WorldWideScience

Sample records for abnormal central hemodynamics

  1. Central Hemodynamics and Microcirculation in Critical Conditions

    Directory of Open Access Journals (Sweden)

    A. A. Kosovskikh

    2013-01-01

    Full Text Available Objective: to compare central hemodynamic and microcirculatory changes in critical conditions caused by different factors and to reveal their possible differences for a further differentiated approach to intensive therapy. Subjects and methods. The study covered 16 subjects with severe concomitant injury (mean age 41.96±2.83 years and 19 patients with general purulent peritonitis (mean age 45.34±2.16 years. Their follow-up was 7 days. The central hemodynamics was estimated by transpulmonary thermodilution using a Pulsion PiCCO Plus system (Pulsion Medical Systems, Germany. The microcirculatory bed was evaluated by cutaneous laser Doppler flowmetry using a LAKK-02 capillary blood flow laser analyzer (LAZMA Research-and-Production Association, Russian Federation. Results. The pattern of central hemodynamic and microcirculatory disorders varies with the trigger that has led to a critical condition. Central hemodynamics should be stabilized to ensure the average level of tissue perfusion in victims with severe concomitant injury. In general purulent peritonitis, microcirculatory disorders may persist even if the macrohemodynamic parameters are normal. Conclusion. The macrohemodynamic and microcirculatory differences obtained during the study suggest that a complex of intensive therapy should be differentiated and, if the latter is used, it is necessary not only to be based on the central hemodynamics, but also to take into consideration functional changes in microcirculation. Key words: severe concomitant injury, general purulent peritonitis, micro-circulation, central hemodynamics, type of circulation.

  2. Quantifying the abnormal hemodynamics of sickle cell anemia

    Science.gov (United States)

    Lei, Huan; Karniadakis, George

    2012-02-01

    Sickle red blood cells (SS-RBC) exhibit heterogeneous morphologies and abnormal hemodynamics in deoxygenated states. A multi-scale model for SS-RBC is developed based on the Dissipative Particle Dynamics (DPD) method. Different cell morphologies (sickle, granular, elongated shapes) typically observed in deoxygenated states are constructed and quantified by the Asphericity and Elliptical shape factors. The hemodynamics of SS-RBC suspensions is studied in both shear and pipe flow systems. The flow resistance obtained from both systems exhibits a larger value than the healthy blood flow due to the abnormal cell properties. Moreover, SS-RBCs exhibit abnormal adhesive interactions with both the vessel endothelium cells and the leukocytes. The effect of the abnormal adhesive interactions on the hemodynamics of sickle blood is investigated using the current model. It is found that both the SS-RBC - endothelium and the SS-RBC - leukocytes interactions, can potentially trigger the vicious ``sickling and entrapment'' cycles, resulting in vaso-occlusion phenomena widely observed in micro-circulation experiments.

  3. Red wine, arterial stiffness and central hemodynamics.

    Science.gov (United States)

    Karatzi, Kalliopi; Papaioannou, Theodore G; Papamichael, Christos; Lekakis, John; Stefanadis, Christodoulos; Zampelas, Antonis

    2009-01-01

    Red wine is considered to reduce cardiovascular risk and decrease peripheral systolic and diastolic blood pressure. Central aortic pressures are often more sensitive clinical and prognostic factors than peripheral pressures, while arterial stiffness is an independent prognostic factor for cardiovascular events. Great efforts are being made to find natural sources of improving health. In order to clarify the mechanisms under which a widely used drink, like red wine, is affecting heart and vessels, we aimed to review the available data regarding the effects of red wine on arterial stiffness, wave reflections and central blood pressures. The effect of red wine on central hemodynamics has been poorly explored with divergent results. Possible consequences of acute and long-term intake on arterial stiffness, wave reflections and central pressures are not clear. This might make someone skeptical when suggesting the consumption of a glass of red wine, although its cardioprotective actions (when moderately consumed) are already shown from epidemiological studies.

  4. Arterial stiffness, central hemodynamics, and cardiovascular risk in hypertension

    Directory of Open Access Journals (Sweden)

    Palatini P

    2011-12-01

    Full Text Available Paolo Palatini1, Edoardo Casiglia1, Jerzy Gąsowski2, Jerzy Głuszek3, Piotr Jankowski4, Krzysztof Narkiewicz5, Francesca Saladini1, Katarzyna Stolarz-Skrzypek4, Valérie Tikhonoff1, Luc Van Bortel6, Wiktoria Wojciechowska4, Kalina Kawecka-Jaszcz41Department of Clinical and Experimental Medicine, University of Padova, Padua, Italy; 2Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland; 3Department of Arterial Hypertension, University Hospital, Poznan, Poland; 4First Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland; 5Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland; 6Heymans Institute of Pharmacology, Ghent University, Ghent, BelgiumAbstract: This review summarizes several scientific contributions at the recent Satellite Symposium of the European Society of Hypertension, held in Milan, Italy. Arterial stiffening and its hemodynamic consequences can be easily and reliably measured using a range of noninvasive techniques. However, like blood pressure (BP measurements, arterial stiffness should be measured carefully under standardized patient conditions. Carotid-femoral pulse wave velocity has been proposed as the gold standard for arterial stiffness measurement and is a well recognized predictor of adverse cardiovascular outcome. Systolic BP and pulse pressure in the ascending aorta may be lower than pressures measured in the upper limb, especially in young individuals. A number of studies suggest closer correlation of end-organ damage with central BP than with peripheral BP, and central BP may provide additional prognostic information regarding cardiovascular risk. Moreover, BP-lowering drugs can have differential effects on central aortic pressures and hemodynamics compared with brachial BP. This may explain the greater beneficial effect provided by newer antihypertensive drugs beyond peripheral BP

  5. Effects of tilting on central hemodynamics and homeostatic mechanisms in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Nørgaard, Annette; Henriksen, Jens H

    2004-01-01

    in the supine patient, we studied the humoral and central hemodynamic responses to changes with posture. Twenty-three patients with alcoholic cirrhosis (Child-Turcotte-Pugh classes A/B/C: 2/13/8) and 14 healthy controls were entered. Measurements of central hemodynamics and activation of SNS and RAAS were taken...

  6. Relationship between Abnormal Characteristics of Sublingual Collateral and Portal Vein Hemodynamic Changes in Patients with Primary Hepatic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    DENG Wei-zhe; LANG Qing-bo; LING Chang-quan

    2008-01-01

    Objective: To investigate the relationship between the abnormal characteristics of sublingual collateral (SC) and portal vein hemodynamic changes in patients with primary hepatic carcinoma (PHC). Methods: A total of 123 patients of PHC with abnormal SC were enrolled. The SC characteristics were classified and evaluated. The principal components (PC) of SC extracted from them by principal component analysis and the relationship between PC and the dynamic changes of portal vein flow were analyzed by correlation analysis. Results: Three groups of PC were extracted, namely PC-1 (length, width, presentation type of visualization), PC-2 (circuitous, vesicular change), and PC-3 (color, collateral hemostasis, petechiae, ecchymosis). Their total accumulative contribution degree reached 56.803%. Correlation analysis shows that PC-1 was significantly positively correlated with the hemodynamic parameters of the portal vein (P0.05). Conclusion= Length, width and presentation type of SC could be used for predicting the changes of portal venous pressure in PHC patients.

  7. Post-Fontan care based on hemodynamic characteristics, with special reference to the central venous pressure.

    Directory of Open Access Journals (Sweden)

    Nawa,Sugato

    1989-08-01

    Full Text Available Changes in the hemodynamics of six patients having received Fontan-like operations were closely observed during the first 48 h after the operation. Catheterization studies and simultaneous angiocardiography were also performed before and after the operation. Hemodynamic derangement was particularly severe during the first 24 h postoperatively as indicated by a low cardiac output of less than 2.01/min/m2, which persisted in spite of very high central venous pressure. Furthermore, the central venous pressure needed to re-establish the circulation soon after the Fontan procedure significantly correlated with the angiocardiographically assessed preoperative size of distal pulmonary arteries. Accordingly, the preoperative evaluation of the distal pulmonary arterial size is very important, that provides a good guide-line for the degree of circulatory volume expansion necessary to elevate the central venous pressure and to sustain the circulation in the early postoperative period.

  8. Central Mechanisms of Abnormal Sympathoexcitation in Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Takuya Kishi

    2012-01-01

    Full Text Available It has been recognized that the sympathetic nervous system is abnormally activated in chronic heart failure, and leads to further worsening chronic heart failure. In the treatment of chronic heart failure many clinical studies have already suggested that the inhibition of the abnormal sympathetic hyperactivity by beta blockers is beneficial. It has been classically considered that abnormal sympathetic hyperactivity in chronic heart failure is caused by the enhancement of excitatory inputs including changes in peripheral baroreceptor and chemoreceptor reflexes and chemical mediators that control sympathetic outflow. Recently, the abnormalities in the central regulation of sympathetic nerve activity mediated by brain renin angiotensin system-oxidative stress axis and/or proinflammatory cytokines have been focused. Central renin angiotensin system, proinflammatory cytokines, and the interaction between them have been determined as the target of the sympathoinhibitory treatment in experimental animal models with chronic heart failure. In conclusion, we must recognize that chronic heart failure is a syndrome with an abnormal sympathoexcitation, which is caused by the abnormalities in the central regulation of sympathetic nerve activity.

  9. Abnormal hemodynamic response to forepaw stimulation in rat brain after cocaine injection

    Science.gov (United States)

    Chen, Wei; Park, Kicheon; Choi, Jeonghun; Pan, Yingtian; Du, Congwu

    2015-03-01

    Simultaneous measurement of hemodynamics is of great importance to evaluate the brain functional changes induced by brain diseases such as drug addiction. Previously, we developed a multimodal-imaging platform (OFI) which combined laser speckle contrast imaging with multi-wavelength imaging to simultaneously characterize the changes in cerebral blood flow (CBF), oxygenated- and deoxygenated- hemoglobin (HbO and HbR) from animal brain. Recently, we upgraded our OFI system that enables detection of hemodynamic changes in response to forepaw electrical stimulation to study potential brain activity changes elicited by cocaine. The improvement includes 1) high sensitivity to detect the cortical response to single forepaw electrical stimulation; 2) high temporal resolution (i.e., 16Hz/channel) to resolve dynamic variations in drug-delivery study; 3) high spatial resolution to separate the stimulation-evoked hemodynamic changes in vascular compartments from those in tissue. The system was validated by imaging the hemodynamic responses to the forepaw-stimulations in the somatosensory cortex of cocaine-treated rats. The stimulations and acquisitions were conducted every 2min over 40min, i.e., from 10min before (baseline) to 30min after cocaine challenge. Our results show that the HbO response decreased first (at ~4min) followed by the decrease of HbR response (at ~6min) after cocaine, and both did not fully recovered for over 30min. Interestingly, while CBF decreased at 4min, it partially recovered at 18min after cocaine administration. The results indicate the heterogeneity of cocaine's effects on vasculature and tissue metabolism, demonstrating the unique capability of optical imaging for brain functional studies.

  10. Heparin Leakage in Central Venous Catheters by Hemodynamic Transport

    Science.gov (United States)

    Barbour, Michael; McGah, Patrick; Gow, Kenneth; Aliseda, Alberto

    2014-11-01

    Central venous catheters (CVCs), placed in the superior vena cava for hemodialysis, are routinely filled with heparin, an anticoagulant, while not in use to maintain patency and prevent thrombus formation at the catheter tip. However, the heparin-lock procedure places the patient at risk for systemic bleeding incidences, as heparin is known to leak into the blood stream. We propose that the driving mechanism behind heparin leakage is advective-diffusive transport due to the pulsatile blood flow surrounding the catheter tip. This novel hypothesis is based on Planar Laser Induced Fluorescence (PLIF) measurements of heparin transport from a CVC placed inside an in vitro pulsatile flow loop and validated with CFD simulations. The results show an initial, fast (catheter lumen, where concentration is still high, that is insufficient at replenishing the lost heparin at the tip. These results, which estimate leakage rates consistent with published in vivo data, predict that the concentration of heparin at the catheter tip is effectively zero for the majority of the interdialytic phase, rendering the heparin lock ineffective.

  11. Hemodynamics of Central Venous Catheters: experiments and simulations

    Science.gov (United States)

    Barbour, Michael; McGah, Patrick; Clark, Alicia; Ng, Chin Hei; Gow, Kenneth; Aliseda, Alberto

    2013-11-01

    Central venous catheters (CVC) are used to provide vascular access during hemodialysis in patients with end-stage kidney disease. Despite several advantages and widespread use, CVCs have a high incidence rate of clot formation during the interdialytic phase (48 hrs). In an attempt the prevent clot formation, hospitals routinely administer heparin, an anticoagulant, into the catheter after a dialysis session. It has been reported, however, that up to 40% of the heparin solution will leak into the blood stream during the interdialytic phase, placing the patient at risk for systemic bleeding incidences. The aim of this study is to determine the role that advective-diffusive transport plays in the heparin leaking process. Numerical simulations of heparin convective mass transfer have been conducted, showing that while advective losses may be significant at the tip, previous studies may be overestimating the total amount of heparin leakage. To validate the quantitative prediction from the simulations, P.L.I.F. is used to experimentally measure heparin transport from CVCs placed in an idealized Superior Vena Cava with physically accurate pulsatile flow conditions. Improved understanding of flow near the catheter tip is applied to improve catheter design and heparin locking procedures.

  12. Effect of volume expansion on systemic hemodynamics and central and arterial blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming; Henriksen, Jens Henrik

    1995-01-01

    and in controls. METHODS: Thirty-nine patients with cirrhosis (12 patients with Child-Turcotte class A, 14 with class B, and 13 with class C) and 6 controls were studied. During hepatic vein catheterization, cardiac output, systemic vascular resistance, central and arterial blood volume, noncentral blood volume...... in patients with either class B or class C. Conversely, the noncentral blood volume increased in patients with class B and C. In both patients and controls, the cardiac output increased and the systemic vascular resistance decreased, whereas the mean arterial blood pressure did not change significantly......BACKGROUND & AIMS: Systemic vasodilatation in cirrhosis may lead to hemodynamic alterations with reduced effective blood volume and decreased arterial blood pressure. This study investigates the response of acute volume expansion on hemodynamics and regional blood volumes in patients with cirrhosis...

  13. Central Hemodynamics and Oxygen Transport in Various Activation of Patients Operated On Under Extracorporeal Circulation

    Directory of Open Access Journals (Sweden)

    Ye. V. Dzybinskaya

    2009-01-01

    Full Text Available Objective: to study central hemodynamics, the determinants of myocardial oxygen balance, and the parameters of oxygen transport in various activation of patients after surgery under extracorporeal circulation. Subjects and methods. Thirty-four patients aged 57.8±2.5 years who had coronary heart disease were divided into 2 groups: 1 those with late activation (artificial ventilation time 157±9 min and 2 those with immediate activation (artificial ventilation time 33±6 min. Group 2 patients were, if required, given fentanyl, midazolam, or myorelaxants. Results. During activation, there were no intergroup differences in the mean levels of the major parameters of cardiac pump function, in the determinants of coronary blood flow (coronary perfusion gradients and myocardial oxygen demand (the product of heart rate by systolic blood pressure, and in the parameters of oxygen transport, including arterial lactatemia. After tracheal extubation, the left ventricular pump coefficient was increased considerably (up to 3.8±0.2 and 4.4±0.2 gm/mm Hg/m2 in Groups 1 and 2, respectively; p<0.05 with minimum inotropic support (dopamine and/or dobutamine being used at 2.7±0.3 and 2.4±0.3 mg/kg/min, respectively. In both groups, there were no close correlations between the indices of oxygen delivery and consumption at all stages of the study, which was indicative of no transport-dependent oxygen uptake. Conclusion. When the early activation protocol was followed up, the maximum acceleration of early activation, including that using specific antagonists of anesthetics, has no negative impact on central hemodynamics, the determinants of myocardial oxygen balance and transport in patients operated on under extracorporeal circulation. Key words: early activation, surgery under extracorporeal circulation, tracheal extubation in the operating-room, central hemodynamics, oxygen transport.

  14. Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey

    Science.gov (United States)

    Convertino, V. A.; Koenig, S. C.; Krotov, V. P.; Fanton, J. W.; Korolkov, V. I.; Trambovetsky, E. V.; Ewert, D. L.; Truzhennikov, A.; Latham, R. D.

    1998-01-01

    Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 degrees head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 degrees upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alternating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

  15. Near-Infrared Spectroscopy Reveals Abnormal Hemodynamics in the Left Dorsolateral Prefrontal Cortex of Menopausal Depression Patients

    Directory of Open Access Journals (Sweden)

    Xiang-Yun Ma

    2017-01-01

    Full Text Available Background/Objective. Menopausal depression (MD is characterized by depressive symptoms along with hormonal fluctuations. We investigate brain function alteration between major depressive disorder (MDD and MD. Methods. The difference in oxygenated hemoglobin (Oxy-Hb for the prefrontal cortex (PFC was compared retrospectively among 90 females presented with 30 MDD, 30 MD, and 30 healthy controls (HCs using verbal fluency task (VFT with near-infrared spectroscopy (NIRS. Results. We observed a significant difference in Oxy-Hb alteration in the left dorsolateral PFC (DLPFC using VFT with NIRS (channel 18, P=0.007 between the MD and MDD groups. A significant difference in Oxy-Hb levels was observed among the three groups in the bilateral DLPFC (channels 18, 27, 33, 39, 41, and 45; P<0.05. Compared to the HCs, the MD group presented lower Oxy-Hb activation in the right DLPFC (channel 41; P=0.048 and the left DLPFC (channels 18, 39, and 45; P<0.05, and the MDD group presented lower Oxy-Hb activation in the right DLPFC (channels 27, 33, and 41; P<0.05 and the left DLPFC (channels 39 and 45; P<0.05. Conclusion. Abnormal hemodynamics of the left DLPFC can differentiate MD from MDD by NIRS.

  16. Near-Infrared Spectroscopy Reveals Abnormal Hemodynamics in the Left Dorsolateral Prefrontal Cortex of Menopausal Depression Patients

    Science.gov (United States)

    Shen, Chen-Yu; Sun, Jing-Jing

    2017-01-01

    Background/Objective. Menopausal depression (MD) is characterized by depressive symptoms along with hormonal fluctuations. We investigate brain function alteration between major depressive disorder (MDD) and MD. Methods. The difference in oxygenated hemoglobin (Oxy-Hb) for the prefrontal cortex (PFC) was compared retrospectively among 90 females presented with 30 MDD, 30 MD, and 30 healthy controls (HCs) using verbal fluency task (VFT) with near-infrared spectroscopy (NIRS). Results. We observed a significant difference in Oxy-Hb alteration in the left dorsolateral PFC (DLPFC) using VFT with NIRS (channel 18, P = 0.007) between the MD and MDD groups. A significant difference in Oxy-Hb levels was observed among the three groups in the bilateral DLPFC (channels 18, 27, 33, 39, 41, and 45; P < 0.05). Compared to the HCs, the MD group presented lower Oxy-Hb activation in the right DLPFC (channel 41; P = 0.048) and the left DLPFC (channels 18, 39, and 45; P < 0.05), and the MDD group presented lower Oxy-Hb activation in the right DLPFC (channels 27, 33, and 41; P < 0.05) and the left DLPFC (channels 39 and 45; P < 0.05). Conclusion. Abnormal hemodynamics of the left DLPFC can differentiate MD from MDD by NIRS. PMID:28293062

  17. Reductions in Central Venous Pressure by Lower Body Negative Pressure or Blood Loss Elicit Similar Hemodynamic Responses

    Science.gov (United States)

    2014-05-29

    individual r2 values and individual regression line slope values of hemodynamic variables vs. central venous pressure r2 r2 Range Slope Slope Range...JUL 2014 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Reductions in Central Venous Pressure by Lower Body Negative Pressure...ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Reductions in central venous pressure by

  18. [Central hemodynamic changes in children reoperated on for congenital spinal cord hernia using balanced anesthesia based on midasolam and propofol].

    Science.gov (United States)

    Diordiev, A V; Kontakevich, M M; Il'in, A V; Kusakin, V V; Ostreĭkov, I F

    2005-01-01

    The central hemodynamics was studied and analyzed in 51 patients reoperated on for congenital spinal cord hernia under balanced anesthesia based on midasolam and proforol. The procedure for anesthesiological provision of replastic repair of operated spinal hernia, which is based on propofol of bolus administration of midasolam with a hypnotic appliance, was found to cause no negative hemodynamic effects. When the benzodiazepine antagonist flumazenyl is used, the interval between the end of surgery and tracheal extubation is virtually identical in the propofol and midasolam groups since the intravenous injection of flumazenyl induces a drastic awakening effect.

  19. Study on the correlation of serum lipid metabolism and central retinal artery hemodynamics with diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Ran-Yang Guo

    2016-01-01

    Objective:To explore the correlation of serum lipid metabolism and central retinal artery (CRA) hemodynamics with diabetic retinopathy (DR).Methods:A total of 120 patients with type 2 diabetes who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and divided into NDR group (non-diabetic retinopathy), NPR group (non-proliferative retinopathy), and PR group (proliferative retinopathy) with 40 cases in each group according to DR clinical staging. Moreover, 50 healthy individuals who came for physical examinations were served as the control group. The full automatic biochemical analyzer was used to detect the levels of TG, TC, LDL-C, and HDL-C. The color Doppler flow imaging (CDFI) was used to detect EDV, PSV, RI, and PI of CRA and OA.Results:The levels of TG, TC, and LDL-C in NDG, NPR, and PR groups were gradually increased with the aggravation of retinopathy, HDL-C was reduced, the comparison among the three groups was statistically significant, and the comparison with the control group was statistically significant. EDV, PSV, and PI of CRA and OA in NDG, NPR, and PR groups were gradually increased with the aggravation of retinopathy, RI was reduced, the comparison among the three groups was statistically significant, and the comparison with the control group was statistically significant. Conclusions: The lipid metabolism disorder can promote the occurrence and development of DR. The change of CRA and OA hemodynamics is an important pathological basis for developing DR. Clinical detection of serum lipid level and monitoring of the changes of fundus artery hemocynamic parameters are of great significance in early detecting DR.

  20. Dynamic observation of vegetative support of central hemodynamics and physical performance in 400-m runners

    Directory of Open Access Journals (Sweden)

    E. L. Mikhalyuk

    2016-01-01

    Full Text Available At the present time problem of human physical performance is relevant, especially in sports, because athletes can achieve good results mostly due to the high level of physical performance. Aim. To determine and compare heart rate variability, central hemodynamics and physical performance in runners at a distance of 400 m, obtained in the preparatory and competitive periods of training process. Results. The study of the functional state of the 400 m runners showed strengthening of parasympathetic effects of the autonomic nervous system (ANS in the competitive period. Also eukinetic circulation type transformation into hypokinetic occurred. Significant increase in physical performance by 8.5% and the IFS by 17.9% was detected. High class runners separate study showed the prevalence of parasympathetic effects of the ANS, hypokinetic circulation type (CT and lack of athletes with hyperkinetic CT. Significant increase in physical performance at 7.95% and the IFS by 20.2% was detected in them. Athletes with II–III level of qualification in the preparatory period had sighs of the increased parasympathetic ANS similar with eukinetic CT. Nobody had hyperkinetic CT. Conclusions. Correlation analysis between the integrated parameters in the whole group of runners in the competitive period found no significant correlations between the studied parameters.

  1. Central hemodynamics and androgen status in men with coronary heart disease, and androgen deficiency in its correction of prolonged administration of testosterone

    Directory of Open Access Journals (Sweden)

    L. M. Gaivoronskaya

    2013-01-01

    Full Text Available This work was designed to study the dynamic of the central hemodynamic disorders symptoms at men with coronary heart disease, stable angina, obesity and androgen deficiency under replacement short-term therapy by Testosterone undecanoate (TU. The comparative assessment of central hemodynamic indicators and total and sub-scale AMS score at two groups of men who receiving (the main group and not receiving (control group replacement therapy of TU is carried out. Results showed that in the main group, unlike control group the positive tendency in a number of indicators (stroke volume, left ventricular end- diastolic volume, left ventricular end- systolic volume of the central hemodynamic and indicators of the androgenic status is observed. Positive dynamics of some parameters of the central hemodynamic even at short-term replacement therapy of TU indicates the therapeutic potential of testosterone at cardiovascular pathology which full realization may require longer period of testosterone administration.

  2. Renal Extraction and Acute Effects of Glucagon-like peptide-1 on Central and Renal Hemodynamics in Healthy Men

    DEFF Research Database (Denmark)

    Asmar, Ali; Simonsen, Lene; Asmar, Meena

    2015-01-01

    The present experiments were performed in order to elucidate the acute effects of intravenous infusion of glucagon-like peptide (GLP-1) on central and renal hemodynamics in healthy men. Seven healthy middle-aged men were examined on two different occasions in random order. During a 3-hour infusion......acute intravenous administration of GLP-1 leads to an increased cardiac output due to a simultaneous increase in stroke volume and heart rate, while no effect on renal hemodynamics could be demonstrated...... of either GLP-1 (1.5 pmol kg-1 min-1) or saline, cardiac output was estimated non-invasively, and intra-arterial blood pressure and heart rate were measured continuously. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured by Fick's Principle after...

  3. Multiple hemodynamic effects of endogenous hydrogen sulfide on central nervous system in rats

    Institute of Scientific and Technical Information of China (English)

    REN Yong-sheng; WU Sheng-ying; WANG Xing-jun; YU Fang; ZHAO Jing; TANG Chao-shu; OUYANG Jing-ping; GENG Bin

    2011-01-01

    Background Endogenous hydrogen sulfide is a new neuromodulator which takes part in the regulation of central nervous system physiology and diseases.Whether endogenous hydrogen sulfide in the central nervous system regulates cardiovascular activity is not known.In the present study,we observed the hemodynamic changes of hydrogen sulfide or its precursor by intracerebroventricular injection,and investigate the possible roles of endogenous digitalis like factors and sympathetic activity in the regulation.Methods Ninety-four Sprague-Dawley rats underwent a right cerebroventricular puncture,then the hydrogen sulfide saturation buffer or its precursor injected by intrcerebroventricular catheter.A heperin-filled catheter was inserted into the right femoral artery or into the left ventricle,and changes of blood pressure or cardiac function recorded by a Powerlab/4S instrument.Phentolamine or metoprolol were pre-injected to observe the possible role in autonomic nerve activity.After rats were sacrificed,plasma was collected and endogenous digitalis-like factors were measured with a commercial radioimmunoassay kit.The aortic,cardiac sarcolemmal vesicles were isolated and the activity of Na+-K+-ATPase was measured as ouabain-sensitive ATP hydrolysis under maximal velocity conditions by measuring the release of inorganic phosphate from ATP.Unpaired Student's ttest for two groups or analysis of variances (ANOVA) for multiple groups were used to compare the differences of the changes.Results Intracerebroventricular injection of hydrogen sulfide induced a transient hypotension,then dramatic hypertenive effects in a dose-dependent manner.Bolus injection of L-cysteine or beta-mercaptopyruvate also increased mean arterial pressure (P <0.01),whereas hydroxylamine-a cystathionine beta synthase inhibitor decreased the arterial pressure (P <0.01).Hydrogen sulfide and L-cysteine increased mean arterial pressure,left ventricular develop pressure and left-ventricle maximal rate of

  4. A randomized controlled trial to assess the central hemodynamic response to exercise in patients with transient ischaemic attack and minor stroke

    Science.gov (United States)

    Faulkner, J; Tzeng, Y-C; Lambrick, D; Woolley, B; Allan, P D; O'Donnell, T; Lanford, J; Wong, L; Stoner, L

    2017-01-01

    Early exercise engagement elicits meaningful changes in peripheral blood pressure in patients diagnosed with transient ischaemic attack (TIA) or minor stroke. However, central hemodynamic markers may provide clinicians with important diagnostic and prognostic information beyond that provided by peripheral blood pressure readings. The purpose of this single-centre, randomized, parallel-group clinical trial was to determine the effect of a 12-week aerobic exercise intervention on central and peripheral hemodynamic variables in patients with TIA or minor stroke. In this study, 47 participants (66±10 years) completed a baseline assessment, which involved the measurement of central and peripheral hemodynamic parameters, undertaken in the morning, in a fasted state. Participants were randomized to either a 12-week exercise or control group on completion of the baseline assessment. An identical follow-up assessment was completed post intervention. Central hemodynamic variables were assessed using an oscillometric device at both assessments. Analysis of covariance demonstrated a significant interaction for central and peripheral blood pressure and augmentation index (all Pprogram soon after stroke/TIA diagnosis may elicit significant beneficial changes to a patient's central systolic blood pressure and augmentation index. This may positively impact upon the treatment strategies implemented by clinicians in the care of patients with TIA and minor stroke. PMID:27680390

  5. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure

    Science.gov (United States)

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziebło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-01-01

    Background Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. Material/Methods In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I–III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e’) assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR – CSR_ [−] (n=110). Results CSR_ [+] patients presented more advanced NYHA class (pCSR_ [+] were identified: NYHA class (OR=3.34 per class, pCSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR. PMID:27558771

  6. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure.

    Science.gov (United States)

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziębło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-08-25

    BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR - CSR_ [-] (n=110). RESULTS CSR_ [+] patients presented more advanced NYHA class (pCSR_ [+] were identified: NYHA class (OR=3.34 per class, pCSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR.

  7. The central hemodynamics special features of sportsmen with a glance to changes in heart rate variability as the response on the training loads

    Directory of Open Access Journals (Sweden)

    Оксана Володимирівна Гузій

    2015-12-01

    Full Text Available Aim: to analyze indices of the central hemodynamics of highly qualified sportsmen at rest taking into account HF-components of heart-rhythm variability after training loads.Methods of research. To study the special features of the central hemodynamics there was used spiroarteriocardiorythmography (SACR that allows to detect in the regimen of momentary registration indices that characterize heart activity (according to ECG data in the first lead, vessels (systolic arterial pressure (SAP and diastolic arterial pressure DAP on the middle phalanx of the finger by Penaz method, respiratory system (according to an ultrasound spirometry data. Statistical analysis was carried out using nonparametric methods with determination of Mann-Whitney criterion.Results. The study of influence of training loads in the period before competitions allowed to establish that after training load in several sportsmen were noticed the low values of HF-component of HRV(58,1%, and in other ones the values of HF-components of HRV were in the limits of population norm (38,7%. This fact indicated the differences of HRV responses in different sportsmen that further formed two groups of research ЕG1 and ЕG2.An analysis of central hemodynamics demonstrated that in most sportsmen from ЕG1 (88,2% and ЕG2 (64% was noticed the hypokinetic type of blood circulation. Hyperkinetic type of blood circulation was not registered in any group. The comparison of separate indices of central hemodynamic demonstrated that final diastolic volume (FDV, final systolic volume (FSV and momentary volume of blood (MVB are reliably higher in experimental group (ЕG2 (р < 0,01. In ЕG1 was noticed the reliably more peripheral resistivity of vessels (PRV (р < 0,05.Conclusion. The study of central hemodynamics in groups of sportsmen whose response on training loads differed on the level of high-frequency component activity of the heart rate variability allowed establish that these changes are

  8. Hemodynamic and ADH responses to central blood volume shifts in cardiac-denervated humans

    Science.gov (United States)

    Convertino, V. A.; Thompson, C. A.; Benjamin, B. A.; Keil, L. C.; Savin, W. M.; Gordon, E. P.; Haskell, W. L.; Schroeder, J. S.; Sandler, H.

    1990-01-01

    Hemodynamic responses and antidiuretic hormone (ADH) were measured during body position changes designed to induce blood volume shifts in ten cardiac transplant recipients to assess the contribution of cardiac and vascular volume receptors in the control of ADH secretion. Each subject underwent 15 min of a control period in the seated posture, then assumed a lying posture for 30 min at 6 deg head down tilt (HDT) followed by 20 min of seated recovery. Venous blood samples and cardiac dimensions (echocardiography) were taken at 0 and 15 min before HDT, 5, 15, and 30 min of HDT, and 5, 15, and 30 min of seated recovery. Blood samples were analyzed for hematocrit, plasma osmolality, plasma renin activity (PRA), and ADH. Resting plasma volume (PV) was measured by Evans blue dye and percent changes in PV during posture changes were calculated from changes in hematocrit. Heart rate (HR) and blood pressure (BP) were recorded every 2 min. Results indicate that cardiac volume receptors are not the only mechanism for the control of ADH release during acute blood volume shifts in man.

  9. Ultrasonic evaluation of central retinal artery hemodynamics in patients with hypertensive disorder complicating pregnancy and the correlation with disease

    Institute of Scientific and Technical Information of China (English)

    Chen-Xia Liu; Jing-Mian Zhou

    2017-01-01

    Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell apoptosis molecules.Methods: 45 healthy pregnant women, 37 patients with gestational hypertension and 24 patients with preeclampsia who gave birth in Obstetrics Department of our hospital between May 2013 and December 2015 were selected and included in the control group, GH group and PE group respectively. Central retinal artery ultrasonography was done to determine peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), serum was collected to determine interleukin-6 (IL-6), IL-17, IL-24, chemokine ligand 10 (CXCL10) and cartilage glycoprotein 40 (YKL40) content, and placenta tissue was collected to determine Fas, FasL, Bax, Caspase-3, Caspase-9, XIAP, Survivin and Livin expression.Results: Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of GH group and PE group were significantly lower than those of control group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of control group (P<0.05). Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of PE group were significantly lower than those of GH group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of GH group (P<0.05). Serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were negatively correlated with PSV and EDV, and positively correlated with RI; XIAP, Survivin and Livin expression in placenta were positively

  10. Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

    NARCIS (Netherlands)

    Kwakernaak, Arjan J.; Zelle, Dorien M.; Bakker, Stephan J. L.; Navis, Gerjan

    2013-01-01

    Central distribution of body fat is associated with a higher risk of renal disease, but whether it is the distribution pattern or the overall excess weight that underlies this association is not well understood. Here, we studied the association between waist-to-hip ratio (WHR), which reflects centra

  11. Effect of volume expansion on systemic hemodynamics and central and arterial blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Bendtsen, F; Henriksen, Jens Henrik Sahl

    1995-01-01

    and in controls. METHODS: Thirty-nine patients with cirrhosis (12 patients with Child-Turcotte class A, 14 with class B, and 13 with class C) and 6 controls were studied. During hepatic vein catheterization, cardiac output, systemic vascular resistance, central and arterial blood volume, noncentral blood volume...

  12. Central venous oxygen saturation and thoracic admittance during dialysis: new approaches to hemodynamic monitoring

    DEFF Research Database (Denmark)

    Cordtz, J.; Olde, B.; Solem, K.

    2008-01-01

    Intradialytic hypotension (IDH) is one of the most important short-term complications to hemodialysis (HD). Inadequate cardiac filling due to a reduction in the central blood volume is believed to be a major etiological factor. The aim of this study was to evaluate whether these pathophysiologic...

  13. Ectopic eruption of maxillary central incisor through abnormally thickened labial frenum: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Neeraj Gugnani

    2017-01-01

    Full Text Available Ectopic eruption is a deviation from the normal eruption pattern, making the tooth erupt out of its normal position, and possibly causing resorption of adjacent primary teeth. A wide range of etiological factors may be responsible for ectopic eruption of the teeth, so their management depends on the correction of the established etiological factor. The present case report describes an unusual case of ectopically erupted central incisor encased within an abnormally thickened labial frenum, which was treated by orthodontic repositioning of the ectopically erupting tooth after frenectomy.

  14. Ectopic eruption of maxillary central incisor through abnormally thickened labial frenum: An unusual presentation.

    Science.gov (United States)

    Gugnani, Neeraj; Pandit, I K; Gupta, Monika; Gugnani, Shalini; Vishnoi, Ashmi; Sabharwal, Ozasvita; Manhas, Swati

    2017-01-01

    Ectopic eruption is a deviation from the normal eruption pattern, making the tooth erupt out of its normal position, and possibly causing resorption of adjacent primary teeth. A wide range of etiological factors may be responsible for ectopic eruption of the teeth, so their management depends on the correction of the established etiological factor. The present case report describes an unusual case of ectopically erupted central incisor encased within an abnormally thickened labial frenum, which was treated by orthodontic repositioning of the ectopically erupting tooth after frenectomy.

  15. Comparison of influence of high thoracic epidural anesthesia and central analgesia on hemodynamic during on-bypass coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    V. A. Sobokar

    2015-06-01

    Full Text Available Objective. Despite some advantages, the use of high thoracic epidural anesthesia (HTEA during cardiac operations may be discouraged by fear of adverse hemodynamic effects. Aim. To compare the hemodynamic effects of HTEA and central analgesia (CA during on-bypass CABG. Methods. 132 patients were assigned into two groups – study group (n = 85, where the surgery was carried out under HTEA and control group (n = 47 - where the surgery was carried out under CA. Data of the intraoperative monitoring and trans-oesophageal cardiac ultrasound - cardiac index (CI, stroke index (SI, ejection fraction (EF and index of systemic vascular resistance (ISVR were obtained. Results. After induction and sternotomy patients in the study group had higher EF - 57(53, 65% vs 54 ± 7% (p = 0,013 and 55 ± 8 vs 52 ± 9%, (p = 0,031. After sternotomy CI and SI in the study group were also higher, respectively 2,42 (2,0;3,1 vs 2,23±0,63 l · min-1 · m-2, (p = 0,041 and 43 (34;46 vs 37±10 ml · m-2 (p = 0.014. Conclusion. We concluded that HTEA has advantages over CA by its influence on hemodynamics.

  16. Endogenous nitric oxide synthase inhibitors, arterial hemodynamics, and subclinical vascular disease: the PREVENCION Study.

    Science.gov (United States)

    Chirinos, Julio A; David, Robert; Bralley, J Alexander; Zea-Díaz, Humberto; Muñoz-Atahualpa, Edgar; Corrales-Medina, Fernando; Cuba-Bustinza, Carolina; Chirinos-Pacheco, Julio; Medina-Lezama, Josefina

    2008-12-01

    Endogenous NO synthase inhibitors (end-NOSIs) have been associated with cardiovascular risk factors and atherosclerosis. In addition, end-NOSIs may directly cause hypertension through hemodynamic effects. We aimed to examine the association between end-NOSI asymmetrical dimethylarginine (ADMA) and N-guanidino-monomethyl-arginine (NMMA), subclinical atherosclerosis, and arterial hemodynamics. We studied 922 adults participating in a population-based study (PREVENCION Study) and examined the correlation between end-NOSI/L-arginine and arterial hemodynamics, carotid-femoral pulse wave velocity, and carotid intima-media thickness using linear regression. ADMA, NMMA, and L-arginine were found to be differentially associated with various classic cardiovascular risk factors. ADMA and NMMA (but not L-arginine) were significant predictors of carotid intima-media thickness, even after adjustment for cardiovascular risk factors, C-reactive protein, and renal function. In contrast, ADMA and NMMA did not predict carotid-femoral pulse wave velocity, blood pressure, or hemodynamic abnormalities. Higher L-arginine independently predicted systolic hypertension, higher central pulse pressure, incident wave amplitude, central augmented pressure, and lower total arterial compliance but not systemic vascular resistance or cardiac output. We conclude that ADMA and NMMA are differentially associated with cardiovascular risk factors, but both end-NOSIs are independent predictors of carotid atherosclerosis. In contrast, they are not associated with large artery stiffness, hypertension, or hemodynamic abnormalities. Our findings are consistent with a role for asymmetrical arginine methylation in atherosclerosis but not in large artery stiffening, hypertension, or long-term hemodynamic regulation. L-arginine is independently associated with abnormal pulsatile (but not resistive) arterial hemodynamic indices, which may reflect abnormal L-arginine transport, leading to decreased intracellular

  17. DAILY CHANGES OF CENTRAL HEMODYNAMICS IN PATIENTS WITH CHRONIC HEART FAILURE WITH NIGHT-TIME DYSPNOEA ATTACK

    Directory of Open Access Journals (Sweden)

    S. A. Dovgolis

    2006-01-01

    Full Text Available Aim. To study daily changes of central hemodynamics (CHD in patients with chronic heart failure (CHF and the effects of therapy. Materials and methods. 22 patients with ischemic heart disease and CHF of III-IV functional class (FC by NYHA, age 60,5±10,5 were observed. Patients were suffering from night-time dyspnoea attacks and had pulmonary artery occlusion pressure (PAOP 15-20 mm Hg. CHD was monitored invasively before the treatment and after 4 weeks of CHF treatment. Results. According to the cardiac index (CI at admission patients were split into two groups. 9 patients of group-I had CI ≤2,15 l\\min\\m2, and 13 patients of group-II had CI >2,15 l\\min\\m2. In patients of group-I CI increased in 4 weeks of treatment. The treatment caused considerable clinical improvement in all patients. The CHD indexes also improved. Initially evening-night-time peaks of PAOP (р≤0,002, systolic (SBP (р≤0,003, diastolic (DBP (р=0,002 and average (BPa (р=0,0007 blood pressure (BP as well as double multiplication (DM (р≤0,008 were registered in patients of group-I. At the end of treatment only evening-night increase in DBP (р=0,002 and BPa (р≤0,006 were noted. In patients of group-II after 4 weeks of treatment CI decreased or didn’t change. Towards 28-th day of treatment 10 patients had clinical improvements. Only one patient’s FC NYHA increased. At the end of treatment the normalization of CHD was registered totally in group. Initially evening-night-time peaks of PAOP (р≤0,002, SBP (р≤0, 0001, CI (р=0,057 and DM (р=0,084 were registered in patients of group-II. At the end of treatment evening-night-time peaks of PAOP (р≤0,015, SBP (р≤0,044, CI (р≤0,005 and DM (р≤0,044 still remained. Besides, evening-night-time peaks of cardiac output (р≤0,01 and systolic index (р≤0, 06 have added. Conclusion. In patients with CHF with initial CI ≤2,15 l\\min\\m2 treatment results in the normalization of CHD and its daily

  18. INVESTIGATION OF CENTRAL HEMODYNAMICS VIA RIGHT HEART AND PULMONARY ARTERY CATHETERIZATION IN PATIENTS WITH SYSTEMIC CONNECTIVE TISSUE DISEASES

    Directory of Open Access Journals (Sweden)

    E. V. Nikolaeva

    2015-01-01

    Full Text Available Pulmonary arterial hypertension (PAH associated with systemic connective tissue diseases (SCTD is a poor prognostic manifestation of the latter that result in death if untreated. The invasive determination of hemodynamic parameters is prominent in diagnosing the disease and determining its treatment policy and prognosis.Objective: to analyze the results of catheterization in PAH-SCTD patients admitted to the V.A. Nasonova Research Institute of Rheumatology.Subjects and methods. The investigation included 59 patients admitted to the V.A. Nasonova Research Institute of Rheumatology from September 2009 to September 2014. PAH was diagnosed in accordance with the conventional guidelines. All the patients underwent right heart and pulmonary artery (PA catheterization at the diagnosis and over time during treatment.Results and discussion. All the patients included in the trial met the pre-capillary pulmonary hypertension (PH criteria: mean pulmonary artery pressure (MPAP ≥25 mm Hg; and PA wedge pressure (PAWP <15 mm Hg. The exclusion of other causes of PH (pulmonary fibrosis, left heart disease, and thromboembolism, as well as a high transpulmonary pressure gradient >15 mm Hg and pulmonary vascular resistance (PVR >3 Wood units could diagnose PAH in all our patients. There was a statistically highly significant association between pathological hemodynamic changes and functional class (FC. FC was found to be most closely correlated with right atrial pressure (RAP, cardiac output (CO, PVR, and cardiac index (CI. Among the most common manifestations of heart failure, only the presence of peripheral edemas was associated with worse hemodynamic parameters in PAH. It should be noted that out of two biomarkers (N-terminal pro-brain natriuretic peptide and uric acid, the former is largely related to the magnitude of changes in hemodynamic factors. The critical values of hemodynamic parameters were due to extreme edema – anasarca (RAP >17 mm Hg

  19. Central poststroke pain: somatosensory abnormalities and the presence of associated myofascial pain syndrome

    Directory of Open Access Journals (Sweden)

    de Oliveira Rogério Adas

    2012-09-01

    Full Text Available Abstract Background Central post-stroke pain (CPSP is a neuropathic pain syndrome associated with somatosensory abnormalities due to central nervous system lesion following a cerebrovascular insult. Post-stroke pain (PSP refers to a broader range of clinical conditions leading to pain after stroke, but not restricted to CPSP, including other types of pain such as myofascial pain syndrome (MPS, painful shoulder, lumbar and dorsal pain, complex regional pain syndrome, and spasticity-related pain. Despite its recognition as part of the general PSP diagnostic possibilities, the prevalence of MPS has never been characterized in patients with CPSP patients. We performed a cross-sectional standardized clinical and radiological evaluation of patients with definite CPSP in order to assess the presence of other non-neuropathic pain syndromes, and in particular, the role of myofascial pain syndrome in these patients. Methods CPSP patients underwent a standardized sensory and motor neurological evaluation, and were classified according to stroke mechanism, neurological deficits, presence and profile of MPS. The Visual Analogic Scale (VAS, McGill Pain Questionnaire (MPQ, and Beck Depression Scale (BDS were filled out by all participants. Results Forty CPSP patients were included. Thirty-six (90.0% had one single ischemic stroke. Pain presented during the first three months after stroke in 75.0%. Median pain intensity was 10 (5 to 10. There was no difference in pain intensity among the different lesion site groups. Neuropathic pain was continuous-ongoing in 34 (85.0% patients and intermittent in the remainder. Burning was the most common descriptor (70%. Main aggravating factors were contact to cold (62.5%. Thermo-sensory abnormalities were universal. MPS was diagnosed in 27 (67.5% patients and was more common in the supratentorial extra-thalamic group (P Conclusions The presence of MPS is not an exception after stroke and may present in association with CPSP

  20. Abnormal surface morphology of the central sulcus in children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Li, Shuyu; Wang, Shaoyi; Li, Xinwei; Li, Qiongling; Li, Xiaobo

    2015-01-01

    The central sulcus (CS) divides the primary motor and somatosensory areas, and its three-dimensional (3D) anatomy reveals the structural changes of the sensorimotor regions. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is associated with sensorimotor and executive function deficits. However, it is largely unknown whether the morphology of the CS alters due to inappropriate development in the ADHD brain. Here, we employed the sulcus-based morphometry approach to investigate the 3D morphology of the CS in 42 children whose ages spanned from 8.8 to 13.5 years (21 with ADHD and 21 controls). After automatic labeling of each CS, we computed seven regional shape metrics for each CS, including the global average length, average depth, maximum depth, average span, surface area, average cortical thickness, and local sulcal profile. We found that the average depth and maximum depth of the left CS as well as the average cortical thickness of bilateral CS in the ADHD group were significantly larger than those in the healthy children. Moreover, significant between-group differences in the sulcal profile had been found in middle sections of the CSs bilaterally, and these changes were positively correlated with the hyperactivity-impulsivity scores in the children with ADHD. Altogether, our results provide evidence for the abnormity of the CS anatomical morphology in children with ADHD due to the structural changes in the motor cortex, which significantly contribute to the clinical symptomatology of the disorder.

  1. Abnormal surface morphology of the central sulcus in children with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Shuyu eLi

    2015-08-01

    Full Text Available The central sulcus (CS divides the primary motor and somatosensory areas, and its three-dimensional (3D anatomy reveals the structural changes of the sensorimotor regions. Attention-deficit/hyperactivity disorder (ADHD is a neurodevelopmental disorder that is associated with sensorimotor and executive function deficits. However, it is largely unknown whether the morphology of the CS alters due to inappropriate development in the ADHD brain. Here, we employed the sulcus-based morphometry approach to investigate the 3D morphology of the CS in 42 children whose ages spanned from 8.8 to 13.5 years (21 with ADHD and 21 controls. After automatic labeling of each CS, we computed 7 regional shape metrics for each CS, including the global average length, average depth, maximum depth, average span, surface area, average cortical thickness and local sulcal profile. We found that the average depth and maximum depth of the left CS as well as the average cortical thickness of bilateral CS in the ADHD group were significantly larger than those in the healthy children. Moreover, significant between-group differences in the sulcal profile had been found in middle sections of the CSs bilaterally, and these changes were positively correlated with the hyperactivity-impulsivity scores in the children with ADHD. Altogether, our results provide evidence for the abnormity of the CS anatomical morphology in children with ADHD due to the structural changes in the motor cortex, which significantly contribute to the clinical symptomatology of the disorder.

  2. Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Stefano Omboni

    2015-01-01

    Full Text Available Objective. Central blood pressure (BP and vascular indices estimated noninvasively over the 24 hours were compared between normotensive volunteers and hypertensive patients by a pulse wave analysis of ambulatory blood pressure recordings. Methods. Digitalized waveforms obtained during each brachial oscillometric BP measurement were stored in the device memory and analyzed by the validated Vasotens technology. Averages for the 24 hours and for the awake and asleep subperiods were computed. Results. 142 normotensives and 661 hypertensives were evaluated. 24-hour central BP, pulse wave velocity (PWV, and augmentation index (AI were significantly higher in the hypertensive group than in the normotensive group (119.3 versus 105.6 mmHg for systolic BP, 75.6 versus 72.3 mmHg for diastolic BP, 10.3 versus 10.0 m/sec for aortic PWV, −9.7 versus −40.7% for peripheral AI, and 24.7 versus 11.0% for aortic AI, whereas reflected wave transit time (RWTT was significantly lower in hypertensive patients (126.6 versus 139.0 ms. After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI. All estimates displayed a typical circadian rhythm. Conclusions. Noninvasive assessment of 24-hour arterial stiffness and central hemodynamics in daily life dynamic conditions may help in assessing the arterial function impairment in hypertensive patients.

  3. Circulatory abnormalities in cirrhosis with focus on neurohumoral aspects

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1997-01-01

    Patients with cirrhosis exhibit characteristic hemodynamic changes with a hyperkinetic circulation and an abnormal distribution of the blood volume and neurohumoral regulation. Their plasma and noncentral blood volumes are increased, and the central and arterial blood volume and systemic vascular...... and hyperkinetic circulation in cirrhosis. Various vasodilators such as atrial natriurectic peptide, calcitonin gene-related peptide, adrenomedullin, and nitric oxide are among potential candidates in the arterial vasodilatation in cirrhosis. Besides enhanced sympathetic nervous activity, activation of the renin......-angiotensin-aldosterone system, and elevated circulating vasopressin, endothelin-1 may also be implicated in the hemodynamic counter-regulation in cirrhosis. Recent research has focused on the assertion that the hemodynamic and neurohumoral abnormalities in cirrhosis are part of a general circulatory dysfunction influencing...

  4. Circulatory abnormalities in cirrhosis with focus on neurohumoral aspects

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    1997-01-01

    -angiotensin-aldosterone system, and elevated circulating vasopressin, endothelin-1 may also be implicated in the hemodynamic counter-regulation in cirrhosis. Recent research has focused on the assertion that the hemodynamic and neurohumoral abnormalities in cirrhosis are part of a general circulatory dysfunction influencing...... resistance are decreased. A peripheral arterial vasodilatation may be of pathogenic importance to the low systemic vascular resistance as it directly correlates to the degree of central hypovolemia. It may therefore be an important element in the development of the low arterial blood pressure...

  5. Cocaine-induced cardiovascular effects: lack of evidence for a central nervous system site of action based on hemodynamic studies with cocaine methiodide.

    Science.gov (United States)

    Dickerson, L W; Rodak, D J; Kuhn, F E; Wahlstrom, S K; Tessel, R E; Visner, M S; Schaer, G L; Gillis, R A

    1999-01-01

    It has been suggested that cocaine acts directly in the brain to enhance central sympathetic outflow. However, some studies suggested that the cardiovascular effects of cocaine are related to a peripheral action. To characterize further the site of cocaine's cardiovascular effect, we compared the hemodynamic effects of cocaine (2 mg/kg, i.v. bolus) with those observed after administration of an equimolar dose (2.62 mg/kg, i.v. bolus) of cocaine methiodide, a quaternary derivative of cocaine that does not penetrate the blood-brain barrier, by using sufentanil-sedated dogs. Cocaine produced significant (p < 0.05) increases in heart rate (+37+/-11 beats/min), mean arterial pressure (+55+/-11 mm Hg), left ventricular end-diastolic pressure (+5.3+/-1.0 mm Hg), and cardiac output (+2.4+/-0.9 L/min). Cocaine methiodide produced increases in heart rate (+57+/-11 beats/min), mean arterial pressure (+45+/-11 mm Hg), left ventricular end-diastolic pressure (+3.4+/-1.0 mm Hg), and cardiac output (1.1+/-0.9 L/min), which were not significantly different from those observed with cocaine. Because opiate sedation potentially might have attenuated central sympathetic outflow, we further confirmed the qualitative similarity of the actions of cocaine and cocaine methiodide on heart rate and blood pressure in unsedated, conscious dogs. Our data suggest that the cardiovascular effects of cocaine result primarily from a peripheral site of action.

  6. Clinical relevance of fetal hemodynamic monitoring: Perinatal implications.

    Science.gov (United States)

    Pruetz, Jay D; Votava-Smith, Jodie; Miller, David A

    2015-08-01

    Comprehensive assessment of fetal wellbeing involves monitoring of fetal growth, placental function, central venous pressure, and cardiac function. Ultrasound evaluation of the fetus using 2D, color Doppler, and pulse-wave Doppler techniques form the foundation of antenatal diagnosis of structural anomalies, rhythm abnormalities and altered fetal circulation. Accurate and timely prenatal identification of the fetus at risk is critical for appropriate parental counseling, antenatal diagnostic testing, consideration for fetal intervention, perinatal planning, and coordination of postnatal care delivery. Fetal hemodynamic monitoring and serial assessment are vital to ensuring fetal wellbeing, particularly in the setting of complex congenital anomalies. A complete hemodynamic evaluation of the fetus gives important information on the likelihood of a smooth postnatal transition and contributes to ensuring the best possible outcome for the neonate.

  7. 65例志愿者颈静脉形态及血流动力学研究%The morphologic and hemodynamic abnormalities study of jugular vein in volunteers

    Institute of Scientific and Technical Information of China (English)

    唐乐梅; 刘铁利; 孙博; 宁殿秀; 苗延巍

    2015-01-01

    Objective To investigate jugular vein morphological changes with three dimension phase contrast magnetic resonance venography(3D PC MRV),and to explore hemodynamic features using MR phase contrast cine (MR PC cine).Methods Sixty-five healthy volunteers performed 3D PC MRV and MR PC-cine sannings.MRV ranged from torcular herophili to brachiocephalic veins, and the raw data of PC-cine was acquired at cervical 2-3(C2-C3)level perpendicular to the Jugular veins(JVs)with the maximum encoding velocity of 50 cm/sec.Jugular vein showing absent or tip shape(cross-sectional area less than 12.5 mm2 )was considered abnormal,and flat,crescent,oval,round shapes were considered normal.Data of PC-cine was processed by computer to evaluate the hemodynamic features.Results Nine (13.85%)of 65 cases were abnormal that unilateral jugular vein showing needle-pointed narrow or absent,and 8 cases on the left,and one case on the right;Weak correlation was found between jugular veins pattern and the age.The right sided values in volunteers were higher than that of the left side.Conclusion The morphology and hemodynamics of jugular veins in volunteers showed significant difference between sides,and weak correlation is found between the morphology and aging.%目的:应用三维相位对比磁共振血管成像技术(3D PC MRV)及 MR 相位对比电影法(MR PC-cine)探讨正常人颈静脉的形态及血流动力学特征。方法65例志愿者进行颈静脉3D PC MRV 及 MR PC-cine 扫描。扫描范围为窦汇至头臂静脉水平;颈静脉形态的判断标准如下:颈静脉缺如、针尖状狭窄(横截面积<12.5 mm2)、局部不显示视为异常;扁平状、新月形、椭圆形、圆形视为正常表现。MR PC-cine 序列扫描定位于 C2~C3水平,与颈静脉走行方向垂直,速率编码(VENC)为50 cm/s。结果65例志愿者中,9例(13.85%)出现单侧颈静脉针尖状狭窄或缺如,左侧(8例)异常的比例高于右侧(1例)(P <0.05);颈静脉形态异常

  8. Childhood moyamoya disease: hemodynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Tzika, A.A. [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Robertson, R.L. [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Barnes, P.D. [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Vajapeyam, S. [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Burrows, P.E. [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Treves, S.T. [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States); Scott, R.M. l [Department of Radiology, Children`s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115 (United States)

    1997-09-01

    Background. Childhood moyamoya disease is a rare progressive cerebrovascular disease. Objective. To evaluate cerebral hemodynamics using dynamic Gd-DTPA-enhanced imaging in children with moyamoya disease. Materials and methods. Eight children (2-11 years of age) with the clinical and angiographic findings typical of moyamoya disease, before and/or after surgical intervention (pial synangiosis), underwent conventional MR imaging (MRI) and hemodynamic MR imaging (HMRI). HMRI used a spoiled gradient-echo with low flip angle (10 deg) and long TE (TR/TE = 24/15 ms) to minimize T 1 effects and emphasize T 2{sup *} weighting. Raw and calculated hemodynamic images were reviewed. Three-dimensional time-of-flight MR angiography (MRA) and perfusion brain single photon emission computed tomography (SPECT) were also performed. Results. Abnormal hemodynamic maps resulting from vascular stenosis or occlusion and basal collaterals were observed in six patient studies. HMRI depicted perfusion dynamics of affected cerebrovascular territories, detected cortical perfusion deficits, and complemented conventional MRI and MRA. HMRI findings were consistent with those of catheter angiography and perfusion SPECT. Conclusion. Our preliminary experience suggests that HMRI may be of value in the preoperative and postoperative evaluation of surgical interventions in moyamoya disease. (orig.). With 4 figs., 3 tabs.

  9. Clinical analysis of abnormal renal hemodynamics in hypertensive patients with early renal injury%高血压早期肾损害肾内血流动力学异常临床分析

    Institute of Scientific and Technical Information of China (English)

    蓝翔; 季乃军; 童丽军; 陈东海; 雷建明; 章春来

    2015-01-01

    目的 对高血压合并早期肾损害患者的肾内动脉血流动力学异常状况进行分析. 方法 随机选择我院200例原发性高血压患者为观察组, 按照既定的标准将其划分无早期肾损害患者100例和早期肾损害患者100例,另外选择100名身体健康的志愿者作为对照组.利用彩超多普勒技术对MRA(主肾动脉)、SRA(叶段动脉)、IRA (叶间动脉)的Vs(收缩期峰速度)、Vd(舒张期末速度)、Vm(平均血流速度)、AT(血流峰速加速时间)、PI(脉冲指数)以及RI(阻力指数)等血流参数进行测定,取两肾的平均值为最总结果. 结果 观察组患者的MRA(主肾动脉)、SRA(叶段动脉)、IRA(叶间动脉)的Vs(收缩期峰速度)、Vd(舒张期末速度)、Vm(平均血流速度)均较对照组低(P0.05);早期肾损害组和无早期肾损害组的组内比较结果为SRA(叶段动脉)、IRA(叶间动脉)的Vs(收缩期峰速度)、Vd(舒张期末速度)、Vm(平均血流速度)降低,AT(血流峰速加速时间)延长,PI(脉冲指数)以及RI(阻力指数)增高(P均0.05). Compared with the group without early renal injury, the group with early renal injury had significantly lower Vs, Vd, and Vm in the SRA and IRA, a significantly prolonged AT, and significantly higher PI and RI (all P<0.05). Conclusion The patients with primary hypertension have abnormal renal hemodynamics in the early stage of renal injury.

  10. Abnormal Intrinsic Functional Hubs in Severe Male Obstructive Sleep Apnea: Evidence from a Voxel-Wise Degree Centrality Analysis

    Science.gov (United States)

    Shao, Yi; Gong, Honghan; Zhang, Wei; Zeng, Xianjun; Ye, Chenglong; Nie, Si; Chen, Liting; Peng, Dechang

    2016-01-01

    Purpose Obstructive sleep apnea (OSA) has been associated with changes in brain structure and regional function in certain brain areas. However, the functional features of network organization in the whole brain remain largely uncertain. The purpose of this study was to identify the OSA-related spatial centrality distribution of the whole brain functional network and to investigate the potential altered intrinsic functional hubs. Methods Forty male patients with newly confirmed severe OSA on polysomnography, and well-matched good sleepers, participated in this study. All participants underwent a resting-state functional MRI scan and clinical and cognitive evaluation. Voxel-wise degree centrality (DC) was measured across the whole brain, and group difference in DC was compared. The relationship between the abnormal DC value and clinical variables was assessed using a linear correlation analysis. Results Remarkably similar spatial distributions of the functional hubs (high DC) were found in both groups. However, OSA patients exhibited a pattern of significantly reduced regional DC in the left middle occipital gyrus, posterior cingulate cortex, left superior frontal gyrus, and bilateral inferior parietal lobule, and DC was increased in the right orbital frontal cortex, bilateral cerebellum posterior lobes, and bilateral lentiform nucleus, including the putamen, extending to the hippocampus, and the inferior temporal gyrus, which overlapped with the functional hubs. Furthermore, a linear correlation analysis revealed that the DC value in the posterior cingulate cortex and left superior frontal gyrus were positively correlated with Montreal cognitive assessment scores, The DC value in the left middle occipital gyrus and bilateral inferior parietal lobule were negatively correlated with apnea-hypopnea index and arousal index in OSA patients. Conclusion Our findings suggest that OSA patients exhibited specific abnormal intrinsic functional hubs including relatively

  11. Abnormal liver function and central obesity associate with work-related fatigue among the Taiwanese workers

    Institute of Scientific and Technical Information of China (English)

    Yu-Cheng Lin; Jong-Dar Chen; Chao-Jen Chen

    2008-01-01

    AIM: TO examine the associations between objective health indicators and high need for recovery (NFR) after work, one of the subjective presentations of work related-fatigue, among apparently healthy workers in modern workplaces. METHODS: From October to December, 2007, an annual health examination was performed for the workers from an electronics manufacturing factory in Taiwan. Health records of 1216 workers with a relatively homogeneous socioeconomic status were used for analysis. The health checkups included personal and NFR scale questionnaires, physical examinations, blood tests for biochemistry and hematology. The workers within the top tertile NFR score were defined as high-NFR workers. RESULTS: After adjusted for potential confounders, the workers with elevated alanine aminotransferase (ALT) and central obesity had a significantly higher NFR after work, with increased risks of 1.4-fold [95% confidence interval (CI) = 1.01-2.0] and 1.8-fold (95% CI = 1.2-2.7), respectively. Shiftworkers had a 2.0-fold (95% CI = 1.5-2.6) increased risk for high-NFR. The associations between high-NFR and lipid profiles, blood sugar, hematology indexes or blood pressure were insignificant after controlling for confounders. CONCLUSION: For apparently healthy workers, high NFR after work is not simply a subjective experience. Objective health measures, such as elevated ALT and increased waist circumference, should be carefully evaluated for the apparently healthy workers having a higher NFR after work.

  12. Central integration of canal and otolith signals is abnormal in vestibular migraine

    Directory of Open Access Journals (Sweden)

    Susan eKing

    2014-11-01

    Full Text Available Vestibular migraine (VM, a common cause of vestibular symptoms within the general population, is a disabling and poorly understood form of dizziness. We sought to examine the underlying pathophysiology of VM with three studies which involved central synthesis of canal and otolith cues, and present preliminary results from each of these studies: 1 VM patients appear to have reduced motion perception thresholds when canal and otolith signals are modulated in a coplanar manner during roll tilt; 2 percepts of roll tilt appear to develop more slowly in VM patients than in control groups during a centrifugation paradigm that presents conflicting, orthogonal canal and otolith cues; and 3 eye movement responses appear to be different in VM patients when studied with a post-rotational tilt paradigm, which also presents a canal-otolith conflict, as the shift of the eye’s rotational axis was larger in VM and the relationship between the axis shift and tilt-suppression of the VOR appeared to differ in VM patients relative to control groups. Based on these preliminary perceptual and eye movement results obtained with three different motion paradigms, we present a hypothesis that the integration of canal and otolith signals by the brain differs in VM and that this difference could be cerebellar in origin. We provide several possible mechanisms that could underlie these observations, and speculate that one of more of these mechanisms contributes to the vestibular symptoms and motion intolerance that are characteristic of the VM syndrome.

  13. Rapid, low-cost MR imaging protocol to document central nervous system and sinus abnormalities prior to pediatric hematopoietic stem cell transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Eliane D.; Barbosa, Felipe G. de; Szarf, Gilberto; Lederman, Henrique M. [Universidade Federal de Sao Paulo, Department of Diagnostic Imaging, Sao Paulo (Brazil); Seber, Adriana; Ginani, Valeria C.; Carlesse, Fabianne C.; Gouvea, Roseane V.; Zecchin, Victor G.; Carvalho, Cinthya R. [Universidade Federal de Sao Paulo, Division of Pediatric Oncology, Department of Pediatrics, Sao Paulo (Brazil)

    2011-06-15

    Patients undergoing bone marrow transplant (BMT) are at risk for infectious complications, including those of the sinus. Central nervous system (CNS) abnormalities related to the chemotherapy or radiation that the patient received for the treatment of underlying malignancy or to transplant-related effects are also commonly seen. The only effective way to differentiate pre- and post-transplant causes is to have a baseline evaluation prior to the admission for transplant. The current method used to evaluate these patients is head CT. However, CT is not accurate to demonstrate CNS abnormalities and exposes the patient to radiation. MRI, despite better sensitivity for white matter abnormalities, has not been routinely used because of the higher cost and longer duration of the exam. Therefore, we designed a fast, low-cost and radiation-free MRI-based protocol to simultaneously evaluate sinus and brain abnormalities. (orig.)

  14. The role of respiratory failure caused by congenital central nervous system abnormalities and the effect of β-casomorphins in sudden infant death syndrome pathogenesis

    Directory of Open Access Journals (Sweden)

    Barbara Sumińska-Ziemann

    2015-08-01

    Full Text Available The aim of the paper is to discuss the role of respiratory failure caused by endogenous (both structural and functional abnormalities in the central nervous system and exogenous food-derived opioid-like peptides in the pathogenesis of sudden infant death syndrome (SIDS. By stimulating μ-opioid receptors, opioid-like peptides may suppress the tonic activity of the respiratory centre in the brain stem.

  15. Abnormal anxiety- and depression-like behaviors in mice lacking both central serotonergic neurons and pancreatic islet cells.

    Science.gov (United States)

    Jia, Yun-Fang; Song, Ning-Ning; Mao, Rong-Rong; Li, Jin-Nan; Zhang, Qiong; Huang, Ying; Zhang, Lei; Han, Hui-Li; Ding, Yu-Qiang; Xu, Lin

    2014-01-01

    Dysfunction of central serotonin (5-HT) system has been proposed to be one of the underlying mechanisms for anxiety and depression, and the association of diabetes mellitus and psychiatric disorders has been noticed by the high prevalence of anxiety/depression in patients with diabetes mellitus. This promoted us to examine these behaviors in central 5-HT-deficient mice and those also suffering with diabetes mellitus. Mice lacking either 5-HT or central serotonergic neurons were generated by conditional deletion of Tph2 or Lmx1b respectively. Simultaneous depletion of both central serotonergic neurons and pancreatic islet cells was achieved by administration of diphtheria toxin (DT) in Pet1-Cre;Rosa26-DT receptor (DTR) mice. The central 5-HT-deficient mice showed reduced anxiety-like behaviors as they spent more time in and entered more often into the light box in the light/dark box test compared with controls; similar results were observed in the elevated plus maze test. However, they displayed no differences in the immobility time of the forced swimming and tail suspension tests suggesting normal depression-like behaviors in central 5-HT-deficient mice. As expected, DT-treated Pet1-Cre;Rosa26-DTR mice lacking both central serotonergic neurons and pancreatic islet endocrine cells exhibited several classic diabetic symptoms. Interestingly, they displayed increased anxiety-like behaviors but reduced immobility time in the forced swimming and tail suspension tests. Furthermore, the hippocampal neurogenesis was dramatically enhanced in these mice. These results suggest that the deficiency of central 5-HT may not be sufficient to induce anxiety/depression-like behaviors in mice, and the enhanced hippocampal neurogenesis may contribute to the altered depression-like behaviors in the 5-HT-deficient mice with diabetes. Our current investigation provides understanding the relationship between diabetes mellitus and psychiatric disorders.

  16. Abnormal anxiety- and depression-like behaviors in mice lacking both central serotonergic neurons and pancreatic islet cells

    Directory of Open Access Journals (Sweden)

    Yun-Fang eJia

    2014-09-01

    Full Text Available Dysfunction of central serotonin (5-HT system has been proposed to be one of the underlying mechanisms for anxiety and depression, and the association of diabetes mellitus and psychiatric disorders has been noticed by the high prevalence of anxiety/depression in patients with diabetes mellitus. This promoted us to examine these behaviors in central 5-HT-deficient mice and those also suffering with diabetes mellitus. Mice lacking either 5-HT or central serotonergic neurons were generated by conditional deletion of Tph2 or Lmx1b respectively. Simultaneous depletion of both central serotonergic neurons and pancreatic islet cells was achieved by administration of diphtheria toxin (DT in Pet1-Cre;Rosa26-DT receptor (DTR mice. The central 5-HT-deficient mice showed reduced anxiety-like behaviors as they spent more time in and entered more often into the light box in the light/dark box test compared with controls; similar results were observed in the elevated plus maze test. However, they displayed no differences in the immobility time of the forced swimming and tail suspension tests suggesting normal depression-like behaviors in central 5-HT-deficient mice. As expected, DT-treated Pet1-Cre;Rosa26-DTR mice lacking both central serotonergic neurons and pancreatic islet endocrine cells exhibited several classic diabetic symptoms. Interestingly, they displayed increased anxiety-like behaviors but reduced immobility time in the forced swimming and tail suspension tests. Furthermore, the hippocampal neurogenesis was dramatically enhanced in these mice. These results suggest that the deficiency of central 5-HT may not be sufficient to induce anxiety/depression-like behaviors in mice, and the enhanced hippocampal neurogenesis may contribute to the altered depression-like behaviors in the 5-HT-deficient mice with diabetes. Our current investigation provides a novel insight into understanding the relationship between diabetes mellitus and psychiatric disorders.

  17. Hemodynamic Profiling in Complicated Pregnancies

    NARCIS (Netherlands)

    J.M.J. Cornette (Jérôme)

    2016-01-01

    textabstractIn order to permit a successful pregnancy outcome, the cardiovascular system must undergo substantial changes. This thesis addresses the hemodynamics in several pregnancy complications. A general overview of normal hemodynamic adaptation to pregnancy is provided . Several techniques of

  18. Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, M.; Sakuma, H.; Takeda, K. [Dept. of Radiology, Mie Univ. School of Medicine, Mie (Japan); Yagishita, A. [Dept. of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Tokyo (Japan); Yamamoto, T. [Dept. of Radiology, Obama Municipal Hospital, Fukui (Japan)

    2003-12-01

    A variety of central nervous system (CNS) diseases are associated with abnormal hyperintensity within the subarachnoid space (SAS) by fluid-attenuated inversion-recovery (FLAIR) MR imaging. Careful attention to the SAS can provide additional useful information that may not be available with conventional MR sequences. The purpose of this article is to provide a pictorial essay about CNS diseases and FLAIR images with abnormal hyperintensity within the SAS. We present several CNS diseases including subarachnoid hemorrhage, meningitis, leptomeningeal metastases, acute infarction, and severe arterial occlusive diseases such as moya-moya disease. We also review miscellaneous diseases or normal conditions that may exhibit cerebrospinal fluid hyperintensity on FLAIR images. Although the detection of abnormal hyperintensity suggests the underlying CNS diseases and narrows differential diagnoses, FLAIR imaging sometimes presents artifactual hyperintensity within the SAS that can cause the misinterpretation of normal SAS as pathologic conditions; therefore, radiologists should be familiar with such artifactual conditions as well as pathologic conditions shown as hyperintensity by FLAIR images. This knowledge is helpful in establishing the correct diagnosis. (orig.)

  19. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  20. Implementation of X-ray fluorescence microscopy for investigation of elemental abnormalities in central nervous system tissue

    Energy Technology Data Exchange (ETDEWEB)

    Chwiej, J. [Faculty of Physics and Applied Computer Science, AGH, University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow (Poland)]. E-mail: jchwiej@novell.ftj.agh.edu.pl; Szczerbowska-Boruchowska, M. [Faculty of Physics and Applied Computer Science, AGH, University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow (Poland); Wojcik, S. [Faculty of Physics and Applied Computer Science, AGH, University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow (Poland); Lankosz, M. [Faculty of Physics and Applied Computer Science, AGH, University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow (Poland); Chlebda, M. [Faculty of Physics and Applied Computer Science, AGH, University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow (Poland); Adamek, D. [Institute of Neurology, Collegium Medicum, Jagiellonian University, ul. Botaniczna-3, 31-503 Cracow (Poland); Tomik, B. [Institute of Neurology, Collegium Medicum, Jagiellonian University, ul. Botaniczna-3, 31-503 Cracow (Poland); Setkowicz, Z. [Department of Neuroanatomy, Institute of Zoology, Jagiellonian University, ul. Ingardena 6, 30-060 Cracow (Poland); Falkenberg, G. [Hamburger Synchrotronstrahlungslabor at Deutsches Elektronen-Synchrotron DESY, Notkestr. 85, Hamburg (Germany); Stegowski, Z. [Faculty of Physics and Applied Computer Science, AGH, University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow (Poland); Szczudlik, A. [Institute of Neurology, Collegium Medicum, Jagiellonian University, ul. Botaniczna-3, 31-503 Cracow (Poland)

    2005-09-29

    The microbeam synchrotron radiation X-ray fluorescence technique (micro-SRXRF) was applied to topographic and quantitative elemental analysis of human spinal cord tissue sections. The feasibility of this technique for the determination of elemental abnormalities caused by neurodegenerative disorder, i.e. amyotrophic lateral sclerosis (ALS), was verified. The applied measurement conditions allowed detecting: P, S, Cl, K, Ca, Fe, Cu, Zn and Br in thin tissue slices. Two-dimensional maps of the elemental distribution were recorded. Quantitative differences in elemental concentration between gray matter, nerve cells and white matter were observed for all analyzed cases. For the motor neuron bodies higher accumulation of S, Cl, K, Fe, Zn and Br was noticed. The results showed significant differences of elemental accumulation between the analyzed ALS cases. Moreover, the feasibility of using tissue sections fixed and embedded in paraffin for micro-SRXRF analysis was tested. These studies were performed on the samples of rat brain.

  1. Abnormal Wave Reflections and Left Ventricular Hypertrophy Late After Coarctation of the Aorta Repair

    Science.gov (United States)

    Quail, Michael A.; Short, Rebekah; Pandya, Bejal; Steeden, Jennifer A.; Khushnood, Abbas; Taylor, Andrew M.; Segers, Patrick

    2017-01-01

    Patients with repaired coarctation of the aorta are thought to have increased afterload due to abnormalities in vessel structure and function. We have developed a novel cardiovascular magnetic resonance protocol that allows assessment of central hemodynamics, including central aortic systolic blood pressure, resistance, total arterial compliance, pulse wave velocity, and wave reflections. The main study aims were to (1) characterize group differences in central aortic systolic blood pressure and peripheral systolic blood pressure, (2) comprehensively evaluate afterload (including wave reflections) in the 2 groups, and (3) identify possible biomarkers among covariates associated with elevated left ventricular mass (LVM). Fifty adult patients with repaired coarctation and 25 age- and sex-matched controls were recruited. Ascending aorta area and flow waveforms were obtained using a high temporal-resolution spiral phase-contrast cardiovascular magnetic resonance flow sequence. These data were used to derive central hemodynamics and to perform wave intensity analysis noninvasively. Covariates associated with LVM were assessed using multivariable linear regression analysis. There were no significant group differences (P≥0.1) in brachial systolic, mean, or diastolic BP. However central aortic systolic blood pressure was significantly higher in patients compared with controls (113 versus 107 mm Hg, P=0.002). Patients had reduced total arterial compliance, increased pulse wave velocity, and larger backward compression waves compared with controls. LVM index was significantly higher in patients than controls (72 versus 59 g/m2, Pcoarctation of the aorta repair, including abnormal wave reflections that are associated with elevated LVM. PMID:28115510

  2. Bench-to-bedside review: An approach to hemodynamic monitoring--Guyton at the bedside.

    Science.gov (United States)

    Magder, Sheldon

    2012-10-29

    Hemodynamic monitoring is used to identify deviations from hemodynamic goals and to assess responses to therapy. To accomplish these goals one must understand how the circulation is regulated. In this review I begin with an historical review of the work of Arthur Guyton and his conceptual understanding of the circulation and then present an approach by which Guyton's concepts can be applied at the bedside. Guyton argued that cardiac output and central venous pressure are determined by the interaction of two functions: cardiac function, which is determined by cardiac performance; and a return function, which is determined by the return of blood to the heart. This means that changes in cardiac output are dependent upon changes of one of these two functions or of both. I start with an approach based on the approximation that blood pressure is determined by the product of cardiac output and systemic vascular resistance and that cardiac output is determined by cardiac function and venous return. A fall in blood pressure with no change in or a rise in cardiac output indicates that a decrease in vascular resistance is the dominant factor. If the fall in blood pressure is due to a fall in cardiac output then the role of a change in the return function and cardiac function can be separated by the patterns of changes in central venous pressure and cardiac output. Measurement of cardiac output is a central component to this approach but until recently it was not easy to obtain and was estimated from surrogates. However, there are now a number of non-invasive devices that can give measures of cardiac output and permit the use of physiological principles to more rapidly appreciate the primary pathophysiology behind hemodynamic abnormalities and to provide directed therapy.

  3. Heart function and hemodynamics

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930469 The effects of different ventricular pac-ing rates on cardiac hemodynamics and theirclinical significance.WEI Meng(魏盟),et al.Zhongshan Hosp,Shanghai Med Univ,Shanghai,200032.Shanghai Med J 1993;16(3):125—126.Changes of hemodynamics were investigated in26 patients at ventricular pacing rate of 60 to120,and 160 bpm.Effects of increasing ventricu-lar pacing rate on EF which were determined bygated blood pool scintigraphy were also studiedin another 11 patients.It is concluded that:1)inpatients with normal cardiac function as well asmost patients with cardiac insufficiency,the rela-tion of CO with increasing pacing rate can be il-

  4. Mexiletine overdose producing status epilepticus without cardiovascular abnormalities.

    Science.gov (United States)

    Nelson, L S; Hoffman, R S

    1994-01-01

    Few cases of mexiletine overdose have been reported in the literature. The available case reports have invariably noted significant hemodynamic or electrocardiographic abnormalities. A 41-year-old woman, on mexiletine for arrhythmia control, ingested up to 90 of her 200 mg mexiletine tablets in a suicide attempt. She presented to the emergency department awake with a normal blood pressure and pulse. Shortly afterwards, the patient had a generalized motor seizure, which responded after 40 minutes to intravenous diazepam 100 mg, phenobarbital 1 g and pyridoxine 5 g. Recurrent status epilepticus at one hour required an additional 40 mg of diazepam and a loading dose of pentobarbital. During the entire episode, her electrocardiogram remained normal. The patient's mexiletine level was 20 micrograms/mL (therapeutic 1-2 micrograms/mL) and the patient's urine screen was negative for cocaine. Mexiletine is a group Ib antidysrhythmic agent with electrophysiologic effects similar to lidocaine. Mexiletine has a little first pass hepatic metabolism and a large volume of distribution along with a high lipid solubility, and prolonged central nervous system toxicity may be expected. As with lidocaine, the toxic deaths from mexiletine have resulted from hypotension and bradycardia. The patient reported had a significant mexiletine overdose which resulted in convulsive status epilepticus, but was devoid of hemodynamic or electrocardiographic abnormalities.

  5. Are There Abnormalities in Peripheral and Central Components of Somatosensory Evoked Potentials in Non-Specific Chronic Low Back Pain?

    Science.gov (United States)

    Puta, Christian; Franz, Marcel; Blume, Kathrin R.; Gabriel, Holger H. W.; Miltner, Wolfgang H. R.; Weiss, Thomas

    2016-01-01

    Chronic low back pain (CLBP) was shown to be associated with longer reflex response latencies of trunk muscles during external upper limb perturbations. One theoretical, but rarely investigated possibility for longer reflex latencies might be related to modulated somatosensory information processing. Therefore, the present study investigated somatosensory evoked potentials (SEPs) to median nerve stimulation in CLBP patients and healthy controls (HC). Latencies of the peripheral N9 SEP component were used as the primary outcome. In addition, latencies and amplitudes of the central N20 SEP component, sensory thresholds, motor thresholds and nerve conduction velocity were also analyzed in CLBP patients and HC. There is a trend for the CLBP patients to exhibit longer N9 latencies at the ipsilateral Erb’s point compared to HC. This trend is substantiated by significantly longer N9 latencies in CLBP patients compared to normative data. None of the other parameters showed any significant difference between CLBP patients and HC. Overall, our data indicate small differences of the peripheral N9 SEP component; however, these differences cannot explain the reflex delay observed in CLBP patients. While it was important to rule out the contribution of early somatosensory processing and to elucidate its contribution to the delayed reflex responses in CLBP patients, further research is needed to find the primary source(s) of time-delayed reflexes in CLBP. PMID:27799904

  6. Central nervous system abnormalities in patients with oculo-auriculo-vertebral spectrum (Goldenhar syndrome Anormalidades do sistema nervoso central em pacientes com espectro óculo-aurículo-vertebral (síndrome de Goldenhar

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano Machado Rosa

    2010-02-01

    Full Text Available OBJECTIVE: To describe the central nervous system (CNS alterations present in a sample of oculo-auriculo-vertebral spectrum (OAVS patients, trying to correlate them with other clinical features. METHOD: Seventeen patients with diagnosis of OAVS were evaluated. All presented radiological evaluation of the CNS, normal GTG-Banding karyotype and clinical features involving at least two from the four following areas: oro-cranio-facial, ocular, auricular and vertebral. RESULTS: CNS alterations were verified in eight from seventeen patients (47%. Diffuse cerebral hypoplasia, dilated lateral cerebral ventricles (asymptomatic hydrocephalus, corpus callosum dysgenesis and frontal hypodensities were the most frequent abnormalities. Presence of ophthalmologic abnormalities was the only clinical association observed, being significantly more frequent among patients with cerebral alterations (63% versus 11%. CONCLUSION: CNS abnormalities are frequent in patients with OAVS, especially in carriers of ophthalmologic alterations. However, the absence of detectable cerebral abnormalities did not exclude the possibility that these subjects will subsequently present neurological symptoms.OBJETIVO: Descrever as alterações do sistema nervoso central (SNC presentes em uma amostra de pacientes com espectro óculo-aurículo-vertebral (EOAV, tentando correlacioná-las com os demais achados clínicos. MÉTODO: Foram avaliados dezessete pacientes com diagnóstico de EOAV. Todos apresentavam avaliação radiológica do SNC, cariótipo por bandas GTG normal e achados clínicos em pelo menos duas das quatro das seguintes áreas: oro-crânio-facial, ocular, auricular e vertebral. RESULTADOS: Alterações do SNC foram verificadas em oito dos dezessete pacientes (47%. Hipoplasia cerebral difusa, dilatação dos ventrículos cerebrais laterais (hidrocefalia assintomática, disgenesia do corpo caloso e hipondesidades frontais foram as anormalidades mais frequentes. A presença de

  7. Central and peripheral hemodynamics in exercising humans

    DEFF Research Database (Denmark)

    Calbet, J A L; González-Alonso, J; Helge, J W

    2015-01-01

    during incremental upright arm cranking (AC) and leg pedalling (LP) to exhaustion (Wmax ) in nine males. Systemic VC, peak cardiac output (Qpeak ) (indocyanine green) and stroke volume (SV) were 18%, 23%, and 20% lower during AC than LP. The mean BP, the rate-pressure product and the associated...... perfusion pressure to increase O2 delivery, allowing a similar peak VO2 per kg of muscle mass in both extremities. In summary, despite a lower Qpeak during arm cranking the cardiovascular strain is much higher than during leg pedalling. The adjustments of regional conductances during incremental exercise...

  8. Staging of hemodynamic parameters during development of experimental arterial hypertension in rabbits.

    Science.gov (United States)

    Frolov, V A; Blagonravov, M L; Zotov, A K; Zotova, T J

    2011-05-01

    The study analyzed changes in parameters of the central and intracardiac hemodynamics during the development of experimental arterial hypertension, which were assessed as the adaptive in nature. The development of hypertension demonstrated staging of the adaptive processes. The development of the adaptive responses was characterized by changes in the magnitude and probabilistic distribution of the hemodynamic parameters.

  9. Hemodynamic effects of dexmedetomidine in critically ill neonates and infants with heart disease.

    Science.gov (United States)

    Lam, Francis; Bhutta, Adnan T; Tobias, Joseph D; Gossett, Jeffrey M; Morales, Laura; Gupta, Punkaj

    2012-10-01

    The primary objective of this study was to evaluate the hemodynamic effects of dexmedetomidine (DEX) infusion on critically ill neonates and infants with congenital heart disease (CHD). The secondary objective of the study was to evaluate the safety and efficacy profile of the drug in this patient population. A retrospective observational study was conducted in the cardiovascular intensive care unit (CVICU) of a single tertiary care university children's hospital. The charts of all neonates and infants who received DEX in the authors' pediatric CVICU between August 2009 and June 2010 were retrospectively reviewed. The demographic data collected included age, weight, sex, diagnosis, and Risk Adjustment in Congenital Heart Surgery (RACHS-1) score. To evaluate the hemodynamic effects of DEX, physiologic data were collected including heart rate, mean arterial pressure (MAP), inotrope score, near-infrared spectroscopy, and central venous pressure (CVP). To assess the efficacy of DEX, the amount and duration of concomitant sedation and analgesic infusions over a period of 24 h were examined together with the number of rescue boluses. The potential side effects evaluated in this study included nausea, vomiting, abdominal distension, dysrhythmias, neurologic abnormalities, seizures, and signs and symptoms of withdrawal. During the study period, 50 neonates and infants received DEX for a median period of 78 h (range, 40-290 h). These patients had an average age of 3.53 ± 2.64 months and a weight of 4.85 ± 1.67 kg. Whereas 34 patients (68%) received DEX after surgery for CHD, 15 patients (30%) received DEX after heart transplantation. Of these 50 infants, 10 (20%) had a single-ventricle anatomy, whereas 13 (26%) had a risk adjustment score (RACHS-1) in the category of 4-6. The median CVICU stay was 29 days (range, 8-69 days). Despite a significant decrease in heart rate, MAP, inotrope score, and CVP, all the patients remained hemodynamically stable during DEX infusion

  10. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types...... of migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do...

  11. Chronic sensory stroke with and without central pain is associated with bilaterally distributed sensory abnormalities as detected by quantitative sensory testing.

    Science.gov (United States)

    Krause, Thomas; Asseyer, Susanna; Geisler, Frederik; Fiebach, Jochen B; Oeltjenbruns, Jochen; Kopf, Andreas; Villringer, Kersten; Villringer, Arno; Jungehulsing, Gerhard J

    2016-01-01

    Approximately 20% of patients suffering from stroke with pure or predominant sensory symptoms (referred to as sensory stroke patients) develop central poststroke pain (CPSP). It is largely unknown what distinguishes these patients from those who remain pain free. Using quantitative sensory testing (QST), we analyzed the somatosensory profiles of 50 patients with chronic sensory stroke, of which 25 suffered from CPSP. As compared with reference data from healthy controls, patients with CPSP showed alterations of thermal and mechanical thresholds on the body area contralateral to their stroke (P pain sensory stroke [NPSS] patients) exhibited similar albeit less pronounced contralesional changes. Paradoxical heat sensation (PHS) and dynamic mechanical allodynia (DMA) showed higher values in CPSP, and an elevated cold detection threshold (CDT) was seen more often in CPSP than in patients with NPSS (P pain summation (wind-up ratio) each correlated with the presence of pain (P < 0.05). On the homologous ipsilesional body area, both patient groups showed additional significant abnormalities as compared with the reference data, which strongly resembled the contralesional changes. In summary, our analysis reveals that CPSP is associated with impaired temperature perception and positive sensory signs, but differences between patients with CPSP and NPSS are subtle. Both patients with CPSP and NPSS show considerable QST changes on the ipsilesional body side. These results are in part paralleled by recent findings of bilaterally spread cortical atrophy in CPSP and might reflect chronic maladaptive cortical plasticity, particularly in patients with CPSP.

  12. Splanchnic and systemic hemodynamic derangement in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming; Henriksen, Jens Henrik

    2001-01-01

    significance to the low systemic vascular resistance and abnormal volume distribution of blood, which are important elements in the development of the concomitant cardiac dysfunction, recently termed 'cirrhotic cardiomyopathy'. Systolic and diastolic functions are impaired with direct relation to the degree...... in vasodilation and increased arterial compliance. Reflex-induced, enhanced sympathetic nervous system activity, activation of the renin-angiotensin aldosterone system, and elevated circulation vasopressin and endothelin-1 are implicated in hemodynamic counter-regulation in cirrhosis. Recent research has focused......Patients with cirrhosis and portal hypertension exhibit characteristic hemodynamic changes with hyperkinetic systemic circulation, abnormal distribution of blood volume and neurohumoral dysregulation. Their plasma and noncentral blood volumes are increased. Splanchnic vasodilation is of pathogenic...

  13. Characteristics of Hemodynamic Disorders in Patients with Severe Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Ryta E. Rzheutskaya

    2012-01-01

    Full Text Available Purpose. To define specific features of central hemodynamic parameter changes in patients with isolated severe traumatic brain injury (STBI and in patients with clinically established brain death and to determine the required course of treatment for their correction. Data and Research Methods. A close study of central hemodynamic parameters was undertaken. The study involved 13 patients with isolated STBI (group STBI and 15 patients with isolated STBI and clinically established brain death (group STBI-BD. The parameters of central hemodynamics were researched applying transpulmonary thermodilution. Results. In the present study, various types of hemodynamic reaction (normodynamic, hyperdynamic, and hypodynamic were identified in patients with isolated STBI in an acute period of traumatic disease. Hyperdynamic type of blood circulation was not observed in patients with isolated STBI and clinically established brain death. Detected hemodynamic disorders led to the correction of the ongoing therapy under the control of central hemodynamic parameters. Conclusions. Monitoring of parameters of central hemodynamics allows to detect the cause of disorders, to timely carry out the required correction, and to coordinate infusion, inotropic, and vasopressor therapy.

  14. Hemodynamics and vasopressor support in therapeutic hypothermia after cardiac arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Søholm, Helle;

    2014-01-01

    AIM: Inducing therapeutic hypothermia (TH) in Out-of-Hospital Cardiac Arrest (OHCA) can be challenging due to its impact on central hemodynamics and vasopressors are frequently used to maintain adequate organ perfusion. The aim of this study was to assess the association between level of vasopres...

  15. Meiotic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  16. Hemodynamic forces in a model left ventricle

    Science.gov (United States)

    Domenichini, Federico; Pedrizzetti, Gianni

    2016-12-01

    Intraventricular pressure gradients were clinically demonstrated to represent one useful indicator of the left ventricle (LV) function during the development of heart failure. We analyze the fluid dynamics inside a model LV to improve the understanding of the development of hemodynamic forces (i.e., mean pressure gradient) in normal conditions and their modification in the presence of alterations of LV tissue motion. To this aim, the problem is solved numerically and the global force exchanged between blood flow and LV boundaries is computed by volume integration. We also introduce a simplified analytical model, based on global conservation laws, to estimate hemodynamic forces from the knowledge of LV tissue information commonly available in cardiac imaging. Numerical results show that the normal intraventricular gradients feature a deep brief suction at early diastolic filling and a persistent thrust during systolic ejection. In presence of abnormalities of the wall motion, the loss of time synchrony is more relevant than the loss of spatial uniformity in modifying the normal pressure gradient spatiotemporal pattern. The main findings are reproduced in the integral model, which represents a possible easy approach for integrating fluid dynamics evaluations in the clinical examination.

  17. Hemodynamic monitoring in the intensive care unit: a Brazilian perspective

    Science.gov (United States)

    Dias, Fernando Suparregui; Rezende, Ederlon Alves de Carvalho; Mendes, Ciro Leite; Silva Jr., João Manoel; Sanches, Joel Lyra

    2014-01-01

    Objective In Brazil, there are no data on the preferences of intensivists regarding hemodynamic monitoring methods. The present study aimed to identify the methods used by national intensivists, the hemodynamic variables they consider important, the regional differences, the reasons for choosing a particular method, and the use of protocols and continued training. Methods National intensivists were invited to answer an electronic questionnaire during three intensive care events and later, through the Associação de Medicina Intensiva Brasileira portal, between March and October 2009. Demographic data and aspects related to the respondent preferences regarding hemodynamic monitoring were researched. Results In total, 211 professionals answered the questionnaire. Private hospitals showed higher availability of resources for hemodynamic monitoring than did public institutions. The pulmonary artery catheter was considered the most trusted by 56.9% of the respondents, followed by echocardiograms, at 22.3%. Cardiac output was considered the most important variable. Other variables also considered relevant were mixed/central venous oxygen saturation, pulmonary artery occlusion pressure, and right ventricular end-diastolic volume. Echocardiography was the most used method (64.5%), followed by pulmonary artery catheter (49.3%). Only half of respondents used treatment protocols, and 25% worked in continuing education programs in hemodynamic monitoring. Conclusion Hemodynamic monitoring has a greater availability in intensive care units of private institutions in Brazil. Echocardiography was the most used monitoring method, but the pulmonary artery catheter remains the most reliable. The implementation of treatment protocols and continuing education programs in hemodynamic monitoring in Brazil is still insufficient. PMID:25607264

  18. Leukocyte abnormalities.

    Science.gov (United States)

    Gabig, T G

    1980-07-01

    Certain qualitative abnormalities in neutrophils and blood monocytes are associated with frequent, severe, and recurrent bacterial infections leading to fatal sepsis, while other qualitative defects demonstrated in vitro may have few or no clinical sequelae. These qualitative defects are discussed in terms of the specific functions of locomotion, phagocytosis, degranulation, and bacterial killing.

  19. Splanchnic and systemic hemodynamic derangement in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Bendtsen, F; Henriksen, Jens Henrik Sahl

    2001-01-01

    Patients with cirrhosis and portal hypertension exhibit characteristic hemodynamic changes with hyperkinetic systemic circulation, abnormal distribution of blood volume and neurohumoral dysregulation. Their plasma and noncentral blood volumes are increased. Splanchnic vasodilation is of pathogenic...... significance to the low systemic vascular resistance and abnormal volume distribution of blood, which are important elements in the development of the concomitant cardiac dysfunction, recently termed 'cirrhotic cardiomyopathy'. Systolic and diastolic functions are impaired with direct relation to the degree...... of liver dysfunction. Significant pathophysiological mechanisms are reduced beta-adrenergic receptor signal transduction, defective cardiac excitation-contraction coupling and conductance abnormalities. Vasodilators such as nitric oxide and calcitonin gene-related peptide are among the candidates...

  20. Effect of breath holding on cerebrovascular hemodynamics in normal pregnancy and preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Zeeman, Gerda G.; Belfort, Michael A.

    2015-01-01

    Preeclampsia (PE) is associated with endothelial dysfunction and impaired autonomic function, which is hypothesized to cause cerebral hemodynamic abnormalities. Our aim was to test this hypothesis by estimating the difference in the cerebrovascular response to breath holding (BH; known to cause symp

  1. Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients

    Directory of Open Access Journals (Sweden)

    Eraldo Occhetta

    2011-01-01

    Full Text Available The rate adaptive sensors applied to cardiac pacing should respond as promptly as the normal sinus node with an highly specific and sensitive detection of the need of increasing heart rate. Sensors operating alone may not provide optimal heart responsiveness: central venous pH sensing, variations in the oxygen content of mixed venous blood, QT interval, breathing rate and pulmonary minute ventilation monitored by thoracic impedance variations, activity sensors. Using sensors that have different attributes but that work in a complementary manners offers distinct advantages. However, complicated sensors interactions may occur. Hemodynamic sensors detect changes in the hemodynamic performances of the heart, which partially depends on the autonomic nervous system-induced inotropic regulation of myocardial fibers. Specific hemodynamic sensors have been designed to measure different expression of the cardiac contraction strength: Peak Endocardial Acceleration (PEA, Closed Loop Stimulation (CLS and TransValvular Impedance (TVI, guided by intraventricular impedance variations. Rate-responsive pacing is just one of the potential applications of hemodynamic sensors in implantable pacemakers. Other issues discussed in the paper include: hemodynamic monitoring for the optimal programmation and follow up of patients with cardiac resynchronization therapy; hemodynamic deterioration impact of tachyarrhythmias; hemodynamic upper rate limit control; monitoring and prevention of vasovagal malignant syncopes.

  2. [Intracardiac hemodynamic changes in the newborns with respiratory distress syndrome].

    Science.gov (United States)

    Perepelitsa, S A; Korotkaia, M V; Pavlenko, O V; Golubev, A M

    2009-01-01

    The paper provides the results of intracardiac circulation ultrasound study in 37 preterm neonatal infants, including 24 patients with severe respiratory distress syndrome (RDS), receiving the exogenous surfactant Curosurf in the complex therapy of the disease. A control comprised 12 apparently healthy preterm neonates who had no clinical signs of RDS in the early adaptive period or artificial ventilation (AV). Both groups were similar in the major anthropometric characteristics and gestational age. The objective of this investigation was to make Doppler echocardiographic study of blood flow through all cardiac valves in the newborn with RDS during AV. The investigation indicated that the neonates with severe RDS had increases in peak blood flow velocity and in peak pressure gradient through the valves of the great vessels: the aorta and pulmonary trunk, and abnormal regurgitation flow mainly through the pulmonary arterial valve, which was a sign of intensive hemodynamic adaptation in the acute phase of disease. By the third day of life, some neonatal infants without clinical signs of RDS were observed to have signs of intensive hemodynamic adaptation: increases in peak blood flow velocity and in peak pressure gradient through the valves of the pulmonary trunk. Irrespective of the specific features of the course of an early neonatal period, neonatal infants need Doppler echocardiographic monitoring for the evaluation of intracardiac hemodynamics.

  3. Hemodynamic changes during robotic radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Vanlal Darlong

    2012-01-01

    Full Text Available Background: Effect on hemodynamic changes and experience of robot-assisted laparoscopic radical prostatectomy (RALRP in steep Trendelenburg position (45° with high-pressure CO 2 pneumoperitoneum is very limited. Therefore, we planned this prospective clinical trial to study the effect of steep Tredelenburg position with high-pressure CO 2 pneumoperitoneum on hemodynamic parameters in a patient undergoing RALRP using FloTrac/Vigileo™1.10. Methods: After ethical approval and informed consent, 15 patients scheduled for RALRP were included in the study. In the operation room, after attaching standard monitors, the radial artery was cannulated. Anesthesia was induced with fentanyl (2 μg/kg and thiopentone (4-7 mg/kg, and tracheal intubation was facilitated by vecuronium bromide (0.1 mg/kg. The patient′s right internal jugular vein was cannulated and the Pre Sep™ central venous oximetry catheter was connected to it. Anesthesia was maintained with isoflurane in oxygen and nitrous oxide and intermittent boluses of vecuronium. Intermittent positive-pressure ventilation was provided to maintain normocapnea. After CO 2 pneumoperitoneum, position of the patient was gradually changed to 45° Trendelenburg over 5 min. The robot was then docked and the robot-assisted surgery started. Intraoperative monitoring included central venous pressure (CVP, stroke volume (SV, stroke volume variation (SVV, cardiac output (CO, cardiac index (CI and central venous oxygen saturation (ScvO 2 . Results: After induction of anesthesia, heart rate (HR, SV, CO and CI were decreased significantly from the baseline value (P>0.05. SV, CO and CI further decreased significantly after creating pneumoperitoneum (P>0.05. At the 45° Trendelenburg position, HR, SV, CO and CI were significantly decreased compared with baseline. Thereafter, CO and CI were persistently low throughout the 45° Trendelenburg position (P=0.001. HR at 20 min and 1 h, SV and mean arterial blood pressure

  4. Diagnosis and treatment guidelines for aberrant portal hemodynamics: The Aberrant Portal Hemodynamics Study Group supported by the Ministry of Health, Labor and Welfare of Japan.

    Science.gov (United States)

    2017-01-06

    Idiopathic portal hypertension (IPH), causing aberrant portal hemodynamics, is a disease with an as yet unidentified cause and no established treatment protocol. The Japanese research group on IPH in Japan was set up in 1975 by the Ministry of Health, Labor and Welfare. Extrahepatic portal obstruction and Budd-Chiari syndrome (BCS) have since been added to the group's research subjects. The aims of the research group are to accurately evaluate the current status of the three diseases in Japan, elucidate their etiology and pathogenesis, and develop new treatments. Due to the long-term efforts of the Japanese research group, aberrant portal hemodynamics has been investigated in a variety of aspects, from epidemiological and pathological studies to molecular biology analyses. As a result, it has been shown that there are abnormal genes in the liver, specific for IPH. In addition, pathological findings of BCS were internationally compared and the difference in findings between Japan and Europe (or North America) has been clarified. Furthermore, it was found that complication rates of hepatocellular carcinoma in BCS were higher in Japan. Based on the research, "Diagnosis and treatment of aberrant portal hemodynamics (2001)", including diagnostic criteria for aberrant portal hemodynamics, was published in 2001. In 2013, it was revised to "Diagnosis and treatment guidelines for aberrant portal hemodynamics (2013)" after the incorporation of diagnosis and treatment in accordance with its current status.

  5. Altering hemodynamics leads to congenital heart defects (Conference Presentation)

    Science.gov (United States)

    Ford, Stephanie M.; McPheeters, Matthew T.; Wang, Yves T.; Gu, Shi; Doughman, Yong Qiu; Strainic, James P.; Rollins, Andrew M.; Watanabe, Michiko; Jenkins, Michael W.

    2016-03-01

    The role of hemodynamics in early heart development is poorly understood. In order to successfully assess the impact of hemodynamics on development, we need to monitor and perturb blood flow, and quantify the resultant effects on morphology. Here, we have utilized cardiac optical pacing to create regurgitant flow in embryonic hearts and OCT to quantify regurgitation percentage and resultant morphology. Embryonic quail in a shell-less culture were optically paced at 3 Hz (well above the intrinsic rate or 1.33-1.67 Hz) on day 2 of development (3-4 weeks human) for 5 minutes. The pacing fatigued the heart and led to a prolonged period (> 1 hour) of increased regurgitant flow. Embryos were kept alive until day 3 (cardiac looping - 4-5 weeks human) or day 8 (4 chambered heart - 8 weeks human) to quantify resultant morphologic changes with OCT. All paced embryos imaged at day 3 displayed cardiac defects. The extent of regurgitant flow immediately after pacing was correlated with cardiac cushion size 24-hours post pacing (p-value congenital heart defects (CHDs) including 11/18 with valve defects, 5/18 with ventricular septal defects and 5/18 with hypoplastic right ventricles. Our data suggests that regurgitant flow leads to smaller cushions, which develop into abnormal valves and septa. Our model produces similar phenotypes as found in our fetal alcohol syndrome and velo-cardio-facial/DiGeorge syndrome models suggesting that hemodynamics plays a role in these syndromes as well. Utilizing OCT and optical pacing to understand hemodynamics in development is an important step towards determining CHD mechanisms and ultimately developing earlier treatments.

  6. Application of ultrasound differential diagnosis in abnormalities of fetus central nerve system%超声鉴别诊断技术在胎儿中枢神经系统畸形诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    邓学东; 李红; 梁青; 常红梅; 姜小力; 唐亚奇; 梁泓; 冯鸿; 陆伟

    2011-01-01

    Objective To improve the clinical application of ultrasound differential diagnosis in abnormalities of fetus central nerve system. Methods Ultrasound imaging features in 217 cases of abnormalities in central nerve system confirmed by autopsy or follow-up were analyzed retrospectively. Results A total of 217 cases of anomaly in the central never system were examined prenatally by ultrasound and each showed typical imaging feature. Among these cases , there were 45 cases of anencephaly, 4 cases of hydranencephaly, 5 cases of arachnoid' s cyst, 2 cases of aneurysm of the vein of Galen, 78 cases of ventriculomegaly ( among them 46 cases of aqueduct stenosis), 13 cases of cephalocele, 17 cases of Dandy-Walker complex, 23 cases of spina bifida, 9 cases of holoprosencephaly, 5 cases of agenesis of the corpus callosum,8 cases of sacrococcygeal teratoma and 8 cases of choroid plexus cysts.Conclusion Application of ultrasound differential diagnosis by ultrasound for detection of abnormalities in fetus central nerve system( i. e. three sections and 12clues ), is extremely important.%目的 探讨产前超声鉴别诊断技术在胎儿中枢神经系统畸形诊断中的应用.方法 对经随访或引产证实217例中枢神经系统畸形的声像图特征进行回顾性分析.结果 产前超声诊断217例胎儿中枢神经系统畸形,其中无脑儿45例、水脑畸形4例、蛛网膜囊肿5例、Galen静脉瘤2例、脑室扩张78例(其中46例是中脑导水管狭窄)、脑膨出13例、Dandy-Walker综合征17例、开放性脊柱裂23例、前脑无裂畸形9例、胼胝体缺失5例、骶尾部畸胎瘤8例、脉络丛囊肿8例.结论 掌握超声检查胎儿中枢神经系统畸形的鉴别诊断技术,即三个切面和12种分析思路,对产前超声检查极为重要.

  7. Bicuspid aortic valve hemodynamics: a fluid-structure interaction study

    Science.gov (United States)

    Chandra, Santanu; Seaman, Clara; Sucosky, Philippe

    2011-11-01

    The bicuspid aortic valve (BAV) is a congenital defect in which the aortic valve forms with two leaflets instead of three. While calcific aortic valve disease (CAVD) also develops in the normal tricuspid aortic valve (TAV), its progression in the BAV is more rapid. Although studies have suggested a mechano-potential root for the disease, the native BAV hemodynamics remains largely unknown. This study aimed at characterizing BAV hemodynamics and quantifying the degree of wall-shear stress (WSS) abnormality on BAV leaflets. Fluid-structure interaction models validated with particle-image velocimetry were designed to predict the flow and leaflet dynamics in idealized TAV and BAV anatomies. Valvular function was quantified in terms of the effective orifice area. The regional leaflet WSS was characterized in terms of oscillatory shear index, temporal shear magnitude and temporal shear gradient. The predictions indicate the intrinsic degree of stenosis of the BAV anatomy, reveal drastic differences in shear stress magnitude and pulsatility on BAV and TAV leaflets and confirm the side- and site-specificity of the leaflet WSS. Given the ability of abnormal fluid shear stress to trigger valvular inflammation, these results support the existence of a mechano-etiology of CAVD in the BAV.

  8. Time series analysis of satellite multi-sensors imagery to study the recursive abnormal grow of floating macrophyte in the lake victoria (central Africa)

    Science.gov (United States)

    Fusilli, Lorenzo; Cavalli, Rosa Maria; Laneve, Giovanni; Pignatti, Stefano; Santilli, Giancarlo; Santini, Federico

    2010-05-01

    integrated use of satellite resources allowed the estimate of the temporal variability of physical parameters that were used to i) sample the spatio-temporal distribution of the whole floating vegetation (i.e. native vegetation and weed) and ii) assess the seasonal recurrence of the abnormal weeds grow, as well as, their possible relation with the hydrological regimes of the rivers. The paper describes how the 2000 - 2009 MODIS images time series, were analysed (navigated and processed) to derive i) the map the floating vegetation on the test area and ii) identify the areas more interested by the growing iii) to discriminate, whenever possible, according to the spectral and spatial resolution of the sensor applied (i.e. LANDSAT, ASTER, CHRIS), the different vegetation species in order to discriminate the weeds from the floating vegetation. The spectral identification of the different species was performed by exploiting the results of a field campaign performed in the past along the Kenyan coastal areas devoted to define a data base of spectral signatures of the main species. Spectral information was treated to define indexes and spectral analysis procedure customized to multispectral high resolution satellite data. Moreover, the results of the images time series has been analysed to identify a possible definition of the temporal occurrence of the floating vegetation growing considering both the natural phenomenological cycles and the conditions related to the abnormal growing. These results, whenever related to ancillary hydrological information (e.g. the amount of rain), they have shown that the synergy of MODIS images time series with lower temporal frequency time series imagery is a powerful tool to monitor the lake Victoria ecosystem and to follow the floating vegetation extension and even to foresee the possibility to set up a model for the abnormal vegetation growing.

  9. Discussion on the value of standardized ultrasound screening for fetal central nerve system abnormalities%产前超声筛查在胎儿神经管畸形中的价值探讨

    Institute of Scientific and Technical Information of China (English)

    刘晶; 张巧莲; 宋涛

    2015-01-01

    Objective To evaluate the clinical value of standardized ultrasound screening for fetal central nerve system abnormalities.Methods During the period of Feb.2008 and Feb.2014 3 056 pregnancy women were subjected to ultrasound screening in our hospital.The structures,such as the head and spine were scanned in detail.Results Eighty-seven fetus with fetal central nerve system abnormalities were ex-amined prenatally by ultrasound and each showed typical imaging feature.Among these cases,there were 32 cases of hydrocephalus,5 cases of holoprosencephaly,11 cases of anencephaly,1 cases of iniencephaly, 8 cases of choroid plexus cysts,3 cases of Dandy-Walker complex,6 cases of cephalocele,19 cases of spina bifida and 2 cases of scoliosis.Conclusion Standardized ultrasound screening is of great value to screen fe-tal abnormality,which can reduce the risk of medical treatment in fetal abnormality screening.%目的:探讨产前超声筛查在胎儿神经管缺陷中的应用价值。方法参考国际妇产超声学会(ISUOG)操作规范,对2008年2月-2014年2月在新疆医科大学第一附属医院就诊的3056例孕妇进行了产前超声筛查,系统检查胎儿头颅、脊柱等结构,对其病例资料进行回顾性分析。结果3056例胎儿中共检出胎儿神经管缺陷87例,其中脑室扩张32例,前脑无裂畸形5例,无脑儿11例,露脑畸形1例,脉络膜囊肿8例,Dandy-walker 畸形3例,脑脊膜膨出4例,脑膜脑膨出2例,脊柱裂19例,半椎体畸形2例。结论产前超声筛查能够最大限度地检出胎儿神经管畸形,对减少漏诊率、降低医疗风险具有重要的临床意义。

  10. Value of Ultrasound Screening for Fetal Central Nerve System Abnormalities in Second Trimester%中孕期产前超声筛查在胎儿神经管缺陷中的应用价值

    Institute of Scientific and Technical Information of China (English)

    刘晶; 宋涛

    2014-01-01

    Objective To evaluate the clinical value of ultrasound screening for fetal central nerve system abnormalities in second trimester.Methods During the period of Feb. 2008 and Sep. 2013 2 661 pregnancy women were subjected to ultrasound screening in second trimester in our hospital. The structures, such as the head and spine were scanned in detail.ResultsEighty-seven fetus with fetal central nerve system abnormalities were examined prenatally by ultrasound and each showed typical imaging feature. Among these cases, there were 32 cases of hydrocephalus, 5 cases of holoprosencephaly, 11 cases of anencephaly, 8 cases of choroid plexus cysts, 6 cases of cephalocele, 19 cases of spina biifda, 1 cases of iniencephaly, 3 cases of Dandy-Walker complex and 2 cases of scoliosis. The cases of no more than 5 temporarily were not discussed in this paper.Conclusion Ultrasound screening in second trimester is of great value to screen fetal abnormality, which can reduce the risk of medical treatment in fetal abnormality screening.%目的:探讨中孕期产前超声筛查在胎儿神经管缺陷中的应用价值。方法2008年2月~2013年9月间,参考国际妇产超声学会(ISUOG)操作规范,对2661例孕妇进行了中孕期产前超声筛查,系统检查胎儿头颅、脊柱等结构。结果2661例胎儿中共检出胎儿神经管缺陷81例,其中脑室扩张32例,前脑无裂畸形5例,无脑儿11例,脉络膜囊肿8例,脑脊膜膨出6例,脊柱裂19例。结论中孕期产前超声筛查能够最大限度地检出胎儿神经管畸形,对减少漏诊率、降低医疗风险具有重要的临床意义。

  11. Evaluation of the hemodynamic impact of continuous renal replacement therapy in healthy dogs.

    Science.gov (United States)

    Shimokawa Miyama, Takako; Itamoto, Kazuhito; Yoshioka, Chihiro; Minami, Koji; Okawa, Takumi; Fujisaki, Yuka; Hiraoka, Hiroko; Mizuno, Takuya; Okuda, Masaru

    2010-04-01

    We performed continuous renal replacement therapy (CRRT) on clinically healthy dogs to evaluate the effects of CRRT on hemodynamics. Heart rate, arterial blood pressure, and central venous pressure of the dogs (n=6) were recorded during the procedure, which was performed under general anesthesia. Throughout the CRRT, heart rate and arterial blood pressure were stable. Central venous pressure increased after CRRT termination but returned to the basal level within 30 min. In this study, hemodynamic alterations, including hypotension, hypertension, and arrhythmias, were not observed during CRRT. These observations suggest that the CRRT protocol used in the present study can be safely applied to clinical cases with acute renal failure.

  12. Invasive hemodynamic monitoring in the postoperative period of cardiac surgery

    Directory of Open Access Journals (Sweden)

    Desanka Dragosavac

    1999-08-01

    Full Text Available OBJETIVE: To assess the hemodynamic profile of cardiac surgery patients with circulatory instability in the early postoperative period (POP. METHODS: Over a two-year period, 306 patients underwent cardiac surgery. Thirty had hemodynamic instability in the early POP and were monitored with the Swan-Ganz catheter. The following parameters were evaluated: cardiac index (CI, systemic and pulmonary vascular resistance, pulmonary shunt, central venous pressure (CVP, pulmonary capillary wedge pressure (PCWP, oxygen delivery and consumption, use of vasoactive drugs and of circulatory support. RESULTS: Twenty patients had low cardiac index (CI, and 10 had normal or high CI. Systemic vascular resistance was decreased in 11 patients. There was no correlation between oxygen delivery (DO2 and consumption (VO2, p=0.42, and no correlation between CVP and PCWP, p=0.065. Pulmonary vascular resistance was decreased in 15 patients and the pulmonary shunt was increased in 19. Two patients with CI < 2L/min/m² received circulatory support. CONCLUSION: Patients in the POP of cardiac surgery frequently have a mixed shock due to the systemic inflammatory response syndrome (SIRS. Therefore, invasive hemodynamic monitoring is useful in handling blood volume, choice of vasoactive drugs, and indication for circulatory support.

  13. A Signal Processing Approach for Detection of Hemodynamic Instability before Decompensation.

    Science.gov (United States)

    Belle, Ashwin; Ansari, Sardar; Spadafore, Maxwell; Convertino, Victor A; Ward, Kevin R; Derksen, Harm; Najarian, Kayvan

    2016-01-01

    Advanced hemodynamic monitoring is a critical component of treatment in clinical situations where aggressive yet guided hemodynamic interventions are required in order to stabilize the patient and optimize outcomes. While there are many tools at a physician's disposal to monitor patients in a hospital setting, the reality is that none of these tools allow hi-fidelity assessment or continuous monitoring towards early detection of hemodynamic instability. We present an advanced automated analytical system which would act as a continuous monitoring and early warning mechanism that can indicate pending decompensation before traditional metrics can identify any clinical abnormality. This system computes novel features or bio-markers from both heart rate variability (HRV) as well as the morphology of the electrocardiogram (ECG). To compare their effectiveness, these features are compared with the standard HRV based bio-markers which are commonly used for hemodynamic assessment. This study utilized a unique database containing ECG waveforms from healthy volunteer subjects who underwent simulated hypovolemia under controlled experimental settings. A support vector machine was utilized to develop a model which predicts the stability or instability of the subjects. Results showed that the proposed novel set of features outperforms the traditional HRV features in predicting hemodynamic instability.

  14. Pharmacological Modulation of Hemodynamics in Adult Zebrafish In Vivo.

    Directory of Open Access Journals (Sweden)

    Daniel Brönnimann

    Full Text Available Hemodynamic parameters in zebrafish receive increasing attention because of their important role in cardiovascular processes such as atherosclerosis, hematopoiesis, sprouting and intussusceptive angiogenesis. To study underlying mechanisms, the precise modulation of parameters like blood flow velocity or shear stress is centrally important. Questions related to blood flow have been addressed in the past in either embryonic or ex vivo-zebrafish models but little information is available for adult animals. Here we describe a pharmacological approach to modulate cardiac and hemodynamic parameters in adult zebrafish in vivo.Adult zebrafish were paralyzed and orally perfused with salt water. The drugs isoprenaline and sodium nitroprusside were directly applied with the perfusate, thus closely resembling the preferred method for drug delivery in zebrafish, namely within the water. Drug effects on the heart and on blood flow in the submental vein were studied using electrocardiograms, in vivo-microscopy and mathematical flow simulations.Under control conditions, heart rate, blood flow velocity and shear stress varied less than ± 5%. Maximal chronotropic effects of isoprenaline were achieved at a concentration of 50 μmol/L, where it increased the heart rate by 22.6 ± 1.3% (n = 4; p < 0.0001. Blood flow velocity and shear stress in the submental vein were not significantly increased. Sodium nitroprusside at 1 mmol/L did not alter the heart rate but increased blood flow velocity by 110.46 ± 19.64% (p = 0.01 and shear stress by 117.96 ± 23.65% (n = 9; p = 0.03.In this study, we demonstrate that cardiac and hemodynamic parameters in adult zebrafish can be efficiently modulated by isoprenaline and sodium nitroprusside. Together with the suitability of the zebrafish for in vivo-microscopy and genetic modifications, the methodology described permits studying biological processes that are dependent on hemodynamic alterations.

  15. Comparison of tricuspid and bicuspid aortic valve hemodynamics under steady flow conditions

    Science.gov (United States)

    Seaman, Clara; Ward, James; Sucosky, Philippe

    2011-11-01

    The bicuspid aortic valve (BAV), a congenital valvular defect consisting of two leaflets instead of three, is associated with a high prevalence of calcific aortic valve disease (CAVD). CAVD also develops in the normal tricuspid aortic valve (TAV) but its progression in the BAV is more severe and rapid. Although hemodynamic abnormalities are increasingly considered potential pathogenic contributor, the native BAV hemodynamics remain largely unknown. Therefore, this study aims at comparing experimentally the hemodynamic environments in TAV and BAV anatomies. Particle-image velocimetry was used to characterize the flow downstream of a native TAV and a model BAV mounted in a left-heart simulator and subjected to three steady flow rates characterizing different phases of the cardiac cycle. While the TAV developed a jet aligned along the valve axis, the BAV was shown to develop a skewed systolic jet with skewness decreasing with increasing flow rate. Measurement of the transvalvular pressure revealed a valvular resistance up to 50% larger in the BAV than in the TAV. The increase in velocity between the TAV and BAV leads to an increase in shear stress downstream of the valve. This study reveals strong hemodynamic abnormalities in the BAV, which may contribute to CAVD pathogenesis.

  16. Immediate hemodynamic response to furosemide in patients undergoing chronic hemodialysis.

    Science.gov (United States)

    Schmieder, R E; Messerli, F H; deCarvalho, J G; Husserl, F E

    1987-01-01

    To evaluate the effect of furosemide on cardiovascular hemodynamics in patients with end-stage renal failure, we studied ten patients undergoing hemodialysis three times a week. Arterial pressure, heart rate, and cardiac output (indocyanine green dye) were measured in triplicate; total peripheral resistance and central blood volume were calculated by standard formulas. Hemodynamics were determined at baseline and 5, 10, 15, and 30 minutes after intravenous (IV) bolus injection of furosemide 60 mg. Furosemide produced a decrease in central blood volume of -13% +/- 2.2% from pretreatment values (P less than .01) that was most pronounced five minutes after injection, together with a fall in cardiac output (from 6.76 +/- 0.59 to 6.17 +/- 0.52 L/min, P less than .10). Stroke volume decreased with a maximum fall occurring after 15 minutes (from 84 +/- 7 to 79 +/- 7 mL/min, P less than .05), and total peripheral resistance increased (from 15.8 +/- 2.1 to 17.8 +/- 2.3 units, P less than .05) after furosemide. Arterial pressure and heart rate did not change. The decrease in central blood volume reflects a shift of the total blood volume from the cardiopulmonary circulation to the periphery, suggesting dilation of the peripheral venous bed. Thus, even in patients undergoing hemodialysis, furosemide acutely decreases left ventricular preload by venous dilation and should therefore prove to be beneficial in acute volume overload.

  17. Effects of Obesity on Cardiovascular Hemodynamics, Cardiac Morphology, and Ventricular Function.

    Science.gov (United States)

    Alpert, Martin A; Omran, Jad; Bostick, Brian P

    2016-12-01

    Obesity produces a variety of hemodynamic alterations that may cause changes in cardiac morphology which predispose to left and right ventricular dysfunction. Various neurohormonal and metabolic alterations commonly associated with obesity may contribute to these abnormalities of cardiac structure and function. These changes in cardiovascular hemodynamics, cardiac morphology, and ventricular function may, in severely obese patients, predispose to heart failure, even in the absence of other forms of heart disease (obesity cardiomyopathy). In normotensive obese patients, cardiac involvement is commonly characterized by elevated cardiac output, low peripheral vascular resistance, and increased left ventricular (LV) end-diastolic pressure. Sleep-disordered breathing may lead to pulmonary arterial hypertension and, in association with left heart failure, may contribute to elevation of right heart pressures. These alterations, in association with various neurohormonal and metabolic abnormalities, may produce LV hypertrophy; impaired LV diastolic function; and less commonly, LV systolic dysfunction. Many of these alterations are reversible with substantial voluntary weight loss.

  18. Clinical study on direct pulp capping of Dycal for broken abnormal central cusp teeth%Dycal直接盖髓在畸形中央尖折断治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    林青

    2011-01-01

    选择2006-07~2008-09济南市口腔医院儿童牙科就诊的畸形中央尖患者36 例,患牙58 颗.分别采用调磨、Dycal直接盖髓、活髓切断术治疗畸形中央尖患牙,追踪观察2 年,以了解不同治疗方法在预防畸形中央尖折断的临床疗效.总结分析以后,我们认为是早期局麻下去除中央尖用Dycal直接盖髓的方法更为可取.%58 abnormal central cusp teeth collected from 36 cases were treated in the department of pediatric dentistry of Jinan Stomatologic Hospital during July in 2006 to September in 2008. Grinding, direct pulp capping treatment of Dycal and vital pulpotomy were used and 2 year follow up was performed. Results show that early removal of the central cusp under local anesthesia with direct pulp capping of Dycal is a more desirable approach.

  19. Clinical value of prenatal ultrasound diagnosis of fetal central nervous system abnormalities%产前超声诊断胎儿神经系统畸形的临床价值

    Institute of Scientific and Technical Information of China (English)

    韩磊; 沈亚梅; 彭建美; 管湘平; 王珍芳; 邹荣莉

    2016-01-01

    Objective To evaluate the clinical value of prenatal routine ultrasound examination in screening of fetal central nervous system abnormalities.Methods Ultrasound imaging features of 27 cases of abnormalities in central nervous system confirmed by autopsy or follow-up were analyzed retrospectively.Results Among these cases, there were 11 cases of spine bifida and meningomyelocele, 3 cases of Dandy-Walker syndrome ( DWS) , 3 cases of cephalocele, 3 cases of hydrocephalus, 1 case of anencephaly, 2 cases of holoprosencephaly, 2 cases of agenesis of corpus callosum, 1 cases of choroid plexus cysts, and 1 case of arachnoid cyst.The accuracy, misdiagnosis rate and missed diagnosis rate of prenatal ultrasound examination was 88.90%, 7.40%and 7.40%, respectively.Conclusion Prenatal ultrasound examination has high diagnostic accuracy for fetal central nervous system malformations, and it has very important clinical value.%目的 探讨产前常规超声检查在胎儿神经系统畸形筛查方面的临床应用价值.方法 对27例经随访及引产证实的中枢神经系统畸形胎儿进行回顾性分析.结果 27例畸形儿中,其中脊柱裂和脊髓脊膜膨出11例,Dandy-Walker畸形3例,脑脊膜膨出3例,脑积水3例,无脑儿1例,全前脑2例,胼胝体发育不全2例,脉络丛囊肿1例,蛛网膜囊肿1例,产前超声诊断准确率为88.90%,误诊率7.40%,漏诊率7.40%.结论 产前超声检查对胎儿中枢神经系统畸形诊断准确率高,具有十分重要的临床应用价值.

  20. [Characteristic features of systemic hemodynamics during cesarean section under general anesthesia with ketamine].

    Science.gov (United States)

    Moiseev, V N

    1983-02-01

    On the basis of a comparative investigation of the central hemodynamics by the method of integrative rheography of the body in two groups of women during the operation of cesarean section under general anesthesia with ether or ketamin the author makes a conclusion that ketamin is a good drug for anesthesia in urgent surgical situations.

  1. The renin-angiotensin system in obesity : metabolic and hemodynamic effects

    NARCIS (Netherlands)

    Goossens, G.H.

    2006-01-01

    Abdominal obesity plays a central role in the metabolic syndrome and is a major risk factor for type 2 diabetes mellitus and cardiovascular disease. Unravelling the underlying mechanisms of obesity and obesity-related metabolic and hemodynamic disorders, such as insulin resistance and hypertension,

  2. Tempol improves renal hemodynamics and pressure natriuresis in hyperthyroid rats.

    Science.gov (United States)

    Moreno, Juan Manuel; Rodríguez Gómez, Isabel; Wangensteen, Rosemary; Alvarez-Guerra, Miriam; de Dios Luna, Juan; García-Estañ, Joaquín; Vargas, Félix

    2008-03-01

    Hyperthyroidism in rats is associated with increased oxidative stress. These animals also show abnormal renal hemodynamics and an attenuated pressure-diuresis-natriuresis (PDN) response. We analyzed the role of oxidative stress as a mediator of these alterations by examining acute effects of tempol, a superoxide dismutase mimetic. The effects of increasing bolus doses of tempol (25-150 micromol/kg) on mean arterial pressure (MAP), renal vascular resistance (RVR), and cortical (CBF) and medullary (MBF) blood flow were studied in control and thyroxine (T4)-treated rats. In another experiment, tempol was infused at 150 micromol.kg(-1).h(-1) to analyze its effects on the glomerular filtration rate (GFR) and on PDN response in these animals. Tempol dose dependently decreased MAP and RVR and increased CBF and MBF in control and T4-treated rats, but the T4 group showed a greater responsiveness to tempol in all of these variables. The highest dose of tempol decreased RVR by 13.5 +/- 2.1 and 5.5 +/- 1.2 mmHg.ml(-1).min(-1) in hyperthyroid (P natriuresis (T4+tempol: 0.17 +/- 0.05; T4: 0.09 +/- 0.03 microeq.min(-1).g(-1).mmHg(-1); P < 0.05) and reduced 8-isoprostane excretion in hyperthyroid rats. These results show that antioxidant treatment with tempol improves renal hemodynamic variables and PDN response in hyperthyroid rats, indicating the participation of an increased oxidative stress in these mechanisms.

  3. Immunologic, hemodynamic, and adrenal incompetence in cirrhosis

    DEFF Research Database (Denmark)

    Risør, Louise Madeleine; Bendtsen, Flemming; Møller, Søren

    2015-01-01

    dysfunction, but is not responsive to volume expansion. Recent research indicates that development of hepatic nephropathy represents a continuous spectrum of functional and structural dysfunction and may be precipitated by the inherent immunologic, adrenal, and hemodynamic incompetence in cirrhosis. New...... research explores several new markers of renal dysfunction that may replace serum creatinine in the future and give new insight on the hepatic nephropathy. Our understanding of the pathophysiological mechanisms causing the immunologic, adrenal, and hemodynamic incompetence, and the impact on renal...

  4. Effect of iptakalim hydrochloride on hemodynamics

    Institute of Scientific and Technical Information of China (English)

    Qing-leiZHU; HaiWANG; Wen-binXIAO

    2004-01-01

    AIM: To study the effect of iptakalim hydrochloride (Ipt) on hemodynamics. METHODS: Effect of Ipt on hemodynamics were studied in anesthetized nomotensive dogs, conscious nomotensive rats (NTR), and stroke prone spontaneously hypertensive rats (SHRsp), respectively. RESULTS: In pentobarbital anesthetized nomotensive dogs, Ipt at doses of 0.125, 0.25, 0.5,1.0, and 2.0 mg/kg iv could dose-dependently decrease blood pressure (BP), with the decrease of systolic BP equivalent

  5. Hemodynamic changes in depressive patients

    Institute of Scientific and Technical Information of China (English)

    MA Ying; LI Hui-chun; ZHENG Lei-lei; YU Hua-liang

    2006-01-01

    Objective: This study is aimed at exploring the relationship between hemodynamic changes and depressive and anxious symptom in depression patients. Methods: The cardiac function indices including the left stroke index (LSI), ejection fraction (EF), heart rate (HR), diastolic pressure mean (DPM), systolic pressure mean (SPM), left ventricle end-diastolic volume (LVDV), effective circulating volume (ECV), resistance total mean (RTM) and blood flow smooth degree (BFSD) were determined in 65 patients with major depressive disorders and 31 healthy normal controls. The clinical symptoms were assessed with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA). Results: In patients with depression without anxiety,LSI, EF, LVDV, DPM, SPM, ECV, BFSD were significantly lower than those in controls, while RTM was higher than that in controls. Patients with comorbidity of depression and anxiety showed decreased LVDV, ECV, BFSD, and increased HR in comparison with the controls. The anxiety/somatization factor score positively correlated with LSI, EF, LVDV, but negatively correlated with RTM. There was negative correlation between retardation factor score and DPM, SPM, LVDV. Conclusion: The study indicated that there are noticeable changes in left ventricle preload and afterload, blood pressure, peripheral resistance, and microcirculation in depressive patients, and that the accompanying anxiety makes the changes more complicated.

  6. Central nervous system abnormalities on midline facial defects with hypertelorism detected by magnetic resonance image and computed tomography; Anomalias de sistema nervoso central em defeitos de linha media facial com hipertelorismo detectados por ressonancia magnetica e tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Vera Lucia Gil da Silva; Giffoni, Silvio David Araujo [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Faculdade de Ciencias Medicas. Dep. de Genetica Medica]. E-mail: vlopes@fcm.unicamp.br

    2006-10-15

    The aim of this study were to describe and to compare structural central nervous system (CNS) anomalies detected by magnetic resonance image (MRI) and computed tomography (CT) in individuals affected by midline facial defects with hypertelorism (MFDH) isolated or associated with multiple congenital anomalies (MCA). The investigation protocol included dysmorphological examination, skull and facial X-rays, brain CT and/or MRI. We studied 24 individuals, 12 of them had an isolated form (Group I) and the others, MCA with unknown etiology (Group II). There was no significant difference between Group I and II and the results are presented in set. In addition to the several CNS anomalies previously described, MRI (n=18) was useful for detection of neuronal migration errors. These data suggested that structural CNS anomalies and MFDH seem to have an intrinsic embryological relationship, which should be taken in account during the clinical follow-up. (author)

  7. The hemodynamic effects of ibopamine, a dopamine congener, in patients with congestive heart failure.

    Science.gov (United States)

    Leier, C V; Ren, J H; Huss, P; Unverferth, D V

    1986-01-01

    Ten patients with congestive heart failure underwent noninvasive and invasive hemodynamic testing before and sequentially after the administration of ibopamine to determine the cardiovascular effects of this oral dopamine congener. Single doses of 200, 400 and 600 mg were administered to all patients and 5 repeated doses of 200 or 400 mg were studied in 8. Hemodynamic effects occurred as early as 30 minutes and lasted up to 4 hours after dosing. In general, ibopamine elicited statistically significant dose-related increases in cardiac output and reductions in the derived resistance of the systemic and pulmonary circulations. A biphasic response in central and peripheral pressures was observed; up to 1 hour after administration, ibopamine elevated mean right and left atrial pressures and pulmonary and systemic arterial pressures with a significant reduction of these measurements beyond 1 hour. It did not alter heart rate. Repeated doses qualitatively affected hemodynamics similar to the initial dose and did not appear to be accompanied by short-term tolerance. While oral ibopamine elicits some favorable hemodynamic effects in humans with cardiac failure, the biphasic hemodynamic response is generally undesirable in the majority of these patients.

  8. MTA在前磨牙畸形中央尖预防性盖髓术中的疗效观察%Clinical observation of MTA applied to the preventive pulp capping of premolar abnormal central cusp

    Institute of Scientific and Technical Information of China (English)

    赵献平; 徐芳

    2015-01-01

    目的:观察MTA在前磨牙畸形中央尖预防性盖髓术中的疗效。方法选择2011年7月~2013年7月在我科就诊的未感染前磨牙高陡畸形中央尖患者66例牙齿78颗,随机分为两组,分别用MTA和氢氧化钙进行预防性盖髓,术后3、6、12个月及2年后复查,观察疗效,评价疗效。结果术后3个月复查,MTA组成功率为97%,Dycal组成功率为95%,比较两组近期疗效,差异无统计学意义(P>0.05),术后2年复查, MTA组成功率为95%,Dycal组为72%,比较两组之间远期疗效,MTA组明显高于Dycal组,差异有统计学意义(P<0.05)。结论应用MTA行前磨牙畸形中央尖预防性盖髓术是一种较好的治疗方法。%Objective To observe the clinical effect of MTA applied to preventive pulp capping of prenmolar abnormal central cusp.Methods 78 unifected premolar steep abnormal central cusp teeth collected from 66 case were treated in our department of our hospital during June in 2011 to June in 2013.They were randomly divided into two groups .MTA was used in preventive pulp capping in the experimental group while Dycal was applied in the control group.At each (3、6、12months and two group),the teeth were assessed dimically to evaluate clinical effect.Results After three months ,the treatment success rate of the MTA group was 97% and the treatment success rate of the Dycal group was 95%.There was no statistically significant difference at the shot term clinical effect between the two groups(P>0.05).After two years ,the treatment success rate of the MTA group was 95% and the treatment success rate of the Dycal group was 72% ,The long term clinical effect of the treatment with MTA was better than Dycal in preventive pulp capping(P<0.05). Conclusion MTA applied to the preventive pulp capping of central cusp deformity is a better way.

  9. Patient-Specific Modeling of Interventricular Hemodynamics in Single Ventricle Physiology

    Science.gov (United States)

    Vedula, Vijay; Feinstein, Jeffrey; Marsden, Alison

    2016-11-01

    Single ventricle (SV) congenital heart defects, in which babies are born with only functional ventricle, lead to significant morbidity and mortality with over 30% of patients developing heart failure prior to adulthood. Newborns with SV physiology typically undergo three palliative surgeries, in which the SV becomes the systemic pumping chamber. Depending on which ventricle performs the systemic function, patients are classified as having either a single left ventricle (SLV) or a single right ventricle (SRV), with SRV patients at higher risk of failure. As the native right ventricles are not designed to meet systemic demands, they undergo remodeling leading to abnormal hemodynamics. The hemodynamic characteristics of SLVs compared with SRVs is not well established. We present a validated computational framework for performing patient-specific modeling of ventricular flows, and apply it across 6 SV patients (3SLV + 3SRV), comparing hemodynamic conditions between the two subgroups. Simulations are performed with a stabilized finite element method coupled with an immersed boundary method for modeling heart valves. We discuss identification of hemodynamic biomarkers of ventricular remodeling for early risk assessment of failure. This research is supported in part by the Stanford Child Health Research Institute and the Stanford NIH-NCATS-CTSA through Grant UL1 TR001085 and due to U.S. National Institute of Health through NIH NHLBI R01 Grants 5R01HL129727-02 and 5R01HL121754-03.

  10. Cerebral hemodynamics: concepts of clinical importance

    Directory of Open Access Journals (Sweden)

    Edson Bor-Seng-Shu

    2012-05-01

    Full Text Available Cerebral hemodynamics and metabolism are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke, with several pathophysiological mechanisms of injury. The resultant uncoupling of cerebral blood flow and metabolism can trigger secondary brain lesions, particularly in early phases, consequently worsening the patient's outcome. Cerebral blood flow regulation is influenced by blood gas content, blood viscosity, body temperature, cardiac output, altitude, cerebrovascular autoregulation, and neurovascular coupling, mediated by chemical agents such as nitric oxide (NO, carbon monoxide (CO, eicosanoid products, oxygen-derived free radicals, endothelins, K+, H+, and adenosine. A better understanding of these factors is valuable for the management of neurocritical care patients. The assessment of both cerebral hemodynamics and metabolism in the acute phase of neurocritical care conditions may contribute to a more effective planning of therapeutic strategies for reducing secondary brain lesions. In this review, the authors have discussed concepts of cerebral hemodynamics, considering aspects of clinical importance.

  11. Urine - abnormal color

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  12. [Hemodynamic evaluation of the patient with microvarices].

    Science.gov (United States)

    Alvarez Sánchez, J A; Vega Gómez, M E; Rodríguez Lacaba, B; Martínez Griñán, M A

    1992-01-01

    The present study included 21 lower limbs with micro varicosities, 56 lower limbs with retrograde flow-varicosities (positive Rivlin) and 35 health lower limbs. Technics used for diagnosis were: Doppler ultrasonography and strain gauge plethysmography. We found a higher incidence of valvular failure on the varicose patients with retrograde flow (showing changes on their viscoelastic features of their venous walls). On the contrary, patient with microvaricosities showed an hemodynamics similar to the healty patient: we did not found any difference on the variables analyzed between the two groups. We conclude that the presence of microvaricosities has no influence on the analyzed hemodynamic parametres.

  13. Antiangiogenic factors and maternal hemodynamics during intensive hemodialysis in pregnancy.

    Science.gov (United States)

    Cornelis, Tom; Spaanderman, Marc; Beerenhout, Charles; Perschel, Frank H; Verlohren, Stefan; Schalkwijk, Casper G; van der Sande, Frank M; Kooman, Jeroen P; Hladunewich, Michelle

    2013-10-01

    We report on a 21-year-old pregnant patient with IgA nephropathy who was initiated on intensive hemodialysis (8 hours of hemodialysis 3 times a week) at a gestational age of 26 weeks on the basis of worsening kidney function resulting in rapidly progressive fatigue and difficulties in metabolic control. Throughout the pregnancy, and while on intensive hemodialysis, 24-hour ambulatory blood pressure control was within the target, and results of weekly 24-hour measurement of central hemodynamics and pulse wave velocity, and of serial levels of circulating (anti-)angiogenic factors were comparable to normal pregnancies. Estimated fetal growth evolved along the 50th percentile, and no polyhydramnios was detected. After induction for a sudden, unexplained increase in blood pressure, she delivered a healthy boy of 2480 g at a gestational age of 36 weeks. This case adds to the expanding literature that supports the use of intensive hemodialysis in pregnant patients with end-stage renal disease and illustrates, for the first time, the potential use of serial (anti-) angiogenic factors and 24-hour measurements of blood pressure and hemodynamic indices in order to facilitate monitoring of these complicated patients.

  14. Hemodynamic monitoring during liver transplantation: Astate of the art review

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Orthotopic liver transplantation can be marked bysignificant hemodynamic instability requiring theuse of a variety of hemodynamic monitors to aide inintraoperative management. Invasive blood pressuremonitoring is essential, but the accuracy of peripheralreadings in comparison to central measurements hasbeen questioned. When discrepancies exist, centralmean arterial pressure, usually measured at the femoralartery, is considered more indicative of adequateperfusion than those measured peripherally. Thetraditional pulmonary artery catheter is less frequentlyused due to its invasive nature and known limitationsin measuring preload but still plays an important role inmeasuring cardiac output (CO) when required and inthe management of portopulmonary hypertension. Pulsewave analysis is a newer technology that uses computeralgorithms to calculate CO, stroke volume variation(SVV) and pulse pressure variation (PPV). Although SVVand PPV have been found to be accurate predicatorsof fluid responsiveness, CO measurements are notreliable during liver transplantation. Transesophagealechocardiography is finding an increasing role in the realtimemonitoring of preload status, cardiac contractilityand the diagnosis of a variety of pathologies. It is limitedby the expertise required, limited transgastric viewsduring key portions of the operation, the potential foresophageal varix rupture and difficulty in obtainingquantitative measures of CO in the absence of tricuspidregurgitation.

  15. Pig model of pulmonary embolism: where is the hemodynamic break point?

    Science.gov (United States)

    Kudlička, J; Mlček, M; Hála, P; Lacko, S; Janák, D; Hrachovina, M; Malík, J; Bělohlávek, J; Neužil, P; Kittnar, O

    2013-01-01

    Early recognition of collapsing hemodynamics in pulmonary embolism is necessary to avoid cardiac arrest using aggressive medical therapy or mechanical cardiac support. The aim of the study was to identify the maximal acute hemodynamic compensatory steady state. Overall, 40 dynamic obstructions of pulmonary artery were performed and hemodynamic data were collected. Occlusion of only left or right pulmonary artery did not lead to the hemodynamic collapse. When gradually obstructing the bifurcation, the right ventricle end-diastolic area expanded proportionally to pulmonary artery mean pressure from 11.6 (10.1, 14.1) to 17.8 (16.1, 18.8) cm(2) (ppoint of maximal hemodynamic compensatory steady state. Similarly, mean arterial pressure decreased from 96 (87, 101) to 60 (53, 78) mmHg (p<0.0001), central venous pressure increased from 4 (4, 5) to 7 (6, 8) mmHg (p<0.0001), heart rate increased from 92 (88, 97) to 147 (122, 165) /min (p<0.0001), continuous cardiac output dropped from 5.2 (4.7, 5.8) to 4.3 (3.7, 5.0) l/min (p=0.0023), modified shock index increased from 0.99 (0.81, 1.10) to 2.31 (1.99, 2.72), p<0.0001. In conclusion, instead of continuous cardiac output all of the analyzed parameters can sensitively determine the individual maximal compensatory response to obstructive shock. We assume their monitoring can be used to predict the critical phase of the hemodynamic status in routine practice.

  16. Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure

    Directory of Open Access Journals (Sweden)

    Luís E. Rohde

    2002-03-01

    Full Text Available OBJECTIVE: To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. METHODS: Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. RESULTS: We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5% with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43% pulmonary artery occlusion pressure (P<0.001, with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001. We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001 and central venous pressure (r=0.63; P<0.001. After clinical optimization, improvement in functional class occurred (P< 0.001, with a tendency towards improvement in ejection fraction and no impairment to renal function. CONCLUSION: Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in imme-diate benefits for patients with severe heart failure.

  17. Hemodynamic, ventilator, and ECG changes in pediatric patients undergoing extraction

    Directory of Open Access Journals (Sweden)

    Y K Sanadhya

    2013-01-01

    Full Text Available Background: Dental treatment induces pain anxiety and fear. This study was conducted to assess the changes in hemodynamic, ventilator, and electrocardiograph changes during extraction procedure among 12-15-year-old children and compare these changes with anxiety, fear, and pain. Materials and Methods: A purposive sample of 60 patients selected based on inclusion and exclusion criteria underwent study procedure in the dental OPD of a medical college and hospital. The anxiety, fear, and pain were recorded by dental anxiety scale, dental fear scale, and visual analogue scale, respectively, before the start of the procedure. The systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and electrocardiogram changes were monitored during the extraction procedure. The recording was taken four times (preinjection phase, injection, extraction, and postextraction and was analyzed. Results: At the preinjection phase the mean vales were systolic blood pressure (128 ± 11.2, diastolic blood pressure (85.7 ± 6.3, heart rate (79.7 ± 9.3, and oxygen saturation (97.9 ± 5.8. These values increased in injection phases and decreased in extraction phase and the least values were found after 10 min of procedure and this relation was significant for all parameters except oxygen saturation (P = 0.48, NS. ECG abnormalities were seen among 22 patients and were significant before and after injection of Local anesthetic (P = 0.0001, S. Conclusions: Anxiety, fear, and pain have an effect on hemodynamic, ventilator, and cardiovascular parameters during the extraction procedure and hence behavioral management has to be emphasized among children in dental clinics.

  18. Disorders of cardiac hemodynamic in attack period of bronchial asthma in children

    Directory of Open Access Journals (Sweden)

    Kondratiev V.А.

    2016-05-01

    Full Text Available By dopplerechocardiography method there was studied functional state of cardiac ventricles and character of hemodynamic disorders in 48 patients aged 5-17 years in attack period of moderately-severe and severe bronchial asthma. Group of comparison included 40 healthy peers. Disorders of central and peripheral hemodynamic in attack period of bronchial asthma in children were accompanied both by systolic and diastolic dysfunction of the left and right heart ventricles, herewith right ventricle was functioning in the mode of hyperdynamic, and left one – in the mode of hypodynamic. Combined systolic-diastolic variant of dysfunction both of right and left ventricles was developing in 58,3% of patients with moderately-severe and in 91,6% of patients with severe bronchial asthma. In the attack period of bronchial asthma in children equal directionality of systolic and diastolic dysfunction of heart ventricles was developing; this was characterized by synchronization of their function. Assessment of functional interaction of the ventricles under conditions of severe asthma attack showed direct and high (r=0,67 correlative interaction between finding of Tei index of the left and right ventricles, which characterize their systolic function; this, under conditions of increased hemodynamic pre-loading testified to compensatory increase of systolic interaction of ventricles. Direct and high (r=0,69 correlative interaction between time indices of isovolumic relaxation of the left and right ventricles, characterizing their diastolic function, testified to compensatory increase of diastolic interaction of ventricles under conditions of increase of hemodynamic post-loading. Imbalance of central and peripheral link of hemodynamic in attack period of bronchial asthma in children testified to development of cardiac insufficiency, which was compensated predominantly at the expense of increase of heart contractions rate.

  19. Invasive hemodynamic characterization of heart failure with preserved ejection fraction

    DEFF Research Database (Denmark)

    Andersen, Mads Jønsson; Borlaug, Barry A

    2014-01-01

    Recent hemodynamic studies have advanced our understanding of heart failure with preserved ejection fraction (HFpEF). Despite improved pathophysiologic insight, clinical trials have failed to identify an effective treatment for HFpEF. Invasive hemodynamic assessment can diagnose or exclude HFpEF......, making it invaluable in understanding the basis of the disease. This article reviews the hemodynamic mechanisms underlying HFpEF and how they manifest clinically, discusses invasive hemodynamic assessment as a diagnostic tool, and explores how invasive hemodynamic profiling may allow understanding...

  20. Combining numerical and clinical methods to assess aortic valve hemodynamics during exercise.

    Science.gov (United States)

    Bahraseman, Hg; Hassani, K; Khosravi, A; Navidbakhsh, M; Espino, Dm; Fatouraee, N; Kazemi-Saleh, D

    2014-07-01

    Computational simulations have the potential to aid understanding of cardiovascular hemodynamics under physiological conditions, including exercise. Therefore, blood hemodynamic parameters during different heart rates, rest and exercise have been investigated, using a numerical method. A model was developed for a healthy subject. Using geometrical data acquired by echo-Doppler, a two-dimensional model of the chamber of aortic sinus valsalva and aortic root was created. Systolic ventricular and aortic pressures were applied as boundary conditions computationally. These pressures were the initial physical conditions applied to the model to predict valve deformation and changes in hemodynamics. They were the clinically measured brachial pressures plus differences between brachial, central and left ventricular pressures. Echocardiographic imaging was also used to acquire different ejection times, necessary for pressure waveform equations of blood flow during exercise. A fluid-structure interaction simulation was performed, using an arbitrary Lagrangian-Eulerian mesh. During exercise, peak vorticity increased by 14.8%, peak shear rate by 15.8%, peak cell Reynolds number by 20%, peak leaflet tip velocity increased by 47% and the blood velocity increased by 3% through the leaflets, whereas full opening time decreased by 11%. Our results show that numerical methods can be combined with clinical measurements to provide good estimates of patient-specific hemodynamics at different heart rates.

  1. Biology and hemodynamics of aneurismal vasculopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Vitor Mendes, E-mail: vitormpbr@hotmail.com [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Brina, Olivier, E-mail: olivier.brina@hcuge.ch [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Gonzalez, Ana Marcos, E-mail: ana.marcosgonzalez@hcuge.ch [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Narata, Ana Paula, E-mail: ana.p.narata@hcuge.ch [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Ouared, Rafik, E-mail: rafik.ouared@unige.ch [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland); Karl-Olof, Lovblad, E-mail: Karl-olof.lovblad@hcuge.ch [Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospital of Geneva (Switzerland)

    2013-10-01

    Aneurysm vasculopathies represents a group of vascular disorders that share a common morphological diagnosis: a vascular dilation, the aneurysm. They can have a same etiology and a different clinical presentation or morphology, or have different etiology and very similar anatomical geometry. The biology of the aneurysm formation is a complex process that will be a result of an endogenous predisposition and epigenetic factors later on including the intracranial hemodynamics. We describe the biology of saccular aneurysms, its growth and rupture, as well as, current concepts of hemodynamics derived from application of computational flow dynamics on patient specific vascular models. Furthermore, we describe different aneurysm phenotypes and its extremely variability on morphological and etiological presentation.

  2. [Invasive and minimally invasive hemodynamic monitoring].

    Science.gov (United States)

    Hansen, Matthias

    2016-10-01

    Advanced hemodynamic monitoring is necessary for adequate management of high-risk patients or patients with derangement of circulation. Studies demonstrate a benefit of early goal directed therapy in unstable cardiopulmonary situations. In these days we have different possibilities of minimally invasive or invasive hemodynamic monitoring. Minimally invasive measurements like pulse conture analysis or pulse wave analysis being less accurate under some circumstances, however only an artery catheter is needed for cardiac output monitoring. Pulmonary artery, transpulmonary thermodilution and lithium dilution technology have acceptable accuracy in cardiac output measurement. For therapy of unstable circulation there are additionally parameters to obtain. The pulmonary artery catheter is the device with the largest rate of complications, used by a trained crew and with a correct indication, his use is unchained justified.

  3. Hereditary urea cycle abnormality

    Science.gov (United States)

    ... vitro so the specific genetic cause is known. Teamwork between parents, the affected child, and doctors can help prevent severe illness. Alternative Names Abnormality of the urea cycle - hereditary; Urea cycle - hereditary abnormality Images Male urinary system Urea cycle References Lichter-Konecki ...

  4. Prevalence of cardiac dysfunction and abnormalities in patients with adolescent idiopathic scoliosis requiring surgery.

    Science.gov (United States)

    Liu, Limin; Xiu, Peng; Li, Qian; Song, Yueming; Chen, Rigao; Zhou, Chunguang

    2010-12-01

    The prevalence of cardiac abnormalities in patients with adolescent idiopathic scoliosis in an Asian population has not been reported. A retrospective study was conducted to evaluate the incidence of cardiac abnormalities in these patients. From January 2007 to April 2009, echocardiography and pulmonary function tests were performed in 80 adolescent idiopathic scoliosis patients who required surgical intervention. A thorough analysis of cardiopulmonary functions and cardiac structures was performed. The risk factors, types of cardiac abnormalities, and associations between severity of scoliosis or pulmonary function and cardiac abnormalities were assessed. Cardiac abnormalities were detected by echocardiogram in 25 patients, including 14 with structural abnormalities and 11 with functional abnormalities. The most common functional abnormality was tricuspid regurgitation (9 of 80; 11.3%), whereas atrial septal defect was the most common structural abnormality (7 of 80). Altered hemodynamics occurred in 5 patients, including 3 with ventricular septal defect and 2 with mitral valve dysplasia. Abnormal electrocardiographic findings presented in only 9 of the 25 patients with cardiac abnormalities. No significant associations were found between severity of scoliosis or pulmonary function and cardiac abnormalities. A high incidence of cardiac abnormality exists in patients with adolescent idiopathic scoliosis in this region. Although most patients tolerated surgery, some patients were at risk of decompensation postoperatively. Electrocardiography is of limited value for detecting cardiac problems in patients with adolescent idiopathic scoliosis, we recommend echocardiography as a routine modality in the preoperative evaluation of patients with adolescent idiopathic scoliosis.

  5. Time-varying modeling of cerebral hemodynamics.

    Science.gov (United States)

    Marmarelis, Vasilis Z; Shin, Dae C; Orme, Melissa; Rong Zhang

    2014-03-01

    The scientific and clinical importance of cerebral hemodynamics has generated considerable interest in their quantitative understanding via computational modeling. In particular, two aspects of cerebral hemodynamics, cerebral flow autoregulation (CFA) and CO2 vasomotor reactivity (CVR), have attracted much attention because they are implicated in many important clinical conditions and pathologies (orthostatic intolerance, syncope, hypertension, stroke, vascular dementia, mild cognitive impairment, Alzheimer's disease, and other neurodegenerative diseases with cerebrovascular components). Both CFA and CVR are dynamic physiological processes by which cerebral blood flow is regulated in response to fluctuations in cerebral perfusion pressure and blood CO2 tension. Several modeling studies to date have analyzed beat-to-beat hemodynamic data in order to advance our quantitative understanding of CFA-CVR dynamics. A confounding factor in these studies is the fact that the dynamics of the CFA-CVR processes appear to vary with time (i.e., changes in cerebrovascular characteristics) due to neural, endocrine, and metabolic effects. This paper seeks to address this issue by tracking the changes in linear time-invariant models obtained from short successive segments of data from ten healthy human subjects. The results suggest that systemic variations exist but have stationary statistics and, therefore, the use of time-invariant modeling yields "time-averaged models" of physiological and clinical utility.

  6. Reduced Prefrontal Cortex Hemodynamic Response in Adults with Methamphetamine Induced Psychosis: Relevance for Impulsivity.

    Science.gov (United States)

    Yamamuro, Kazuhiko; Kimoto, Sohei; Iida, Junzo; Kishimoto, Naoko; Nakanishi, Yoko; Tanaka, Shohei; Ota, Toyosaku; Makinodan, Manabu; Kishimoto, Toshifumi

    2016-01-01

    Patients with methamphetamine abuse/dependence often exhibit high levels of impulsivity, which may be associated with the structural abnormalities and functional hypoactivities observed in the frontal cortex of these subjects. Although near-infrared spectroscopy (NIRS) is a simple and non-invasive method for characterizing the clinical features of various psychiatric illnesses, few studies have used NIRS to directly investigate the association between prefrontal cortical activity and inhibitory control in patients with methamphetamine-induced psychosis (MAP). Using a 24-channel NIRS system, we compared hemodynamic responses during the Stroop color-word task in 14 patients with MAP and 21 healthy controls matched for age, sex and premorbid IQ. In addition, we used the Barrett Impulsivity Scale-11 (BIS-11) to assess impulsivity between subject groups. The MAP group exhibited significantly less activation in the anterior and frontopolar prefrontal cortex accompanied by lower Stroop color-word task performance, compared with controls. Moreover, BIS-11 scores were significantly higher in the MAP group, and were negatively correlated with the hemodynamic responses in prefrontal cortex. Our data suggest that reduced hemodynamic responses in the prefrontal cortex might reflect higher levels of impulsivity in patients with MAP, providing new insights into disrupted inhibitory control observed in MAP.

  7. The hemodynamics of human septic shock relate to circulating innate immunity factors.

    Science.gov (United States)

    Hartemink, Koen J; Groeneveld, A B Johan

    2010-01-01

    The role of innate immunity, e.g., complement activation and cytokine release in the hemodynamic alterations in the course of human septic shock is largely unknown. We prospectively studied 14 consecutive septic shock patients with a pulmonary artery catheter in place. For 3 days after admission, hemodynamic variables and plasma levels of C3a, a product of complement activation, and interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) were measured 6-hourly. Doses of vasoactive drugs were recorded. Of the 14 patients, 8 died in the ICU. Patients had a hyperdynamic circulation with tachycardia, mild hypotension, increased cardiac index, peripheral vasodilation and myocardial depression. C3a, IL-6 and TNF-α plasma levels were supranormal in 123 of 138 (89%), 132 of 138 (96%) and 83 of 111 (75%) measurements, respectively. Independently of blood culture results, treatment with vasoactive drugs and outcome, mean arterial blood pressure and systemic vascular resistance index were lower when IL-6 levels were higher and left ventricular function was less depressed when C3a levels were higher in the course of septic shock. The TNF-α levels did not invariably relate to peripheral vascular and myocardial function parameters. Our serial observations suggest that, in human septic shock, peripheral vasodilation is most strongly and independently, of all inflammatory factors, associated with IL-6 release, whereas complement activation partly offsets the myocardial depression of the syndrome. Innate immunity factors may thus differ in their contribution to the course of hemodynamic abnormalities of septic shock.

  8. Deep Phenotyping of Systemic Arterial Hemodynamics in HFpEF (Part 1): Physiologic and Technical Considerations.

    Science.gov (United States)

    Chirinos, Julio A

    2017-02-16

    A better understanding of the pathophysiology of heart failure with a preserved left ventricular ejection fraction (HFpEF) is important. Detailed phenotyping of pulsatile hemodynamics has provided important insights into the pathophysiology of left ventricular remodeling and fibrosis, diastolic dysfunction, microvascular disease, and impaired oxygen delivery to peripheral skeletal muscle, all of which contribute to exercise intolerance, the cardinal feature of HFpEF. Furthermore, arterial pulsatile hemodynamic mechanisms likely contribute to the frequent presence of comorbidities, such as renal failure and dementia, in this population. Our therapeutic approach to HFpEF can be enhanced by clinical phenotyping tools with the potential to "segment" this population into relevant pathophysiologic categories or to identify individuals exhibiting prominent specific abnormalities that can be targeted by pharmacologic interventions. This review describes relevant technical and physiologic aspects regarding the deep phenotyping of arterial hemodynamics in HFpEF. In an accompanying review, the potential of this approach to enhance our clinical and therapeutic approach to HFpEF is discussed.

  9. Characterization of pulmonary microcirculation according to hemodynamic changes with computed tomography

    Science.gov (United States)

    Choi, Byoung W.; Choe, Kyu O.; Kim, Hee-Joung; Cho, Bum K.; Chung, Kyung Y.; Kim, Se K.; Kim, Bong K.; Yang, In S.

    2002-04-01

    The common and important change of pulmonary hemodynamics is represented by increased or decreased pulmonary blood flow (PBF) and increased pulmonary vascular resistance (PVR). We made 3 hemodynamic models in 5 dogs, that is, increased and decreased PBF model and increased PVR model. CT perfusion scan was performed. Perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT), and maximal slope (MS) were analyzed. In normal state, blood flow was affected by gravity and dependent area showed higher BF, BV and lower MS, MTT than non-dependent area. First, decreased PBF model showed no significant change in BV and elongation of MTT. Secondly, increased PBF model showed slightly increased BV and decreased MTT. Thirdly, increased PVR model showed significant decrease of BF, BV, and MS and slight increase of MTT without statistical significance. However, it was noticeable that the distribution of MTT according to gravity in normal lung was completely reversed in increased PVR model. In conclusion, on the basis of our understanding of perfusion characteristic in normal state, we can detect and evaluate the abnormal regional hemodynamic change in lung. Predicting the change of pulmonary vascular resistance should be possible by thorough analysis of CT perfusion parameters.

  10. Reduced Prefrontal Cortex Hemodynamic Response in Adults with Methamphetamine Induced Psychosis: Relevance for Impulsivity.

    Directory of Open Access Journals (Sweden)

    Kazuhiko Yamamuro

    Full Text Available Patients with methamphetamine abuse/dependence often exhibit high levels of impulsivity, which may be associated with the structural abnormalities and functional hypoactivities observed in the frontal cortex of these subjects. Although near-infrared spectroscopy (NIRS is a simple and non-invasive method for characterizing the clinical features of various psychiatric illnesses, few studies have used NIRS to directly investigate the association between prefrontal cortical activity and inhibitory control in patients with methamphetamine-induced psychosis (MAP. Using a 24-channel NIRS system, we compared hemodynamic responses during the Stroop color-word task in 14 patients with MAP and 21 healthy controls matched for age, sex and premorbid IQ. In addition, we used the Barrett Impulsivity Scale-11 (BIS-11 to assess impulsivity between subject groups. The MAP group exhibited significantly less activation in the anterior and frontopolar prefrontal cortex accompanied by lower Stroop color-word task performance, compared with controls. Moreover, BIS-11 scores were significantly higher in the MAP group, and were negatively correlated with the hemodynamic responses in prefrontal cortex. Our data suggest that reduced hemodynamic responses in the prefrontal cortex might reflect higher levels of impulsivity in patients with MAP, providing new insights into disrupted inhibitory control observed in MAP.

  11. The association between cognitive deficits and prefrontal hemodynamic responses during performance of working memory task in patients with schizophrenia.

    Science.gov (United States)

    Pu, Shenghong; Nakagome, Kazuyuki; Itakura, Masashi; Iwata, Masaaki; Nagata, Izumi; Kaneko, Koichi

    2016-04-01

    Schizophrenia-associated cognitive deficits are resistant to treatment and thus pose a lifelong burden. The Brief Assessment of Cognition in Schizophrenia (BACS) provides reliable and valid assessments across cognitive domains. However, because the prefrontal functional abnormalities specifically associated with the level of cognitive deficits in schizophrenia have not been examined, we explored this relationship. Patients with schizophrenia (N=87) and matched healthy controls (N=50) participated in the study. Using near-infrared spectroscopy (NIRS), we measured the hemodynamic responses in the prefrontal and superior temporal cortical surface areas during a working memory task. Correlation analyses revealed a relationship between the hemodynamics and the BACS composite and domain scores. Hemodynamic responses of the left dorsolateral prefrontal cortex (DLPFC) and left frontopolar cortex (FPC) in the higher-level-of-cognitive-function schizophrenia group were weaker than the responses of the controls but similar to those of the lower-level-of-cognitive-function schizophrenia group. However, hemodynamic responses in the right DLPFC, bilateral ventrolateral PFC (VLPFC), and right temporal regions decreased with increasing cognitive deficits. In addition, the hemodynamic response correlated positively with the level of cognitive function (BACS composite scores) in the right DLPFC, bilateral VLPFC, right FPC, and bilateral temporal regions in schizophrenia. The correlation was driven by all BACS domains. Our results suggest that the linked functional deficits in the right DLPFC, bilateral VLPFC, right FPC, and bilateral temporal regions may be related to BACS-measured cognitive impairments in schizophrenia and show that linking the neurocognitive deficits and brain abnormalities can increase our understanding of schizophrenia pathophysiology.

  12. HEMODYNAMIC EFFECTS OF CARVEDILOL IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    L. I. Markova

    2006-01-01

    Full Text Available Aim. To evaluate the influence of carvedilol (Talliton, Egis, Hungary on daily profile of blood pressure (BP, anatomical and functional conditions of left ventricle (LV and cerebral circulation in patients with arterial hypertension (AH, stage II-III. Material and methods. 30 patients (10 men, 20 women, average age 51,9±7,9 y.o. with AH II-III stage ( RSSC,2004 and with initially affected daily profile of BP, cerebral circulation, anatomical and functional disorders of LV took carvedilol 25-75 mg/d during 6 months. Hemodynamics was estimated by ambulatory BP monitoring, Doppler Echocardiography, and ultrasound Dopplerography of extra cranial vessels. Results. A normalizing effect of carvedilol on abnormal daily profile of BP and cerebral circulation was determined. The treatment resulted in the regress of LV hypertrophy with predominant reduction of interventricular septum thickness and also the transformation of concentrical LV hypertrophy in excentrical one. Conclusion. Long-term therapy with carvedilol in patients with AH II-III stage provides a stable BP control and cardioprotective effect, improves cerebral circulation.

  13. Leonardo da Vinci and the first hemodynamic observations.

    Science.gov (United States)

    Martins e Silva, J

    2008-02-01

    Leonardo da Vinci was a genius whose accomplishments and ideas come down to us today, five centuries later, with the freshness of innovation and the fascination of discovery. This brief review begins with a summary of Leonardo's life and a description of the most important works of art that he bequeathed us, and then concentrates on his last great challenge. There was a point at which Leonardo's passion for art gave way to the study of human anatomy, not only to improve his drawing but to go beyond what had been simply a representation of form to understand the underlying functioning. Among his many interests, we focus on his study of the heart and blood vessels, which he observed carefully in animals and human autopsies, and reproduced in drawings of great quality with annotations of astonishing acuteness. The experience that he had acquired from observing the flow of water in currents and around obstacles, and the conclusions that he drew concerning hydrodynamics, were central to his interpretation of the mechanisms of the heart and of blood flow, to which he devoted much of his time between 1508 and 1513. From these studies, immortalized in drawings of great clarity, come what are acknowledged to be the first hemodynamic records, in which Leonardo demonstrates the characteristics of blood flow in the aorta and great vessels and the importance of blood reflux and the formation of eddies in the sinus in aortic valve his assiduous and careful observations, and his subsequent deductions, Leonardo put forward detailed findings on hemodynamic questions that advanced technology has only recently enabled us to confirm.

  14. Neurobehavioural Correlates of Abnormal Repetitive Behaviour

    Directory of Open Access Journals (Sweden)

    R. A. Ford

    1991-01-01

    Full Text Available Conditions in which echolalia and echopraxia occur are reviewed, followed by an attempt to elicit possible mechanisms of these phenomena. A brief description of stereotypical and perseverative behaviour and obsessional phenomena is given. It is suggested that abnormal repetitive behaviour may occur partly as a result of central dopaminergic dysfunction.

  15. Occupational exposure in hemodynamic; Exposicao ocupacional em hemodinamica

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Amanda J.; Fernandes, Ivani M.; Silva, Paula P. Nou; Sordi, Gian Maria A.A.; Carneiro, Janete C.G.G., E-mail: ajsilva@ipen.b, E-mail: imfernandes@ipen.b, E-mail: ppsilva@ipen.b, E-mail: gmsordi@ipen.b, E-mail: janetegc@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-10-26

    This paper has an objective to perform a radiometric survey at a hemodynamic service. Besides, it was intended to evaluate the effective dose of health professionals and to provide data which can contribute with minimization of exposures during the realization of hemodynamic procedure. The radiometric survey was realized in the real environment of work simulating the conditions of a hemodynamic study with a ionization chamber

  16. Increased Hemodynamic Load in Early Embryonic Stages Alters Endocardial to Mesenchymal Transition

    Science.gov (United States)

    Midgett, Madeline; López, Claudia S.; David, Larry; Maloyan, Alina; Rugonyi, Sandra

    2017-01-01

    Normal blood flow is essential for proper heart formation during embryonic development, as abnormal hemodynamic load (blood pressure and shear stress) results in cardiac defects seen in congenital heart disease. However, the progressive detrimental remodeling processes that relate altered blood flow to cardiac defects remain unclear. Endothelial–mesenchymal cell transition is one of the many complex developmental events involved in transforming the early embryonic outflow tract into the aorta, pulmonary trunk, interventricular septum, and semilunar valves. This study elucidated the effects of increased hemodynamic load on endothelial–mesenchymal transition remodeling of the outflow tract cushions in vivo. Outflow tract banding was used to increase hemodynamic load in the chicken embryo heart between Hamburger and Hamilton stages 18 and 24. Increased hemodynamic load induced increased cell density in outflow tract cushions, fewer cells along the endocardial lining, endocardium junction disruption, and altered periostin expression as measured by confocal microscopy analysis. In addition, 3D focused ion beam scanning electron microscopy analysis determined that a portion of endocardial cells adopted a migratory shape after outflow tract banding that is more irregular, elongated, and with extensive cellular projections compared to normal cells. Proteomic mass-spectrometry analysis quantified altered protein composition after banding that is consistent with a more active stage of endothelial–mesenchymal transition. Outflow tract banding enhances the endothelial–mesenchymal transition phenotype during formation of the outflow tract cushions, suggesting that endothelial–mesenchymal transition is a critical developmental process that when disturbed by altered blood flow gives rise to cardiac malformation and defects. PMID:28228731

  17. "Jeopardy" in Abnormal Psychology.

    Science.gov (United States)

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  18. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  19. Abnormal menstrual periods (image)

    Science.gov (United States)

    ... may have a variety of causes, such as endometrial hyperplasia, endometrial polyps, uterine fibroids, and abnormal thyroid or ... the endometrium becomes unusually thick it is called endometrial ... Hyperplasia may cause profuse or extended menstrual bleeding.

  20. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  1. Abnormal protein aggregationand neurodegenerativediseases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Abnormal protein aggregation or amyloid is the major cause ofmany neurodegenerative disorders. The present review focuses on the correlation between sequence and structure features of proteins related to the diseases and abnormal protein aggregation. Recent progress has improved our knowledge on understand-ing the mechanism of amyloid formation. We suggest a nucleation model for ordered protein aggregation, which can also explain pathogenesis mechanisms of these neurodegenerative diseases in vivo.

  2. Impaired myocardial oxygen availability contributes to abnormal exercise hemodynamics in heart failure with preserved ejection fraction

    NARCIS (Netherlands)

    van Empel, Vanessa P M; Mariani, Justin; Borlaug, Barry A; Kaye, David M

    2014-01-01

    BACKGROUND: Hypertension is a frequent risk factor for the development of heart failure with preserved ejection fraction (HFPEF). Progressive extracellular matrix accumulation has been presumed to be the fundamental pathophysiologic mechanism that leads to the transition to impaired diastolic reserv

  3. Hemodynamic response to the upright posture.

    Science.gov (United States)

    Smith, J J; Porth, C M; Erickson, M

    1994-05-01

    The authors' objective was to review previous studies of immediate (first 30 seconds) and stabilized (30 seconds to 20 minutes) hemodynamic responses of healthy adults to the head-up posture, with particular reference to alteration of such responses in the elderly and the usefulness of such data in the diagnosis of orthostatic hypotension. The immediate response in healthy young adults is characterized by a prompt rise in heart rate, which peaks at about 8 to 15 seconds and then tapers; the arterial pressure and total vascular resistance decrease sharply at 5 to 10 seconds, followed by a rapid rebound and overshoot. Over the first 30 seconds there is a steady parallel decline of thoracic blood volume and stroke volume; there is also an initial surge of cardiac output followed by a steady decrease. During the stabilized response (30 seconds to 20 minutes), the hemodynamic variables are relatively steady, showing average increases in heart rate of about 15 to 30%, in diastolic pressure of 10 to 15%, and in total vascular resistance of 30 to 40%; during the 5th to 20th minutes there are also decreases in thoracic blood volume averaging about 25 to 30%, in cardiac output 15 to 30%, and in pulse pressure about 5 to 10%. It is evident that in normal human subjects, assumption of the upright posture results in profound hemodynamic changes, most of them occurring during the first 30 seconds. In elderly subjects (aged 60-69 years), there are, in the upright posture, lesser increments of heart rate and diastolic pressure, but no significant differences from younger age groups in the response of thoracic blood volume, cardiac output or total vascular resistance. However, beginning at about age 75, there is an increasing incidence of orthostatic hypotension, which averages about 14 to 20% at age 75 and older. The tendency toward orthostatic hypotension in the elderly is due (1) to the structural and functional changes in the circulation itself, (2) to a decline in autonomic

  4. Hemodynamic significance of internal carotid artery disease

    DEFF Research Database (Denmark)

    Schroeder, T

    1988-01-01

    . Examination of periorbital flow direction or oculoplethysmography could be used as a screening procedure. Negative tests most certainly rule out any severe pressure gradient across the stenosis, irrespective of the luminal reduction. A positive result, on the other hand, should be further quantified since...... cerebral hemodynamics in terms of increased flow through the reconstructed vessel and elimination of pressure gradients. The cerebral blood flow, though remains unchanged in the majority of patients, at least when measured at baseline. Only in those patients with a reduction in perfusion pressure can...

  5. Emergency management of hemodynamically unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang

    2011-01-01

    Pelvic fractures are serious injuries.Death within 24 hours is most often a result of acute blood loss.The emergency management of these patients is challenging and controversial.The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding.Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team.The issues addressed in this management algorithm are diagnostic evaluation,damage control resuscitation,indications for noninvasive pelvic stabilization,preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography.This review article focuses on the recent body of knowledge on those determinations.

  6. Cerebral hemodynamics and functional prognosis in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime (Hamamatsu Rosai Hospital, Shizuoka (Japan))

    1989-11-01

    The functional outcome of cerebral hemodynamics in the chronic stage of juvenile hydrocephalus was determined using single photon emission computed tomography (SPECT). Five patients including three with aqueductal stenosis, one with post-meningitic hydrocephalus, and one case with hydrocephalus having developed after repair of a huge occipital encephalocele. Early images of cerebral blood flow (CBF) were obtained 25 minutes after intravenous injection of 123-I-iodoamphetamine (IMP), and late images were scanned 3 hours later. Cerebral blood volume (CBV) was also measured using {sup 99m}Tc in three patients. Twenty cases with adult communicating hydrocephalus were also investigated from the point of view of shunt effectiveness. Although there was no remarkable change in the cerebrovascular bed in the juvenile cases, CBF of the remnant brain parenchyma was good irrespective of the degree of ventricular dilatation. There was a periventricular-related IMP uptake in each case; however, it somehow matched the ventricular span. Functional outcome one to 23 years after the initial shunt operation was good in every case, despite multiple shunt revisions. Redistribution on late images had no bearing on clinical states. In adult cases, 8 patients with effective shunting demonstrated a relatively localized periventricular low perfusion, with preoperative increased cerebrospinal fluid (CSF) pressure. On the contrary, 12 patients with no improvement with or without ventricular-reduced IMP uptake, despite low CSF pressure. The present study indicates that periventricular hemodynamics may play an important role in cerebral function compromised by hydrocephalus. (J.P.N.).

  7. Cerebrovascular hemodynamics in patients with cerebral arteriosclerosis

    Institute of Scientific and Technical Information of China (English)

    Jianbo Yang; Changcong Cui; Chengbin Wu

    2011-01-01

    The present study observed hemodynamic changes in 26 patients with cerebral arteriosclerosis using a cerebral circulation dynamics detector and transcranial Doppler.In patients with cerebral arteriosclerosis the blood supply and flow rate in the bilateral carotid arteries and the blood flow rate in the anterior cerebral and middle cerebral arteries were similar to normal controls, but the cerebral vascular resistance, critical pressure and pulsatility index were increased, and cerebral arterial elasticity and cerebral blood flow autoregulation were decreased.Compared with the lesioned hemisphere of patients with cerebral infarction, the total blood supply and blood flow rate of patients with cerebral arteriosclerosis were higher.Compared with normal subjects, patients with cerebral arteriosclerosis exhibited cognitive disturbances, mainly in short-term memory, attention, abstract capability, and spatial and executive dysfunction.Results showed that cerebral arteriosclerosis does not directly affect the blood supply of a cerebral hemisphere, but affects cognitive function.The increased cerebral vascular resistance and reduced autoregulation of cerebral blood vessels may be important hemodynamic mechanisms of arteriosclerosis-induced cerebral infarction.

  8. Cerebral hemodynamic dysfunction in parkinsonian patients

    Directory of Open Access Journals (Sweden)

    Mirjana Vladetić

    2009-02-01

    Full Text Available Aim The purpose of this investigation was to determine the cerebral hemodynamics in patients withparkinsonism and the influence of hemodynamic dysfunction in developing the lacunar infarcts.Methods Fifty patients with the signs of parkinsonism were included in this study. The patients weredevided into two subgroups depending on whether they had vascular parkinsonism (VP (N-22 or idiopathicParkinson disease (N-28. The control group consisted of 30 patients who had ischemic stroke.The conventional transcranial dopler sonography was performed to evaluate the cerebral blood flow.To evaluate the cognitive impairment we performed the mini mental state examination to patients withparkinsonism.Results Patients with vascular parkinsonism have greater cognitive disturbances than patients withParkinson disease. In most of the parkinsonian patients the cerebral blood flow was decreased and themicroangiopathy was present.Conclusion In most patients with parkinsonism, the cerebral blood flow was decreased as a consequenceof microangiopathy. In our opinion, this led to lacunar infarction in VP patients, but can also bea risk factor for developing the same changes in patients with idiopathic Parkinson disease.

  9. Bayesian model comparison in nonlinear BOLD fMRI hemodynamics

    DEFF Research Database (Denmark)

    Jacobsen, Danjal Jakup; Hansen, Lars Kai; Madsen, Kristoffer Hougaard

    2008-01-01

    Nonlinear hemodynamic models express the BOLD (blood oxygenation level dependent) signal as a nonlinear, parametric functional of the temporal sequence of local neural activity. Several models have been proposed for both the neural activity and the hemodynamics. We compare two such combined model...... different visual stimulation paradigms. The results show that the simple model is the better one for these data....

  10. Advanced Hemodynamic Management in Patients with Septic Shock

    Science.gov (United States)

    Huber, Wolfgang; Nierhaus, Axel; Kluge, Stefan; Reuter, Daniel A.; Wagner, Julia Y.

    2016-01-01

    In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these “organ dysfunction syndromes” is a key therapeutic component. It needs, however, to be differentiated between “early goal-directed therapy” (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and “hemodynamic management” using advanced hemodynamic monitoring in the intensive care unit (ICU). Recent large trials demonstrated that nowadays protocolized EGDT does not seem to be superior to “usual care” in terms of a reduction in mortality in emergency department patients with early identified septic shock who promptly receive antibiotic therapy and fluid resuscitation. “Hemodynamic management” comprises (a) making the diagnosis of septic shock as one differential diagnosis of circulatory shock, (b) assessing the hemodynamic status including the identification of therapeutic conflicts, and (c) guiding therapeutic interventions. We propose two algorithms for hemodynamic management using transpulmonary thermodilution-derived variables aiming to optimize the cardiocirculatory and pulmonary status in adult ICU patients with septic shock. The complexity and heterogeneity of patients with septic shock implies that individualized approaches for hemodynamic management are mandatory. Defining individual hemodynamic target values for patients with septic shock in different phases of the disease must be the focus of future studies. PMID:27703980

  11. The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

    NARCIS (Netherlands)

    Postma, Ineke R.; van Veen, Teelkien R.; Mears, Scott L.; Zeeman, Gerda G.; Haeri, Sina; Belfort, Michael A.

    2014-01-01

    Objective Neuraxial anesthesia is known to reduce sympathetic tone and mean arterial pressure. Effects on cerebral hemodynamics in pregnancy are not well known. We hypothesize that cerebral hemodynamic parameters will change with respect to baseline following regional analgesia/anesthesia. Study Des

  12. Non-invasive assessment of maternal hemodynamics in early pregnancy

    NARCIS (Netherlands)

    van der Graaf, Anne Marijn; Zeeman, Gerda G.; Groen, Henk; Roberts, Claire; Dekker, Gus A.

    2013-01-01

    Objectives: Non-invasive assessment of maternal hemodynamics in early pregnancy may be promising in evaluating maternal hemodynamic (mal)adaptation to pregnancy. We explored usage of applanation tonometry and Doppler ultrasound for assessment of cardiac output (CO), systemic vascular resistance (SVR

  13. [Hair shaft abnormalities].

    Science.gov (United States)

    Itin, P H; Düggelin, M

    2002-05-01

    Hair shaft disorders may lead to brittleness and uncombable hair. In general the hair feels dry and lusterless. Hair shaft abnormalities may occur as localized or generalized disorders. Genetic predisposition or exogenous factors are able to produce and maintain hair shaft abnormalities. In addition to an extensive history and physical examination the most important diagnostic examination to analyze a hair shaft problem is light microscopy. Therapy of hair shaft disorders should focus to the cause. In addition, minimizing traumatic influences to hair shafts, such as dry hair with an electric dryer, permanent waves and dyes is important. A short hair style is more suitable for such patients with hair shaft disorders.

  14. Abnormalities of gonadal differentiation.

    Science.gov (United States)

    Berkovitz, G D; Seeherunvong, T

    1998-04-01

    Gonadal differentiation involves a complex interplay of developmental pathways. The sex determining region Y (SRY) gene plays a key role in testis determination, but its interaction with other genes is less well understood. Abnormalities of gonadal differentiation result in a range of clinical problems. 46,XY complete gonadal dysgenesis is defined by an absence of testis determination. Subjects have female external genitalia and come to clinical attention because of delayed puberty. Individuals with 46,XY partial gonadal dysgenesis usually present in the newborn period for the valuation of ambiguous genitalia. Gonadal histology always shows an abnormality of seminiferous tubule formation. A diagnosis of 46,XY true hermaphroditism is made if the gonads contain well-formed testicular and ovarian elements. Despite the pivotal role of the SRY gene in testis development, mutations of SRY are unusual in subjects with a 46,XY karyotype and abnormal gonadal development. 46,XX maleness is defined by testis determination in an individual with a 46,XX karyotype. Most affected individuals have a phenotype similar to that of Klinefelter syndrome. In contrast, subjects with 46,XX true hermaphroditism usually present with ambiguous genitalia. The majority of subjects with 46,XX maleness have Y sequences including SRY in genomic DNA. However, only rare subjects with 46,XX true hermaphroditism have translocated sequences encoding SRY. Mosaicism and chimaerism involving the Y chromosome can also be associated with abnormal gonadal development. However, the vast majority of subjects with 45,X/46,XY mosaicism have normal testes and normal male external genitalia.

  15. Cortical Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available Grey-matter abnormalities at the cortical surface and regional brain size were mapped by high-resolution MRI and surface-based, computational image analytical techniques in a group of 27 children and adolescents with attention deficit hyperactivity disorder (ADHD and 46 controls, matched by age and sex, at the University of California at Los Angeles.

  16. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...

  17. Lacrimal system abnormalities.

    Science.gov (United States)

    Moore, B D

    1994-03-01

    This report outlines several of the more important abnormalities of the lacrimal system in infants and young children. Although rare, alacrima can be a very difficult clinical problem to treat. The most common cause of alacrima is the Riley-Day syndrome. Nasolacrimal duct obstruction is a very common anomaly in children. The clinical appearance and treatment of this disorder are discussed.

  18. The Influence of Normal and Early Vascular Aging on Hemodynamic Characteristics in Cardio- and Cerebrovascular Systems.

    Science.gov (United States)

    Yu, Hongtao; Huang, George P; Yang, Zifeng; Liang, Fuyou; Ludwig, Bryan

    2016-06-01

    Age-associated alterations in cardiovascular structure and function induce cardiovascular disease in elderly subjects. To investigate the effects of normal vascular aging (NVA) and early vascular aging (EVA) on hemodynamic characteristics in the circle of Willis (CoW), a closed-loop one-dimensional computational model was developed based on fluid mechanics in the vascular system. The numerical simulations revealed that higher central pulse pressure and augmentation index (AIx) appear in the EVA subjects due to early arrival of reflected waves, resulted in the increase of cardiac afterload compared with the NVA subjects. Moreover, the hemodynamic characteristics in the CoW show that the EVA subjects in an older age display a higher blood pressure than that of the NVA with a complete CoW. Herein, the increased blood pressure and flow rate coexist in the subjects with an incomplete CoW. In conclusion, the hemodynamic characteristics in the aortic tree and CoW related to aging appear to play an important role in causing cardiovascular and intravascular disease.

  19. Monitoring changes in hemodynamics following optogenetic stimulation

    Science.gov (United States)

    Frye, Seth

    The brain is composed of billions of neurons, all of which connected through a vast network. After years of study and applications of different technologies and techniques, there are still more questions than answers when it comes to the fundamental functions of the brain. This project aims to provide a new tool which can be used to gain a better understanding of the fundamental mechanisms that govern neurological processes inside the brain. In order for neural networks to operate, blood has to be supplied through neighboring blood vessels. As such, the increase or decrease in the blood supply has been used as an indicator of neural activity. The neural activity and blood supply relationship is known as neural vasculature coupling. Monitoring the hemodynamics is used as an indicator of neurological activity, but the causal relationship is an area of current research. Gaining a better understanding of the coupling of neural activity and the surrounding vasculature provides a more accurate methodology to evaluate regional neural activity. The new optical technology applied in this project provides a set of tools to both stimulate and monitor this coupling relationship. Optogenetics provides the capability of stimulating neural activity using specific wavelengths of light. Essentially this tool allows for the direct stimulation of networks of neurons by simply shining one color of light onto the brain. Optical Coherence Tomography (OCT), another new optical technology applied in this project, can record volumetric images of blood vessels and flow using only infrared light. The combination of the two optical technologies is then capable of stimulating neural activity and monitoring the hemodynamic response inside the brain using only light. As a result of this project we have successfully demonstrated the capability of both stimulating and imaging the brain using new optical technologies. The optical stimulation of neural activity has evoked a direct hemodynamic effect

  20. Systemic and Ocular Hemodynamic Risk Factors in Glaucoma

    Directory of Open Access Journals (Sweden)

    Jaewan Choi

    2015-01-01

    Full Text Available Primary open angle glaucoma (POAG is a multifactorial disease characterized by progressive retinal ganglion cell death and visual field loss. It is known that alterations in intraocular pressure (IOP, blood pressure (BP, and ocular perfusion pressure (OPP can play a significant role in the pathogenesis of the disease. Impaired autoregulatory capacity of ocular blood vessels may render tissues vulnerable to OPP changes and potentially harmful tissue ischemia-reperfusion damage. Vascular risk factors should be considered more important in a subgroup of patients with POAG, and especially in patients with normal tension glaucoma (NTG with evidence of unphysiological BP response. For example, reduction of BP during the nighttime has an influence on OPP, and increased circadian OPP fluctuation, which might stand for unstable ocular blood flow, has been found to be the consistent risk factor for NTG development and progression. Central visual field may be affected more severely than peripheral visual field in NTG patients with higher 24-hour fluctuation of OPP. This review will discuss the current understanding of allegedly major systemic and ocular hemodynamic risk factors for glaucoma including systemic hypertension, arterial stiffness, antihypertensive medication, exaggerated nocturnal hypotension, OPP, and autonomic dysregulation.

  1. Evaluation of Hemodynamic Parameters as Predictors of Glaucoma Progression

    Directory of Open Access Journals (Sweden)

    Ingrida Januleviciene

    2011-01-01

    Full Text Available Purpose. To evaluate hemodynamic parameters as possible predictors for glaucoma progression. Methods. An 18-month randomized double-masked cohort study including 30 open-angle glaucoma patients receiving fixed-combination treatment with Dorzolamide/Timolol (DTFC or Latanoprost/Timolol (LTFC (n=15 per group was performed. Intraocular pressure (IOP, arterial blood pressure (BP, ocular and diastolic perfusion pressures (OPP, DPP, color Doppler imaging, pulsatile ocular blood flow analysis, scanning laser polarimetry, and Humphrey visual field evaluations were included. Results. Both treatments showed statistically similar IOP reduction. Six patients in DTFC and 7 in LTFC group met glaucoma progression criteria. DTFC group had higher OPP, DPP, and lower vascular resistivity indices as compared to the LTFC. Progressing patients had higher nerve fiber index, lower systolic BP, OPP, DPP, higher ophthalmic and central retinal artery vascular resistance, and lower pulse volume (P<.05; t-test. Conclusions. Structural changes consistent with glaucoma progression correlate with non-IOP-dependent risk factors.

  2. Distinct neurohumoral biomarker profiles in children with hemodynamically defined orthostatic intolerance may predict treatment options.

    Science.gov (United States)

    Wagoner, Ashley L; Shaltout, Hossam A; Fortunato, John E; Diz, Debra I

    2016-02-01

    Studies of adults with orthostatic intolerance (OI) have revealed altered neurohumoral responses to orthostasis, which provide mechanistic insights into the dysregulation of blood pressure control. Similar studies in children with OI providing a thorough neurohumoral profile are lacking. The objective of the present study was to determine the cardiovascular and neurohumoral profile in adolescent subjects presenting with OI. Subjects at 10-18 yr of age were prospectively recruited if they exhibited two or more traditional OI symptoms and were referred for head-up tilt (HUT) testing. Circulating catecholamines, vasopressin, aldosterone, renin, and angiotensins were measured in the supine position and after 15 min of 70° tilt. Heart rate and blood pressure were continuously measured. Of the 48 patients, 30 patients had an abnormal tilt. Subjects with an abnormal tilt had lower systolic, diastolic, and mean arterial blood pressures during tilt, significantly higher levels of vasopressin during HUT, and relatively higher catecholamines and ANG II during HUT than subjects with a normal tilt. Distinct neurohumoral profiles were observed when OI subjects were placed into the following groups defined by the hemodynamic response: postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension (OH), syncope, and POTS/syncope. Key characteristics included higher HUT-induced norepinephrine in POTS subjects, higher vasopressin in OH and syncope subjects, and higher supine and HUT aldosterone in OH subjects. In conclusion, children with OI and an abnormal response to tilt exhibit distinct neurohumoral profiles associated with the type of the hemodynamic response during orthostatic challenge. Elevated arginine vasopressin levels in syncope and OH groups are likely an exaggerated response to decreased blood flow not compensated by higher norepinephrine levels, as observed in POTS subjects. These different compensatory mechanisms support the role of measuring neurohumoral

  3. [Myocardial contractility and hemodynamics in hypothyroidism].

    Science.gov (United States)

    Selivonenko, V G

    1977-01-01

    The author determined the phasic structure of the systole of the left ventricle by the method of polycardiography and hemodynamics in 20 patients suffering from hypothyrodism. Blood plasma and erythrocyte electrolytes were examined at the same time. Patients with hypothyroidism displayed a phasic syndrome of hypodynamia and a marked correlation between the phase of the synchronous contraction, the period of ejection, the strength of contraction of the left ventricle and the electrolyte content. Sodium and magnesium produced the greatest influence on the phasic structure of the systole; potassium and calcium had a lesser effect. The heart stroke volume diminished; as to the cardiac index, expenditure of the energy of cardiac contractions directed to the maintenance of movement of 1 litre of the minute blood volume; the external work, and the peripheral vascular resistance displayed no significant change.

  4. 10.1.Heart function and hemodynamics

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930252 Pathophysiological effects oftranscoronary chemical ablation in dogs.QI Xi-angqian (齐向前),et al.Cardiovasc Instit &Fuwai Hosp,CAMS,Beijing.Chin Cir J 1992;7(6):567—569.This study was designed to evaluate thepathophysiologic changes induced by intracoro-nary ethanol (ICE) in normal dogs.CK—MBactivity,ECG,hemodynamics,myocardialnecrosis size and histologic changes resultingfrom ICE were observed.In anesthetized dogs,0.4~0.6 ml (group A,n=9) and 1.0~1.2 ml(group B,n=9) of 95% ethanol were injectedinto the diagonal branch of the lelt anterior de-

  5. Large eddy simulation of powered Fontan hemodynamics.

    Science.gov (United States)

    Delorme, Y; Anupindi, K; Kerlo, A E; Shetty, D; Rodefeld, M; Chen, J; Frankel, S

    2013-01-18

    Children born with univentricular heart disease typically must undergo three open heart surgeries within the first 2-3 years of life to eventually establish the Fontan circulation. In that case the single working ventricle pumps oxygenated blood to the body and blood returns to the lungs flowing passively through the Total Cavopulmonary Connection (TCPC) rather than being actively pumped by a subpulmonary ventricle. The TCPC is a direct surgical connection between the superior and inferior vena cava and the left and right pulmonary arteries. We have postulated that a mechanical pump inserted into this circulation providing a 3-5 mmHg pressure augmentation will reestablish bi-ventricular physiology serving as a bridge-to-recovery, bridge-to-transplant or destination therapy as a "biventricular Fontan" circulation. The Viscous Impeller Pump (VIP) has been proposed by our group as such an assist device. It is situated in the center of the 4-way TCPC intersection and spins pulling blood from the vena cavae and pushing it into the pulmonary arteries. We hypothesized that Large Eddy Simulation (LES) using high-order numerical methods are needed to capture unsteady powered and unpowered Fontan hemodynamics. Inclusion of a mechanical pump into the CFD further complicates matters due to the need to account for rotating machinery. In this study, we focus on predictions from an in-house high-order LES code (WenoHemo(TM)) for unpowered and VIP-powered idealized TCPC hemodynamics with quantitative comparisons to Stereoscopic Particle Imaging Velocimetry (SPIV) measurements. Results are presented for both instantaneous flow structures and statistical data. Simulations show good qualitative and quantitative agreement with measured data.

  6. Linear superposition of sensory-evoked and ongoing cortical hemodynamics

    Directory of Open Access Journals (Sweden)

    Mohamad Saka

    2010-08-01

    Full Text Available Modern non-invasive brain imaging techniques utilise changes in cerebral blood flow, volume and oxygenation that accompany brain activation. However, stimulus-evoked hemodynamic responses display considerable inter-trial variability even when identical stimuli are presented and the sources of this variability are poorly understood. One of the sources of this response variation could be ongoing spontaneous hemodynamic fluctuations. To investigate this issue, 2-dimensional optical imaging spectroscopy was used to measure cortical hemodynamics in response to sensory stimuli in anaesthetised rodents Pre-stimulus cortical hemodynamics displayed spontaneous periodic fluctuations and as such, data from individual stimulus presentation trials were assigned to one of four groups depending on the phase angle of pre-stimulus hemodynamic fluctuations and averaged. This analysis revealed that sensory evoked cortical hemodynamics displayed distinctive response characteristics and magnitudes depending on the phase angle of ongoing fluctuations at stimulus onset. To investigate the origin of this phenomenon, ‘null-trails’ were collected without stimulus presentation. Subtraction of phase averaged ‘null trials’ from their phase averaged stimulus-evoked counterparts resulted in four similar time series that resembled the mean stimulus-evoked response. These analyses suggest that linear superposition of evoked and ongoing cortical hemodynamic changes may be a property of the structure of inter-trial variability.

  7. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft;

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... or fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

  8. Advanced hemodynamic monitoring: principles and practice in neurocritical care.

    Science.gov (United States)

    Lazaridis, Christos

    2012-02-01

    Advanced hemodynamic monitoring is necessary for many patients with acute brain and/or spinal cord injury. Optimizing cerebral and systemic physiology requires multi-organ system function monitoring. Hemodynamic manipulations are cardinal among interventions to regulate cerebral perfusion pressure and cerebral blood flow. The pulmonary artery catheter is not any more the sole tool available; less invasive and potentially more accurate methodologies have been developed and employed in the operating room and among diverse critically ill populations. These include transpulmonary thermodilution, arterial pressure pulse contour, and waveform analysis and bedside critical care ultrasound. A thorough understanding of hemodynamics and of the available monitoring modalities is an essential skill for the neurointensivist.

  9. Effects of sauna alone and postexercise sauna baths on blood pressure and hemodynamic variables in patients with untreated hypertension.

    Science.gov (United States)

    Gayda, Mathieu; Paillard, François; Sosner, Philippe; Juneau, Martin; Garzon, Mauricio; Gonzalez, Mariel; Bélanger, Manon; Nigam, Anil

    2012-08-01

    The effects of sauna alone vs exercise and sauna on ambulatory blood pressure monitoring and central hemodynamic variables were measured in 16 patients with untreated hypertension assigned to a control period, sauna, or exercise and sauna. Exercise and sauna had positive effects on 24-hour systolic and mean blood pressure in patients with untreated hypertension. Exercise and sauna and sauna alone reduce total vascular resistance, with positive effects lasting up to 120 minutes after heat exposure.

  10. [Molecular abnormalities in lymphomas].

    Science.gov (United States)

    Delsol, G

    2010-11-01

    Numerous molecular abnormalities have been described in lymphomas. They are of diagnostic and prognostic value and are taken into account for the WHO classification of these tumors. They also shed some light on the underlying molecular mechanisms involved in lymphomas. Overall, four types of molecular abnormalities are involved: mutations, translocations, amplifications and deletions of tumor suppressor genes. Several techniques are available to detect these molecular anomalies: conventional cytogenetic analysis, multicolor FISH, CGH array or gene expression profiling using DNA microarrays. In some lymphomas, genetic abnormalities are responsible for the expression of an abnormal protein (e.g. tyrosine-kinase, transcription factor) detectable by immunohistochemistry. In the present review, molecular abnormalities observed in the most frequent B, T or NK cell lymphomas are discussed. In the broad spectrum of diffuse large B-cell lymphomas microarray analysis shows mostly two subgroups of tumors, one with gene expression signature corresponding to germinal center B-cell-like (GCB: CD10+, BCL6 [B-Cell Lymphoma 6]+, centerine+, MUM1-) and a subgroup expressing an activated B-cell-like signature (ABC: CD10-, BCL6-, centerine-, MUM1+). Among other B-cell lymphomas with well characterized molecular abnormalies are follicular lymphoma (BCL2 deregulation), MALT lymphoma (Mucosa Associated Lymphoid Tissue) [API2-MALT1 (mucosa-associated-lymphoid-tissue-lymphoma-translocation-gene1) fusion protein or deregulation BCL10, MALT1, FOXP1. MALT1 transcription factors], mantle cell lymphoma (cycline D1 [CCND1] overexpression) and Burkitt lymphoma (c-Myc expression). Except for ALK (anaplastic lymphoma kinase)-positive anaplastic large cell lymphoma, well characterized molecular anomalies are rare in lymphomas developed from T or NK cells. Peripheral T cell lymphomas not otherwise specified are a heterogeneous group of tumors with frequent but not recurrent molecular abnormalities

  11. Abnormal skull shape

    Energy Technology Data Exchange (ETDEWEB)

    Blaser, Susan I. [Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Division of Paediatric Neuroradiology, Toronto, ON (Canada)

    2008-06-15

    MRI may be required in cases at risk of acquired tonsillar herniation or central nervous system anomalies. Additional CT or MR venography or catheter angiography may be necessary to map anomalous or vigorous collateral venous drainage preoperatively. (orig.)

  12. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    Science.gov (United States)

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  13. New approach to intracardiac hemodynamic measurements in small animals

    DEFF Research Database (Denmark)

    Eskesen, Kristian; Olsen, Niels T; Dimaano, Veronica L

    2012-01-01

    Invasive measurements of intracardiac hemodynamics in animal models have allowed important advances in the understanding of cardiac disease. Currently they are performed either through a carotid arteriotomy or via a thoracotomy and apical insertion. Both of these techniques have disadvantages...

  14. Aortic endograft sizing in trauma patients with hemodynamic instability

    NARCIS (Netherlands)

    Jonker, Frederik H. W.; Verhagen, Hence J. M.; Mojibian, Hamid; Davis, Kimberly A.; Moll, Frans L.; Muhs, Bart E.

    2010-01-01

    Objectives: To investigate changes in aortic diameter in hemodynamically unstable trauma patients and the implications for sizing of thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injury (TTAI). Methods: We retrospectively evaluated all trauma patients that we

  15. Hemodynamics of patient-specific aorta-pulmonary shunt configurations

    OpenAIRE

    Pekkan, Kerem; Pişkin, Senol; Altın, H. Fırat; Yıldız, Okan; Bakır, İhsan

    2017-01-01

    Optimal hemodynamics in aorta-pulmonary shunt reconstruction is essential for improved post-operative recovery of the newborn congenital heart disease patient. However, prior to in vivo execution, the prediction of post-operative hemodynamics is extremely challenging due to the interplay of multiple confounding physiological factors. It is hypothesized that the post-operative performance of the surgical shunt can be predicted through computational blood flow simulations that consider patient ...

  16. Russia: An Abnormal Country

    Directory of Open Access Journals (Sweden)

    Steven Rosefielde

    2005-06-01

    Full Text Available Andrei Shleifer and Daniel Treisman recently rendered a summary verdict on the post Soviet Russian transition experience finding that the Federation had become a normal country with the west's assistance, and predicting that it would liberalize and develop further like other successful nations of its type. This essay demonstrates that they are mistaken on the first count, and are likely to be wrong on the second too. It shows factually, and on the norms elaborated by Pareto, Arrow and Bergson that Russia is an abnormal political economy unlikely to democratize, westernize or embrace free enterprise any time soon

  17. Abnormal ionization in sonoluminescence

    Science.gov (United States)

    Zhang, Wen-Juan; An, Yu

    2015-04-01

    Sonoluminescence is a complex phenomenon, the mechanism of which remains unclear. The present study reveals that an abnormal ionization process is likely to be present in the sonoluminescing bubble. To fit the experimental data of previous studies, we assume that the ionization energies of the molecules and atoms in the bubble decrease as the gas density increases and that the decrease of the ionization energy reaches about 60%-70% as the bubble flashes, which is difficult to explain by using previous models. Project supported by the Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20120002110031) and the National Natural Science Foundation of China (Grant No. 11334005).

  18. Effects of different vasopressors on hemodynamics in patients undergoing orthotopic liver transplantation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-ping; LI Min; YANG Lu

    2005-01-01

    Background The hyperdynamic circulatory state in end-stage liver disease is similar to the hemodynamic state in endotoxic shock. Recent research indicated that proper use of norepinephrine (NE) in patients with endotoxic shock could improve the perfusion of visceral organs and raise the survival rate. In this study, dopamine (DA) or NE combined with DA was infused during the orthotopic liver transplantation (OLT) to observe and compare their effects on hemodynamics, oxygenation, and renal function during different stages of the operation. Methods Thirty American Society of Anesthesiology (ASA) Ⅲ-Ⅳ patients undergoing OLT were randomly divided into group DA and group NE with 15 patients in each group. Vasopressors were infused after induction of anesthesia. DA was infused in group DA; DA and NE in group NE. Data of hemodynamics, oxygenation and renal function were collected after induction, 1 hour in preanhepatic, anhepatic, neohepatic phase and at the end of operation.Results Heart rate(HR) and mean arterial pressure (MAP) of the two groups were stable. In anhepatic phase, central venous pressure(CVP), mean pulmonary arterial pressure(MPAP), pulmonary arterial wedge pressure(PAWP), cardiac output (CO), and cardiac index (CI) decreased, whereas systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI) increased significantly (P<0.05). The hemodynamic variables of group NE were more stable than that of group DA. Pulmonary vascular resistance(PVR), pulmonary vascular resistance index(PVRI), power of hydrogen(pH), and mixed venous oxygen saturation (SvO2) had no significant changes. Oxygen delivery (DO2) and oxygen consumption(VO2) decreased during anhepatic phase (P<0.05), but lactic acid (LAC)increased since anhepatic phase. Blood urea nitrogen (BUN) maintained relatively stable during different phases. Group NE had more urine output (F=4.733, P=0.039). Conclusions During OLT, both DA and NE combined with DA can maintain hemodynamics stable

  19. Dopaminergic system abnormalities Etiopathogenesis of dystonia

    Institute of Scientific and Technical Information of China (English)

    Shuhui Wu; Huifang Shang; Xiaoyi Zou

    2008-01-01

    BACKGROUND: Much research has focused on the close relationship between etiopathogenesis of dystonia and abnormalities of the dopaminergic system. Nevertheless, details of the mechanism are still not clear.OBJECTIVE: To review studies from the past few years about pathogenesis and molecular interactions involved in the relationship between dystonia and abnormalities of the dopaminergic system.RETRIEVAL STRATEGY: Using the key words "dystonia" and "dopamine", PubMed database and SCI databases were searched from January 1990 to December 2005 for relevant English publications. A total of 73 articles were searched and, initially, all articles were selected. Inclusive criteria: studies based on pathogenesis and molecular interactions involved in the relationship between dystonia and abnormalities of the dopaminergic system. Exclusive criteria: duplicated studies. A total of 19 articles were extracted after preliminary screening.LITERATURE EVALUATION: The data sources were the PubMed and SCI databases. The types of articles chosen were reviews and original articles.DATA SYNTHESIS: Metabolism and function of dopamine in the central nervous system: the chemical constitution of dopamine is a single benzene ring. The encephalic regions of dopamine synthesis and their fiber projections comprise four nervous system pathways. One of these pathways is the substantia nigra-striatum dopamine pathway, which is a side-loop of the basal ganglia circuitry that participates in movement control and plays a main role in the adjustment of extracorticospinal tract movement. Dopamine can lead to the facilitation of movement. Dystonia and abnormalities of the dopaminergic system: different modes of dopamine abnormality exist in various forms of dystonia. Abnormalities of the dopaminergic system in several primary dystonias: at present, fifteen gene loci of primary dystonia have been reported (DYT1-DYT15). The relationship between abnormalities of the dopaminergic system and the

  20. Hemodynamic simulations in coronary aneurysms of a patient with Kawasaki Disease

    Science.gov (United States)

    Sengupta, Dibyendu; Marsden, Alison; Burns, Jane

    2010-11-01

    Kawasaki Disease is the leading cause of acquired pediatric heart disease, and can cause large coronary artery aneurysms in untreated cases. A simulation case study has been performed for a 10-year-old male patient with coronary aneurysms. Specialized coronary boundary conditions along with a lumped parameter heart model mimic the interactions between the ventricles and the coronary arteries, achieving physiologic pressure and flow waveforms. Results show persistent low shear stress in the aneurismal regions, and abnormally high shear at the aneurysm neck. Correlation functions have been derived to compare wall shear stress and wall shear stress gradients with recirculation time with the idea of localizing zones of calcification and thrombosis. Results are compared with those of an artificially created normal coronary geometry for the same patient. The long-term goal of this work is to develop links between hemodynamics and thrombotic risk to assist in clinical decision-making.

  1. Effect of an inelastic aortic synthetic vascular graft on exercise hemodynamics.

    Science.gov (United States)

    Kim, S Y; Hinkamp, T J; Jacobs, W R; Lichtenberg, R C; Posniak, H; Pifarré, R

    1995-04-01

    This study compared aortic input impedance characteristics between patients with aortic interposition Dacron grafts placed for traumatic aortic injury and normal age-matched control subjects. All subjects were examined at rest and after treadmill exercise. Magnetic resonance imaging was conducted to rule out anatomic (stenosis) effects. Exercise increased characteristic impedance (ie, reduced aortic distensibility) by 29% and decreased total systemic arterial compliance by 21% in the patient group, whereas the normal control group showed insignificant change in these variables after exercise. Peripheral pressure wave reflection was reduced substantially with exercise (27%) in the control group, with much less reduction observed in the patient group. These abnormal vascular hemodynamics were associated with significantly high cardiac energetic costs in the patient group. A plausible explanation for the observed differences lies in the exaggerated vascular impedance mismatch between compliant aorta and inelastic graft, when cardiac output increases dramatically.

  2. Wireless Monitoring of Liver Hemodynamics In Vivo

    Energy Technology Data Exchange (ETDEWEB)

    Akl, Tony [Texas A& M University; Wilson, Mark A. [University of Pittsburgh School of Medicine, Pittsburgh PA; Ericson, Milton Nance [ORNL; Farquhar, Ethan [ORNL; Cote, Gerard L. [Texas A& M University

    2014-01-01

    Liver transplants have their highest technical failure rate in the first two weeks following surgery. Currently, there are limited devices for continuous, real-time monitoring of the graft. In this work, a three wavelengths system is presented that combines near-infrared spectroscopy and photoplethysmography with a processing method that can uniquely measure and separate the venous and arterial oxygen contributions. This strategy allows for the quantification of tissue oxygen consumption used to study hepatic metabolic activity and to relate it to tissue stress. The sensor is battery operated and communicates wirelessly with a data acquisition computer which provides the possibility of implantation provided sufficient miniaturization. In two in vivo porcine studies, the sensor tracked perfusion changes in hepatic tissue during vascular occlusions with a root mean square error (RMSE) of 0.135 mL/min/g of tissue. We show the possibility of using the pulsatile wave to measure the arterial oxygen saturation similar to pulse oximetry. The signal is also used to extract the venous oxygen saturation from the direct current (DC) levels. Arterial and venous oxygen saturation changes were measured with an RMSE of 2.19% and 1.39% respectively when no vascular occlusions were induced. This error increased to 2.82% and 3.83% when vascular occlusions were induced during hypoxia. These errors are similar to the resolution of a commercial oximetry catheter used as a reference. This work is the first realization of a wireless optical sensor for continuous monitoring of hepatic hemodynamics.

  3. Inverse correlation between testosterone and ventricle ejection fraction, hemodynamics and exercise capacity in heart failure patients with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Edimar A. Bocchi

    2008-06-01

    Full Text Available BACKGROUND: Neurohormonal activation and abnormalities in growth hormone and testosterone concentrations have been reported in heart failure (HF. Erectile dysfunction(ED is common in these patients and contributes to a low quality of life. No data are known regarding the correlation between testosterone and hemodynamics, exercise capacity and cardiac function in HF patients with ED, a marker of endothelial dysfunction. The aim of this study was to correlate testosterone levels with cardiac function, hemodynamic and exercise capacity in HF patients with ED. MATERIALS AND METHODS: Fifteen HF patients underwent a six-minute treadmill cardiopulmonary walking test (6'CWT and, ten minutes later, a maximum cardiopulmonary exercise test. Also, testosterone and other hormones were determined at rest. RESULTS: Among hemodynamic variables only diastolic blood pressure on 6'CWT was correlated with testosterone levels(r =- 0.66, p = 0.007. The variables on exercise tests, VE/VCO2 slope and oxygen consumption did not show any correlation, except the distance at 6'CWT (r = 0.50, p = 0,047. Right and left ventricle ejection fraction showed inverse correlation with testosterone (r =- 0.55, p = 0.03 and r =- 0.69, p = 0.004 respectively. CONCLUSION: Testosterone levels correlated directly with distance at six-minute cardiopulmonary walk test and inversely with diastolic blood pressure, right and left ventricle ejection fraction in heart failure patients with erectile dysfunction. Further elucidation of mechanisms as regards testosterone action in these patients is warranted.

  4. Hemodynamics, inflammation, vascular remodeling, and the development and rupture of intracranial aneurysms: a review

    Directory of Open Access Journals (Sweden)

    Francesco Signorelli

    2015-06-01

    Full Text Available The central nervous system is an immunologically active environment where several components of the immune and inflammatory response interact among them and with the constituents of nervous tissue and vasculature in a critically orchestrated manner, influencing physiologic and pathologic processes. In particular, inflammation takes a central role in the pathogenesis of intracranial aneurysms (IAs. The common pathway for aneurysm formation involves endothelial dysfunction and injury, a mounting inflammatory response, vascular smooth muscle cells (VSMCs phenotypic modulation, extracellular matrix remodeling, and subsequent cell death and vessel wall degeneration. We conducted a literature review (1980-2014 by Medline and EMBASE databases using the searching terms "IA" and "cerebral aneurysm" and further search was performed to link the search terms with the following key words: inflammation, hemodynamic(s, remodeling, macrophages, neutrophils, lymphocytes, complement, VSMCs, mast cells, cytokines, and inflammatory biomarkers. The aim of this review was to summarize the most recent and pertinent evidences regarding the articulated processes of aneurysms formation, growth, and rupture. Knowledge of these processes may guide the diagnosis and treatment of these vascular malformations, the most common cause of subarachnoid hemorrhage, which prognosis remains dismal.

  5. Hemodynamic changes in patients with extracorporeal membrane oxygenation (ECMO) demonstrated by contrast-enhanced CT examinations - implications for image acquisition technique.

    Science.gov (United States)

    Lambert, Lukas; Grus, Tomas; Balik, Martin; Fichtl, Jaromir; Kavan, Jan; Belohlavek, Jan

    2016-10-30

    Extracorporeal membrane oxygenation (ECMO) is an established tool for respiratory and circulatory support. In computed tomography, altered hemodynamics in ECMO patients requires special considerations and handling in contrast injection and its timing. In this article, we demonstrate changes in hemodynamics in ECMO patients captured on contrast-enhanced CT examinations and pitfalls in strategies for contrast injection in relation to the ECMO flow, cardiac function and the placement of ECMO cannulas. Contrast-enhanced CT of patients with ECMO requires prior knowledge of the ECMO cannulas, central venous lines, changes of hemodynamics induced by low cardiac output and the influence of adjustment of ECMO on blood flow in order to optimize injection of the contrast material and timing of the scan. Special considerations include temporary reduction of the ECMO flow, selection of the injection site and increasing volume or flow rate of the contrast material.

  6. A Rare Stapes Abnormality

    Directory of Open Access Journals (Sweden)

    Hala Kanona

    2015-01-01

    Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.

  7. Computational Investigation of Hemodynamics in Fully Stenosed CABG

    Institute of Scientific and Technical Information of China (English)

    QIAOAi-ke; LIUYou-jun

    2004-01-01

    Coronary Artery Bypass Graft (CABG) is an important surgical treatment for critically stenosed arteries. Unfortunately restenosis always occurs after CABG surgery, which bring about surgery failure, lntimal thickening in the CABG distal anastomosis has been implicated as the major cause of restenosis and long-term graft failure. The nonuniform hemodynamics including disturbed flows, recirculation zones, oscillating wall shear stress, and long particle residence time were thought to be the possible etiologies. Numerical simulation was proved to be of great help and guidance meaning for the biofluid mechanics research and the CABG surgical plan. The present study was based on the hypothesis that the geometry configuration of CABG could greatly influence the hemodynamics in the vicinity of anastomosis. The hemodynamic features of two geometry models of end-to-side CABG were studied and compared. One simulated a conventional CABG with 1-way bypass graft, and the other simulated a modified CABG with symmetric 2-way bypass graft. The numerical investigations of hemodynamics in these two models with fully stenosed coronary arteries were accomplished using finite element method. The temporal and spatial distributions of hemodynamics were analyzed and compared. Results showed that the presence of symmetric 2-way bypass graft was of reasonable and favorable hemodynamics than 1-way bypass graft. The modified CABG model created a more hemodynamically efficient streamlined environment with higher mean and maximum axial velocities and lower radial velocities than the conventional 1-way model. Meanwhile, the symmetric 2-way bypass graft was featured with low pressure near the wall, high and uniform WSS in the host artery. All of these were favorable for inhibiting the development of intimal thickening, restenosis, and ultimate failure of the CABG, and it could considerably improve the flow conditions and decrease the probability of intimal hyperplasia and restenosis of CABG.

  8. Wireless monitoring of liver hemodynamics in vivo.

    Directory of Open Access Journals (Sweden)

    Tony J Akl

    Full Text Available Liver transplants have their highest technical failure rate in the first two weeks following surgery. Currently, there are limited devices for continuous, real-time monitoring of the graft. In this work, a three wavelengths system is presented that combines near-infrared spectroscopy and photoplethysmography with a processing method that can uniquely measure and separate the venous and arterial oxygen contributions. This strategy allows for the quantification of tissue oxygen consumption used to study hepatic metabolic activity and to relate it to tissue stress. The sensor is battery operated and communicates wirelessly with a data acquisition computer which provides the possibility of implantation provided sufficient miniaturization. In two in vivo porcine studies, the sensor tracked perfusion changes in hepatic tissue during vascular occlusions with a root mean square error (RMSE of 0.135 mL/min/g of tissue. We show the possibility of using the pulsatile wave to measure the arterial oxygen saturation similar to pulse oximetry. The signal is also used to extract the venous oxygen saturation from the direct current (DC levels. Arterial and venous oxygen saturation changes were measured with an RMSE of 2.19% and 1.39% respectively when no vascular occlusions were induced. This error increased to 2.82% and 3.83% when vascular occlusions were induced during hypoxia. These errors are similar to the resolution of a commercial oximetry catheter used as a reference. This work is the first realization of a wireless optical sensor for continuous monitoring of hepatic hemodynamics.

  9. An Attempt to evaluate cerebral hemodynamics before and after neurosurgical treatment of Moyamoya disease by factor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nakazawa, Keiji; Ishii, Katsumi; Sakai, Fumihiko; Matsubayashi, Takashi (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

    1991-09-01

    We made factor analysis on the data obtained by the radionuclide angiography to evaluate cerebral hemodynamics before and after neurosurgical treatment in a patient with Moyamoya disease (bilateral occlusion of internal carotid arteries). Tracer used was {sup 99m}Tc-RBC or {sup 99m}TcHSA. Before the neurosurgical treatment, the cerebral factor image obtained by the factor analysis showed defects in the right and the left frontal cerebral regions, and the venous factor image showed abnormal accumulations in the right and the left frontal cerebral regions. After Encephalo-Myo-Synangiosis and burr hole operations, defects in the right and the left frontal cerebral regions on the cerebral factor image were improved and abnormal accumulations in the right and the left frontal cerebral regions on the venous factor image disappeared. (author).

  10. Cardiac Arrhythmias and Abnormal Electrocardiograms After Acute Stroke.

    Science.gov (United States)

    Ruthirago, Doungporn; Julayanont, Parunyou; Tantrachoti, Pakpoom; Kim, Jongyeol; Nugent, Kenneth

    2016-01-01

    Cardiac arrhythmias and electrocardiogram (ECG) abnormalities occur frequently but are often underrecognized after strokes. Acute ischemic and hemorrhagic strokes in some particular area of brain can disrupt central autonomic control of the heart, precipitating cardiac arrhythmias, ECG abnormalities, myocardial injury and sometimes sudden death. Identification of high-risk patients after acute stroke is important to arrange appropriate cardiac monitoring and effective management of arrhythmias, and to prevent cardiac morbidity and mortality. More studies are needed to better clarify pathogenesis, localization of areas associated with arrhythmias and practical management of arrhythmias and abnormal ECGs after acute stroke.

  11. A Case of Habitual Neck Compression Induced Electroencephalogram Abnormalities: Differentiating from Epileptic Seizures Using a Tc-99m HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hongyoon; Seo, Minseok; Lee, Hoyoung; Kim, Youngsoo; Yun, Changho; Kim, Sangeun; Park, Sungho [Seoul National Univ. Bundang Hospital, Seongnam (Korea, Republic of)

    2014-06-15

    Self-induced hypoxia has been reported particularly in adolescents, and it can result in neurological injury. Here, we present a case of electroencephalogram (EEG) abnormalities induced by habitual neck compression differentiated from epileptic seizures by Tc-99m HMPAO SPECT. A 19-year-old male was admitted for evaluation of recurrent generalized tonic-clonic seizures. No interictal EEG abnormality was detected; however, abnormal slow delta waves were found immediately after habitual right neck compression. To differentiate EEG abnormalities due to a hemodynamic deficit induced by habitual neck compression from an epileptic seizure, Tc-99m HMPAO SPECT was performed immediately after right carotid artery compression. Abnormal delta waves were triggered, and cerebral hypoperfusion in the right internal carotid artery territory was detected on Tc-99m HMPAO SPECT. The slow delta wave detected on the EEG resulted from the cerebral hypoperfusion because of the habitual neck compression.

  12. Hemodynamics in Idealized Stented Coronary Arteries: Important Stent Design Considerations.

    Science.gov (United States)

    Beier, Susann; Ormiston, John; Webster, Mark; Cater, John; Norris, Stuart; Medrano-Gracia, Pau; Young, Alistair; Cowan, Brett

    2016-02-01

    Stent induced hemodynamic changes in the coronary arteries are associated with higher risk of adverse clinical outcome. The purpose of this study was to evaluate the impact of stent design on wall shear stress (WSS), time average WSS, and WSS gradient (WSSG), in idealized stent geometries using computational fluid dynamics. Strut spacing, thickness, luminal protrusion, and malapposition were systematically investigated and a comparison made between two commercially available stents (Omega and Biomatrix). Narrower strut spacing led to larger areas of adverse low WSS and high WSSG but these effects were mitigated when strut size was reduced, particularly for WSSG. Local hemodynamics worsened with luminal protrusion of the stent and with stent malapposition, adverse high WSS and WSSG were identified around peak flow and throughout the cardiac cycle respectively. For the Biomatrix stent, the adverse effect of thicker struts was mitigated by greater strut spacing, radial cell offset and flow-aligned struts. In conclusion, adverse hemodynamic effects of specific design features (such as strut size and narrow spacing) can be mitigated when combined with other hemodynamically beneficial design features but increased luminal protrusion can worsen the stent's hemodynamic profile significantly.

  13. Hemodynamic coherence and the rationale for monitoring the microcirculation.

    Science.gov (United States)

    Ince, Can

    2015-01-01

    This article presents a personal viewpoint of the shortcoming of conventional hemodynamic resuscitation procedures in achieving organ perfusion and tissue oxygenation following conditions of shock and cardiovascular compromise, and why it is important to monitor the microcirculation in such conditions. The article emphasizes that if resuscitation procedures are based on the correction of systemic variables, there must be coherence between the macrocirculation and microcirculation if systemic hemodynamic-driven resuscitation procedures are to be effective in correcting organ perfusion and oxygenation. However, in conditions of inflammation and infection, which often accompany states of shock, vascular regulation and compensatory mechanisms needed to sustain hemodynamic coherence are lost, and the regional circulation and microcirculation remain in shock. We identify four types of microcirculatory alterations underlying the loss of hemodynamic coherence: type 1, heterogeneous microcirculatory flow; type 2, reduced capillary density induced by hemodilution and anemia; type 3, microcirculatory flow reduction caused by vasoconstriction or tamponade; and type 4, tissue edema. These microcirculatory alterations can be observed at the bedside using direct visualization of the sublingual microcirculation with hand-held vital microscopes. Each of these alterations results in oxygen delivery limitation to the tissue cells despite the presence of normalized systemic hemodynamic variables. Based on these concepts, we propose how to optimize the volume of fluid to maximize the oxygen-carrying capacity of the microcirculation to transport oxygen to the tissues.

  14. Down-regulation of integrin β1 and focal adhesion kinase in renal glomeruli under various hemodynamic conditions.

    Directory of Open Access Journals (Sweden)

    Xiaoli Yuan

    Full Text Available Given that integrin β1 is an important component of the connection to maintain glomerular structural integrity, by binding with multiple extracellular matrix proteins and mediating intracellular signaling. Focal adhesion kinase (FAK is the most essential intracellular integrator in the integrin β1-FAK signalling pathway. Here, we investigated the changes of the two molecules and visualized the possible interaction between them under various hemodynamic conditions in podocytes. Mice kidney tissues were prepared using in vivo cryotechnique (IVCT and then were stained and observed using light microscopy, confocal laser scanning microscopy and immunoelectron microscopy. The expression of these molecules were examined by western blot. Under the normal condition, integrin β1 stained continually and evenly at the membrane, and FAK was located in the cytoplasm and nuclei of the podocytes. There were significant colocalized plaques of two molecules. But under acute hypertensive and cardiac arrest conditions, integrin β1 decreased and stained intermittently. Similarly, FAK decreased and appeared uneven. Additionally, FAK translocated to the nuclei of the podocytes. As a result, the colocalization of integrin β1 and FAK reduced obviously under these conditions. Western blot assay showed a consistent result with the immunostaining. Collectively, the abnormal redistribution and decreased expressions of integrin β1 and FAK are important molecular events in regulating the functions of podocytes under abnormal hemodynamic conditions. IVCT could offer considerable advantages for morphological analysis when researching renal diseases.

  15. Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

    Directory of Open Access Journals (Sweden)

    Elif Basagan-Mogo

    2010-01-01

    Full Text Available OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting surgery is both the attenuation of sympathetic responses to noxious stimuli and the prevention of hypotension. METHODS: Thirty patients undergoing coronary artery bypass grafting surgery were randomized to receive either ketamine 2 mg.kg-1 (Group K or propofol 0.5 mg.kg-1 (Group P during induction of anesthesia. Patients also received standardized doses of midazolam, fentanyl, and rocuronium in the induction sequence. The duration of anesthesia from induction to skin incision and sternotomy, as well as the supplemental doses of fentanyl and sevoflurane, were recorded. Heart rate, mean arterial pressure, central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index, systemic and pulmonary vascular resistance indices, stroke work index, and left and right ventricular stroke work indices were obtained before induction of anesthesia; one minute after induction; one, three, five, and ten minutes after intubation; one minute after skin incision; and at one minute after sternotomy. RESULTS: There were significant changes in the measured and calculated hemodynamic variables when compared to their values before induction. One minute after induction, mean arterial pressure and the systemic vascular resistance index decreased significantly in group P (p<0.01. CONCLUSION: There were no differences between groups in the consumption of sevoflurane or in the use of additional fentanyl. The combination of ketamine, midazolam, and

  16. Computational study of the hemodynamics of the patients after the fontan procedure

    Energy Technology Data Exchange (ETDEWEB)

    Shim, E.B.; Ko, H.J.; Kim, K.H. [Kumoh National University of Technology, Kumi (Korea); Roger D, Kamm [MIT, Cambridge (United States)

    2000-11-01

    In this study, the computational method is presented to simulate the hemodynamics of the patients after the Fontan procedure. The short-term feedback control models are implemented to assess the hemodynamic responses of the patients exposed to the stresses such as gravitational effect or hemorrhage. To construct the base line of the Fontan model, we assume an increase in venous tone, in heart rates, and in systemic resistance that are based on the clinical observations. For the verification of the present method we simulate the LBNP(lower body negative pressure) test for the normal and the Fontan model and we compare these with experimental data. Computational results show that the diastolic ABP(arterial blood pressure) increases but the systolic ABP decreases during LBNP. The increase in heart rate is due to the control system activated by the decreased mean ABP and CVP(central venous pressure). In case of the Fontan model, the increased venous tone is the reason of the diminished CVP change during LBNP. We also simulate 20 % hemorrhage stress to the patient after the Fontan procedure and these results are compared with the experimental and the existing computational one. Computational results on the hemodynamics of patients after the Fontan procedure show that the mean ABP and cardiac output decrease. Heart rate and systemic resistance increase to compensate for the decrease in ABP. The sensitivity analysis according to the conduit resistance is also presented to delineate the effects of the local blood flow resistance. The cardiac output decreases according to the increase of the conduit resistance. The 50 % increase in the conduit resistance causes about 3 % decrease of cardiac output. (author). 12 refs., 8 figs.

  17. Communication and abnormal behaviour.

    Science.gov (United States)

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

  18. Upper extremity hemodynamics and sensation with backpack loads.

    Science.gov (United States)

    Kim, Sae Hoon; Neuschwander, Timothy B; Macias, Brandon R; Bachman, Larry; Hargens, Alan R

    2014-05-01

    Heavy backpacks are often used in extreme environments, for example by military during combat, therefore completion of tasks quickly and efficiently is of operational relevance. The purpose of this study was to quantify hemodynamic parameters (brachial artery Doppler and microvascular flow by photoplethysmography; tissue oxygenation by near-infrared spectroscopy; arterial oxygen saturation by pulse oximeter) and sensation in upper extremities and hands (Semmes-Weinstein monofilament test and 2-point discrimination test) while wearing a loaded backpack (12 kg) in healthy adults for 10 min. All values were compared to baseline before wearing a backpack. Moderate weight loaded backpack loads significantly decreased upper extremity sensation as well as all macrovascular and microvascular hemodynamic values. Decreased macrovascular and microvascular hemodynamics may produce neurological dysfunction and consequently, probably affect fine motor control of the hands.

  19. Non-invasive quantification of hemodynamics in human choriocapillaries

    Science.gov (United States)

    Yu, Huidan (Whitney); Chen, Rou; An, Senyou; McDonough, James; Gelfand, Bradley; Yao, Jun

    2016-11-01

    The development of retinal disease is inextricably linked to defects in the choroidal blood supply. However, to date a description of the hemodynamics in the human choroidal circulation is lacking. Through high resolution choroidal vascular network mapped from immunofluorescent labeling and confocal microscopy of human cadaver donor eyes. We noninvasively quantify hemodynamics including velocity, pressure, and wall-shear stress (WSS) in choriocapillaries through mesoscale modeling and GPU-accelerated fast computation. This is the first-ever map of hemodynamic parameters (WSS, pressure, and velocity) in anatomically accurate human choroidal vasculature in health and disease. The pore scale simulation results are used to evaluate porous media models with the same porosity and boundary conditions. School of Medicine, Indiana University.

  20. Association of interatrial septal abnormalities with cardiac impulse conduction disorders in adult patients: experience from a tertiary center in Kosovo.

    Directory of Open Access Journals (Sweden)

    Zaim Gashi

    2011-06-01

    Full Text Available Interatrial septal disorders, which include: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Intera trial septal anomalies were detected in around 85% of the examined patients.

  1. Hemodynamic response of modified fluid gelatin compared with lactated ringer's solution for volume expansion in emergency resuscitation of hypovolemic shock patients: preliminary report of a prospective, randomized trial.

    Science.gov (United States)

    Wu, J J; Huang, M S; Tang, G J; Kao, W F; Shih, H C; Su, C H; Lee, C H

    2001-05-01

    The objective of this study was to compare the cardiac and hemodynamic responses to a rapid infusion of 1000 ml of modified fluid gelatin (group A) or 1000 ml of lactated Ringer's solution (group B) in emergency room patients suffering from shock. This prospective, randomized, open, noncrossover study was performed at a medical center university hospital in a surgical resuscitation room in the emergency department. The subjects were 34 patients with either hypovolemic or neurogenic shock who were admitted to the emergency room. A resuscitation protocol according to Advanced Trauma Life Support (ATLS) with an additional central venous line or Swan-Ganz catheters for hemodynamic monitoring was used. Physical parameters and hemodynamic variables were measured at baseline and 15 minutes, 30 minutes, and 1 hour after the infusion of each fluid. In both groups the mean arterial blood pressure (MAP), systolic and diastolic pressure, central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP) increased significantly. The CVP and PAOP increased significantly more in the modified fluid gelatin resuscitation group. In patients with traumatic or neurogenic shock due to acute volume deficiency, there was significantly better hemodynamic improvement, judged by CVP and PAOP measurements using the modified fluid gelatin for volume replacement than with lactated Ringer's solution during the first hour of resuscitation.

  2. Ultrasonic Imaging of Hemodynamic Force in Carotid Blood Flow

    Science.gov (United States)

    Nitta, N.; Homma, K.

    Hemodynamic forces including blood pressure and shear stress affect vulnerable plaque rupture in arteriosclerosis and biochemical activation of endothelium such as NO production. In this study, a method for estimating and imaging shear stress and pressure gradient distributions in blood vessel as the hemodynamic force based on viscosity estimation is presented. Feasibility of this method was investigated by applying to human carotid blood flow. Estimated results of shear stress and pressure gradient distributions coincide with the ideal distributions obtained by numerical simulation and flow-phantom experiment.

  3. Effect of dialysate temperature on hemodynamic stability among hemodialysis patients

    OpenAIRE

    Azar Ahmad

    2009-01-01

    Cooling the dialysate below 36.5°C is an important factor that contributes to hemody-namic stability in patients during hemodialysis (HD). In this study, the effect of dialysate tempe-rature on hemodynamic stability, patients′ perception of dialysis discomfort and post dialysis fatigue were assessed in a group of patients on HD. A total of 50 patients, all of whom were on 3-times-per-week dialysis regimen, were studied. Patients were assessed during six dialysis sessions; in thr...

  4. The hemodynamic management of elderly patients with sepsis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Sepsis is among the most common reason for admission to intensive care units throughout the world. In the US and most Western nations sepsis is largely a disease of the elderly. Management of elderly patients with severe sepsis is challenging. Early recognition of this syndrome, together with the early administration of appropriate antibiotics and cautious fluid resuscitation is the cornerstone of therapy. Echocardiography together with non-invasive or invasive hemodynamic monitoring is recommended in patients who have responded poorly to fluids or have significant underlying cardiac disease. This paper reviews the hemodynamic changes that characterize sepsis, particularly as they apply to elderly patients and provides recommendations for the management of these patients.

  5. Hemodynamic management of cardiovascular failure by using PCO(2) venous-arterial difference.

    Science.gov (United States)

    Dres, Martin; Monnet, Xavier; Teboul, Jean-Louis

    2012-10-01

    The difference between mixed venous blood carbon dioxide tension (PvCO(2)) and arterial carbon dioxide tension (PaCO(2)), called ∆PCO(2) has been proposed to better characterize the hemodynamic status. It depends on the global carbon dioxide (CO(2)) production, on cardiac output and on the complex relation between CO(2) tension and CO(2) content. The aim of this review is to detail the physiological background allowing adequate interpretation of ∆PCO(2) at the bedside. Clinical and experimental data support the use of ∆PCO(2) as a valuable help in the decision-making process in patients with hemodynamic instability. The difference between central venous CO(2) tension and arterial CO(2) tension, which is easy to obtain can substitute for ∆PCO(2) to assess the adequacy of cardiac output. Differences between local tissue CO(2) tension and arterial CO(2) tension can also be obtained and provide data on the adequacy of local blood flow to the local metabolic conditions.

  6. Effect of inhibition of converting enzyme on renal hemodynamics and sodium management in polycystic kidney disease.

    Science.gov (United States)

    Torres, V E; Wilson, D M; Burnett, J C; Johnson, C M; Offord, K P

    1991-10-01

    We compared the tubular transport of sodium and the erythrocyte sodium-lithium countertransport activity in hypertensive patients with autosomal dominant polycystic kidney disease (ADPKD) and in normotensive control subjects. In addition, we assessed the effects of inhibition of converting enzyme on renal hemodynamics and sodium excretion in hypertensive patients with ADPKD to provide information on mechanisms responsible for the increased renal vascular resistance and filtration fraction and the adjustment of the pressure-natriuresis relationship during saline expansion, observed in patients with ADPKD, hypertension, and preserved renal function. In comparison with normotensive control subjects, the hypertensive patients with ADPKD had lower renal plasma flows, higher renal vascular resistances and filtration fractions, and similar proximal and distal fractional reabsorptions of sodium. The administration of enalapril resulted in significant increases in the renal plasma flow and significant reductions in mean arterial pressure, renal vascular resistance, and filtration fraction, but the glomerular filtration rate remained unchanged. Despite the significant reduction in mean arterial pressure during inhibition of converting enzyme, the distal fractional reabsorption of sodium decreased while the total fractional excretion of sodium remained unchanged or increased slightly. No significant differences were detected between the normotensive control subjects and the hypertensive patients with ADPKD in erythrocyte sodium-lithium countertransport activity, plasma renin activity, plasma aldosterone concentration, or atrial natriuretic factor. These results suggest that the renal renin-angiotensin system plays a central role in the alterations in renal hemodynamics and sodium management associated with the development of hypertension in ADPKD.

  7. Systemic abnormalities in liver disease

    Institute of Scientific and Technical Information of China (English)

    Masami Minemura; Kazuto Tajiri; Yukihiro Shimizu

    2009-01-01

    Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases.

  8. Abnormal pressure in hydrocarbon environments

    Science.gov (United States)

    Law, B.E.; Spencer, C.W.

    1998-01-01

    Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

  9. Magnetic resonance imaging based noninvasive measurements of brain hemodynamics in neonates : A review

    NARCIS (Netherlands)

    De Vis, Jill B; Alderliesten, Thomas; Hendrikse, Jeroen; Petersen, Esben T; Benders, Manon Jnl

    2016-01-01

    Perinatal disturbances of brain hemodynamics can have a detrimental effect on the brain's parenchyma with consequently adverse neurodevelopmental outcome. Noninvasive, reliable tools to evaluate the neonate's brain hemodynamics are scarce. Advances in magnetic resonance imaging have provided new met

  10. The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals

    DEFF Research Database (Denmark)

    Wolsk, Emil; Bakkestrøm, Rine; Thomsen, Jacob H

    2017-01-01

    . Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. RESULTS: During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise...

  11. The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals

    DEFF Research Database (Denmark)

    Wolsk, Emil; Bakkestrøm, Rine; Thomsen, Jacob H

    2016-01-01

    The authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds...

  12. Methylene Blue Is Effective to Reverse Refractory Hemodynamic Instability due to Dimethoate Poisoning

    Directory of Open Access Journals (Sweden)

    Nick Youssefi

    2015-09-01

    Conclusion:MB treatment was effective to reverse hypotension and restore hemodynamic instability caused by dimethoate poisoning. This index case may pave way to further investigation of MB therapy for OP-induced hemodynamic instabilities.

  13. Acute coronary hemodynamic effects of equihypotensive doses of nisoldipine and diltiazem

    NARCIS (Netherlands)

    H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); A.L. Soward; J. Planellas; G. Vanhaleweyk; P.G. Hugenholtz (Paul)

    1985-01-01

    textabstractThe hemodynamic effects of nisoldipine and diltiazem were investigated in two groups of patients undergoing investigation for suspected coronary artery disease. Emphasis was placed on the coronary hemodynamic changes. Approximately equihypotensive doses of these two calcium channel block

  14. Visually evoked hemodynamical response and assessment of neurovascular coupling in the optic nerve and retina.

    Science.gov (United States)

    Riva, Charles E; Logean, Eric; Falsini, Benedetto

    2005-03-01

    The retina and optic nerve are both optically accessible parts of the central nervous system. They represent, therefore, highly valuable tissues for studies of the intrinsic physiological mechanism postulated more than 100 years ago by Roy and Sherrington, by which neural activity is coupled to blood flow and metabolism. This article describes a series of animal and human studies that explored the changes in hemodynamics and oxygenation in the retina and optic nerve in response to increased neural activity, as well as the mechanisms underlying these changes. It starts with a brief review of techniques used to assess changes in neural activity, hemodynamics, metabolism and tissue concentration of various potential mediators and modulators of the coupling. We then review: (a) the characteristics of the flicker-induced hemodynamical response in different regions of the eye, starting with the optic nerve, the region predominantly studied; (b) the effect of varying the stimulus parameters, such as modulation depth, frequency, luminance, color ratio, area of stimulation, site of measurement and others, on this response; (c) data on activity-induced intrinsic reflectance and functional magnetic resonance imaging signals from the optic nerve and retina. The data undeniably demonstrate that visual stimulation is a powerful modulator of retinal and optic nerve blood flow. Exploring the relationship between vasoactivity and metabolic changes on one side and corresponding neural activity changes on the other confirms the existence of a neurovascular/neurometabolic coupling in the neural tissue of the eye fundus and reveals that the mechanism underlying this coupling is complex and multi-factorial. The importance of fully exploiting the potential of the activity-induced vascular changes in the assessment of the pathophysiology of ocular diseases motivated studies aimed at identifying potential mediators and modulators of the functional hyperemia, as well as conditions

  15. Magnetic resonance imaging based noninvasive measurements of brain hemodynamics in neonates

    DEFF Research Database (Denmark)

    De Vis, Jill B; Alderliesten, Thomas; Hendrikse, Jeroen

    2016-01-01

    Perinatal disturbances of brain hemodynamics can have a detrimental effect on the brain's parenchyma with consequently adverse neurodevelopmental outcome. Noninvasive, reliable tools to evaluate the neonate's brain hemodynamics are scarce. Advances in magnetic resonance imaging have provided new...... methods to noninvasively assess brain hemodynamics. More recently these methods have made their transition to the neonatal population. The aim of this review is twofold. Firstly, to describe these newly available noninvasive methods to investigate brain hemodynamics in neonates. Secondly, to discuss...

  16. Abnormal calcium homeostasis in peripheral neuropathies.

    Science.gov (United States)

    Fernyhough, Paul; Calcutt, Nigel A

    2010-02-01

    Abnormal neuronal calcium (Ca2+) homeostasis has been implicated in numerous diseases of the nervous system. The pathogenesis of two increasingly common disorders of the peripheral nervous system, namely neuropathic pain and diabetic polyneuropathy, has been associated with aberrant Ca2+ channel expression and function. Here we review the current state of knowledge regarding the role of Ca2+ dyshomeostasis and associated mitochondrial dysfunction in painful and diabetic neuropathies. The central impact of both alterations of Ca2+ signalling at the plasma membrane and also intracellular Ca2+ handling on sensory neurone function is discussed and related to abnormal endoplasmic reticulum performance. We also present new data highlighting sub-optimal axonal Ca2+ signalling in diabetic neuropathy and discuss the putative role for this abnormality in the induction of axonal degeneration in peripheral neuropathies. The accumulating evidence implicating Ca2+ dysregulation in both painful and degenerative neuropathies, along with recent advances in understanding of regional variations in Ca2+ channel and pump structures, makes modulation of neuronal Ca2+ handling an increasingly viable approach for therapeutic interventions against the painful and degenerative aspects of many peripheral neuropathies.

  17. Abnormal parietal encephalomalacia associated with schizophrenia

    Science.gov (United States)

    Pan, Fen; Wang, Jun-Yuan; Xu, Yi; Huang, Man-Li

    2017-01-01

    Abstract Rationale: It is widely believed that structural abnormalities of the brain contribute to the pathophysiology of schizophrenia. The parietal lobe is a central hub of multisensory integration, and abnormities in this region might account for the clinical features of schizophrenia. However, few cases of parietal encephalomalacia associated with schizophrenia have been described. Patient concerns and Diagnoses: In this paper, we present a case of a 25-year-old schizophrenia patient with abnormal parietal encephalomalacia. The patient had poor nutrition and frequently had upper respiratory infections during childhood and adolescence. She showed severe schizophrenic symptoms such as visual hallucinations for 2 years. After examining all her possible medical conditions, we found that the patient had a lesion consistent with the diagnosis of encephalomalacia in her right parietal lobe and slight brain atrophy. Interventions: The patient was prescribed olanzapine (10 mg per day). Outcomes: Her symptoms significantly improved after antipsychotic treatment and were still well controlled 1 year later. Lessons: This case suggested that parietal encephalomalacia, which might be caused by inflammatory and infectious conditions in early life and be aggravated by undernutrition, might be implicated in the etiology of schizophrenia. PMID:28272261

  18. Hemodynamic and neurochemical determinates of renal function in chronic heart failure.

    Science.gov (United States)

    Gilbert, Cameron; Cherney, David Z I; Parker, Andrea B; Mak, Susanna; Floras, John S; Al-Hesayen, Abdul; Parker, John D

    2016-01-15

    Abnormal renal function is common in acute and chronic congestive heart failure (CHF) and is related to the severity of congestion. However, treatment of congestion often leads to worsening renal function. Our objective was to explore basal determinants of renal function and their response to hemodynamic interventions. Thirty-seven patients without CHF and 59 patients with chronic CHF (ejection fraction; 23 ± 8%) underwent right heart catheterization, measurements of glomerular filtration rate (GFR; inulin) and renal plasma flow (RPF; para-aminohippurate), and radiotracer estimates of renal sympathetic activity. A subset (26 without, 36 with CHF) underwent acute pharmacological intervention with dobutamine or nitroprusside. We explored the relationship between baseline and drug-induced hemodynamic changes and changes in renal function. In CHF, there was an inverse relationship among right atrial mean pressure (RAM) pressure, RPF, and GFR. By contrast, mean arterial pressure (MAP), cardiac index (CI), and measures of renal sympathetic activity were not significant predictors. In those with CHF there was also an inverse relationship among the drug-induced changes in RAM as well as pulmonary artery mean pressure and the change in GFR. Changes in MAP and CI did not predict the change in GFR in those with CHF. Baseline values and changes in RAM pressure did not correlate with GFR in those without CHF. In the CHF group there was a positive correlation between RAM pressure and renal sympathetic activity. There was also an inverse relationship among RAM pressure, GFR, and RPF in patients with chronic CHF. The observation that acute reductions in RAM pressure is associated with an increase in GFR in patients with CHF has important clinical implications.

  19. New approach to intracardiac hemodynamic measurements in small animals

    DEFF Research Database (Denmark)

    Eskesen, Kristian; Olsen, Niels T; Dimaano, Veronica L;

    2012-01-01

    Invasive measurements of intracardiac hemodynamics in animal models have allowed important advances in the understanding of cardiac disease. Currently they are performed either through a carotid arteriotomy or via a thoracotomy and apical insertion. Both of these techniques have disadvantages and...

  20. Acute hemodynamic response to vasodilators in primary pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Kulkarni H

    1996-01-01

    Full Text Available Acute hemodynamic effects of high flow oxygen (O2 inhalation, sublingual isosorbide dinitrate (ISDN, intravenous aminophylline (AMN and sublingual nifedipine (NIF were studied in 32 patients with primary pulmonary hypertension (PPH. In 30 out of 32 patients the basal ratio of pulmonary to systemic vascular resistance (Rp/Rs was > 0.5 (mean = 0.77 +/- 0.20. Oxygen caused significant decrease in the mean resistance ratio to 0.68 +/- 0.20 (p = 0.005. ISDN, AMN and NIF caused increase in the resistance ratio to 0.79 +/- 0.26; 0.78 +/- 0.26; and 0.80 +/- 0.23 respectively. O2, ISDN, AMN and NIF caused a fall of Rp/Rs in 21 (65.6%, 10 (31.2%, 10(31.2% and 9(28.1% patients respectively. Thus, of the four drugs tested high flow O2 inhalation resulted in fall of Rp/Rs in two thirds of patients whereas ISDN, AMN and NIF caused a mean rise in Rp/Rs. One third of patients did respond acutely to the latter three drugs. Acute hemodynamic studies are useful before prescribing vasodilators in patients with PPH since more of the commonly used drugs like ISDN, AMN, NIF could have detrimental hemodynamic responses in some patients. However, great caution should be exercised before performing hemodynamic study as the procedure has definite mortality and morbidity.

  1. Relationship Between Serum Uric Acid Levels and Intrarenal Hemodynamic Parameters

    Directory of Open Access Journals (Sweden)

    Hideki Uedono

    2015-06-01

    Full Text Available Background/Aims: Hyperuricemia has been reported to affect renal hemodynamics in rat models. We evaluate the relationship between serum uric acid and intrarenal hemodynamic parameters in humans, utilizing the plasma clearance of para-aminohippurate (CPAH and inulin (Cin. Methods: Renal and glomerular hemodynamics were assessed by simultaneous measurement of CPAH and Cin in 58 subjects. Of these, 19 subjects were planned to provide a kidney for transplantation; 26 had diabetes without proteinuria; and 13 had mild proteinuria. Renal and glomerular hemodynamics were calculated using Gomez`s formulae. Results: Cin was more than 60 ml/min/1.73m2 in all subjects. Serum uric acid levels correlated significantly with vascular resistance at the afferent arteriole (Ra (r = 0.354, p = 0.006 but not with that of the efferent arteriole (Re. Serum uric acid levels (β = 0.581, p = a after adjustment for several confounders (R2 = 0.518, p = Conclusions: These findings suggest, for the first time in humans, that higher serum uric acid levels are associated significantly with Ra in subjects with Cin > 60 ml/min/1.73m2. The increase in Ra in subjects with higher uric acid levels may be related to dysfunction of glomerular perfusion.

  2. Risk factors for hemodynamic instability during surgery for pheochromocytoma

    NARCIS (Netherlands)

    H. Bruynzeel; R.A. Feelders (Richard); T.H.N. Groenland (Theo); A.H. van den Meiracker (Anton); C.H.J. van Eijck (Casper); J.F. Lange (Johan); W.W. de Herder (Wouter); G. Kazemier (Geert)

    2010-01-01

    textabstractBackground: Surgery on pheochromocytoma carries a risk for hemodynamic (HD) instability. The aim of this study was to identify preoperative risk factors for intraoperative HD instability. In addition, efficacy of pretreatment with the α-adrenergic receptor (α) antagonists phenoxybenzamin

  3. Transmediastinal and Transcardiac Gunshot Wound with Hemodynamic Stability

    Directory of Open Access Journals (Sweden)

    Leire Zarain Obrador

    2014-01-01

    Full Text Available Cardiac injuries caused by knives and firearms are slightly increasing in our environment. We report the case of a 43-year-old male patient with a transmediastinal gunshot wound (TGSW and a through-and-through cardiac wound who was hemodynamically stable upon his admission. He had an entrance wound below the left clavicle, with no exit wound, and decreased breath sounds in the right hemithorax. Chest X-ray showed the bullet in the right hemithorax and large right hemothorax. The ultrasound revealed pericardial effusion, and a chest tube produced 1500 cc. of blood, but he remained hemodynamically stable. Considering these findings, a median sternotomy was carried out, the through-and-through cardiac wounds were suture-repaired, lung laceration was sutured, and a pacemaker was placed in the right ventricle. The patient had uneventful recovery and was discharged home on the twelfth postoperative day. The management and prognosis of these patients are determined by the hemodynamic situation upon arrival to the Emergency Department (ED, as well as a prompt surgical repair if needed. Patients with a TGSW have been divided into three groups according to the SBP: group I, with SBP >100 mmHg; group II, with SBP 60–100 mmHg; and group III, with SBP <60 mmHg. The diagnostic workup and management should be tailored accordingly, and several series have confirmed high chances of success with conservative management when these patients are hemodynamically stable.

  4. Pharmacological management of hemodynamic complications following spinal cord injury.

    Science.gov (United States)

    McMahon, Deanna; Tutt, Matthew; Cook, Aaron M

    2009-05-01

    Damage from spinal cord injury (SCI) may be complicated by concomitant hemodynamic alterations within hours to months of the initial insult. Neurogenic shock, symptomatic bradycardia, autonomic dysreflexia, and orthostatic hypotension are specific conditions occurring commonly with SCI. Early recognition and appropriate management of each disorder may minimize secondary injury to the cord, avert systemic complications, and help alleviate patient discomfort.

  5. Initial approach to hypertension in the hemodynamics unit: review article

    Directory of Open Access Journals (Sweden)

    Gustavo Teixeira Fulton Schimit

    2013-06-01

    Full Text Available Correct identification and early management of hypertensive disorders should be a part of the therapeutic repertoire of every professional working in hemodynamics units. Based on recent publications, this study aims to propose a practical approach to the identification and early management of these disorders in this type of service.

  6. Less invasive hemodynamic monitoring in critically ill patients

    NARCIS (Netherlands)

    Teboul, Jean-Louis; Saugel, Bernd; Cecconi, Maurizio; De Backer, Daniel; Hofer, Christoph K.; Monnet, Xavier; Perel, Azriel; Pinsky, Michael R.; Reuter, Daniel A.; Rhodes, Andrew; Squara, Pierre; Vincent, Jean-Louis; Scheeren, Thomas W.

    2016-01-01

    Over the last decade, the way to monitor hemodynamics at the bedside has evolved considerably in the intensive care unit as well as in the operating room. The most important evolution has been the declining use of the pulmonary artery catheter along with the growing use of echocardiography and of co

  7. Imaging findings of sternal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Franquet, T. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Gimenez, A. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Alegret, X. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Sanchis, E. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Rivas, A. [Dept. of Radiology, Hospital Vall d`Hebron, Universidad Autonoma de Barcelona (Spain)

    1997-05-01

    Radiographic findings in the sternal abnormalities are often nonspecific, showing appearances from a localized benign lesion to an aggressive lesion as seen with infections and malignant neoplasms. A specific diagnosis of sternal abnormalities can be suggested on the basis of CT and MR characteristics. Familiarity with the presentation and variable appearance of sternal abnormalities may aid the radiologist is suggesting a specific diagnosis. We present among others characteristic radiographic findings of hemangioma, chondrosarcoma, hydatid disease, and SAPHO syndrome. In those cases in which findings are not specific, cross-sectional imaging modalities may help the clinician in their management. (orig.)

  8. A web-based Italian survey of current trends, habits and beliefs in hemodynamic monitoring and management.

    Science.gov (United States)

    Biancofiore, Gianni; Cecconi, Maurizio; Rocca, Giorgio Della

    2015-10-01

    Significant evidence outlines that the management of the high-risk surgical patient with perioperative hemodynamic optimization leads to significant benefits. This study aimed at studying the current practice of hemodynamic monitoring and management of Italian anesthesiologists. An invitation to participate in a web-based survey was published on the web site of the Società Italiana di Anestesia Analgesia Rianimazione Terapia Intensiva. Overall, 478 questionnaires were completed. The most frequently used monitoring techniques was invasive blood pressure (94.1 %). Cardiac output was used in 41.3% of the cases mainly throughout less-invasive methods. When cardiac output was not monitored, the main reason given was that other surrogate techniques, mainly central venous oxygen saturation (40.5%). Written protocols concerning hemodynamic management in high-risk surgical patients were used by the 29.1% of the respondents. 6.3% of the respondents reported not to be aware if such document was available at their institution. 86.3% of the respondents reported that they usually optimize high risk patients but to use blood flow assessment rarely (39.7%). The most used parameter in clinical practice to assess the effects of volume loading were an increase in urine output and arterial blood pressure together with a decrease in heart rate and blood lactates. The 45.1% or the respondents outlined that hemodynamic optimization in the high risk patients is of major clinical value. Our study outlines an important gap between available evidence and clinical practice emphasizing the need for a better awareness, more information and knowledge on the specific topic.

  9. Understanding the physiology of mindfulness: aortic hemodynamics and heart rate variability.

    Science.gov (United States)

    May, Ross W; Bamber, Mandy; Seibert, Gregory S; Sanchez-Gonzalez, Marcos A; Leonard, Joseph T; Salsbury, Rebecca A; Fincham, Frank D

    2016-01-01

    Data were collected to examine autonomic and hemodynamic cardiovascular modulation underlying mindfulness from two independent samples. An initial sample (N = 185) underwent laboratory assessments of central aortic blood pressure and myocardial functioning to investigated the association between mindfulness and cardiac functioning. Controlling for religiosity, mindfulness demonstrated a strong negative relationship with myocardial oxygen consumption and left ventricular work but not heart rate or blood pressure. A second sample (N = 124) underwent a brief (15 min) mindfulness inducing intervention to examine the influence of mindfulness on cardiovascular autonomic modulation via blood pressure variability and heart rate variability. The intervention had a strong positive effect on cardiovascular modulation by decreasing cardiac sympathovagal tone, vasomotor tone, vascular resistance and ventricular workload. This research establishes a link between mindfulness and cardiovascular functioning via correlational and experimental methodologies in samples of mostly female undergraduates. Future directions for research are outlined.

  10. Skin - abnormally dark or light

    Science.gov (United States)

    ... ency/article/003242.htm Skin - abnormally dark or light To use the sharing features on this page, ... the hands. The bronze color can range from light to dark (in fair-skinned people) with the ...

  11. Pregnancy Complications: Umbilical Cord Abnormalities

    Science.gov (United States)

    ... defects. These tests may include a detailed ultrasound, amniocentesis (to check for chromosomal abnormalities) and in some ... the provider may recommend additional tests, such as amniocentesis and a detailed ultrasound, to diagnose or rule ...

  12. Early Hemodynamic Disorders and Their Association with the Development of Acute Pulmonary Lesion in Severe Concomitant Injury

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2005-01-01

    Full Text Available Early changes in the parameters of central hemodynamics and pulmonary extravascular fluid were studied in patients who had sustained a severe concomitant injury in combination with acute massive blood loss. Early postoperative monitoring of these parameters by a «Pulsion Picco Plus» invasive monitoring apparatus was ascertained to verify the early stages on non-cardiogenic pulmonary edema, to assess a risk for acute lung lesion and acute respiratory distress syndrome in the phase of reperfusion lesions, and to perform an adequate correction of therapy.

  13. Cardiac Effects of Echinocandins after Central Venous Administration in Adult Rats

    OpenAIRE

    2014-01-01

    Echinocandins have become the agents of choice for early and specific antifungal treatment in critically ill patients. In vitro studies and clinical case reports revealed a possible impact of echinocandin treatment on cardiac function. The aim of our study was to evaluate echinocandin-induced cardiac failure. Using an in vivo rat model, we assessed hemodynamic parameters and time to hemodynamic failure after central venous application (vena jugularis interna) of anidulafungin (low-dose group,...

  14. Re-examine tumor-induced alterations in hemodynamic responses of BOLD fMRI. Implications in presurgical brain mapping

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Liya [Dept. of Radiology and Imaging Sciences, Emory Univ., School of Medicine, Atlanta (United States); Dept. of Radiology, Baoan Hospital, Shenzhen (China); Ali, Shazia; Fa, Tianning; Mao, Hui [Dept. of Radiology and Imaging Sciences, Emory Univ., School of Medicine, Atlanta (United States)], e-mail: hmao@emory.edu; Dandan, Chen [Dept. of Physics, Emory Univ., Atlanta, (United States); School of Radiation Medicine and Protection, Soochow Univ., Suzhou (China); Olson, Jeffrey [Dept. of Neurosurgery, Emory Univ., School of Medicine, Atlanta (United States)

    2012-09-15

    Background: Blood oxygenation level dependent (BOLD) fMRI is used for presurgical functional mapping of brain tumor patients. Abnormal tumor blood supply may affect hemodynamic responses and BOLD fMRI signals. Purpose: To perform a multivariate and quantitative investigation of the effect of brain tumors on the hemodynamic responses and its impact on BOLD MRI signal time course, data analysis in order to better understand tumor-induced alterations in hemodynamic responses, and accurately mapping cortical regions in brain tumor patients. Material and Methods: BOLD fMRI data from 42 glioma patients who underwent presurgical mapping of the primary motor cortex (PMC) with a block designed finger tapping paradigm were analyzed, retrospectively. Cases were divided into high grade (n = 24) and low grade (n = 18) groups based on pathology. The tumor volume and distance to the activated PMCs were measured. BOLD signal time courses from selected regions of interest (ROIs) in the PMCs of tumor affected and contralateral unaffected hemispheres were obtained from each patient. Tumor-induced changes of BOLD signal intensity and time to peak (TTP) of BOLD signal time courses were analyzed statistically. Results: The BOLD signal intensity and TTP in the tumor-affected PMCs are altered when compared to that of the unaffected hemisphere. The average BOLD signal level is statistically significant lower in the affected PMCs. The average TTP in the affected PMCs is shorter in the high grade group, but longer in the low grade tumor group compared to the contralateral unaffected hemisphere. Degrees of alterations in BOLD signal time courses are related to both the distance to activated foci and tumor volume with the stronger effect in tumor distance to activated PMC. Conclusion: Alterations in BOLD signal time courses are strongly related to the tumor grade, the tumor volume, and the distance to the activated foci. Such alterations may impair accurate mapping of tumor-affected functional

  15. [Diagnosticum of abnormalities of plant meiotic division].

    Science.gov (United States)

    Shamina, N V

    2006-01-01

    Abnormalities of plant meiotic division leading to abnormal meiotic products are summarized schematically in the paper. Causes of formation of monads, abnormal diads, triads, pentads, polyads, etc. have been observed in meiosis with both successive and simultaneous cytokinesis.

  16. Memetics clarification of abnormal behavior

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: Biological medicine is hard to fully and scientifically explain the etiological factor and pathogenesis of abnormal behaviors; while, researches on philosophy and psychology (including memetics) are beneficial to better understand and explain etiological factor and pathogenesis of abnormal behaviors. At present, the theory of philosophy and psychology is to investigate the entity of abnormal behavior based on the views of memetics.METHODS: Abnormal behavior was researched in this study based on three aspects, including instinctive behavior disorder, poorly social-adapted behavior disorder and mental or body disease associated behavior disorder. Most main viewpoints of memetics were derived from "The Meme Machine", which was written by Susan Blackmore. When questions about abnormal behaviors induced by mental and psychological diseases and conduct disorder of teenagers were discussed, some researching achievements which were summarized by authors previously were added in this study, such as aggressive behaviors, pathologically aggressive behaviors, etc.RESULTS: The abnormal behaviors mainly referred to a part of people's substandard behaviors which were not according with the realistic social environment, culture background and the pathologic behaviors resulted from people's various psychological diseases. According to the theory of "meme", it demonstrated that the relevant behavioral obstacles of various psychological diseases, for example, the unusual behavior of schizophrenia, were caused, because the old meme was destroyed thoroughly but the new meme was unable to establish; psychoneurosis and personality disorder were resulted in hard establishment of meme; the behavioral obstacles which were ill-adapted to society, for example, various additional and homosexual behaviors, were because of the selfish replications and imitations of "additional meme" and "homosexual meme"; various instinct behavioral and congenital intelligent obstacles were not significance

  17. Retinal Image Analysis for Abnormality Detection-An Overview

    Directory of Open Access Journals (Sweden)

    R. Karthikeyan

    2012-01-01

    Full Text Available Problem statement: Classification plays a major role in retinal image analysis for detecting the various abnormalities in retinal images. Classification refers to one of the mining concepts using supervised or unsupervised learning techniques. Approach: Diabetic retinopathy is one of the common complications of diabetes. Unfortunately, in many cases, the patient is not aware of any symptoms until it is too late for effective treatment. Diabetic retinopathy is the leading cause of blindness. Diabetic retinopathy results in retinal disorders that include microaneursyms, drusens, hard exudates and intra-retinal micro-vascular abnormalities. Results: Automatic methods to detect various lesions associated with diabetic retinopathy facilitate the opthalmologists in accurate diagnosis and treatment planning. Abnormal retinal images fall into four different classes namely Non-Proliferative Diabetic Retinopathy (NPDR, Central Retinal Vein Occlusion (CRVO, Choroidal Neo-Vascularization Membrane (CNVM and Central Serous Retinopathy (CSR.. Conclusion: In this study, we have analysed the various methodologies for detecting the abnormalities in retinal images automatically along with their merits and demerits and proposed the new framework for detection of abnormalities using Cellular Neural Network (CNN.

  18. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Prasanna Byna

    2015-11-01

    Full Text Available Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women's health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4% were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42% women, 6 (31.57% had polymenorrhagia, 5 (26.31% had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women was heavy menstrual bleeding in 5 (41.6% women, 3 (25% had oligomennorhoea, 4 (33.3% had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57% had oligomenorrhoea, 3 (42.8% had heavy menstrual bleeding, 2 (28.57% had polymenorrhagia. In a total of 55 patients with AUB, 11 (20% had structural abnormalities in uterus and ovaries. 5 (9% had adenomyosis, 3 (5.4% had ovarian cysts, 3 (5.4% had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. [Int J Res Med Sci 2015; 3(11.000: 3250-3253

  19. Assessment of turbulent viscous stress using ICOSA 4D Flow MRI for prediction of hemodynamic blood damage

    Science.gov (United States)

    Ha, Hojin; Lantz, Jonas; Haraldsson, Henrik; Casas, Belen; Ziegler, Magnus; Karlsson, Matts; Saloner, David; Dyverfeldt, Petter; Ebbers, Tino

    2016-12-01

    Flow-induced blood damage plays an important role in determining the hemodynamic impact of abnormal blood flow, but quantifying of these effects, which are dominated by shear stresses in highly fluctuating turbulent flow, has not been feasible. This study evaluated the novel application of turbulence tensor measurements using simulated 4D Flow MRI data with six-directional velocity encoding for assessing hemodynamic stresses and corresponding blood damage index (BDI) in stenotic turbulent blood flow. The results showed that 4D Flow MRI underestimates the maximum principal shear stress of laminar viscous stress (PLVS), and overestimates the maximum principal shear stress of Reynolds stress (PRSS) with increasing voxel size. PLVS and PRSS were also overestimated by about 1.2 and 4.6 times at medium signal to noise ratio (SNR) = 20. In contrast, the square sum of the turbulent viscous shear stress (TVSS), which is used for blood damage index (BDI) estimation, was not severely affected by SNR and voxel size. The square sum of TVSS and the BDI at SNR >20 were underestimated by less than 1% and 10%, respectively. In conclusion, this study demonstrated the feasibility of 4D Flow MRI based quantification of TVSS and BDI which are closely linked to blood damage.

  20. [The hemodynamic characterization of the diabetic patient with arterial calcifications].

    Science.gov (United States)

    Vega Gómez, M E; Ley Pozo, J; Aldama Figueroa, A; Lima Santana, B; Montalvo Diago, J; Bustillo, C; Fernández Boloña, A; Gutiérrez Jiménez, O; Ramirez Muñoz, O; Martínez Hernández, R

    1993-01-01

    This study was designed to describe the presence of calcifications according to the clinical features of the diabetic patient and the hemodynamics of the calcified arteries. With this purpose, 197 lower limbs from diabetic patients (type I and II) and carbon-hydrate intolerant patients, were studied. In all of the patients, the pressure ratio leg/arm was measured. On the same way, the arterial flow velocity was recorded using the Doppler ultrasonography on the pedia and postero-tibial arteries. The arterial calcifications, evident on the radiography of the foot, were more frequent between the type I patients and the neuro-infections diabetic foot. According to the hemodynamics point of view, we found a trend of association of more pathologic arterial flow velocity curves with the presence of calcifications (specially on the intima layer). It was also remarkable that an arterial incomprensibility was always associated with arterial calcifications.

  1. Effects of an interatrial shunt on rest and exercise hemodynamics

    DEFF Research Database (Denmark)

    Kaye, David; Shah, Sanjiv J; Borlaug, Barry A

    2014-01-01

    BACKGROUND: A treatment based on an interatrial shunt device has been proposed for counteracting elevated pulmonary capillary wedge pressure (PCWP) in patients with heart failure and mildly reduced or preserved ejection fraction (HFpEF). We tested the theoretical hemodynamic effects...... of the conditions tested. CONCLUSIONS: The interatrial shunt reduced left-sided cardiac output with a marked reduction in PCWP. This approach may reduce the propensity for heart failure exacerbations and allow patients to exercise longer, thus attaining higher heart rates and cardiac outputs with the shunt compared...... of this approach with the use of a previously validated cardiovascular simulation. METHODS AND RESULTS: Rest and exercise hemodynamics data from 2 previous independent studies of patients with HFpEF were simulated. The theoretical effects of a shunt between the right and left atria (diameter up to 12 mm) were...

  2. Rifaximin has no effect on hemodynamics in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Kimer, Nina; Pedersen, Julie Steen; Busk, Troels Malte

    2017-01-01

    , P = 0.14, or vasoactive hormones were found. Subgroup analyses on patients with increased lipopolysaccharide binding protein and systemic vascular resistance below the mean (1,011 dynes × s/cm(5) ) revealed no effect of rifaximin. CONCLUSION: Four weeks of treatment with rifaximin did not reduce......Decompensated cirrhosis is characterized by disturbed systemic and splanchnic hemodynamics. Bacterial translocation from the gut is considered the key driver in this process. Intestinal decontamination with rifaximin may improve hemodynamics. This double-blind, randomized, controlled trial...... years (±8.4), average Child score 8.3 (±1.3), and Model for End-Stage Liver Disease score 11.7 (±3.9). Measurements of hepatic venous pressure gradient, cardiac output, and systemic vascular resistance were made at baseline and after 4 weeks. The glomerular filtration rate and plasma renin...

  3. Continuous Hemodynamic Monitoring in Acute Stroke: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Ayan Sen

    2014-07-01

    Full Text Available Introduction: Non-invasive, continuous hemodynamic monitoring is entering the clinical arena. The primary objective of this study was to test the feasibility of such monitoring in a pilot sample of Emergency Department (ED stroke patients. Secondary objectives included analysis of hemodynamic variability and correlation of continuous blood pressure measurements with standard measurements. Methods: This study was a secondary analysis of 7 stroke patients from a prospectively collected data set of patients that received 2 hours of hemodynamic monitoring in the ED. Stroke patients were included if hemorrhagic or ischemic stroke was confirmed by neuroimaging, and symptom onset was within 24 hours. They were excluded for the presence of a stroke mimic or transient ischemic attack. Monitoring was performed using the Nexfin device (Edwards Lifesciences, Irvine CA. Results: The mean age of the cohort was 71 ± 17 years, 43% were male, and the mean National Institute of Health Stroke Scale (NIHSS was 6.9 ± 5.5. Two patients had hemorrhagic stroke. We obtained 42,456 hemodynamic data points, including beat-to-beat blood pressure measurements with variability of 18 mmHg and cardiac indices ranging from 1.8 to 3.6 l/min/m2. The correlation coefficient between continuous blood pressure measurements with the Nexfin device and standard ED readings was 0.83. Conclusion: This exploratory investigation revealed that continuous, noninvasive monitoring in the ED is feasible in acute stroke. Further research is currently underway to determine how such monitoring may impact outcomes in stroke or replace the need for invasive monitoring. [West J Emerg Med. 2014;15(4:–0.

  4. Combined Visualization of Vessel Deformation and Hemodynamics in Cerebral Aneurysms.

    Science.gov (United States)

    Meuschke, Monique; Voss, Samuel; Beuing, Oliver; Preim, Bernhard; Lawonn, Kai

    2017-01-01

    We present the first visualization tool that combines patient-specific hemodynamics with information about the vessel wall deformation and wall thickness in cerebral aneurysms. Such aneurysms bear the risk of rupture, whereas their treatment also carries considerable risks for the patient. For the patient-specific rupture risk evaluation and treatment analysis, both morphological and hemodynamic data have to be investigated. Medical researchers emphasize the importance of analyzing correlations between wall properties such as the wall deformation and thickness, and hemodynamic attributes like the Wall Shear Stress and near-wall flow. Our method uses a linked 2.5D and 3D depiction of the aneurysm together with blood flow information that enables the simultaneous exploration of wall characteristics and hemodynamic attributes during the cardiac cycle. We thus offer medical researchers an effective visual exploration tool for aneurysm treatment risk assessment. The 2.5D view serves as an overview that comprises a projection of the vessel surface to a 2D map, providing an occlusion-free surface visualization combined with a glyph-based depiction of the local wall thickness. The 3D view represents the focus upon which the data exploration takes place. To support the time-dependent parameter exploration and expert collaboration, a camera path is calculated automatically, where the user can place landmarks for further exploration of the properties. We developed a GPU-based implementation of our visualizations with a flexible interactive data exploration mechanism. We designed our techniques in collaboration with domain experts, and provide details about the evaluation.

  5. Morphological and hemodynamic analysis of mirror posterior communicating artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Jinyu Xu

    Full Text Available BACKGROUND AND PURPOSE: Hemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology. MATERIALS AND METHODS: 3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs. Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture. RESULTS: The normalized mean wall shear stress (WSS of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012. The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018. The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012. By contrast, parameters that had no significant differences between the two groups were OSI (P = .674, aneurysm size (P = .327, size ratio (P = .779, vessel angle (P = 1.000 and aneurysm inclination angle (P = 1.000. CONCLUSIONS: Pcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.

  6. Abnormal insulin levels and vertigo.

    Science.gov (United States)

    Proctor, C A

    1981-10-01

    Fifty patients with unexplained vertigo (36) or lightheadedness (14) are evaluated, all of whom had abnormal ENGs and normal audiograms. Five hour insulin glucose tolerance tests were performance on all patients, with insulin levels being obtained fasting and at one-half, one, two, and three hours. The results of this investigation were remarkable. Borderline or abnormal insulin levels were discovered in 82% of patients; 90% were found to have either an abnormal glucose tolerance test or at least borderline insulin levels. The response to treatment in these dizzy patients was also startling, with appropriate low carbohydrate diets improving the patient's symptoms in 90% of cases. It is, therefore, apparent that the earliest identification of carbohydrate imbalance with an insulin glucose tolerance test is extremely important in the work-up of the dizzy patients.

  7. Comprehensive cognitive and cerebral hemodynamic evaluation after cranioplasty

    Directory of Open Access Journals (Sweden)

    Coelho F

    2014-05-01

    Full Text Available Fernanda Coelho,1 Arthur Maynart Oliveira,2 Wellingson Silva Paiva,2 Fabio Rios Freire,1 Vanessa Tome Calado,1 Robson Luis Amorim,2 Iuri Santana Neville,2 Almir Ferreira de Andrade,2 Edson Bor-Seng-Shu,3 Renato Anghinah,1 Manoel Jacobsen Teixeira21Neurorehabilitation Group, Division of Neurology, 2Division of Neurosurgery, 3Neurosonology and Cerebral Hemodynamics Group, University of São Paulo Medical School, São Paulo, BrazilAbstract: Decompressive craniectomy is an established procedure to lower intracranial pressure and can save patients' lives. However, this procedure is associated with delayed cognitive decline and cerebral hemodynamics complications. Studies show the benefits of cranioplasty beyond cosmetic aspects, including brain protection, and functional and cerebrovascular aspects, but a detailed description of the concrete changes following this procedure are lacking. In this paper, the authors report a patient with trephine syndrome who underwent cranioplasty; comprehensive cognitive and cerebral hemodynamic evaluations were performed prior to and following the cranioplasty. The discussion was based on a critical literature review.Keywords: cranioplasty, decompressive craniotomy, perfusion CT, traumatic brain injury, cognition, neuropsychological test

  8. Effect of dialysate temperature on hemodynamic stability among hemodialysis patients.

    Science.gov (United States)

    Azar, Ahmad Taher

    2009-07-01

    Cooling the dialysate below 36.5 degrees C is an important factor that contributes to hemodynamic stability in patients during hemodialysis (HD). In this study, the effect of dialysate temperature on hemodynamic stability, patients' perception of dialysis discomfort and post dialysis fatigue were assessed in a group of patients on HD. A total of 50 patients, all of whom were on 3-times-per-week dialysis regimen, were studied. Patients were assessed during six dialysis sessions; in three sessions, the dialysate temperature was normal (37 degrees C) and in three other sessions, the dialysate temperature was low (35 degrees C). Specific scale questionnaires were used in each dialysis session, to evaluate the symptoms during the dialysis procedure as well as post-dialysis fatigue, and respective scores were noted. The results showed that usage of low dialysate temperature was associated with the following: higher post dialysis systolic blood pressure (Pperceptions were measured by a questionnaire, which showed that 76% of them felt more energetic after dialysis with cool dialysate and requested to be always dialyzed with cool dialysate. Low temperature dialysate is particularly beneficial for highly symptomatic patients, improves tolerance to dialysis in hypotensive patients and helps increase ultrafiltration while maintaining hemodynamic stability during and after dialysis.

  9. Particle Image Velocimetry studies of bicuspid aortic valve hemodynamics

    Science.gov (United States)

    Saikrishnan, Neelakantan; Yap, Choon-Hwai; Yoganathan, Ajit P.

    2010-11-01

    Bicuspid aortic valves (BAVs) are a congenital anomaly of the aortic valve with two fused leaflets, affecting about 1-2% of the population. BAV patients have much higher incidence of valve calcification & aortic dilatation, which may be related to altered mechanical forces from BAV hemodynamics. This study aims to characterize BAV hemodynamics using Particle Image Velocimetry(PIV). BAV models are constructed from normal explanted porcine aortic valves by suturing two leaflets together. The valves are mounted in an acrylic chamber with two sinuses & tested in a pulsatile flow loop at physiological conditions. 2D PIV is performed to obtain flow fields in three planes downstream of the valve. The stenosed BAV causes an eccentric jet, resulting in a very strong vortex in the normal sinus. The bicuspid sinus vortex appears much weaker, but more unstable. Unsteady oscillatory shear stresses are also observed, which have been associated with adverse biological response; characterization of the hemodynamics of BAVs will provide the first step to understanding these processes better. Results from multiple BAV models of varying levels of stenosis will be presented & higher stenosis corresponded to stronger jets & increased aortic wall shear stresses.

  10. Human bulbar conjunctival hemodynamics in hemoglobin SS and SC disease.

    Science.gov (United States)

    Wanek, Justin; Gaynes, Bruce; Lim, Jennifer I; Molokie, Robert; Shahidi, Mahnaz

    2013-08-01

    The known biophysical variations of hemoglobin (Hb) S and Hb C may result in hemodynamic differences between subjects with SS and SC disease. The purpose of this study was to measure and compare conjunctival hemodynamics between subjects with Hb SS and SC hemoglobinopathies. Image sequences of the conjunctival microcirculation were acquired in 9 healthy control subjects (Hb AA), 24 subjects with SC disease, and 18 subjects with SS disease, using a prototype imaging system. Diameter (D) and blood velocity (V) measurements were obtained in multiple venules of each subject. Data were categorized according to venule caliber by averaging V and D for venules with diameters less than (vessel size 1) or greater than (vessel size 2) 15 µm. V in vessel size 2 was significantly greater than V in vessel size 1 in the AA and SS groups (P ≥ 0.009), but not in the SC group (P = 0.1). V was significantly lower in the SC group as compared to the SS group (P = 0.03). In AA and SS groups, V correlated with D (P ≤ 0.005), but the correlation was not statistically significant in the SC group (P = 0.08). V was inversely correlated with hematocrit in the SS group for large vessels (P = 0.03); however, no significant correlation was found in the SC group (P ≥ 0.2). Quantitative assessment of conjunctival microvascular hemodynamics in SS and SC disease may advance understanding of sickle cell disease pathophysiology and thereby improve therapeutic interventions.

  11. Hemodynamic stroke: A rare pitfall in cranio cervical junction surgery

    Directory of Open Access Journals (Sweden)

    Jan Frederick Cornelius

    2014-01-01

    Full Text Available Surgical C1C2-stabilization may be complicated by arterial-arterial embolism or arterial injury. Another potential complication is hemodynamic stroke. The latter might be induced in patients with poor posterior fossa collateralization (risk factor 1 when the vertebral artery (VA is compressed during reduction (risk factor 2. We report a clinical case where this rare situation occurred: A 72-year old patient was undergoing C1C2-stabilization for subluxation due to rheumatoid arthritis. Preoperative computed tomography angiography (CTA had shown poor collaterals in the posterior fossa. Furthermore, intraoperative Doppler ultrasound (US detected unilateral VA occlusion during reduction. It appeared to be a high-risk situation for hemodynamic stroke. Surgical inspection of the VA found osteofibrous compressing elements. Arterial decompression was performed resulting in the normal flow as detected by US. Subsequently, C1C2-stabilization could be realized. The clinical and radiological outcome was very favorable. In C1C2-stabilization precise analysis of preoperative CTA and intraoperative US are important to detect risk factors of hemodynamic stroke. Using these data may prevent this rare, but potentially life-threatening complication.

  12. Brain Abnormalities in Neuromyelitis Optica Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Woojun Kim

    2012-01-01

    Full Text Available Neuromyelitis optica (NMO is an idiopathic inflammatory syndrome of the central nervous system that is characterized by severe attacks of optic neuritis (ON and myelitis. Until recently, NMO was considered a disease without brain involvement. However, since the discovery of NMO-IgG/antiaqaporin-4 antibody, the concept of NMO was broadened to NMO spectrum disorder (NMOSD, and brain lesions are commonly recognized. Furthermore, some patients present with brain symptoms as their first manifestation and develop recurrent brain symptoms without ON or myelitis. Brain lesions with characteristic locations and configurations can be helpful in the diagnosis of NMOSD. Due to the growing recognition of brain abnormalities in NMOSD, these have been included in the NMO and NMOSD diagnostic criteria or guidelines. Recent technical developments such as diffusion tensor imaging, MR spectroscopy, and voxel-based morphometry reveal new findings related to brain abnormalities in NMOSD that were not identified using conventional MRI. This paper focuses on the incidence and characteristics of the brain lesions found in NMOSD and the symptoms that they cause. Recent studies using advanced imaging techniques are also introduced.

  13. Skeletal muscle abnormalities in patients with fibromyalgia.

    Science.gov (United States)

    Olsen, N J; Park, J H

    1998-06-01

    Widespread muscle pain and tender points are the most common complaints of fibromyalgia patients, and the underlying mechanisms responsible for these symptoms have been studied intensively during the past decade. It has been suggested that fatigue and pain may lead to decreased levels of physical activity in many patients. The resulting deconditioned state may itself contribute to muscle abnormalities. Associated symptoms such as disturbed sleep, anxiety, depression, or irritable bowel also may have a negative impact on muscle function and level of daily activities. The important interactions between the central nervous and musculoskeletal systems may involve another element, the neuroendocrine stress-response system. This review will consider both the current state of knowledge and also future studies which might be designed to answer more effectively the outstanding questions regarding the underlying pathogenesis of fibromyalgia.

  14. 控制性低中心静脉压对肝切除手术患者心率变异性和血流动力学的影响%Effect of controlled low central venous pressure on heart rate variability and hemodynamics of patients during hepatectomy

    Institute of Scientific and Technical Information of China (English)

    冯龙; 刘洋; 冯泽国; 米卫东; 张宏

    2012-01-01

    目的 探讨在肝切除手术中采用控制性低中心静脉压技术对自主神经系统和血流动力学的影响.方法 ASA Ⅰ - Ⅱ级29 例患者在静吸复合全麻下择期行肝切除手术,术中采用控制性低中心静脉压技术.分别在诱导前、降压前、降压稳定即刻,降压后5、10、15min,复压稳定即刻,复压后5、10、15min,记录低频(LF),高频(HF),LF/HF 比值,HR、MBP 和双频谱指数(BIS) 的值.结果 LF/HF 在复压稳定后10min 较基础值升高(P0.05).HF 在降压稳定即刻、降压后5-15min 较降压前下降(P5mmHg. Results The LF/HF ratio was higher at 1 0min after pressure restore than its basic value(P<0.05). However, no significant difference was found in the LF/HF ratio and its basic value at the other time points. The HF was lower at T8 than at T6(P<0.05). The LF/HF was higher at T8-T9 than at T6(P<0.05). The HR was higher at T4 than at T0(P<0.05). The mean blood pressure was lower at T,-T9 than at T0(P<0.05). Conclusion Venous-inhalation general anesthesia exerts no significant effect on the autonomic nervous system of patients during hepatectomy with controlled low central venous pressure technique under venous-inhalation general anesthesia and can maintain their normal sympathetic and parasympathetic tone, blood pressure and mean blood pressure.

  15. Hemodynamic response to treatment of iron deficiency anemia in pulmonary arterial hypertension: longitudinal insights from an implantable hemodynamic monitor

    OpenAIRE

    Mehmood, Muddassir; Agarwal, Richa; Raina, Amresh; Correa-Jaque, Priscilla; Benza, Raymond L.

    2016-01-01

    Despite new therapeutic options, pulmonary arterial hypertension (PAH) remains a progressive disease associated with substantial morbidity and mortality. As such, additional strategies for monitoring and adjunctive management of this disease are important. A 59-year-old woman with scleroderma-associated PAH received an implantable hemodynamic monitor (IHM) as part of a research protocol at our institution. Pulmonary artery pressures, heart rate, and cardiac output (sensor-based algorithm) wer...

  16. Central nervous system abnormalities on midline facial defects with hypertelorism detected by magnetic resonance image and computed tomography Anomalias de sistema nervoso central em defeitos de linha média facial com hipertelorismo detectados por ressonância magnética e tomografia computadorizada

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Gil-da-Silva-Lopes

    2006-12-01

    Full Text Available The aim of this study were to describe and to compare structural central nervous system (CNS anomalies detected by magnetic resonance image (MRI and computed tomography (CT in individuals affected by midline facial defects with hypertelorism (MFDH isolated or associated with multiple congenital anomalies (MCA. The investigation protocol included dysmorphological examination, skull and facial X-rays, brain CT and/or MRI. We studied 24 individuals, 12 of them had an isolated form (Group I and the others, MCA with unknown etiology (Group II. There was no significative difference between Group I and II and the results are presented in set. In addition to the several CNS anomalies previously described, MRI (n=18 was useful for detection of neuronal migration errors. These data suggested that structural CNS anomalies and MFDH seem to have an intrinsic embryological relationship, which should be taken in account during the clinical follow-up.Este estudo objetivou descrever e comparar as anomalias estruturais do sistema nervoso central (SNC detectadas por meio de ressonância magnética (RM e tomografia computadorizada (TC de crânio em indivíduos com defeitos de linha média facial com hipertelorismo (DLMFH isolados ou associados a anomalias congênitas múltiplas (ACM. O protocolo de investigação incluiu exame dismorfológico, RX de crânio e face, CT e RM de crânio. Foram estudados 24 indivíduos, sendo que 12 apresentavam a forma isolada (Grupo I e os demais, DLMFH com ACM de etiologia não esclarecida (Grupo II. Não houve diferença entre os dois grupos e os resultados foram agrupados. Além de várias anomalias de SNC já descritas, a RM foi útil para detecção de erros de migração neuronal. Os dados sugerem que as alterações estruturais de SNC e os DLMFH têm relação embriológica, o que deve ser levado em conta durante o seguimento clínico.

  17. Hemodynamics analysis of patient-specific carotid bifurcation: a CFD model of downstream peripheral vascular impedance.

    Science.gov (United States)

    Dong, Jingliang; Wong, Kelvin K L; Tu, Jiyuan

    2013-04-01

    The study of cardiovascular models was presented in this paper based on medical image reconstruction and computational fluid dynamics. Our aim is to provide a reality platform for the purpose of flow analysis and virtual intervention outcome predication for vascular diseases. By connecting two porous mediums with transient permeability at the downstream of the carotid bifurcation branches, a downstream peripheral impedance model was developed, and the effect of the downstream vascular bed impedance can be taken into consideration. After verifying its accuracy with a healthy carotid bifurcation, this model was implemented in a diseased carotid bifurcation analysis. On the basis of time-averaged wall shear stress, oscillatory shear index, and the relative residence time, fractions of abnormal luminal surface were highlighted, and the atherosclerosis was assessed from a hemodynamic point of view. The effect of the atherosclerosis on the transient flow division between the two branches because of the existence of plaque was also analysed. This work demonstrated that the proposed downstream peripheral vascular impedance model can be used for computational modelling when the outlets boundary conditions are not available, and successfully presented the potential of using medical imaging and numerical simulation to provide existing clinical prerequisites for diagnosis and therapeutic treatment.

  18. Pulmonary hemodynamics in obstructive sleep apnea: frequency and causes of pulmonary hypertension.

    Science.gov (United States)

    Hetzel, M; Kochs, M; Marx, N; Woehrle, H; Mobarak, I; Hombach, V; Hetzel, J

    2003-01-01

    The association between nocturnal apneas and transient pulmonary hypertension (PHT) has been well documented. However, there is controversy over the frequency and pathophysiological mechanisms of daytime pulmonary hypertension in patients with obstructive sleep apnea (OSAS). The present study sought to evaluate frequency and mechanisms of pulmonary hypertension in patients with OSAS. It included 49 consecutive patients with polysomnographically proven OSAS without pathological lung function testing. All patients performed daytime measurements of pulmonary hemodynamics at rest and during exercise (50-75W). Six patients (12%) had resting PHT mean pulmonary of artery pressure (PAPM) of >20 mmHg), whereas 39 patients (80%) showed PHT during exercise (PAPM >30 mmHg). Multiple regression analysis revealed 3 independent contributing factors for mean pulmonary artery pressure during exercise (PAPMmax): body mass index, age and total lung capacity % of predicted. Twenty-five of the 39 patients with pathologically high PAPMmax (64%) showed elevated pulmonary capillary wedge pressures (PCWPmax > 20 mmHg), whereas no patient had elevated pulmonary vascular resistance (PVRmax > 120 dynes x s x cm(-5)). In conclusion, daytime PHT during exercise is frequently seen in patients with OSAS and normal lung function testing and is mainly caused by abnormally high PCWP, whereas PVR seems to play a minor role.

  19. Cardiac Variation of Internal Jugular Vein for the Evaluation of Hemodynamics.

    Science.gov (United States)

    Nakamura, Kensuke; Qian, Kun; Ando, Takehiro; Inokuchi, Ryota; Doi, Kent; Kobayashi, Etsuko; Sakuma, Ichiro; Nakajima, Susumu; Yahagi, Naoki

    2016-08-01

    Evaluations of intravascular fluid volume are considered to be one of the most important assessments in emergency and intensive care. Focusing on pulse-induced variation of the internal jugular vein (IJV) area, i.e., cardiac variation, we investigated its correlation with various hemodynamic indices using newly developed software. Software that automatically can track and analyze the IJV during ultrasonography was developed. Eleven healthy patients were subjected to an exercise load to increase their stroke volume (SV) and a dehydration load to decrease their central venous pressure (CVP). The cardiac variation in the area of the IJV, CVP, the SV and the respiratory variation in the inferior vena cava (IVC) were evaluated. The exercise protocol increased the patients' mean SV by 14.5 ± 3.7 mL, and the dehydration protocol caused their mean CVP to fall by 3.75 ± 0.33 cm H2O, which resulted in the collapse index (max IJV area - min IJV area/max IJV area) changing from 0.32 ± 0.04 to 0.44 ± 0.06 and 0.49 ± 0.04, respectively (p variation in the area of the great veins is considered to be induced by venous return to the right atrium under negative pressure. It is possible that intravascular dehydration can be detected and hemodynamic indices, such as CVP and SV, can be estimated by evaluating cardiac variation in the area of the IJV.

  20. Relationship Between Cerebral Oxygenation and Hemodynamic and Oxygen Transport Parameters in Surgery for Acquired Heart Diseases

    Directory of Open Access Journals (Sweden)

    A. I. Lenkin

    2012-01-01

    Full Text Available Objective: to evaluate the relationship between cerebral oxygenation and hemodynamic and oxygen transport parameters in surgical correction of concomitant acquired heart diseases. Subjects and methods. Informed consent was received from 40 patients who required surgery because of concomitant (two or more acquired heart defects. During procedure, perioperative monitoring of oxygen transport and cerebral oxygenation was performed with the aid of PiCCO2 monitor (Pulsion Medical Systems, Germany and a Fore-Sight cerebral oximeter (CASMED, USA. Anesthesia was maintained with propofol and fen-tanyl, by monitoring the depth of anesthesia. Early postoperative intensive therapy was based on the protocol for early targeted correction of hemodynamic disorders. Oxygen transport and cerebral oxygenation parameters were estimated intraopera-tively and within 24 postoperative hours. A statistical analysis including evaluation of Spearman correlations was performed with the aid of SPSS 15.0. Results. During perfusion, there was a relationship between cerebral oximetry values and hemat-ocrit levels, and oxygen partial pressure in the venous blood. Furthermore, a negative correlation between cerebral oximetry values and blood lactate levels was found 30 minutes after initiation of extracorporeal circulation (EC. During the study, there was a positive correlation between cerebral oxygenation and values of cardiac index, central venous saturation, and oxygen delivery index. There was a negative relationship between cerebral oxygenation and extravascular lung water at the beginning of surgery and a correlation between cerebral oximetry values and oxygenation index by the end of the first 24 postoperative hours. Conclusion. The cerebral oxygenation values correlate -with the main determinants of oxygen transport during EC and after cardiac surgical procedures. Cerebral oximetry may be used in early targeted therapy for the surgical correction of acquired combined

  1. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  2. Congenital abnormalities in methylmercury poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Gilani, S.H.

    1975-04-01

    This study was undertaken to determine the teratogenic potential of methylmercury on chick embryogenesis. Methylmercuric chloride was dissolved in sodium bicarbonate (0.2%) and administered to the chick embryos at doses ranging from 0.0009 to 0.010 mg per egg. The injections were made at days 2 and 3 on incubation (Groups A and B). All the embryos including controls were examined on the 7th day of incubation. Methylmercury poisoning was observed to be both embryolethal and teratogenic. Within the two groups, embryolethality was higher in Group A. The following congenital abnormalities were observed: exencephaly, shortened and twisted limbs, microphthalmia, shortened and twisted neck, beak abnormalities, everted viscera, reduced body size and hemorrhage all over the body. Exencephaly and limb abnormalities were very common. No differences in the incidence and types of gross abnormalities within both the groups (A and B) were noted. The incidence of malformations among the controls was low. The results of present investigation show that methylmercury poisoning is both embryolethal and teratogenic to early chick embryogenesis. (auth)

  3. The Diagnosis and Hemodynamic Monitoring of Circulatory Shock: Current and Future Trends

    Directory of Open Access Journals (Sweden)

    Hendy Adham

    2016-07-01

    Full Text Available Circulatory shock is a complex clinical syndrome encompassing a group of conditions that can arise from different etiologies and presented by several different hemodynamic patterns. If not corrected, cell dysfunction, irreversible multiple organ insufficiency, and death may occur. The four basic types of shock, hypovolemic, cardiogenic, obstructive and distributive, have features similar to that of hemodynamic shock. It is therefore essential, when monitoring hemodynamic shock, to making accurate clinical assessments which will guide and dictate appropriate management therapy. The European Society of Intensive Care has recently made recommendations for monitoring hemodynamic shock. The present paper discusses the issues raised in the new statements, including individualization of blood pressure targets, prediction of fluid responsiveness, and the use of echocardiography as the first means during the initial evaluation of circulatory shock. Also, the place of more invasive hemodynamic monitoring techniques and future trends in hemodynamic and metabolic monitoring in circulatory shock, will be debated.

  4. Physiological responses to environmental factors related to space flight. [hemodynamic and metabolic responses to weightlessness

    Science.gov (United States)

    Pace, N.

    1973-01-01

    Physiological base line data are established, and physiological procedures and instrumentation necessary for the automatic measurement of hemodynamic and metabolic parameters during prolonged periods of weightlessness are developed.

  5. Effect of dialysate temperature on hemodynamic stability among hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Azar Ahmad

    2009-01-01

    Full Text Available Cooling the dialysate below 36.5°C is an important factor that contributes to hemody-namic stability in patients during hemodialysis (HD. In this study, the effect of dialysate tempe-rature on hemodynamic stability, patients′ perception of dialysis discomfort and post dialysis fatigue were assessed in a group of patients on HD. A total of 50 patients, all of whom were on 3-times-per-week dialysis regimen, were studied. Patients were assessed during six dialysis sessions; in three sessions, the dialysate temperature was normal (37°C and in three other sessions, the dialysate tem-perature was low (35°C. Specific scale questionnaires were used in each dialysis session, to evaluate the symptoms during the dialysis procedure as well as post-dialysis fatigue, and respective scores were noted. The results showed that usage of low dialysate temperature was associated with the fol-lowing: higher post dialysis systolic blood pressure (P< 0.05 and lower post dialysis heart rate (P< 0.01, with similar ultrafiltration rates, better intra-dialysis symptoms score and post-dialysis fatigue scores (P< 0.001, and P < 0.001, respectively, shorter post-dialysis fatigue period (P< 0.001 as well as higher urea removal (P< 00001 and Kt/V (P< 0.0001. Patients′ perceptions were measured by a questionnaire, which showed that 76% of them felt more energetic after dialysis with cool dialysate and requested to be always dialyzed with cool dialysate. Low temperature dialysate is particularly beneficial for highly symptomatic patients, improves tolerance to dialysis in hypotensive patients and helps increase ultrafiltration while maintaining hemodynamic stability during and after dialysis.

  6. Post-Treatment Hemodynamics of a Basilar Aneurysm and Bifurcation

    Energy Technology Data Exchange (ETDEWEB)

    Ortega, J; Hartman, J; Rodriguez, J; Maitland, D

    2008-01-16

    Aneurysm re-growth and rupture can sometimes unexpectedly occur following treatment procedures that were initially considered to be successful at the time of treatment and post-operative angiography. In some cases, this can be attributed to surgical clip slippage or endovascular coil compaction. However, there are other cases in which the treatment devices function properly. In these instances, the subsequent complications are due to other factors, perhaps one of which is the post-treatment hemodynamic stress. To investigate whether or not a treatment procedure can subject the parent artery to harmful hemodynamic stresses, computational fluid dynamics simulations are performed on a patient-specific basilar aneurysm and bifurcation before and after a virtual endovascular treatment. The simulations demonstrate that the treatment procedure produces a substantial increase in the wall shear stress. Analysis of the post-treatment flow field indicates that the increase in wall shear stress is due to the impingement of the basilar artery flow upon the aneurysm filling material and to the close proximity of a vortex tube to the artery wall. Calculation of the time-averaged wall shear stress shows that there is a region of the artery exposed to a level of wall shear stress that can cause severe damage to endothelial cells. The results of this study demonstrate that it is possible for a treatment procedure, which successfully excludes the aneurysm from the vascular system and leaves no aneurysm neck remnant, to elevate the hemodynamic stresses to levels that are injurious to the immediately adjacent vessel wall.

  7. Nail abnormalities in rheumatoid arthritis.

    Science.gov (United States)

    Michel, C; Cribier, B; Sibilia, J; Kuntz, J L; Grosshans, E

    1997-12-01

    Many nail abnormalities have traditionally been described in association with rheumatoid arthritis (RA), but their specificity has never been assessed in a controlled study. Our purpose was to evaluate the frequency and the specificity of nail changes associated with RA in a case-controlled study including 50 patients suffering from RA and 50 controls. For each patient, a general skin examination was performed and the 20 nails were examined. The nail features were noted and classified. A chi 2 test or a Fisher test was used to compare the two groups. The only nail abnormalities significantly associated with RA were longitudinal ridging on nine or 10 finger nails (29 patients in the RA group vs. three in the controls, chi 2: P nail (24 patients vs. 10, chi 2: P nail changes were noticed but were not frequent enough to be significant. The presence of longitudinal ridging on the finger nails was significantly associated with RA.

  8. Neuroendocrine abnormalities in Parkinson's disease.

    Science.gov (United States)

    De Pablo-Fernández, Eduardo; Breen, David P; Bouloux, Pierre M; Barker, Roger A; Foltynie, Thomas; Warner, Thomas T

    2017-02-01

    Neuroendocrine abnormalities are common in Parkinson's disease (PD) and include disruption of melatonin secretion, disturbances of glucose, insulin resistance and bone metabolism, and body weight changes. They have been associated with multiple non-motor symptoms in PD and have important clinical consequences, including therapeutics. Some of the underlying mechanisms have been implicated in the pathogenesis of PD and represent promising targets for the development of disease biomarkers and neuroprotective therapies. In this systems-based review, we describe clinically relevant neuroendocrine abnormalities in Parkinson's disease to highlight their role in overall phenotype. We discuss pathophysiological mechanisms, clinical implications, and pharmacological and non-pharmacological interventions based on the current evidence. We also review recent advances in the field, focusing on the potential targets for development of neuroprotective drugs in Parkinson's disease and suggest future areas for research.

  9. Comparison of hemodynamic, biochemical and hematological parameters of healthy pregnant women in the third trimester of pregnancy and the active labor phase

    Directory of Open Access Journals (Sweden)

    Flisser Ana

    2011-05-01

    Full Text Available Abstract Background Pregnancy is accompanied by several hemodynamic, biochemical and hematological changes which revert to normal values after labor. The mean values of these parameters have been reported for developed countries, but not for Mexican women. Furthermore, labor constitutes a stress situation, in which these factors may be altered. It is known that serologic increase of heat shock protein (Hsp 70 is associated with abnormal pregnancies, presenting very low level in normal pregnant women. Nevertheless, there are no studies where these measurements are compared in healthy pregnant women at their third trimester of pregnancy (3TP and the active labor phase (ActLP. Methods Seventy five healthy Mexican pregnant women were included. Hemodynamic, biochemical and hematological parameters were obtained in all cases, and serum Hsp70 levels were measured in a sample of 15 women at 3TP and at ActLP. Results Significant differences were found in most analysis performed and in Hsp70 concentration at 3TP as compared to ActLP, however all were within normal range in both conditions, supporting that only in pathological pregnancies Hsp70 is drastically increased. Conclusion Results obtained indicate that 3TP and ActLP have clinical similarities in normal pregnancies, therefore if abnormalities are found during 3TP, precautions should be taken before ActLP.

  10. Asiatic Acid Alleviates Hemodynamic and Metabolic Alterations via Restoring eNOS/iNOS Expression, Oxidative Stress, and Inflammation in Diet-Induced Metabolic Syndrome Rats

    Directory of Open Access Journals (Sweden)

    Poungrat Pakdeechote

    2014-01-01

    Full Text Available Asiatic acid is a triterpenoid isolated from Centella asiatica. The present study aimed to investigate whether asiatic acid could lessen the metabolic, cardiovascular complications in rats with metabolic syndrome (MS induced by a high-carbohydrate, high-fat (HCHF diet. Male Sprague-Dawley rats were fed with HCHF diet with 15% fructose in drinking water for 12 weeks to induce MS. MS rats were treated with asiatic acid (10 or 20 mg/kg/day or vehicle for a further three weeks. MS rats had an impairment of oral glucose tolerance, increases in fasting blood glucose, serum insulin, total cholesterol, triglycerides, mean arterial blood pressure, heart rate, and hindlimb vascular resistance; these were related to the augmentation of vascular superoxide anion production, plasma malondialdehyde and tumor necrosis factor-alpha (TNF-α levels (p < 0.05. Plasma nitrate and nitrite (NOx were markedly high with upregulation of inducible nitric oxide synthase (iNOS expression, but dowregulation of endothelial nitric oxide synthase (eNOS expression (p < 0.05. Asiatic acid significantly improved insulin sensitivity, lipid profiles, hemodynamic parameters, oxidative stress markers, plasma TNF-α, NOx, and recovered abnormality of eNOS/iNOS expressions in MS rats (p < 0.05. In conclusion, asiatic acid improved metabolic, hemodynamic abnormalities in MS rats that could be associated with its antioxidant, anti-inflammatory effects and recovering regulation of eNOS/iNOS expression.

  11. Local hemodynamic changes caused by main branch stent implantation and subsequent virtual side branch balloon angioplasty in a representative coronary bifurcation.

    Science.gov (United States)

    Williams, Andrew R; Koo, Bon-Kwon; Gundert, Timothy J; Fitzgerald, Peter J; LaDisa, John F

    2010-08-01

    Abnormal blood flow patterns promoting inflammation, cellular proliferation, and thrombosis may be established by local changes in vessel geometry after stent implantation in bifurcation lesions. Our objective was to quantify altered hemodynamics due to main vessel (MV) stenting and subsequent virtual side branch (SB) angioplasty in a coronary bifurcation by using computational fluid dynamics (CFD) analysis. CFD models were generated from representative vascular dimensions and intravascular ultrasound images. Time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and fractional flow reserve (FFR) were quantified. None of the luminal surface was exposed to low TAWSS (stenting introduced eccentric areas of low TAWSS along the lateral wall of the MV. Virtual SB angioplasty resulted in a more concentric region of low TAWSS in the MV distal to the carina and along the lateral wall of the SB. The luminal surface exposed to low TAWSS was similar before and after virtual SB angioplasty (rest: 43% vs. 41%; hyperemia: 18% vs. 21%) and primarily due to stent-induced flow alterations. Sites of elevated OSI (>0.1) were minimal but more impacted by general vessel geometry established after MV stenting. FFR measured at a jailed SB was within the normal range despite angiographic stenosis of 54%. These findings indicate that the most commonly used percutaneous interventional strategy for a bifurcation lesion causes abnormal local hemodynamic conditions. These results may partially explain the high clinical event rates in bifurcation lesions.

  12. Radiological appearances of sinonasal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    El-Beltagi, A.H.; Sobeih, A.A.; Valvoda, M.; Dahniya, M.H.; Badr, S.S

    2002-08-01

    The aim of this pictorial review is to present a variety of abnormalities of the sinonasal cavities to emphasize the diversity of lesions occurring in this region. These include congenital, neoplastic and granulomatous disorders and some allergic and inflammatory lesions with uncommon radiological appearances, as well as expanding lesions of the facial bones or of dental origin with secondary involvement of the related sinus(es). El-Beltagi, A.H. et al. (2002). Clinical Radiology 57, 702-718.

  13. Computed tomography of thymic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Schnyder, P.; Candardjis, G.

    1987-05-01

    Computed tomographic examinations of 38 patients with surgically and histologically proven diagnosis were reviewed. Twenty subjects (52%) had an invasive thymoma and 16% an hyperplastic thymus. Myasthenia gravis was present in 6 cases (16%) of thymic abnormalities, four (10,5%) with invasive thymoma and two (5%) with thymic hyperplasia. Graves' disease was also present in one case of thymic hyperplasia. We emphasize the contribution of CT to the diagnosis and the prognosis.

  14. Hemodynamics and annuloplasty in isolated mitral regurgitation in children.

    Science.gov (United States)

    Sulayman, R; Mathew, R; Thilenius, O G; Replogle, R; Arcilla, R A

    1975-12-01

    Isolated mitral insufficiency in children is quantitated angiographically by comparing the stroke volumes of the right ventricle and left ventricle. The disease results in greater enlargement of the left atrium than of the left ventricle and is accompanied by a significant increase in left atrial "distensibility." Right and left heart pressures may be normal or may be increased; they tend to be elevated in the group with regurgitant fractions of over 50%. Annuloplasty results in marked clinical and hemodynamic improvement and may even be corrective.

  15. Vascular aging and hemodynamic stability in the intraoperative period

    Directory of Open Access Journals (Sweden)

    Ferrante S. Gragasin

    2012-04-01

    Full Text Available The proportion of elderly people in the population is steadily increasing, and the inevitable consequence is that this subpopulation is more frequently represented in common medical procedures and surgeries. Understanding the circulatory changes that accompany the aging process is therefore becoming increasingly timely and relevant. In this short review, we discuss aspects of vascular control in aging that are particularly relevant in the maintenance of intraoperative hemodynamic stability. We subsequently review the effects of certain notable anesthetic agents with respect to the aging vasculature.

  16. Study on hemodynamics in patient-specific thoracic aortic aneurysm

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The objective of this study is to investigate the hemodynamics in patient-specific thoracic aortic aneurysm and discuss the reason for formation of aortic plaque.A 3-Dimensional pulsatile blood flow in thoracic aorta with a fusiform aneurysm and 3 main branched vessels was studied numerically with the average Reynolds number of 1399 and the Womersley number of 19.2.Based on the clinical 2-Dimensional CT slice data,the patient-specific geometry model was constructed using medical image process software.Un...

  17. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N

    2002-01-01

    In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH.......05). These changes were qualitatively similar but quantitatively less pronounced than in 15 women with overt hypothyroidism, also studied. Taking the two groups together (n = 31), pretreatment thyroid function (expressed as either TSH or free T(4) estimate) correlated to CO and SVR as well as the changes induced...... by LT(4) (p hypothyroidism should...

  18. Effects of Dietary Nitrates on Systemic and Cerebrovascular Hemodynamics

    Directory of Open Access Journals (Sweden)

    Vernon Bond

    2013-01-01

    Full Text Available Cerebral blood flow dysregulation is often associated with hypertension. We hypothesized that a beetroot juice (BRJ treatment could decrease blood pressure and cerebrovascular resistance (CVR. We subjected 12 healthy females to control and BRJ treatments. Cerebrovascular resistance index (CVRI, systolic blood pressure (SBP, total vascular resistance (TVR, and the heart rate-systolic pressure product (RPP measured at rest and at two exercise workloads were lower after the BRJ treatment. CVRI, SBP, and RPP were lower without a lower TVR at the highest exercise level. These findings suggest improved systemic and cerebral hemodynamics that could translate into a dietary treatment for hypertension.

  19. A sliding mode observer for hemodynamic characterization under modeling uncertainties

    KAUST Repository

    Zayane, Chadia

    2014-06-01

    This paper addresses the case of physiological states reconstruction in a small region of the brain under modeling uncertainties. The misunderstood coupling between the cerebral blood volume and the oxygen extraction fraction has lead to a partial knowledge of the so-called balloon model describing the hemodynamic behavior of the brain. To overcome this difficulty, a High Order Sliding Mode observer is applied to the balloon system, where the unknown coupling is considered as an internal perturbation. The effectiveness of the proposed method is illustrated through a set of synthetic data that mimic fMRI experiments.

  20. From hemodynamic towards cardiomechanic sensors in implantable devices

    Science.gov (United States)

    Ferek-Petric, Bozidar

    2013-06-01

    Sensor could significantly improve the cardiac electrotherapy. It has to provide long-term stabile signal not impeding the device longevity and lead reliability. It may not introduce special implantation and adjustment procedures. Hemodynamic sensors based on the blood flow velocity and cardiomechanic sensors based on the lead bending measurement are disclosed. These sensors have a broad clinical utility. Triboelectric and high-frequency lead bending sensors yield accurate and stable signals whereby functioning with every cardiac lead. Moreover, high frequency measurement avoids use of any kind of special hardware mounted on the cardiac lead.

  1. Clitoral hemodynamic changes after a topical application of alprostadil.

    Science.gov (United States)

    Becher, E F; Bechara, A; Casabe, A

    2001-01-01

    We performed duplex ultrasonography of the clitoris to assess the local hemodynamic changes after a topical application of alprostadil. Color duplex ultrasonography was used to evaluate 18 women before and after the application of 1 g of 0.2% alprostadil gel. The peak systolic velocity and end diastolic velocity showed a statistically significant difference after the application. All women showed labial and clitoral engorgement, 72% reported a pleasant sensation of warmth, and no systemic side effects were found. These findings are similar to the values reported after sexual stimulation, indicating that topical vasoactive drugs might help in the differential diagnosis of the vascular component of female sexual dysfunction.

  2. A comparison of hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve repair / replacement for severe mitral stenosis

    Directory of Open Access Journals (Sweden)

    Ravikumar Gandham

    2013-01-01

    Full Text Available Aims and Objectives: We aimed to compare the hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve surgery on cardiopulmonary bypass (CPB. Materials and Methods: Sixty patients were divided into 2 groups of 30 each. Group-L patients received levosimendan 0.1 μg/kg/min and Group-D patients received dobutamine 5 μg/kg/min while weaning off CPB. Additional inotrope and/or vasoconstrictor were started based on hemodynamic parameters. Hemodynamic data were collected at the end and at 30 minutes after CPB, thereafter at 6, 12, 24, and 36 hours post-CPB. Mean arterial pressure (MAP, central venous pressure (CVP, heart rate (HR, cardiac index (CI, systemic vascular resistance index (SVRI, and lactate levels were measured. Results: Group-L showed increased requirement of inotropes and vasoconstrictors. The SVRI, CVP, and MAP were reduced more in Group-L. The CI was low in Group-L in the initial period when compared to Group-D. Later Group-L patients showed a statistically significant increase in CI even after 12 hrs of discontinuation of levosimendan infusion. The HR was increased more in Group-D. Lactate levels, intensive care unit stay, and duration of ventilation were similar in both groups. Conclusions: Levosimendan 0.1 μg/kg/min compared to dobutamine 5 μg/kg/min showed more vasodilation and lesser inotropic activity in patients undergoing mitral valve surgery for mitral stenosis. Levosimendan compared to dobutamine showed a statistically significant increase in CI even after 12 hrs of discontinuation. The requirement of another inotrope or vasopressor was frequent in levosimendan group.

  3. Meiotic abnormalities in infertile males.

    Science.gov (United States)

    Egozcue, J; Sarrate, Z; Codina-Pascual, M; Egozcue, S; Oliver-Bonet, M; Blanco, J; Navarro, J; Benet, J; Vidal, F

    2005-01-01

    Meiotic anomalies, as reviewed here, are synaptic chromosome abnormalities, limited to germ cells that cannot be detected through the study of the karyotype. Although the importance of synaptic errors has been underestimated for many years, their presence is related to many cases of human male infertility. Synaptic anomalies can be studied by immunostaining of synaptonemal complexes (SCs), but in this case their frequency is probably underestimated due to the phenomenon of synaptic adjustment. They can also be studied in classic meiotic preparations, which, from a clinical point of view, is still the best approach, especially if multiplex fluorescence in situ hybridization is at hand to solve difficult cases. Sperm chromosome FISH studies also provide indirect evidence of their presence. Synaptic anomalies can affect the rate of recombination of all bivalents, produce achiasmate small univalents, partially achiasmate medium-sized or large bivalents, or affect all bivalents in the cell. The frequency is variable, interindividually and intraindividually. The baseline incidence of synaptic anomalies is 6-8%, which may be increased to 17.6% in males with a severe oligozoospermia, and to 27% in normozoospermic males with one or more previous IVF failures. The clinical consequences are the production of abnormal spermatozoa that will produce a higher number of chromosomally abnormal embryos. The indications for a meiotic study in testicular biopsy are provided.

  4. Clinical analysis and treatment of central pain due to headinjury

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@Central pain is induced by the involvement of the abnormal pain pathway due to diseases of the central nervous system. Central pain after brain trauma is common clinically, but it is often misdiagnosed and neglected because of lack of objective disturbances. We treated 20 cases of central pain after head injury by invigorating blood circulation and satisfactory result was obtained.

  5. Hemodynamic measurement using four-dimensional phase-contrast MRI: Quantification of hemodynamic parameters and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Ho Jin; Lee, Sang Joon [POSTECH Biotech Center, Pohang University of Science and Technology, Pohang (Korea, Republic of); Kim, Guk Bae; Kweon, Ji Hoon; Kim, Young Hak; Lee, Deok Hee; Yang, Dong Hyun; KIm, Nam Kug [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    Recent improvements have been made to the use of time-resolved, three-dimensional phase-contrast (PC) magnetic resonance imaging (MRI), which is also named four-dimensional (4D) PC-MRI or 4D flow MRI, in the investigation of spatial and temporal variations in hemodynamic features in cardiovascular blood flow. The present article reviews the principle and analytical procedures of 4D PC-MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Lastly, this article provides an overview of the clinical applications of 4D PC-MRI in various cardiovascular regions.

  6. Hemodynamic Measurement Using Four-Dimensional Phase-Contrast MRI: Quantification of Hemodynamic Parameters and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Hojin [POSTECH Biotech Center, Pohang University of Science and Technology, Pohang 37673 (Korea, Republic of); Kim, Guk Bae [Asan Institute of Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Kweon, Jihoon [Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Lee, Sang Joon [POSTECH Biotech Center, Pohang University of Science and Technology, Pohang 37673 (Korea, Republic of); Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang 37673 (Korea, Republic of); Kim, Young-Hak [Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Lee, Deok Hee; Yang, Dong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Kim, Namkug [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of); Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505 (Korea, Republic of)

    2016-11-01

    Recent improvements have been made to the use of time-resolved, three-dimensional phase-contrast (PC) magnetic resonance imaging (MRI), which is also named four-dimensional (4D) PC-MRI or 4D flow MRI, in the investigation of spatial and temporal variations in hemodynamic features in cardiovascular blood flow. The present article reviews the principle and analytical procedures of 4D PC-MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Lastly, this article provides an overview of the clinical applications of 4D PC-MRI in various cardiovascular regions.

  7. Closed-Loop Dynamic Modeling of Cerebral Hemodynamics

    Science.gov (United States)

    Marmarelis, V. Z.; Shin, D. C.; Orme, M. E.; Zhang, R.

    2013-01-01

    The dynamics of cerebral hemodynamics have been studied extensively because of their fundamental physiological and clinical importance. In particular, the dynamic processes of cerebral flow autoregulation and CO2 vasomotor reactivity have attracted broad attention because of their involvement in a host of pathologies and clinical conditions (e.g. hypertension, syncope, stroke, traumatic brain injury, vascular dementia, Alzheimer’s disease, mild cognitive impairment etc.). This raises the prospect of useful diagnostic methods being developed on the basis of quantitative models of cerebral hemodynamics, if cerebral vascular dysfunction can be quantified reliably from data collected within practical clinical constraints. This paper presents a modeling method that utilizes beat-to-beat measurements of mean arterial blood pressure, cerebral blood flow velocity and end-tidal CO2 (collected non-invasively under resting conditions) to quantify the dynamics of cerebral flow autoregulation (CFA) and cerebral vasomotor reactivity (CVMR). The unique and novel aspect of this dynamic model is that it is nonlinear and operates in a closed-loop configuration. PMID:23292615

  8. Hemodynamic simulations in coronary aneurysms of children with Kawasaki disease

    Science.gov (United States)

    Sengupta, Dibyendu; Burns, Jane; Marsden, Alison

    2009-11-01

    Kawasaki disease (KD) is a serious pediatric illness affecting the cardiovascular system. One of the most serious complications of KD, occurring in about 25% of untreated cases, is the formation of large aneurysms in the coronary arteries, which put patients at risk for myocardial infarction. In this project we performed patient specific computational simulations of blood flow in aneurysmal left and right coronary arteries of a KD patient to gain an understanding about their hemodynamics. Models were constructed from CT data using custom software. Typical pulsatile flow waveforms were applied at the model inlets, while resistance and RCR lumped models were applied and compared at the outlets. Simulated pressure waveforms compared well with typical physiologic data. High wall shear stress values are found in the narrow region at the base of the aneurysm and low shear values occur in regions of recirculation. A Lagrangian approach has been adopted to perform particle tracking and compute particle residence time in the recirculation. Our long-term goal will be to develop links between hemodynamics and the risk for thrombus formation in order to assist in clinical decision-making.

  9. A Liquid-Solid Coupling Hemodynamic Model with Microcirculation Load

    Directory of Open Access Journals (Sweden)

    Bai Li

    2016-01-01

    Full Text Available From the aspect of human circulation system structure, a complete hemodynamic model requires consideration of the influence of microcirculation load effect. This paper selected the seepage in porous media as the simulant of microcirculation load. On the basis of a bi-directional liquid-solid coupling tube model, we built a liquid-solid-porous media seepage coupling model. The simulation parameters accorded with the physiological reality. Inlet condition was set as transient single-pulse velocity, and outlet as free outlet. The pressure in the tube was kept at the state of dynamic stability in the range of 80–120 mmHg. The model was able to simulate the entire propagating process of pulse wave. The pulse wave velocity simulated was 6.25 m/s, which accorded with the physiological reality. The complex pressure wave shape produced by reflections of pressure wave was also observed. After the model changed the cardiac cycle length, the pressure change according with actual human physiology was simulated successfully. The model in this paper is well-developed and reliable. It demonstrates the importance of microcirculation load in hemodynamic model. Moreover the properties of the model provide a possibility for the simulation of dynamic adjustment process of human circulation system, which indicates a promising prospect in clinical application.

  10. Prefrontal Hemodynamic Changes Associated with Subjective Sense of Occlusal Discomfort

    Directory of Open Access Journals (Sweden)

    Yumie Ono

    2015-01-01

    Full Text Available We used functional near-infrared spectroscopy to measure prefrontal brain activity accompanying the physical sensation of oral discomfort that arose when healthy young-adult volunteers performed a grinding motion with mild occlusal elevation (96 μm. We simultaneously evaluated various forms of occlusal discomfort using the visual analogue scale (VAS and hemodynamic responses to identify the specific prefrontal activity that occurs with increased occlusal discomfort. The Oxy-Hb responses of selected channels in the bilateral frontopolar and dorsolateral prefrontal cortices increased in participants who reported increased severity of occlusal discomfort, while they decreased in those who reported no change or decreased occlusal discomfort during grinding. Moreover, the cumulative values of Oxy-Hb response in some of these channels were statistically significant predictive factors for the VAS scores. A generalized linear model analysis of Oxy-Hb signals in a group of participants who reported increased discomfort further indicated significant cerebral activation in the right frontopolar and dorsolateral prefrontal cortices that overlapped with the results of correlation analyses. Our results suggest that the increased hemodynamic responses in the prefrontal area reflect the top-down control of attention and/or self-regulation against the uncomfortable somatosensory input, which could be a possible marker to detect the subjective sense of occlusal discomfort.

  11. Bioimpedance Measurement of Segmental Fluid Volumes and Hemodynamics

    Science.gov (United States)

    Montgomery, Leslie D.; Wu, Yi-Chang; Ku, Yu-Tsuan E.; Gerth, Wayne A.; DeVincenzi, D. (Technical Monitor)

    2000-01-01

    Bioimpedance has become a useful tool to measure changes in body fluid compartment volumes. An Electrical Impedance Spectroscopic (EIS) system is described that extends the capabilities of conventional fixed frequency impedance plethysmographic (IPG) methods to allow examination of the redistribution of fluids between the intracellular and extracellular compartments of body segments. The combination of EIS and IPG techniques was evaluated in the human calf, thigh, and torso segments of eight healthy men during 90 minutes of six degree head-down tilt (HDT). After 90 minutes HDT the calf and thigh segments significantly (P < 0.05) lost conductive volume (eight and four percent, respectively) while the torso significantly (P < 0.05) gained volume (approximately three percent). Hemodynamic responses calculated from pulsatile IPG data also showed a segmental pattern consistent with vascular fluid loss from the lower extremities and vascular engorgement in the torso. Lumped-parameter equivalent circuit analyses of EIS data for the calf and thigh indicated that the overall volume decreases in these segments arose from reduced extracellular volume that was not completely balanced by increased intracellular volume. The combined use of IPG and EIS techniques enables noninvasive tracking of multi-segment volumetric and hemodynamic responses to environmental and physiological stresses.

  12. Computational Hemodynamic Simulation of Human Circulatory System under Altered Gravity

    Science.gov (United States)

    Kim. Chang Sung; Kiris, Cetin; Kwak, Dochan

    2003-01-01

    A computational hemodynamics approach is presented to simulate the blood flow through the human circulatory system under altered gravity conditions. Numerical techniques relevant to hemodynamics issues are introduced to non-Newtonian modeling for flow characteristics governed by red blood cells, distensible wall motion due to the heart pulse, and capillary bed modeling for outflow boundary conditions. Gravitational body force terms are added to the Navier-Stokes equations to study the effects of gravity on internal flows. Six-type gravity benchmark problems are originally presented to provide the fundamental understanding of gravitational effects on the human circulatory system. For code validation, computed results are compared with steady and unsteady experimental data for non-Newtonian flows in a carotid bifurcation model and a curved circular tube, respectively. This computational approach is then applied to the blood circulation in the human brain as a target problem. A three-dimensional, idealized Circle of Willis configuration is developed with minor arteries truncated based on anatomical data. Demonstrated is not only the mechanism of the collateral circulation but also the effects of gravity on the distensible wall motion and resultant flow patterns.

  13. Hemodynamic effects of stenting on wide-necked intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yi-sen; LUO Bin; LI Chuan-hui; YANG Xin-jian; WANG Sheng-zhang; QIAO Ai-ke; CHEN Jia-liang; ZHANG Kun-ya; LIU Zhi-cheng; ZHAO Yu-jing; ZHANG Ying

    2010-01-01

    Background Stent placement has been widely used to assist coiling in cerebral aneurysm treatments. The present study aimed to investigate the hemodynamic effects of stenting on wide-necked intracranial aneurysms.Methods Three idealized plexiglass aneudsmal models with different geometries before and after stenting were created, and their three-dimensional computational models were constructed. Flow dynamics in stented and unstented aneurismal models were studied using in vitro flow visualization and computational fluid dynamics (CFD) simulations. In addition, effects of stenting on flow dynamics in a patient-specific aneurysm model were also analyzed by CFD.Results The results of flow visualization were consistent with those obtained with CFD simulations. Stent deployment reduced vortex inside the aneurysm and its impact on the aneurysm sac, and decreased wall shear stress on the sac.Different aneurysm geometries dictated fundamentally different hemodynamic patterns and outcomes of stenting.Conclusions Stenting across the neck of aneurysms improves local blood flow profiles. This may facilitate thrombus formation in aneurysms and decrease the chance of recanalization.

  14. Central nervous system manifestations of neonatal lupus: a systematic review.

    Science.gov (United States)

    Chen, C C; Lin, K-L; Chen, C-L; Wong, A May-Kuen; Huang, J-L

    2013-12-01

    Neonatal lupus is a rare and acquired autoimmune disease. Central nervous system abnormalities are potential manifestations in neonatal lupus. Through a systematic literature review, we analyzed the clinical features of previously reported neonatal lupus cases where central nervous system abnormalities had been identified. Most reported neonatal lupus patients with central nervous system involvement were neuroimaging-determined and asymptomatic. Only seven neonatal lupus cases were identified as having a symptomatic central nervous system abnormality which caused physical disability or required neurosurgery. A high percentage of these neurosymptomatic neonatal lupus patients had experienced a transient cutaneous skin rash and had no maternal history of autoimmune disease before pregnancy.

  15. Prognostic value of renal hemodynamic characteristics in patients with proliferative lupus nephritis

    NARCIS (Netherlands)

    Martens, Henk A.; Bijl, Marc; Kallenberg, Cees G. M.

    2007-01-01

    Background/Aim: Previous studies showed that renal hemodynamic parameters, especially the filtration fraction ( FF), are decreased in patients with active lupus nephritis ( LN). In this study, we evaluate the prognostic value of renal hemodynamic function tests on the renal outcome in patients with

  16. Encephalic hemodynamic phases in subarachnoid hemorrhage: how to improve the protective effect in patient prognoses

    Directory of Open Access Journals (Sweden)

    Marcelo de Lima Oliveira

    2015-01-01

    Full Text Available Subarachnoid hemorrhage is frequently associated with poor prognoses. Three different hemodynamic phases were identified during subarachnoid hemorrhage: oligemia, hyperemia, and vasospasm. Each phase is associated with brain metabolic changes. In this review, we correlated the hemodynamic phases with brain metabolism and potential treatment options in the hopes of improving patient prognoses.

  17. Hemodynamic modelling of BOLD fMRI - A machine learning approach

    DEFF Research Database (Denmark)

    Jacobsen, Danjal Jakup

    2007-01-01

    This Ph.D. thesis concerns the application of machine learning methods to hemodynamic models for BOLD fMRI data. Several such models have been proposed by different researchers, and they have in common a basis in physiological knowledge of the hemodynamic processes involved in the generation...

  18. Encephalic hemodynamic phases in subarachnoid hemorrhage:how to improve the protective effect in patient prognoses

    Institute of Scientific and Technical Information of China (English)

    Marcelo de Lima Oliveira; Daniel Silva de Azevedo; Milena Krajnyk de Azevedo; Ricardo de Carvalho Nogueira; Manoel Jacobsen Teixeira; Edson Bor-Seng-Shu

    2015-01-01

    Subarachnoid hemorrhage is frequently associated with poor prognoses. Three different hemo-dynamic phases were identified during subarachnoid hemorrhage: oligemia, hyperemia, and vasospasm. Each phase is associated with brain metabolic changes. In this review, we correlated the hemodynamic phases with brain metabolism and potential treatment options in the hopes of improving patient prognoses.

  19. Effect of tilting on cerebral hemodynamics in preterm and term infants

    NARCIS (Netherlands)

    Pichler, G; van Boetzelar, MC; Muller, W; Urlesberger, B

    2001-01-01

    Tilting is known to cause changes in hemodynamics due to hydrostatic pressure. The present study is an analysis of changes in cerebral hemodynamics measured by near infrared spectroscopy (NIRS) following tilting up and down in preterm and term infants. A significantly different effect of tilting up

  20. Use of lignocaine or nitroglycerine for blunting of hemodynamic stress response during electroconvulsive therapy

    Directory of Open Access Journals (Sweden)

    Muhammad Umar Zahoor

    2014-01-01

    Conclusion: NTG provided more hemodynamic stability in post-ECT period as compared to lignocaine which only prevented a surge in HR without any effect on MAP. We conclude that NTG can safely be instituted for anaesthesia in ECT patients for prevention of hemodynamic stress response.

  1. Multi-scale computational model of three-dimensional hemodynamics within a deformable full-body arterial network

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Nan [Department of Bioengineering, Stanford University, Stanford, CA 94305 (United States); Department of Biomedical Engineering, King’s College London, London SE1 7EH (United Kingdom); Humphrey, Jay D. [Department of Biomedical Engineering, Yale University, New Haven, CT 06520 (United States); Figueroa, C. Alberto, E-mail: alberto.figueroa@kcl.ac.uk [Department of Biomedical Engineering, King’s College London, London SE1 7EH (United Kingdom)

    2013-07-01

    In this article, we present a computational multi-scale model of fully three-dimensional and unsteady hemodynamics within the primary large arteries in the human. Computed tomography image data from two different patients were used to reconstruct a nearly complete network of the major arteries from head to foot. A linearized coupled-momentum method for fluid–structure-interaction was used to describe vessel wall deformability and a multi-domain method for outflow boundary condition specification was used to account for the distal circulation. We demonstrated that physiologically realistic results can be obtained from the model by comparing simulated quantities such as regional blood flow, pressure and flow waveforms, and pulse wave velocities to known values in the literature. We also simulated the impact of age-related arterial stiffening on wave propagation phenomena by progressively increasing the stiffness of the central arteries and found that the predicted effects on pressure amplification and pulse wave velocity are in agreement with findings in the clinical literature. This work demonstrates the feasibility of three-dimensional techniques for simulating hemodynamics in a full-body compliant arterial network.

  2. Low-set ears and pinna abnormalities

    Science.gov (United States)

    Low-set ears; Microtia; "Lop" ear; Pinna abnormalities; Genetic defect-pinna; Congenital defect-pinna ... conditions: Abnormal folds or location of the pinna Low-set ears No opening to the ear canal ...

  3. [Phenomenology of abnormal body perceptions].

    Science.gov (United States)

    Schäfer, M L

    1983-01-01

    The present paper deals with the problematic nature of the phenomenological grasping of the consciousness of the body and its pathological modifications. The reasoning is oriented by the doctrine of Husserl of the so-called sentiments as the fundamentals of the experience of the own body. This basic approach does not only seem to be basically for a psychology of the consciousness of the body, but also to give the theoretical-conceptual structure for a great number of psychopathological modifications. Subsequent to a criticism of the conventional use of the term 'hallucination of the body' we attempt to chart elements of a scheme of the abnormal consciousness of the body.

  4. On Regularity of Abnormal Subriemannian Geodesics

    CERN Document Server

    Tan, Kanghai

    2012-01-01

    We prove the smoothness of abnormal minimizers of subriemannian manifolds of step 3 with a nilpotent basis. We prove that rank 2 Carnot groups of step 4 admit no strictly abnormal minimizers. For any subriemannian manifolds of step less than 7, we show all abnormal minimizers have no corner type singularities, which partly generalize the main result of Leonardi-Monti.

  5. Hemodynamic response to treatment of iron deficiency anemia in pulmonary arterial hypertension: longitudinal insights from an implantable hemodynamic monitor.

    Science.gov (United States)

    Mehmood, Muddassir; Agarwal, Richa; Raina, Amresh; Correa-Jaque, Priscilla; Benza, Raymond L

    2016-12-01

    Despite new therapeutic options, pulmonary arterial hypertension (PAH) remains a progressive disease associated with substantial morbidity and mortality. As such, additional strategies for monitoring and adjunctive management of this disease are important. A 59-year-old woman with scleroderma-associated PAH received an implantable hemodynamic monitor (IHM) as part of a research protocol at our institution. Pulmonary artery pressures, heart rate, and cardiac output (sensor-based algorithm) were measured on a daily basis, and parameters of right ventricular (RV) performance and afterload were calculated. At the time of IHM implant, the patient had functional class III symptoms, was receiving triple-drug therapy, and had normal hemoglobin levels. Four months after implant, and with further optimization of prostacyclin therapy, she had improvement in her symptoms. However, shortly thereafter, while the patient was receiving stable drug therapy, her case regressed with worsening symptoms, and the patient received a new diagnosis of iron deficiency anemia. Oral iron supplementation resulted in normalization of hemoglobin levels and improvement in the patient's iron profile. A gradual and sustained reduction in pulmonary pressures was noted after initiation of oral iron accompanied by increased RV performance and favorable reduction in RV afterload. The patient had significant symptomatic improvement. Iron deficiency is an underappreciated yet easily treatable risk factor in PAH. Use of IHM in this case longitudinally illustrates the optimization of pulmonary hemodynamics and RV afterload in tandem with clinical improvement achieved by a simple therapy.

  6. Hemodynamic response to treatment of iron deficiency anemia in pulmonary arterial hypertension: longitudinal insights from an implantable hemodynamic monitor

    Science.gov (United States)

    2016-01-01

    Abstract Despite new therapeutic options, pulmonary arterial hypertension (PAH) remains a progressive disease associated with substantial morbidity and mortality. As such, additional strategies for monitoring and adjunctive management of this disease are important. A 59-year-old woman with scleroderma-associated PAH received an implantable hemodynamic monitor (IHM) as part of a research protocol at our institution. Pulmonary artery pressures, heart rate, and cardiac output (sensor-based algorithm) were measured on a daily basis, and parameters of right ventricular (RV) performance and afterload were calculated. At the time of IHM implant, the patient had functional class III symptoms, was receiving triple-drug therapy, and had normal hemoglobin levels. Four months after implant, and with further optimization of prostacyclin therapy, she had improvement in her symptoms. However, shortly thereafter, while the patient was receiving stable drug therapy, her case regressed with worsening symptoms, and the patient received a new diagnosis of iron deficiency anemia. Oral iron supplementation resulted in normalization of hemoglobin levels and improvement in the patient’s iron profile. A gradual and sustained reduction in pulmonary pressures was noted after initiation of oral iron accompanied by increased RV performance and favorable reduction in RV afterload. The patient had significant symptomatic improvement. Iron deficiency is an underappreciated yet easily treatable risk factor in PAH. Use of IHM in this case longitudinally illustrates the optimization of pulmonary hemodynamics and RV afterload in tandem with clinical improvement achieved by a simple therapy. PMID:28090307

  7. Chromosomal phenotypes and submicroscopic abnormalities

    Directory of Open Access Journals (Sweden)

    Devriendt Koen

    2004-01-01

    Full Text Available Abstract The finding, during the last decade, that several common, clinically delineated syndromes are caused by submicroscopic deletions or, more rarely, by duplications, has provided a powerful tool in the annotation of the human genome. Since most microdeletion/microduplication syndromes are defined by a common deleted/duplicated region, abnormal dosage of genes located within these regions can explain the phenotypic similarities among individuals with a specific syndrome. As such, they provide a unique resource towards the genetic dissection of complex phenotypes such as congenital heart defects, mental and growth retardation and abnormal behaviour. In addition, the study of phenotypic differences in individuals with the same microdeletion syndrome may also become a treasury for the identification of modifying factors for complex phenotypes. The molecular analysis of these chromosomal anomalies has led to a growing understanding of their mechanisms of origin. Novel tools to uncover additional submicroscopic chromosomal anomalies at a higher resolution and higher speed, as well as the novel tools at hand for deciphering the modifying factors and epistatic interactors, are 'on the doorstep' and will, besides their obvious diagnostic role, play a pivotal role in the genetic dissection of complex phenotypes.

  8. Abnormal visuomotor processing in schizophrenia

    Directory of Open Access Journals (Sweden)

    Siân E. Robson

    2016-01-01

    Full Text Available Subtle disturbances of visual and motor function are known features of schizophrenia and can greatly impact quality of life; however, few studies investigate these abnormalities using simple visuomotor stimuli. In healthy people, electrophysiological data show that beta band oscillations in sensorimotor cortex decrease during movement execution (event-related beta desynchronisation (ERBD, then increase above baseline for a short time after the movement (post-movement beta rebound (PMBR; whilst in visual cortex, gamma oscillations are increased throughout stimulus presentation. In this study, we used a self-paced visuomotor paradigm and magnetoencephalography (MEG to contrast these responses in patients with schizophrenia and control volunteers. We found significant reductions in the peak-to-peak change in amplitude from ERBD to PMBR in schizophrenia compared with controls. This effect was strongest in patients who made fewer movements, whereas beta was not modulated by movement in controls. There was no significant difference in the amplitude of visual gamma between patients and controls. These data demonstrate that clear abnormalities in basic sensorimotor processing in schizophrenia can be observed using a very simple MEG paradigm.

  9. Effect of recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy on hemodynamics and cardiac in patients with acute decompensated heart failure

    Institute of Scientific and Technical Information of China (English)

    Qiao-Li Xing; Xian-Hong Ma; Lu Wang

    2016-01-01

    Objective:To evaluate the effect of recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy on hemodynamics and cardiac function levels in patients with acute decompensated heart failure.Methods:A total of 118 patients with acute decompensated heart failure were randomly divided into observation group and the control group (n=59). Control group received clinical conventional therapy for heart failure, observation group received recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy, and the differences in hemodynamics, cardiac function and circulation factor levels were compared between two groups after 12 hours of treatment. Results: After 12 hours of treatment, central venous pressure, right atrial pressure and pulmonary capillary wedge pressure values as well as circulating blood IL-6, hsCRP, ST2, NT-proBNP and cTnⅠlevels of observation group were lower than those of control group, and left heart GLS, GCS, GSRs, GSRe, GSRa, ROT and ROTR levels were higher than those of control group (P<0.05).Conclusions:Recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy for patients with acute decompensated heart failure has significant advantages in optimizing hemodynamics, cardiac function and other aspects.

  10. Value of portal hemodynamics and hypersplenism in cirrhosis staging

    Institute of Scientific and Technical Information of China (English)

    Bao-Min Shi; Xiu-Yan Wang; Qing-Ling Mu; Tai-Huang Wu; Jian Xu

    2005-01-01

    AIM: To determine the correlation between portal hemodynamics and spleen function among different grades of cirrhosis and verify its significance in cirrhosis staging.METHODS: The portal and splenic vein hemodynamics and spleen size were investigated by ultrasonography in consecutive 38 cirrhotic patients with cirrhosis (Child's grades A to C) and 20 normal controls. The differences were compared in portal vein diameter and flow velocity between patients with and without ascites and between patients with mild and severe esophageal varices. The correlation between peripheral blood cell counts and Child's grades was also determined.RESULTS: The portal flow velocity and volume were significantly lower in patients with Child's C (12.25±1.67 cm/s vs 788.59±234 mm/min, respectively) cirrhosis compared to controls (19.55±3.28 cm/s vs 1254.03±410 mm/min,respectively) and those with Child's A (18.5±3.02 cm/s vs1358.48±384 mm/min, respectively) and Child's B (16.0±3.89cm/s vs 1142.23±390 mm/min, respectively)cirrhosis.Patients with ascites had much lower portal flow velocity and volume (13.0±1.72 cm/s vs 1078±533 mm/min) than those without ascites (18.6±2.60 cm/s vs 1394±354 mm/min).There was no statistical difference between patients with mild and severe esophageal varices. The portal vein diameter was not significantly different among the above groups.There were significant differences in splenic vein diameter,flow velocity and white blood cell count, but not in spleen size, red blood cell and platelet counts among the various grades of cirrhosis. The spleen size was negatively correlated with red blood cell and platelet counts (r= -0.620and r = -0.8.34, respectively).CONCLUSION: An optimal system that includes parameters representing the portal hemodynamics and spleen function should be proposed for cirrhosis staging.

  11. CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Fainardi, Enrico; Borrelli, Massimo; Saletti, Andrea; Ceruti, Stefano; Tamarozzi, Riccardo [Azienda Ospedaliera Universitaria, Neuroradiology Unit, Department of Neuroscience, Ferrara (Italy); Schivalocchi, Roberta; Cavallo, Michele [Azienda Ospedaliera Universitaria, Neurosurgery Unit, Department of Neuroscience, Ferrara (Italy); Azzini, Cristiano [Azienda Ospedaliera Universitaria, Neurology Unit, Department of Neuroscience, Ferrara (Italy); Chieregato, Arturo [Ospedale M. Bufalini, Neurocritical Care Unit, Cesena (Italy)

    2008-08-15

    We sought to quantify perfusion changes associated to acute spontaneous intracerebral hemorrhage (SICH) by means of computed tomography perfusion (CTP) imaging. We studied 89 patients with supratentorial SICH at admission CT by using CTP scanning obtained within 24 h after symptom onset. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV) and mean transit time (rMTT) levels were measured in four different regions of interest manually outlined on CT scan: (1) hemorrhagic core; (2) perihematomal low-density area; (3) 1 cm rim of normal-appearing brain tissue surrounding the perilesional area; and (4) a mirrored area, including the clot and the perihematomal region, located in the non-lesioned contralateral hemisphere. rCBF, rCBV, and rMTT mean levels showed a centrifugal distribution with a gradual increase from the core to the periphery (p < 0.0001). Perfusion absolute values were indicative of ischemia in hemorrhagic core, oligemia in perihematomal area, and hyperemia in normal-appearing and contralateral areas. Perihematomal rCBF and rCBV mean levels were higher in small ({<=}20 ml) than in large (>20 ml) hematomas (p<0.01 and p <0.02, respectively). Multi-parametric CTP mapping of acute SICH indicates that perfusion values show a progressive improvement from the core to the periphery. In the first 24 h, perihemorrhagic region was hypoperfused with CTP values which were not suggestive of ischemic penumbra destined to survive but more likely indicative of edema formation. These findings also argue for a potential influence of early amounts of bleeding on perihematomal hemodynamic abnormalities. (orig.)

  12. Time course of the hemodynamic responses to aortic depressor nerve stimulation in conscious spontaneously hypertensive rats

    Energy Technology Data Exchange (ETDEWEB)

    Durand, M.T.; Mota, A.L. [Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Barale, A.R. [Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Castania, J.A.; Fazan, R. Jr.; Salgado, H.C. [Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2012-03-16

    The time to reach the maximum response of arterial pressure, heart rate and vascular resistance (hindquarter and mesenteric) was measured in conscious male spontaneously hypertensive (SHR) and normotensive control rats (NCR; Wistar; 18-22 weeks) subjected to electrical stimulation of the aortic depressor nerve (ADN). The parameters of stimulation were 1 mA intensity and 2 ms pulse length applied for 5 s, using frequencies of 10, 30, and 90 Hz. The time to reach the hemodynamic responses at different frequencies of ADN stimulation was similar for SHR (N = 15) and NCR (N = 14); hypotension = NCR (4194 ± 336 to 3695 ± 463 ms) vs SHR (3475 ± 354 to 4494 ± 300 ms); bradycardia = NCR (1618 ± 152 to 1358 ± 185 ms) vs SHR (1911 ± 323 to 1852 ± 431 ms), and the fall in hindquarter vascular resistance = NCR (6054 ± 486 to 6550 ± 847 ms) vs SHR (4849 ± 918 to 4926 ± 646 ms); mesenteric = NCR (5574 ± 790 to 5752 ± 539 ms) vs SHR (5638 ± 648 to 6777 ± 624 ms). In addition, ADN stimulation produced baroreflex responses characterized by a faster cardiac effect followed by a vascular effect, which together contributed to the decrease in arterial pressure. Therefore, the results indicate that there is no alteration in the conduction of the electrical impulse after the site of baroreceptor mechanical transduction in the baroreflex pathway (central and/or efferent) in conscious SHR compared to NCR.

  13. EFFECTS OF AMLODIPINE, FOSINOPRIL AND METOPROLOL ON HEMODYNAMICS IN HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    A. L. Hohlov

    2007-01-01

    Full Text Available Aim. To assess an efficacy of antihypertensive therapy with calcium antagonist, angiotensin converting enzyme inhibitor and β-blocker in patients with arterial hypertension (AH taking into account influence on central and peripheral hemodynamics.Material and methods. 60 patients with AH of I-II stage, 1-2 grade were studied. They were split in 3 groups. Patients of the first group received amlodipine (Tenox, 5-10 mg/d, the second group – fosinopril (Monopril, 10-20 mg/d and the third group – metoprolol (Metocard, 50-200 mg/d.Diuretics were added when necessary. Ambulatory blood pressure (BP monitoring, echocardiography, ultrasound investigation of brachiocephalic and main cerebral arteries, test on reactive hyperemia and nitroglycerine were conducted before and after 6 months of therapy.Results. Amlodipine, fosinopril and metoprolol had similar antihypertensive effect. Amlodipine was more effective in comparison with fosinopril and metoprolol in reduction of left ventricular (LV myocardial mass and improving of LV diastolic function. Amlodipine and fosinopril had positive effect on vascular remodeling. Metoprolol reduced in BP morning elevation and heart rate, but had no effect on systolic BP variability.Conclusion. Amlodipine, fosinopril and metoprolol have similar antihypertensive effect but different influence on the heart, arteries, BP variability and hemodinamics.

  14. Real-time monitoring of hemodynamic changes in tumor vessels during photoimmunotherapy using optical coherence tomography

    Science.gov (United States)

    Liang, Chia-Pin; Nakajima, Takahito; Watanabe, Rira; Sato, Kazuhide; Choyke, Peter L.; Chen, Yu; Kobayashi, Hisataka

    2014-09-01

    Photoimmunotherapy (PIT) is a cell-specific cancer therapy based on an armed antibody conjugate that induces rapid and highly selective cancer cell necrosis after exposure to near-infrared (NIR) light. The PIT treatment also induces the superenhanced permeability and retention effect, which allows high concentrations of nanoparticles to accumulate in the tumor bed. In our pilot studies, optical coherence tomography (OCT) reveals dramatic hemodynamic changes during PIT. We developed and applied speckle variance analysis, Doppler flow measurement, bulk motion removal, and automatic region of interest selection to quantify vessel diameter and blood velocity within tumors in vivo. OCT imaging reveals that blood velocity in peripheral tumor vessels quickly drops below the detection limit while the vessel lumen remains open (4 vessels from 3 animals). On the other hand, control tumor vessels (receive NIR illumination but no PIT drug) do not show the sustained blood velocity drop (5 vessels from 3 animals). Ultraslow blood velocity could result in a long drug circulation time in tumor. Increase of the blood pool volume within the central tumor (shown in histology) may be the leading cause of the periphery blood velocity drop and could also increase the drug pool volume in tumor vessels.

  15. Coagulation abnormalities in the cirrhotic patient.

    Science.gov (United States)

    Muciño-Bermejo, Jimena; Carrillo-Esper, Raúl; Uribe, Misael; Méndez-Sánchez, Nahum

    2013-01-01

    The clotting process is a dynamic array of multiple processes which can be described in four phases: platelet plug initiation and formation, clotting process propagation by the coagulation cascade, clotting termination by antithrombotic mechanisms and clot removal by fibrinolysis. The liver plays a central role in each of these phases of clotting process, as it synthesizes the majority of coagulation factors and proteins involved in fibrinolysis as well as thrombopoeitin, which is responsible for platelet production from megakaryocytes. Many pathological processes associated with cirrhosis, such as portal hypertension and endothelial dysfunction, as well as co-morbid conditions, may also alter the coagulation process. Consequently, patients with liver disease have a disturbed balance of procoagulant and anti-coagulant factors which deviates from the normal coagulation cascade. This situation poses an additional problem in the diagnostic and therapeutic approach to this group of patients, since traditional coagulation test may not be reliable for assessing bleeding or thrombotic risk and traditional transfusional strategies may not be applicable in cirrhotic patients. In this article, we review the pathophysiological bases of coagulation abnormalities, in cirrhotic patients, the diagnostic therapeutic strategies to be followed and its impact on the clinical outcome in the cirrhotic patient.

  16. Current concepts on hemodynamic support and therapy in septic shock

    Directory of Open Access Journals (Sweden)

    Leonardo Lima Rocha

    2015-10-01

    Full Text Available ABSTRACTSevere sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary. This article is a literature review of the available evidence on the initial hemodynamic support of the septic shock patients presenting to the emergency room or to the intensive care unit and the main interventions available to reach those targets, focusing on fluid and vasopressor therapy, blood transfusion and inotrope administration.

  17. Vascular development and hemodynamic force in the mouse yolk sac

    Directory of Open Access Journals (Sweden)

    Monica D Garcia

    2014-08-01

    Full Text Available Vascular remodeling of the mouse embryonic yolk sac is a highly dynamic process dependent on multiple genetic signaling pathways as well as biomechanical factors regulating proliferation, differentiation, migration, cell-cell and cell-matrix interactions. During this early developmental window, the initial primitive vascular network of the yolk sac undergoes a dynamic remodeling process concurrent with the onset of blood flow, in which endothelial cells establish a branched, hierarchical structure of large vessels and smaller capillary beds. In this review, we will describe the molecular and biomechanical regulators which guide vascular remodeling in the mouse embryonic yolk sac, as well as live imaging methods for characterizing endothelial cell and hemodynamic function in cultured embryos.

  18. CFD modeling of pulsatile hemodynamics in the total cavopulmonary connection

    Science.gov (United States)

    Zobaer, S. M. Tareq; Hasan, A. B. M. Toufique

    2016-07-01

    Total cavopulmonary connection is a blood flow pathway which is created surgically by an operation known as Fontan procedure, performed on children with single ventricle heart defects. Recent studies have shown that the hemodynamics in the connection can be strongly influenced by the presence of pulsatile flow. The aim of this paper is model the pulsatile flow patterns, and to calculate the vorticity field and power losses in an idealized 1.5D offset model of Total Cavopulmonary Connection. A three-dimensional polyhedral mesh was constructed for the numerical simulation. The rheological properties of blood were considered as Newtonian, and flow in the connection was assumed to be laminar. The results demonstrated complex flow patterns in the connection. The outcomes of the simulation showed reasonable agreement with the results available in the literature for a similar model.

  19. Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses

    DEFF Research Database (Denmark)

    Nielsen, T G; Djurhuus, C; Pedersen, Erik Morre;

    1996-01-01

    PURPOSE: The purpose of this study was to assess the impact of arteriovenous fistulas combined with varying degrees of stenosis on distal bypass hemodynamics and Doppler spectral parameters. METHODS: In an in vitro flow model bypass stenoses causing 30%, 55%, and 70% diameter reduction were induced...... 10 cm upstream of a fistula with low outflow resistance. Flow and intraluminal pressure were measured proximal to the stenosis and downstream of the fistula. The waveform parameters peak systolic velocity, end-diastolic velocity, pulsatility index, and pulse rise time were determined from midstream...... Doppler spectra obtained 10 cm downstream of the fistula. All measurements were carried out with open and clamped fistula. RESULTS: At 30% diameter reducing stenosis opening of the fistula induced a 12% systolic pressure drop across the stenosis but had no adverse effect on the Doppler waveform parameters...

  20. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N

    2002-01-01

    was then calculated as MAP/CO. Measurements were performed before and after 60 degrees head-up tilting, and before and after LT(4) substitution. Plasma levels of catecholamines were also measured. In 16 otherwise healthy women with SH (ages 44-74 years; serum TSH in mean 17.1 mU/L (range, 6.8-27), and normal free T(4.......05). These changes were qualitatively similar but quantitatively less pronounced than in 15 women with overt hypothyroidism, also studied. Taking the two groups together (n = 31), pretreatment thyroid function (expressed as either TSH or free T(4) estimate) correlated to CO and SVR as well as the changes induced...... by LT(4) (p changes in hemodynamic parameters of potentially beneficial character. SH and overt hypothyroidism should...

  1. Ocular hemodynamics in patients with rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    N. H. Zavgorodnya

    2014-10-01

    Full Text Available Aim. In case of retinal detachment atrophic processes lead to irreversible loss of functions within 4–6 days, it happens on underlying low ocular blood flow. In order to evaluate the degree of violation of regional hemodynamics in patients with retinal detachment two groups of patients were examined: the main group (52 patients with rhegmatogenous retinal detachment and the control group (24 myopic patients with lattice form of peripheral chorioretinal dystrophy. Methods and results. Doppler and reography results had been compared, significant decrease of blood flow in patients with retinal detachment was found. No differences between affected and fellow eye in these patients, close negative correlation between the level of ocular blood flow and the degree of myopia in the control group. Conclusion. This demonstrates the feasibility of actions to improve regional blood flow in patients operated on for retinal detachment.

  2. The hemodynamics of septic shock: a historical perspective.

    Science.gov (United States)

    Feihl, Francois; Waeber, Bernard; Liaudet, Lucas

    2013-03-01

    In the late 19th century, it was already known that severe infections could be associated with cardiovascular collapse, a fact essentially attributed to cardiac failure. A major experimental work in the rabbit, published by Romberg and Pässler in 1899, shifted attention to disturbed peripheral vascular tone as the mechanism of hypotension in these conditions. In the first half of the 20th century, great progresses were made in the pathophysiologic understanding of hemorrhagic and traumatic shocks, while researchers devoted relatively little attention to septic shock. Progress in the hemodynamic understanding of septic shock resumed with the advent of critical care units. The hyperdynamic state was recognized in the late fifties and early sixties. The present short review ends with landmark studies by Max Harry Weil, demonstrating the importance of venous pooling, and John H. Siegel, which introduced the concept of deficient peripheral utilization of oxygen, inspiring later work on the microvascular disturbances of septic shock.

  3. Efficient hemodynamic event detection utilizing relational databases and wavelet analysis

    Science.gov (United States)

    Saeed, M.; Mark, R. G.

    2001-01-01

    Development of a temporal query framework for time-oriented medical databases has hitherto been a challenging problem. We describe a novel method for the detection of hemodynamic events in multiparameter trends utilizing wavelet coefficients in a MySQL relational database. Storage of the wavelet coefficients allowed for a compact representation of the trends, and provided robust descriptors for the dynamics of the parameter time series. A data model was developed to allow for simplified queries along several dimensions and time scales. Of particular importance, the data model and wavelet framework allowed for queries to be processed with minimal table-join operations. A web-based search engine was developed to allow for user-defined queries. Typical queries required between 0.01 and 0.02 seconds, with at least two orders of magnitude improvement in speed over conventional queries. This powerful and innovative structure will facilitate research on large-scale time-oriented medical databases.

  4. Breathing abnormalities in a female mouse model of Rett syndrome.

    Science.gov (United States)

    Johnson, Christopher M; Cui, Ningren; Zhong, Weiwei; Oginsky, Max F; Jiang, Chun

    2015-09-01

    Rett syndrome (RTT) is a female neurodevelopmental disease with breathing abnormalities. To understand whether breathing defects occur in the early lives of a group of female Mecp2(+/-) mice, a mouse model of RTT, and what percentage of mice shows RTT-like breathing abnormality, breathing activity was measured by plethysmography in conscious mice. Breathing frequency variation and central apnea in a group of Mecp2(+/-) females displayed a distribution pattern similar to Mecp2(-/Y) males, while the rest resembled the wild-type mice. Similar results were obtained using the k-mean clustering statistics analysis. With two independent methods, about 20% of female Mecp2(+/-) mice showed RTT-like breathing abnormalities that began as early as 3 weeks of age in the Mecp2(+/-) mice, and were suppressed with 3% CO2. The finding that only a small proportion of Mecp2(+/-) mice develops RTT-like breathing abnormalities suggests incomplete allele inactivation in the RTT-model Mecp2(+/-) mice.

  5. Deployable centralizers

    Energy Technology Data Exchange (ETDEWEB)

    Grubelich, Mark C.; Su, Jiann-Cherng; Knudsen, Steven D.

    2017-02-28

    A centralizer assembly is disclosed that allows for the assembly to be deployed in-situ. The centralizer assembly includes flexible members that can be extended into the well bore in situ by the initiation of a gas generating device. The centralizer assembly can support a large load carrying capability compared to a traditional bow spring with little or no installation drag. Additionally, larger displacements can be produced to centralize an extremely deviated casing.

  6. Hemodynamic Effect of Laser Therapy in Spontaneously Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Suely Tomimura

    2014-08-01

    Full Text Available Systemic arterial hypertension (SAH is considered to be the greatest risk factor for the development of neuro-cardiovascular pathologies, thus constituting a severe Public Health issue in the world. The Low-Level Laser Therapy (LLLT, or laser therapy, activates components of the cellular structure, therefore converting luminous energy into photochemical energy and leading to biophysical and biochemical reactions in the mitochondrial respiratory chain. The LLLT promotes cellular and tissue photobiomodulation by means of changes in metabolism, leading to molecular, cellular and systemic changes. The objective of this study was to analyze the action of low-level laser in the hemodynamic modulation of spontaneously hypertensive rats, in the long term. Animals (n = 16 were randomly divided into the Laser Group (n = 8, which received three weekly LLLT irradiations for seven weeks, and into the Sham Group (n = 8, which received three weekly simulations of laser for seven weeks, accounting for 21 applications in each group. After seven weeks, animals were cannulated by the implantation of a catheter in the left carotid artery. On the following day, the systemic arterial pressure was recorded. The Laser Group showed reduced levels of mean blood pressure, with statistically significant reduction (169 ± 4 mmHg* vs. 182 ± 4 mmHg from the Sham Group and reduced levels of diastolic pressure (143 ± 4 mmHg* vs. 157 ± 3 mmHg from the Sham Group, revealing a 13 and 14 mmHg decrease, respectively. Besides, there was a concomitant important decline in heart rate (312 ± 14 bpm vs. 361 ± 13 bpm from the Sham Group. Therefore, laser therapy was able to produce hemodynamic changes, thus reducing pressure levels in spontaneously hypertensive rats.

  7. Hemodynamic Effect of Laser Therapy in Spontaneously Hypertensive Rats

    Energy Technology Data Exchange (ETDEWEB)

    Tomimura, Suely, E-mail: suelytomimura@uol.com.br [Programa de Pós-Graduação em Biofotônica em Ciências da Saúde da Universidade Nove de Julho (UNINOVE) (Brazil); Silva, Bianca Passos Assumpção [Programa de Graduação e Pós-Graduação em Medicina da UNINOVE (Brazil); Sanches, Iris Callado [Laboratório de Fisiologia Translacional da UNINOVE (Brazil); Canal, Marina [Programa de Graduação e Pós-Graduação em Medicina da UNINOVE (Brazil); Consolim-Colombo, Fernanda [Programa de Graduação e Pós-Graduação em Medicina da UNINOVE (Brazil); Unidade de Hipertensão e Central Médica de Laser do Instituto do Coração - Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HC-FMUSP), São Paulo, SP (Brazil); Conti, Felipe Fernandes; Angelis, Katia De [Laboratório de Fisiologia Translacional da UNINOVE (Brazil); Chavantes, Maria Cristina [Programa de Pós-Graduação em Biofotônica em Ciências da Saúde da Universidade Nove de Julho (UNINOVE) (Brazil); Programa de Graduação e Pós-Graduação em Medicina da UNINOVE (Brazil); Unidade de Hipertensão e Central Médica de Laser do Instituto do Coração - Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HC-FMUSP), São Paulo, SP (Brazil)

    2014-08-15

    Systemic arterial hypertension (SAH) is considered to be the greatest risk factor for the development of neuro-cardiovascular pathologies, thus constituting a severe Public Health issue in the world. The Low-Level Laser Therapy (LLLT), or laser therapy, activates components of the cellular structure, therefore converting luminous energy into photochemical energy and leading to biophysical and biochemical reactions in the mitochondrial respiratory chain. The LLLT promotes cellular and tissue photobiomodulation by means of changes in metabolism, leading to molecular, cellular and systemic changes. The objective of this study was to analyze the action of low-level laser in the hemodynamic modulation of spontaneously hypertensive rats, in the long term. Animals (n = 16) were randomly divided into the Laser Group (n = 8), which received three weekly LLLT irradiations for seven weeks, and into the Sham Group (n = 8), which received three weekly simulations of laser for seven weeks, accounting for 21 applications in each group. After seven weeks, animals were cannulated by the implantation of a catheter in the left carotid artery. On the following day, the systemic arterial pressure was recorded. The Laser Group showed reduced levels of mean blood pressure, with statistically significant reduction (169 ± 4 mmHg* vs. 182 ± 4 mmHg from the Sham Group) and reduced levels of diastolic pressure (143 ± 4 mmHg* vs. 157 ± 3 mmHg from the Sham Group), revealing a 13 and 14 mmHg decrease, respectively. Besides, there was a concomitant important decline in heart rate (312 ± 14 bpm vs. 361 ± 13 bpm from the Sham Group). Therefore, laser therapy was able to produce hemodynamic changes, thus reducing pressure levels in spontaneously hypertensive rats.

  8. Fast Computation of Hemodynamic Sensitivity to Lumen Segmentation Uncertainty.

    Science.gov (United States)

    Sankaran, Sethuraman; Grady, Leo; Taylor, Charles A

    2015-12-01

    Patient-specific blood flow modeling combining imaging data and computational fluid dynamics can aid in the assessment of coronary artery disease. Accurate coronary segmentation and realistic physiologic modeling of boundary conditions are important steps to ensure a high diagnostic performance. Segmentation of the coronary arteries can be constructed by a combination of automated algorithms with human review and editing. However, blood pressure and flow are not impacted equally by different local sections of the coronary artery tree. Focusing human review and editing towards regions that will most affect the subsequent simulations can significantly accelerate the review process. We define geometric sensitivity as the standard deviation in hemodynamics-derived metrics due to uncertainty in lumen segmentation. We develop a machine learning framework for estimating the geometric sensitivity in real time. Features used include geometric and clinical variables, and reduced-order models. We develop an anisotropic kernel regression method for assessment of lumen narrowing score, which is used as a feature in the machine learning algorithm. A multi-resolution sensitivity algorithm is introduced to hierarchically refine regions of high sensitivity so that we can quantify sensitivities to a desired spatial resolution. We show that the mean absolute error of the machine learning algorithm compared to 3D simulations is less than 0.01. We further demonstrate that sensitivity is not predicted simply by anatomic reduction but also encodes information about hemodynamics which in turn depends on downstream boundary conditions. This sensitivity approach can be extended to other systems such as cerebral flow, electro-mechanical simulations, etc.

  9. CONCENTRATION AND HEMODYNAMICS PATTERN CHANGES IN CIRRHOTIC RATS

    Institute of Scientific and Technical Information of China (English)

    黄颖秋; 萧树东; 莫剑忠; 张德中

    2000-01-01

    Objective To investigate the effects of hemoglobin (Hb) on serum nitric oxide (NO) concentration and hemodynamics pattern changes in rats with cirrhosis. Methods Cirrhosis model was induced in male SD rats by injection of 60% CCl4 oily solution subcutaneously. Cirrhotic rats were treated with erythropoietin (l00U/kg) injected subcutaneously for 2 weeks. Mean arterial pressure (MAP), cardiac output (CO), cardiac index (CI), splanchnic vascular resistance (SVR), splanchnic blood flow (SBF) and serum NO concentration were determined in erythropoietin - treated, erythropoietin - untreated cirrhotic rats and controls by using 57Co- labelled microsphere technique and a fluorometric assay, respectively. In addition, blood Hb levels were also measured in the 3 groups. Results Untreated cirrhotic rats had significantly lower MAP, SVR, Hb and higher CO, CI, SBF and NO concentration than those of the controls (P<0.01). In treated cirrhotic rats, erythropoietin significantly attenuated the increase of CO, CI, SBF, NO concentration and the decrease of MAP and SVR. In cirrhotic rats,epoetin beta in subcutaneous dose of 100U· kg-1· d-1 induced a markedly increment of blood Hb levels and decrement of NO concentration in comparison with untreated cirrhotic rats (181±11g/L vs 120±15g/L;1.14±0.62μmol/L vs 4.20±1.25μmol/L). Conclusion The endogenous NO may play an important role in the changes of hemodynamics pattern in cirrhosis, and hyperdynamic circulatory status in rats with cirrhosis might be ameliorated by inactivation of overproduced NO by increasing hemoglobin with erythropoietin.

  10. Abnormal Returns and Contrarian Strategies

    Directory of Open Access Journals (Sweden)

    Ivana Dall'Agnol

    2003-12-01

    Full Text Available We test the hypothesis that strategies which are long on portfolios of looser stocks and short on portfolios of winner stocks generate abnormal returns in Brazil. This type of evidence for the US stock market was interpreted by The Bondt and Thaler (1985 as reflecting systematic evaluation mistakes caused by investors overreaction to news related to the firm performance. We found evidence of contrarian strategies profitability for horizons from 3 months to 3 years in a sample of stock returns from BOVESPA and SOMA from 1986 to 2000. The strategies are more profitable for shorter horizons. Therefore, there was no trace of the momentum effect found by Jagadeesh and Titman (1993 for the same horizons with US data. There are remaing unexplained positive returns for contrarian strategies after accounting for risk, size, and liquidity. We also found that the strategy profitability is reduced after the Real Plan, which suggests that the Brazilian stock market became more efficient after inflation stabilization.

  11. Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema

    Directory of Open Access Journals (Sweden)

    M. V. Gorbunova

    2007-01-01

    Full Text Available Objective: to evaluate the clinical and hemodynamic effects of CPAP-therapy in the treatment of alveolar cardiogenic pulmonary edema (CPE in patients with acute myocardial infarction (AMI.Subjects and methods. The open-labeled prospective study included 22 patients (19 males; mean age, 59.2±5.8 years with CPE that had complicated the course of AMI. Despite the drug and oxygen therapies of CPE for 30 minutes, progressive respiratory and left ventricular failures were an indication for the initiation of CPAP-therapy (7.3±1.2 cm H2O that was performed, by employing REM-Star apparatuses (Respironics, USA and Ultra Mirage facial masks (ResMed, Australia. Oxygen, 2 l/min (FiO2 = 40%, was delivered through the mask circuit. Central hemodynamic parameters were measured before and 60 and 180 minutes after the initiation of CPAP-therapy, by using a Swan-Ganz thermodilution cathether (HANDS OFF, model AH-05000-H, ARROW, USA. Arterial and mixed venous blood gas composition was rapidly determined on an automatic gas analyzer (Rapidlab 348, Bayer, USA.Results. Cyanosis and acrocyanosis disappeared and the number of congestive moist rales reduced in the lung in 19 (86.4% patients during 30-min CPAP-therapy. The patients’ oxygen status changed: the value of PaO2 significantly increased (82.5±2.5 versus 57.4±4.2 mm Hg at the baseline;p<0.05; SaO2 reached the normal values 60 minutes following CPAP-therapy. There was an increase in the cardiac index (3.1±0.2 versus 2.3±0.1 l/min/m2 at the baseline; p<0.05, a decrease in pulmonary wedge pressure (14.4±21 versus 23.6±2.1 mm Hg at the baseline; p<0.05, and synchronism of right and left cardiac performance.Conclusion. CPAP-therapy optimizes treatment of patients with CPE-complicated AMI, results in the normalization of the arterial blood gas composition, significantly diminishes hydrostatic pulmonary capillary pressure, and promotes the synchronism of the right and left hearts. 

  12. Correlation between electrical and hemodynamic responses during visual stimulation with graded contrasts

    Science.gov (United States)

    Si, Juanning; Zhang, Xin; Li, Yuejun; Zhang, Yujin; Zuo, Nianming; Jiang, Tianzi

    2016-09-01

    Brain functional activity involves complex cellular, metabolic, and vascular chain reactions, making it difficult to comprehend. Electroencephalography (EEG) and functional near infrared spectroscopy (fNIRS) have been combined into a multimodal neuroimaging method that captures both electrophysiological and hemodynamic information to explore the spatiotemporal characteristics of brain activity. Because of the significance of visually evoked functional activity in clinical applications, numerous studies have explored the amplitude of the visual evoked potential (VEP) to clarify its relationship with the hemodynamic response. However, relatively few studies have investigated the influence of latency, which has been frequently used to diagnose visual diseases, on the hemodynamic response. Moreover, because the latency and the amplitude of VEPs have different roles in coding visual information, investigating the relationship between latency and the hemodynamic response should be helpful. In this study, checkerboard reversal tasks with graded contrasts were used to evoke visual functional activity. Both EEG and fNIRS were employed to investigate the relationship between neuronal electrophysiological activities and the hemodynamic responses. The VEP amplitudes were linearly correlated with the hemodynamic response, but the VEP latency showed a negative linear correlation with the hemodynamic response.

  13. The hemodynamic status of preascitic cirrhosis: an evaluation under steady-state conditions and after postural change.

    Science.gov (United States)

    Bernardi, M; Di Marco, C; Trevisani, F; De Collibus, C; Fornalé, L; Baraldini, M; Andreone, P; Cursaro, C; Zacá, F; Ligabue, A

    1992-08-01

    To assess the hemodynamic status of patients with compensated cirrhosis, mean arterial pressure, cardiac index and peripheral vascular resistance and markers of central (plasma concentrations of atrial natriuretic factor) and arterial volemia (plasma norepinephrine concentration, plasma renin activity) were studied in 10 patients and 10 healthy control subjects under steady-state conditions (after 2 hr of standing) and after assumption of the supine position (30, 60, and 120 min). After standing, neither hemodynamics nor markers of effective volemia differed significantly between controls and patients. By evaluating the areas under the curve during the 2 hr of supine posture, the increase in cardiac output and plasma natriuretic factor and the decrease in peripheral vascular resistance were greater in patients (2.59 +/- 0.43 [S.E.M.] L/min/hr; 32.8 +/- 7.2 pg/ml/hr -1,103 +/- 248.4 dyn.sec/cm5/hr, respectively) than in controls (0.53 +/- 0.24 L/min/hr, p = 0.005; 17.4 +/- 4.7 pg/ml/hr, p = 0.005; -265.5 +/- 206.2 dyn.sec/cm5/hr, p = 0.02). The declines in heart rate, plasma norepinephrine concentration and plasma renin activity did not differ significantly. Mean arterial pressure did not significantly change. Our results suggest that during periods of upright posture, cirrhotic patients in the preascitic stage, who are known to have expanded blood volume, compensate for dilatation of the splanchnic vascular bed through total hypervolemia. The latter becomes excessive during recumbency, leading to supernormal increases in venous return, central volemia and cardiac index. The decline in peripheral vascular resistance appears to be a compensatory mechanism to maintain steady arterial blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Osteopenia, abnormal dentition, hydrops fetalis and communicating hydrocephalus.

    Science.gov (United States)

    MacDermot, K D; Buckley, B; Van Someren, V

    1995-10-01

    We describe a single male infant who developed severe hydrops fetalis between 19 and 28 weeks of gestation. After delivery at 32 weeks he was treated by hemofiltration, prolonged ventilation and intravenous feeding. He had hypertelorism, orbital hypoplasia without proptosis, brachydactyly, frontal and temporal bossing of the skull, central hypotonia, communicating hydrocephalus, and severe delay in psychomotor development. Signs of connective tissue disorder included: osteopenia, pathological fracture, yellow/grey discolored teeth, blue sclerae and easy bruising. Laboratory investigations failed to reveal the cause of fetal hydrops or collagen abnormality. His mother and one sib had learning difficulties. Although some of these findings may be due to perinatal factors, the connective tissue abnormalities suggest a genetic syndrome in the heterogeneous group of osteogenesis imperfecta. This case either represents the more severe end of the spectrum of Type IV osteogenesis imperfecta or the mild end of the spectrum of Cole-Carpenter syndrome.

  15. The direct effect of incretin hormones on glucose and glycerol metabolism and hemodynamics

    DEFF Research Database (Denmark)

    Karstoft, Kristian; Mortensen, Stefan; Knudsen, Sine H;

    2015-01-01

    The objective of this study was to assess the insulin-independent effects of incretin hormones on glucose and glycerol metabolism and hemodynamics under eu- and hyperglycemic conditions. Young, healthy males (n=10) underwent three trials in a randomized, controlled, cross-over study. Each trial...... consisted of a 2-stage (eu- and hyperglycemia) pancreatic clamp (using somatostatin to prevent endogenous insulin secretion). Glucose and lipid metabolism were measured via infusion of stable glucose and glycerol isotopic tracers. Hemodynamic variables (femoral, brachial and common carotid artery blood flow...... a higher femoral blood flow during hyperglycemia in GIP (vs. CON and GLP-1, Pmetabolism or hemodynamics during euglycemia. On contrary, during...

  16. Hemodynamic analysis of esophageal varices in patients with liver cirrhosis using color Doppler ultrasound

    Institute of Scientific and Technical Information of China (English)

    Feng-Hua Li; Jing Hao; Jian-Guo Xia; Hong-Li Li; Hua Fang

    2005-01-01

    percentage changes in flow velocity and the size of varices. Patients who responded excessively to food ingestion might have a high risk for bleeding. The changes of blood flow velocity in the LGV were greater than those in the PV (LGV: 28.3±26.1%, PV: 7.2±13.2%, P<0.01), whereas no significant changes in the LGV occurred before and after ingestion of glucose in the control subjects.CONCLUSION: Hemodynamics of the PV is unrelated to the degree of endoscopic abnormalities in patients with liver cirrhosis. The most important combinations are endoscopic findings followed by the LGV hemodynamics.Duplex-Doppler ultrasonography has no value in the identification of patients with cirrhosis at risk of variceal bleeding. Hemodynamics of the LGV appears to be superior to those of the PV in predicting bleeding.

  17. Coiling of central venous catheter in the left subclavian vein, a rare complication

    Directory of Open Access Journals (Sweden)

    Vipin Goyal

    2014-01-01

    Full Text Available Invasive monitoring is the need of the hour in today′s scenario in intensive care units and perioperatively in hemodynamically unstable patients. Despite careful placement using proper landmarks and USG guided methods central venous canuulation (CVC is associated sometimes with unforeseen complications. We report a rare complication of coiling of CVC in the left subclavian vein.

  18. ABNORMAL CARDIOVASCULAR REFLEXES IN PATIENTS WITH ACHALASIA

    Institute of Scientific and Technical Information of China (English)

    戈峰; 李泽坚; 柯美云

    1994-01-01

    Using 3 non-invasive tests,abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia.Abnormalities of heart rate responses to the Valsalva maneuver,deep breathing ,and standing were moted in patients with autonomic neuropathy defect.The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.

  19. Semen abnormalities with SSRI antidepressants.

    Science.gov (United States)

    2015-01-01

    Despite decades of widespread use, the adverse effect profile of "selective" serotonin reuptake inhibitor (SSRI) antidepressants has still not been fully elucidated. Studies in male animals have shown delayed sexual development and reduced fertility. Three prospective cohort studies conducted in over one hundred patients exposed to an SSRI for periods ranging from 5 weeks to 24 months found altered semen param-eters after as little as 3 months of exposure: reduced sperm concentration, reduced sperm motility, a higher percentage of abnormal spermatozoa, and increased levels of sperm DNA fragmentation. One clinical trial showed growth retardation in children considered depressed who were exposed to SSRls. SSRls may have endocrine disrupting properties. Dapoxetine is a short-acting serotonin reuptake inhibitor that is chemically related to fluoxetine and marketed in the European Union for men complaining of premature ejaculation. But the corresponding European summary of product characteristics does not mention any effects on fertility. In practice, based on the data available as of mid-2014, the effects of SSRI exposure on male fertility are unclear. However, it is a risk that should be taken into account and pointed out to male patients who would like to father a child or who are experiencing fertility problems.

  20. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease.

  1. Biochemical abnormalities in Pearson syndrome.

    Science.gov (United States)

    Crippa, Beatrice Letizia; Leon, Eyby; Calhoun, Amy; Lowichik, Amy; Pasquali, Marzia; Longo, Nicola

    2015-03-01

    Pearson marrow-pancreas syndrome is a multisystem mitochondrial disorder characterized by bone marrow failure and pancreatic insufficiency. Children who survive the severe bone marrow dysfunction in childhood develop Kearns-Sayre syndrome later in life. Here we report on four new cases with this condition and define their biochemical abnormalities. Three out of four patients presented with failure to thrive, with most of them having normal development and head size. All patients had evidence of bone marrow involvement that spontaneously improved in three out of four patients. Unique findings in our patients were acute pancreatitis (one out of four), renal Fanconi syndrome (present in all patients, but symptomatic only in one), and an unusual organic aciduria with 3-hydroxyisobutyric aciduria in one patient. Biochemical analysis indicated low levels of plasma citrulline and arginine, despite low-normal ammonia levels. Regression analysis indicated a significant correlation between each intermediate of the urea cycle and the next, except between ornithine and citrulline. This suggested that the reaction catalyzed by ornithine transcarbamylase (that converts ornithine to citrulline) might not be very efficient in patients with Pearson syndrome. In view of low-normal ammonia levels, we hypothesize that ammonia and carbamylphosphate could be diverted from the urea cycle to the synthesis of nucleotides in patients with Pearson syndrome and possibly other mitochondrial disorders.

  2. Hemostatic abnormalities in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Kendal YALÇIN

    2009-06-01

    Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.

  3. Hemodynamic study of hepatocellular car-cinoma nodules by multi-slice spiral computed tomographic perfusion

    Institute of Scientific and Technical Information of China (English)

    马国林

    2013-01-01

    Objective To analyze the 64-slice computed tomographic(CT) perfusion parameters of hepatocellular carcinoma(HCC) nodule so as to assess the diagnostic value of hemodynamic changes of HCC nodule by this perfusion

  4. A cohort study on the relationship between cerebrovascular hemodynamic changing and risk of strok

    Institute of Scientific and Technical Information of China (English)

    郭吉平

    2013-01-01

    Objective To study the role of cerebrovascular hemodynamic indexes(CVHI)changing in stroke and to provide reference for stroke prevention and risk factor study.Methods From 2003 to 2004,participants aged 40 years

  5. Oral premedication with pregabalin and clonidine for hemodynamic stability during laryngoscopy: A comparative study

    Directory of Open Access Journals (Sweden)

    Asmita Chaudhary

    2015-04-01

    Conclusion: Hemodynamic pressure response of airway instrumentation was attenuated with pregabalin and clonidine oral premedication without prolongation of recovery time and side effects. [Int J Basic Clin Pharmacol 2015; 4(2.000: 294-299

  6. Survival function Of Realization process for Hemodynamic and hormonal effects of human GH in healthy volunteers

    Directory of Open Access Journals (Sweden)

    Geetha.T

    2014-12-01

    Full Text Available Hemodynamic and hormonal effects of human ghrelin in healthy volunteers. To investigate hemodynamic and hormonal effects of ghrelin, a novel growth hormone (GH-releasing peptide, we gave six healthy men an intravenous bolus of human ghrelin or placebo and vice versa 1–2 wk apart in a randomized fashion. Ghrelin elicited a marked increase in circulating GH. The elevation of GH lasted longer than 60 min after the bolus injection. Injection of ghrelin significantly decreased mean arterial pressure without a significant change in heart rate .In summary, human ghrelin elicited a potent, long lasting GH release and had beneficial hemodynamic effects via reducing cardiac after load and increasing cardiac output without an increase in heart rate. Thus, the purpose of this study was to investigate hemodynamic and hormonal effects of intravenous ghrelin in healthy volunteers. This paper discussed the constant stress level of healthy volunteers with times to damage of stress effect and recoveries

  7. Hemodynamics and early recovery characteristics of desflurane versus sevoflurane in bariatric surgery

    Directory of Open Access Journals (Sweden)

    Amandeep Kaur

    2013-01-01

    Conclusions: Both desflurane and sevoflurane produce similar hemodynamic changes but the immediate and intermediate recovery was significantly faster after desflurane thus contributing to fast tracking and early discharge of patients.

  8. Effect of fiberoptic bronchoscope compared with direct laryngoscope on hemodynamic responses to orotracheal intubation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Guo-hua; XUE Fu-shan; LI Ping; SUN Hai-yan; LIU Kun-peng; XU Ya-chao; LIU Yi; SUN Hai-tao

    2007-01-01

    @@ Fiberoptic bronchoscope (FOB) is an important instrument for respiratory, disorder examination and difficult airway management.1 The fiberoptic intubation can avoid the mechanical stimulus to oropharyngolaryngeal structures thereby it is likely to attenuate hemodynamic responses during orotracheal intubation.

  9. Transitional cardiovascular physiology and comprehensive hemodynamic monitoring in the neonate: relevance to research and clinical care.

    Science.gov (United States)

    Azhibekov, Timur; Noori, Shahab; Soleymani, Sadaf; Seri, Istvan

    2014-02-01

    A thorough understanding of developmental cardiovascular physiology is essential for early recognition of cardiovascular compromise, selective screening of at-risk groups of neonates, and individualized management using pathophysiology-targeted interventions. Although we have gained a better understanding of the physiology and pathophysiology of postnatal cardiovascular transition over the past decade with the use of sophisticated methods to study neonatal hemodynamics, most aspects of neonatal hemodynamics remain incompletely understood. In addition, targeted therapeutic interventions of neonatal hemodynamic compromise have not been shown to improve mortality and clinically relevant outcomes. However, the recent development of comprehensive hemodynamic monitoring systems capable of non-invasive, continuous and simultaneous bedside assessment of cardiac output, organ blood flow, microcirculation, and tissue oxygen delivery has made sophisticated analysis of the obtained physiologic data possible and has created new research opportunities with the potential of direct implications to patient care.

  10. Comparison of the hemodynamic effects of etomidate between hypertensive and normotensive patients

    Directory of Open Access Journals (Sweden)

    Hayrettin Daşkaya

    2014-06-01

    Full Text Available Objective: Comparison of the hemodynamic effect of ethomidate induction in normotensive and hypertensive patients. Methods: Forty ASA 1-2 patients were included. After informed consent were obtained, patients were divided into two group; Group H: Hypertensive patients, Group N: Normotensive patients. Fentanile and midazolam were administrated for premedication. Anesthesia induction was performed by etomidate 0.3 mg/kg and rocuronium 0.6 mg/kg. Arterial pressures and heart rates were measured at certain intervals: control, pre-intubation and 1, 3 and 5 min post-intubation. Myoclonic movements and hemodynamic parameters were noted by an anesthetist who was masked to the groups. Results: Hemodynamic parameters were higher in hypertensive patients but were in clinically tolerable limits. Conclusion: No hemodynamic instability was observed in anesthesia induction with ethomidate in neither hypertensive nor normotensive patients. J Clin Exp Invest 2014; 5 (2: 164-168

  11. Cardioselectivity, kinetics, hemodynamics, and metabolic effects of xamoterol.

    Science.gov (United States)

    Jennings, G; Bobik, A; Oddie, C; Restall, R

    1984-05-01

    Xamoterol is a new orally active partial beta-adrenoceptor agonist. Its kinetics, hemodynamic and metabolic effects, and cardioselectivity were investigated in eight normal subjects. Plasma xamoterol concentrations after 100 micrograms/kg iv declined biexponentially over 8 hr and t 1/2 beta averaged 2.6 hr. Resting heart rate (HR) increased slightly in the supine position but was unchanged on sitting. Systolic blood pressure (SBP) rose by 5 to 10 mm Hg and cardiac index (CI) rose 15% to 20%. Both parameters were above control values 6 hr after dosing, when plasma xamoterol concentrations had fallen to about 10 ng/ml. There were no changes in diastolic or mean arterial pressure (MAP). During graded exercise the effects of xamoterol on HR and SBP were the reverse of those at rest, with lowering of exercise HR and SBP at higher work loads. CI during exercise was not altered by xamoterol. Doses of xamoterol were calculated from the kinetic data to give plasma concentrations of 100, 200, 400, and 800 ng/ml. HR and blood pressure effects at each xamoterol level were compared before and after inhibition of cardiovascular reflexes with prazosin, atropine, and clonidine. Hemodynamic effects of xamoterol and isoproterenol were compared. Before autonomic block xamoterol increased HR by 10 bpm and MAP by 7 mm Hg at the highest dose. After autonomic block there was a 200% to 300% rise in HR at each dose and MAP still rose. The rise in MAP after block could be entirely accounted for by a 23% increase in CI because total peripheral resistance did not change. The effects of isoproterenol after autonomic block were a rise in HR and a fall in MAP. Metabolic responses to xamoterol were measured at the four dose levels. There was a dose-related increase in nonesterified fatty acids and a fall in plasma lactate levels but no changes in plasma renin activity or blood glucose. Results suggest that xamoterol is a cardioselective partial beta-adrenoceptor agonist in man.

  12. CT and MR imaging of odontoid abnormalities: A pictorial review

    Directory of Open Access Journals (Sweden)

    Nishchint Jain

    2016-01-01

    Full Text Available Odontoid process is the central pillar of the craniovertebral junction. Imaging of this small structure continues to be a challenge for the radiologists due to complex bony and ligamentous anatomy. A wide range of developmental and acquired abnormalities of odontoid have been identified. Their accurate radiologic evaluation is important as different lesions have markedly different clinical course, patient management, and prognosis. This article seeks to provide knowledge for interpreting appearances of odontoid on computed tomography (CT and magnetic resonance imaging (MRI with respect to various disease processes, along with providing a quick review of the embryology and relevant anatomy.

  13. Resting-state hemodynamics are spatiotemporally coupled to synchronized and symmetric neural activity in excitatory neurons.

    Science.gov (United States)

    Ma, Ying; Shaik, Mohammed A; Kozberg, Mariel G; Kim, Sharon H; Portes, Jacob P; Timerman, Dmitriy; Hillman, Elizabeth M C

    2016-12-27

    Brain hemodynamics serve as a proxy for neural activity in a range of noninvasive neuroimaging techniques including functional magnetic resonance imaging (fMRI). In resting-state fMRI, hemodynamic fluctuations have been found to exhibit patterns of bilateral synchrony, with correlated regions inferred to have functional connectivity. However, the relationship between resting-state hemodynamics and underlying neural activity has not been well established, making the neural underpinnings of functional connectivity networks unclear. In this study, neural activity and hemodynamics were recorded simultaneously over the bilateral cortex of awake and anesthetized Thy1-GCaMP mice using wide-field optical mapping. Neural activity was visualized via selective expression of the calcium-sensitive fluorophore GCaMP in layer 2/3 and 5 excitatory neurons. Characteristic patterns of resting-state hemodynamics were accompanied by more rapidly changing bilateral patterns of resting-state neural activity. Spatiotemporal hemodynamics could be modeled by convolving this neural activity with hemodynamic response functions derived through both deconvolution and gamma-variate fitting. Simultaneous imaging and electrophysiology confirmed that Thy1-GCaMP signals are well-predicted by multiunit activity. Neurovascular coupling between resting-state neural activity and hemodynamics was robust and fast in awake animals, whereas coupling in urethane-anesthetized animals was slower, and in some cases included lower-frequency (neural activity. The patterns of bilaterally-symmetric spontaneous neural activity revealed by wide-field Thy1-GCaMP imaging may depict the neural foundation of functional connectivity networks detected in resting-state fMRI.

  14. Temporal analysis of fluctuations in cerebral hemodynamics revealed by near-infrared spectroscopy

    Science.gov (United States)

    Toronov, Vlad; Fantini, Sergio; Franceschini, Maria-Angela; Filiaci, Mattia A.; Wolf, Martin; Gratton, Enrico

    2000-04-01

    We have non-invasively studied the motor cortex hemodynamics in human subjects under rest and motor stimulation conditions using a multichannel near-IR tissue spectrometer. We obtained optical maps of oxy- and deoxy-hemoglobin concentration changes in terms of amplitudes of folding average, power spectrum and coherence at the stimulation repetition frequency, and the phase synchronization index. Under periodic motor stimulation conditions, we observed coherence and phase synchronization of the local hemodynamic changes with stimulation.

  15. Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic accumulative score

    Institute of Scientific and Technical Information of China (English)

    HUANG Jiuyi; WANG Guiqing; GUO Jiping; CAO Yifeng; WANG Yan; YANG Yongju; YU Xuehai

    2007-01-01

    The relative risk(RR)of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics.A total of 7,371 patients with hypertension with ages≥40 years were selected from a population-based cohort study of the risk factors for stroke.The data on the baseline investigation of risk factors,the determination of cerebrovascular hemodynamic parameters (CVHP),and stroke follow-up were analyzed.The RR of stroke in patients with hypertension was evaluated by CVHP scores.Univariate analysis indicated that hypertension,complicated by other risk factors,had significant statistical association with the onset of stroke.RRS for stroke when hypertension complicated with decrease of hemodynamic scores,heart disease,cigarette smoking and alcohol consumption were 4.93(95%CI,3.26-7.45),1.90(95%CI,1.36-2.66),1.99(95%CI,1.42-2.79)and 1.73(95%CI,1.19-2.53)respectively.In multivariate analysis,hemodynamic score,age,sex,cigarette smoking,family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis.Among them,the RR of hemodynamic score was highest.The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points,the RR of stroke at 75,60,45,30 and 15 points were 2.85,4.43,4.54,5.40 and 9.88,respectively.The risk of stroke in patients with hypertension is closely associated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

  16. Platelet enzyme abnormalities in leukemias

    Directory of Open Access Journals (Sweden)

    S Sharma

    2011-01-01

    Full Text Available Aim of the Study: The aim of this study was to evaluate platelet enzyme activity in cases of leukemia. Materials and Methods: Platelet enzymes glucose-6-phosphate dehydrogenase (G6PD, pyruvate kinase (PK and hexokinase (HK were studied in 47 patients of acute and chronic leukemia patients, 16 patients with acute myeloid leukemia (AML(13 relapse, three in remission, 12 patients with acute lymphocytic leukemia (ALL (five in relapse, seven in remission, 19 patients with chronic myeloid leukemia (CML. Results: The platelet G6PD activity was significantly low in cases of AML, ALL and also in CML. G6PD activity was normalized during AML remission. G6PD activity, although persistently low during ALL remission, increased significantly to near-normal during remission (P < 0.05 as compared with relapse (P < 0.01. Platelet PK activity was high during AML relapse (P < 0.05, which was normalized during remission. Platelet HK however was found to be decreased during all remission (P < 0.05. There was a significant positive correlation between G6PD and PK in cases of AML (P < 0.001 but not in ALL and CML. G6PD activity did not correlate with HK activity in any of the leukemic groups. A significant positive correlation was however seen between PK and HK activity in cases of ALL remission (P < 0.01 and CML (P < 0.05. Conclusions: Both red cell and platelet enzymes were studied in 36 leukemic patients and there was no statistically significant correlation between red cell and platelet enzymes. Platelet enzyme defect in leukemias suggests the inherent abnormality in megakaryopoiesis and would explain the functional platelet defects in leukemias.

  17. Sub-band denoising and spline curve fitting method for hemodynamic measurement in perfusion MRI

    Science.gov (United States)

    Lin, Hong-Dun; Huang, Hsiao-Ling; Hsu, Yuan-Yu; Chen, Chi-Chen; Chen, Ing-Yi; Wu, Liang-Chi; Liu, Ren-Shyan; Lin, Kang-Ping

    2003-05-01

    In clinical research, non-invasive MR perfusion imaging is capable of investigating brain perfusion phenomenon via various hemodynamic measurements, such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean trasnit time (MTT). These hemodynamic parameters are useful in diagnosing brain disorders such as stroke, infarction and periinfarct ischemia by further semi-quantitative analysis. However, the accuracy of quantitative analysis is usually affected by poor signal-to-noise ratio image quality. In this paper, we propose a hemodynamic measurement method based upon sub-band denoising and spline curve fitting processes to improve image quality for better hemodynamic quantitative analysis results. Ten sets of perfusion MRI data and corresponding PET images were used to validate the performance. For quantitative comparison, we evaluate gray/white matter CBF ratio. As a result, the hemodynamic semi-quantitative analysis result of mean gray to white matter CBF ratio is 2.10 +/- 0.34. The evaluated ratio of brain tissues in perfusion MRI is comparable to PET technique is less than 1-% difference in average. Furthermore, the method features excellent noise reduction and boundary preserving in image processing, and short hemodynamic measurement time.

  18. Enhanced External Counterpulsation Inducing Arterial Hemodynamic Variations and Its Chronic Effect on Endothelial Function

    Institute of Scientific and Technical Information of China (English)

    DU Jian-hang; WU Gui-fu; ZHENG Zhen-sheng; DAI Gang; FENG Ming-zhe

    2014-01-01

    To make clear the precise hemodynamic mechanism underlying the anti-atherogenesis benefit of enhanced external couterpulsation(EECP) treatment, and to investigate the proper role of some important hemodynamic factors during the atherosclerotic progress, a comprehensive study combining long-term animal experiment and numerical solving was conducted in this paper. An experimentally induced hypercholesterolemic porcine model was developed and the chronic EECP intervention was subjected. Basic hemodynamic measurement was performed in vivo, as well as the arterial endothelial samples were extracted for physiological examination. Meanwhile, a numerical model was introduced to solve the complex hemodynamic factors such as WSS and OSI. The results show that EECP treatment resulted in significant increase of the instant levels of arterial WSS, blood pressure, and OSI. During EECP treatment, the instant OSI level of the common carotid arteries over cardiac cycles raised to a mean value of 8.58 ×10-2 ±2.13 ×10-2. Meanwhile, the chronic intervention of EECP treatment significantly reduced the atherosclerotic lesions in abdominal aortas and the endothelial cellular adherence. The present study suggests that the unique blood flow pattern induced by EECP treatment and the augmentation of WSS level in cardiac cycles may be the most important hemodynamic mechanism that contribute to its anti-atherogenesis effect. And as one of the indices that cause great concern in current hemodynamic study, OSI may not play a key role during the initiation of atherosclerosis.

  19. Approximating hemodynamics of cerebral aneurysms with steady flow simulations.

    Science.gov (United States)

    Geers, A J; Larrabide, I; Morales, H G; Frangi, A F

    2014-01-03

    Computational fluid dynamics (CFD) simulations can be employed to gain a better understanding of hemodynamics in cerebral aneurysms and improve diagnosis and treatment. However, introduction of CFD techniques into clinical practice would require faster simulation times. The aim of this study was to evaluate the use of computationally inexpensive steady flow simulations to approximate the aneurysm's wall shear stress (WSS) field. Two experiments were conducted. Experiment 1 compared for two cases the time-averaged (TA), peak systole (PS) and end diastole (ED) WSS field between steady and pulsatile flow simulations. The flow rate waveform imposed at the inlet was varied to account for variations in heart rate, pulsatility index, and TA flow rate. Consistently across all flow rate waveforms, steady flow simulations accurately approximated the TA, but not the PS and ED, WSS field. Following up on experiment 1, experiment 2 tested the result for the TA WSS field in a larger population of 20 cases covering a wide range of aneurysm volumes and shapes. Steady flow simulations approximated the space-averaged WSS with a mean error of 4.3%. WSS fields were locally compared by calculating the absolute error per node of the surface mesh. The coefficient of variation of the root-mean-square error over these nodes was on average 7.1%. In conclusion, steady flow simulations can accurately approximate the TA WSS field of an aneurysm. The fast computation time of 6 min per simulation (on 64 processors) could help facilitate the introduction of CFD into clinical practice.

  20. Bayesian estimation of the hemodynamic response function in functional MRI

    Science.gov (United States)

    Marrelec, G.; Benali, H.; Ciuciu, P.; Poline, J.-B.

    2002-05-01

    Functional MRI (fMRI) is a recent, non-invasive technique allowing for the evolution of brain processes to be dynamically followed in various cognitive or behavioral tasks. In BOLD fMRI, what is actually measured is only indirectly related to neuronal activity through a process that is still under investigation. A convenient way to analyze BOLD fMRI data consists of considering the whole brain as a system characterized by a transfer response function, called the Hemodynamic Response Function (HRF). Precise and robust estimation of the HRF has not been achieved yet: parametric methods tend to be robust but require too strong constraints on the shape of the HRF, whereas non-parametric models are not reliable since the problem is badly conditioned. We therefore propose a full Bayesian, non-parametric method that makes use of basic but relevant a priori knowledge about the underlying physiological process to make robust inference about the HRF. We show that this model is very robust to decreasing signal-to-noise ratio and to the actual noise sampling distribution. We finally apply the method to real data, revealing a wide variety of HRF shapes.

  1. Right Ventricular Hemodynamics in Patients with Pulmonary Hypertension

    Science.gov (United States)

    Browning, James; Fenster, Brett; Hertzberg, Jean; Schroeder, Joyce

    2012-11-01

    Recent advances in cardiac magnetic resonance imaging (CMR) have allowed for characterization of blood flow in the right ventricle (RV), including calculation of vorticity and circulation, and qualitative visual assessment of coherent flow patterns. In this study, we investigate qualitative and quantitative differences in right ventricular hemodynamics between subjects with pulmonary hypertension (PH) and normal controls. Fifteen (15) PH subjects and 10 age-matched controls underwent same day 3D time resolved CMR and echocardiography. Echocardiography was used to determine right ventricular diastolic function as well as pulmonary artery systolic pressure (PASP). Velocity vectors, vorticity vectors, and streamlines in the RV were visualized in Paraview and total RV Early (E) and Atrial (A) wave diastolic vorticity was quantified. Visualizations of blood flow in the RV are presented for PH and normal subjects. The hypothesis that PH subjects exhibit different RV vorticity levels than normals during diastole is tested and the relationship between RV vorticity and PASP is explored. The mechanics of RV vortex formation are discussed within the context of pulmonary arterial pressure and right ventricular diastolic function coincident with PH.

  2. Adrenergic Metabolic and Hemodynamic Effects of Octopamine in the Liver

    Directory of Open Access Journals (Sweden)

    Adelar Bracht

    2013-11-01

    Full Text Available The fruit extracts of Citrus aurantium (bitter orange are traditionally used as weight-loss products and as appetite suppressants. A component of these extracts is octopamine, which is an adrenergic agent. Weight-loss and adrenergic actions are always related to metabolic changes and this work was designed to investigate a possible action of octopamine on liver metabolism. The isolated perfused rat liver was used to measure catabolic and anabolic pathways and hemodynamics. Octopamine increased glycogenolysis, glycolysis, oxygen uptake, gluconeogenesis and the portal perfusion pressure. Octopamine also accelerated the oxidation of exogenous fatty acids (octanoate and oleate, as revealed by the increase in 14CO2 production derived from 14C labeled precursors. The changes in glycogenolysis, oxygen uptake and perfusion pressure were almost completely abolished by α1-adrenergic antagonists. The same changes were partly sensitive to the β-adrenergic antagonist propranolol. It can be concluded that octopamine accelerates both catabolic and anabolic processes in the liver via adrenergic stimulation. Acceleration of oxygen uptake under substrate-free perfusion conditions also means acceleration of the oxidation of endogenous fatty acids, which are derived from lipolysis. All these effects are compatible with an overall stimulating effect of octopamine on metabolism, which is compatible with its reported weight-loss effects in experimental animals.

  3. Dietary melatonin alters uterine artery hemodynamics in pregnant Holstein heifers.

    Science.gov (United States)

    Brockus, K E; Hart, C G; Gilfeather, C L; Fleming, B O; Lemley, C O

    2016-04-01

    The objective was to examine uterine artery hemodynamics and maternal serum profiles in pregnant heifers supplemented with dietary melatonin (MEL) or no supplementation (CON). In addition, melatonin receptor-mediated responses in steroid metabolism were examined using a bovine endometrial epithelial culture system. Twenty singleton pregnant Holstein heifers were supplemented with 20 mg of melatonin (n = 10) or no melatonin supplementation (control; n = 10) from days 190 to 262 of gestation. Maternal measurements were recorded on days 180 (baseline), 210, 240, and 262 of gestation. Total uterine blood flow was increased by 25% in the MEL-treated heifers compared with the CON. Concentrations of progesterone were decreased in MEL vs CON heifers. Total serum antioxidant capacity was increased by 43% in MEL-treated heifers when compared with CON. Activity of cytochrome P450 1A, 2C, and superoxide dismutase was increased in bovine endometrial epithelial cells treated with melatonin, whereas the melatonin receptor antagonist, luzindole, negated the increase in cytochrome P450 2C activity. Moreover, estradiol or progesterone treatment altered bovine uterine melatonin receptor expression, which could potentiate the melatonin-mediated responses during late gestation. The observed increase in total uterine blood flow during melatonin supplementation could be related to its antioxidant properties. Compromised pregnancies are typically accompanied by increased oxidative stress; therefore, melatonin could serve as a therapeutic supplementation strategy. This could lead to further fetal programming implications in conjunction with offspring growth and development postnatally.

  4. Venous hemodynamic changes of lower extremity during gynecological laparoscopy

    Institute of Scientific and Technical Information of China (English)

    YIN Shan-de; LIU Yan; HE Sheng

    2004-01-01

    To study the effect of CO2 pneumoperitoneum and the special 30 degree head-down tilt positionon the venous hemodynamics in the lower extremity. Methods: Color doplex ultrasound was adopted to evaluate the diameterand blood flow velocity of the right femoral vein of 18 patients undergoing gynecologic laparoscopy under the same pressure ofpneumoperitoneum of 12 mmHg. The diameter of femoral vein and the flow velocity were measured; the blood flow volumewas calculated based on the equation of Q = vπr2 . Result: After establishment of pneumoperitoneum, the dilation of the fem-oral vein and the decrease in the velocity and volume can be observed (P < 0.05). And the 30 degree head-down positioncould increase the flow velocity and volume of the femoral vein and decrease the diameter of the vessel ( P < 0.05). At 30minutes of the 30 degree head-down tilt position, the blood flow ameliorated compared with that in prone position after theestablishment of pneumoperitoneum. After deflation of pneumoperitoneum, the femoral vein remained dilated( P < 0.05 ).Conclusion: During laparoscopy, CO2 pneumoperitoneum may result in the dilation of the vein in lower extremity and retar-dance of blood flow. The 30 degree Trendlenburg position can ameliorate the blood flow in the lower extremity. The deflationof the pneumoperitoneum cannot eliminate the effect of CO2 pneumoperitoneum on the lower extremity veins, which may pre-dispose deep venous thrombosis after laparoscopy.

  5. Mining data from hemodynamic simulations via Bayesian emulation

    Directory of Open Access Journals (Sweden)

    Nair Prasanth B

    2007-12-01

    Full Text Available Abstract Background: Arterial geometry variability is inevitable both within and across individuals. To ensure realistic prediction of cardiovascular flows, there is a need for efficient numerical methods that can systematically account for geometric uncertainty. Methods and results: A statistical framework based on Bayesian Gaussian process modeling was proposed for mining data generated from computer simulations. The proposed approach was applied to analyze the influence of geometric parameters on hemodynamics in the human carotid artery bifurcation. A parametric model in conjunction with a design of computer experiments strategy was used for generating a set of observational data that contains the maximum wall shear stress values for a range of probable arterial geometries. The dataset was mined via a Bayesian Gaussian process emulator to estimate: (a the influence of key parameters on the output via sensitivity analysis, (b uncertainty in output as a function of uncertainty in input, and (c which settings of the input parameters result in maximum and minimum values of the output. Finally, potential diagnostic indicators were proposed that can be used to aid the assessment of stroke risk for a given patient's geometry.

  6. Image based numerical simulation of hemodynamics in a intracranial aneurysm

    Science.gov (United States)

    Le, Trung; Ge, Liang; Sotiropoulos, Fotis; Kallmes, David; Cloft, Harry; Lewis, Debra; Dai, Daying; Ding, Yonghong; Kadirvel, Ramanathan

    2007-11-01

    Image-based numerical simulations of hemodynamics in a intracranial aneurysm are carried out. The numerical solver based on CURVIB (curvilinear grid/immersed boundary method) approach developed in Ge and Sotiropoulos, JCP 2007 is used to simulate the blood flow. A curvilinear grid system that gradually follows the curved geometry of artery wall and consists of approximately 5M grid nodes is constructed as the background grid system and the boundaries of the investigated artery and aneurysm are treated as immersed boundaries. The surface geometry of aneurysm wall is reconstructed from an angiography study of an aneurysm formed on the common carotid artery (CCA) of a rabbit and discretized with triangular meshes. At the inlet a physiological flow waveform is specified and direct numerical simulations are used to simulate the blood flow. Very rich vortical dynamics is observed within the aneurysm area, with a ring like vortex sheds from the proximal side of aneurysm, develops and impinge onto the distal side of the aneurysm as flow develops, and destructs into smaller vortices during later cardiac cycle. This work was supported in part by the University of Minnesota Supercomputing Institute.

  7. [The pathophysiology of hemodynamic shock syndrome (part one)].

    Science.gov (United States)

    Kovac, Z; Belina, D

    1998-12-01

    Hemodynamic shock syndrome represents an acute circulatory failure leading to a multiple organ failure. Such circulatory failure develops due to a decrease of arteriovenous blood pressure gradient as a consequence of three independent groups of pathogenic mechanisms (cardiogenic, vasohypotonic and hypovolemic), all of which lead to the common pathogenic pathways. A decrease of arteriovenous pressure gradient induces vasomotoric responses, reactive body fluids redistribution, endocrine, metabolic as well as tissue energy adjustments. In this review a comprehensive synopsis of pathogenic processes is outlined. The cardiogenic mechanisms include the acute systolic and/or diastolic heart failure. Vasohypotonic mechanisms (neurogenic, septic and anaphylactic) are due to vascular tonus missadjustment. Hypovolemia caused by blood, plasma, water and electrolytes losses and/or sequestration, leads to decrease of pressure gradient as soon as the extent of hypovolemia overcomes the compensatory vascular capacity. The decrease of tissue perfusion is direct consequence of the arteriovenous pressure gradient loss. Tissue hypoperfusion causes a progressive depletion of cellular ATP concentration (cellular hypoenergosis), which very often falls lower than 0,1 mmol/L. Cellular hypoenergosis plays the critical role in conversion of negative homeostatic regulation into a positive feedback mode. Positive homeostatic regulation (circuli vitiosi) amplifies deterioration of arteriovenous blood pressure gradient, which reversely intensifies the degree of energy depletion in the tissues. Such homeostatic conversion plays a critical role in the development of progressive phase (systemic failure, decompensation) of the shock.

  8. Numerical predictions of hemodynamics following surgeries in cerebral aneurysms

    Science.gov (United States)

    Rayz, Vitaliy; Lawton, Michael; Boussel, Loic; Leach, Joseph; Acevedo, Gabriel; Halbach, Van; Saloner, David

    2014-11-01

    Large cerebral aneurysms present a danger of rupture or brain compression. In some cases, clinicians may attempt to change the pathological hemodynamics in order to inhibit disease progression. This can be achieved by changing the vascular geometry with an open surgery or by deploying a stent-like flow diverter device. Patient-specific CFD models can help evaluate treatment options by predicting flow regions that are likely to become occupied by thrombus (clot) following the procedure. In this study, alternative flow scenarios were modeled for several patients who underwent surgical treatment. Patient-specific geometries and flow boundary conditions were obtained from magnetic resonance angiography and velocimetry data. The Navier-Stokes equations were solved with a finite volume solver Fluent. A porous media approach was used to model flow-diverter devices. The advection-diffusion equation was solved in order to simulate contrast agent transport and the results were used to evaluate flow residence time changes. Thrombus layering was predicted in regions characterized by reduced velocities and shear stresses as well as increased flow residence time. The simulations indicated surgical options that could result in occlusion of vital arteries with thrombus. Numerical results were compared to experimental and clinical MRI data. The results demonstrate that image-based CFD models may help improve the outcome of surgeries in cerebral aneurysms. acknowledge R01HL115267.

  9. Varicose veins of lower extremities, hemodynamics and treatment methods.

    Science.gov (United States)

    Chwała, Maciej; Szczeklik, Wojciech; Szczeklik, Michał; Aleksiejew-Kleszczyński, Tomasz; Jagielska-Chwała, Maria

    2015-01-01

    Chronic venous insufficiency is one of the most common disorders of the vascular system, affecting approximately 50% of adults. If left untreated it can lead to a number of complications, including venous ulceration and venous thrombosis. This review paper outlines the epidemiology and ethiopathogenesis of the disease with regard to hemodynamics and microcirculation disturbances. It describes the medical treatment as well as the traditional surgical approach to varicose veins (with several modifications of this technique), and its limitations and contraindications. Furthermore, it discusses a number of new, minimally invasive treatment methods, namely thermal in form (radiofrequency ablation, endovenous laser ablation, steam ablation) and nonthermal (sclerotherapy, echosclerotherapy, Clarivein, Sapheon). For each method, there is a brief historical overview, a description of its mechanism of action, and its indications and limitations. The results of comparative studies on individual treatment methods as well as meta-analyses on this topic are briefly discussed. This paper highlights the progressive trend towards minimally invasive methods and attempts to predict the further development.

  10. Nail abnormalities in patients with vitiligo*

    Science.gov (United States)

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  11. An Abnormal Psychology Community Based Interview Assignment

    Science.gov (United States)

    White, Geoffry D.

    1977-01-01

    A course option in abnormal psychology involves students in interviewing and observing the activities of individuals in the off-campus community who are concerned with some aspect of abnormal psychology. The technique generates student interest in the field when they interview people about topics such as drug abuse, transsexualism, and abuse of…

  12. Abnormal Event Detection Using Local Sparse Representation

    DEFF Research Database (Denmark)

    Ren, Huamin; Moeslund, Thomas B.

    2014-01-01

    measurement based on the difference between the normal space and local space. Specifically, we provide a reasonable normal bases through repeated K spectral clustering. Then for each testing feature we first use temporal neighbors to form a local space. An abnormal event is found if any abnormal feature...

  13. An Abnormal Vibrational Mode of Torsion Pendulum

    Institute of Scientific and Technical Information of China (English)

    赵亮; 涂英; 顾邦明; 胡忠坤; 罗俊

    2003-01-01

    In the experiment for the determination of the gravitational constant G, we found an abnormal vibrational mode of the torsion pendulum. The abnormal mode disappeared as a magnetic damper was introduced to the torsion pendulum system. Our experimental results also show that the magnetic damper can be used to suppress the high frequency vibrational noises to torsion pendulums effectively.

  14. Abnormal Raman spectral phenomenon of silicon nanowires

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The Raman spectra of two one-dimensional silicon nanowire samples with different excitation wavelengths were measured and an abnormal phenomenon was discovered that the Raman spectral features change with the wavelengths of excitation. Closer analysis of the crystalline structure of samples and the changes in Raman spectral features showed that the abnormal behavior is the result of resonance Raman scattering selection effect.

  15. A dose-finding study of methylene blue to inhibit nitric oxide actions in the hemodynamics of human septic shock.

    Science.gov (United States)

    Juffermans, Nicole P; Vervloet, Marc G; Daemen-Gubbels, Catharina R G; Binnekade, Jan M; de Jong, Martin; Groeneveld, A B Johan

    2010-05-15

    Methylene blue increases blood pressure and myocardial function in septic shock mainly by inhibiting nitric oxide (NO) actions. However, a dose-dependency of methylene blue has not been established. Therefore, the compound is currently used as rescue treatment only. To evaluate dose-dependency, a prospective, randomized, double blind, single centre study was performed in 15 consecutive, mechanically ventilated patients with septic shock admitted to the intensive care unit, in whom methylene blue was infused at 1 mg/kg (n=4), 3 mg/kg (n=6) or 7 mg/kg (n=5) over 20 min. Hemodynamic parameters were measured before and after the infusion. Gastric tonometry was performed. Methylene blue treatment increased heart rate, cardiac index, mean arterial, pulmonary artery, pulmonary artery occlusion and central venous pressures, systemic vascular resistance, ventricular stroke work indices and O(2) delivery and uptake, and decreased lactate levels. Methylene blue had a dose-dependent effect on cardiac index, mean arterial, mean pulmonary artery and pulmonary artery occlusion pressures, left ventricular function, O(2) delivery and consumption and lactate levels. The drug dose-dependently increased the gastric-arterial blood PCO(2) gap. The data suggest that in human septic shock, methylene blue increases mean arterial blood pressure by an increase in cardiac index and systemic vascular resistance. The rise in cardiac index is caused by an increase in left ventricular filling and function, increasing tissue oxygenation, even at a dose of 1mg/kg. High doses of methylene blue may compromise splanchnic perfusion, even though further enhancing global hemodynamics, and should therefore, be avoided in future studies.

  16. Chromosomal abnormalities in patients with sperm disorders

    Directory of Open Access Journals (Sweden)

    L. Y. Pylyp

    2013-02-01

    Full Text Available Chromosomal abnormalities are among the most common genetic causes of spermatogenic disruptions. Carriers of chromosomal abnormalities are at increased risk of infertility, miscarriage or birth of a child with unbalanced karyotype due to the production of unbalanced gametes. The natural selection against chromosomally abnormal sperm usually prevents fertilization with sperm barring in cases of serious chromosomal abnormalities. However, assisted reproductive technologies in general and intracytoplasmic sperm injection in particular, enable the transmission of chromosomal abnormalities to the progeny. Therefore, cytogenetic studies are important in patients with male factor infertility before assisted reproduction treatment. The purpose of the current study was to investigate the types and frequencies of chromosomal abnormalities in 724 patients with infertility and to estimate the risk of chromosomal abnormalities detection in subgroups of patients depending on the severity of spermatogenic disruption, aiming at identifying groups of patients in need of cytogenetic studies. Karyotype analysis was performed in 724 blood samples of men attending infertility clinic. Chromosomal preparation was performed by standard techniques. At least 20 GTG-banded metaphase plates with the resolution from 450 to 750 bands per haploid set were analysed in each case. When chromosomal mosaicism was suspected, this number was increased to 50. Abnormal karyotypes were observed in 48 (6.6% patients, including 67% of autosomal abnormalities and 33% of gonosomal abnormalities. Autosomal abnormalities were represented by structural rearrangements. Reciprocal translocations were the most common type of structural chromosomal abnormalities in the studied group, detected with the frequency of 2.6% (n = 19, followed by Robertsonian translocation, observed with the frequency of 1.2% (n = 9. The frequency of inversions was 0.6% (n = 4. Gonosomal abnormalities included 14 cases

  17. In vitro characterization of bicuspid aortic valve hemodynamics using particle image velocimetry.

    Science.gov (United States)

    Saikrishnan, Neelakantan; Yap, Choon-Hwai; Milligan, Nicole C; Vasilyev, Nikolay V; Yoganathan, Ajit P

    2012-08-01

    The congenital bicuspid aortic valve (BAV) is associated with increased leaflet calcification, ascending aortic dilatation, aortic stenosis (AS) and regurgitation (AR). Although underlying genetic factors have been primarily implicated for these complications, the altered mechanical environment of BAVs could potentially accelerate these pathologies. The objective of the current study is to characterize BAV hemodynamics in an in vitro system. Two BAV models of varying stenosis and jet eccentricity and a trileaflet AV (TAV) were constructed from excised porcine AVs. Particle Image Velocimetry (PIV) experiments were conducted at physiological flow and pressure conditions to characterize fluid velocity fields in the aorta and sinus regions, and ensemble averaged Reynolds shear stress and 2D turbulent kinetic energy were calculated for all models. The dynamics of the BAV and TAV models matched the characteristics of these valves which are observed clinically. The eccentric and stenotic BAV showed the strongest systolic jet (V = 4.2 m/s), which impinged on the aortic wall on the non-fused leaflet side, causing a strong vortex in the non-fused leaflet sinus. The magnitudes of TKE and Reynolds stresses in both BAV models were almost twice as large as comparable values for TAV, and these maximum values were primarily concentrated around the central jet through the valve orifice. The in vitro model described here enables detailed characterization of BAV flow characteristics, which is currently challenging in clinical practice. This model can prove to be useful in studying the effects of altered BAV geometry on fluid dynamics in the valve and ascending aorta. These altered flows can be potentially linked to increased calcific responses from the valve endothelium in stenotic and eccentric BAVs, independent of concomitant genetic factors.

  18. Gravitational effects on global hemodynamics in different postures: A closed-loop multiscale mathematical analysis

    Science.gov (United States)

    Zhang, Xiancheng; Noda, Shigeho; Himeno, Ryutaro; Liu, Hao

    2017-02-01

    We present a novel methodology and strategy to predict pressures and flow rates in the global cardiovascular network in different postures varying from supine to upright. A closed-loop, multiscale mathematical model of the entire cardiovascular system (CVS) is developed through an integration of one-dimensional (1D) modeling of the large systemic arteries and veins, and zero-dimensional (0D) lumped-parameter modeling of the heart, the cardiac-pulmonary circulation, the cardiac and venous valves, as well as the microcirculation. A versatile junction model is proposed and incorporated into the 1D model to cope with splitting and/or merging flows across a multibranched junction, which is validated to be capable of estimating both subcritical and supercritical flows while ensuring the mass conservation and total pressure continuity. To model gravitational effects on global hemodynamics during postural change, a robust venous valve model is further established for the 1D venous flows and distributed throughout the entire venous network with consideration of its anatomically realistic numbers and locations. The present integrated model is proven to enable reasonable prediction of pressure and flow rate waveforms associated with cardiopulmonary circulation, systemic circulation in arteries and veins, as well as microcirculation within normal physiological ranges, particularly in mean venous pressures, which well match the in vivo measurements. Applications of the cardiovascular model at different postures demonstrate that gravity exerts remarkable influence on arterial and venous pressures, venous returns and cardiac outputs whereas venous pressures below the heart level show a specific correlation between central venous and hydrostatic pressures in right atrium and veins.

  19. Intraoperative goal directed hemodynamic therapy in noncardiac surgery: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Javier Ripollés

    Full Text Available Abstract Background: The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. Methods: A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014. Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary and mortality (secondary. Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal, and predefined sensitivity analysis. Results: 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p < 0.001. No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p = 0.30. Quality sensitive analyses confirmed the main overall results. Conclusions: Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac

  20. Hemodynamic stress response during laparoscopic cholecystectomy: Effect of two different doses of intravenous clonidine premedication

    Directory of Open Access Journals (Sweden)

    Deepshikha C Tripathi

    2011-01-01

    Full Text Available Background : Clonidine has emerged as an attractive premedication desirable in laparoscopic surgery wherein significant hemodynamic stress response is seen. The minimum safe and effective dose of intravenous clonidine to attenuate the hemodynamic stress response during laparoscopic surgery has however not yet been determined. Materials and Methods : This prospective, randomized, double-blind controlled study was conducted on 90 adults of ASA physical status I and II, scheduled for laparoscopic cholecystectomy under general anesthesia. Patients were randomized to one of the three groups (n= 30. Group I received 100 ml of normal saline, while groups II and III received 1 μg/ kg and 2 μg/ kg of clonidine respectively, intravenous, in 100 ml of normal saline along. All patients received glycopyrrolate 0.004 mg/kg and tramadol 1.5 mg/kg intravenously, 30 min before induction. Hemodynamic variables (heart rate, systolic, diastolic, mean arterial pressure, SpO2, and sedation score were recorded at specific timings. MAP above 20% from baseline was considered significant and treated with nitroglycerine. Results : In group I, there was a significant increase in hemodynamic variables during intubation pneumoperitoneum and extubation (P<0.001. Clonidine given 1 μg/kg intravenous attenuated hemodynamic stress response to pneumoperitoneum (P<0.05, but not that associated with intubation and extubation. Clonidine 2 μg/kg intravenous prevented hemodynamic stress response to pneumoperitoneum and that associated with intubation and extubation (P<0.05. As against 14 and 2 patients in groups I and II respectively, no patient required nitroglycerine infusion in group III. Conclusions : Clonidine, 2 μg/ kg intravenously, 30 min before induction is safe and effective in preventing the hemodynamic stress response during laparoscopic cholecystectomy.

  1. Entrainment of spontaneous cerebral hemodynamic oscillations to behavioral responses.

    Science.gov (United States)

    Pfurtscheller, Gert; Walther, Mario; Bauernfeind, Günther; Barry, Robert J; Witte, Herbert; Müller-Putz, Gernot R

    2014-04-30

    Entrainment in physiological systems can be manifest in cases where phase-coupling (synchronization) between slow intrinsic oscillations and periodic motor responses, or vice versa, takes place. To test whether voluntary movement has something in common with entrainment of slow hemodynamic oscillations to motor responses, we studied blood pressure (BP), heart rate beat-to-beat intervals (RRI) and prefrontal (de)oxyhemoglobin (Hb/HbO2) during 5min of rest, 10min of self-paced, voluntary movements and 10min of stimulus-paced movements at 10s intervals in 9 subjects. Subjects were divided into 2 groups according to the timing of voluntary finger movements. It appeared that these movements occurred at relatively regular intervals of approximately 10s in 5 subjects (group A); while 4 subjects showed random or very short inter-movement intervals (group B). Two remarkable results were obtained: first, the phase coupling (COH(2)) between BP and RRI showed a significant (p=0.0061) interaction between activity (rest vs. movement) and group (A vs. B), with an increased (p=0.0003) coupling in group A. Second, the COH(2) between BP and Hb oscillations showed a significant (p=0.034) interaction between activity and group, with a decreased (p=0.079) coupling in group B. These results suggest that subjects able to initiate self-paced, voluntary movements at relatively regular intervals of ∼10s show an entrainment potential between physiological oscillations and motor responses. This also provides the first evidence that not only physiological oscillations can be entrained to motor responses, but also motor responses (voluntary movements) can be entrained to slow intrinsic oscillations.

  2. Hemodynamic Parameters of Low-Flow Isoflurane and Low-Flow Sevoflurane Anesthesia During Controlled Ventilation With Laryngeal Mask Airway

    OpenAIRE

    Negargar, Sohrab; Peirovifar, Ali; Mahmoodpoor, Ata; Parish, Masoud; Golzari, Samad EJ; Molseqi, Haniye; Negargar, Soheil

    2014-01-01

    Background: Nowadays laryngeal mask airway (LMA) is popular as one of the best choices for airway management. Low-flow anesthesia has some advantages like lower pollution, hemodynamic stability and cost effectiveness. Volatile anesthetics are widely used for anesthesia maintenance during operations. Sevoflurane has more hemodynamic stability compared to isoflurane, but there are few studies comparing the hemodynamic stabilities of these two anesthetics during controlled low flow anesthesia wi...

  3. Numerically abnormal chromosome constitutions in humans

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 24, discusses numerically abnormal chromosome constitutions in humans. This involves abnormalities of human chromosome number, including polyploidy (when the number of sets of chromosomes increases) and aneuploidy (when the number of individual normal chromosomes changes). Chapter sections discuss the following chromosomal abnormalities: human triploids, imprinting and uniparental disomy, human tetraploids, hydatidiform moles, anomalies caused by chromosomal imbalance, 13 trisomy (D{sub 1} trisomy, Patau syndrome), 21 trisomy (Down syndrome), 18 trisomy syndrome (Edwards syndrome), other autosomal aneuploidy syndromes, and spontaneous abortions. The chapter concludes with remarks on the nonrandom participation of chromosomes in trisomy. 69 refs., 3 figs., 4 tabs.

  4. In vivo isolation of the effects of melanin from underlying hemodynamics across skin types using spatial frequency domain spectroscopy

    Science.gov (United States)

    Saager, Rolf B.; Sharif, Ata; Kelly, Kristen M.; Durkin, Anthony J.

    2016-05-01

    Skin is a highly structured tissue, raising concerns as to whether skin pigmentation due to epidermal melanin may confound accurate measurements of underlying hemodynamics. Using both venous and arterial cuff occlusions as a means of inducing differential hemodynamic perturbations, we present analyses of spectra limited to the visible or near-infrared regime, in addition to a layered model approach. The influence of melanin, spanning Fitzpatrick skin types I to V, on underlying estimations of hemodynamics in skin as interpreted by these spectral regions are assessed. The layered model provides minimal cross-talk between melanin and hemodynamics and enables removal of problematic correlations between measured tissue oxygenation estimates and skin phototype.

  5. Correction of Hemodynamics with Hypertonic Sodium Chloride Solution in Critical Conditions

    Directory of Open Access Journals (Sweden)

    P. S. Zhbannikov

    2007-01-01

    Full Text Available Objective: to assess the capabilities of small-volume hypertonic infusion in the context of early goal-directed therapy for critical conditions in surgical patients.Subjects and methods. Twenty-nine patients (SAPS II 47.5±6.81 scores operated on for generalized peritonitis (n=24 or severe concomitant injury with damages to chest and/or abdominal organs (n=5 who had the clinical and laboratory signs of a systemic inflammatory reaction were intravenously injected 4 ml/kg of 7.5% of hypertonic sodium chloride solution (HS and colloidal solution, followed by infusion and, if indicated, inotropic maintenance of hemodynamics for 6 hours in order to achieve the goal vales of mean blood pressure (BP, central venous pressure (CVP, central venous blood oxygen saturation (ScvO2, and diuresis. Plasma concentrations of sodium, chlorine, and lactate, acid-base balance, and osmotic blood pressure were monitored.Results. The patients were found to have infusion therapy-refractory critical arterial hypotension, low ScvO2, and oliguria before small-volume circulation maintenance. In all the patients, HS infusion originally caused a rapid rise in BP up to the goal value, with its further colloid infusion maintenance requiring additional dopamine infusion in 12 patients and red blood cell transfusion in 3. This could stabilize over 6 hours BP at the required level in 25 patients, in 9 of whom CVP only approximated the goal value. All the patients were found to have a significant increase in ScvO2 up to an average of 68% in response to HP infusion after 30—60 minutes; in 14 out of them ScvO2 exceeded 70%. By hour 6, ScvO2 stabilized at its goal level in 23 (79% examinees. Administration of HS caused a significantly increased diuresis. In patients with recovered renal function, the observed hypernatremia, hyperchloremia with hyperchloremic acidosis were transient.Conclusion. The results of the study show it possible to include small-volume hypertonic infusion at

  6. The Effectiveness of Intravenous Dexmedetomidine on Perioperative Hemodynamics, Analgesic Requirement, and Side Effects Profile in Patients Undergoing Laparoscopic Surgery Under General Anesthesia

    Science.gov (United States)

    Panchgar, Vinayak; Shetti, Akshaya N.; Sunitha, H. B.; Dhulkhed, Vithal K.; Nadkarni, A. V.

    2017-01-01

    Background: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively. Dexmedetomidine is one of the α2 agonist drugs which acts at both supraspinal and spinal level and modulate the transmission of nociceptive signals in the central nervous system. The basic effect of dexmedetomidine on the cardiovascular system is to decrease the heart rate and systemic vascular resistance with additional feature of opioid sparing effect. This drug has become an ideal adjuvant during general anesthesia, especially when stress is expected. Hence, the drug was studied in laparoscopic surgeries. Aims and Objectives: (a) To study the effect of dexmedetomidine on hemodynamic parameters during perioperative period in patients undergoing laparoscopic surgery. (b) To study the postoperative sedation score and analgesic requirement. (c) To study the side effect profile of dexmedetomidine. Settings and Design: Randomized double blind controlled trial. Subjects and Methods: After obtaining the Institutional Ethical Clearance, the study was conducted. Forty patients of American Society of Anesthesiologists Class I and II were enrolled in this randomized study. The patients were randomly divided into two groups; group normal saline (NS) and group dexmedetomidine. Patient received either NS or dexmedetomidine in group NS and group dexmedetomidine, respectively, depending upon the allocation. The infusion rate was adjusted according to; loading dose (1 μg/kg) over 10 min and maintenance dose (0.5 μg/kg/h) and

  7. The glycometabolism abnormality among schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    吴小立

    2013-01-01

    Objective To explore the potential glycometabolism abnormality and the related factors of schizophrenia patients in China. Methods This cross-sectional study included 44 healthy controls(group 1) and 178 inpatient

  8. Amphibian abnormalities on National Wildlife Refuges

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This fact sheet outlines a study done to 1) find the percentage of abnormal frogs and toads on the nation’s National Wildlife Refuges and 2) determine how the...

  9. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  10. Abnormal Chromosome Segregation May Trigger Tumors

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Cancer is a primary threat to human health as it kills millions of people each year.Scientists have shown that 75% of human cancers have an abnormal number of chromosomes in cells,and the proportion of the cells with an abnormal chromosome number is tightly and positively related to malignance progression and metastasis of cancers. But the pathological mechanism behind the anomaly still remains unknown.

  11. Nail abnormalities in patients with vitiligo

    OpenAIRE

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Abstract: Background: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the corre...

  12. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  13. Basilar artery migraine and reversible imaging abnormalities.

    Science.gov (United States)

    Maytal, J; Libman, R B; Lustrin, E S

    1998-01-01

    We report a case of a basilar artery migraine in a 17-year-old boy with transient CT and MR abnormalities after each of two migraine episodes. A repeat MR study 6 months after the last event showed complete resolution of the lesion. Transient abnormalities on brain images similar to those shown in our case have been reported in patients with migraine and other neurologic conditions and are most likely related to cerebral vasogenic edema.

  14. Abnormal Asymmetry of Brain Connectivity in Schizophrenia

    OpenAIRE

    Ribolsi, Michele; Zafiris J Daskalakis; Siracusano, Alberto; Koch, Giacomo

    2014-01-01

    Recently, a growing body of data has revealed that beyond a dysfunction of connectivity among different brain areas in schizophrenia patients (SCZ), there is also an abnormal asymmetry of functional connectivity compared with healthy subjects. The loss of the cerebral torque and the abnormalities of gyrification, with an increased or more complex cortical folding in the right hemisphere may provide an anatomical basis for such aberrant connectivity in SCZ. Furthermore, diffusion tensor imagin...

  15. Physiological Evaluation of a Student in E-learning Sessions by Hemodynamic Responses

    Science.gov (United States)

    Nomura, Shusaku; Irfan, C. M. Althaff; Yamagishi, Takao; Kurosawa, Yoshimasa; Yajima, Kuniaki; Nakahira, Katsuko T.; Ogawa, Nobuyuki; Handri, Santoso; Fukumura, Yoshimi

    In this study, a novel approach towards the evaluation of students in e-learning sessions is regarded; the physiological responses of the students who were engaged in e-learning materials were investigated. Among a full battery of physiological signals, we focused on human hemodynamic activity, which is represented by the blood pressure. The past hemodynamic studies on mental stress showed that the difference in subject's stress coping style, i.e., active and passive coping, induced different hemodynamic responses. Such a variety of stress coping styles is also anticipated to be prevailing in attendees of e-learning course. In the experiment, the hemodynamic responses of the students who were engaged in the e-learning session were investigated with two considerably contrasting e-learning materials, one is characterized by an interactive material and the other is by non-interactive material. As a developing result, a particular hemodynamic pattern, which is involved in the subject's active coping, was observed in the interactive condition, and that of passive coping was observed in the non-interactive condition, whereas there was no significant difference in the score of questionnaire on the materials. These results thus led to an idea of the objective evaluation of the attendees of e-learning courses.

  16. Impact of Sitting or Semi-Setting Position of Patients During Breast Surgery on Hemodynamic Indexes

    Directory of Open Access Journals (Sweden)

    Kasra Karvandian

    2016-09-01

    Full Text Available Background: Keeping the patient in a sitting or semi-sitting position for time-consuming oncoplastic breast surgery is a major challenge for anesthesiologists due to several considerations. This cohort study was conducted on two groups of patients undergoing breast surgery.Methods: Study participants were categorized into two groups: one group was composed of normotensive women (group A and the other group comprised women with controlled hypertension (group B. After the induction of anesthesia in the supine position, the position was changed to sitting and the surgery was done in the sitting position. Hemodynamic monitoring included ECG, heart rate, non-invasive blood pressure (NIBP, invasive blood pressure (IBP, cardiac output (CO, arterial O2 saturation (SPO2, end-tidal CO2 (EtCO2, and bispectral index (BIS. The amount of administrated fluid and vasopressor was recorded for each patient. Any episode of hemodynamic instability was recorded, too.Results: Hemodynamic variation occurred in both groups, but the changes were more significant in group B and the amount of fluid and vasopressor administration was more prominent in group B. Changing the position caused no significant variation in BIS, SPO2, and EtCO2 in the two groups.Conclusions: The sitting position can be safe for time-consuming oncoplastic breast surgery using adequate hemodynamic monitoring. Hemodynamic changes are more significant in patients with controlled hypertension, and more medical interference is needed for these patients.

  17. Prediction of Hemodynamic Reactivity during Sevoflurane Remifentanyl Anesthesia for Laparoscopic Cholecystectomy Using Analgesia Nociception Index

    Directory of Open Access Journals (Sweden)

    Ali Şefik Köprülü

    2016-12-01

    Full Text Available Aim: Pneumoperitoneum may cause serious side effects in high-risk patients during laparoscopic cholecystectomy. Perioperative analgesic sufficiency has been measured by the Analgesia Nociception index (ANI in recent years. We examine the possibility of predicting hemodynamic reactivity by observing sudden changes in ANI during operation. Methods: In this retrospective study, recorded hemodynamic parameters (including heart rate, systolic/ diastolic blood pressure values and ANI values, before and after intubation, nasogastric tube application, intraperitoneal gas insufflation, and surgical incision in 31 patients who were applied laparoscopic cholecystectomy were compared by paired t-test. Additionally, an increment or decrement of 20% in ANI and 15% in hemodynamic parameters with respect to basal observation values were called “sudden changes”. Correlation of these parameters with sudden changes in ANI values was examined either. Results: There was a statistically significant difference in parameters after premedication and intubation. After induction, a statistically significant decrement was detected only in heart rate and systolic/diastolic blood pressure values. There was no significant change after nasogastric tube insertion. During pneumoperitoneum and surgical incision, there was no change in heart rate and systolic/diastolic blood pressure values, but a statistically significant decrement was observed in ANI. No correlation was detected between sudden changes in ANI values and hemodynamic parameters. Conclusion: We assume that use of ANI in analgesia evaluation under general anesthesia at perioperative period is suitable, however, it is not reliable in predicting hemodynamic interaction.

  18. Temporal coupling between stimulus-evoked neural activity and hemodynamic responses from individual cortical columns

    Energy Technology Data Exchange (ETDEWEB)

    Bruyns-Haylett, Michael; Zheng Ying; Berwick, Jason; Jones, Myles [The Centre for Signal Processing in Neuroimaging and Systems Neuroscience (SPINSN), Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TP (United Kingdom)], E-mail: m.jones@sheffield.ac.uk

    2010-04-21

    Using previously published data from the whisker barrel cortex of anesthetized rodents (Berwick et al 2008 J. Neurophysiol. 99 787-98) we investigated whether highly spatially localized stimulus-evoked cortical hemodynamics responses displayed a linear time-invariant (LTI) relationship with neural activity. Presentation of stimuli to individual whiskers of 2 s and 16 s durations produced hemodynamics and neural activity spatially localized to individual cortical columns. Two-dimensional optical imaging spectroscopy (2D-OIS) measured hemoglobin responses, while multi-laminar electrophysiology recorded neural activity. Hemoglobin responses to 2 s stimuli were deconvolved with underlying evoked neural activity to estimate impulse response functions which were then convolved with neural activity evoked by 16 s stimuli to generate predictions of hemodynamic responses. An LTI system more adequately described the temporal neuro-hemodynamics coupling relationship for these spatially localized sensory stimuli than in previous studies that activated the entire whisker cortex. An inability to predict the magnitude of an initial 'peak' in the total and oxy- hemoglobin responses was alleviated when excluding responses influenced by overlying arterial components. However, this did not improve estimation of the hemodynamic responses return to baseline post-stimulus cessation.

  19. Saturation thresholds of evoked neural and hemodynamic responses in awake and asleep rats

    Science.gov (United States)

    Schei, Jennifer L.; Van Nortwick, Amy S.; Meighan, Peter C.; Rector, David M.

    2011-03-01

    Neural activation generates a hemodynamic response to the localized region replenishing nutrients to the area. Changes in vigilance state have been shown to alter the vascular response where the vascular response is muted during wake compared to quiet sleep. We tested the saturation thresholds of the neurovascular response in the auditory cortex during wake and sleep by chronically implanting rats with an EEG electrode, a light emitting diode (LED, 600 nm), and photodiode to simultaneously measure evoked response potentials (ERPs) and evoked hemodynamic responses. We stimulated the cortex with a single speaker click delivered at random intervals 2-13 s at varied stimulus intensities ranging from 45-80 dB. To further test the potential for activity related saturation, we sleep deprived animals for 2, 4, or 6 hours and recorded evoked responses during the first hour recovery period. With increasing stimulus intensity, integrated ERPs and evoked hemodynamic responses increased; however the hemodynamic response approached saturation limits at a lower stimulus intensity than the ERP. With longer periods of sleep deprivation, the integrated ERPs did not change but evoked hemodynamic responses decreased. There may be physical limits in cortical blood delivery and vascular compliance, and with extended periods of neural activity during wake, vessels may approach these limits.

  20. Study of endothelial cell apoptosis using fluorescence resonance energy transfer (FRET) biosensor cell line with hemodynamic microfluidic chip system.

    Science.gov (United States)

    Yu, J Q; Liu, X F; Chin, L K; Liu, A Q; Luo, K Q

    2013-07-21

    To better understand how hyperglycemia induces endothelial cell dysfunction under the diabetic conditions, a hemodynamic microfluidic chip system was developed. The system combines a caspase-3-based fluorescence resonance energy transfer (FRET) biosensor cell line which can detect endothelial cell apoptosis in real-time, post-treatment effect and with a limited cell sample, by using a microfluidic chip which can mimic the physiological pulsatile flow profile in the blood vessel. The caspase-3-based FRET biosensor endothelial cell line (HUVEC-C3) can produce a FRET-based sensor protein capable of probing caspase-3 activation. When the endothelial cells undergo apoptosis, the color of the sensor cells changes from green to blue, thus sensing apoptosis. A double-labeling fluorescent technique (yo pro-1 and propidium iodide) was used to validate the findings revealed by the FRET-based caspase sensor. The results show high rates of apoptosis and necrosis of endothelial cells when high glucose concentration was applied in our hemodynamic microfluidic chip combined with an exhaustive pulsatile flow profile. The two apoptosis detection techniques (fluorescent method and FRET biosensor) are comparable; but FRET biosensor offers more advantages such as real-time observation and a convenient operating process to generate more accurate and reliable data. Furthermore, the activation of the FRET biosensor also confirms the endothelial cell apoptosis induced by the abnormal pulsatile shear stress and high glucose concentration is through caspase-3 pathway. A 12% apoptotic rate (nearly a 4-fold increase compared to the static condition) was observed when the endothelial cells were exposed to a high glucose concentration of 20 mM under 2 h exhaustive pulsatile shear stress of 30 dyne cm(-2) and followed with another 10 h normal pulsatile shear stress of 15 dyne cm(-2). Therefore, the most important finding of this study is to develop a novel endothelial cell apoptosis detection

  1. SvO(2)-guided resuscitation for experimental septic shock: effects of fluid infusion and dobutamine on hemodynamics, inflammatory response, and cardiovascular oxidative stress.

    Science.gov (United States)

    Rosário, André Loureiro; Park, Marcelo; Brunialti, Milena Karina; Mendes, Marialice; Rapozo, Marjorie; Fernandes, Denise; Salomão, Reinaldo; Laurindo, Francisco Rafael; Schettino, Guilherme Paula; Azevedo, Luciano Cesar P

    2011-12-01

    The pathogenetic mechanisms associated to the beneficial effects of mixed venous oxygen saturation (SvO(2))-guided resuscitation during sepsis are unclear. Our purpose was to evaluate the effects of an algorithm of SvO(2)-driven resuscitation including fluids, norepinephrine and dobutamine on hemodynamics, inflammatory response, and cardiovascular oxidative stress during a clinically resembling experimental model of septic shock. Eighteen anesthetized and catheterized pigs (35-45 kg) were submitted to peritonitis by fecal inoculation (0.75 g/kg). After hypotension, antibiotics were administered, and the animals were randomized to two groups: control (n = 9), with hemodynamic support aiming central venous pressure 8 to 12 mmHg, urinary output 0.5 mL/kg per hour, and mean arterial pressure greater than 65 mmHg; and SvO(2) (n = 9), with the goals above, plus SvO(2) greater than 65%. The interventions lasted 12 h, and lactated Ringer's and norepinephrine (both groups) and dobutamine (SvO(2) group) were administered. Inflammatory response was evaluated by plasma concentration of cytokines, neutrophil CD14 expression, oxidant generation, and apoptosis. Oxidative stress was evaluated by plasma and myocardial nitrate concentrations, myocardial and vascular NADP(H) oxidase activity, myocardial glutathione content, and nitrotyrosine expression. Mixed venous oxygen saturation-driven resuscitation was associated with improved systolic index, oxygen delivery, and diuresis. Sepsis induced in both groups a significant increase on IL-6 concentrations and plasma nitrate concentrations and a persistent decrease in neutrophil CD14 expression. Apoptosis rate and neutrophil oxidant generation were not different between groups. Treatment strategies did not significantly modify oxidative stress parameters. Thus, an approach aiming SvO(2) during sepsis improves hemodynamics, without any significant effect on inflammatory response and oxidative stress. The beneficial effects associated

  2. Central nervous system lupus erythematosus in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Yokota, Shumpei; Kimura, Kazue; Yoshida, Naotaka; Mitsuda, Toshihiro; Ibe, Masa-aki; Shimizu, Hiroko (Yokohama City Univ. (Japan). Faculty of Medicine)

    1989-12-01

    Clinical features of central nervous system (CNS) invlvement in childhood systemic lupus erythematosus (SLE) was investigated. Neuropsychiatric manifestations including seizures, chorea, headache, overt psychosis, tremor, increase of muscle spastisity, and disturbed memory were found in 47% of 15 patients with SLE. There was a well correlatin between CNS abnormalities and SLE disease activity judged by serum complement levels and anti-nuclear antibody and anti-DNA antibody titers. The administration of Prednisolon was effective for the treatment of these CNS abnormalities and steroid psychosis was rare in the present study. EEG abnormalities involving diffuse slowing and slowing bursts were found in 73% of the patients. Cranial CT scan revealed basel ganglia calcifications in 2 patients, and marked brain atrophy in 3 patients. This study indicated that in the long term following of SLE children CNS abnormalities need to be serially checked by EEG and cranial CT scans as well as serological investigations. (author).

  3. Hemodynamic effect of avanafil and glyceryl trinitrate coadministration

    Directory of Open Access Journals (Sweden)

    Dennis Swearingen

    2013-02-01

    Full Text Available A Phase I, double-blind, randomized, crossover study in healthy males (N=106 was conducted between March 21, 2004, and May 17, 2004, to determine the magnitude and duration of the hemodynamic interaction of avanafil (a phosphodiesterase type-5 inhibitor for treating males with erectile dysfunction when coadministered with glyceryl trinitrate (NTG compared with sildenafil and placebo. Subjects received avanafil (200 mg, sildenafil (100 mg, and placebo (on separate days via the oral route followed by NTG (0.4 mg 12, 8, 4, 1, or 0.5 hours post-dose via the sublingual route. Blood pressure (BP and heart rate (HR were assessed at defined intervals.Throughout the study (after administration of the study drug, and including the period after NTG administration, the effects of avanafil and sildenafil on BP and HR were significantly greatest overall, at the shortest (0.5-hour time interval compared with placebo. By the 8- and 12-hour time intervals, no significant difference in BP or HR was observed for avanafil (8 and 12 hours or sildenafil (12 hours (p>0.05, compared with placebo. Compared with avanafil, sildenafil had a significantly greater effect when dosed 0.5 hours before NTG on standing HR (p=0.05; 1 hour before NTG on standing systolic blood pressure (SBP (p<0.05, sitting SBP (p=0.01 and standing HR (p<0.01; and 12 hours before NTG on standing SBP (p=0.05. Throughout the study, symptomatic hypotension adverse events occurred in 27%, 29%, and 12%, and clinically significant reductions in standing SBP (≥30 mmHg occurred in 15%, 29%, and 12% of subjects dosed with avanafil, sildenafil, and placebo, respectively (overall treatment differences: p<0.01 and p<0.05,respectively.These data show that avanafil and sildenafil have no significant effect on BP and HR if administered to healthy males ≥8 hours (avanafil or ≥12 hours (sildenafil before a sublingual dose of NTG. However, results may differ in populations with known vascular disease

  4. The impact of deformation of an aneurysm model under pulsatile flow on hemodynamic analysis.

    Science.gov (United States)

    Kawakami, T; Takao, H; Ichikawa, C; Kamiya, K; Murayama, Y; Motosuke, M

    2016-08-01

    Hemodynamic analysis of cerebral aneurysms has been widely carried out to clarify the mechanisms of their growth and rupture. In several cases, patient-specific aneurysm models made of transparent polymers have been used. Even though periodic changes in aneurysms due to the pulsation of blood flow could be important, the deformation of the model geometry and its effect on hemodynamic evaluation has not been fully investigated. In addition, the fabrication accuracy of aneurysm models has not been evaluated even though it may affect the hemodynamic parameters to be analyzed. In this study, the fabrication accuracy of a silicone aneurysm model was investigated. Additionally, the deformation of the model under pulsatile flow as well as its correlation with flow behavior was evaluated. Consequently, a fabrication method for an aneurysm model with high accuracy was established and the importance of the wall thickness of the model was also specified.

  5. Appreciating the Strengths and Weaknesses of Transthoracic Echocardiography in Hemodynamic Assessments

    Directory of Open Access Journals (Sweden)

    Stephen J. Huang

    2012-01-01

    Full Text Available Transthoracic echocardiography (TTE is becoming the choice of hemodynamic assessment tool in many intensive care units. With an ever increasing number of training programs available worldwide, learning the skills to perform TTE is no longer a limiting factor. Instead, the future emphasis will be shifted to teach the users how to recognize measurement errors and artefacts (internal validity, to realize the limitations of TTE in various applications, and finally how to apply the information to the patient in question (external validity. This paper aims to achieve these objectives in a common area of TTE application—hemodynamic assessments. We explore the strengths and weaknesses of TTE in such assessments in this paper. Various methods of hemodynamic assessments, such as cardiac output measurements, estimation of preload, and assessment of fluid responsiveness, will be discussed.

  6. Metabolic and hemodynamic evaluation of brain metastases from small cell lung cancer with positron emission tomography

    DEFF Research Database (Denmark)

    Lassen, U; Andersen, P; Daugaard, G

    1998-01-01

    for studies of metabolic and hemodynamic features. This study was performed to determine regional cerebral metabolic rate of glucose (rCMRglu), regional cerebral blood flow (rCBF), and regional cerebral blood volume (rCBV) in brain metastases from small cell lung cancer and the surrounding brain. Tumor r......CMRglu, rCBF, and rCBV exerted a broad variability, but were higher than the corresponding values in white matter and higher than or similar to those of gray matter. Tumor rCMRglu and rCBF were highly correlated (P metabolic or hemodynamic parameters...... was not observed. Other methods for noninvasive in vivo analysis of tumor hemodynamics are needed, especially for discrimination between tumor necrosis and hypoxia....

  7. [Patients with hemodynamic unstable pelvic fractures in extremis: pelvic packing or angiography?].

    Science.gov (United States)

    Liñán-Padilla, A; Giráldez-Sánchez, M Á; Serrano-Toledano, D; Lázaro-Gonzálvez, A; Cano-Luís, P

    2013-01-01

    The multidisciplinary management of patients with pelvic trauma has improved prognosis, but mortality is still very high. The appropriate treatment strategy remains controversial, especially regarding the control of bleeding in patients whose clinical situation is extreme by using angiography or pelvic packing. We propose using a tool of evidence-based medicine (CAT) the benefit of the completion of pelvic packing in relation to a specific clinical question from a specific situation. What is best for the management of bleeding, extraperitoneal pelvic packing or angiography, in patients with hemodynamically unstable pelvic fracture in extremis? From this study we can conclude that angiography may improve control of bleeding in patients with arterial bleeding and hemodynamically stable but the packing has priority in patients with pelvic fractures and hemodynamic instability.

  8. Hemodynamic monitoring of the critically ill neonate: An eye on the future.

    Science.gov (United States)

    Azhibekov, Timur; Soleymani, Sadaf; Lee, Ben H; Noori, Shahab; Seri, Istvan

    2015-08-01

    By continuous assessment of dynamic changes in systemic and regional perfusion during transition to extrauterine life and beyond, comprehensive neonatal hemodynamic monitoring creates numerous opportunities for both clinical and research applications. In particular, it has the potential of providing additional details about physiologic interactions among the key hemodynamic factors regulating systemic blood flow and blood flow distribution along with the subtle changes that are frequently transient in nature and would not be detected without such systems in place. The data can then be applied for predictive mathematical modeling and validation of physiologically realistic computer models aiming to identify patient subgroups at higher risk for adverse outcomes and/or predicting the response to a particular perturbation or therapeutic intervention. Another emerging application that opens an entirely new era in hemodynamic research is the use of the physiometric data obtained by the monitoring and data acquisition systems in conjunction with genomic information.

  9. [Effect of somatostatin on the hemodynamic changes induced by acute experimental pancreatitis in the conscious rat].

    Science.gov (United States)

    Ais, G; Novo, C; Ortega, M; González, A; Jiménez, I; López, J; Romeo, J M

    1994-03-01

    The aim of this study was to determine the hemodynamic effect of somatostatin, either prophylactically or therapeutically, in shock caused by acute necrohemorragic pancreatitis in conscious rats. For this purpose, radioactive microspheres were used in 3 groups (control pancreatitis, therapeutic somatostatin and prophylactic somatostatin), performing a basal and final hemodynamic study. In the control group, acute necrohemorragic pancreatitis resulted in overwhelming shock with decrease of 55% in cardiac output, 58% in renal blood flow, increase in total peripheral resistances of 342%, and death after 70 min. Therapeutic somatostatin decreased cardiac output by 42%, renal blood flow by 47%, and increased total peripheral resistances by 153%. Prophylactic somatostatin decreased cardiac output by 24%, and renal blooded flow by 28%; it increased peripheral resistances by 146%, and improved survival up to 97 min. In conclusion, therapeutic somatostatin, and particularly prophylactic somatostatin, improved hemodynamic shock after acute necrohemorragic pancreatitis in conscious rats.

  10. Hemodynamics of physiological blood flow in the aorta with nonlinear anisotropic heart valve

    Science.gov (United States)

    Sotiropoulos, Fotis; Gilmanov, Anvar; Stolarski, Henryk

    2016-11-01

    The hemodynamic blood flow in cardiovascular system is one of the most important factor, which causing several vascular diseases. We developed a new Curvilinear Immersed Boundary - Finite Element - Fluid Structure Interaction (CURVIB-FE-FSI) method to analyze hemodynamic of pulsatile blood flow in a real aorta with nonlinear anisotropic aortic valve at physiological conditions. Hyperelastic material model, which is more realistic for describing heart valve have been incorporated in the CURVIB-FE-FSI code to simulate interaction of aortic heart valve with pulsatile blood flow. Comparative studies of hemodynamics for linear and nonlinear models of heart valve show drastic differences in blood flow patterns and hence differences of stresses causing impact at leaflets and aortic wall. This work is supported by the Lillehei Heart Institute at the University of Minnesota.

  11. Hemodynamics of Stent Implantation Procedures in Coronary Bifurcations: an in vitro study

    CERN Document Server

    Brindise, Melissa C; Burzotta, Francesco; Migliavacca, Francesco; Vlachos, Pavlos P

    2016-01-01

    Stent implantation in coronary bifurcations presents unique challenges and currently there is no universally accepted stent deployment approach. Despite clinical and computational studies, to date, the effect of each stent implantation method on the coronary artery hemodynamics is not well understood. In this study the hemodynamics of stented coronary bifurcations under pulsatile flow conditions were investigated experimentally. Three implantation methods, provisional side branch (PSB), culotte (CUL), and crush (CRU), were investigated using time-resolved particle image velocimetry (PIV) to measure the velocity fields. Subsequently, hemodynamic parameters including wall shear stress (WSS), oscillatory shear index (OSI), and relative residence time (RRT) were calculated and the pressure field through the vessel was non-invasively quantified. The effects of each stented case were evaluated and compared against an un-stented case. CRU provided the lowest compliance mismatch, but demonstrated detrimental stent in...

  12. The influence of stenosis degrees and graft suture position on local hemodynamics of coronary bypass

    Science.gov (United States)

    Totorean, A. F.; Bernad, S. I.; Susan-Resiga, R. F.

    2016-06-01

    Bypass graft failure is mainly caused by intimal hyperplasia (IH) that occurs at the graft anastomosis after coronary artery bypass grafting (CABG) surgery. It has been shown that local hemodynamics influences the process of IH initiation and progression. A main concern at this type of surgery is to increase the graft patency, respectively to improve the local hemodynamics. This paper analyzes the influence of different degree of stenosis severity and graft suture position on graft patency, taking into consideration the local hemodynamics. Bypass configurations with anastomosis angle of 45° were numerically investigated, with respect to wall shear stress and pressure variation. We can assume that in the conditions of our study, different stenosis degrees and position of the graft suture influence the local blood flow conditions, and, nevertheless, the graft patency.

  13. Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

    Science.gov (United States)

    McGee, William T; Raghunathan, Karthik; Adler, Adam C

    2015-12-01

    The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.

  14. Color Doppler imaging features in patients presenting central retinal artery occlusion with and without giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Catalin Jianu Dragos

    2016-01-01

    Full Text Available Introduction. Central retinal artery obstruction (CRAO represents an abrupt diminution of blood flow through the CRA that is severe enough to cause ischemia of the inner retina with permanent unilateral visual loss. We presented the role of color Doppler imaging (CDI of orbital vessels and of extracranial duplex sonography (EDS in the etiological diagnosis of CRAO in two patients with clinical suspicion of unilateral CRAO. Case report. Patients were examined following the protocol which included CDI of orbital vessels and EDS. Both patients had no emboli visible on ophthalmoscopy. The B-scan ultrasound evaluation of the first patient found a small round, moderately reflective echo within the right optic nerve, 1.5 mm behind the optic disc (emboli of cholesterol. CDI of retrobulbar vessels revealed the normal right ophthalmic artery (OA hemodynamic parameters, but the first patient had no arterial flow signal on CDI at the distance of 1.5 mm behind the right optic disc. In contrast, the left eye had the normal aspect on CDI of retrobulbar vessels. The right internal carotid artery EDS identified a severe stenosis at its origin as CRA’s emboli source. The second patient had characteristic CDI findings for giant cell arteritis (GCA with eye involvement: severe diminished blood flow velocities, especially end-diastolic velocities, in both CRAs. Less abnormalities were observed in the posterior ciliary arteries, and in the ophthalmic arteries. The second patient had no systemic symptoms or signs of GCA. Conclusion. In the presented cases, the ultrasound investigation enabled prompt differentiation between central retinal artery occlusion of embolic mechanism and CRAO caused by GCA.

  15. Electrocardiographic abnormalities and serum magnesium in patients with subarachnoid hemorrhage

    NARCIS (Netherlands)

    van den Bergh, Walter M; Algra, Ale; Rinkel, Gabriël J E

    2004-01-01

    BACKGROUND AND PURPOSE: ECG abnormalities and hypomagnesemia frequently occur after aneurysmal subarachnoid hemorrhage (SAH). Because hypomagnesemia is associated with several ECG abnormalities, we studied whether hypomagnesemia mediates ECG abnormalities after SAH. METHODS: We prospectively studied

  16. Fetal calcifications are associated with chromosomal abnormalities.

    Directory of Open Access Journals (Sweden)

    Ellika Sahlin

    Full Text Available The biological importance of calcifications occasionally noted in fetal tissues (mainly liver at autopsy or ultrasound is largely unexplored. Previous reports hint at an association to infection, circulatory compromise, malformations or chromosomal abnormalities. To identify factors associated with calcifications, we have performed a case-control study on the largest cohort of fetuses with calcifications described thus far.One-hundred and fifty-one fetuses with calcifications and 302 matched controls were selected from the archives of the Department of Pathology, Karolinska University Hospital. Chromosome analysis by karyotyping or quantitative fluorescence-polymerase chain reaction was performed. Autopsy and placenta reports were scrutinized for presence of malformations and signs of infection.Calcifications were mainly located in the liver, but also in heart, bowel, and other tissues. Fetuses with calcifications showed a significantly higher proportion of chromosomal abnormalities than controls; 50% vs. 20% (p<0.001. The most frequent aberrations among cases included trisomy 21 (33%, trisomy 18 (22%, and monosomy X (18%. A similar distribution was seen among controls. When comparing cases and controls with chromosomal abnormalities, the cases had a significantly higher prevalence of malformations (95% vs. 77%, p=0.004. Analyzed the other way around, cases with malformations had a significantly higher proportion of chromosomal abnormalities compared with controls, (66% vs. 31%, p<0.001.The presence of fetal calcifications is associated with high risk of chromosomal abnormality in combination with malformations. Identification of a calcification together with a malformation at autopsy more than doubles the probability of detecting a chromosomal abnormality, compared with identification of a malformation only. We propose that identification of a fetal tissue calcification at autopsy, and potentially also at ultrasound examination, should infer

  17. Obesity & hypertension are determinants of poor hemodynamic control during total joint arthroplasty: a retrospective review

    Directory of Open Access Journals (Sweden)

    Nwachukwu Benedict U

    2013-01-01

    Full Text Available Abstract Background Proper blood pressure control during surgical procedures such as total joint arthroplasty (TJA is considered critical to good outcome. There is poor understanding of the pre-operative risk factors for poor intra-operative hemodynamic control. The purpose of this study is to identify risk factors for poor hemodynamic control during TJA. Methods We performed a retrospective cohort analysis of 118 patients receiving TJA in the Dominican Republic. We collected patient demographic and comorbidity data. We developed an a priori definition for poor hemodynamic control: 1 Mean arterial pressure (MAP 135% of preoperative MAP. We performed bivariate and multivariate analyses to identify risk factors for poor hemodynamic control during TJA. Results Hypertension was relatively common in our study population (76 of 118 patients. Average preoperative mean arterial pressure was 109.0 (corresponding to an average SBP of 149 and DBP of 89. Forty-nine (41.5% patients had intraoperative blood pressure readings consistent with poor hemodynamic control. Based on multi-variable analysis preoperative hypertension of any type (RR 2.9; 95% CI 1.3-6.3 and an increase in BMI (RR 1.2 per 5 unit increase; 95% CI 1.0-1.5 were significant risk factors for poor hemodynamic control. Conclusions Preoperative hypertension and being overweight/obese increase the likelihood of poor blood pressure control during TJA. Hypertensive and/or obese patients warrant further attention and medical optimization prior to TJA. More work is required to elucidate the relationship between these risk factors and overall outcome.

  18. Resolution and outcome of acute circulatory failure does not correlate with hemodynamics

    Science.gov (United States)

    Suistomaa, Matti; Uusaro, Ari; Parviainen, Ilkka; Ruokonen, Esko

    2003-01-01

    Introduction Hemodynamic goals in the treatment of acute circulatory failure (ACF) are controversial. In critical care, organ failures can be assessed using Sequential Organ Failure Assessment and its refinement, total maximal Sequential Organ Failure Assessment (TMS). We studied the associations between resolution of ACF and hemodynamics in the early ( 2 mmol/l and/or base deficit > 4) who had pulmonary artery catheters and stayed for longer than 24 hours in the intensive care unit were included. Hemodynamics, oxygen transport, vasoactive drugs and TMS scores were recorded. Normalisation of hyperlactatemia and metabolic acidosis in less than 24 hours after admission was defined as a positive response to hemodynamic resuscitation. Results Fifty-two patients responded to resuscitation. Nonresponders had higher mortality than responders (52% versus 33%, P = 0.044). Hospital mortality was highest (63%) among nonresponders who received vasoactive drugs. The TMS scores of nonresponders (median [interquartile range], 12 [9-16]) were higher than the scores of responders (10 [7-12], P = 0.019). Late accumulation of TMS scores was associated with increasing mortality, and if the TMS score increase occurred > 5 days after admission then the mortality was 77%. Responders had higher mean arterial pressure at 24 hours, but it was no different between survivors and nonsurvivors. No other hemodynamic and oxygen transport variables were associated with the success of resuscitation or with mortality. Conclusions Except for the mean arterial pressure at 24 hours, invasively derived hemodynamic and oxygen transport variables are not associated with the response to resuscitation or with mortality. Positive response to resuscitation in ACF is associated with less severe organ failures as judged by TMS scores. Late accumulation of the TMS score predicts poor outcome. PMID:12930556

  19. Evaluation of hemodynamic effects of xenon in dogs undergoing hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Ruben C. Franceschi

    2013-01-01

    Full Text Available OBJECTIVES: The anesthetic gas xenon is reported to preserve hemodynamic stability during general anesthesia. However, the effects of the gas during shock are unclear. The objective of this study was to evaluate the effect of Xe on hemodynamic stability and tissue perfusion in a canine model of hemorrhagic shock. METHOD: Twenty-six dogs, mechanically ventilated with a fraction of inspired oxygen of 21% and anesthetized with etomidate and vecuronium, were randomized into Xenon (Xe; n = 13 or Control (C; n = 13 groups. Following hemodynamic monitoring, a pressure-driven shock was induced to reach an arterial pressure of 40 mmHg. Hemodynamic data and blood samples were collected prior to bleeding, immediately after bleeding and 5, 20 and 40 minutes following shock. The Xe group was treated with 79% Xe diluted in ambient air, inhaled for 20 minutes after shock. RESULT: The mean bleeding volume was 44 mL.kg-1 in the C group and 40 mL.kg-1 in the Xe group. Hemorrhage promoted a decrease in both the cardiac index (p<0.001 and mean arterial pressure (p<0.001. These changes were associated with an increase in lactate levels and worsening of oxygen transport variables in both groups (p<0.05. Inhalation of xenon did not cause further worsening of hemodynamics or tissue perfusion markers. CONCLUSIONS: Xenon did not alter hemodynamic stability or tissue perfusion in an experimentally controlled hemorrhagic shock model. However, further studies are necessary to validate this drug in other contexts.

  20. Central line infections - hospitals

    Science.gov (United States)

    ... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...

  1. How the kidney hyperfiltrates in diabetes: From moleculesto hemodynamics

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    In this review, we focused on two molecules, connexinand sodium-glucose cotransporter, which can link todiabetic hyperfiltration. In diabetic kidney, the activationof renin-angiotensin system occurs simultaneously withglomerular hyperfiltration. The latter largely dependson pathophysiological afferent arteriolar dilation in thepresence of high angiotensin Ⅱ. As a mechanistic basisfor the above, tubular hypothesis has been proposedfor type 1 diabetic patients as well as experimentalmodels. Although tubular hypothesis has not beenwell evaluated in type 2 diabetes, clinical observationssupport that tubular hypothesis is true also in type 2diabetes. Recent results on tubular hypothesis alongwith connexin abnormality in type 2 diabetes wererevisited. In addition, the importance of sodium-glucosecotransporter in diabetic hyperfiltration is discussed. Thelink between salt paradox and the activation of reninangiotensinsystem will be also reviewed.

  2. Hemodynamic Sensor in Cardiac Implantable Electric Devices: The Endocardial Accelaration Technology

    Directory of Open Access Journals (Sweden)

    Stefania Sacchi

    2013-01-01

    Full Text Available There have been substantial progresses in the technology of cardiac implantable electric devices (CIEDs during the past decades. One of the progresses is represented by the development of a hemodynamic sensor embedded at the tip of a pacing lead that measures myocardial contractility by the analysis of myocardial mechanical vibrations occurring during the cardiac cycle. This sensor, providing continuous hemodynamic monitoring, could play an important role in clinical practice because of several clinical applications in CIEDs recipients. The objectives of this work are to report how this sensor operates and to review the main findings about its clinical applications.

  3. Some peculiarities of hemodynamic indices in pregnant women with rheumatic heart disease during childbirth

    Directory of Open Access Journals (Sweden)

    Tashpulat Abdukarimov

    2012-05-01

    Full Text Available During childbirth some pronounced hemodynamic displacements take place increasing together with the aggravation of uterine contractions, in such a way leading to the increased heart loading. We carried out the comparative investigation of hemodynamic indices in women with rheumatic heart disease depending on their bodies’ posture during labor. The obtained results testify the facts of decreasing of venous blood relapse during every birth pang in women in childbirth with heart valvular disease in supine posture during labor, and that impedes the providing of necessary extension of cardiac output and, correspondingly, adequate blood supply of uterus and oxygenation of foetus.

  4. Premedication with clonidine versus fentanyl for intraoperative hemodynamic stability and recovery outcome during laparoscopic cholecystectomy under general anesthesia

    OpenAIRE

    Gupta, Kumkum; Lakhanpal, Mahima; Prashant K.Gupta; Krishan, Atul; Rastogi, Bhawna; Tiwari, Vaibhav

    2013-01-01

    Background: Laparoscopic cholecystectomy under general anesthesia induced intraoperative hemodynamic responses which should be attenuated by appropriate premedication. The present study was aimed to compare the clinical efficacy of clonidine and fentanyl premedication during laparoscopic cholecystectomy for attenuation of hemodynamic responses with postoperative recovery outcome. Subjects and Methods: In this prospective randomized double blind study 64 adult consented patients of either sex ...

  5. MRI of fetal GI tract abnormalities.

    Science.gov (United States)

    Veyrac, C; Couture, A; Saguintaah, M; Baud, C

    2004-01-01

    We describe the magnetic resonance (MR) patterns of a variety of fetal gastrointestinal (GI) abnormalities. Thirty-two fetuses between 23 and 38 weeks' gestation with abnormal appearance of the GI tract by ultrasound underwent MR imaging with T1- and T2-weighted sequences. The MR aspect of intestinal atresia (duodenal atresia, one case; small bowel atresia, nine cases) included dilatation of the bowel loops, accurate assessment of the normal bowel distal to the atresia (except in the patient with multiple atresia and apple-peel syndrome), and micro-rectum with decreased T1 signal (except in the patient with duodenal atresia). Megacystis-microcolon-intestinal hypoperistalsis syndrome (one case) was indicated by an abnormal signal of the entire bowel and an abnormal pattern for the urinary tract. Meconium pseudocysts (two cases) were easily differentiated from enteric cysts (two cases). High anorectal malformations with (two cases) or without (one case) urinary fistula and cloacal malformation (one case) are described and MR findings are discussed. The capability of MR imaging to demonstrate the normal bowel with intraperitoneal anomalies (e.g., congenital diaphragmatic hernia, and sacrococcygeal teratoma) is emphasized. MR imaging is informative in the diagnosis of GI tract abnormalities, especially the severe malformations, with much more accuracy than sonography.

  6. Prevalence of asymptomatic urinary abnormalities among adolescents.

    Science.gov (United States)

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had adolescents from rural than urban areas (P adolescents in our population.

  7. Abnormal cervical cytology and health care use

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Baillet, Miguel Vázquez-Prada; Dugué, Pierre-Antoine

    2015-01-01

    OBJECTIVE: This study aimed to assess the long-term use of health care services in women with abnormal cytology results compared to women with normal cytology results. METHODS: We did a nationwide population-based study, using women aged 23 to 59years participating in the national organized cervi...... they have the abnormal cytology. This difference is further enhanced after the abnormal cytology result.......OBJECTIVE: This study aimed to assess the long-term use of health care services in women with abnormal cytology results compared to women with normal cytology results. METHODS: We did a nationwide population-based study, using women aged 23 to 59years participating in the national organized...... cervical cancer screening program. We included a study population of 40,153 women with abnormal cytology (exposed) and 752,627 women with normal cytology (non-exposed). We retrieved data from the Danish Civil Registration System, the Danish Pathology Data Bank, the National Health Service, the National...

  8. OPHTHALMOLOGIC ABNORMALITIES IN CHILDREN WITH IMPAIRED HEARING

    Directory of Open Access Journals (Sweden)

    Inderjit

    2014-02-01

    Full Text Available AIM: To determine the nature of ophthalmologic abnormalities in severe and profound grades of hearing impaired children and to treat visual impairment if any at the earliest . MATERIAL AND METHODS: Study was conducted on100 children in the age group of 5 - 14 years with severe and profound hearing loss visiting outpatient department of Ram Lal Eye and ENT hospital Govt. Medical College Amritsar and subjected to detailed ophthalmological examination. RESULTS: 100 children in the age group 5 - 14 years with hearing impairment were enrolled for t he study , 68 had profound and 32 had severe hearing loss . Visual disorders were found to be as high as 71%. Highest percentage was seen in children aged 7 years. Majority of them (50% had refractive error. Out of these 50 children , 28(56% had myopia , 10 (20% hypermetropia and 12(24% had astigmatism . The other ophthalmic abnormalities in our study were conjunctivitis 14(19.71% , fundus abnormalities and squint 11(15.49% , blepharitis 5 (7.04% , vitamin A deficiency 6 (8.04% , amblyopia 8 (11.26% , pupil disorder 3 (4.22% , cataract 3 (4.22% and heterochromia iridis 7 (9.85%. CONCLUSION : The high prevalence of ophthalmic abnormalities in deaf children mandate screening them for possible ophthalmic abnormalities. Early diagnosis and correction of visual d isturbances would go a long way in social and professional performance of these children.

  9. Hemodynamic mechanisms of the attenuated blood pressure response to mental stress after a single bout of maximal dynamic exercise in healthy subjects

    Directory of Open Access Journals (Sweden)

    F.J. Neves

    2012-07-01

    Full Text Available To determine the hemodynamic mechanisms responsible for the attenuated blood pressure response to mental stress after exercise, 26 healthy sedentary individuals (age 29 ± 8 years underwent the Stroop color-word test before and 60 min after a bout of maximal dynamic exercise on a treadmill. A subgroup (N = 11 underwent a time-control experiment without exercise. Blood pressure was continuously and noninvasively recorded by infrared finger photoplethysmography. Stroke volume was derived from pressure signals, and cardiac output and peripheral vascular resistance were calculated. Perceived mental stress scores were comparable between mental stress tests both in the exercise (P = 0.96 and control (P = 0.24 experiments. After exercise, the blood pressure response to mental stress was attenuated (pre: 10 ± 13 vs post: 6 ± 7 mmHg; P 0.05. In conclusion, a single bout of maximal dynamic exercise attenuates the blood pressure response to mental stress in healthy subjects, along with lower stroke volume and cardiac output, denoting an acute modulatory action of exercise on the central hemodynamic response to mental stress.

  10. Cerebral volumetric abnormalities in Neurofibromatosis type 1: associations with parent ratings of social and attention problems, executive dysfunction, and autistic mannerisms

    NARCIS (Netherlands)

    Huijbregts, S.C.; Loitfelder, M.; Rombouts, S.A.R.B.; Swaab, H.; Verbist, B.M.; Arkink, E.B.; Buchem, M.A. van; Veer, I.M.

    2015-01-01

    Neurofibromatosis type 1 (NF1) is a single-gene neurodevelopmental disorder, in which social and cognitive problems are highly prevalent. Several commonly observed central nervous system (CNS) abnormalities in NF1 might underlie these social and cognitive problems. Cerebral volumetric abnormalities

  11. Bilateral Pneumothoraces Following Central Venous Cannulation

    Directory of Open Access Journals (Sweden)

    F. Pazos

    2009-01-01

    Full Text Available We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax.

  12. Swallowing abnormalities in HIV infected children: an important cause of morbidity

    Directory of Open Access Journals (Sweden)

    Nel Etienne D

    2012-06-01

    Full Text Available Abstract Background Swallowing disorders, well recognised in adults, contribute to HIV-infection morbidity. Little data however is available for HIV-infected children. The purpose of this study is to describe swallowing disorders in a group of HIV-infected children in Africa after the introduction of combined anti-retroviral therapy. Methods We describe 25 HIV-infected children referred for possible swallowing disorders. Clinical and videofluoroscopic assessment of swallowing (VFSS, HIV stage, and respiratory and neurological examination were recorded. Results Median age was 8 months (range 2.8-92 and 15 (60% were male. Fifteen (60% were referred for recurrent respiratory complaints, 4 (16% for poor growth, 4 (16% for poor feeding and 2 (8% patients for respiratory complaints and either poor growth or feeding. Twenty patients (80% had clinical evidence of swallowing abnormalities: 11 (44% in the oral phase, 4 (16% in the pharyngeal phase, and 5 (25% in both the oral and pharyngeal phases. Thirteen patients had a videofluoroscopic assessment of which 6 (46% where abnormal. Abnormalities were detected in the oral phase in 2, in the pharyngeal phase in 3, and in the oral and pharyngeal phase in 1; all of these patients also had evidence of respiratory involvement. Abnormal swallowing occurred in 85% of children with central nervous system disease. CNS disease was due to HIV encephalopathy (8 and miscellaneous central nervous system diseases (5. Three of 4 (75% patients with thrush had an abnormal oral phase on assessment. No abnormalities of the oesophagus were found. Conclusions This report highlights the importance of swallowing disorders in HIV infected children. Most patients have functional rather than structural or mucosal abnormalities. VFSS makes an important contribution to the diagnosis and management of these patients.

  13. Spectrum of electroencephalographic abnormalities in a cohort of patients from a teaching tertiary care hospital in Western India

    OpenAIRE

    Piyush Ostwal; Varsha S Dabadghao

    2016-01-01

    Context: Electroencephalogram (EEG) is a very important tool for investigation of the central nervous system as it provides information about the function of neurons at the time of recording. The major utility of EEG is in the detection of abnormal, excessive electrical activity seen in patients with seizures. Aims: To determine the prevalence of abnormality on EEG in our patient population and to assess the contribution of EEG as a diagnostic modality in a multispecialty hospital. Materials ...

  14. Spectrum of electroencephalographic abnormalities in a cohort of patients from a teaching tertiary care hospital in Western India

    Directory of Open Access Journals (Sweden)

    Piyush Ostwal

    2016-01-01

    Full Text Available Context: Electroencephalogram (EEG is a very important tool for investigation of the central nervous system as it provides information about the function of neurons at the time of recording. The major utility of EEG is in the detection of abnormal, excessive electrical activity seen in patients with seizures. Aims: To determine the prevalence of abnormality on EEG in our patient population and to assess the contribution of EEG as a diagnostic modality in a multispecialty hospital. Materials and Methods: EEG findings of 107 patients (age 187 ± 80 months who underwent EEG for various indications was analyzed. Results: It was found that 20 (18.69% patients had abnormal EEG. The abnormalities included spikes (50%, sharp waves (50%, spike and wave discharges (20% and the background abnormalities. Conclusions: The yield of EEG was lower in our study as compared to some other studies. The possible reason may be a higher proportion of patients with febrile seizures and unselected patient population.

  15. Hemodynamic management of septic shock: is it time for "individualized goal-directed hemodynamic therapy" and for specifically targeting the microcirculation?

    Science.gov (United States)

    Saugel, Bernd; Trepte, Constantin J; Heckel, Kai; Wagner, Julia Y; Reuter, Daniel A

    2015-06-01

    Septic shock is a life-threatening condition in both critically ill medical patients and surgical patients during the perioperative phase. In septic shock, specific alterations in global cardiovascular dynamics (i.e., the macrocirculation) and in the microcirculatory blood flow (i.e., the microcirculation) have been described. However, the presence and degree of microcirculatory failure are in part independent from systemic macrohemodynamic variables. Macrocirculatory and microcirculatory failure can independently induce organ dysfunction. We review current diagnostic and therapeutic approaches for the assessment and optimization of both the macrocirculation and the microcirculation in septic shock. There are various technologies for the determination of macrocirculatory hemodynamic variables. We discuss the data on early goal-directed therapy for the resuscitation of the macrocirculation. In addition, we describe the concept of "individualized goal-directed hemodynamic therapy." Technologies to assess the local microcirculation are also available. However, adequate resuscitation goals for the optimization of the microcirculation still need to be defined. At present, we are not ready to specifically monitor and target the microcirculation in clinical routine outside studies. In the future, concepts for an integrative approach for individualized hemodynamic management of the macrocirculation and in parallel the microcirculation might constitute a huge opportunity to define additional resuscitation end points in septic shock.

  16. Advances in understanding paternally transmitted Chromosomal Abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Marchetti, F; Sloter, E; Wyrobek, A J

    2001-03-01

    Multicolor FISH has been adapted for detecting the major types of chromosomal abnormalities in human sperm including aneuploidies for clinically-relevant chromosomes, chromosomal aberrations including breaks and rearrangements, and other numerical abnormalities. The various sperm FISH assays have been used to evaluate healthy men, men of advanced age, and men who have received mutagenic cancer therapy. The mouse has also been used as a model to investigate the mechanism of paternally transmitted genetic damage. Sperm FISH for the mouse has been used to detect chromosomally abnormal mouse sperm, while the PAINT/DAPI analysis of mouse zygotes has been used to evaluate the types of chromosomal defects that can be paternally transmitted to the embryo and their effects on embryonic development.

  17. Persistent Pain and Sensory Abnormalities after Abdominoplasty

    DEFF Research Database (Denmark)

    Presman, Benjamin; Finnerup, Kenneth; Andresen, Sven Robert

    2015-01-01

    University Hospital, Denmark. The questionnaire included questions about pain and sensory abnormalities located to the abdominal skin, and physical and psychological function; patient satisfaction with surgery was rated on a 4-point scale. RESULTS: One hundred seventy patients answered the questionnaire......%) patients. The majority of patients reported improvement on all physical and psychological factors. Patients with pain were more often disappointed with the surgery and unwilling to recommend the surgery. CONCLUSIONS: Overall, patients were satisfied with the procedure, although abnormal abdominal skin....... Fourteen patients (8.2%) reported pain within the past 7 days related to the abdominoplasty. Abnormal abdominal skin sensation was common and reported by 138 patients (81%). Sensory hypersensitivity was associated with the presence of persistent pain. Satisfaction with the procedure was reported by 149 (88...

  18. Neurological abnormalities associated with CDMA exposure.

    Science.gov (United States)

    Hocking, B; Westerman, R

    2001-09-01

    Dysaesthesiae of the scalp and neurological abnormality after mobile phone use have been reported previously, but the roles of the phone per se or the radiations in causing these findings have been questioned. We report finding a neurological abnormality in a patient after accidental exposure of the left side of the face to mobile phone radiation [code division multiple access (CDMA)] from a down-powered mobile phone base station antenna. He had headaches, unilateral left blurred vision and pupil constriction, unilateral altered sensation on the forehead, and abnormalities of current perception thresholds on testing the left trigeminal ophthalmic nerve. His nerve function recovered during 6 months follow-up. His exposure was 0.015-0.06 mW/cm(2) over 1-2 h. The implications regarding health effects of radiofrequency radiation are discussed.

  19. XYY chromosome abnormality in sexual homicide perpetrators.

    Science.gov (United States)

    Briken, Peer; Habermann, Niels; Berner, Wolfgang; Hill, Andreas

    2006-03-05

    In a retrospective investigation of the court reports about sexual homicide perpetrators chromosome analysis had been carried out in 13 of 166 (7.8%) men. Three men (1.8%) with XYY chromosome abnormality were found. This rate is much higher than that found in unselected samples of prisoners (0.7-0.9%) or in the general population (0.01%). The three men had shown prepubescent abnormalities, school problems, and had suffered from physical abuse. The chromosome analysis in all cases had been carried out in connection with the forensic psychiatric court report due to the sexual homicide. However, two men had earlier psychiatric referrals. All were diagnosed as sexual sadistic, showed a psychopathic syndrome or psychopathy according to the Psychopathy Checklist-Revised [Hare RD, 1991, The Hare Psychopathy Checklist-Revised, Toronto, Ontario, Canada: Multi-Health Systems]. Two were multiple murderers. Especially forensic psychiatrists should be vigilant of the possibility of XYY chromosome abnormalities in sexual offenders.

  20. Parsing abnormal grain growth in specialty aluminas

    Science.gov (United States)

    Lawrence, Abigail Kremer

    Grain growth in alumina is strongly affected by the impurities present in the material. Certain impurity elements are known to have characteristic effects on abnormal grain growth in alumina. Specialty alumina powders contain multiple impurity species including MgO, CaO, SiO2, and Na 2O. In this work, sintered samples made from alumina powders containing various amounts of the impurities in question were characterized by their grain size and aspect ratio distributions. Multiple quantitative methods were used to characterize and classify samples with varying microstructures. The grain size distributions were used to partition the grain size population into subpopulations depending on the observed deviation from normal behavior. Using both grain size and aspect ratio a new visual representation for a microstructure was introduced called a morphology frequency map that gives a fingerprint for the material. The number of subpopulations within a sample and the shape of the distribution on the morphology map provided the basis for a classification scheme for different types of microstructures. Also using the two parameters a series of five metrics were calculated that describe the character of the abnormal grains in the sample, these were called abnormal character values. The abnormal character values describe the fraction of grains that are considered abnormal, the average magnitude of abnormality (including both grain size and aspect ratio), the average size, and variance in size. The final metric is the correlation between grain size and aspect ratio for the entire population of grains. The abnormal character values give a sense of how different from "normal" the sample is, given the assumption that a normal sample has a lognormal distribution of grain size and a Gaussian distribution of aspect ratios. In the second part of the work the quantified measures of abnormality were correlated with processing parameters such as composition and heat treatment conditions. A

  1. Abnormal Head Position in Infantile Nystagmus Syndrome

    Science.gov (United States)

    Noval, Susana; González-Manrique, Mar; Rodríguez-Del Valle, José María; Rodríguez-Sánchez, José María

    2011-01-01

    Infantile nystagmus is an involuntary, bilateral, conjugate, and rhythmic oscillation of the eyes which is present at birth or develops within the first 6 months of life. It may be pendular or jerk-like and, its intensity usually increases in lateral gaze, decreasing with convergence. Up to 64% of all patients with nystagmus also present strabismus, and even more patients have an abnormal head position. The abnormal head positions are more often horizontal, but they may also be vertical or take the form of a tilt, even though the nystagmus itself is horizontal. The aim of this article is to review available information about the origin and treatment of the abnormal head position associated to nystagmus, and to describe our treatment strategies. PMID:24533187

  2. Enhanced monitoring of abnormal emergency department demands

    KAUST Repository

    Harrou, Fouzi

    2016-06-13

    This paper presents a statistical technique for detecting signs of abnormal situation generated by the influx of patients at emergency department (ED). The monitoring strategy developed was able to provide early alert mechanisms in the event of abnormal situations caused by abnormal patient arrivals to the ED. More specifically, This work proposed the application of autoregressive moving average (ARMA) models combined with the generalized likelihood ratio (GLR) test for anomaly-detection. ARMA was used as the modelling framework of the ARMA-based GLR anomaly-detection methodology. The GLR test was applied to the uncorrelated residuals obtained from the ARMA model to detect anomalies when the data did not fit the reference ARMA model. The ARMA-based GLR hypothesis testing scheme was successfully applied to the practical data collected from the database of the pediatric emergency department (PED) at Lille regional hospital center, France. © 2015 IEEE.

  3. Central Solenoid

    CERN Multimedia

    2002-01-01

    The Central Solenoid (CS) is a single layer coil wound internally in a supporting cylinder housed in the cryostat of the Liquid Argon Calorimeter. It was successfully tested at Toshiba in December 2000 and was delivered to CERN in September 2001 ready for integration in the LAr Calorimeter in 2003. An intermediate test of the chimney and proximity cryogenics was successfully performed in June 2002.

  4. Europa central

    Directory of Open Access Journals (Sweden)

    Karel BARTOSEK

    2010-02-01

    Full Text Available La investigación francesa continúa interesándose por Europa Central. Desde luego, hay límites a este interés en el ambiente general de mi nueva patria: en la ignorancia, producto del largo desinterés de Francia por este espacio después de la Segunda Guerra Mundial, y en el comportamiento y la reflexión de la clase política y de los medios de comunicación (una anécdota para ilustrar este ambiente: durante la preparación de nuestro coloquio «Refugiados e inmigrantes de Europa Central en el movimiento antifascista y la Resistencia en Francia, 1933-1945», celebrado en París en octubre de 1986, el problema de la definición fue planteado concreta y «prácticamente». ¡Y hubo entonces un historiador eminente, para quién Alemania no formaría parte de Europa Central!.

  5. Hemorheological abnormalities in human arterial hypertension

    Science.gov (United States)

    Lo Presti, Rosalia; Hopps, Eugenia; Caimi, Gregorio

    2014-05-01

    Blood rheology is impaired in hypertensive patients. The alteration involves blood and plasma viscosity, and the erythrocyte behaviour is often abnormal. The hemorheological pattern appears to be related to some pathophysiological mechanisms of hypertension and to organ damage, in particular left ventricular hypertrophy and myocardial ischemia. Abnormalities have been observed in erythrocyte membrane fluidity, explored by fluorescence spectroscopy and electron spin resonance. This may be relevant for red cell flow in microvessels and oxygen delivery to tissues. Although blood viscosity is not a direct target of antihypertensive therapy, the rheological properties of blood play a role in the pathophysiology of arterial hypertension and its vascular complications.

  6. Nonpathologizing trauma interventions in abnormal psychology courses.

    Science.gov (United States)

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

  7. Occult intraspinal abnormalities and congenital scoliosis

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Erfani

    2007-06-01

    Full Text Available

    BACKGROUND: Congenital scoliosis occurs because of either the failure of formation or the failure of segmentation or both. Evaluation of the incidence and the types of occult intraspinal abnormalities in congenital scoliosis is the subject of this study.

    METHODS: During a period of 29 years, 103 patients with congenital scoliosis were studied. MRI was used in 46 patients, myelography or CT myelography was used in 64 patients and both MRI and myelography or CT myelography were used in 7 patients for intraspinal abnormalities.

    RESULTS: In the MRI group, among the 46 patients, 19 patients (41.3% had intraspinal abnormalities consisting syringomyelia in 9 (19.5% diastematomyelia in 8 (17.4%, tethered cord syndrome in 6 (13%, low conus in 5 (10.8% and diplomyelia in 3 (6.5% of the patients. In the myelography group, among the 64 patients, 17 (26.5% had intraspinal abnormalities and diastematomyelia was the most common one found in 14 (21.8% patients.

    CONCLUSIONS: Intraspinal abnormalities are frequent in congenital scoliosis. Syringomyelia may be associated with congenital scoliosis. In congenital scoliosis, rib fusion may be an indicator of intraspinal abnormalities in MRI. A significant difference between clinical findings and intraspinal anomalies (P<0.05 was noted. Moreover, we believe that total spinal MRI with coronal, sagittal and axial views is a valuable tool in determining the intraspinal abnormalities in congenital scoliosis. This method is highly

  8. Anaesthesia in operations of congenital craniofacial abnormalities

    Directory of Open Access Journals (Sweden)

    Jahangirie B

    1996-07-01

    Full Text Available Some syndromes that are characterized by abnormalities of the skull, facial bones, and mandibule, most of these patients are from the pediatric population. For the anaesthetic management of patients with various craniofacial dysostosis are as follows: 1 The necessary for careful evaluation of the airway by simply observing the patient. 2 Evaluation of the patient for abnormalities of the heart and lungs. 3 Patients may also have increased intracranial pressure. 4 Anaesthetic drugs and techniques: no particular drugs is recommended. Techniques controlled ventilation. 5 All patients should be cared in the intensive care unit after operation between 24-48 hours

  9. Temporal abnormalities in children with developmental dyscalculia.

    Science.gov (United States)

    Vicario, Carmelo Mario; Rappo, Gaetano; Pepi, Annamaria; Pavan, Andrea; Martino, Davide

    2012-01-01

    Recent imaging studies have associated Developmental dyscalculia (DD) to structural and functional alterations corresponding Parietal and the Prefrontal cortex (PFC). Since these areas were shown also to be involved in timing abilities, we hypothesized that time processing is abnormal in DD. We compared time processing abilities between 10 children with pure DD (8 years old) and 11 age-matched healthy children. Results show that the DD group underestimated duration of a sub-second scale when asked to perform a time comparison task. The timing abnormality observed in our DD participants is consistent with evidence of a shared fronto-parietal neural network for representing time and quantity.

  10. MR evaluation of fetal abnormalities by SSFP sequence

    Energy Technology Data Exchange (ETDEWEB)

    Amanuma, Makoto; Hasegawa, Makoto; Enomoto, Kyoko; Watabe, Tsuneya; Heshiki, Atsuko (Saitama Medical School, Moroyama (Japan))

    1993-07-01

    We examined the feasibility of fast steady-state free precession (SSFP) MR imaging with time-reversed free induction decay (FID) signal for detecting fetal abnormality. Its strong T[sub 2]-weighted contrast enabled to clearly differentiate fetal part from the amniotic fluid and detect some fluid-filled organs. Although the sequence is very sensitive to motion, short imaging time (20 seconds) with breath-holding minimized motion-related artifacts and provided high quality images. It was also possible to image repeatedly in arbitrary slice orientations within a reasonable examination time. This technique was particularly useful to demonstrate gross fetal anomalies of the body surface and central nervous system without need for a potentially harmful fetal anesthesia. However, due to poor soft tissue contrast supplemental T[sub 1]-weighted images were mandatory. (author).

  11. Novel Application of a Multiscale Entropy Index as a Sensitive Tool for Detecting Subtle Vascular Abnormalities in the Aged and Diabetic

    Directory of Open Access Journals (Sweden)

    Hsien-Tsai Wu

    2013-01-01

    Full Text Available Although previous studies have shown the successful use of pressure-induced reactive hyperemia as a tool for the assessment of endothelial function, its sensitivity remains questionable. This study aims to investigate the feasibility and sensitivity of a novel multiscale entropy index (MEI in detecting subtle vascular abnormalities in healthy and diabetic subjects. Basic anthropometric and hemodynamic parameters, serum lipid profiles, and glycosylated hemoglobin levels were recorded. Arterial pulse wave signals were acquired from the wrist with an air pressure sensing system (APSS, followed by MEI and dilatation index (DI analyses. MEI succeeded in detecting significant differences among the four groups of subjects: healthy young individuals, healthy middle-aged or elderly individuals, well-controlled diabetic individuals, and poorly controlled diabetic individuals. A reduction in multiscale entropy reflected age- and diabetes-related vascular changes and may serve as a more sensitive indicator of subtle vascular abnormalities compared with DI in the setting of diabetes.

  12. A new image-based process for quantifying hemodynamic contributions to long-term morbidity in a rabbit model of aortic coarctation

    Science.gov (United States)

    Wendell, David C.; Dholakia, Ronak J.; Larsen, Paul M.; Menon, Arjun; LaDisa, John F., Jr.

    2010-03-01

    Coarctation of the aorta (CoA) is associated with reduced life expectancy despite successful surgical treatment. Interestingly, much of the related long-term morbidity can be explained by abnormal hemodynamics, vascular biomechanics and cardiac function. MRI has played an important role in assessing coarctation severity, but the heterogeneity and small number of patients at each center presents an obstacle for determining causality. This work describes optimized imaging parameters to create computational fluid dynamics (CFD) models revealing changes in hemodynamics and vascular biomechanics from a rabbit model. CoA was induced surgically at 10 weeks using silk or dissolvable ligatures to replicate native and end-to-end treatment cases, respectively. Cardiac function was evaluated at 32 weeks using a fastcard SPGR sequence in 6-8 two-chamber short-axis views. Left ventricular (LV) volume, ejection fraction, and mass were quantified and compared to control rabbits. Phase contrast (PC) and angiographic MRI were used to create CFD models. Ascending aortic PCMRI data were mapped to the model inflow and outflow boundary conditions replicated measured pressure (BP) and flow. CFD simulations were performed using a stabilized finite element method to calculate indices including velocity, BP and wall shear stress (WSS). CoA models displayed higher velocity through the coarctation region and decreased velocity elsewhere, leading to decreased WSS above and below the stenosis. Pronounced wall displacement was associated with CoA-induced changes in BP. CoA caused reversible LV hypertrophy. Cardiac function was maintained, but caused a persistent hyperdynamic state. This model may now be used to investigate potential mechanisms of long-term morbidity.

  13. Markers of inflammation and hemodynamic measurements in obesity: Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Asferg, Camilla; Asferg, Camilla Lundegaard; Jensen, Jan S

    2009-01-01

    was to investigate the relationship between two markers of inflammation, C-reactive protein (CRP) and fibrinogen, and blood pressure (BP) and other hemodynamic variables in obese subjects. METHODS: From a large cardiovascular study based in the general population, we selected subjects with a body mass index (BMI...

  14. Constraining OCT with Knowledge of Device Design Enables High Accuracy Hemodynamic Assessment of Endovascular Implants.

    Directory of Open Access Journals (Sweden)

    Caroline C O'Brien

    Full Text Available Stacking cross-sectional intravascular images permits three-dimensional rendering of endovascular implants, yet introduces between-frame uncertainties that limit characterization of device placement and the hemodynamic microenvironment. In a porcine coronary stent model, we demonstrate enhanced OCT reconstruction with preservation of between-frame features through fusion with angiography and a priori knowledge of stent design.Strut positions were extracted from sequential OCT frames. Reconstruction with standard interpolation generated discontinuous stent structures. By computationally constraining interpolation to known stent skeletons fitted to 3D 'clouds' of OCT-Angio-derived struts, implant anatomy was resolved, accurately rendering features from implant diameter and curvature (n = 1 vessels, r2 = 0.91, 0.90, respectively to individual strut-wall configurations (average displacement error ~15 μm. This framework facilitated hemodynamic simulation (n = 1 vessel, showing the critical importance of accurate anatomic rendering in characterizing both quantitative and basic qualitative flow patterns. Discontinuities with standard approaches systematically introduced noise and bias, poorly capturing regional flow effects. In contrast, the enhanced method preserved multi-scale (local strut to regional stent flow interactions, demonstrating the impact of regional contexts in defining the hemodynamic consequence of local deployment errors.Fusion of planar angiography and knowledge of device design permits enhanced OCT image analysis of in situ tissue-device interactions. Given emerging interests in simulation-derived hemodynamic assessment as surrogate measures of biological risk, such fused modalities offer a new window into patient-specific implant environments.

  15. Physiology of school burnout in medical students: Hemodynamic and autonomic functioning

    Directory of Open Access Journals (Sweden)

    Ross W. May

    2016-09-01

    Full Text Available This study investigated the relationship between burnout and hemodynamic and autonomic functioning in both medical students (N = 55 and premedical undergraduate students (N = 77. Questionnaires screened for health related issues and assessed school burnout and negative affect symptomatology (anxiety and depression. Continuous beat-to-beat blood pressure (BP through finger plethysmography and electrocardiogram (ECG monitoring was conducted during conditions of baseline and cardiac stress induced via the cold pressor task to produce hemodynamic, heart rate variability, and blood pressure variability indices. Independent sample t-tests demonstrated that medical students had significantly higher school burnout scores compared to their undergraduate counterparts. Controlling for age, BMI, anxiety and depressive symptoms, multiple regression analyses indicated that school burnout was a stronger predictor of elevated hemodynamics (blood pressure, decreased heart rate variability, decreased markers of vagal activity and increased markers of sympathetic tone at baseline for medical students than for undergraduates. Analyses of physiological values collected during the cold pressor task indicated greater cardiac hyperactivity for medical students than for undergraduates. The present study supports previous research linking medical school burnout to hemodynamic and autonomic functioning, suggests biomarkers for medical school burnout, and provides evidence that burnout may be implicated as a physiological risk factor in medical students. Study limitations and potential intervention avenues are discussed.

  16. Modeling the hemodynamic response in fMRI using smooth FIR filters

    DEFF Research Database (Denmark)

    Goutte, Cyril; Nielsen, Finn Årup; Hansen, Lars Kai

    2000-01-01

    -parameters using the evidence framework, or sampling using a Markov Chain Monte Carlo (MCMC) approach. The authors present a comparison of their model with standard hemodynamic response kernels on simulated data, and perform a full analysis of data acquired during an experiment involving visual stimulation....

  17. Calibrated MRI to evaluate cerebral hemodynamics in patients with an internal carotid artery occlusion

    NARCIS (Netherlands)

    De Vis, Jill B.; Petersen, Esben T.; Bhogal, Alex; Hartkamp, Nolan S.; Klijn, Catharina J. M.; Kappelle, L. J.; Hendrikse, J.

    2015-01-01

    The purpose of this study was to assess whether calibrated magnetic resonance imaging (MRI) can identify regional variances in cerebral hemodynamics caused by vascular disease. For this, arterial spin labeling (ASL)/blood oxygen level-dependent (BOLD) MRI was performed in 11 patients (65 +/- 7 years

  18. Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Bahadir Ezmek

    2010-08-01

    Full Text Available OBJECTIVE: Local anesthetic solutions with vasoconstrictors are not contraindicated in hypertensive patients, but due to their hemodynamic effects, local anesthetics without vasoconstrictors are mainly preferred by the clinicians. The aim of this study was to compare hemodynamic effects of three different local anesthetics without vasoconstrictors during tooth extraction in hypertensive patients. MATERIAL AND METHODS: Sixty-five mandibular molars and premolars were extracted in 60 hypertensive patients (29 females and 31 males; mean age: 66.95 ± 10.87 years; range: 38 to 86 years old. Inferior alveolar and buccal nerve blocks were performed with 2% lidocaine hydrochloride (HCl, 2% prilocaine HCl or 3% mepivacaine HCl without vasoconstrictor. Hemodynamic parameters namely systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, heart rate (HR, saturation rate (SR, rate pressure product (RPP and pressure rate quotient (PRQ were investigated before and at different intervals after anesthetic injection. RESULTS: The hemodynamic effects of the three agents were similar to each other, although some significance was observed for DBP, MAP, RPP and PRQ values in the lidocaine, prilocaine and mepivacaine groups. CONCLUSION: Lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor can be safely used in hypertensive patients. It is advisable that dental practitioners select anesthetic solutions for hypertensive patients considering their cardiovascular effects in order to provide patient comfort and safety.

  19. A Novel Technique for Identifying Patients with ICU Needs Using Hemodynamic Features

    Directory of Open Access Journals (Sweden)

    A. Jalali

    2012-01-01

    Full Text Available Identification of patients requiring intensive care is a critical issue in clinical treatment. The objective of this study is to develop a novel methodology using hemodynamic features for distinguishing such patients requiring intensive care from a group of healthy subjects. In this study, based on the hemodynamic features, subjects are divided into three groups: healthy, risky and patient. For each of the healthy and patient subjects, the evaluated features are based on the analysis of existing differences between hemodynamic variables: Blood Pressure and Heart Rate. Further, four criteria from the hemodynamic variables are introduced: circle criterion, estimation error criterion, Poincare plot deviation, and autonomic response delay criterion. For each of these criteria, three fuzzy membership functions are defined to distinguish patients from healthy subjects. Furthermore, based on the evaluated criteria, a scoring method is developed. In this scoring method membership degree of each subject is evaluated for the three classifying groups. Then, for each subject, the cumulative sum of membership degree of all four criteria is calculated. Finally, a given subject is classified with the group which has the largest cumulative sum. In summary, the scoring method results in 86% sensitivity, 94.8% positive predictive accuracy and 82.2% total accuracy.

  20. Acute effects of ferumoxytol on regulation of renal hemodynamics and oxygenation

    Science.gov (United States)

    Cantow, Kathleen; Pohlmann, Andreas; Flemming, Bert; Ferrara, Fabienne; Waiczies, Sonia; Grosenick, Dirk; Niendorf, Thoralf; Seeliger, Erdmann

    2016-01-01

    The superparamagnetic iron oxide nanoparticle ferumoxytol is increasingly used as intravascular contrast agent in magnetic resonance imaging (MRI). This study details the impact of ferumoxytol on regulation of renal hemodynamics and oxygenation. In 10 anesthetized rats, a single intravenous injection of isotonic saline (used as volume control) was followed by three consecutive injections of ferumoxytol to achieve cumulative doses of 6, 10, and 41 mg Fe/kg body mass. Arterial blood pressure, renal blood flow, renal cortical and medullary perfusion and oxygen tension were continuously measured. Regulation of renal hemodynamics and oxygenation was characterized by dedicated interventions: brief periods of suprarenal aortic occlusion, hypoxia, and hyperoxia. None of the three doses of ferumoxytol resulted in significant changes in any of the measured parameters as compared to saline. Ferumoxytol did not significantly alter regulation of renal hemodynamics and oxygenation as studied by aortic occlusion and hypoxia. The only significant effect of ferumoxytol at the highest dose was a blunting of the hyperoxia-induced increase in arterial pressure. Taken together, ferumoxytol has only marginal effects on the regulation of renal hemodynamics and oxygenation. This makes ferumoxytol a prime candidate as contrast agent for renal MRI including the assessment of renal blood volume fraction. PMID:27436132

  1. Experimental Comparison of the Hemodynamic Effects of Bifurcating Coronary Stent Implantation Techniques

    Science.gov (United States)

    Brindise, Melissa; Vlachos, Pavlos; AETheR Lab Team

    2015-11-01

    Stent implantation in coronary bifurcations imposes unique effects to the blood flow patterns and currently there is no universally accepted stent deployment approach. Despite the fact that stent-induced changes can greatly alter clinical outcomes, no concrete understanding exists regarding the hemodynamic effects of each implantation method. This work presents an experimental evaluation of the hemodynamic differences between implantation techniques. We used four common stent implantation methods including the currently preferred one-stent provisional side branch (PSB) technique and the crush (CRU), Culotte (CUL), and T-stenting (T-PR) two-stent techniques, all deployed by a cardiologist in coronary models. Particle image velocimetry was used to obtain velocity and pressure fields. Wall shear stress (WSS), oscillatory shear index, residence times, and drag and compliance metrics were evaluated and compared against an un-stented case. The results of this study demonstrate that while PSB is preferred, both it and T-PR yielded detrimental hemodynamic effects such as low WSS values. CRU provided polarizing and unbalanced results. CUL demonstrated a symmetric flow field, balanced WSS distribution, and ultimately the most favorable hemodynamic environment.

  2. [Study of sharing platform of web-based enhanced extracorporeal counterpulsation hemodynamic waveform data].

    Science.gov (United States)

    Huang, Mingbo; Hu, Ding; Yu, Donglan; Zheng, Zhensheng; Wang, Kuijian

    2011-12-01

    Enhanced extracorporeal counterpulsation (EECP) information consists of both text and hemodynamic waveform data. At present EECP text information has been successfully managed through Web browser, while the management and sharing of hemodynamic waveform data through Internet has not been solved yet. In order to manage EECP information completely, based on the in-depth analysis of EECP hemodynamic waveform file of digital imaging and communications in medicine (DICOM) format and its disadvantages in Internet sharing, we proposed the use of the extensible markup language (XML), which is currently the Internet popular data exchange standard, as the storage specification for the sharing of EECP waveform data. Then we designed a web-based sharing system of EECP hemodynamic waveform data via ASP. NET 2.0 platform. Meanwhile, we specifically introduced the four main system function modules and their implement methods, including DICOM to XML conversion module, EECP waveform data management module, retrieval and display of EECP waveform module and the security mechanism of the system.

  3. Effects of midazolam and morphine on cerebral oxygenation and hemodynamics in ventilated premature infants.

    NARCIS (Netherlands)

    Velden, A.A.E.M. van der; Hopman, J.C.W.; Klaessens, J.H.G.M.; Feuth, A.B.; Sengers, R.C.A.; Liem, K.D.

    2006-01-01

    BACKGROUND: Midazolam sedation and morphine analgesia are commonly used in ventilated premature infants. OBJECTIVES: To evaluate the effects of midazolam versus morphine infusion on cerebral oxygenation and hemodynamics in ventilated premature infants. METHODS: 11 patients (GA 26.6-33.0 weeks, BW 78

  4. Diffuse optical measurements of head and neck tumor hemodynamics for early prediction of chemoradiation therapy outcomes

    Science.gov (United States)

    Dong, Lixin; Kudrimoti, Mahesh; Irwin, Daniel; Chen, Li; Kumar, Sameera; Shang, Yu; Huang, Chong; Johnson, Ellis L.; Stevens, Scott D.; Shelton, Brent J.; Yu, Guoqiang

    2016-08-01

    This study used a hybrid near-infrared diffuse optical instrument to monitor tumor hemodynamic responses to chemoradiation therapy for early prediction of treatment outcomes in patients with head and neck cancer. Forty-seven patients were measured once per week to evaluate the hemodynamic status of clinically involved cervical lymph nodes as surrogates for the primary tumor response. Patients were classified into two groups: complete response (CR) (n=29) and incomplete response (IR) (n=18). Tumor hemodynamic responses were found to be associated with clinical outcomes (CR/IR), wherein the associations differed depending on human papillomavirus (HPV-16) status. In HPV-16 positive patients, significantly lower levels in tumor oxygenated hemoglobin concentration ([HbO2]) at weeks 1 to 3, total hemoglobin concentration at week 3, and blood oxygen saturation (StO2) at week 3 were found in the IR group. In HPV-16 negative patients, significantly higher levels in tumor blood flow index and reduced scattering coefficient (μs‧) at week 3 were observed in the IR group. These hemodynamic parameters exhibited significantly high accuracy for early prediction of clinical outcomes, within the first three weeks of therapy, with the areas under the receiver operating characteristic curves (AUCs) ranging from 0.83 to 0.96.

  5. Peripheral Perfusion in Relation to Systemic Hemodynamics : And its Importance in Critically Ill Patients

    NARCIS (Netherlands)

    M.E. van Genderen (Michel)

    2015-01-01

    markdownabstract__Abstract__ Hemodynamic monitoring is a cornerstone in the care of the critically ill patient. Monitoring techniques have greatly improved over the last decade and technologies have evolved from invasive to non-invasive monitoring devices. The rationale of peripheral perfusion moni

  6. Hemodynamic effects of partial liquid ventilation with perfluorocarbon in acute lung injury

    NARCIS (Netherlands)

    R.J.M. Houmes (Robert Jan); S.J.C. Verbrugge (Serge); E. Hendrik (Edwin); B.F. Lachmann (Burkhard)

    1995-01-01

    textabstractObjective: To assess the effect of partial liquid ventilation with perfluorocarbons on hemodynamics and gas exchange in large pigs with induced acute lung injury (ALI). Design: Randomized, prospective, double-control, experimental study. Setting: Experimental intensive care unit of a uni

  7. Altered cerebral hemodynamics in early Alzheimer disease: a pilot study using transcranial Doppler.

    NARCIS (Netherlands)

    Claassen, J.A.H.R.; Diaz-Arrastia, R.; Martin-Cook, K.; Levine, B.D.; Zhang, R.

    2009-01-01

    Cerebrovascular disease may contribute to the development and progression of Alzheimer's disease (AD). This study investigated whether impairments in cerebral hemodynamics can be detected in early-stage AD. Nine patients with mild AD and eight cognitively normal controls matched for age underwent br

  8. Correlation between Hemodynamics and Treatment Outcome of Intracranial Aneurysms after Intervention with Flow Diverters

    Science.gov (United States)

    Paliwal, Nikhil; Damiano, Robert; Davies, Jason; Siddiqui, Adnan; Meng, Hui

    2015-11-01

    Endovascular intervention by Flow Diverter (FD) - a densely woven stent - occludes an aneurysm by inducing thrombosis in the aneurysm sac and reconstructing the vessel. Hemodynamics plays a vital role in the thrombotic occlusion of aneurysms and eventual treatment outcome. CFD analysis of pre- and post-treatment aneurysms not only provides insight of flow modifications by FD, but also allows investigation of interventional strategies and prediction of their outcome. In this study 80 patient-specific aneurysms treated with FDs were retrospectively studied to evaluate the effect of intervention. Out of these cases, 16 required retreatment and thus are considered as having unfavorable outcome. Clinical FD deployment in these cases was simulated using an efficient virtual stenting workflow. CFD analysis was carried out on both pre- and post-treatment cases, and changes in hemodynamic parameters were calculated. Support vector machine algorithm was used to correlate the hemodynamic changes with outcome. Results show that cases having higher flow reduction into the aneurysmal sac have a better likelihood of occlusion. This suggests that changes in hemodynamics can be potentially used to predict the outcome of different clinical intervention strategies in aneurysms. This work was supported by the National Institutes of Health (R01 NS091075).

  9. Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure

    DEFF Research Database (Denmark)

    Damgaard, Morten; Norsk, Peter; Gustafsson, Finn

    2006-01-01

    inhibitors and beta-adrenoreceptor blockers. Therefore, we determined the hemodynamic and neuroendocrine responses to 1 wk of a low-sodium diet (70 mmol/day) and 1 wk of a high-sodium diet (250 mmol/day) in 12 HF patients and 12 age-matched controls in a randomized, balanced fashion. During steady...

  10. Role of vascular potassium channels in the regulation of renal hemodynamics

    DEFF Research Database (Denmark)

    Sørensen, Charlotte Mehlin; Braunstein, Thomas Hartig; von Holstein-Rathlou, Niels-Henrik

    2012-01-01

    of one or more classes of K+ channels will lead to a change in hemodynamic resistance and therefore of renal blood flow and glomerular filtration pressure. Through these effects, the activity of renal vascular K+ channels influences renal salt and water excretion, fluid homeostasis, and ultimately blood...

  11. Simultaneous measurement of neuronal activity and cortical hemodynamics by unshielded magnetoencephalography and near-infrared spectroscopy

    Science.gov (United States)

    Seki, Yusuke; Miyashita, Tsuyoshi; Kandori, Akihiko; Maki, Atsushi; Koizumi, Hideaki

    2012-10-01

    The correlation between neuronal activity and cortical hemodynamics, namely, neurovascular coupling (NVC), is important to shed light on the mechanism of a variety of brain functions or neuronal diseases. NVC can be studied by simultaneously measuring neuronal activity and cortical hemodynamics. Consequently, noninvasive measurements of the NVC have been widely studied using both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). However, electromagnetic interference between EEG and fMRI is still a major problem. On the other hand, near-infrared spectroscopy (NIRS) is another promising tool for detecting cortical hemodynamics because it can be combined with EEG or magnetoencephalography (MEG) without any electromagnetic interference. Accordingly, in the present study, a simultaneous measurement system-combining an unshielded MEG using a two-dimensional gradiometer based on a low-T superconducting quantum interference device (SQUID) and an NIRS using nonmagnetic thin probes-was developed. This combined system was used to simultaneously measure both an auditory-evoked magnetic field and blood flow change in the auditory cortex. It was experimentally demonstrated that the combined unshielded MEG/NIRS system can simultaneously measure neuronal activity and cortical hemodynamics.

  12. Multislice CT scans in patients on extracorporeal membrane oxygenation: Emphasis on hemodynamic changes and imaging pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Kao Lang; Wang, Yu Feng; Chang, Yeun Chung; Huang, Shu Chien; Chen, Shyh Jye; Chang, Chin Chen [National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (China); Tsang, Yuk Ming [Dept. of Medical Imaging, Far Eastern Memorial Hospital, New Taipei City (China)

    2014-06-15

    This pictorial review provides the principles of extracorporeal membrane oxygenation (ECMO) support and associated CT imaging features with emphasis on the hemodynamic changes and possible imaging pitfalls encountered. It is important that radiologists in ECMO centers apply well-designed imaging protocols and familiarize themselves with post-contrast CT imaging findings in patients on ECMO.

  13. Microvascular hemodynamics in human hypothermic circulatory arrest and selective antegrade cerebral perfusion

    NARCIS (Netherlands)

    P.W.G. Elbers; A. Ozdemir; R.H. Heijmen; J. Heeren; M. van Iterson; E.P.A. van Dongen; C. Ince

    2010-01-01

    Objective: The behavior of the human microcirculation in the setting of cardiac arrest is largely unknown. Animal experiments have consistently revealed that global hemodynamics do not necessarily reflect microvascular perfusion. In addition, the time it takes for capillary blood flow to stop after

  14. Feasibility of In-Vivo Simulation of Acute Hemodynamics in Human Atrial Fibrillation

    Science.gov (United States)

    Sramko, Marek; Wichterle, Dan; Kautzner, Josef

    2016-01-01

    This study evaluated hemodynamic feasibility and reproducibility of a new method for in vivo simulation of human atrial fibrillation (AF). The method was tested during sinus rhythm in 10 patients undergoing catheter ablation for AF. A simple electronic device was assembled that allowed triggering a cardiac stimulator by predefined series of RR intervals. Irregular RR interval sequences with a mean heart rate of 90/min and 130/min were obtained from ECG recordings of another patients with AF. Simultaneous atrioventricular pacing was delivered by catheters placed inside the coronary sinus and at the His bundle region. Hemodynamic effect of the simulated AF was assessed by invasive measurement of the left ventricular (LV) pressure, dP/dt, and Tau. Compared to regular pacing at the same mean heart rate, the simulated AF significantly impaired the LV both systolic and diastolic function. Repeated AF pacing in the same patients generated similar LV hemodynamics. The proposed method provides a realistic and reproducible in-vivo model of AF. It can be exploited for investigation of the hemodynamic consequences of AF in various patient populations. PMID:27764240

  15. Evaluation of hemodynamics changes during interventional stent placement using Doppler optical coherence tomography

    Science.gov (United States)

    Vuong, Barry; Genis, Helen; Wong, Ronnie; Ramjist, Joel; Jivraj, Jamil; Farooq, Hamza; Sun, Cuiru; Yang, Victor X. D.

    2015-03-01

    Carotid atherosclerosis is a critical medical concern that can lead to ischemic stroke. Local hemodynamic patterns have also been associated with the development of atherosclerosis, particularly in regions with disturbed flow patterns such as bifurcations. Traditionally, this disease was treated using carotid endarterectomy, however recently there is an increasing trend of carotid artery stenting due to its minimally invasive nature. It is well known that this interventional technique creates changes in vasculature geometry and hemodynamic patterns due to the interaction of stent struts with arterial lumen, and is associated with complications such as distal emboli and restenosis. Currently, there is no standard imaging technique to evaluate regional hemodynamic patterns found in stented vessels. Doppler optical coherence tomography (DOCT) provides an opportunity to identify in vivo hemodynamic changes in vasculature using high-resolution imaging. In this study, blood flow profiles were examined at the bifurcation junction in the internal carotid artery (ICA) in a porcine model following stent deployment. Doppler imaging was further conducted using pulsatile flow in a phantom model, and then compared to computational fluid dynamics (CFD) simulation of a virtual bifurcation to assist with the interpretation of emphin vivo results.

  16. Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure

    DEFF Research Database (Denmark)

    Damgaard, Morten; Norsk, Peter; Gustafsson, Finn;

    2005-01-01

    was unchanged. Therefore, the total peripheral resistance decreased by 10 +/- 4%. Similar hemodynamic changes were observed during an incremental bicycle exercise test. Plasma concentrations of angiotensin II and norepinephrine were suppressed, whereas plasma pro-B-type natriuretic peptide remained unchanged...... not support the advice for HF patients to restrict dietary sodium....

  17. Association between social functioning and prefrontal hemodynamic responses in elderly adults.

    Science.gov (United States)

    Pu, Shenghong; Nakagome, Kazuyuki; Yamada, Takeshi; Yokoyama, Katsutoshi; Matsumura, Hiroshi; Mitani, Hideaki; Adachi, Akiko; Kaneko, Koichi

    2014-10-01

    Social functioning has received widespread attention as one of the most important outcomes in psychiatric disorders and has been related to cognitive functioning and the underlying brain activity. Cognitive decline, however, appears not only in the psychiatric population but also in aged individuals. In our previous study, we demonstrated a significant relationship between social functioning and prefrontal cortex (PFC) activity in patients with depression. However, it has not been shown whether the above relationship could be extended to healthy populations. The purpose of the present study was to investigate a possible association between social functioning and prefrontal hemodynamic responses in healthy elderly adults by using a non-invasive and low-constraint functional neuroimaging technique, near-infrared spectroscopy (NIRS). Study subjects included 55 healthy, elderly volunteers. We measured hemodynamic responses over prefrontal cortical (PFC) areas during the verbal fluency task by using multi-channel NIRS and analyzed the relationship between task-associated hemodynamic responses and social functioning as measured by the social adaptation self-evaluation scale (SASS). A significant positive relationship was observed between the SASS total score and PFC activation. Our findings suggest that PFC activation is associated with social functioning in healthy elderly adults. Furthermore, hemodynamic responses assessed using non-invasive NIRS could be a useful biological marker of these characteristics.

  18. Hemodynamic response of children with attention-deficit and hyperactive disorder (ADHD) to emotional facial expressions.

    Science.gov (United States)

    Ichikawa, Hiroko; Nakato, Emi; Kanazawa, So; Shimamura, Keiichi; Sakuta, Yuiko; Sakuta, Ryoichi; Yamaguchi, Masami K; Kakigi, Ryusuke

    2014-10-01

    Children with attention-deficit/hyperactivity disorder (ADHD) have difficulty recognizing facial expressions. They identify angry expressions less accurately than typically developing (TD) children, yet little is known about their atypical neural basis for the recognition of facial expressions. Here, we used near-infrared spectroscopy (NIRS) to examine the distinctive cerebral hemodynamics of ADHD and TD children while they viewed happy and angry expressions. We measured the hemodynamic responses of 13 ADHD boys and 13 TD boys to happy and angry expressions at their bilateral temporal areas, which are sensitive to face processing. The ADHD children showed an increased concentration of oxy-Hb for happy faces but not for angry faces, while TD children showed increased oxy-Hb for both faces. Moreover, the individual peak latency of hemodynamic response in the right temporal area showed significantly greater variance in the ADHD group than in the TD group. Such atypical brain activity observed in ADHD boys may relate to their preserved ability to recognize a happy expression and their difficulty recognizing an angry expression. We firstly demonstrated that NIRS can be used to detect atypical hemodynamic response to facial expressions in ADHD children.

  19. Craniofacial abnormalities among patients with Edwards Syndrome

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano M. Rosa

    2013-09-01

    Full Text Available OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES. METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%. Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%, abnormalities of the ear helix/dysplastic ears (70%, prominent occiput (52%, posteriorly rotated (46% and low set ears (44%, and short palpebral fissures/blepharophimosis (46%. Other uncommon - but relevant - abnormalities included: microtia (18%, orofacial clefts (12%, preauricular tags (10%, facial palsy (4%, encephalocele (4%, absence of external auditory canal (2% and asymmetric face (2%. One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature.

  20. Engineering molecular crystals with abnormally weak cohesion.

    Science.gov (United States)

    Maly, Kenneth E; Gagnon, Eric; Wuest, James D

    2011-05-14

    Adding astutely placed methyl groups to hexaphenylbenzene increases molecular weight but simultaneously weakens key C-H···π interactions, thereby leading to decreased enthalpies of sublimation and showing that materials with abnormally weak cohesion can be made by identifying and then obstructing interactions that help control association.

  1. Schizophrenogenic Parenting in Abnormal Psychology Textbooks.

    Science.gov (United States)

    Wahl, Otto F.

    1989-01-01

    Considers the treatment of family causation of schizophrenia in undergraduate abnormal psychology textbooks. Reviews texts published only after 1986. Points out a number of implications for psychologists which arise from the inclusion in these texts of the idea that parents cause schizophrenia, not the least of which is the potential for…

  2. Teaching Abnormal Psychology in a Multimedia Classroom.

    Science.gov (United States)

    Brewster, JoAnne

    1996-01-01

    Examines the techniques used in teaching an abnormal psychology class in a multimedia environment with two computers and a variety of audiovisual equipment. Students respond anonymously to various questions via keypads mounted on their desks, then immediately view and discuss summaries of their responses. (MJP)

  3. Psychology Faculty Perceptions of Abnormal Psychology Textbooks

    Science.gov (United States)

    Rapport, Zachary

    2011-01-01

    The problem. The purpose of the current study was to investigate the perceptions and opinions of psychology professors regarding the accuracy and inclusiveness of abnormal psychology textbooks. It sought answers from psychology professors to the following questions: (1) What are the expectations of the psychology faculty at a private university of…

  4. [Y chromosome structural abnormalities and Turner's syndrome].

    Science.gov (United States)

    Ravel, C; Siffroi, J-P

    2009-06-01

    Although specifically male, the human Y chromosome may be observed in female karyotypes, mostly in women with Turner syndrome stigmata. In women with isolated gonadal dysgenesis but otherwise normal stature, the testis determining factor or SRY gene may have been removed from the Y chromosome or may be mutated. In other women with Turner syndrome, the karyotype is usually abnormal and shows a frequent 45,X/46,XY mosaicism. In these cases, the phenotype depends on the ratio between Y positive and 45,X cell lines in the body. When in mosaicism, Y chromosomes are likely to carry structural abnormalities which explain mitotic instability, such as the existence of two centromeres. Dicentric Y isochromosomes for the short arm (idic[Yp]) or ring Y chromosomes (r[Y]) are the most frequent abnormal Y chromosomes found in infertile patients and in Turner syndrome in mosaic with 45,X cells. Although monocentric, deleted Y chromosomes for the long arm and those carrying microdeletions in the AZF region are also instable and are frequently associated with a 45,X cell line. Management of infertile patients carrying such abnormal Y chromosomes must take into account the risk and the consequences of a mosaicism in the offspring.

  5. Metabolic Abnormalities in Children with Asthma

    OpenAIRE

    2010-01-01

    Rationale: Childhood asthma and obesity have reached epidemic proportions worldwide, and the latter is also contributing to increasing rates of related metabolic disorders, such as diabetes. Yet, the relationship between asthma, obesity, and abnormal lipid and glucose metabolism is not well understood, nor has it been adequately explored in children.

  6. Morphological Abnormalities of Thalamic Subnuclei in Migraine

    DEFF Research Database (Denmark)

    Magon, Stefano; May, Arne; Stankewitz, Anne

    2015-01-01

    . SIGNIFICANCE STATEMENT: This multicenter imaging study shows morphological thalamic abnormalities in a large cohort of patients with episodic migraine compared with healthy subjects using state-of-the-art MRI and advanced, fully automated multiatlas segmentation techniques. The results stress that migraine...

  7. Abnormal Events for Emergency Trip in HANARO

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Guk Hun; Choi, M. J.; Park, S. I.; Kim, H. W.; Kim, S. J.; Park, J. H.; Kwon, I. C

    2006-12-15

    This report gathers abnormal events related to emergency trip of HANARO that happened during its operation over 10 years since the first criticality on February 1995. The collected examples will be utilized to the HANARO's operators as a useful guide.

  8. Esophageal motility abnormalities in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Irene; Martinucci; Nicola; de; Bortoli; Maria; Giacchino; Giorgia; Bodini; Elisa; Marabotto; Santino; Marchi; Vincenzo; Savarino; Edoardo; Savarino

    2014-01-01

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophagealmotility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from nonerosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  9. Esophageal motility abnormalities in gastroesophageal reflux disease.

    Science.gov (United States)

    Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

    2014-05-06

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  10. Meiotic chromosome abnormalities in human spermatogenesis.

    Science.gov (United States)

    Martin, Renée H

    2006-08-01

    The last few years have witnessed an explosion in the information about chromosome abnormalities in human sperm and the meiotic events that predispose to these abnormalities. We have determined that all chromosomes are susceptible to nondisjunction, but chromosomes 21 and 22 and, especially, the sex chromosomes have an increased frequency of aneuploidy. Studies are just beginning on the effects of potential mutagens on the chromosomal constitution of human sperm. The effects of pesticides and cancer therapeutic agents have been reviewed. In the last decade, there has been a great impetus to study chromosome abnormalities in sperm from infertile men because the advent of intracytoplasmic sperm injection (ICSI) made it possible for these men to father pregnancies. A large number of studies have demonstrated that infertile men have an increased frequency of chromosomally abnormal sperm and children, even when they have a normal somatic karyotype. Meiotic studies on the pachytene stage of spermatogenesis have demonstrated that infertile men have impaired chromosome synapsis, a significantly decreased frequency of recombination, and an increased frequency of chromosomes completely lacking a recombination site. Such errors make these cells susceptible to meiotic arrest and the production of aneuploid gametes.

  11. [Right ventricular perforation and cardiac tamponade caused by a central venous catheter].

    Science.gov (United States)

    Fukuda, H; Kasuda, H; Shimizu, R

    1993-02-01

    A 5 year old girl with ASD was scheduled for open heart surgery. A central venous catheter was placed via the right infraclavicular vein after induction of anesthesia. Thirty minutes after insertion of the catheter, a decrease in arterial pressure and pulse pressure, an increase in heart rate and central venous pressure were observed. Cardiac tamponade was revealed by rapid opening of the chest. Gushing blood out of a hole in the right ventricular free wall was confirmed by pericardiotomy. The hemodynamics were stabilized by blood transfusion and surgical closure of the hole on the ventricle. This perforation was thought to be caused by careless insertion of a relatively stiff central venous catheter.

  12. Malposition of a Peripherally Inserted Central Venous Catheter in the Graft Hepatic Vein.

    Science.gov (United States)

    Ersoy, Zeynep; Araz, Coşkun; Taşkın, Duygu; Moray, Gökhan; Torgay, Adnan

    2015-11-01

    Central venous catheters are used for delivering medications and parenteral nutrition, measuring hemodynamic variations, and providing long-term intravenous access. In our clinic, during liver transection using a living-liver donor, peripherally inserted central venous catheters are generally preferred because they involve a less invasive technique with a lower risk of complications. In this report, we present the case of a 36-year-old male liver donor into whom we peripherally inserted a central venous catheter from his left basilic vein. After transecting the hepatic vein, the surgeon found foreign material inside the venous lumen, which turned out to be the distal segment of the catheter.

  13. Abnormal Selective Attention Normalizes P3 Amplitudes in PDD

    Science.gov (United States)

    Hoeksma, Marco R.; Kemner, Chantal; Kenemans, J. Leon; van Engeland, Herman

    2006-01-01

    This paper studied whether abnormal P3 amplitudes in PDD are a corollary of abnormalities in ERP components related to selective attention in visual and auditory tasks. Furthermore, this study sought to clarify possible age differences in such abnormalities. Children with PDD showed smaller P3 amplitudes than controls, but no abnormalities in…

  14. Utility of electrocardiogram in the assessment and monitoring of pulmonary hypertension (idiopathic or secondary to pulmonary developmental abnormalities) in patients≤18 years of age.

    Science.gov (United States)

    Lau, Kelvin C; Frank, David B; Hanna, Brian D; Patel, Akash R

    2014-07-15

    Electrocardiograms have utility in disease stratification and monitoring in adult pulmonary arterial hypertension (PAH). We examined the electrocardiographic findings that are common in pediatric PAH and assessed for correlation with disease severity and progression. We retrospectively identified patients aged≤18 years followed at a single institution from January 2001 to June 2012 with catheterization-confirmed diagnosis of idiopathic PAH and PAH secondary to pulmonary developmental abnormalities. Patients with an electrocardiography performed within 60 days of catheterization were included. Primary and secondary outcomes are the prevalence of abnormal electrocardiographic findings at the time of catheterization and the association between electrocardiographic and hemodynamic findings and electrocardiographic changes with disease progression on follow-up catheterization, respectively. Of the 100 electrocardiography-catheterization pairs derived from the 46 patients identified, 93% had an electrocardiographic abnormality: 78% had right ventricular hypertrophy (RVH) and 52% had right axis deviation (RAD) for age. In patients with idiopathic PAH, the presence of RVH and RAD correlated with pulmonary vascular resistance and transpulmonary gradient. RAD and RVH on baseline electrocardiogram was associated with an increased risk of disease progression on subsequent catheterization (odds ratio 11.0, 95% confidence interval 1.3 to 96.2, p=0.03) after adjusting for PAH subgroup. The sensitivity, specificity, and positive and negative predictive values of RAD and RVH on baseline electrocardiogram for disease progression were 92%, 48%, 33%, and 95%, respectively. In conclusion, electrocardiographic abnormalities are common in pediatric PAH. RAD and RVH on electrocardiogram were associated with worse hemodynamics, whereas their absence is suggestive of a lack of disease progression.

  15. Central pain.

    Science.gov (United States)

    Singh, Supreet

    2014-12-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed.

  16. central t

    Directory of Open Access Journals (Sweden)

    Manuel R. Piña Monarrez

    2007-01-01

    Full Text Available Dado que la Regresión Ridge (RR, es una estimación sesgada que parte de la solución de la regresión de Mínimos Cuadrados (MC, es vital establecer las condiciones para las que la distribución central t de Student que se utiliza en la prueba de hipótesis en MC, sea también aplicable a la regresión RR. La prueba de este importante resultado se presenta en este artículo.

  17. Pathology of the Trachea and Central Bronchi.

    Science.gov (United States)

    Shroff, Girish S; Ocazionez, Daniel; Vargas, Daniel; Carter, Brett W; Wu, Carol C; Nachiappan, Arun C; Gupta, Pushpender; Restrepo, Carlos S

    2016-06-01

    A wide variety of disorders can affect the trachea and central bronchi. Computed tomography is the imaging modality of choice in the evaluation of tracheobronchial disease. Tracheobronchial abnormalities are sometimes incidentally detected on routine imaging or when imaging is performed for another reason. Abnormalities of the tracheobronchial tree, however, can be easily missed because they can be subtle. Furthermore, because symptoms in patients with tracheobronchial disorders often overlap symptoms of lung disease, radiologists may focus their attention on the lungs and overlook the tracheobronchial tree. In this article, we review a wide range of tracheobronchial diseases with emphasis on their computed tomographic appearances.

  18. Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Piga, M.; Serra, A.; Loi, G.L.; Satta, L. [University of Cagliari, Nuclear Medicine - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy); Deiana, L.; Liberto, M. Di; Mariotti, S. [University of Cagliari, Endocrinology - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy)

    2004-12-01

    Brain perfusion abnormalities have recently been demonstrated by single-photon emission computed tomography (SPECT) in rare cases of severe Hashimoto's thyroiditis (HT) encephalopathy; moreover, some degree of subtle central nervous system (CNS) involvement has been hypothesised in HT, but no direct evidence has been provided so far. The aim of this study was to assess cortical brain perfusion in patients with euthyroid HT without any clinical evidence of CNS involvement by means of {sup 99m}Tc-ECD brain SPECT. Sixteen adult patients with HT entered this study following informed consent. The diagnosis was based on the coexistence of high titres of anti-thyroid auto-antibodies and diffuse hypoechogenicity of the thyroid on ultrasound in association with normal circulating thyroid hormone and TSH concentrations. Nine consecutive adult patients with non-toxic nodular goitre (NTNG) and ten healthy subjects matched for age and sex were included as control groups. All patients underwent {sup 99m}Tc-ECD brain SPECT. Image assessment was both qualitative and semiquantitative. Semiquantitative analysis was performed by generation of four regions of interest (ROI) for each cerebral hemisphere - frontal, temporal, parietal and occipital - and one for each cerebellar hemisphere in order to evaluate cortical perfusion asymmetry. The Asymmetry Index (AI) was calculated to provide a measurement of both magnitude and direction of perfusion asymmetry. As assessed by visual examination, {sup 99m}Tc-ECD cerebral distribution was irregular and patchy in HT patients, hypoperfusion being more frequently found in frontal lobes. AI revealed abnormalities in 12/16 HT patients, in three of the nine NTNG patients and in none of the normal controls. A significant difference in the mean AI was found between patients with HT and both patients with NTNG (p<0.003) and normal controls (p<0.001), when only frontal lobes were considered. These results show the high prevalence of brain perfusion

  19. Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dekker, Martijn A.M. den; Pelgrim, Gert Jan; Pundziute, Gabija; Heuvel, Edwin R. van den; Oudkerk, Matthijs; Vliegenthart, Rozemarijn, E-mail: r.vliegenthart@umcg.nl

    2015-01-15

    Highlights: • The majority of anatomical coronary stenoses do not cause myocardial ischemia. • cCTA-derived CCO decrease expresses luminal density gradient across stenosis. • CCO decrease differentiates between anatomical stenoses with and without associated myocardial ischemia. • CCO decrease assessment can exclude the majority of stenoses without hemodynamic significance. - Abstract: Purpose: We assessed the association between corrected contrast opacification (CCO) based on coronary computed tomography angiography (cCTA) and inducible ischemia by adenosine perfusion magnetic resonance imaging (APMR). Methods: Sixty cardiac asymptomatic patients with extra-cardiac arterial disease (mean age 64.4 ± 7.7 years; 78% male) underwent cCTA and APMR. Luminal CT attenuation values (Hounsfield Units) were measured in coronary arteries from proximal to distal, with additional measurements across sites with >50% lumen stenosis. CCO was calculated by dividing coronary CT attenuation by descending aorta CT attenuation. A reversible perfusion defect on APMR was considered as myocardial ischemia. Results: In total, 169 coronary stenoses were found. Seven patients had 8 perfusion defects on APMR, with 11 stenoses in corresponding vessels. CCO decrease across stenoses with hemodynamic significance was 0.144 ± 0.112 compared to 0.047 ± 0.104 across stenoses without hemodynamic significance (P = 0.003). CCO decrease in lesions with and without anatomical stenosis was similar (0.054 ± 0.116 versus 0.052 ± 0.101; P = 0.89). Using 0.20 as preliminary CCO decrease cut-off, hemodynamic significance would be excluded in 82.9% of anatomical stenoses. Conclusions: CCO decrease across coronary stenosis is associated with myocardial ischemia on APMR. CCO based on common cCTA data is a novel method to assess hemodynamic significance of anatomical stenosis.

  20. Monitoring of renal hemodynamics during acute hemorrhagic shock with Doppler ultrasonic imaging: an experimental study

    Directory of Open Access Journals (Sweden)

    Rui-hong LIU

    2015-07-01

    Full Text Available Objective To evaluate the value of color Doppler flow imaging (CDFI and pulsed-wave Doppler (PWD in monitoring renal hemodynamics in rabbits with acute hemorrhagic shock. Methods The experimental model of acute hemorrhagic shock was reproduced in 16 normal New Zealand white rabbits by controlled exsanguination which was divided into 4 different grades: normal (100% MAP, mild (70% MAP, moderate (50% MAP, and severe (40% MAP. The right kidney of the experimental animal was examined by gray-scale ultrasound (2DUS, CDFI and PWD. The structure of the right kidney was observed with 2DUS. CDFI was used to monitor the change in right renal hemodynamics along with the progression of shock. The hemodynamic parameters of main renal artery (MRA, segmental renal artery (SRA and interlobar renal artery (IRA were measured by PWD, including the peak systolic velocity (Vmax, minimum diastolic velocity (Vmin and resistive index (RI. Results The animal model of hemorrhagic shock was successfully reproduced in 16 healthy New Zealand rabbits, of which 14 rabbits survived at the end of the experiment, and 2 died of severe shock. The mean arterial pressure (MAP declined, while the respiratory rate and heart rate increased as the circulation changed from normal to severe shock (P<0.05. Observation of the right renal structure by 2DUS revealed no obvious changes after bleeding in different degrees. CDFI showed a gradually reduced distribution of blood flow in renal hemodynamics along with the progression of hemorrhagic shock. Vmax and Vmin declined gradually, while RI intensity increased as the hemorrhagic shock progressed from minor to severe. There was statistically significant difference in RI intensity between different grades of shock (P<005. Conclusion CDFI and PWD can quantitatively assess the renal hemodynamics during acute hemorrhagic shock, so it can be used as a noninvasive monitoring tool in the diagnosis and treatment of hemorrhagic shock. DOI: 10