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Biomedical subjects

Y Mahler

Publications and source records attributed to Y Mahler.

At least 19 recordsLinked to original sources

Day vs night ECG and heart rate variability patterns in patients without obvious heart disease.

The day vs night values of variables that may be related to the autonomic nervous system were compared in 50 individuals without obvious heart disease. Using ambulatory electrocardiographic monitoring and heart rate variability analysis, it was found that in contrast to daytime, nocturnal heart rate and total heart rate variability were reduced and low (0-0.05 Hz) and high (0.2-0.35 Hz) frequency power of nocturnal heart rate variability were increased, whereas mid-frequency (0.05-0.2 Hz) power was reduced. In addition, nocturnal episodes of trapezoidal-shaped waveforms of heart rate increase were present primarily at night and ST was elevated to a greater extent at night. Many of these factors were related to age and tentatively, despite the small sample size, reflect an age-related diminished autonomic nervous system response. These results serve to establish a circadian basis for comparison when evaluating disease states such as ischemic heart disease and its prognosis.

Adult

Intra-articular pressure measurements in patients with suddenly developing, severely limited mouth opening.

A condition of sudden, severe, and persistent limited mouth opening, which readily responds to arthrocentesis, is postulated to be the effect of a vacuum between disc and fossa in the upper compartment of the temporomandibular joint. In 16 patients with this condition, the negative intra-articular pressure was found to be significantly lower (mean, -82.6 +/- 25.4 mm Hg) than in the control group (mean, -7.7 +/- 2.5 mm Hg) (P less than .0001). It is suggested that the process underlying the vacuum effect starts with persistent pressure (eg, clenching) resulting in the viscoelastic disc being pressed flat against the fossa. Immediately on cessation of the pressure, the disc resumes its natural biconcave shape, but its rims remain fastened to the fossa. The consequent increased negative pressure in the closed space created firmly anchors the disc to the fossa and any attempt to elicit condyle and disc sliding will only stretch the joint capsule and cause pain. This, in turn, will reflexly prevent the pterygoid muscle from exerting sufficient force to pull the disc and thus release the vacuum. This chain of events may account for the severe and persistent limitation in jaw movement and for the easy reversal of the condition by simple nonsurgical treatment.

Adolescent

ECG gated radionuclide plethysmography--a method for the assessment of pulmonary systolic blood volume increase.

During cardiac systole the stroke volume of blood which is ejected from the right ventricle increases the pulmonary blood volume. This systolic pulmonary blood volume increase is measured by using ECG gated chest scintigrams obtained with 99Tcm-labelled red blood cells. The total radiation counts in a region of interest that includes either the right or the left lung increases during systole. On the average, the increase of the total pulmonary systolic radiation was found to be 62% of the systolic radiation decrease in the left ventricle region of interest. The discrepancy between the value of the systolic pulmonary blood volume increase and that of stroke volume is attributed to blood flow from the lungs into the left atrium during the cardiac systole period.

Adult

Diagnostic value of computer analysis of multipeaked EMG spikes.

Computer analysis of absolute number of peaks per second and the number of peaks in the multipeaked spikes/sec was carried out in the EMG interference recordings of 5 healthy, 6 myopathic and 8 neuropathic subjects. The purpose of the study was to detect diagnostically different patterns. A spike was considered multipeaked if it had 6 or more peaks. The amplitude of elimination (baseline) was examined at 1: 5, 1: 10 and 1: 15 of the average amplitude per second. Both the number of peaks and the number of peaks in multipeaked spikes in the neuropathic and myopathic muscles showed statistically significant differences when compared to healthy muscles. This technique could give an indication for the differential diagnosis of myopathic, neuropathic or healthy state of the muscle.

Arm

Fourier series analysis of the electrophysiological pattern of fatigue in healthy human beings, after curare administration.

Real time computer analysis of the electrophysiological development of muscular fatigue after small doses of d-tubocurarine (TC), has been examined in anesthetized human beings. As compared to a decrease of frequency in the control measurements, previous studies have shown an increase of the frequency of spikes after TC administration. The present experiments were carried out on the biceps brachii of 8 healthy human volunteers maintained in isometric contraction against a constant counter load until complete fatigue occurred. The Fourier spectrum analysis showed a statistically significant shift to lower frequencies before, and a milder statistically non significant shift after TC. These results may indicate that under mild curarization the early phase of muscular contraction requires a higher number of large motor units and thus, at a later stage of the contraction the pool of available large motor units becomes smaller. This conclusion supports the hypothesis that mild curarization causes a state of initial muscular fatigue.

Action Potentials

The effect of swimming exercise on spontaneous ventricular defibrillation and ventricular fibrillation threshold in the isolated perfused rat heart.

Effects of swimming exercise training on left ventricular contraction and relaxation, the incidence of spontaneous defibrillation and the ventricular fibrillation threshold were studied in the isolated, perfused rat heart. The heart/body weight ratio was 4.8 +/- 0.4 x 10(-3) in swimmers compared with 3.9 +/- 0.6 x 10(-3) in sedentary controls (p less than 0.0005). The spontaneous heart rate was lower in isolated hearts of trained animals (222 +/- 18 bpm compared with 244 +/- 28, p less than 0.05). Left ventricular systolic pressure was higher in trained hearts and the rate of ventricular relaxation enhanced (p less than 0.05). The ventricular fibrillation threshold was 7.2 +/- 5.2 and 10.8 +/- 6.1 mamp in hearts of swimmers and controls, respectively, the difference not being significant. The incidence of spontaneous defibrillation was not significantly different between the two groups. It is concluded that, while swimming induces cardiac hypertrophy and hemodynamic changes, it neither protects against the induction of ventricular fibrillation nor facilitates spontaneous defibrillation in the isolated, non-ischemic rat heart.

Animals

Comparison of the electrophysiological pattern of fatigue between athletes required to perform explosive and endurance sports.

The electrophysiological behavior of an isometric contraction sustained to fatigue, was examined in 6 long distance runners and 9 athletes involved in explosive (burst) sports, by on line computer analysis of the electrical activity of vastus medialis, rectus femoris and vastus lateralis. The experiments were carried out with a counterload of 50% of the maximal strength of the muscle. The duration of spike increased and the frequency decreased in the 3 examined muscles, in both types of sport. In the burst sports the changes of value of both parameters were statistically significant in the 3 muscles. In endurance sports the variations of duration were not significant and the changes of frequency were statistically significant only in the vastus lateralis. These results could be explained by the gradual activation of motor units of more strikingly different sizes in burst sports. Thus it may be speculated that prolonged training in burst sports may result in the automatic mobilization of higher number of small motor units, for the initiation of contraction while in endurance sports the onset of contraction is more gradual and carried out by large motor units.

Adolescent

QRS-activated ventilation during general anesthesia for extracorporeal shock wave lithotripsy.

High frequency ventilation has been claimed to improve the efficiency of extracorporeal shock wave lithotripsy (ESWL) by minimizing the movement of urinary stones during the procedure. A ventilatory mode, QRS-activated ventilation, was developed in which the stones remain motionless during the delivery of shock waves. As the shock wave is triggered to occur approximately 20 milliseconds after the R wave of the QRS complex, the mechanical breath was synchronized to occur approximately 150 ms later. QRS-activated ventilation is used in 16 patients undergoing ESWL under general anesthesia. Tidal volume was set at 3 ml/kg (234 +/- 36 ml; mean +/- SD) at a rate that equaled the heart rate (71 +/- 9 beats/min). The time between the R wave and the initiation of mechanical breath (T1) was 124 +/- 25 ms, time of mechanical breath itself (T2) was 431 +/- 67 ms, and time between end of T2 and next R wave (T3) was 264 +/- 84 ms. End-tidal CO2 measured by the large breath technique was 28.1 +/- 4.8 mmHg. During the clinical use of QRS-activated ventilation and during earlier studies using an EKG simulator and a test lung, the shock wave occurred invariably at end-expiration even at high heart rates.

Adult

Detection of breast cancer by measuring areolar blood flow--a pilot study.

Regional blood flow in the areola was measured by using the non-invasive transient thermal clearance method in normal breasts and in breasts involved with cancer. Areolar blood flow (ABF) in normal breasts was almost constant for women in the age range 20-60y, but decreased at higher ages. ABF in breasts involved with cancer was higher than that in the contralateral breast, and higher than the average normal ABF in the corresponding age group. The effect was more prominent in the left breast. The transient thermal clearance method provides a potential non-invasive means for detection of breast cancer.

Adult

The transient thermal clearance method for regional blood flow measurement--the influence of tissue heat conduction.

When heat is supplied to or retrieved from living tissue, the heat in or out is either conducted by means of the tissue or convected by blood. In order quantitatively to assess blood flow by thermal clearance the contributions of conduction and convection have to be separated, and various methods have been developed for this purpose. The various methods are reviewed and it is shown that the adequacy of each depends on the specific thermal clearance method used. The review concentrates on aspects of the role of thermal conduction in the non-invasive transient thermal clearance method. It is shown that by applying correct methodology, for regional blood flow of around 0.0025 ml blood per ml tissue per second the predominant contribution to the heat transfer is by convection. However, if the regional blood flow is much lower, the effect of heat conduction cannot be ignored.

Adult

Modeling mechanical alternans in the beating heart: advantages of a systems-oriented approach.

A model employing an original discrete method is proposed to explain mechanical alternans in the beating heart. This is compared with analysis using the difference-equation method, which has been utilized in some other areas of science and found to better represent the cardiac beat-to-beat behavior. The model shows the critical role of a slope with an exact value of 2 in the functional dependence between stroke volume (SV) and the end-diastolic volume (EDV). The implications of this model with respect to the factors causing sustained mechanical alternans (SMA) in the heart are shown. A criterion for determining whether SMA is caused by variations in EDV is described. However, this possibility is ruled out on the basis of experimental findings. It is further shown that SMA caused primarily by alterations in the contractile state leads to secondary variations in EDV. In this case the model predicts that the mean slope of SV as a function of EDV, as determined by the two alternating beats, has a value of 2 and is independent of the SV-EDV relation. This prediction concerning the relationship between SV and EDV is confirmed by available experimental data. The implications and advantages of the modeling approaches are explored.

Heart

A three-level amplitude discriminator for the separation of multi-unit electrophysiological information.

A device is described that consists of two parallel, three-level differential amplitude discriminators suitable for the selection of electrophysiological data. The present device has been designed for simplicity of construction and operation. The unit allows for a visualisation of the selected levels in precise relationship to the input signal oscilloscope channel. The design eliminates the possibility that a lower level will exceed a higher level. The resulting ease with which complex multi-unit electrophysiological data may be discriminated for analysis using the three digital reference level outputs, makes this instrument suitable for a wide range of electrophysiological experiments.

Electrophysiology

Model of mechanical alternans in the mammalian myocardium.

A model is proposed to elucidate the cause and mechanism of mechanical alternans in cardiac muscle in terms of discrete calcium movements. Mechanical alternans, the cause of which lies within the borders of excitation-contraction-coupling (ECC), is analyzed. In this case, the "input" of the ECC system (the action potentials and intervals) is constant while the "output" (contractile force) oscillates between two constant values, indicating that the system has a "memory" with two "internal states". It is proposed that these two "states" are associated with a part of the sarcoplasmic reticulum ("releasable terminal") containing the readily releasable calcium. A mechanism of "calcium-concentration-dependent threshold" is suggested to govern the "release function", i.e. the release of calcium from the "releasable terminal" to the myofilaments. The "release function" is analyzed in both the linear and the non-linear cases and its implication on the initiation of sustained and transient mechanical alternans are described. The dependence of mechanical alternans on a disturbance is also explained. The model response resembles the experimental observations of mechanical alternans in mammalian myocardium in the following manners: abrupt transition from low to high heart rates, slow progressive acceleration of rate, variations in persistence at subthreshold rates, effect of premature and delayed beat following the small and large beats, restitution curves, and transient mechanical alternans initiated by a delayed beat.

Animals