significantly. Digestible energy intake was low on the hay-only diets [L1: 0.28 +/- 0.06 MJ/kg body weight (BW)0.75; L2: 0.33 +/- 0.10 MJ/kg BW0.75] and increased from L2C (0.60 +/- 0.13 MJ/kg BW0.75) to a significant increase with L2CB3 (0.72 +/- 0.17 MJ/kg BW0.75); no further increase was obvious for L2CB6 (0.63 +/- 0.15MJ/kg BW0.75). The results confirm that giraffes are unlikely to meet energy requirements on lucerne hay-only diets. In a feeding scenario where both lucerne hay and the concentrate component of the diet are fed ad libitum, the animals tended to exchange hay for browse when browse was added. Only the higher level of browse supplementation led to a potentially beneficial increase in fibre intake. Whether additional browse supplementation will lead to increased intakes in a feeding scenario with restricted concentrate provision can be suspected but remains to be demonstrated.

Animal Feed↗
PubMed2004

Intake, ingesta retention, particle size distribution and digestibility in the hippopotamidae.

Although several aspects of the digestive physiology of the hippopotamidae-non-ruminating foregut fermenters-have been described, ingesta kinetics and passage characteristics of these species are not well understood. The most outstanding feature of the hippo digestive physiology reported so far is the very long mean ingesta retention times (MRTs) measured by Foose [Foose, T., 1982. Trophic strategies of ruminant versus nonruminant ungulates. PhD dissertation, University of Chicago, Chicago.]. Since those data had been investigated with animals without water access, we intended to measure MRT in hippos which were allowed to enter water pools during the night. MRT parameters as well as dry matter (DM) digestibility were determined in four common (Hippopotamus amphibius) and four pygmy hippos (Hexaprotodon liberiensis) on two different diets each using cobalt ethylendiamintetraacetate (Co-EDTA) as a fluid, chromium (Cr)-mordanted fibre (<2 mm) as a particle and acid detergent lignin (ADL) as an internal digestibility marker. Four of the animals additionally received cerium (Ce)-mordanted fibres (2-10 mm) as particle markers. Total MRTs for fluids and particles ranged between 20-35 and 48-106 h in the common and between 13-39 and 32-107 h in the pygmy hippos. The difference between fluid and particle retention was greater than usually reported in ruminants. Excretion patterns of the markers differed from those usually observed in ruminants but resembled those reported for macropods (kangaroos), indicating a plug-flow reactor-like physiology in the hippo forestomach (FRST). This finding complements other described similarities between the macropod and the hippo forestomach. The measurements of larger particle retention profiles suggest that in the hippo, larger particles might be excreted either faster or at the same rate as smaller particles, indicating a general difference between ruminants and hippos with respect to differential particle retention. The digestive physiology of hippos is characterised by a generally low food intake, long ingesta retention times and dry matter digestibilities lower than reported in ruminants. Moderate digestibilities in spite of long retention times might be the result of the generally high average ingesta particle size in hippos. The comparatively easy management of pygmy hippos, together with the significant correlations between food intake, MRT and digestibility in the pygmy hippos of this study, recommends this species for further studies on the interplay of these parameters in herbivore digestive physiology.

Animals↗
PubMed2001

Assessment of pacemaker chronotropic response: implementation of the Wilkoff mathematical model.

There are few practical guidelines for proper adjustment of rate responsive pacemaker sensor parameters. This study describes the application of the chronotropic assessment exercise protocol (CAEP) and the Wilkoff model of chronotropic response to assess the adjustment of pacemaker sensor parameters. In 31 patients implanted 1 month previously with a dual sensor pacemaker, pacemaker sensor parameters were adjusted to yield a peak sensor rate of 100 beats/min on a simple 6-minute walk (low intensity treadmill exercise [LITE] protocol); the maximum sensor rate was set to the age predicted maximum heart rate (220-age). The rate response behavior of the pacemaker was then assessed using the slope of metabolic-chronotropic relation (MCR) during CAEP exercise. After adjustments based on the LITE protocol, CAEP exercise yielded MCR slopes of 0.92 +/- 0.25 for the entire study group, which compares well with the predicted normal slope of 1. However, 7 of the 31 patients had sensor MCR slopes during CAEP exercise that were 2 SD or more below expected. To test the sensitivity of this approach to suboptimal pacemaker programming or suboptimal exercise, simulations were performed with the maximum sensor rate programmed below age-predicted maximum heart rate or with exercise truncated before maximum exertion; with these conditions, MCR slopes were sharply lower for the entire group. The authors conclude that a simple treadmill walk (LITE) allowed for optimum programming of sensor parameters in most patients, but in a minority the chronotropic behavior was underresponsive. Failure to appropriately adjust pacemaker maximum sensor rate or failure to achieve peak exercise sharply limits the accuracy of this methodology.

Equipment Design↗
PubMed2000

Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study. Cooled RF Multi Center Investigators Group.

OBJECTIVES: The purpose of this multicenter study was to evaluate the safety and efficacy of a radiofrequency (RF) catheter ablation system with internal saline irrigation. BACKGROUND: Catheter ablation of ventricular tachycardia (VT) associated with structural heart disease is more difficult than ablation of idiopathic VT. The larger size of responsible reentrant circuits contributes to the difficulty in achieving an adequate ablation lesion with conventional techniques. Recently, cooling of the ablation electrode by saline irrigation has been shown to increase RF lesion size. METHODS: The patient population included 146 patients who participated in the Cooled RF Ablation System clinical trial and underwent an attempt at ablation of VT occurring in the presence of structural heart disease. The duration of follow-up was 243 +/- 153 days. RESULTS: Catheter ablation was acutely successful, as defined by elimination of all mappable VTs, in 106 patients (75%). In 59 patients (41%), no VT of any type was inducible after ablation. Twelve patients (8%) experienced a major complication. After catheter ablation, 66 patients (46%) developed one or more episodes of a sustained ventricular arrhythmia. CONCLUSIONS: The results of this study demonstrate that catheter ablation of all mappable forms of sustained VT can be performed with high initial success and a moderate incidence of major complications (8%).

Adult↗
PubMed2000

Impact of biventricular pacing on mortality in a randomized crossover study of patients with heart failure and ventricular arrhythmias.

Biventricular (BV) pacing is under clinical investigation for the treatment of heart failure. Its impact on mortality is unknown. Patients with heart failure and ventricular tachyarrhythmias received an implantable cardioverter defibrillator with BV pacing capability. Patients were randomized 1:1 to BV pacing or no pacing, then crossed over to the alternate mode after 3 months. All-cause mortality was measured in each arm up to the point of crossover. Fifteen of 222 patients died between implant and crossover. Five patients died while programmed to BV pacing and 19 died while programmed to no pacing. Survival in the BV pacing arm was 93 +/- 4% versus 86 +/- 6% in the no pacing arm (P = 0.18). In a patient population with symptomatic heart failure and ventricular arrhythmias, BV pacing does not appear to be associated with excess mortality. Larger and longer studies will be needed to determine if BV pacing confers a survival benefit.

Aged↗
PubMed1999

Biventricular pacing in patients with congestive heart failure: two prospective randomized trials. The VIGOR CHF and VENTAK CHF Investigators.

Epidemiologic studies suggest that 20-30% of patients diagnosed with symptomatic congestive heart failure (CHF) have intraventricular conduction disorders characterized by a discoordinate contraction pattern and wide QRS. Biventricular pacing is an emerging therapy allowing simultaneous electrical stimulation of the right and left ventricles with the use of an implantable pacing system. The aim of this article is to describe 2 prospective randomized multicenter trials examining the effects of biventricular pacing on functional capacity, quality of life, and hemodynamic status in patients with dilated cardiomyopathy and intraventricular delay. The VIGOR CHF Trial is designed to assess functional and symptomatic improvement in heart failure patients with biventricular pacing and without a concomitant indication for conventional bradycardia pacemaker therapy. To assess for potential placebo effects, patients are randomized to receive either biventricular pacemaker therapy or no pacing therapy for the first 6 weeks, after which both groups receive pacing therapy. The VENTAK CHF trial uses an implantable cardioverter defibrillator system (ICD) designed to provide chronic biventricular pacing therapy in addition to treating ventricular tachyarrhythmias. All patients receive conventional ICD and CHF therapy throughout the study and are randomized in a 2-period crossover design to receive either no pacing or biventricular pacing for 3-month intervals. Patient enrollment in both studies is ongoing, with a closed analysis. The unique designs of these trials provide the opportunity to study this therapy in high-risk patients who have been optimally treated for heart failure.

Adult↗
PubMed1999

Mode switching in dual chamber pacemakers: effect of onset criteria on arrhythmia-related symptoms.

AIMS: Various mode-switching algorithms are available with different tachyarrhythmia detection criteria to be satisfied to initiate mode-switching. This study evaluated three different mode-switching algorithms in patients with paroxysmal atrial fibrillation. METHODS AND RESULTS: Seventeen patients completed the study. Three mode-switching algorithms were downloaded as software into the pacemaker, each for 1 month in a single-blind, randomized sequence. The criteria to initiate mode-switching were: mean atrial rate ('standard'), '4-of-7' or '1-of-1' atrial intervals to exceed the atrial detection rate. Symptoms for each were measured using the Symptom Checklist Frequency and Severity index. The median number of mode-switch episodes increased from 20 for 'standard' to 39 for '4-of-7' (P=0.029 vs 'standard') and 103 for '1-of-1' (P=0.0012 vs 'standard') onset criteria. Median duration of episodes decreased from 2.5 min with 'standard' to 1.4 min with '4-of-7' and 0.4 min with '1-of-1' onset criteria. Frequency of symptoms was lower using '4-of-7' (18.2 +/- 12.0 vs 23 +/- 12.0, P=0.08) or '1-of-1' (20.4 +/- 12.4 vs 23 +/- 12.0, P=0.07) than 'standard' onset criteria. Severity of arrhythmia tended to be less with either '4-of-7' (16 +/- 10.4 vs 19.1 +/- 19.4, P=0.12) or '1-of-1' (17.5 +/- 10.3 vs 19.1 +/- 9.4, P=0.18) than with 'standard' onset criteria. CONCLUSIONS: The more sensitive onset criteria for detection of atrial tachyarrhythmias were associated with lower frequency and severity of symptoms.

Algorithms↗
PubMed1995

Atrial electrogram characteristics in patients with and without atrioventricular nodal reentrant tachycardia.

BACKGROUND: Multicomponent atrial electrograms and "slow pathway potentials" are helpful in identifying target sites for radiofrequency catheter ablation of the slow pathway in patients with atrioventricular (AV) nodal reentrant tachycardia. The purpose of this study was to compare the atrial electrograms recorded at various locations in the right atrium in patients with and without AV nodal reentrant tachycardia to assess the specificity of multicomponent atrial electrograms and possible slow pathway potentials both for the posteroseptal right atrium and for patients with AV nodal reentrant tachycardia. METHODS AND RESULTS: In 25 patients with AV nodal reentrant tachycardia and 23 control patients without AV nodal reentrant tachycardia or dual AV nodal physiology, atrial electrograms with an AV ratio of < or = 1:2 were recorded at the posteroseptal right atrium near the coronary sinus ostium and in the right atrium near the posterior, lateral, and anterior aspects of the tricuspid annulus. Attempts were made to identify broad, multicomponent, and double atrial electrograms. There were no significant differences between the patients with and without AV nodal reentrant tachycardia in the mean number of deflections in the atrial electrograms or in the mean duration of the atrial electrograms recorded at any of the atrial sites. In all patients, the number of atrial electrogram deflections and the atrial electrogram duration were significantly greater at the posteroseptal position than at the other three atrial sites. The prevalence of potentials with the appearance of slow pathway potentials in the posterior septum was similar in patients with and without AV nodal reentrant tachycardia (68% and 70%, respectively). The prevalence of these potentials was 6% to 25% at the other three atrial sites (P < .005 compared with the posterior septum). CONCLUSIONS: The atrial electrogram characteristics that have been found to be useful in identifying effective posteroseptal slow pathway ablation sites in patients with AV nodal reentrant tachycardia are equally prevalent in patients without AV nodal reentrant tachycardia or dual AV nodal physiology. Atrial electrograms in the posteroseptal area are broader and contain more deflections than at other areas in the right atrium, possibly because of conduction properties of the posterior transitional zone that are independent of the presence of AV nodal reentrant tachycardia.

Adult↗
PubMed1995

Effect of accessory pathway location on the efficiency of heating during radiofrequency catheter ablation.

During radiofrequency catheter ablation of accessory pathways there is a poor correlation between applied power and temperature at target sites for catheter ablation. This study was designed to examine the relation between power and temperature during radiofrequency catheter ablation in patients with accessory pathways and to identify the factors that affect the efficiency of heating, defined as the ratio of applied power and temperature. Twenty-nine patients underwent radiofrequency catheter ablation of an accessory pathway. Among 257 energy applications, 108 were applied for ablation of a right-sided accessory pathway, 105 for a left-sided accessory pathway, and 44 for a posteroseptal accessory pathway. During each application of radiofrequency energy, temperature was continually monitored by use of an ablation catheter with a thermistor embedded in the tip of the distal electrode. During some applications of energy, fluctuations in temperature were observed. The average power, impedance, temperature, and efficiency of heating for all applications of radiofrequency energy was 37 +/- 11 W, 100 +/- 9 ohms, 53 +/- 9 degrees C, and 1.7 +/- 0.8 degrees C/W (range 0.9 degrees to 6.6 degrees C/W), respectively. The efficiency of heating varied by location (p < 0.0001), with the greatest efficiency of heating for posteroseptal energy applications (2.3 +/- 1.2 degrees C/W, which were significantly greater than for left-sided (1.8 +/- 0.8 degrees C/W; p < 0.01) or right-sided (1.2 +/- 0.4 degrees C/W; p < 0.0001) applications. Phasic fluctuation in temperature was observed during 127 (49%) energy applications, and the efficiency of heating was 1.5 +/- 0.7 degrees C/W.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗