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Biomedical subjects

M Runge

Publications and source records attributed to M Runge.

98 records · Page 6Linked to original sources
PubMedDate not supplied

[The adaptation of AV-nodal conduction time on gliding increase and decrease of atrial frequency before and after autonomic blockade (author's transl)].

In 19 patients with healthy AV-nodes the adaptation of the intranodal conduction time (A-H time) to gliding increase and decrease in atrial frequency and to the blockade of the autonomic nervous system was investigated using His bundle electrograms. The measurements were performed during right atrial stimulation with three frequencies, each with a duration of one minute, before and after blockade of the parasympathetic (8 pat.; 1 mg atropine i.v.) and the sympathetic (11 pat.; 0.4 mg Visken i.v.) nervous system. Gliding increase and decrease in atrial frequency results in a staircase pattern of A-H-adaptation in 18 of the patients. The height of the steps was identical in both phases of stimulation in each individual patient. One patient showed functional dissociation of intranodal conduction which was different during increase and decrease of atrial frequency. With parasympathetic blockade the staircase behavior of the A-H time basically remained unchanged with the exception of shorter A-H intervals resulting in lower steps. Atropine abolished the functional dissociation of intranodal conduction; thus the drug might prevent reentrytachycardias due to functional dissociation in the AV-node. Sympathetic blockade lengthens the intranodal conduction time; thus shifting the staircase pattern of the A-H time to higher levels. The results are discussed with respect to the electrophysiological characteristics of AV nodal cells as slow response fibers, and to the changes caused by atrial stimulation, acetylcholine and adrenaline.

Atrioventricular Node↗
PubMedDate not supplied

[Influence of cycle length shortening, atropine and beta-receptor blockage on sinus node recovery time (SRT) in patients with healthy sinus node (author's transl)].

Sinus node recovery time (SRT) was measured in 30 patients with healthy sinus nodes to examine the influence of the increase in atrial frequency, atropine and beta-receptor blockade. The measurements were performed following pacing with 3 atrial frequencies before and after administration of 1 mg atropine i.v. (13 patients) and 0.4 mg prindolol (Visken) i.v. (17 patients). Total group; Increase of frequency alone caused prolongation of the SRT in 17 patients and shortening in 13 patients. Atropine group: Blockade of the parasympathicus alone induced a highly significant reduction in the SRT. Simultaneous increase in frequency and blockade of the parasympathicus led to greater SRT-shortening during low frequency than with high frequency. This interrelationship of frequency and blockade of the parasympathicus influencing the SRT is statistically significant. Visken-group: Blockade of the sympathicus causes a highly significant prolongation of the SRT. Simultaneous increase in frequency and blockade of the sympathicus led to greater SRT-prolongation during low frequency than with high frequency. This interrelationship of frequency and blockade of the sympathicus influencing the SRT has slight statistical significance. The results are discussed in respect to the electrophysiological influences of atrial cycle length shortening, acetylcholine and catecholamines on the sinus node, the perinodal atrial fibres and the atrial working myocardium.

Atropine↗
PubMedDate not supplied

Use of serum PIVKA-II (DCP) determination for differentiation between benign and malignant liver diseases.

BACKGROUND: The concentration of Des-gamma-carboxy-prothrombin (DCP) or PIVKA-II has been described to be increased in patients with hepatocellular cancer, along with its elevation in vitamin K deficient states by warfarin or dicoumarol treatment. The aim of the study was to investigate its clinical value in HCC in comparison with alpha-fetoprotein. PATIENTS AND METHODS: Measurements were performed in duplicate in serum of 87 patients with benign (acute/chronic hepatitis B/C/autoimmune, liver cirrhosis B/C/alcoholic) and 154 patients with highly probable (CT, MRT imaging) or histologically proven HCC. Two commercial or research ELISA tests (1: Eitest MonoP-II, Eisai, Tokyo, Japan; 2: Asserachrom PIVKA-II, Stago, France) using murine monoclonal anti-PIVKA-II antibodies were used comparatively and compared with a laboratory-developed conventional AFP-RIA. RESULTS: By ROC analysis, a highly significant discrimination (p < 0.0001) was found at cutoffs of 0.09 AU/ml (Eisai) or 0.8 ng/ml (Stago) at a specificity of about 90% (Eisai: s = 78.6%, ppv = 0.92, npv = 0.70; Stago: s = 77.9%, ppv = 0.93, npv = 0.70) compared with the AFP-test at a cutoff of 45 ng/ml (sp = 91%, s = 58.4%, ppv = 0.92, npv = 0.55). A higher significant correlation was seen between both DCP tests in malignant (rS = 0.89, p < 0.0001) than benign groups (rS = 0.41, p < 0.001) and a lower correlation between the AFP and Eisai (rS = 0.27/0.36, p < 0.01) and Stago test for the malignant group (0.16; p < 0.05). CONCLUSION: DCP determination in serum/plasma adds significantly in the discrimination between benign and malignant liver diseases.

Adult↗
PubMedDate not supplied

[The influence of frequency and blockade of the autonomic nervous system on the functional behaviour of the human conduction system. Part A: Conduction velocity (author's transl)].

32 patients were studied by His-bundle recordings to examine the extent to which frequency and autonomic nervous system influence the conduction velocity in the subdivisions (atrium, AV-node, His-Purkinje system) of the normal PR-interval. The measurements were performed during sinus rhythm and three electrically induced atrial frequencies before and after intravenous administration of 1 mg Atropine (15 patients) and 0.4 mg Visken (17 patients). In influencing the atrial conduction velocity frequency dominates the blockade of both components of the autonomic nervous system. Increase in frequency lengthens the intraatrial conduction time. Blockade of parasympathicus and sympathicus does not significantly influence the changes in intraatrial conduction velocity induced by increase of frequency. Patients with prolonged intraatrial conduction respond in the same way to cycle length shortening and blockade of the autonomic tone as patients with normal conduction. The results are discussed with respect to acetylcholine and catecholamine influence on the electrophysiological properties of the atrial myocardium. The AV-node is the part of the conduction system most sensitive to the influence of both cycle length shortening and blockade of the autonomic nervous system. Artificially induced cycle length shortening prolongs the intranodal conduction time to a different individual level for each patient. Blockade of the parasympathicus not only shortens this interval but also reduces the steepness of the AH-time induced by atrial pacing. Blockade of the sympathicus has the opposite effect. The most likely explanation for these results is the abolishing of the functional dissociation within the AV-node by blocking the autonomic influence on this structure. The conduction velocity in the His-Purkinje system is influenced neither by atrial pacing nor by blockade of both components of the autonomic nervous system.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

[Multifactorial pathogenesis of gait disorders, falls and hip fractures in the elderly].

Age, gait disorders, falls, and hip fractures are connected in a pathological cascade. 90% of hip fractures happen at the age of 70 and older; 90% are a consequence of a fall. Only a minority of these patients regain their former level of locomotion. For many of them a hip fracture ends in dependence on personal help, placement in a nursing home, or even death. About 80% of falls occur due to pathological balance and gait disorder and are not due to syncope or overwhelming external force. 5% of all falls result in a fracture, including 1% of all falls with hip fractures. What determines the fracture risk is the relation of bone fragility to geometrical and physical factors of the fall. Regarding the cascade gait disorder-fall-hip fracture, there are always multiple factors interacting. It is useful to give this distinct entity of multifactorial gait disorder with high risk of falling a new diagnostic label: We suggest "age-associated multifactorial gait disorder." To identify individual risk factors and regard their interactions can be a basis for therapy and interventions to prevent falls.

Accidental Falls↗