Search Results - (Author, Cooperation:Adam)

Adam, Konrad

Unknown

192 S.

3549071663

Adam, Hans [Verfasser] 1925-2013; Czihak, Gerhard [Verfasser]

Book

XV, 583 S., zahlr. Ill., graph. Darst.

Grosses zoologisches Praktikum 1

German

Lemberg, Eugen [Verfasser] 1903-1976; Bauer, Adam [Verfasser]; Klaus-Roeder, Rosemarie [Verfasser]

Book

VII, 129 S.

348503049X, 3485040495

Sammlung Dialog 49

German

Lizenz d. Wiss. Buchges., Darmstadt.

Drescher, Reinhold [Hrsg.]; Adam, Willi [Hrsg.]

Book

292 S., graph. Darst.

1. Aufl.

3523670055

Wolf-Handbücher

German

Adam, Gisela

Unknown

263 S.

1. Aufl.

3407580061

Beltz-Forschungsberichte

German

Curle, Adam [Verfasser] 1916-

Book

144 S.

1. publ.

0470189509

English

Pradel, Gregor; Adam, Hans-Günther

Unknown

342 S.

3., erw. Auflage

Naturlehre-Unterricht : Physik und Chemie ; Didaktik, Methode, Praxis für die Unterrichtsvorbereitung des Lehrers an Haupt- und Realschulen 1

German

Pradel, Gregor; Adam, Hans-Günther

Unknown

307 S.

3., erw. Auflage

Naturlehre-Unterricht : Physik und Chemie ; Didaktik, Methode, Praxis für die Unterrichtsvorbereitung des Lehrers an Haupt- und Realschulen 3

German

Pradel, Gregor; Adam, Hans-Günther

Unknown

404 S.

3., erw. Auflage

Naturlehre-Unterricht : Physik und Chemie ; Didaktik, Methode, Praxis für die Unterrichtsvorbereitung des Lehrers an Haupt- und Realschulen 2

German

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Ventricular Defibrillation and Cardiac Function. Introduction: The effect of implantable defibrillator shocks on cardiac hemodynamics is poorly understood. The purpose of this study was to test the hypothesis that ventricular defibrillator shocks adversely effect cardiac hemodynamics. Methods and Results: The cardiac index was determined by calculating the mitral valve inflow with transesophogeal Doppler during nonthoracotomy defibrillator implantation in 17 patients. The cardiac index was determined before, and immediately, 1 minute, 2 minutes, and 4 minutes after shocks were delivered during defibrillation energy requirement testing with 27- to 34-, 15-, 10-, 5-, 3-, or 1-J shocks. The cardiac Index was also measured at the same time points after 27- to 34-, and 1-J shocks delivered during the baseline rhythm. The cardiac index decreased from 2.30 ± 0.40 L/min per m2 before a 27- to 34-J shock during defibrillation energy requirement testing to 2.14 ± 0.45 L/min per m2 immediately afterwards (P= 0.001). This effect persisted for 〉4 minutes. An adverse hemodynamic effect of similar magnitude occurred after 15 J (P= 0.003) and 10-J shocks (P= 0.01), but dissipated after 4 minutes and within 2 minutes, respectively. There was a significant correlation between shock strength and the percent change in cardiac index (r = 0.3, P= 0.03). The cardiac index decreased 14% after a 27- to 34-J shock during the baseline rhythm (P 〈 0.0001). This effect persisted for 〈4 minutes. A 1- J shock during the baseline rhythm did not effect the cardiac index. Conclusion: Defibrillator shocks 〉9 J delivered during the baseline rhythm or during defibrillation energy requirement testing result in a 10% to 15% reduction in cardiac index, whereas smaller energy shocks do not affect cardiac hemodynamics. The duration and extent of the adverse effect are proportional to the shock strength. Shock strength, and not ventricular fibrillation, appears to be most responsible for This effect. Therefore, the detrimental hemodynamic effects of high-energy shocks may be avoided when low-energy defibrillation is used.

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Adenosine and Retrograde Fast Pathway Conduction. Introduction: Several studies have shown that the fast pathway is more responsive to adenosine than the slow pathway in patients with AV nodal reentrant tachycardia. Little information is available regarding the effect of adenosine on anterograde and retrograde fast pathway conduction. Methods and Results: The effects of adenosine on anterograde and retrograde fast pathway conduction were evaluated in 116 patients (mean age 47 ± 16 years) with typical AV nodal reentrant tachycardia. Each patient received 12 mg of adenosine during ventricular pacing at a cycle length 20 msec longer than the fast pathway VA block cycle length and during sinus rhythm or atrial pacing at 20 msec longer than the fast pathway AV block cycle length. Anterograde block occurred in 98% of patients compared with retrograde fast pathway block in 62% of patients (P 〈 0.001). Unresponsiveness of the retrograde fast pathway to adenosine was associated with a shorter AV block cycle length (374 ± 78 vs 333 ± 74 msec, P 〈 0.01), a shorter VA block cycle length (383 ± 121 vs 307 ± 49 msec, P 〈 0.001), and a shorter VA interval during tachycardia (53 ± 23 vs 41 ± 17 msec, P 〈 0.01). Conclusion: Although anterograde fast pathway conduction is almost always blocked by 12 mg of adenosine, retrograde fast pathway conduction is not blocked by adenosine in 38% of patients with typical AV nodal reentrant tachycardia. This indicates that the anterograde and retrograde fast pathways may be anatomically and/or functionally distinct. Unresponsiveness of VA conduction to adenosine is not a reliable indicator of an accessory pathway.

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Cardiac Memory. Introduction: “Cardiac memory” (primary T wave change) is thought to occur after 15 minutes to several hours of right ventricular (RV) pacing. The two components of the temporal change in repolarization are memory and accumulation. The purpose of this study was to examine quantitatively the effect of short periods of ventricular pacing on the human cardiac action potential, using monophasic action potential (MAP) recordings. Methods and Results: Thirty-one patients (ages 43 ± 14 years) with structurally normal hearts undergoing a clinically indicated electrophysiologic procedure were enrolled. Catheters were placed in the right atrium (RA) and RV, and a MAP catheter was positioned at the RV septum. APD90 was calculated from digitized MAP recordings. MAP morphology comparisons were performed using the root mean square (RMS) of the difference between complexes. All pacing was at 500-msec cycle length. There were four pacing protocols: (1) RA pacing was performed for approximately 15 minutes to evaluate temporal stability of the MAP recordings (5 pts); (2) to evaluate the memory phenomenon, four successive 1-minute episodes of RV pacing were interspersed with 2 minutes of RA pacing (5 pts); (3) the accumulation phenomenon was evaluated by assessing the effects of 1, 5, 10, and 15 minutes of RV pacing on the MAP during RA pacing (16 pts); and (4) 20 minutes of RV pacing was followed by 10 minutes of RA pacing to correlate visually apparent T wave changes with changes in MAP recordings (5 pts). In the control patients, no changes in APD90 or RMS analysis were noted during 14.9 ± 1.4 minutes of RA pacing. In the second protocol, RMS of the difference between the baseline MAP complexes and the signal average of the first 50 beats following each of four 1-minute RV pacing trains demonstrated progressively greater differences in morphology after successive episodes of RV pacing. In protocol 3, RMS analysis identified a progressively greater difference between the baseline MAP recording and the average of the first 50 beats after 1,5, 10, and 15 minutes of RV pacing. In protocol 4, visually apparent changes in T waves occurred in parallel with the RMS of the difference between the baseline MAP recordings and the average of the first 50 beats after 20 minutes of RV pacing. Similar changes also were demonstrated by APD90 analysis. Conclusion: This study is the first to demonstrate that episodes of abnormal ventricular activation as short as 1 minute in duration may exert lingering effects on the repolarization process once normal ventricular activation resumes.

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Defibrillation Energy Requirements. Introduction: Defibrillation energy requirements in patients with nonthoracotomy defibrillators may increase within several months after implantation. However, the stability of the defibrillation energy requirement beyond 1 year has not been reported. The purpose of this study was to characterize the defibrillation energy requirement during 2 years of clinical follow-up. Methods and Results: Thirty-one consecutive patients with a biphasic nonthoracotomy defibrillation system underwent defibrillation energy requirement testing using a step-down technique (20, 15, 12, 10, 8, 6, 5, 4, 3, 2, and 1 J) during defibrillator implantation, and then 24 hours, 2 months, 1 year, and 2 years after implantation. The mean defibrillation energy requirement during these evaluations was 10.9 ± 5.5 J, 12.3 ± 7.3 J, 11.7 ± 5.6 J, 10.2 ± 4.0 J, and 11.7 ± 7.4 J, respectively (P= 0.4). The defibrillation energy requirement was noted to have increased by 10 J or more after 2 years of follow-up in five patients. In one of these patients, the defibrillation energy requirement was no longer associated with an adequate safety margin, necessitating revision of the defibrillation system. There were no identifiable clinical characteristics that distinguished patients who did and did not develop a 10-J or more increase in the defibrillation energy requirement. Conclusion: The mean defibrillation energy requirement does not change significantly after 2 years of biphasic nonthoracotomy defibrillator system implantation. However, approximately 15% of patients develop a 10-J or greater elevation in the defibrillation energy requirement, and 3% may require a defibrillation system revision. Therefore, a yearly evaluation of the defibrillation energy requirement may he appropriate.

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Fascicular Tachycardia. Introduction: Idiopathic left ventricular tachycardia typically has a right bundle branch block configuration. The purpose of this case report is to demonstrate that idiopathic ventricular tachycardia arising in or near the left posterior fascicle also may have a left bundle branch block configuration. Methods and Results: A 27-year-old woman underwent an electrophysiologic procedure because of recurrent, verapamil-responsive, wide QRS complex tachycardia. Two types of ventricular tachycardia (cycle lengths 330 to 340 msec) were reproducibly inducible, one with a right bundle branch block configuration and left-axis deviation that had been documented clinically, and the other with a left bundle branch block configuration and axis of zero. A Purkinje potential recorded at the junction of the left ventricular mid-septum and inferior wall preceded the ventricular complex by 40 msec in both tachycardias. A single application of ra-diofrequency energy at this site successfully ablated both ventricular tachycardias. Conclusion: The findings of this case report demonstrate that idiopathic ventricular tachycardia arising in or near the left posterior fascicle may have a left bundle branch block configuration

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Low-Energy Defibrillation. Introduction: In patients undergoing defibrillator implantation, an appropriate defibrillation safety margin has been considered to be either 10 J or an energy equal to the defibrillation energy requirement. However, a previous clinical report suggested that a larger safety margin may be required in patients with a low defibrillation energy requirement. Therefore, the purpose of this prospective study was to compare the defibrillation efficacy of the two safety margin techniques in patients with a low defibrillation energy requirement. Methods and Results: Sixty patients who underwent implantation of a defibrillator and who had a low defibrillation energy requirement (≤ 6 J) underwent six separate inductions of ventricular fibrillation, at least 5 minutes apart. For each of the first three inductions of ventricular fibrillation, the first two shocks were equal to either the defibrillation energy requirement plus 10 J (14.6 ± 1.0 J), or to twice the defibrillation energy requirement (9.9 ± 2.3 J). The alternate technique was used for the subsequent three inductions of ventricular fibrillation. For each induction of ventricular fibrillation, the first shock success rate was 99.5%± 4.3% for shocks using the defibrillation energy requirement plus 10 J, compared to 95.0%± 17.2% for shocks at twice the defibrillation energy requirement (P = 0.02). The charge time (P 〈 0.0001) and the total duration of ventricular fibrillation (P 〈 0.0001) were each approximately 1 second longer with the defibrillation energy requirement plus 10 J technique. Conclusion: This study is the first to compare prospectively the defibrillation efficacy of two defibrillation safety margins. In patients with a defibrillation energy requirement ≤ 6 J, a higher rate of successful defibrillation is achieved with a safety margin of 10 J than with a safety margin equal to the defibrillation energy requirement.

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Unipolar Electrogram. Introduction: The purpose of this study was to determine the accuracy of the unipolar electrogram for identifying the earliest site of ventricular activation. The earliest site of ventricular activation may be identified with the unipolar electrogram by the absence of an R wave. However, the accuracy of this technique is unknown. Methods and Results: A single ventricular premature complex was induced mechanically at the tip of an electrode catheter to simulate a ventricular premature depolarization site of origin. Unipolar electrograms were recorded from the right ventricular septum at the tip electrode and at 2, 5, 8, and 11 mm from the electrode tip in 20 patients. No R waves were detected at the ventricular premature depolarization site of origin. R waves were detected in 4 of 20 patients (20%) at 2 mm from the tip electrode and 7 of 20 patients (35%) at 5, 8, and 11 mm from the tip electrode. An R wave was not observed at distances ≤ 11 mm from the site of tachycardia origin in 13 of 20 patients (65%). Conclusions: While an R wave in the unipolar electrogram can he seen as close as 2 mm from the site of impulse origin, the absence of an R wave as an indicator of the site of impulse origin in the right ventricle is highly inaccurate. Therefore, the absence of an R wave in the unipolar electrogram is unlikely to be an adequate guide for identification of an effective target site for ablation of right ventricular tachycardia.

Electronic Resource

1540-8167

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Postdefibrillation Ventricular Arrhythmias. Background: The relationship between postdefibrillation ventricular arrhythmias and shock strength is poorly understood in patients with implantable defibrillators. The purpose of this study was to characterize the relationship between postdefibrillation ventricular arrhythmias and shock strength. Methods and Results: Forty-three patients with an implanted defibrillator underwent six separate inductions of ventricular fibrillation (VF) after a step-down defibrillation energy requirement (7.3 ± 4.6 J) was determined. For each of the first three inductions of VF, the first two shocks were low energy and equal to approximately 75 % of the defibrillation energy requirement (5.4 ± 3.3 J), or to the defibrillation energy requirement plus 10 J (17.5 ± 4.3 J). After the first two shocks, subsequent shocks were programmed to the maximum available energy (29.0 ± 2.5 J). The alternate technique was used for the subsequent three inductions of VF. Post defibrillation ventricular arrhythmias were noted. Post defibrillation ventricular arrhythmias with a cycle length ≤ 300 msec were more frequent after a low-energy shock (19%), than after a high-energy shock (1.5 %; P = 0.005). Postdefibrillation ventricular arrhythmias with a cycle length 〉 300 msec were more frequent after a high-energy shock (32%), than after a low-energy shock (7.1%; P = 0.002). A relationship between the cycle length of the post defibrillation ventricular arrhythmias and the absolute defibrillation energy was observed (P 〈 0.001; r = 0.6), and ventricular arrhythmias with a cycle length 〉 300 msec were uncommon after shocks ≤ 10 J (P = 0.001). The characteristics of ventricular arrhythmias after maximum-energy shocks were similar to those that occurred after high-energy shocks. Conclusions: Post defibrillation ventricular arrhythmias with a cycle length ≤ 300 msec are more common after shocks of strength associated with a low probability of successful defibrillation. Postdefibrillation ventricular arrhythmias with a cycle length of 〉 300 msec are more common after high- and maximum-energy shocks, and are directly related to the absolute defibrillation energy.

Electronic Resource

1467-9515

Blackwell Publishing Journal Backfiles 1879-2005

Political Science

Sociology

Electronic Resource

1546-1718

Nature Archives 1869 - 2009

Biology

Medicine

[Auszug] We recently described a disorder termed Huntington disease–like 2 (HDL2) that completely segregates with an unidentified CAG/CTG expansion in a large pedigree (W). We now report the cloning of this expansion and its localization to a variably spliced exon of JPH3 (encoding junctophilin-3), a ...

Electronic Resource

1540-8159

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Atrial pacing (AP), despite its beneficial hemodynamic and antiarrhythmic effect, is still an underused mode of stimulation. The main purpose of this study was to evaluate the long-term results of AP. Sixty four patients (pts) with sinus node disease (28 male and 36 female: mean age 54,2; range:44–88 years), 3,2% of the total implantation at our clinic were treated with AP between 1982–96. Criteria for atrial pacing were: no AV block in the history, no AV-block during carotid sinus massage, Wenckebach point 〉 130/min, left atrium 〈50mm, left ventricular EF 〉40%. The indication for pacing was predominant sinus bradycardia (SB) in 34 pts and tachycardia-bradycardia syndrome (TBS) in 30 pts. Pts with TBS were on antiarrhythmic treatment, while most pts with SB received no antiarrhythmic drugs. All the pts were checked up at every 3–6 month. Sixty-two pts were followed for 3–154 (mean: 67) months, two pts were lost for follow-up. Repeated lead dislodgment occurred in two pts, which made a pacing mode change necessary. Four pts died during the follow-up period for non-cardiac reasons. At the end of the follow-up period the data of 60 pts were available for evaluation (33 pts with SB, 27 pts with TBS). All the pts with SB were in sinus rhythm, and no patient developed AV block by the end of the follow-up period Seven out of 27 pts with TBS developed chronic atrial fibrillation, 3 out of them suffered a cerebral embolism; the remaining 20 pts were in sinus rhythm, and the number of paroxysmal attacks decreased significantly, which improved their quality of life significantly. Three pts in this group developed a temporary complete AV block, which regressed with decreasing the dosage of antiarrhythmic drugs. Atrial pacing is proved to be a safe and reliable treatment for sick sinus syndrome. Proper patient selection is crucial in preventing the development of AV conduction disturbance. Atrial stimulation had a satisfactory long-term antiarrhythmic effect in pts with sick sinus syndrome (SSS).

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