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T Korte

Publications and source records attributed to T Korte.

At least 55 records · Page 3Linked to original sources
PubMed1996

Drugs usage of drivers suspected of driving under the influence of alcohol and/or drugs. A study of one week's samples in 1979 and 1993 in Finland.

The extent of drug use among drivers suspected of driving under the influence of alcohol and/or drugs in Finland was studied. All blood samples submitted to the laboratory during 1 week in two study periods, in 1979 (n = 298) and 1993 (n = 332), were analyzed for alcohol and psychotropic drugs. Drugs classified as hazardous to traffic safety were detected in 7.0% of the samples in 1979 and 26.8% in 1993. Benzodiazepines were the most frequently found drugs in both years: 6.0% of the cases in 1979 and 22.9% in 1993. Illegal drugs were found in 4% of the cases in 1993. Of the samples tested, 296 in 1979 and 317 in 1993 were from drivers suspected of driving under the influence of alcohol only. In 1979 every fourteenth and in 1993 every fourth of these suspected drunken drivers had drugs in their blood. Drugs, other than alcohol, were found six times more often than expected by the police. The results indicate that the trend of drug use, multidrug use and drug abuse is increasing among cases suspected of driving under the influence of alcohol/drugs.

Accidents, Traffic↗
PubMed1996

[Clinical experiences with pectoral defibrillator implantation].

UNLABELLED: The pectoral approach to implantation of cardioverter/defibrillators has the aim to further simplify the implantation of transvenous defibrillation systems. The PCD 7219 D/C is a device of the fourth generation which makes the pectoral implantation feasible due to a weight of 132 g, a size of 89 x 64 x 18 mm, a volume of 83 cm3 and a surface of 108 cm2. The use of the "active-can"-system (PCD 7219 C) requires the implantation of only one right ventricular lead. The PCD 7219 D/C was implanted in 75 patients with ventricular tachyarrhythmias, the follow-up period was 12 +/- 4 (1-24) months. Subpectoral implantation was feasible in 59 patients (79%), in 55 with a left pectoral, in 4 with a right pectoral approach due to previous left-sided operation or thrombosis of the left subclavian vein. Male sex (p < 0.005), body weight (p < 0.005) and body surface (p < 0.05) were predictors of pectoral implantation. In the 45 patients (60%) with a unipolar defibrillation system ("active can") the defibrillation threshold was significantly lower compared to those with a dual lead system (9.9 +/- 6.5, 2.5-24 Joule vs. 19 +/- 4.5, 6-24 Joule p < 0.0001). In one patient with pectoral and in one patient with abdominal implantation a dislodgement of the right ventricular lead was diagnosed and an operative revision was indicated. CONCLUSION: The down-sized implantable cardioverter/defibrillator PCD 7219 D/C makes the pectoral implantation feasible in the majority of patients. The use of the "active-can"-system requires the implantation of only one right ventricular lead with significantly lower defibrillation thresholds.

Adolescent↗
PubMed1996

[Exogenous adenosine as an anti-arrhythmia agent].

Adenosine has potent cardiac electrophysiologic effects including a negative chronotropic action on the sinus node and a predominant negative dromotropic action on the AV node. The latter property has mainly led to the use of adenosine as antiarrhythmic agent for the acute management of paroxysmal supraventricular tachycardia (PSVT) mediated by a reentrant mechanism involving the AV node. The effects of adenosine are dose-dependent and of very short duration since the half-life is less than 10s. The efficacy rates for termination of AV reentrant tachycardias were found to be 35% with 3 mg, 60-70% with 6 mg, 80% with 9 mg, and 90-95% with 12 mg adenosine. The AV nodal depressant effects of adenosine have also been used for determining the mechanism of wide QRS tachycardias for differentiating supraventricular tachyarrhythmias with aberrant conduction from ventricular tachycardia. Adenosine either terminates or slows almost all types of supraventricular tachyarrhythmias or it leads to unmasking of the underlying mechanism such as atrial flutter with aberrant conduction. One form of ventricular tachycardia, the idiopathic type originating from the right ventricular outflow tract can usually be terminated with adenosine due to its cAMP-mediated mechanism. Adenosine is helpful to detect or to increase preexcitation which is important for planning a catheter ablation procedure since the preexcitation pattern allows to localize the accessory pathway. Since the action of adenosine usually does not alter the accessory pathway conduction it is also useful for control ablation efficacy noninvasively in terms of antegrade conduction and during ventricular pacing for the retrograde conduction. Further evaluation and research is necessary for better understanding of adenosine action on the human atrial electrophysiology since it provokes atrial fibrillation in some patients, and of adenosine action on the different pathways in AV nodal reentrant tachycardias and some accessory pathways with decremental (AV nodal-like) conduction properties.

Adenosine↗
PubMed1995

Analysis of delay times of hemagglutinin-mediated fusion between influenza virus and cell membranes.

We have studied the kinetics of low pH-induced fusion between influenza virus A/PR 8/34 and human erythrocyte membranes in suspension by using an assay based on fluorescence dequenching (FDQ) of the lipophilic dye octadecylrhodamine B chloride (R 18). As shown previously (Clague et al. 1991) the onset of FDQ is preceded by a characteristic lag time (tlag) following pH reduction. Whereas tlag represents only a subpopulation of fusing viruses with the shortest delay time we suggest here that a representative mean lag time mu lag of virus-cell fusion can be deduced from the R 18-assay. Kinetics of FDQ reflects the cumulative distribution function of lag times tau lag of single fusion events with the mean value mu lag. We show that tau lag obtained from the onset of FDQ does not always reflect the fusion behaviour of the whole population of fusing viruses. While both lag times, taulag and mu lag, exhibit a similar temperature dependence we found a significantly different dependence of both delay times on virus inactivation by low pH-pretreatment. We conclude that the mean lag time mu lag appears to be a more appropriate parameter describing the kinetics of virus-cell fusion. The analysis of delay times offers a new approach to test the validity of different kinetic models of HA-mediated fusion and to gain valuable information about HA-mediated fusion. The analysis confirms that the inactivation process proceeds via steps of the formation of the fusion pore. Although the increase of lag times can be explained by a depletion of fusion competent HA's, our data suggest that intermediate structures of HA along the inactivation pathway can still transform into a fusion site.

Cells, Cultured↗
PubMed1995

Incidence of ICD lead related complications during long-term follow-up: comparison of epicardial and endocardial electrode systems.

UNLABELLED: The aim of this study was to evaluate the long-term stability of epicardial and endocardial lead systems for third-generation cardioverter defibrillators (ICDs) and to assess the usefulness of diagnostic tools. One hundred forty patients with 61 epicardial (43.6%) and 79 nonthoracotomy systems (56.4%) were followed for 25 +/- 19 months. A total of 18 (12.9%) lead related complications were documented. Complications of epicardial systems were detected in 10 patients (16.4%) during a follow-up time of 36 +/- 8 months: crinkling of patch electrodes in 6 patients (9.8%), insulation breakage of sensing electrodes in 2 patients (3.3%), and adapter defect in 2 patients (3.3%). Eight of the patients (10.1%) with transvenous-subcutaneous systems had lead related complications during a 13 +/- 6 months follow-up: fracture of the subcutaneous patch lead in 2 patients (2.5%), dislodgement of the right ventricular lead in 2 patients (2.5%), dislodgement of the superior vena cava lead in 2 patients (2.5%), insulation breakage of sensing electrodes in 1 patient (1.3%), and connector defect in 1 patient (1.3%). There was no significant difference in the incidence of lead related complications between epicardial and endocardial systems (P > 0.05). Fractures, dislodgements, and crinklings were documented within the first 8 +/- 5 months by regular chest X ray. Defects of insulation, adapter, or connector were detected 22 +/- 10 months after implantation and were associated with delivery of multiple inappropriate ICD therapies. An operative lead revision was indicated for 4 epicardial (6.6%) and 6 endocardial (7.6%) lead systems. CONCLUSIONS: Endocardial lead systems offer a similar long-term stability as compared to epicardial lead systems. Chest X ray is the most useful tool to detect lead fracture, dislodgment, and patch crinkling. Marker recordings or real-time electrograms have not been helpful in this series to identify patients with suspected lead defects prior to the experience of inappropriate ICD discharges.

Alloys↗
PubMed1994

On the validity of lipid dequenching assays for estimating virus fusion kinetics.

Octadecylrhodamine (R18) has often been used to measure membrane fusion of enveloped viruses by fluorescence dequenching. In order to see whether non-specific R18 exchange between non-fused membranes occurs we have measured fusion of influenza virus with erythrocyte membranes by utilizing dequenching of the non-exchangeable lipid analogue N-(lissamine-rhodamine B-sulfonyl)diacylphosphatidylethanolamine (N-Rh-PE). Rather low concentration of N-Rh-PE (< 0.1 mol%) were required to assess fusion since self-quenching in the influenza virus membrane was more efficient in comparison to R18. For both markers we observed the same kinetics as well as the same extent of fluorescence dequenching upon triggering low pH-induced fusion. Non-specific marker transfer was not observed. Haemolysis was not affected by either type of fluorophore. Our results confirm that R18 is a valuable tool to investigate membrane fusion of enveloped viruses in a quantitative manner. Differences in the efficiency of self-quenching of both markers are discussed.

Cytopathogenic Effect, Viral↗
PubMed1994

pH-dependent binding of the fluorophore bis-ANS to influenza virus reflects the conformational change of hemagglutinin.

Binding of the fluorophore 1,1'-bis(4-anilino)naphthalene-5,5'-disulfonic acid (bis-ANS) to influenza virus A/PR 8/34 is strongly enhanced at low pH. Binding is accompanied by a significant increase in fluorescence intensity. The binding and the fluorescence increase are associated with the low-pH induced conformational change of the viral spike protein, hemagglutinin, exposing hydrophobic binding sites. The data indicate that in addition to the hydrophobic N-terminus of HA2 other hydrophobic sequences of the HA ectodomain become accessible to bis-ANS at low pH. It is shown that the time course of the fluorescence increase of bis-ANS at low pH is determined by the conformational change of HA. The application of this assay for continuously monitoring the kinetics of the structural alteration in HA is discussed and its relevance for elucidating the temporal relationship between the conformational change of HA and virus-membrane fusion is outlined.

Anilino Naphthalenesulfonates↗
PubMed1994

Clinical efficacy of shock waveforms and lead configurations for defibrillation.

A randomized, prospective comparison of the defibrillation efficacy of various shock waveforms and nonthoracotomy lead configurations was performed in five distinct patient groups undergoing implantation of a cardioverter defibrillator. In the first group using a bidirectional lead configuration, there was no significant difference in the mean defibrillation threshold (DFT) between simultaneous and sequential monophasic shocks (17.8 +/- 5.8 joules versus 17.3 +/- 2.7 joules). In the second group using a bidirectional lead configuration, the mean DFT was 21.9 +/- 7.3 joules with monophasic shocks and 14.9 +/- 5.0 joules with biphasic shocks (p < 0.001). In the third group using a unidirectional lead configuration, the mean DFT was significantly higher (p < 0.001) with monophasic shocks (22.1 +/- 4.2 joules) compared with biphasic shocks (15.0 +/- 5.4 joules). In the fourth group, an intraindividual comparison with monophasic shock waveforms showed no significant differences in DFT using either a bidirectional (21.3 +/- 5.8 joules) or a unidirectional (21.7 +/- 2.6 joules) lead configuration. In the fifth group, a simplified unipolar transvenous defibrillation lead system ("active can") demonstrated significant lower DFTs (9.7 +/- 3.8 joules) compared with a standardized unidirectional lead configuration (18.0 +/- 6.8 joules). It is concluded that: (1) there seems to be no significant difference in the DFT between simultaneous and sequential monophasic shocks; (2) biphasic waveforms require significantly less energy for defibrillation than their corresponding monophasic waveforms; and (3) the unipolar single-electrode defibrillation system is easy to implant and provides DFTs at energies comparable with epicardial lead systems.

Adolescent↗
PubMed1994

Complications of pacemaker-defibrillator devices: diagnosis and management.

Treatment of resuscitated patients with implantable cardioverter defibrillators has become increasingly more common as a method for the prevention of sudden cardiac death. Major complications such as perioperative death (incidence 2% to 8%), infection (2% to 11%); and lead-related problems (3% to 27%) have been described in previous trials. In our experience with 140 patients, problems were related to leads (n = 11), the device (n = 2), pacing (n = 1), sensing (n = 13), and defibrillation function (n = 5). Additional problems that occurred during the perioperative period included infection (n = 11), hematoma, and seroma (n = 2). Thrombus formation along endocardial leads was observed in 13 of 62 (21%) patients. Different arrhythmias (n = 10), such as sinus tachycardia, atrial fibrillation, and nonsustained, slow or incessant ventricular tachycardia with shock delivery, were also detected. Surgical management (predominantly for the major problems) was used in 31 (48%) patients, drug treatment in 25 (39%), and reprogramming of the device in 24 (38%) patients. All of these problems can result in an increase in mortality rates. This article provides an overview of the complications of cardioverter defibrillator treatment and is based on both published data and our series.

Arrhythmias, Cardiac↗
PubMed1994

Predictors of outcome in patients with implantable transvenous cardioverter defibrillators.

The identification of patients who benefit most from implantable cardioverter defibrillator (ICD) therapy is of great interest. To find out if clinical variables, the signal-averaged electrocardiogram, and electrophysiologic study predict occurrence of appropriate ICD discharges and death, we followed-up on 76 patients after implantation of a transvenous ICD. During a mean follow-up period of 18.2 +/- 6.4 months, 29 patients (38.6%) experienced at least one appropriate episode. When these patients were compared with those who had either no therapy or inappropriate episodes, three variables were found to be significant in the identification of patients who experienced appropriate discharges: (1) The mean ejection fraction of patients who received appropriate discharges was 35.4% +/- 13.5% versus 45.1% +/- 15.3% in the other group (p < 0.05); (2) patients with appropriate therapy had sustained monomorphic ventricular tachycardia that was more likely to be inducible (75.9% vs 21.2%, p < 0.01); and (3) in patients with appropriate therapy ventricular fibrillation was less likely to be inducible (10.3% vs 25.5%, p < 0.05). The signal-averaged electrocardiograms were more often abnormal, but the differences were not significant. The total mortality rate in our patient group was 7.8%, with nonsudden cardiac death in four patients, noncardiac death in one patient, and sudden death in one patient. In our patient group a lower ejection fraction and inducible sustained monomorphic ventricular tachycardia were predictors of future ICD discharge after implantation. The survival rate after transvenous ICD implantation is excellent; a longer follow-up period is necessary to further define predictors of total mortality rate.

Cardiac Pacing, Artificial↗
PubMed1992

The influence of dextran sulfate on influenza A virus fusion with erythrocyte membranes.

Dextran sulfate suppresses the low pH-induced fusion of influenza virus A/Brazil 11/78 with erythrocyte membranes, as shown by fluorescence dequenching assay, using the fluorophore octadecylrhodamine B chloride (R18). Inhibition of fusion was maximal at pH 5.0, while at higher pH values (> 5.6) fusion was not affected. Hemolysis of intact red blood cells by influenza A virus at low pH values is also prevented by dextran sulfate. The inhibiting effect of the polymer is mainly ascribed to repression of virus attachment. Evidence is given that the conformational change of the virus envelope protein hemagglutinin (HA) responsible for triggering fusion is not affected by the polymer.

Anilino Naphthalenesulfonates↗
PubMed1992

The role of phospholipid asymmetry in calcium-phosphate-induced fusion of human erythrocytes.

To elucidate the role of phospholipid asymmetry in calcium-phosphate-induced fusion of human erythrocytes, we examined the interaction of erythrocyte membranes with asymmetric and symmetric bilayer distributions of phospholipids. Fusion of human erythrocytes was monitored by light microscopy as well as spectrophotometrically by the octadecylrhodamine dequenching assay. Phospholipid translocation and distribution between the inner and the outer leaflet of intact red blood cells were determined with spin-labeled phosphatidylserine (PS), phosphatidylethanolamine (PE), and phosphatidylcholine (PC). Significant fusion of lipid-asymmetric red blood cells where PS and PE are predominantly oriented to the inner leaflet was only observed at Ca2+ concentrations greater than or equal to 10 mM (in the presence of 10 mM phosphate buffer) while fusion of lipid-symmetric erythrocyte membranes was established at greater than or equal to 1.5 mM Ca2+. The Ca2+ threshold of fusion of lipid-asymmetric red blood cells was significantly reduced (i) after exposure of PS to the outer layer but not after redistribution of PE alone, and (ii) upon incorporation of spin-labeled PS into the outer leaflet of red blood cells. Spin-labeled PE or PC did not affect fusion, suggesting that the serine headgroup is an important factor in calcium-phosphate-induced fusion.

Calcimycin↗
PubMed1992

ph-dependent hydrophobicity profile of hemagglutinin of influenza virus and its possible relevance in virus fusion.

The hydropathy profile of hemagglutinin (HA) subunits HA1 and HA2 of influenza virus X31 and A/PR 8/34 is analyzed at different pH. At neutral pH (7.4) pronounced hydrophobic sequences of HA correspond to the N-terminus and the transmembrane spanning sequence of HA2. At pH 5.0 where influenza virus is known to fuse with biological membranes several hydrophobic sequences in the ectodomain exist which are comparable in both the hydrophobicity and length of the N-terminus of HA2. It is suggested that these hydrophobic stretches are important for the fusion complex, in addition to the N-terminal site of HA2.

Hemagglutinins↗
PubMed1991

Determination of ring- and N-substituted amphetamines as heptafluorobutyryl derivatives.

An improved derivatization method for analysing 12 ring- and N-substituted amphetamine-derivatives in body fluids or seized materials by gas chromatograph combined either with mass spectrometer, electron capture or nitrogen phosphorus detector is presented. Heptafluorobutyric anhydride is used as derivatization reagent. No heating or standing period is needed in this procedure. Most of the drugs considered were distinguishable from each other according to their retention times and all of them according to their EI mass spectra. The base peak or one of the most intense peaks in the mass spectra contained benzyl radical and the m/e values were different according to the substituent.

Amphetamines↗
PubMed1987

Normalization of lipoprotein lipase and hepatic lipase by gemfibrozil results in correction of lipoprotein abnormalities in chronic renal failure.

Eighteen patients with chronic renal failure (serum creatinine 173-756 mumol/l) and hyperlipidemia were treated with gemfibrozil (1200 mg/day). The drug caused a significant improvement of the dyslipidemia within one week and the effect was progressive during the 28 weeks of treatment. Very-low-density lipoprotein triglycerides and very-low-density lipoprotein cholesterol decreased by about 50% and high-density lipoprotein cholesterol increased by 30%. The lipoprotein changes occurred simultaneously with a significant activation to normal levels of postheparin plasma lipoprotein and hepatic lipases. Opposite effects were observed when gemfibrozil was discontinued and the patients were given placebo. No major harmful effects were observed.

Adult↗