1933-1953 German Jewish Children's Aid

The records of the GJCA relate to the entire range of activities involved in receiving and placing refugee children from 1933 through the 1950s. The later materials are records of the European Jewish Children's Aid. Activities included: maintaining the reception center in New Jersey; transportation arrangements; placement in homes; issuing affidavits and passports; granting scholarships; naturalization of children; setting of GJCA policy. By-laws, minutes, reports, correspondence and certificate of incorporation. Correspondence of executive officers, mainly Cecilia Razovsky, 1930s. Correspondence between William Haber and Lotte Marcuse, 1939-40. File of Dr. Solomon Lowenstein. Minutes of meetings of the Finance Committee. Field reports, inter-office memoranda, financial and statistical reports. Correspondence with organizations and governmental agencies: Society of Friends (Quakers) in Vienna; Israelitische Kultusgemeinde of Vienna; Reichsvereinigung der Juden in Deutschland; Federation for the Support of Jewish Philanthropic Societies; Department of Justice; New York State Department of Social Welfare; U.S. Immigration and Naturalization Service; American Friends Service Committee; American Jewish Congress; B'nai Brith; National Council of Jewish Women. Correspondence with individuals: Max S. Perlman, William Rosenwald, Paul Felix Warburg. In addition to the general administrative records, there are thousands of case files.

Sequence diversity and differential expression of major phenylpropanoid-flavonoid biosynthetic genes among three mango varieties

Background: Mango fruits contain a broad spectrum of phenolic compounds which impart potential health benefits; their biosynthesis is catalysed by enzymes in the phenylpropanoid-flavonoid (PF) pathway. The aim of this study was to reveal the variability in genes involved in the PF pathway in three different mango varieties Mangifera indica L., a member of the family Anacardiaceae: Kensington Pride (KP), Irwin (IW) and Nam Doc Mai (NDM) and to determine associations with gene expression and mango flavonoid profiles. Results: A close evolutionary relationship between mango genes and those from the woody species poplar of the Salicaceae family (Populus trichocarpa) and grape of the Vitaceae family (Vitis vinifera), was revealed through phylogenetic analysis of PF pathway genes. We discovered 145 SNPs in total within coding sequences with an average frequency of one SNP every 316bp. Variety IW had the highest SNP frequency (one SNP every 258bp) while KP and NDM had similar frequencies (one SNP every 369bp and 360bp, respectively). The position in the PF pathway appeared to influence the extent of genetic diversity of the encoded enzymes. The entry point enzymes phenylalanine lyase (PAL), cinnamate 4-mono-oxygenase (C4H) and chalcone synthase (CHS) had low levels of SNP diversity in their coding sequences, whereas anthocyanidin reductase (ANR) showed the highest SNP frequency followed by flavonoid 3'-hydroxylase (F3'H). Quantitative PCR revealed characteristic patterns of gene expression that differed between mango peel and flesh, and between varieties. Conclusions: The combination of mango expressed sequence tags and availability of well-established reference PF biosynthetic genes from other plant species allowed the identification of coding sequences of genes that may lead to the formation of important flavonoid compounds in mango fruits and facilitated characterisation of single nucleotide polymorphisms between varieties. We discovered an association between the extent of sequence variation and position in the pathway for up-stream genes. The high expression of PAL, C4H and CHS genes in mango peel compared to flesh is associated with high amounts of total phenolic contents in peels, which suggest that these genes have an influence on total flavonoid levels in mango fruit peel and flesh. In addition, the particularly high expression levels of ANR in KP and NDM peels compared to IW peel and the significant accumulation of its product epicatechin gallate (ECG) in those extracts reflects the rate-limiting role of ANR on ECG biosynthesis in mango. © 2015 Hoang et al.

Invitation to the opening of new Home for Aged and Infirm Hebrews.

Invitation to Opening of New Home for Aged and Infirm Hebrews. Invitation to a reception for new building. Simeon N. Leo, M.D., Hon. Sec.

'Insider-other': spectator-dancer relationships fostered through open rehearsals

This thesis addresses audience engagement challenges during professional mainstream ballet and contemporary dance company performances by examining spectator-dancer relationships. Focusing on the open rehearsal as an audience engagement tool, this project presents a new line of enquiry in dance reception studies. The findings signify that open rehearsal attendance can contribute to more meaningful and enjoyable performance experiences for audience members by opening up the possibility of different relationships with dancers.

Der Prediger vom weißen Berg : Zur Rezeption der besseren Gerechtigkeit aus Mt 5 in Martin Luthers Predigtüberlieferung 1522 1546.

The purpose of this study is to examine the reception of Matthew 5 in Martin Luther s sermons; in other words to investigate how Luther interprets and applies Jesus teaching of the better righteousness and the law in Mt 5. The study applies the reception-historical approach and contributes to the history of effects and the history of interpretation in New Testament exegesis. The study shows that Luther understands the better righteousness of Mt 5 as good works and fulfillment of the law. Luther s interpretation coheres with the intention of the Evangelist, even if Luther s overall concept of righteousness is foreign to Matthew. In Luther s view righteousness is twofold: The greater righteousness of Mt 5 is the second and the actual righteousness (iustitia activa), which follows the first and the foreign righteousness (iustitia passiva). The first righteousness (faith) is for Luther the work of God, while the second righteousness (good works) is co-operation between a Christian and God. In this co-operation the law, as it is taught by Jesus, is not the opposite of the gospel, but the gospel itself in the sense of Christ as an example . The task of the law is to show the dependence of a Christian on God and to help one to love and to serve one s neighbour (brothers as well as enemies) properly. The study underlines a feature in Luther s thinking that has received little attention in Lutheran theology: Luther insists on preaching the law to Christians. In his view Mt 5 is directed to all Christians and particularly to pastors, for whom Jesus here gives an example of how to preach the law. Luther believes similarly to Matthew that Jesus reveals the real meaning of Mosaic Law and confirms its validity for Christians in Mt 5. Like Matthew, Luther insists on the practicability of the commandments of Mt 5 in his view Christians fulfil the law also with joy yet his interpretation of Mt 5 attenuates the radical nature of its commandments. Luther s reception of the individual pericopes of Mt 5 is considerably generative and occasionally contradictory, which is explained by the following factors, among others: Luther receives many ideas from tradition and reads them and his own theological concepts into Matthew s Gospel. He interprets Mt 5 through his understanding of some Old Testament passages as well as Paul. Most of all, Luther s reception of Mt 5 is shaped by his own experience as a preacher, by his relation to his religious enemies, rulers and to the congregation of Wittenberg. Here Luther shares with Matthew the experience of being opposed and concern about the upright living of the believers, which in both cases also explains the polemical tone of the paraenesis.

New light on the optical equivalence theorem and a new type of discrete diagonal coherent state representation

In many instances we find it advantageous to display a quantum optical density matrix as a generalized statistical ensemble of coherent wave fields. The weight functions involved in these constructions turn out to belong to a family of distributions, not always smooth functions. In this paper we investigate this question anew and show how it is related to the problem of expanding an arbitrary state in terms of an overcomplete subfamily of the overcomplete set of coherent states. This provides a relatively transparent derivation of the optical equivalence theorem. An interesting by-product is the discovery of a new class of discrete diagonal representations.

Socialist Realism instead of Formalism : the Formation and Development of the Soviet Music Control System 1932-1950

Whereas it has been widely assumed in the public that the Soviet music policy system had a “top-down” structure of control and command that directly affected musical creativity, in fact my research shows that the relations between the different levels of the music policy system were vague, and the viewpoints of its representatives differed from each other. Because the representatives of the party and government organs controlling operas could not define which kind of music represented Socialist Realism, the system as it developed during the 1930s and 1940s did not function effectively enough in order to create such a centralised control of Soviet music, still less could Soviet operas fulfil the highly ambiguous aesthetics of Socialist Realism. I show that musical discussions developed as bureaucratic ritualistic arenas, where it became more important to reveal the heretical composers, making scapegoats of them, and requiring them to perform self-criticism, than to give directions on how to reach the artistic goals of Socialist Realism. When one opera was found to be unacceptable, this lead to a strengthening of control by the party leadership, which lead to more operas, one after the other, to be revealed as failures. I have studied the control of the composition, staging and reception of the opera case-studies, which remain obscure in the West despite a growing scholarly interest in them, and have created a detailed picture of the foundation and development of the Soviet music control system in 1932-1950. My detailed discussion of such case-studies as Ivan Dzerzhinskii’s The Quiet Don, Dmitrii Shostakovich’s Lady Macbeth of Mtsensk District, Vano Muradeli’s The Great Friendship, Sergei Prokofiev’s Story of a Real Man, Tikhon Khrennikov’s Frol Skobeev and Evgenii Zhukovskii’s From All One’s Heart backs with documentary precision the historically revisionist model of the development of Soviet music. In February 1948, composers belonging to the elite of the Union of Soviet Composers, e.g. Dmitri Shostakovich and Sergei Prokofiev, were accused in a Central Committee Resolution of formalism, as been under the influence of western modernism. Accusations of formalism were connected to the criticism of the conciderable financial, material and social privileges these composers enjoyed in the leadership of the Union. With my new archival findings I give a more detailed picture of the financial background for the 1948 campaign. The independent position of the music funding organization of the Union of Soviet Composers (Muzfond) to decide on its finances was an exceptional phenomenon in the Soviet Union and contradicted the strivings to strengthen the control of Soviet music. The financial audits of the Union of Soviet Composers did not, however, change the elite status of some of its composers, except for maybe a short duration in some cases. At the same time the independence of the significal financial authorities of Soviet theatres was restricted. The cuts in the governmental funding allocated to Soviet theatres contradicted the intensified ideological demands for Soviet operas.

The Vexing Case of Igor Shafarevich, a Russian Political Thinker

The Russian mathematician, academician and former dissident Igor Shafarevich (b. 1923) is commonly mentioned in Western scholarly studies on perestroika and post-perestroika-era Russian politics as one of the most notable anti-Semites and extreme nationalists of the country. This notoriety owes to Shafarevich’s old samizdat article Russophobia, which was published in 1988. The scandal surrounding Russophobia came to a head when the president of The National Academy of Sciences in the United States asked Shafarevich, its honorary member, to resign. Nothing like this had ever happened in the academy’s history. The present dissertation discusses Shafarevich’s political activities, his texts and ideas as well as their reception. Particular attention is given to Russophobia, whose detailed examination proves very clearly that its reputation as an anti-Semitic text is groundless. The reasons for Russophobia’s hasty but fierce condemnation were many, but only one was that when the Soviet system began to tumble, it was commonly assumed that a vigorous rise in anti-Semitism and extreme nationalism in the Soviet Union/Russia would be just a matter of time. Many observers were highly sensitised to detecting its signs and symptoms. The dissertation also shows that most of those to write the first criticisms of Russophobia and to liken Shafarevich to the ideologues of Nazi Germany were the same people he had criticised in Russophobia for their deterministic view of history and irrational manner of connecting things for the purpose of fanning the flames of distrust between Russia’s Jews and Russians. In retrospect, it is fairly evident that Shafarevich actually managed to effectively “neutralise” the message of many of those obsessed with the Jews among his Russian contemporaries and contributed to the fact that anti-Jewish sentiments have been a great deal less popular in post-communist Russia than so many had feared and expected. The thesis also thoroughly discusses Shafarevich’s other texts and activities before Russophobia’s appearance and after it. In the 1970s, Shafarevich was one of the best-known dissidents in the Soviet Union. He worked together with academician Andrei Sakharov in a dissidents’ unofficial human rights committee and co-operated closely with Aleksandr Solzhenitsyn before Solzhenitsyn’s exile. Then, during the chaotic years of perestroika, Shafarevich defended the basic rights of ordinary citizens and warned that the hype concerning democracy could become counterproductive if the most palpable result of the reforms was the disappearance of citizens’ basic security and elementary social justice. One of the conclusions of the thesis is that even if the world around Shafarevich has changed considerably, his views have remained essentially the same since the late 1960s and early 1970s.

A world of Bose particles

Editor's Note: Satyendranath Bose, known primarily as one of the co–founders of quantum statistics, died on 4 February 1974, a few weeks after a symposium in honor of his 80th birthday was held at the Saha Institute for Nuclear Physics in Calcutta. The following paper, originally prepared in that connection, reviews some of the more important developments in particle physics which followed from the fundamental insight contained in a four–page paper published by Bose exactly fifty years ago. At the request of the editors of the AJP, Professor Sudarshan has kindly consented to adapt his paper for reproduction here. We would like to thank William Blanpied for bringing this paper to our attention.

Studies on the assessment of the adequacy of anesthesia

Several hypnosis monitoring systems based on the processed electroencephalogram (EEG) have been developed for use during general anesthesia. The assessment of the analgesic component (antinociception) of general anesthesia is an emerging field of research. This study investigated the interaction of hypnosis and antinociception, the association of several physiological variables with the degree of intraoperative nociception, and aspects of EEG Bispectral Index Scale (BIS) monitoring during general anesthesia. In addition, EEG features and heart rate (HR) responses during desflurane and sevoflurane anesthesia were compared. A propofol bolus of 0.7 mg/kg was more effective than an alfentanil bolus of 0.5 mg in preventing the recurrence of movement responses during uterine dilatation and curettage (D C) after a propofol-alfentanil induction, combined with nitrous oxide (N2O). HR and several HR variability-, frontal electromyography (fEMG)-, pulse plethysmography (PPG)-, and EEG-derived variables were associated with surgery-induced movement responses. Movers were discriminated from non-movers mostly by the post-stimulus values per se or normalized with respect to the pre-stimulus values. In logistic regression analysis, the best classification performance was achieved with the combination of normalized fEMG power and HR during D C (overall accuracy 81%, sensitivity 53%, specificity 95%), and with the combination of normalized fEMG-related response entropy, electrocardiography (ECG) R-to-R interval (RRI), and PPG dicrotic notch amplitude during sevoflurane anesthesia (overall accuracy 96%, sensitivity 90%, specificity 100%). ECG electrode impedances after alcohol swab skin pretreatment alone were higher than impedances of designated EEG electrodes. The BIS values registered with ECG electrodes were higher than those registered simultaneously with EEG electrodes. No significant difference in the time to home-readiness after isoflurane-N2O or sevoflurane-N2O anesthesia was found, when the administration of the volatile agent was guided by BIS monitoring. All other early and intermediate recovery parameters were also similar. Transient epileptiform EEG activity was detected in eight of 15 sevoflurane patients during a rapid increase in the inspired volatile concentration, and in none of the 16 desflurane patients. The observed transient EEG changes did not adversely affect the recovery of the patients. Following the rapid increase in the inhaled desflurane concentration, HR increased transiently, reaching its maximum in two minutes. In the sevoflurane group, the increase was slower and more subtle. In conclusion, desflurane may be a safer volatile agent than sevoflurane in patients with a lowered seizure threshold. The tachycardia induced by a rapid increase in the inspired desflurane concentration may present a risk for patients with heart disease. Designated EEG electrodes may be superior to ECG electrodes in EEG BIS monitoring. When the administration of isoflurane or sevoflurane is adjusted to maintain BIS values at 50-60 in healthy ambulatory surgery patients, the speed and quality of recovery are similar after both isoflurane-N2O and sevoflurane-N2O anesthesia. When anesthesia is maintained by the inhalation of N2O and bolus doses of propofol and alfentanil in healthy unparalyzed patients, movement responses may be best avoided by ensuring a relatively deep hypnotic level with propofol. HR/RRI, fEMG, and PPG dicrotic notch amplitude are potential indicators of nociception during anesthesia, but their performance needs to be validated in future studies. Combining information from different sources may improve the discrimination of the level of nociception.

Atrial remodeling in atrial fibrillation : Epidemiological, clinical and magnetocardiographic aspects

Atrial fibrillation is the most common arrhythmia requiring treatment. This Thesis investigated atrial fibrillation (AF) with a specific emphasis on atrial remodeling which was analysed from epidemiological, clinical and magnetocardiographic (MCG) perspectives. In the first study we evaluated in real-life clinical practice a population-based cohort of AF patients referred for their first elective cardioversion (CV). 183 consecutive patients were included of whom in 153 (84%) sinus rhythm (SR) was restored. Only 39 (25%) of those maintained SR for one year. Shorter duration of AF and the use of sotalol were the only characteristics associated with better restoration and maintenance of SR. During the one-year follow-up 40% of the patients ended up in permanent AF. Female gender and older age were associated with the acceptance of permanent AF. The LIFE-trial was a prospective, randomised, double-blinded study that evaluated losartan and atenolol in patients with hypertension and left ventricular hypertrophy (LVH). Of the 8,851 patients with SR at baseline and without a history of AF 371 patients developed new-onset AF during the study. Patients with new-onset AF had an increased risk of cardiac events, stroke, and increased rate of hospitalisation for heart failure. Younger age, female gender, lower systolic blood pressure, lesser LVH in ECG and randomisation to losartan therapy were independently associated with lower frequency of new-onset AF. The impact of AF on morbidity and mortality was evaluated in a post-hoc analysis of the OPTIMAAL trial that compared losartan with captopril in patients with acute myocardial infarction (AMI) and evidence of LV dysfunction. Of the 5,477 randomised patients 655 had AF at baseline, and 345 patients developed new AF during the follow-up period, median 3.0 years. Older patients and patients with signs of more serious heart disease had and developed AF more often. Patients with AF at baseline had an increased risk of mortality (hazard ratio (HR) of 1.32) and stroke (HR 1.77). New-onset AF was associated with increased mortality (HR 1.82) and stroke (HR of 2.29). In the fourth study we assessed the reproducibility of our MCG method. This method was used in the fifth study where 26 patients with persistent AF had immediately after the CV longer P-wave duration and higher energy of the last portion of atrial signal (RMS40) in MCG, increased P-wave dispersion in SAECG and decreased pump function of the atria as well as enlarged atrial diameter in echocardiography compared to age- and disease-matched controls. After one month in SR, P-wave duration in MCG still remained longer and left atrial (LA) diameter greater compared to the controls, while the other measurements had returned to the same level as in the control group. In conclusion is not a rare condition in either general population or patients with hypertension or AMI, and it is associated with increased risk of morbidity and mortality. Therefore, atrial remodeling that increases the likelihood of AF and also seems to be relatively stable has to be identified and prevented. MCG was found to be an encouraging new method to study electrical atrial remodeling and reverse remodeling. RAAS-suppressing medications appear to be the most promising method to prevent atrial remodeling and AF.

RTK-based GNSS drifters for monitoring in estuaries and rivers: Field experimental results

This paper presents a novel RTK-based GNSS Lagrangian drifter system that is capable of monitoring water velocity, turbulence and dispersion coefficients of river and estuarine. The Lagrangian drifters use the dual-frequency real time kinematic (RTK) technique for both position and velocity estimations. The capsule is designed to meet the requirements such as minimizing height, diameter, minimizing the direct wind drag, positive buoyancy for satellite signal reception and stability, and waterproof housing for electronic components, such as GNSS receiver and computing board. The collected GNSS data are processed with post-processing RTK software. Several experiments have been carried out in two rivers in Brisbane and Sunshine Coast in Queensland. Results show that the high accuracy GNSS-drifters can be used to measure dispersion coefficient resulting from sub-tidal velocity fluctuations in shallow tidal water. In addition, the RTK-GNSS drifters respond well to vertical motion and thus could be applicable to flood monitoring.

The effects of entacapone on cardiorespiratory, autonomic, and clinical responses in L-dopa-treated patients with Parkinson's disease

Rest tremor, rigidity, and slowness of movements-considered to be mainly due to markedly reduced levels of dopamine (DA) in the basal ganglia-are characteristic motor symptoms of Parkinson's disease (PD). Although there is yet no cure for this illness, several drugs can alleviate the motor symptoms. Among these symptomatic therapies, L-dopa is the most effective. As a precursor to DA, it is able to replace the loss of DA in the basal ganglia. In the long run L-dopa has, however, disadvantages. Motor response complications, such as shortening of the duration of drug effect ("wearing-off"), develop in many patients. In addition, extensive peripheral metabolism of L-dopa by aromatic amino acid decarboxylase and catechol-O-methyltransferase (COMT) results in its short half-life, low bioavailability, and reduced efficacy. Entacapone, a nitrocatechol-structured compound, is a highly selective, reversible, and orally active inhibitor of COMT. It increases the bioavailability of L-dopa by reducing its peripheral elimination rate. Entacapone extends the duration of clinical response to each L-dopa dose in PD patients with wearing-off fluctuations. COMT is important in the metabolism of catecholamines. Its inhibition could, therefore, theoretically lead to adverse cardiovascular reactions, especially in circumstances of enhanced sympathetic activity (physical exercise). PD patients may be particularly vulnerable to such effects due to high prevalence of cardiovascular autonomic dysfunction, and the common use of monoamine oxidase B inhibitor selegiline, another drug with effects on catecholamine metabolism. Both entacapone and selegiline enhance L-dopa's clinical effect. Their co-administration may therefore lead to pharmacodynamic interactions, either beneficial (improved L-dopa efficacy) or harmful (increased dyskinesia). We investigated the effects of repeated dosing (3-5 daily doses for 1-2 weeks) of entacapone 200 mg administered either with or without selegiline (10 mg once daily), on several safety and efficacy parameters in 39 L-dopa-treated patients with mild to moderate PD in three double-blind placebo-controlled, crossover studies. In the first two, the cardiovascular, clinical, and biochemical responses were assessed repeatedly for 6 hours after drug intake, first with L-dopa only (control), and then after a 2 weeks on study drugs (entacapone vs. entacapone plus selegiline in one; entacapone vs. selegiline vs. entacapone plus selegiline in the other). The third study included cardiovascular reflex and spiroergometric exercise testing, first after overnight L-dopa withdrawal (control), and then after 1 week on entacapone plus selegiline as adjuncts to L-dopa. Ambulatory ECG was recorded in two of the studies. Blood pressure, heart rate, ECG, cardiovascular autonomic function, cardiorespiratory exercise responses, and the resting/exercise levels of circulating catecholamines remained unaffected by entacapone, irrespective of selegiline. Entacapone significantly enhanced both L-dopa bioavailability and its clinical response, the latter being more pronounced with the co-administration of selegiline. Dyskinesias were also increased during simultaneous use of both entacapone and selegiline as L-dopa adjuncts. Entacapone had no effect on either work capacity or work efficiency. The drug was well tolerated, both with and without selegiline. Conclusions: the use of entacapone-either alone or combined with selegiline-seems to be hemodynamically safe in L-dopa-treated PD patients, also during maximal physical effort. This is in line with the safety experience from larger phase III studies. Entacapone had no effect on cardiovascular autonomic function. Concomitant administration of entacapone and selegiline may enhance L-dopa's clinical efficacy but may also lead to increased dyskinesia.

Levosimendan in patients with ischaemic heart disease

Levosimendan is a drug developed for the treatment of heart failure. Its mechanism of action includes calcium sensitization of contractile proteins and the opening of ATP-sensitive potassium channels. The combination of positive inotropy with possible anti-ischaemic effects via potassium channel opening may offer benefits in comparison with currently available intravenous inotropes, which are contraindicated in patients with ongoing myocardial ischaemia. The active levosimendan metabolite OR-1896 significantly prolongs the duration of the haemodynamic effects of levosimendan. The aims of the present study were to investigate: 1) the clinical effects and safety of intravenous and oral levosimendan and 2) the pharmacodynamics and pharmacokinetics of intravenous and oral levosimendan and its metabolites in patients with ischaemic heart disease. Levosimendan was administered intravenously or orally in four studies to 557 patients with ischaemic heart disease with or without concomitant heart failure. One study included patients with acute myocardial infarction, while the other three studies included stable ischaemic patients. Non-invasive haemodynamic measurements were used in all studies, and blood samples for pharmacokinetics were drawn in three studies. Safety was followed by ECG recordings, adverse event inquiries and laboratory assessments. Intravenous levosimendan, administered as a 6-hour infusion did not cause clinically significant hypotension or ischaemia in comparison with placebo and reduced worsening heart failure and short- and long-term mortality. Increase in incidence of hypotension and ischaemia was seen only with the highest dose (0.4 µg/kg/min). Both intravenous and oral levosimendan possessed a moderate positive inotropic effect. Vasodilatory effect was more pronounced with intravenous levosimendan. A chronotropic effect was seen in all studies; however, it was not accompanied by any increase in arrhythmic events. The formation of levosimendan metabolites after oral dosing increased linearly with the daily dose of the parent drug, leading to increased inotropic and chronotropic response. Levosimendan was well tolerated in all studies. In conclusion, levosimendan was safe and effective in the treatment of patients with acute or chronic ischaemia. The risk-benefit ratio of intravenous levosimendan is favourable up to the dose of 0.2 µg/kg/min. The daily dose of oral levosimendan in patients with ischaemic heart failure should not exceed 4 mg due to an increase in chronotropic response.

Electrocardiographic repolarization variables in detecting myocardial infarction and ischemic injury : From body surface potential mapping to a single lead

The aim of the studies was to improve the diagnostic capability of electrocardiography (ECG) in detecting myocardial ischemic injury with a future goal of an automatic screening and monitoring method for ischemic heart disease. The method of choice was body surface potential mapping (BSPM), containing numerous leads, with intention to find the optimal recording sites and optimal ECG variables for ischemia and myocardial infarction (MI) diagnostics. The studies included 144 patients with prior MI, 79 patients with evolving ischemia, 42 patients with left ventricular hypertrophy (LVH), and 84 healthy controls. Study I examined the depolarization wave in prior MI with respect to MI location. Studies II-V examined the depolarization and repolarization waves in prior MI detection with respect to the Minnesota code, Q-wave status, and study V also with respect to MI location. In study VI the depolarization and repolarization variables were examined in 79 patients in the face of evolving myocardial ischemia and ischemic injury. When analyzed from a single lead at any recording site the results revealed superiority of the repolarization variables over the depolarization variables and over the conventional 12-lead ECG methods, both in the detection of prior MI and evolving ischemic injury. The QT integral, covering both depolarization and repolarization, appeared indifferent to the Q-wave status, the time elapsed from MI, or the MI or ischemia location. In the face of evolving ischemic injury the performance of the QT integral was not hampered even by underlying LVH. The examined depolarization and repolarization variables were effective when recorded in a single site, in contrast to the conventional 12-lead ECG criteria. The inverse spatial correlation of the depolarization and depolarization waves in myocardial ischemia and injury could be reduced into the QT integral variable recorded in a single site on the left flank. In conclusion, the QT integral variable, detectable in a single lead, with optimal recording site on the left flank, was able to detect prior MI and evolving ischemic injury more effectively than the conventional ECG markers. The QT integral, in a single-lead or a small number of leads, offers potential for automated screening of ischemic heart disease, acute ischemia monitoring and therapeutic decision-guiding as well as risk stratification.