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P Wach

Publications and source records attributed to P Wach.

At least 37 records · Page 2Linked to original sources
PubMed1998

Lactate metabolism of subcutaneous adipose tissue studied by open flow microperfusion.

Open flow microperfusion and a novel calibration technique (ionic reference technique) were evaluated for the frequent measurement of the absolute lactate concentration in sc adipose tissue. Furthermore, the influence of the plasma insulin concentration on the lactate concentration of sc adipose tissue was investigated during hyperglycemia. Sixteen lean healthy young men participated in the studies. In the postabsorbtive state the mean sc lactate concentrations were 1.29 and 1.36 mmol/L for the ionic reference technique and the no net flux protocol, respectively (not significant, P > 0.05). The simultaneously measured arterialized plasma lactate concentration was significantly lower at 0.77 mmol/L (P < 0.05). Both the sc lactate concentration (1.8+/-0.33 mmol/L) and the plasma lactate concentration (0.96+/-0.03 mmol/L) were significantly elevated during a hyperinsulinemic euglycemic clamp experiment. During a hyperglycemic clamp experiment the sc lactate concentration reached a significantly elevated plateau (2.15+/-0.27 mmol/L) that was not influenced by the increasing plasma insulin concentration. It is concluded that 1) open flow microperfusion combined with the ionic reference technique enables frequent measurement of the sc lactate concentration; 2) sc adipose tissue is a significant source of lactate release in the postabsorbtive state as well as during hyperinsulinemic clamp conditions; and 3) insulin concentrations greater than 180 pmol/L have no further influence on adipocyte stimulation of sc adipose tissue with respect to lactate release.

Adipose Tissue↗
PubMed1998

Validation of home blood glucose meters with respect to clinical and analytical approaches.

OBJECTIVE: To evaluate the clinical and analytical accuracy of home blood glucose meters. RESEARCH DESIGN AND METHODS: Six blood glucose meters--Reflolux S (Boehringer Mannheim, Mannheim, Germany), One Touch II (LifeScan, Milpitas, CA), Glucocard Memory (Menarini, Florence, Italy), Precision QID (Medisense, Cambridge, U.K.), HaemoCue (HaemoCue, Angelholm, Sweden), and Accutrend alpha (Boehringer Mannheim, Mannheim, Germany)--were compared with a reference method (Beckman Glucose Analyzer II) under controlled conditions (glucose clamp technique). Validation of the blood glucose meters was accomplished by clinically oriented approaches (error grid analysis), statistical approaches (variance components analysis), and by the criteria of the American Diabetes Association (ADA), which recommend a target variability of < 5%. RESULTS: A total of 1,794 blood glucose monitor readings and 299 reference values ranging from 2.2 to 18.2 mmol/l were analyzed (705 readings < 3.89 mmol/l, 839 readings between 3.89 and 9.99 mmol/l, and 250 readings > 9.99 mmol/l). According to error grid analysis, only Reflolux S and Glucocard M had 100% of estimations within the clinically acceptable zones A and B. Assessment of analytical accuracy revealed substantial differences between the glucose meters after separation of the data into defined glycemic ranges. None of the devices met the ADA criteria. CONCLUSIONS: To evaluate accuracy of blood glucose meters, error grid analysis, as well as statistical models, are helpful means and should be performed together. Analytical performance of currently available home blood glucose meters differs substantially within defined glycemic ranges.

Blood Glucose Self-Monitoring↗
PubMed1997

Magnetic source imaging in the human heart: estimating cardiac electrical sources from simulated and measured magnetocardiogram data.

The estimation of pseudo primary current dipoles on a 2D-manifold in the atrial and ventricular myocardium and septum, and of the transmembrane potential on the endocardium and epicardium, from the magnetic heart field is investigated. The human thorax surrounding the heart is modelled by an inhomogeneous boundary element volume conductor model, including the outer thorax surface and the surfaces of the lungs. The influence of the blood mass is neglected. In the inverse problem Tikhonov's regularisation is applied. The regularisation parameter is determined by the L-curve method. An algorithm for iterative improvement is applied to estimate the pseudo primary current dipoles. Synthetic magnetic field and electric potential data are generated using a cellular automaton model of the entire human heart. Real world magnetic field data for a normal subject are analysed to demonstrate the practicability and effectiveness of the presented method.

Algorithms↗
PubMed1997

Post-movement EEG synchronization studied with different high resolution methods.

In this paper we present a study of spline surface Laplacian (LP), linear estimation (LE) and analytical deblurring (AD) utilized to improve the spatial resolution of single trial EEG data. AD is a method to reconstruct the potential distribution on the cortical surface. The dependency of AD on the electrode grid size as well as the sensitivity to uncorrelated noise and errors in the volume conductor model are investigated in detail and compared with LP. Finally, all methods (LP,LE and AD) are applied to single trial EEG data recorded in three subjects during voluntary and self-paced extension and flexion movements of the right index finger. In each subject postmovement beta oscillations were found in specific frequency bands. Cortical dipolar source strengths were reconstructed by LE and cortex potentials were estimated with AD. Both results are compared with LP calculated from the scalp EEG. All methods, although having different theoretical basis, yield similar results and reveal a maximal event-related synchronization over the left sensorimotor area approximately 500-875 ms after termination of the movement.

Adult↗
PubMed1997

Open-flow microperfusion of subcutaneous adipose tissue for on-line continuous ex vivo measurement of glucose concentration.

OBJECTIVE: To evaluate a novel technique for on-line continuous glucose measurement in subcutaneous adipose tissue, and to investigate its accuracy for detection of hypoglycemia. RESEARCH DESIGN AND METHODS: The method combined an open-flow microperfusion of subcutaneous adipose tissue using a double lumen catheter and an extracorporeal sensor cell. An isotonic ion-free solution was perfused through the inner lumen of the catheter, equilibrated with the subcutaneous tissue fluid, and sampled through the outer lumen. The recovery was continuously monitored as the ratio between the measured sampled fluid conductivity and the subcutaneous tissue fluid conductivity (assumed to have a constant value of 1.28 S/m at 25 degrees C). Glucose concentration was calculated on-line from the measured glucose in the sampled fluid and the measured recovery in healthy volunteers during hyperglycemic glucose loads (n = 8), hypoglycemic hyperinsulinemic clamp (n = 6), and a 24-h monitoring period (n = 7). RESULTS: Subcutaneous glucose concentrations in the fasting state were 94% of the plasma glucose concentrations in arterialized venous samples. According to the error grid analysis, 96.9% of the on-line measured subcutaneous glucose concentrations during hyperglycemia and 96.3% during hypoglycemia were in accurate or acceptable zones. The mean differences between the measured subcutaneous glucose and the actual plasma glucose concentration were -0.06-3.3 mmol/l (hyperglycemia), and -0.6-1.1 mmol/l (hypoglycemia). CONCLUSIONS: By combining open-flow microperfusion, glucose sensor, and conductivity measurement, glucose concentration in the subcutaneous adipose tissue can be monitored on-line, extracorporeally, and continuously without any in vivo calibration, and gives accurate measurements during hyper- and hypoglycemia.

Adipose Tissue↗
PubMed1996

Thin-film microbiosensors for glucose-lactate monitoring.

A miniaturized device for simultaneous measurement of glucose and lactate levels was produced by means of photopatterning of enzyme-containing photosensitive membrane precursors. This device shows no cross-talk and a lifetime for both the glucose and the lactate sensors of more than 2 weeks when continuously operated in undiluted bovine serum. Linear response ranges of up to 40 mM for glucose and 25 mM for L-lactate, in combination with 95% response times of < 30 s, were realized. The devices are mass produced by means of thin-film technology on flexible carriers to give catheter-type multisensing devices for in vivo applications. Ex vivo experiments, performed with human volunteers, where the device was continuously operated in an extracorporeal, undiluted, heparinized blood stream for 6 h, gave a correlation of r > 0.98 with respect to laboratory techniques. Subcutaneous measurements of glucose levels in pigs were close to the corresponding blood levels obtained without in vivo calibration.

Adult↗
PubMed1996

Imaging of the active B1 field in vivo.

The authors describe a method for accurate in vivo multislice imaging of the active component of the B1 field which is based on a previously proposed method, which uses the signal intensity ratio of two images measured with different excitation angles, and a repetition time TR 5 > or = 5 T1. The new method essentially reduces repetition and scan time by means of an additional compensating pulse. The suppression of T1 effects by this pulse are verified with simulations and measurements. Further investigations concerned the influence of slice selective excitation and magnetization transfer in multislice imaging to the B1 field determination. The stability and accuracy of the presented method is shown by several phantom and in vivo measurements. With the described method the active B1 field can be determined in vivo in 23 cross-sections in less than 6 min.

Animals↗
PubMed1996

The antiarrhythmic effect of verapamil on atrioventricular re-entry in the Wolff-Parkinson-White syndrome: a computer model study.

Verapamil is supposed to suppress the initiation of circus movement supraventricular tachycardia by affecting the atrioventricular node. In electrophysiological tests, programmed stimulation is usually performed by using the same location for pacing and premature stimulus. Spontaneous ectopic activity starts from a different location than the sinus node and can therefore find altered re-entry conditions. In this study a 3D computer model based on Huygen's principle is used for simulation of the spread of excitation in the human heart in combination with a posterobasal, right or left lateral accessory pathway (AP). The effect of verapamil on properties of the atrioventricular node were modelled by prolonging the effective refractory period and basal conduction time. For each of the three APs, ectopic foci at the atrial base and between sinus node and AP were modelled at various coupling intervals for investigating re-entrant activation. In the control state (without verapamil) only orthodromic echoes were found. The maximum echo zone (EZ) range was found near the AP. If stimuli were selected further away from the AP on the atrial basis, the EZ range decreased until no EZ was found. The EZ range decreased from it's maximum value near the AP, towards the difference of the effective refractory periods between AP and AV-node near the sinus node Verapamil abolished the EZ in case of a posteroseptal AP. For a lateral AP the administration of verapamil resulted in an orthodromic and antidromic EZ depending on the atrial premature activation site. A maximum orthodromic EZ was found for premature stimuli near the AP. As stimulus site moved away from the AP, the EZ range first decreased continuously to zero leading eventually to an antidromic EZ. These findings suggest the important influence of the site of premature stimuli with respect to the accessory pathway and AV-node on the inducibility of atrial re-entry.

Anti-Arrhythmia Agents↗
PubMed1996

Fuzzy filter for state estimation of a glucoregulatory system.

A filter based on fuzzy logic for state estimation of a glucoregulatory system is presented. A published non-linear model for the dynamics of glucose and its hormonal control including a single glucose compartment, five insulin compartments and a glucagon compartment was used for simulation. The simulated data were corrupted by an additive white noise with zero mean and a coefficient of variation (CV) of between 2 and 20% and then submitted to the state estimation procedure using a fuzzy filter (FF). The performance of the FF was compared with an extended Kalman filter (EKF) for state estimation. Both the FF and the EKF were evaluated in the following cases: (a) five state variables are measurable; three plasma variables are measurable; only plasma glucose is measurable; (b) for different measurement noise levels (CV of 2-20%); and (c) a mismatch between the glucoregulatory system and the given mathematical model (uncertain or approximate model). In contrast to the FF, in the case of approximate model of the glucose system, the EKF failed to achieve useful state estimation. Moreover, the performance of the FF was independent of the noise level. In conclusion, the FF approach is a viable alternative for state estimation in a noisy environment and with an uncertain mathematical model of the glucoregulatory system.

Blood Glucose↗
PubMed1996

Portable device for continuous fractionated blood sampling and continuous ex vivo blood glucose monitoring.

The objective of the study was to develop and evaluate a portable device for continuous fractionated blood sampling and continuous ex vivo monitoring of blood glucose. The inner lumen of a double lumen catheter (18 gauge x 45 mm) was placed in a peripheral vein and perfused with heparin solution (1.4 U min-1). The outer lumen was used to collect heparinized blood into 48 vacuum tubes at programmable sample volumes and time intervals (0.2-2 ml in 2.5-30 min). A sensor flow chamber with an internal volume of 1 mm3 incorporating a miniaturized thin-film amperometric glucose sensor was placed in the sampling line for continuous ex vivo blood glucose monitoring. Blood glucose and plasma insulin were measured during a frequently sampled intravenous glucose tolerance test (250 mg kg-1) and a subsequent oral glucose tolerance test (150 g) over 6 h in eight healthy volunteers (BMI 24.5 +/- 3.2 kg m-2). Additionally, in four experiments blood glucose was measured on-line using the glucose sensors. The overall correlation coefficients for whole blood glucose and plasma insulin between the manually drawn samples and the vacuum tubes were 0.73 and 0.87, respectively (p < 0.001). The miniaturized glucose sensor exhibited a linear measuring range of 25 mmol-1 glucose concentration and 95% response times of less than 30 s. Sensor readings and laboratory analyser results for the blood glucose measurement correlated between 0.93 and 0.98 (p < 0.001). In summary, continuous fractionated blood sampling and ex vivo blood glucose monitoring in ambulatory subjects is possible with a portable device.

Adult↗
PubMed1996

Spatial distribution of high-frequency electromagnetic energy in human head during MRI: numerical results and measurements.

Finite Element Method (FEM) using 26-node isoparametric finite elements was applied for modeling saddle-shaped head coils used in Magnetic Resonance Imaging (MRI) generating linearly polarized radiofrequency (RF) pulses at 64 MHz. The human head was modeled from MR scans of a volunteer and additional information were taken from Atlas of Sectional Human Anatomy. The physical dimensions of the head coil and the head permit a calculation of the outside magnetic field by a quasistatic approach. Of course, a full-wave approach was applied within the head. Values of specific energy--specific absorption (SA)--as well as of specific power--specific absorption rate (SAR)--were calculated by the method, simulating the real exposure conditions during MRI. Although the results of the used numerical method were compared previously to the results of the analytical solution with homogeneous sphere and to the results of RF measurements on heterogeneous phantom, a comparison between the numerical results of the modeled human head and in vivo measurements performed on the human head of the volunteer was made once more. Since the results are in excellent agreement, they argue for the correctness of the numerical method. The "worst-case" temperature elevations delta theta of the "hot-spots" were calculated, as well. Finally, the results of SA, SAR, and delta theta are compared to the existing recommendations.

Body Composition↗
PubMed1996

Analysis of eddy currents originating from switched magnetic gradient fields in magnetic resonance imaging.

The fact that time-varying magnetic fields cause eddy currents in conductive objects is very well known. Switched magnetic gradient fields, used in echo planar imaging, were shown in the past to be able to elicit a stimulation process in peripheral nerves. We report about the distribution and values of induced current densities in the human torso, modeled by the Finite Element Method using isoparametric formulation. Since the applied numerical method is a frequency-domain one, the trapezoidal waveform is decomposed into a Fourier series. The simulation was made for four different exposures to switched magnetic gradient fields: transverse (x- and y-gradients) coil systems, longitudinal (z-gradients) coil system and for all the three coil systems working simultaneously. Special attention was paid to the region of the heart, since stimulation of the heart muscle could be extremely dangerous for human health. Therefore, the three components of the current density in the region of the heart muscle were spatially analyzed in all directions (x, y, and z), trying to find out the 'worst case' position of the heart muscle relative to the gradient coil system at which the highest current density is induced. Finally, the calculated values were compared to existing recommendations, showing that the simulated 'worst case' amplitude is relatively close to the limiting value for sinusoidal currents.

Computer Simulation↗
PubMed1996

Accuracy of home blood glucose meters during hypoglycemia.

OBJECTIVE: To evaluate the accuracy of home blood glucose meters during hypoglycemia. METHODS: Six blood glucose meters-One Touch II (LifeScan, Milpitas, CA), Companion II (Medisense, Cambridge, U.K.), Reflolux (Boehringer Mannheim, Mannheim, Germany), Accutrend (Boehringer Mannheim), Elite (Bayer, Munich, Germany), and HemoCue (HemoCue, Angelholm, Sweden)-were compared with a reference method (Beckman Glucose Analyzer 2). Glucose concentrations from arterialized venous blood samples were measured using all glucose meters (whole blood) and the reference method (plasma) during hypoglycemic-hyperinsulinemic clamps in 15 subjects. RESULTS: In total, 663 blood glucose monitor readings and 119 reference values ranging from 2.28 to 3.89 mmol/l were analyzed. The correlation coefficients and the percentage of measurements within 20% and outside 40% of the reference values for each glucose meter were as follows: One Touch II: 0.91, 99.2% and 0%; Companion II: 0.81, 88.2% and 2.5%; Reflolux: 0.78, 85.0% and 0.9%; Accutrend: 0.88, 46.0% and 6.6%; Elite: 0.78, 75.6% and 4.2%; and HemoCue: 0.93, 96.6% and 0% (P < 0.001). CONCLUSIONS: There were substantial differences between the blood glucose meters during hypoglycemia, and none of the devices met the latest criteria recommended by the American Diabetes Association.

Blood Glucose↗
PubMed1996

Effects of propafenone on the median frequency of ventricular fibrillation in Langendorff perfused guinea-pig hearts.

OBJECTIVE: The aim was to investigate the antifibrillatory effects of two concentrations of propafenone by means of signal analysis of epicardial ECG recordings in isolated, Langendorff-perfused guinea-pig hearts. METHODS: Isolated Langendorff-perfused guinea-pig hearts were used as a model for sustained ventricular fibrillation (VF) during reperfusion after global ischaemia. ECG signals were recorded for the first 20 min of reperfusion. The recording was divided into episodes of 1 s and the median frequency (FM) of the dynamic power spectrum was computed for each episode. Cardiac electrical activity was monitored for an additional 10 min. Additionally steady state conditions (i.e. constant FM values for the remaining observation period) were analysed and the effects of 0.1 microM and 1.0 microM propafenone added at reperfusion on the FM were examined. RESULTS: After initial irregularities, FM remained on a high steady state level in the control group. The addition of propafenone altered the steady state value of FM in a dose-dependent and significant manner but had no effects on the time until steady state was reached. During reperfusion without propafenone, 1 out of 6 hearts spontaneously converted to a stable sinus rhythm. Reperfusion with 0.1 microM propafenone caused spontaneous conversion to stable sinus rhythm in 1 out of 6 hearts and intermittent periods of sinus rhythms in 2 additional hearts. During the first 30 min of reperfusion with 1.0 microM propafenone, 5 out of 6 hearts spontaneously converted to stable sinus rhythm. The sixth heart showed repeated switching between VF and periods of non-sustained sinus rhythm. CONCLUSION: Propafenone caused a dose-dependent decrease of FM at steady state conditions. The rate of spontaneous termination of VF appeared to be dose dependent and the stability of the sinus rhythm was correlated inversely with the FM immediately before spontaneous defibrillation. Therefore, in this model the FM value prior to spontaneous termination of VF may be useful in the estimation of defibrillation success.

Animals↗
PubMed1995

Localisation of myocardial ischaemia from the magnetocardiogram using current density reconstruction method: computer simulation study.

A computer simulation study is performed to investigate the method of current density reconstruction to localise myocardial ischaemia. A computer model of the entire human heart is used to simulate the excitation and repolarisation process in eight topographically different cases of myocardial ischaemia. The associated magnetocardiogram is calculated at 37 positions of the KRENIKON biomagnetic measurement equipment. The method of current density reconstruction is applied at the S-point (the last discernible deviation from the ST-segment at the end of the QRS-complex) of the MCG to find characteristics of the myocardial ischaemia simulated by the model. The results show that it is possible to determine the location of the ischaemia. The current density distribution may be interpreted physiologically in terms of the so-called 'injury-current'. This indicates that magnetocardiography might be a suitable method for noninvasive ischaemia diagnosis, and further investigations of the current density reconstruction method for the injury current should be performed on patients with ischaemic heart disease.

Computer Simulation↗
PubMed1995

Numerical approximation of mathematical model for absorption of subcutaneously injected insulin.

A pharmacokinetic model is modified to enable quantitation of subcutaneous insulin absorption following insulin injections of soluble insulin and monomeric insulin analogues. The model for soluble insulin includes diffusion, equilibration between hexameric and dimeric insulin and absorption of dimeric insulin molecules. Numerical approximation is carried out by modelling the whole system as a capacitor-resistor network with lumped elements and discrete sources and sinks. By means of the analytical solution for monomeric-insulin absorption, it can be shown that the approximation scheme yields sufficiently accurate results. The modified model for soluble insulin demonstrates dose- and concentration-dependent insulin absorption within the range of therapeutic concentrations and volumes. Additionally, parameters are estimated from published glucose-clamp data. The results of the data fitting indicate that the model presented is adequate for pharmacological studies. The model is suitable for individual parameter estimation from the time course of plasma insulin or from the disappearance curves of radiolabelled injected insulin.

Humans↗