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Biomedical subjects

D L Heene

Publications and source records attributed to D L Heene.

At least 109 records · Page 6Linked to original sources
PubMed1988

A simple technique for sonographic estimation of liver volume.

A procedure for estimation of liver volume with the sonographic real-time technique is reported. Testing of this procedure in vitro revealed a very good linear correlation of sonographically determined liver volumes and liver volumes measured by water displacement. In an in-vivo measurement of 70 healthy subjects, a mean of 1402 ccm was determined for men and 1257 ccm for women. A statistically significant correlation was found with body weight and body surface. The method presented is simple and can be carried out in a short time during a routine examination.

Adult↗
PubMed1987

Isolation and purification of fibrinogen/fibrin degradation products by chromatography on protamine-agarose.

Protamine-agarose chromatography is introduced as a rapid and efficient method for the isolation of fibrinogen/fibrin degradation products from biological fluids such as human plasma. All fibrinogen/fibrin fragments above a MW of 35000, including fragments D and E are quantitatively adsorbed to insolubilized protamine and can be eluted with a buffer containing 0.2 M sodium citrate/citric acid pH 5.3, following previous elution of non-fibrinogen proteins with a buffer containing 0.8 M NaCl at neutral pH. Fragments D and E are separated by stepwise elution. The efficiency of the method is - evaluated by applying it to plasma samples obtained from healthy donors and from patients with clinical and laboratory evidence of disseminated intravascular coagulation.

Chromatography, Agarose↗
PubMed1987

[Recurrent meningitis in familial deficiency of the 8th component of the complement system].

An 18-year-old man suffered from recurrent bacterial meningitis. Investigation of the complement system revealed deficiency of the 8th complement component (C8) in the patient and his sister. Genetic defects of the terminal complement components C5 to C8 predispose to Neisseria infections, probably due to a lack in bacteriolytic activity. It is to be noted that 1 year ago the patient had been hospitalized for a culture-proved pneumococcal meningitis.

Adolescent↗
PubMed1987

Purification of human plasma fibrinogen by chromatography on protamine-agarose.

A study was performed to investigate if protamine covalently attached to CNBr-activated agarose is a useful tool for the purification of fibrinogen from human plasma samples. One chromatography step yielded a preparation with a clottability greater than 90% from platelet-poor plasma with a yield of 65-80% of fibrinogen applied. The preparation is free of plasminogen, immunoglobulins, fibronectin, albumin, antithrombin III, alpha 2-macroglobulin, and alpha 1-antitrypsin, as determined by immunological and functional methods. 6.5 mg of fibrinogen were adsorbed to 1.0 ml of protamine-agarose. Protamine-agarose chromatography can be applied to plasma samples as small as 200 microliters.

Adsorption↗
PubMed1987

[Beat-by-beat validation of the Oxford Medilog 4500, a 24-hour long-term ECG system with real-time analysis].

We compared the annotation of the AHA and MIT databases beat-to-beat with the classification preformed by the microprocessor of a 24-hour ambulatory electrocardiographic device, based on real-time analysis. Sensitivity and positive predictive accuracy for QRS detection were 99.9% (99.9%) and 99.9% (99.8%) for the AHA database (MIT database respectively). Sensitivity and positive predictive accuracy were 99.1% (96.6%) and 98.3% (94.9%) for ventricular ectopic beats, 98.3% (91.8%) and 96.0% (63.0%) for couplets and 96.4% (74.2%) and 99.2% (41.1%) for salvoes. On 90% of the AHA tapes (MIT tapes) sensitivity and positive predictive accuracy were at least 93.8% (76.6%) and 92.7% (65.5%) for ventricular ectopic beats, at least 98.0% (96.3%) and 54.5% (0%) for couplets and at least 100% (66.6%) and 100% (0%) for salvoes. A sensitivity of 100% was achieved for ventricular ectopic beats on 56% (45%), for couplets on 90% (82%) and for salvoes on 95% (84%) of the AHA tapes (MIT tapes). A positive predictive accuracy of 100% was achieved for ventricular ectopic beats on 49% (52%), for couplets on 76% (61%) and for salvoes on 97% (75%) of the AHA tapes (MIT tapes). Real-time analysis of the Oxford Medilog 4500 proved sufficient for QRS detection and classification of ventricular ectopic beats. The quantification of frequent couplets and salvoes was sufficient, too. Sporadic false-positive detections of complex ventricular ectopic beats produced the false Lown grade IVA/IVB on 10% of the tapes as a consequence. The final computer report must hence be edited by a physician.

American Heart Association↗
PubMed1986

[Dose-effect relation of N-prajmalium bitartrate with control of plasma levels].

15 patients with ventricular ectopic beats classified to at least Lown class III with more than 100 ventricular ectopic beats in one hour were treated with N-prajmalium bitartrate (NPAB) in increasing dosages. The first dosage of 4 X 5 mg/d has been increased by 5 mg in three steps of three days to a level of 4 X 20 mg/d. A resting ECG, the systolic time intervals and a 24 h ECG were registered before treatment and after every dose. The median PQ time increased from 170 msec to 200 msec, the increase becoming significant (p less than 0.05) with a dose of 4 X 5 mg/d NPAB and above. Frequency, QRS and the frequency-corrected QT time did not change significantly. At a dose of 4 X 10 mg/d NPAB the increase of the quotient pre-ejection period to ejection time PEP/LVET became significant, increasing continuously from 0.35 to 0.48. Six of the 15 patients showed a significant reduction of ventricular ectopic beats, couplets and salvoes. In two patients the antiarrhythmic effect was significant at 4 X 5 mg/d. With an increasing dose from 4 X 10 mg/d each responder showed a significant reduction of ventricular ectopy. The lowest effective plasma concentrations ranged from 15 to 213 ng/ml with a median value of 58 ng/ml and an upper quartile of 94 ng/ml. There was no significant difference in plasma concentrations between responders and non-responders.

Aged↗
PubMed1986

[Differential diagnosis of jaundice by combined noninvasive diagnostic means using a logistic discriminant analysis].

Using a logistic discriminant function we retrospectively evaluated the diagnostic value of laboratory features and abdominal sonography in 70 patients with jaundice. 18 patients had an extrahepatic obstruction of the common bile duct (EHO), 22 patients had metastatic liver disease (MLD) and 30 patients had an infectious or toxic hepatocellular disease (HCD). The sensitivity resp. specificity of the 5 laboratory values AP, GGT, GPT, GOT and bilirubin was 22% resp. 90% for diagnosing EHO, 82% resp. 79% for diagnosing MLD and 67% resp. 68% for diagnosing HCD. The diagnostic value determined by their Chi2-value was AP greater than GPT greater than bilirubin greater than GOT greater than GGT. An undoubtedly dilated common bile duct was seen in 56% of the patients with EHO and in none of the other patients. Metastatic lesions were seen exclusively in 81% of the patients with MLD. No distinct sonographic sign could be found for the patients with HCD. The combination of AP, GPT and bilirubin with the result of abdominal sonography in a logistic discriminant function led to a correct a posteriori classification of all patients. Using a mathematical classification model jaundiced patients can be diagnosed on the basis of noninvasive methods alone and invasive procedures should be restricted to therapeutic interventions.

Cholestasis, Extrahepatic↗
PubMed1986

Shock-induced alterations in hemostasis.

The major constituents of the hemostatic potential, i.e., platelets and the plasma factors of coagulation and fibrinolysis, guarantee the integrity of the vessel wall and provide effective hemostasis in case of vascular damage. The equilibrium between anticoagulant and procoagulant forces which is essential for the maintenance of the fluidity of blood is controlled by inhibitors, the fibrinolytic system, and the clearance of activated components by the reticuloendothelial system. The proper function of this humoral balance is essentially dependent on hemodynamic factors such as adequate circulation and capillary perfusion.

Blood Coagulation Factors↗
PubMed1985

Unusual mechanism of PR interval variation and nonreentrant supraventricular tachycardia as manifestation of simultaneous anterograde fast and slow conduction through dual atrioventricular nodal pathways.

Noninvasive recordings in a 69-year-old woman showed two distinct PR intervals of about 0.21 and 0.58 s, suggestive of dual AV nodal conduction. Various unusual mechanisms of transition from short to long and from long to short conduction intervals and phenomena of concealed conduction were due to the presence of two functionally separated intranodal pathways. Refractoriness of the slow pathway was associated with bradycardia. Episodes of tachycardia exhibited a one-to-two relationship between P-waves and ventricular activations as a consequence of simultaneous anterograde fast and slow conduction leading to double ventricular responses to single P-waves.

Aged↗
PubMed1985

[Tachycardias caused by double ventricular responses and unusual atrioventrio-ventricular relations in linear dissociation of the AV node].

Noninvasive recordings in a 69-year-old woman showed phasic shifts between two distinct PR intervals of about 0.21 and 0.58 s suggestive of dual AV nodal conduction in the presence of two intranodal pathways. Episodes of tachycardia exhibited a one to two relationship between P waves and QRS complexes, with the same short and long PR intervals interpreted as simultaneous anterograde fast and slow conduction via the two AV nodal pathways, leading to a double ventricular response to single P waves. Various mechanisms of transition from short to long or long to short conduction times and concealed conduction phenomena could be demonstrated supporting the concept of two functionally separated intranodal pathways.

Aged↗
PubMed1985

Fibrinolysis inhibition in acute respiratory distress syndrome.

To evaluate the availability of the fibrinolytic system in patients suffering from acute respiratory distress syndrome, ARDS, induced by septicemia or trauma, the following parameters were analysed: fibrinogen, FG, antithrombin III, AT III, plasma prekallikrein, PPK, plasminogen, PG, alpha 2-antiplasmin, alpha 2-AP, alpha 2-macroglobulin, alpha 2-MG, urokinase-inhibitor, UK-I, streptokinase-inhibitor, SK-I, C1-inhibitor, C1-I, alpha 1-antitrypsin, alpha 1-AT, and fibrinogen-fibrin degradation products, FDP. Survivors and non-survivors of septicemia induced ARDS showed a characteristic feature: marked increase of FG and pronounced decrease of AT III and PPK in the coagulation system; concerning the fibrinolytic system a decrease of PG, alpha 2-AP and alpha 2-MG as well as an increase of inhibitors of PG-activators (PG-antiactivators) UK-I, SK-I, C1-I and alpha 1-AT; the FDP-titer was elevated. This constellation of parameters is interpreted as indicative of a marked procoagulant stimulation rendering the organism a state of hypercoagulability coinciding with a diminished availability of the fibrinolytic system, due to exhaustion of the fibrinolytic potential and increase of PG-antiactivators. In the trauma group initially the rise of FG, SK-I, C1-I and alpha 1-AT is absent independent of the outcome, but develops with progression of the disease. As ARDS is more frequently associated with septicemia, diminished availability of the fibrinolytic system simultaneously with increased procoagulant stimulation may be a particular pathophysiologic mechanism in the pathogenesis of ARDS.

Acute Disease↗
PubMed1985

[Estimation of pulmonary capillary mean pressure using TM-mode echocardiography].

The feasibility of estimating the mean pulmonary capillary pressure by simultaneous noninvasive recording of the ECG, the aortic and mitral valve echocardiogram was tested in 50 patients with miscellaneous heart lesions. The Q-MVC-/AVC-E ratio was measured from the onset of the QRS-complex in the ECG, the closure point of the aortic valve, the early diastolic opening of the anterior mitral valve (E-point) and the systolic closure of the mitral valve leaflets on the echocardiogram (C-point). A linear correlation exists between the mean pulmonary artery wedge pressure and the Q-MVC-/AVC-E ratio (n = 50, r = 0.75, p less than 0.001). The echocardiographic derivate index (Q-MVC-/AVC-E) is useful in assessing an elevated left ventricular filling pressure, but the individual data revealed variation in the predicted relation between Q-MVC-/AVC-E and left ventricular end-diastolic pressure. The Q-MVC-/AVC-E ratio is not a useful parameter in predicting left ventricular end-diastolic pressure in patients suffering from a left ventricular aneurysm or an acute transmural myocardial infarction with extensive regional abnormal wall motion. Many criteria such as mitral valve disease, atrial fibrillation, atrioventricular block and left bundle-branch block suggest that the Q-MVC-/AVC-E ratio is of limited clinical value. The left atrial emptying index was measured by using the amplitude of the posterior aortic wall motion occurring in the first third of the passive emptying period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Lorcainide in stable ventricular extrasystole. A double-blind study with 48-hour continuous ECG recording].

In a randomized double-blind cross-over trial, the effectiveness of lorcainide at a dosage of three times 100 mg/d by mouth was compared with that of a placebo for the treatment of subjectively disturbing stable ventricular extrasystoles (VES), using 48-hour continuous ECG monitoring. In 11 of 20 patients there was a regression in the VES rate to under 5%, in other 3 patients to under 50% of the initial values. Continuing the treatment, good therapeutic effect was still demonstrable 14 and 28 days later. However, only three patients had no side-effects. The others had sleep disturbances, hot flushes, sweating, restlessness, anxiety, dizziness, hallucinations and gastrointestinal symptoms. Lorcainide thus has a good anti-arrhythmic effect but, because of its side-effects, it should be used only in special circumstances.

Adult↗
PubMed1984

[Fibronectin].

Fibronectin is a dimeric glycoprotein with a molecular weight of 440,000. It is a soluble constituent of plasma and other body fluids and a fibrillar matrix protein of connective tissue. The two components are structurally similar and convertible. The possibility of multiple molecular interactions gives rise to a variety of biological functions. The regulation of cell growth and the reduced shedding of fibronectin from malignant cells raises the question as to whether fibronectin is valid as a tumour marker. In wound healing and chronic inflammation fibronectin serves as a scaffold for the formation of collagen. As opsonic protein it maintains reticuloendothelial function. Especially in shock, fibronectin may become the limiting factor of unspecific host defence mechanisms. The value of a substitution therapy will be discussed.

Animals↗