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K Schorn

Publications and source records attributed to K Schorn.

At least 37 records · Page 2Linked to original sources
PubMed1997

Lipid mixing in dimyristoyl phosphatidylcholine-dimyristoyl glycerol dispersions: spin label ESR studies.

The lipid transfer and mixing properties in hydrated dispersions of dimyristoyl phosphatidylcholine (DMPC)/dimyristoyl glycerol (DMG) binary mixtures have been investigated by using electron spin resonance spectroscopy of the spin-labelled lipid components. The assay system is based on the reduction in spectral broadening from spin-spin interactions that takes place by dilution of the spin-labelled lipid on transfer to a 9-fold excess of dispersions that contain no spin label. Lipid dispersions with DMPC:DMG compositions of 70:30, 40:60 and 20:80 mol/mol, for which the fluid phases have lamellar, inverted hexagonal and isotropic structures, respectively, have been studied. Essentially no transfer of spin-labelled lipid takes place for any of the lipid mixtures in the lamellar gel phase, or in dispersions of DMPC alone at all temperatures studied. The greatest degrees of transfer are found in the fluid phase of the DMPC/DMG mixtures. In general, the extent of lipid transfer is greater for the diacylglycerol component than for the phosphatidylcholine component. The extent of transfer of phosphatidylcholine is very low in the fluid lamellar phase of the 70:30 mol/mol DMPC/DMG, as compared with that of diacylglycerol. Only in the case of the 40:60 mol/mol DMPC/DMG mixture, in the inverted hexagonal phase, are the extents of transfer comparable for both phosphatidylcholine and diacylglycerol components, indicating a bulk transfer of lipid within the dispersions. The largest extent of transfer is found for diacylglycerol in the 20:80 mol/mol DMPC/DMG mixture in the isotropic phase.

Diglycerides↗
PubMed1997

Risk factors for early degeneration of allografts in pulmonary circulation.

OBJECTIVE: The aim of this study was to define risk factors for early degeneration of allografts in pulmonary circulation and to recommend some guidelines to minimize them. METHODS: Between January 1988 and March 1995, 202 patients with various types of congenital heart disease received cryopreserved allograft conduits for reconstruction of their right ventricular outflow tract. We report on 63 patients receiving allografts ranging from 9-24 mm size within the first 2 years of life. RESULTS: Survivors have been followed for 4-67 months. Survival at 5 years, including hospital mortality, was 66%. Two patients died at reoperation. Of the patients 19.6% (9/46) had early structural deterioration (SD) of their vascular allografts at a mean of 15.2 months after implantation. Seven of these have already been reoperated with allograft exchange. Freedom of reoperation was 66% at 5 years. Infants showed 48% freedom of reoperation at 5 years compared to 90% in the 1-2 years age group, while freedom of SD was 59% in infants at 48 months compared to 87% in the 1-2 years age group. Of allografts with SD in the infant group 66% had an allograft size of < 14 mm. In aortic allografts freedom of SD was 62% compared to 93% in pulmonary allografts. Freedom of allograft wall calcification was 46% at 18 months in all patients. In the statistical analysis, only infant age (P = 0.03) and aortic allograft (P = 0.02) were shown to be significant risk factors for early SD. CONCLUSION: The use of pulmonary allografts, avoidance of relatively short and small conduits of < 14 mm in diameter, might improve the durability of allografts in infants and small children.

Bioprosthesis↗
PubMed1997

[Possibility for quantitative and frequency-specific assessment of auditory threshold with otoacoustic emissions].

BACKGROUND: Otoacoustic emissions can be used to study cochlear function in a non-invasive manner. They are an effective clinical tool for infant hearing screening. The purpose of this study was to determine their utility for a frequency-specific and quantitative estimation of the hearing threshold. METHODS: Transiently evoked otoacoustic emissions (TEOAE) and distortion-product emissions (DPOAE) were recorded from 16 normal and 86 hearing impaired ears and correlated with their hearing threshold between 0.5 and 6.0 kHz. RESULTS: The correlations of TEOAE and the hearing threshold ranged from 0.53 (0.5 kHz) to 0.69 (6.0 kHz), of the DPOAE from 0.51 (0.5 kHz) to 0.83 (6.0 kHz). Based on the optimal correlating OAE frequency we tried to predict the hearing threshold. We obtained 95% prediction intervals for TEOA between 19 dB (1.0 kHz) and 39 dB (4.0 and 6.0 kHz), for DPOAE between 21 dB (1.0) and 34 dB (3.0 and 4.0 kHz). CONCLUSION: Despite their clinically irrelevant greater prediction intervals at the low frequencies, our results suggest that DPOAEs are generally more valuable for the frequency-specific estimation of the hearing threshold. Prediction intervals may improve the interpretation of OAEs.

Adolescent↗
PubMed1997

[Hypercholesteremia and hyperfibrinogenemia in sudden deafness].

BACKGROUND: The pathogenesis of sudden hearing loss has not been elucidated as yet. Insufficient perfusion of the cochlea due to an increased blood viscosity, microthrombosis, or altered vasomotion are assumed. Hypercholesterolemia and hyperfibrinogenemia are frequently observed in patients with sudden sensorineural hearing loss. The aim of this study was to investigate the incidence of hypercholesterolemia and hyperfibrinogenemia in patients suffering from sudden hearing loss compared to normal controls. In an intervention study the impact of drastic lowering of plasma cholesterol and fibrinogen by a selective extracorporal apheresis was studied. METHODS: In a case-control study of 23 patients suffering from sudden hearing loss, plasma cholesterol and fibrinogen levels as well as erythrocyte aggregation and plasma viscosity were determined. Seven sudden hearing loss patients from this group were treated with H.E.L.P. apheresis, an extracorporal procedure removing fibrinogen and idl-cholesterol from plasma. RESULTS: Plasma fibrinogen and cholesterol levels were higher in sudden hearing loss patients, leading to significantly elevated values of erythrocyte aggregation and plasmaviscosity. Six out of the seven patients treated with a single H.E.L.P. apheresis immediately showed an improvement of auditory thresholds. CONCLUSIONS: We conclude that hyperfibrinogenemia and hypercholesterolemia may contribute to the clinical event of sudden hearing loss. Our study shows for the first time that acute and drastic removal of plasma fibrinogen and low density lipoproteins can be an effective clinical tool in the treatment of patients with sudden hearing loss.

Adult↗
PubMed1997

[Reference curves for hearing surface scaling in clinical use].

METHODS: A commercially available system for the purpose of categorial loudness rating (WHF, WESTRA ELECTRONIC GmbH, Wertingen) was applied with 57 subjects with normal hearing to evaluate reference loudness level functions for 1/3-octave bandpass filtered noise and octave bandpass filtered environmental sounds. RESULTS: The procedure can be carried out with high reproducibility without effects of training due to repetition and only slight influence of subject sex, whereas the labeling of input device and temporal structure of the environmental sounds influence results, as does the center frequency. CONCLUSIONS: Our results showed deviations compared with the reference functions displayed in the WHF system.

Adolescent↗
PubMed1996

Lipid chain dynamics and molecular location of diacylglycerol in hydrated binary mixtures with phosphatidylcholine: spin label ESR studies.

The lipid chain motions in hydrated binary mixtures of dimyristoylglycerol (DMG) with dimyristoylphosphatidylcholine (DMPC) have been studied by using ESR spectroscopy of analogues of both components that are spin-labeled at one of eight different positions along the sn-2 chain. The phase diagram of the binary mixtures divides into three separate regions along the composition axis, corresponding to the formation of isothermally melting compounds, with DMPC/DMG stoichiometries of approximately 1:1 and 1:2 mol/mol in the gel phase [Heimburg, T., Wurz, U., & Marsh, D. (1992) Biophys. J. 63, 1369-1378]. In the first region (up to 50 mol % DMG), comparison of the chain flexibility profiles, and the chain profiles of the polarity-dependent isotropic hyperfine coupling constant, of the two different spin-labeled components indicates that DMG is incorporated in the fluid lipid bilayer in a manner similar to that of the host DMPC but is situated approximately two CH2 groups deeper into the hydrophobic interior. At lower contents of DMG, the chain packing is increased by the addition of DMG, whereas at higher DMG contents the lipid chain order decreases rapidly, on reaching the inverted hexagonal phase of the second region of the phase diagram. In the second region of the phase diagram (50-67 mol % DMG), the DMG fits better into the fluid inverted hexagonal phase than into the fluid lamellar phase of the first region and is located only approximately one CH2 group deeper than the corresponding DMPC. In these first two regions of the phase diagram, the ESR spectra of both spin-labeled components display an axial anisotropy that evidences the increasing angular amplitude of motion with position down the chain that is characteristic of liquid crystalline fluid phases. In the third region of the phase diagram (above 67 mol % DMG), the fluid phase consists of isotropically tumbling DMG molecules in which the DMPC molecules are incorporated as inverted micelles as indicated by the residual anisotropic motion of the spin-labeled phosphatidylcholine analogues.

Anisotropy↗
PubMed1996

Dynamic chain conformations in dimyristoyl glycerol-dimyristoyl phosphatidylcholine mixtures. 2H-NMR studies.

The dynamic molecular lipid chain conformations in fully hydrated dimyristoyl phosphatidylcholine (DMPC)-dimyristoyl glycerol (DMG) mixtures have been investigated by 2H-NMR spectroscopy of the individual lipid components, the sn-2 chains of which were perdeuterated or, in the case of DMG, specifically deuterated at the C-2 position. Mixtures of compositions corresponding to the three different regions of the binary phase diagram in which the fluid phase is lamellar (DMPC:DMG 70:30 mol/mol), inverted hexagonal (DMPC:DMG 45:55 and 40:60 mol/mol), or isotropic (DMPC:DMG 20:80 mol/mol) were investigated. The gel phase in all three regions of the phase diagram has a lamellar structure, with the lipid chains rotating about the molecular long axis but executing only limited angular excursions. In the fluid lamellar phase of the 70:30 mol/mol DMPC-DMG mixture the profile of segmental chain flexibility is similar to that in single-component phospholipid bilayers and is characterized by an order parameter plateau for both lipid components. The chain order of the DMPC component is greater than in bilayers of DMPC alone and is also greater than that of the DMG component. In the inverted hexagonal phase of the 45:55 mol/mol DMPC-DMG mixture the chain flexibility profile is characterized by more widely spaced segmental order parameters off the plateau region. The intrinsic degree of chain order in the inverted hexagonal phase is less than in the lamellar phase of the 70:30 mol/mol mixture, and the difference in chain order between the DMPC and DMG components is reduced relative to that in the lamellar phase. The unique conformational features at the C-2 position of the sn-2 chain that characterize bilayers of diacyl phospholipids are found also for the diacylglycerol molecules in the fluid lamellar phase and most probably also in the inverted hexagonal phase. The DMG molecules are therefore integrated in the membrane (or nonlamellar lipid phase) in a configuration that is similar to that of the phospholipids and different from the crystal structure of diacylglycerols.

Deuterium↗
PubMed1996

Evaluation of TEOAE and DPOAE measurements for the assessment of auditory thresholds in sensorineural hearing loss.

Transiently evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) can be quantified concerning their amplitude and frequency. They are known to be diminished or absent in sensorineural hearing loss. It is therefore of interest how TEOAE and DPOAE correlate with the auditory threshold and whether the auditory threshold can be predicted by these variables. In a cross sectional study of 61 patients (102 ears) with sensorineural hearing loss, auditory threshold, tympanometry, stapedius reflexes, TEOAE and DPOAE were measured. Correlation coefficients of the hearing loss (0.5-6 kHz) and the amplitude of the distortion product 2f1-f2 (0.46 4 kHz) respectively TEOAE amplitude (1-4 kHz) were computed. TEOAE showed lower correlation coefficients and less frequency specificity than DPOAE. In order to increase the correlations with the auditory threshold we fitted a multivariate linear regression model with TEOAE and DPOAE simultaneously as predictors for the auditory threshold gaining 95% prediction intervals of 19-39 dB depending on the frequency investigated. By restricting the hearing loss to a maximum of 70 dB HL the 95% prediction interval of the auditory threshold could be decreased to 18-26 dB. Further improvements can be expected if the high inter- and intraindividual variability of TEOAE and particularly DPOAE measurements can be reduced. The results allow us to use TEOAE and DPOAE in addition to click-evoked brainstem audiometry in order to provide more frequency specific information about the hearing loss in newborns, which is of the utmost importance for an ideal fitting of hearing aids.

Acoustic Impedance Tests↗
PubMed1995

Accelerated degeneration of allografts in the first two years of life.

Between January 1988 and May 1994, 53 of 159 patients have received cryopreserved aortic and pulmonary allografts for reconstruction of the pulmonary circuit in the first 2 years of life with body weight ranging from 2.2 to 18 kg (mean, 8.2 +/- 3.4 kg). The implanted allografts ranged in internal diameter from 9 to 23 mm (mean, 16.3 +/- 3.5 mm). Of the 38 survivors who regularly had postoperative echocardiographic examinations 15 (39.5%) underwent cardiac catheterization 1 to 31 months after operation. Allograft dysfunction (gradient > or = 50 mm Hg with or without pulmonary insufficiency) was confirmed in 9 patients leading to reoperation in 5 and valvulo-angioplasty in 4. At 48 months actuarial survival was 64%. In the aortic and pulmonary allografts freedom from wall calcification at 20 months was 19% and 100%, respectively. Freedom from valve dysfunction in patients with aortic and pulmonary allografts was 53% and 88%, respectively; it was 49% in allografts with an internal diameter of 17 mm or smaller. Freedom from reoperation in all patients was 78%. In conclusion, young age, antigenicity (ABO compatibility), and type of allograft seemed to be independent risk factors for early allograft conduit degeneration and late valve dysfunction. Pulmonary allografts seemed to be more resistant to early wall calcification and valve dysfunction than aortic allografts.

Actuarial Analysis↗
PubMed1995

[Screening program for selection of hearing loss in newborn infants instituted by the European Community].

Early identification of hearing impairment in children poses a major problem for clinical research and development. In the last two years we determined the hearing sensitivity of 1202 newborns, small infants and children. 52.4% of the children exhibited risk factors for hearing impairment in their medical history. The majority of children was referred to our department by pediatricians (52%), who first suspected hearing impairment, 40% by parents, 3.5% by otolaryngologists, 3% by educators, and 1.5% by general practitioners. The following examinations were performed: transiently evoked otoacoustic emissions (TEOAE), impedance audiometry, auropalpebralreflex, behavioral observation audiometry, and, if necessary, auditory brain stem response (ABR) with air and bone-conducted clicks as well as frequency-following responses at 500 Hz tone burst. In 378 children TEOAE were recorded on both sides, in 151 at least on one side. These results were confirmed by the other techniques. Only three children presented false negative results of TEOAE on one side. Two of these children had a middle ear effusion and a threshold of 35 dB, one had retrocochlear hearing loss. The absence of TEOAE in both ears in 155 children as well as in one ear in 16 children was detected by ABR. Seventy-seven patients showed no response on both sides, 25 on one side, although a hearing impairment more than 25 dB could not be verified by ABR. This high number of false positive results is explained in 77 cases (76%) by a middle ear dysfunction during the recording of TEOAE, when ABR was performed following adenotomy and paracentesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[New aspects of hearing aid fitting].

Improved methods to diagnose a hearing loss and the enormous progress in the development of digital and programmable hearing aids have been helpful in promoting the social integration of patients, even of those affected by a profound deafness. Besides the hearing loss, recruitment effects and alteration of sound can also be compensated by the new hearing aids. However, one precondition is that the hearing aid fitting is carried out professionally, with plenty of time, and including the new hearing aid fitting methods. The new techniques developed in our hospital to optimize hearing aid fitting are pointed out. Fitting should start by considering what kind of ear mould and what kind of different modifications are to be taken. In a great number of patients we were able to verify that venting combined with the insertion of a Bakke- or Libby-horn increases not only the subjective acceptance of the hearing aid, but also significantly improves speech discrimination, particularly under background noise. The preselection of the hearing device and precise adjustment are based on the hearing loss in different frequencies, involving the principle that the frequency response of the hearing aid and the audiogram mirror each other accordingly, whereas the gain of the hearing aid can not be recognised exactly from the audiogram. In contrast to the POGO- and the NAL-method, we recommend a greater amplification, especially in the higher range of frequency. Today, the in-situ-measurement with a probe microphone is considered to be the method of choice for accurate frequency adjustment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Temporal resolution with a hearing aid in hearing impaired persons].

The purpose of hearing aid fitting is to improve the communication of the hearing impaired. Despite rigorous efforts to optimize hearing aid fitting there are still some patients who remain unsatisfied. The subject of research was to find improved methods of measuring, to increase the correlation between subjective information from the patient and objectively measurable data. With this goal in mind the variation of temporal resolution in hearing aid fitting was investigated in 88 patients comparing unaided and aided hearing basing on the method of determining the temporal resolution factor TRF at 500 Hz, 1500 Hz and 4000 Hz under free sound field conditions, as previously described by Schorn and Zwicker. The method is based on masking period patterns but measures only their maximum and minimum using continuous and 30-Hz square-wave amplitude modulated masking noise. The following three values of interest are measured: Threshold in quiet using interrupted continuous tones (500 ms on, 500 ms off) with the masker off; threshold masked by a continuous masker (octave-wide continuous noise) and threshold masked by a rectangulary modulated masker using 14 Hz, so that periods of 72 ms and pauses of 36 ms occur. TRF was defined as the ratio between the level differences derived from the three measured values. For normal hearing subjects this factor is about 1. The results show significant variation of the TRF comparing the data of the patients with and without hearing aids. The values for TRF unaided were 0.5 and 0.6 as well as under hearing aid.(ABSTRACT TRUNCATED AT 250 WORDS)

Audiometry, Pure-Tone↗
PubMed1993

[Value of in situ measurement for evaluating effective hearing aid amplification at high sound pressure levels].

A careful hearing aid fitting requires consideration of various characteristics of inner ear pathology. The recruitment phenomenon restricts the dynamic range of the impaired hearing and this increase the demands on the hearing aids for a satisfactory correction of the frequency characteristics as well as for an intensity reduction at higher sound pressure level SPL. For years data from coupler or KEMAR (Knowles Electronics Manikin of Acoustical Research) have served to estimate the real ear gain of a hearing aid at higher input levels. In previous papers we reported on some of the differences between coupler measurement and probe tube measurement. The object of this study was to investigate the differences between these two methods at higher input SPL. Therefore, we measured the real ear insertion gain as well as the output characteristics with a 2 cm3 coupler in 80 patients at input levels of 60 dB, 80 dB and 100 dB. The results show differences between the two methods up to 30 dB in both directions in the single patient. Furthermore, the highest compression rate was found in the middle and high frequency range which are crucial for speech discrimination. Consequently, probe tube measurement should be used not only to adjust the frequency characteristics of the hearing aid but also to characterise the real effect of Automatic Gain Control AGC and Peak Clipping PC on insertion gain at higher input SPL. Multichannel hearing aids should be used whenever possible to reduce the disturbances to speech discrimination at low frequencies.

Hearing Aids↗
PubMed1993

The Munich screening programme in neonates.

For development, it is necessary to stimulate the auditory pathway during the first weeks of life. This knowledge and improved techniques for the treatment of young children with hearing loss make early detection even more important, otherwise developmental disabilities inevitably occur. The method of transient-evoked otoacoustic emissions is the most useful test for neonatal screening and has the following advantages: emissions are quickly measured (i.e. within a few minutes), the measurements can be performed in the hospital nursery by trained volunteer examiners, the test produces the same results in awake, anaesthetized, sedated, and sleeping patients, and the existence of TEOAEs excludes with very high probability a peripheral hearing loss which may influence the development of speech. A prerequisite of a successful evaluation with crying and moving neonates is an apparatus with two specific rejection thresholds; one for time, the second for amplitude. Additionally, the probe has to be robust, but also small both to minimize its weight and to fit comfortably within the diameter of the neonatal ear canal.

Acoustic Impedance Tests↗
PubMed1992

[What improvements can be gained by additional boring in hearing aid fitting?].

In several investigations the authors tried to find a objective correlation to the subjective positive reactions after venting an earmold. There was no notable effect neither on insertion gain nor on speech intelligibility in different background noise situations. In this study the most comfortable hearing level has been used. This stimulus is influenced by the suprathreshold loudness growth. The measurement has been carried out with and without venting. Comparing the results there can be seen only a little effect of venting at all frequencies. Might be that patient's report about improvement after venting results from the direct input of low frequencies through the vent to the eardrum. These frequency region plays a special part of hearing comfort to reach a comfortable sound quality.

Adult↗
PubMed1992

[Various uncomfortable loudness thresholds, their correlation and use in general practice].

In the present study we examined the relationship of the loudness discomfort level LDL of different signals. We carried out measurements in 97 patients, all of whom suffered from a sensorineural hearing loss. The results showed almost no difference between the LDL of pure tones and narrow band noise. The LDL of broad band noise showed a good correlation to the LDL of 250 Hz. Only the LDL of monosyllables ranged at a higher SPL. For an up-to-date hearing aid fitting, all forms of LDL should be taken into consideration. This is especially necessary when using digital hearing aids.

Adolescent↗