[The effect of paroxysmal atrial fibrillation during ischemic heart disease on parameters of atrial signal-averaged electrocardiography]. / Wplyw czasu trwania napadowego migotania przedsionków w przebiegu choroby niedokrwiennej serca na parametry usrednionego sygnalu przedsionkowego.

The aim of this study was assess the correlation between duration of paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD) and atrial signal-averaged electrocardiogram (ALP). The study population consisted of 75 patients with PAF during IHD whose were divided according to duration of PAF into three groups; gr. I- < 1 year, gr. II-1-5 years, gr. III- > 5 years. The control group (gr. IV) composed of 50 healthy. Recording of ALP were carried out by HIPEC-200 HA. We calculated time domain parameters of ALP; root mean square voltage of the signals in the last 10, 20 and 30 ms of the filtered P-wave and filtered P-wave duration. During frequency analysis of ALP we calculated frequency parameters in range from 40 to 400 Hz in linear scale; area ratio 20-50/0-20 Hz and marked the highest peak amplitude of signals and in logarithmic scale; defined energy spectra of frequency component > -60 dB and value of frequency component 40 Hz. Our results suggest that: 1. The values of root mean square voltage of the signals in the last 10 ms of the filtered P-wave have been decreasing according to passage of duration PAF. 2. Patients with longer anamnesis of PAF have had longer duration of filtered P-wave. 3. Proposed parameters of frequency analysis of ALP in both scales (linear and logarithmic) seemed useless in differential diagnosis of patients with PAF during IHD and healthy.

[Correlations between left atrial size and parameters of averaged atrial signal in patients with paroxysmal atrial fibrillation in the course of ischemic heart diseases]. / Korelacje miedzy wielkoscia lewego przedsionka a parametrami usrednionego sygnalu przedsionkowego u chorych z napadowym migotaniem przedsionków w przebiegu choroby niedokrwiennej serca.

The aim of this study was to assess the correlation between left atrial size and atrial signal-averaged electrocardiogram (ALP) in time-domain and frequency analysis in patients with paroxysmal atrial fibrillation (PAF) during ischaemic heart disease (IHD). The study population consisted of 75 patients with PAF during IHD who were divided into two groups; gr. I (left atrial dimension 40 mm) and gr. II (left atrial dimension 40 mm). The control group (gr. III) consisted of 50 healthy subjects. Recording of ALP was carried out by HIPEC-200HA. The high gain ECG was recorded during basic rhythm with orthogonal Frank leads X,Y,Z. These signals were amplified, averaged and filters. The filtered signals were combined into a vector magnitude and time-domain and frequency analysis was done. These findings suggest that the size of the left atrium does not change time-domain and frequency parameters of ALP in patients with PAF and IHD. We noticed significant influence of IHD on these parameters. On the other hand frequency analysis of ALP did not show any uselessness in diagnostic identification of patients with PAF during IHD and healthy subjects.

[Effect of intravenous propafenone on maintenance of atrial signal-averaged ECG in patients with paroxysmal atrial fibrillation]. / Wplyw podanego dozylnie chlorowodorku propafenonu na usredniony sygnal przedsionkowy u chorych z napadowym migotaniem przedsionków.

The aim of this study was evaluation of intravenous propafenone hydrochloride effects on maintenance of atrial signal-averaged ECG (ASAECG) during time-domain and frequency-domain analyses in patients paroxysmal atrial fibrillation (PAF) accompanying ischemic heart disease (IHD). The study population of 20 patients included 12 women and 8 men (mean age 58.8 +/- 8.9). For ASAECG were calculated time-domain parameters: the root mean square voltage of the signals in the last 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and duration of filtered P-wave (PWD). During frequency-domain analysis of the terminal part of P-wave the following parameters were calculated in the range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A, YA) and decibel drop at 40 Hz (Dd, YDd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar, YAr), peak (P1-7, YP1-7), magnitude ratio (MR1-7, YMP1-7) in linear scale for a vector magnitude and Frank lead Y. Time-domain analysis of ASAECG did not show any significant changes--RMS10 increased from 5.2 +/- 2.5 microV to 5.9 +/- 2.6 microV, RMS20 from 6.9 +/- 3.4 microV to 7.3 +/- 2.5 microV and RMS30 from 8.4 +/- 3.1 microV to 8.5 +/- 2.2 microV after propafenone. Duration of filtered P-wave (PWD) increased from 125.1 +/- 21.9 ms to 128.4 +/- 22.7 ms (p > 0.05). During frequency-domain analysis both in linear and logarithmic scales no any significant differences after administration of propafenone were noted. The obtained results have indicated that intravenous propafenone hydrochloride did not change significantly time-domain and frequency-domain parameters of ASAECG in patients with PAF during IHD.

[The effect of intravenously given amiodarone on maintenance of ventricular signal averaged electrocardiogram in patients with ischemic heart disease]. / Wplyw dozylnie podanego amiodaronu na zachowanie sie usrednionego sygnalu komorowego u chorych na chorobe niedokrwienna serca.

Recording of ventricular signal-averaged ECG (VSAE) were carried out in 19 patients suffering from ischemic heart disease before and after intravenously administration of amiodarone using a commercially available machine HIPEC-200 HA device of Aerotel's. The high gain ECG was recorded during basic rhythm with orthogonal Frank leads X, Y, Z. These combined into a vector magnitude and the QRS duration (QRS), the duration of low amplitude signals < 40 microV (LPD) and the root mean square voltage of the signals in the last 40 and 50 ms of the filtered QRS (RMS 40,50) were calculated for VSAE. It was time-domain analysis of VSAE. In frequency domain analysis were calculated the following parameters in range from 40 Hz to 400 Hz in linear scale: area ratio 20-50 Hz/0-20 Hz, peak and magnitude ratio and in logarithmic scale: energy spectrum > -60 dB and decibel drop at 40 Hz. Subsequently amiodarone hydrochloride was given intravenously 5 mg/kg c.c. and again time-domain and frequency domain analysis were done. Data presented are mean +/- standard deviation. Statistical comparisons were performed with paired t-Student test. Significance refers to a p values < 0.05. Time-domain analysis of VSAE didn't show any significant differences after amiodarone injection. During frequency-domain analysis of VSAE statistically significant differences were displayed in Frank lead X and Y for energy spectrum > -60 dB. In Frank lead X decrease of this parameter after amiodarone (from 3322 +/- 1057 dB-Hz to 2628 +/- 733) and in lead Y increase (from 2793 +/- 500 dB-Hz to 3199 +/-938 dB-Hz) was noticed. Our observation have indicated that intravenously application of amiodarone hydrochloride didn't change parameters in time-domain analysis. Statistically significant differences were noticed only during frequency analysis VSAE in logarithmic scale -energy spectrum > -60 dB but only in two leads X and Y.

[Characteristics of ischemic heart disease patients with late ventricular potentials]. / Charakterystyka chorych na chorobe niedokrwienna serca z obecnoscia póznych potencjalów komorowych.

The purpose of this study was to compare ischemic heart disease (IHD) patients with and without late potentials (LP) by using noninvasive diagnostic methods as: echocardiographic examination, exercise testing, 24-hours Holter ambulatory monitoring, recording of atrial and ventricular signal-averaged ECG. Examination covered 25 IHD pts (12 male and 13 female) with LP, mean age 58.6 +/- 7.3 (group I) and 100 IHD pts (65 male and 35 female) without LP, mean age 56.8 +/- 8.5 (group II). Summing up, it should be stated that despite showing tendencies to much often occurrences of ventricular arrhythmias on Holter monitoring and silent ischemia during exercise testing in IHD pts with LP we were unable to indicate distinctive differentiating parameters between investigated groups.

[Diurnal fluctuations of arterial blood pressure and heart rate in patients with atrial fibrillation]. / Dobowe wahania cisnienia tetniczego i czestosci serca u chorych z migotaniem przedsionków.

In patients with atrial fibrillation and in patients with sinus rhythm aged below and over 40 years 24-hour automatic measurement of systolic and diastolic arterial blood pressure was carried out. The systolic and diastolic arterial blood pressure in atrial fibrillation was higher than in patients with sinus rhythm, both during daily activities and during night rest. The heart rate in those below 40 years showed greater diurnal fluctuations than in atrial fibrillation and patients aged over 40 years. Moreover, circadian systolic and diastolic blood pressure recordings were lower in night hours, similarly as heart rate values an all the studied groups, and only in the group of atrial fibrillation the differences between the parameters recorded during the night and in daytime were not so evident as in the groups with sinus rhythm.

[Clinical value of indirect automatic blood pressure determination in patients with atrial fibrillation]. / Znaczenie kliniczne automatycznego pomiaru cisnienia tetniczego metoda posrednia u chorych z migotaniem przedsionków.

The value of indirect blood pressure in patients with atrial fibrillation was studied. Three methods were compared; single measurement, mean of three measurements and mean value of automatic measurement during 2-hours and whole day. The study comprised 13 patients; 7 men and 6 women aged 52-77 (mean 62.8 congruent to 6.6) hospitalized for cardiac diseases. The measurement were done using the mercury sphygmomanometer and auscultatory Korotkoff technique and automatic blood pressure monitoring (Acutracker--Medilog Oxford). The investigations showed that systolic and diastolic blood pressure during 24-hours monitoring were lower than single or repeated three measurements. The highest correlation coefficient to 24-hours recording was found for the mean value of 2-hours recording. It seems that blood pressure measurement in patients with atrial fibrillation (3-times in few minutes intervals) should be verified by using prolonged automatic recording.

Komputerwa analiza, identyfikacja i graficzna prezentacja badan ABR--system audiometrii klinicznej. [Computer analysis, identification and graphic representation of ABR research--clinical audiometric system].

A microcomputer-based system for auditory evoked potentials and tonal audiometry. The software which directs stimulus generation, data recording, displaying and analysis is written in Pascal 5.5. The system hardware is commercially available and of own components.

[Tonal audiometry in hearing evaluation with a microcomputer system]. / Audiometria tonalna w mikrokomputerowym systemie badania sluchu.

The own experiences with the computer microsystem for hearing evaluation "Audiocomp" were presented. The air and bone conduction thresholds as well as the others suprathreshold testing were performed by computer. The reproducibility of results were better than in standard audiometry. The influence of the examined person is lowered making the testing more objective.

Activation of leukocytes during prolonged physical exercise.

Previous studies have demonstrated an increment of circulating leukocytes and enhanced secretion of interleukin-1 by monocytes and macrophages during physical exercise. In the present study the effect of physical exertion on the activity of polymorphonuclear (PMN) leukocytes was investigated. Following both short-term (running 2,000 meters) and long-term (running 10,000 meters) exertion, phorbol-stimulated chemiluminescence, as an indicator of leukocytic oxygen radical formation and release of leukocytic elastase, as a parameter of degranulation, were determined immediately after running. The number of circulating leukocytes increased both after short-term (+21%) and long-term (+61%) exercise. There was a minor release of PMN elastase following short-term activity causing plasma levels of this compound to rise from 100 +/- 4.0 ng/ml to 116 +/- 12.3 ng/ml. Long-term exercise, on the other hand, induced a significant increase of elastase plasma levels from 107 +/- 9.1 ng/ml to 300 +/- 23.4 ng/ml, suggesting a remarkable release of this proteinase from neutrophils. Based on these findings we conclude that during physical exercise degranulation of PMN leukocytes occurs. Moreover, the fact that phorbol-stimulated chemiluminescence is decreased after running demonstrates an impaired capability of white cells to generate oxygen radicals.

Stimulation and inhibition of elastase release from human neutrophils dependent on the calcium messenger system.

The neutral proteinase elastase is released from polymorphonuclear (PMN) leukocytes in various physiological and pathological conditions. Aim of the present study was to gain further insight into the mechanisms which govern the liberation of this proteinase. Therefore, the effects of the calcium ionophore A23187 and of the protein kinase-C activator phorbol myristate acetate (PMA) on neutrophils were investigated in human whole-blood samples. Furthermore, the inhibitory effects of the calcium channel blocker verapamil and of the calmodulin blocker trifluoperazine were followed. A23187 induced a release of elastase from neutrophils in a dose- and time-dependent manner. Complexation of extracellular calcium by ethylenediamine tetraacetate (EDTA) completely abolished the stimulatory effect of A23187. In a concentration of 10(-4) M verapamil was capable to attenuate (-49%) the A23187-induced secretion of PMN elastase. Beside the increase in intracellular calcium concentration, the activation of protein kinase C by PMA did also cause a release of neutrophil elastase. This release was strictly depending on the concentration of PMA and the time of incubation. In contrast to the stimulatory effect of A23187, the PMA-induced liberation of neutrophil elastase was attenuated, but not completely abolished, by complexation of extracellular calcium with EDTA. Both 10(-4) M verapamil (-43%) and 10(-5) M trifluoperazine (-42%) were able to reduce the PMA-induced release of neutrophil elastase. Based upon these data, we conclude that both the translocation of calcium intracellularly by A23187 and the activation of protein kinase C by PMA stimulate the release of neutrophil elastase. Verapamil and trifluoperazine were capable to suppress the stimulation of elastase release.

Enhanced biocompatibility with a new cellulosic membrane: Cuprophan versus Hemophan.

Recently, a new type of modified cellulosic membrane (Hemophan) has been made available for the first clinical trials. In contrast to cellulose acetate membranes only about 5% of the hydroxyl groups of cellulose are substituted by tertiary amino groups. Objective of the present study was to assess the compatibility performance of this new membrane material. Therefore, 10 patients were dialyzed consecutively with membranes made of regenerated cellulose (Cuprophan) and modified cellulose. The modified cellulosic membrane showed less leukopenia. The generation of C3adesarg was reduced throughout the dialysis session. Both, the release of lactoferrin and elastase from granulocytes was diminished with the modified cellulosic membrane. All these differences reached the level of significance. Therefore, it seems that with Hemophan a more biocompatible type of cellulosic membrane has been introduced into hemodialysis treatment.

Stimulation and inhibition of elastase release from human neutrophil-dependence on the calcium messenger system.

The neutral proteinase elastase is released from polymorphonuclear (PMN) leukocytes in various physiological and pathological conditions. Aim of the present study was to gain further insight into the mechanisms which govern the liberation of this proteinase. Therefore, the effects of the calcium ionophore A23187 and of the protein kinase C activator phorbol myristate acetate (PMA) on neutrophils were investigated in human whole-blood samples. Furthermore, the inhibitory effects of the calcium channel blocker verapamil and of the calmodulin blocker trifluoperazine were followed. A23187 induced a release of elastase from neutrophils in a dose- and time-dependent manner. Complexation of extracellular calcium by ethylenediamine tetraacetate (EDTA) completely abolished the stimulatory effect of A23187. In a concentration of 10(-4) M verapamil was capable of attenuating (-49%) the A23187-induced secretion of PMN elastase. Besides the increase in intracellular calcium concentration, the activation of protein kinase C by PMA did also cause a release of neutrophil elastase. This release was strictly depending on the concentration of PMA and the time of incubation. In contrast to the stimulatory effect of A23187, the PMA-induced liberation of neutrophil elastase was attenuated, but not completely abolished, by complexation of extracellular calcium with EDTA. Both 10(-4) M verapamil (-43%) and 10(-5) M trifluoperazine (-42%) were able to reduce the PMA-induced release of neutrophil elastase. Based upon these data, we conclude that both the translocation of calcium intracellularly by A23187 and the activation of protein kinase C by PMA stimulate the release of neutrophil elastase. Verapamil and trifluoperazine were capable of suppressing the stimulation of elastase release.