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Sample records for aspects cerebral monitoring

  1. Balloon occlusion of the internal carotid artery in 40 cases of giant intracavernous aneurysm: Technical aspects, cerebral monitoring, and results

    International Nuclear Information System (INIS)

    Vazquez Anon, V.; Aymard, A.; Gobin, Y.P.; Casasco, A.; Rueffenacht, D.; Khayata, M.H.; Merland, J.J.; Abizanda, E.; Redondo, A.

    1992-01-01

    We have studied the results of carotid occlusion in the treatment of giant intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical, angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of occlusion are discussed. The patients had headaches (47.5%), cranial nerve compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and 5% were asymptomatic. Balloon occlusion tests were performed under light sedation anaesthesia; a successful test required perfect clinical tolerance and adequate angiographic collateral circulation in arterial, parenchymatous, and venous phases. Additional criteria included xenon 133 CBF measurements, and transcranial Doppler sonography of the middle cerebral artery. According to these criteria, 5 patients did not tolerate test occlusion and required an extra-intracranial (EC-IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured of their aneurysm, and in 35 the symptoms resolved, although 3 had persistent ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications were 1 permament and 3 transient neurological deficits. Balloon occlusion of the ICA is an effective, reliable form of treatment for intracavernous giant aneurysm and should replace surgical ligation of the cervical carotid artery. With CBF or Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass prior to ICA occlusion is indicated if test occlusion is not tolerated. (orig.)

  2. Cerebral hemometabolism: from isolated measurements to monitoring and therapy

    Directory of Open Access Journals (Sweden)

    Julio Cruz

    1993-03-01

    Full Text Available An overview is presented on historical and multivariate aspects of cerebral hemometabolism. This involves a full multivariate approach, from blood pressure to cerebral metabolism. From isolated measurements, to monitoring and management, a comprehensive overview of cerebral hemometabolism is addressed, from its inception to current days, up to a new concept, the cerebral hemodynamic reserve. A multivariate functional diagram is proposed, to summarize the multivariate interrelationships of cerebral hemometabolism. A generic proposition is mode for studies of truly normal cerebral hemometabolism in children, for subsequent clinical applications. Another proposition is made for multivariate cerebral hemometabolic monitoring, in a broad variety of circumstances of predominantly global changes in intracranial dynamics, both in animal and clinical research.

  3. Monitoring Cerebral Oxygenation in Neonates: An Update

    Science.gov (United States)

    Dix, Laura Marie Louise; van Bel, Frank; Lemmers, Petra Maria Anna

    2017-01-01

    Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit. PMID:28352624

  4. Cerebral blood flow: Physiologic and clinical aspects

    International Nuclear Information System (INIS)

    Wood, J.H.

    1987-01-01

    This book contains 46 chapters divided among nine sections. The section titles are: Historical Perspectives; Cerebrovascular Anatomy; Cerebrovascular Physiology; Methods of Clinical Measurement; Experimental Methods; Imaging of Cerebral Circulation; Cerebrovascular Pathophysiology; Cerebrovascular Pharmacology; and Surgical and Interventional Augmentation

  5. Crew Cerebral Oxygen Monitor Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This Phase I SBIR proposal is aimed at developing a non-invasive, optical method for monitoring the state of consciousness of crew members in operational...

  6. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemod...

  7. Cerebral monitoring during carotid endarterectomy – a comparison ...

    African Journals Online (AJOL)

    All patients had general anaesthesia and were operated on by the same vascular surgeon (JvM). All patients were evaluated preoperatively by an experienced sonographer. Cerebral monitoring during carotid endarterectomy – a comparison between electroencephalography, transcranial cerebral oximetry and carotid ...

  8. ASPECTS OF MOTOR DEVELOPMENT IN CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Erna Žgur

    2017-01-01

    Full Text Available Child’s motor development is not an isolated process but it rather involves numerous other developmental aspects, such as cognitive and conative. The research is focused on defining the developmental principles of motor abilities and skills in children with prominent motor deficits who were diagnosed with cerebral palsy (CP. The research compares the motor maturity between two groups of children with CP; the younger group (up to 10 years of age and the older group (10 – 16 years of age. The research included 78 primary school children with different forms of CP (diplegia, hemiplegia, mixed forms, aged between 6 and 16. The discriminant analysis used in the research showed that there is a statistically significant relationship between age and motor maturity in children with CP. The structural matrix confirmed the different hierarchical representation of the motor components (strength, coordination, precision and graphomotor skills for the selected motor model, in relation to children’s age. The function of explosive strength showed significant differences between younger and older children as regards their motor maturity. We can conclude that there is a significant developmental difference between the groups of younger and older children with CP, in relation to their motor maturity (different hierarchical representation, with the most obvious difference in motor ability of explosive strength.

  9. Cerebral aspects of neonatal extracorporeal membrane oxygenation: a review.

    NARCIS (Netherlands)

    Mol, A.C. de; Liem, K.D.; Heijst, A.F.J. van

    2013-01-01

    Background: Neonatal extracorporeal membrane oxygenation (ECMO) is a lifesaving therapeutic approach in newborns suffering from severe, but potentially reversible, respiratory insufficiency, mostly complicated by neonatal persistent pulmonary hypertension. However, cerebral damage, intracerebral

  10. Crew Cerebral Oxygen Monitor, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — This Phase II SBIR proposal is aimed at developing a non-invasive, optical method for monitoring crew member state of awareness in operational environments. All...

  11. Crew Cerebral Oxygen Monitor, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This Phase I SBIR proposal is aimed at developing a non-invasive, optical method for monitoring the state of consciousness of crew members in operational...

  12. Spatial sensitivity and penetration depth of three cerebral oxygenation monitors

    Science.gov (United States)

    Gunadi, Sonny; Leung, Terence S.; Elwell, Clare E.; Tachtsidis, Ilias

    2014-01-01

    The spatial sensitivities of NIRO-100, ISS Oximeter and TRS-20 cerebral oxygenation monitors are mapped using the local perturbation method to inform on their penetration depths and susceptibilities to superficial contaminations. The results show that TRS-20 has the deepest mean penetration depth and is less sensitive than the other monitors to a localized absorption change in the superficial layer. However, an integration time of more than five seconds is required by the TRS-20 to achieve an acceptable level of signal-to-noise ratio, which is the poorest amongst the monitors. With the exception of NIRO-100 continuous wave method, the monitors are not significantly responsive to layer-wide absorption change that occurs in the superficial layer. PMID:25401006

  13. Bedside Monitoring of Cerebral Energy State During Cardiac Surgery

    DEFF Research Database (Denmark)

    Mölström, Simon; Nielsen, Troels H; Andersen, Claus

    2017-01-01

    OBJECTIVES: This study investigated whether the lactate-to-pyruvate (LP) ratio obtained by microdialysis (MD) of the cerebral venous outflow reflected a derangement of global cerebral energy state during cardiopulmonary bypass (CPB). DESIGN: Interventional, prospective, randomized study. SETTING...... in either group during CPB. In each group, 50% of the patients showed significant cognitive decline (mini-mental state examination, 3 points) 2 days after surgery. CONCLUSION: The LP ratio of cerebral venous blood increased significantly during CPB, indicating compromised cerebral oxidative metabolism...

  14. Cerebral monitoring during carotid endarterectomy using near-infrared diffuse optical spectroscopies and electroencephalogram

    Energy Technology Data Exchange (ETDEWEB)

    Shang Yu; Cheng Ran; Dong Lixin; Yu Guoqiang [Center for Biomedical Engineering, University of Kentucky, KY (United States); Ryan, Stephen J [Department of Neurology, University of Kentucky, KY (United States); Saha, Sibu P, E-mail: guoqiang.yu@uky.edu [Division of Cardiothoracic Surgery, University of Kentucky, KY (United States)

    2011-05-21

    Intraoperative monitoring of cerebral hemodynamics during carotid endarterectomy (CEA) provides essential information for detecting cerebral hypoperfusion induced by temporary internal carotid artery (ICA) clamping and post-CEA hyperperfusion syndrome. This study tests the feasibility and sensitivity of a novel dual-wavelength near-infrared diffuse correlation spectroscopy technique in detecting cerebral blood flow (CBF) and cerebral oxygenation in patients undergoing CEA. Two fiber-optic probes were taped on both sides of the forehead for cerebral hemodynamic measurements, and the instantaneous decreases in CBF and electroencephalogram (EEG) alpha-band power during ICA clamping were compared to test the measurement sensitivities of the two techniques. The ICA clamps resulted in significant CBF decreases (-24.7 {+-} 7.3%) accompanied with cerebral deoxygenation at the surgical sides (n = 12). The post-CEA CBF were significantly higher (+43.2 {+-} 16.9%) than the pre-CEA CBF. The CBF responses to ICA clamping were significantly faster, larger and more sensitive than EEG responses. Simultaneous monitoring of CBF, cerebral oxygenation and EEG power provides a comprehensive evaluation of cerebral physiological status, thus showing potential for the adoption of acute interventions (e.g., shunting, medications) during CEA to reduce the risks of severe cerebral ischemia and cerebral hyperperfusion syndrome.

  15. Educational, scientific and administrative aspects of environmental monitoring system analysis

    Directory of Open Access Journals (Sweden)

    Наталія Сергіївна Бордюг

    2016-01-01

    Full Text Available The condition and problems of environmental monitoring system in Ukraine have been considered. The shortcomings of its operation in terms of management, research and educational aspects have been detected. The possibility of improving the system of environmental monitoring are shown and approaches to improve its efficiency have been suggested, as well as issues to be included in to the subject "Environmental monitoring" for future ecologists have been substantiated in higher educational establishments

  16. Non-invasive Continuous Monitoring of Cerebral Edema Using Portable Microwave Based System

    Science.gov (United States)

    Jiang, Yuhao; Zhao, Minji; Wang, Huiqian; Li, Guoquan

    2018-01-01

    A portable non-invasive head detecting system based on microwave technology was developed for evaluation of cerebral edema change inside human brain. Real-time monitoring of cerebral edema in the brain helps the clinician to assess medical condition and treatment. In this work, a microwave signal was transmitted and coupled into an open-end circular waveguide sensor, incident on a 3D printed head phantom, and reflected back to receiver. Theoretically, the operation of this instrument depends on the conductivity contrast between cerebral edema and healthy brain tissues. The efficacy of the proposed detecting system is verified using 3D printed anatomically and dielectrically realistic human head phantoms with simulated cerebral edema targets with different size. Changes in the amplitude of time domain result were shown to be induced by the expansion or decrease of the edema volume. The eventual goal of this proposed head evaluating system is use in the hospital as an effective real-time monitoring tool.

  17. Development and clinical evaluation of noninvasive near-infrared monitoring of cerebral oxygenation

    Science.gov (United States)

    Wickramasinghe, Yappa A.; Rolfe, Peter J.; Palmer, Keith; Watkins, S.; Spencer, S. A.; Doyle, M.; O'Brien, S.; Walker, A.; Rice, C.; Smallpeice, C.

    1994-02-01

    Near infrared spectroscopy (NIRS) is a relatively new method which is suitable for monitoring oxygenation in blood and tissue in the brain of the fetus and the neonate. The technique involves in-vivo determination of the absorption of light in the wavelength range 775 to 900 nm through such tissue and converting such changes in absorbance to provide information about the changes in the concentration of oxygenated and de-oxygenated haemoglobin (HbO2 and Hb). Recent developments of the methodology now enable the calculation of changes in cerebral blood volume (CBV) as well as absolute CBV and cerebral blood flow (CBF). The attraction of this method is its applicability to monitor cerebral function in a wide variety of patient groups. Although primarily developed for neonatal use it is today applied on the fetus to investigate fetal hypoxia and on adults undergoing surgery.

  18. Diagnostic Value of Somatosensory-Evoked Potential Monitoring During Cerebral Aneurysm Clipping: A Systematic Review.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Udesh, Reshmi; Muralidharan, Aditya; Thiagarajan, Karthy; Crammond, Donald J; Chang, Yue-Fang; Balzer, Jeffrey R

    2016-05-01

    Perioperative stroke is a known complication in patients undergoing surgical clipping of cerebral aneurysms. To evaluate whether intraoperative changes in somatosensory-evoked potential (SSEP) monitoring during cerebral aneurysm clipping is diagnostic of perioperative stroke. An electronic search of PubMed, Embase, and Web of Science databases was done for studies published through May 2015 on SSEP monitoring in cerebral aneurysm clipping for predicting postoperative outcomes. All titles and abstracts were screened independently on the basis of predetermined criteria. Inclusion criteria included randomized clinical trials and prospective or retrospective cohort reviews; patients with intracranial aneurysms who underwent surgical clipping with intra-operative SSEP monitoring and postoperative neurologic assessment; studies published in English on adult humans ≥18 years with sample size of ≥50; and studies inclusive of an abstract with adequate details on outcomes. A total of 14 articles with a sample population of 2015 patients were analyzed. SSEP monitoring demonstrated a strong mean specificity of 84.5% (95% confidence interval [95% CI] -76.3 to 90.3) but weaker sensitivity of 56.8% (95% CI 44.1-68.6) for predicting stroke. A diagnostic odds ratio of 7.772 (95% CI 5.133-11.767) suggested that the odds of observing an SSEP change among those with a postoperative neurologic deficit were 7 times greater than those without a neurologic deficit. Intraoperative SSEP monitoring is highly specific for predicting neurologic outcome after cerebral aneurysm clipping. Patients with postoperative neurologic deficits are 7 times more likely to have had intraoperative SSEP changes. SSEP monitoring may help design prevention strategies to reduce stroke rates after cerebral aneurysm clipping. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. MRI monitoring of experimental cerebral ischaemia: comparison of two models

    International Nuclear Information System (INIS)

    Forsting, M.; Reith, W.; Doerfler, A.; Meyding-Lamade, U.; Sartor, K.

    1994-01-01

    The aim of this study was to compare two minimally invasive rat models of focal ischaemic stroke as to their ability to simulate clinical stroke reproducibly. In one model a focal infarct was induced using the photochemical Rose Bengal technique. The second model was based on transvascular occlusion of the middle cerebral artery using a cervical approach. In all animals we performed MRI at different times with two different paramagnetic contrast agents. The time course of blood-brain-barrier disruption in the Rose Bengal model differed entirely from that in human brain ischaemia. The experimental stroke showed marked contrast enhancement in the first hour after the onset of ischaemia. On the other hand, the MRI changes in the suture occlusion model were very similar to the changes observed in human brain ischaemia: no early disruption of the blood-brain-barrier and increased T2-signal 4-6 h after the onset of stroke. (orig.)

  20. Invos Cerebral Oximeter compared with the transcranial Doppler for monitoring adequacy of cerebral perfusion in patients undergoing carotid endarterectomy.

    Science.gov (United States)

    Fassiadis, N; Zayed, H; Rashid, H; Green, D W

    2006-12-01

    The aim of this prospective study was to assess the correlation between signals obtained during carotid endarterectomy (CEA) under local (LA) or general anesthesia from the Somanetics Invos cerebral oximeter (CO) and transcranial Doppler (TCD). Forty patients were enrolled in the study. The percentages fall in TCD mean flow velocity (FVm) and CO regional oxygen saturation (rSO2) on the ipsilateral side following clamping were recorded and the correlation coefficient and Spearman's coefficient of rank correlation were calculated. Fourteen patients were not included in the statistical analysis because either no TCD window or reliable TCD signal was obtained. The remaining 26 patients had a fall in either FVm, rSO2 or both during carotid clamping. There was a highly statistically significant correlation between the percentage fall in FVm and rSO2 with a correlation coefficient of 0.73, P<0.0001, with a 95% confidence interval (CI) for r=0.48 to 0.87; Spearman's coefficient of rank correlation (rho) =0.67, P=0.0008, with a 95% CI for rho=0.384 to 0.84. A significant decline in both TCD and rSO2 was noted in 3 patients under LA out of which 2 required shunts for alteration in conscious level. In 2 LA patients there was a significant decline in TCD but not in rSO2 and the endarterectomy was completed without a shunt. Regional oxygen saturation correlates well with FVm during carotid clamping. However, the inability to obtain reliable TCD FVm readings in 35% of patients is a serious disadvantage for this monitor. It appears that CO is a satisfactory and possibly superior device for monitoring adequacy of cerebral perfusion and oxygenation during CEA in comparison with the TCD.

  1. The importance of bilateral monitoring of cerebral oxygenation (NIRS): Clinical case of asymmetry during cardiopulmonary bypass secondary to previous cerebral infarction.

    Science.gov (United States)

    Matcan, S; Sanabria Carretero, P; Gómez Rojo, M; Castro Parga, L; Reinoso-Barbero, F

    2018-03-01

    Cerebral oximetry based on near infrared spectroscopy (NIRS) technology is used to determine cerebral tissue oxygenation. We hereby present the clinical case of a 12-month old child with right hemiparesis secondary to prior left middle cerebral artery stroke 8 months ago. The child underwent surgical enlargement of the right ventricular outflow tract (RVOT) with cardiopulmonary bypass. During cardiopulmonary bypass, asymmetric NIRS results were detected between both hemispheres. The utilization of multimodal neuromonitoring (NIRS-BIS) allowed acting on both perfusion pressure and anesthetic depth to balance out the supply and demand of cerebral oxygen consumption. No new neurological sequelae were observed postoperatively. We consider bilateral NIRS monitoring necessary in order to detect asymmetries between cerebral hemispheres. Although asymmetries were not present at baseline, they can arise intraoperatively and its monitoring thus allows the detection and treatment of cerebral ischemia-hypoxia in the healthy hemisphere, which if undetected and untreated would lead to additional neurological damage. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Clinical aspects and characteristics of the course of Parkinson’s disease with chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Voskresenskaya O.N.

    2012-06-01

    Full Text Available

    The article is devoted characteristics current of Parkinson’s disease with chronic cerebral ischemia. Objective: to study the clinical presentation and features of PD against cerebral ischemia. Methods. A total of 44 patients with a diagnosis of “Parkinson’s disease”, 20 of which were determined by accurate clinical and instrumental signs of chronic cerebral ischemia. Comparative characteristics of the neurological status, cognitive functions, some laboratory and instrumental data in the two groups of patients: Parkinson’s disease with a background of chronic ischemia of the brain and without it. Results. Statistically signifcant differences between groups are observed on the following variables: duration of illness, severity of depression, the concentration of glucose in the blood. Formed groups of signifcant difference in the severity of atherosclerosis of cerebral vessels. Conclusion. The data of the acceleration of the progression of Parkinson’s disease with chronic cerebral ischemia, as well as the more frequent occurrence of depression in this patient group.

  3. Monitoring variables affecting positron emission tomography measurements of cerebral blood flow in anaesthetized pigs

    DEFF Research Database (Denmark)

    Alstrup, Aage Kristian Olsen; Zois, Nora Elisabeth; Simonsen, Mette

    2018-01-01

    Background Positron emission tomography (PET) imaging of anaesthetized pig brains is a useful tool in neuroscience. Stable cerebral blood flow (CBF) is essential for PET, since variations can affect the distribution of several radiotracers. However, the effect of physiological factors regulating...... and the monitoring parameters. Results No significant statistical correlations were found between CBF and the nine monitoring variables. However, we found that arterial carbon dioxide tension (PaCO2) and body temperature were important predictors of CBF that should be observed and kept constant. In addition, we...

  4. Doppler sonography to monitor flow in different cerebral arteries in the rabbit.

    Science.gov (United States)

    Roatta, S; Roncari, S; Micieli, G; Bosone, D; Passatore, M

    2000-07-01

    Most of the transcranial Doppler (TCD) experimental studies on cerebral haemodynamics have been performed in the rabbit because of the similarity between its Willis circle and that of the human, but these studies have mainly been limited to the basilar artery. The present study was aimed at extending the use of TCD sonography to all other large cerebral arteries. In anaesthetised rabbits, these arteries were insonated from three different recording sites, i.e. top-cranial, suboccipital and orbital, using a two-channel pulsed Doppler device equipped with 4 and 8 MHz probes. First, discrimination between intra- and extracranial arteries was achieved through a standard 'rebreathing' test (hypercapnic-hypoxic stimulation). The distinctive blood velocity response patterns, reflecting the different extents of metabolic reactivity in intra- and extracranial territories, are described and discussed. Intracranial arteries were then identified on the basis of their response to ipsi- and contralateral common carotid artery occlusion. This procedure allowed recording from the following arteries: anterior common trunk, anterior cerebral, internal carotid, middle cerebral and basilar; the latter could be simultaneously monitored with any of the others. This study provides an experimental model allowing investigation of regional differences in the haemodynamic response to neurogenic and pharmacological stimuli.

  5. [Rasnmussen syndrome. 7 years' follow-up. Aspects related to cerebral plasticity in epilepsy].

    Science.gov (United States)

    Aguilar Rebolledo, Francisco; Ruvalcaba García, Cristina; Rayo Mares, Darío; Rojas, Juan Carlos

    2002-01-01

    Present study represents a case follow up for seven years. A case of Epilepsy Partialis Continua (EPC) in a fifteen year old girl was studied with CT, MRI, cerebral SPECT and constantly EEG procedures: The SPECT study showed in right frontal lobe and right temporal lobe hypoperfusion (reduction of regional cerebral blood flow [rCBF]) cerebral zone in the interictal period and hyperperfusion (increase rCBF) in the ictal period in the same hemisphere. The EEG showed abnormal activity consisting in sharp wave and polyphasic sharp wave in frontal and temporal regions. The medical treatment was refractory at all kind of anticonvulsant drugs. In order to improve the refractory epilepsy the team decided an epilepsy surgery with right temporal lobotomy and right frontal corticetomy. This procedure were done at the eight year old and the results were satisfactory immediately after the surgery with absolute control and normal cognitive performance two weeks later the surgery. This patient was follow up for seven years with EEG constantly with normal activity, SPECT and MRI, all studies showed functional hemispherectomy, total absence in the structure and cerebral blood flow in right hemisphere with normal perfusion and structure in left hemisphere. The late control of neuropsychology assessment showed some deficits in the I.Q. cognitive performance, evaluated by the Weschler scale and Machover tests. These findings would be able to demonstrate a phenomenon of brain plasticity and neuronal restoration in the left cerebral hemisphere after to remove the abnormal cerebral epilepsy focus. This procedure might permits the restoration of inadequate neuronal environment and normalization of neural physiological stability. The postulated mechanisms of reorganization of function are unmasking, nonsynaptic diffusion neurotransmission and receptor plasticity, trophic factors, synapsins and neurotransmitters. The neuropsychological mechanism to preserve the functions would be involving

  6. Fiber-based hybrid probe for non-invasive cerebral monitoring in neonatology

    Science.gov (United States)

    Rehberger, Matthias; Giovannella, Martina; Pagliazzi, Marco; Weigel, Udo; Durduran, Turgut; Contini, Davide; Spinelli, Lorenzo; Pifferi, Antonio; Torricelli, Alessandro; Schmitt, Robert

    2015-07-01

    Improved cerebral monitoring systems are needed to prevent preterm infants from long-term cognitive and motor restrictions. Combining advanced near-infrared diffuse spectroscopy measurement technologies, time-resolved spectroscopy (TRS) and diffuse correlation spectroscopy (DCS) will introduce novel indicators of cerebral oxygen metabolism and blood flow for neonatology. For non-invasive sensing a fiber-optical probe is used to send and receive light from the infant head. In this study we introduce a new fiber-based hybrid probe that is designed for volume production. The probe supports TRS and DCS measurements in a cross geometry, thus both technologies gain information on the same region inside the tissue. The probe is highly miniaturized to perform cerebral measurements on heads of extreme preterm infants down to head diameters of 6cm. Considerations concerning probe production focus on a reproducible accuracy in shape and precise optical alignment. In this way deviations in measurement data within a series of probes should be minimized. In addition to that, requirements for clinical use like robustness and hygiene are considered. An additional soft-touching sleeve made of FDA compatible silicone allows for a flexible attachment with respect to the individual anatomy of each patient. We present the technical concept of the hybrid probe and corresponding manufacturing methods. A prototype of the probe is shown and tested on tissue phantoms as well as in vivo to verify its operational reliability.

  7. Cerebral monitoring during neonatal surgery for non-cardiac congenital anomalies: a first step to improve outcome?

    NARCIS (Netherlands)

    Stolwijk, L.J.

    2017-01-01

    Monitoring the newborn brain during surgery Cerebral monitoring in newborns, who require surgery in the first month of life, is important to protect the brain. The newborn brain is vulnerable during neonatal surgery. Newborn babies with a congenital anomaly requiring surgery in the first month of

  8. Monitoring Cerebral and Renal Oxygenation Status during Neonatal Digestive Surgeries Using Near Infrared Spectroscopy

    Directory of Open Access Journals (Sweden)

    Jonathan Beck

    2017-06-01

    Full Text Available BackgroundDepending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause.ObjectiveEvaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters. Analyzing retrospectively the inter-relationships between NIRS values and mean arterial pressure (MAP values as well as pre-ductal SpO2.MethodsProspective, descriptive, monocentric study. All neonates referred for surgery were included. NIRS allows the measurement of cerebral and renal oxygenation fluctuations, as well as calculating difference in intraoperative and postoperative values.ResultsNineteen patients were included. Cerebral regional oxygen saturation (C rSO2 values were stable while renal regional oxygen saturation (R rSO2 values tended to decrease with time during surgery. Indeed, 72% of rSO2 decline episodes occurred after the first 30 min of surgery, without any significant statistical differences for the next 90 min of surgery. After surgery, the lowest average C and R rSO2 values were evidenced during the first 6 h, with 60% of C rSO2 and R rSO2 anomalies occurring in that time frame. There was no significant statistical difference observed in the following 18 h. There was a significant correlation between R rSO2 and SpO2 values (p < 0.01, but not with C rSO2 values. There was no correlation with the MAP either for the C rSO2 values or R rSO2 ones.ConclusionNIRS is a promising non-invasive bedside tool to monitor cerebral and tissue perfusion, analyzing tissue microcirculation. NIRS has its interest to guide neonatal digestive

  9. Use of electrical impedance tomography to monitor regional cerebral edema during clinical dehydration treatment.

    Science.gov (United States)

    Fu, Feng; Li, Bing; Dai, Meng; Hu, Shi-Jie; Li, Xia; Xu, Can-Hua; Wang, Bing; Yang, Bin; Tang, Meng-Xing; Dong, Xiu-Zhen; Fei, Zhou; Shi, Xue-Tao

    2014-01-01

    Variations of conductive fluid content in brain tissue (e.g. cerebral edema) change tissue impedance and can potentially be measured by Electrical Impedance Tomography (EIT), an emerging medical imaging technique. The objective of this work is to establish the feasibility of using EIT as an imaging tool for monitoring brain fluid content. a prospective study. In this study EIT was used, for the first time, to monitor variations in cerebral fluid content in a clinical model with patients undergoing clinical dehydration treatment. The EIT system was developed in house and its imaging sensitivity and spatial resolution were evaluated on a saline-filled tank. 23 patients with brain edema. The patients were continuously imaged by EIT for two hours after initiation of dehydration treatment using 0.5 g/kg intravenous infusion of mannitol for 20 minutes. Overall impedance across the brain increased significantly before and after mannitol dehydration treatment (p = 0.0027). Of the all 23 patients, 14 showed high-level impedance increase and maintained this around 4 hours after the dehydration treatment whereas the other 9 also showed great impedance gain during the treatment but it gradually decreased after the treatment. Further analysis of the regions of interest in the EIT images revealed that diseased regions, identified on corresponding CT images, showed significantly less impedance changes than normal regions during the monitoring period, indicating variations in different patients' responses to such treatment. EIT shows potential promise as an imaging tool for real-time and non-invasive monitoring of brain edema patients.

  10. Continuous monitoring of the partial pressure of oxygen in cerebral venous blood.

    Science.gov (United States)

    Rieger, A; Menzel, M; Rainov, N G; Sanchin, L; Rot, S; Furka, I; Görömbey, Z; Burkert, W

    1997-08-01

    Clinical oxygen monitoring in the injured brain is somewhat difficult. However, ischemia is one of the major factors responsible for secondary tissue damage after head injury or subarachnoid hemorrhage. Therefore, the aim of the present study was to investigate the value of continuously monitoring the partial pressure of oxygen in cerebral venous blood (PcvO2) during changes in intracranial pressure (ICP). In eight domestic pigs with Clark type probes placed in the posterior third of the superior sagittal sinus, PcvO2 was continuously registered while ICP was stepwise elevated by an inflatable balloon placed below the tentorium. Arterial blood pressure was continuously monitored, cerebral perfusion pressure (CPP) was calculated, and arterial partial carbon dioxide pressure and partial pressure of oxygen were registered intermittently. The mean intraparenchymal ICP before the start of balloon inflation was 5 +/- 1 mm Hg, the mean CPP was 80 +/- 15 mm Hg, and the mean PcvO2 was 36 +/- 3 mm Hg. At maximum ICP elevation, CPP decreased to 20 +/- 12 mm Hg, PcvO2 decreased to 10 +/- 6 mm Hg, and ICP increased to 90 +/- 10 mm Hg. Strong linear correlations between ICP and PcvO2 and between CPP and PcvO2 were revealed, and mean correlation coefficients of 0.89 for ICP/PcvO2 and 0.73 for CPP/PcvO2 were calculated. The present study demonstrates that polarographic PcvO2 monitoring in the superior sagittal sinus is a reliable method for the early detection of reduced CPP during ICP elevation. This technique is capable of registering the global oxygen supply and oxygen consumption of the brain. It seems superior to jugular venous oxymetry and is better suited for clinical use because of a somewhat low artifact susceptibility.

  11. Bimanual Fine Motor Function (BFMF) Classification in Children with Cerebral Palsy: Aspects of Construct and Content Validity.

    Science.gov (United States)

    Elvrum, Ann-Kristin G; Andersen, Guro L; Himmelmann, Kate; Beckung, Eva; Öhrvall, Ann-Marie; Lydersen, Stian; Vik, Torstein

    2016-01-01

    The Bimanual Fine Motor Function (BFMF) is currently the principal classification of hand function recorded by the Surveillance of Cerebral Palsy in Europe (SCPE) register. The BFMF is used in a number of epidemiological studies, but has not yet been validated. To examine aspects of construct and content validity of the BFMF. Construct validity of the BFMF was assessed by comparison with the Manual Ability Classification System (MACS) using register-based data from 539 children born 1999-2003 (304 boys; 4-12 years). The high correlation with the MACS (Spearman's rho = 0.89, CI: 0.86-0.91, pclassification of fine motor capacity or performance. Our results suggest that the BFMF may provide complementary information to the MACS regarding fine motor function and actual use of the hands, particularly if used as a classification of fine motor capacity.

  12. Practical Aspects of Research Monitoring: Methodological and Functional Solutions

    Directory of Open Access Journals (Sweden)

    A A Onosov

    2013-12-01

    Full Text Available The article describes the experience of designing, testing and implementing the National system of monitoring the quality of meteorological services in Russia. Within the framework of this project a large-scale research program was carried out aimed to develop the conception, methodology, research tools and design of customer assessment of the Roshydromet services.

  13. Comparative Aspects of the Regulation of Cutaneous and Cerebral Microcirculation During Acute Blood Loss

    Directory of Open Access Journals (Sweden)

    I. A. Ryzhkov

    2017-01-01

    Full Text Available Objective. Using laser Doppler flowmetry (LDF and wavelet-analysis of microvascular blood flow oscillations to determine the features of regulation of cutaneous and cerebral microhemocirculation at early stages of acute fixed volume blood loss.Materials and methods.Experiments were carried out on 31 male outbred rats weighing 300 g to 400 g. The animals were anesthetized by intraperitoneal injection of pentobarbital (45 mg/kg. The tail artery was catheterized for invasive measurement of mean blood pressure (BP and blood withdrawal. The LDF method (ЛАКК-02 device, LAZMA, Russia was used to record microvascular blood flow simultaneously in the right ear and the pial vessels of the left parietal region. An acute fixed-volume hemorrhage model was used. The target blood loss volume was 30% of the total blood volume (TBV. Within 10 minutes after the end of hemorrhage (posthemorrhagic period, the blood pressure and the LDF-gram were recorded. The following LDF-gram parameters were analyzed: the mean value of IP; the maximum amplitude of blood flow oscillations (Amax and the corresponding frequency (Fmax in the frequency band 0.01—0.4 Hz. Statistical processing of the data was performed using Statistica 7.0.Results. At baseline, the values of IP, Аmax and Fmax in the brain were higher than in the skin. At posthemorrhagic period, BP decreased, on average, from 105 to 41 mm Hg. Against this background, IP in the skin decreased by 65%, while in the brain it reduced only by 17%, as compared with the baseline values (P0,0001. In the same time these organs were characterized by a unidirectional dynamics of patterns of fluxmotion. In both investigated organs, Amax increased sharply, and Fmax decreased. In posthemorrhagic period, fluxmotion not only «slowed down», but was also synchronized in a relatively narrow frequency band: for the skin Fmax was about 0.04 Hz (at the border of the endothelial and neurogenic band, for the brain about 0.09 Hz

  14. Time-resolved near-infrared technique for bedside monitoring of absolute cerebral blood flow

    Science.gov (United States)

    Diop, Mamadou; Tichauer, Kenneth M.; Elliott, Jonathan T.; Migueis, Mark; Lee, Ting-Yim; St. Lawrence, Keith

    2010-02-01

    A primary focus of neurointensive care is monitoring the injured brain to detect harmful events that can impair cerebral blood flow (CBF). Since current non-invasive bedside methods can only indirectly assess blood flow, the goal of this research was to develop an optical technique for measuring absolute CBF. A time-resolved near-infrared (NIR) apparatus was built and its ability to accurately measure changes in optical properties was demonstrated in tissue-mimicking phantoms. The time-resolved system was combined with a bolus-tracking method for measuring CBF using the dye indocyanine green (ICG) as an intravascular flow tracer. Cerebral blood flow was measured in newborn piglets and for comparison, CBF was concurrently measured using a previously developed continuous-wave NIR method. Measurements were acquired with both techniques under three conditions: normocapnia, hypercapnia and following occlusion of the carotid arteries. Mean CBF values (N = 3) acquired with the TR-NIR system were 31.9 +/- 11.7 ml/100g/min during occlusion, 39.7 +/- 1.6 ml/100g/min at normocapnia, and 58.8 +/- 9.9 ml/100g/min at hypercapnia. Results demonstrate that the developed TR-NIR technique has the sensitivity to measure changes in CBF; however, the CBF measurements were approximately 25% lower than the values obtained with the CW-NIRS technique.

  15. Cerebral Blood Flow Autoregulation in Sepsis for the Intensivist: Why Its Monitoring May Be the Future of Individualized Care.

    Science.gov (United States)

    Goodson, Carrie M; Rosenblatt, Kathryn; Rivera-Lara, Lucia; Nyquist, Paul; Hogue, Charles W

    2018-02-01

    Cerebral blood flow (CBF) autoregulation maintains consistent blood flow across a range of blood pressures (BPs). Sepsis is a common cause of systemic hypotension and cerebral dysfunction. Guidelines for BP management in sepsis are based on historical concepts of CBF autoregulation that have now evolved with the availability of more precise technology for its measurement. In this article, we provide a narrative review of methods of monitoring CBF autoregulation, the cerebral effects of sepsis, and the current knowledge of CBF autoregulation in sepsis. Current guidelines for BP management in sepsis are based on a goal of maintaining mean arterial pressure (MAP) above the lower limit of CBF autoregulation. Bedside tools are now available to monitor CBF autoregulation continuously. These data reveal that individual BP goals determined from CBF autoregulation monitoring are more variable than previously expected. In patients undergoing cardiac surgery with cardiopulmonary bypass, for example, the lower limit of autoregulation varied between a MAP of 40 to 90 mm Hg. Studies of CBF autoregulation in sepsis suggest patients frequently manifest impaired CBF autoregulation, possibly a result of BP below the lower limit of autoregulation, particularly in early sepsis or with sepsis-associated encephalopathy. This suggests that the present consensus guidelines for BP management in sepsis may expose some patients to both cerebral hypoperfusion and cerebral hyperperfusion, potentially resulting in damage to brain parenchyma. The future use of novel techniques to study and clinically monitor CBF autoregulation could provide insight into the cerebral pathophysiology of sepsis and offer more precise treatments that may improve functional and cognitive outcomes for survivors of sepsis.

  16. Superficial Temporal Artery to Middle Cerebral Artery Bypass via a Minimized Approach: Operative Nuances and Problem-Solving Aspects.

    Science.gov (United States)

    Fischer, Gerrit; Senger, Sebastian; Sharif, Salman; Oertel, Joachim

    2016-04-01

    The minimized approach for superficial temporal to middle cerebral artery (STA-MCA) bypass surgery is frequently associated with unfamiliar situations and technical problems. Description of operative nuances and evaluation of problem-solving aspects to facilitate potential limitations related with a limited exposure approach. In patients who underwent STA-MCA bypass surgery between February 2012 and August 2014, a preoperative high-resolution computed tomography-angiography 3-dimensional dataset was obtained to select the optimal vessels for anastomosis. Intraoperative exposure was assessed under standard neuronavigation. Anastomoses were performed with specific instruments developed by the authors. Intraoperative video documentation and follow-up records were analyzed retrospectively. Seventeen STA-MCA minimally invasive bypass procedures were performed on 12 patients. In all cases, the procedure could be performed through planned craniotomy (mean diameter 2.5 cm). All cases of the procedures dealt with the limitation of surgical field during bypass surgery. The described applications facilitated microsurgical handling in the environment of a limited exposure in all procedures. Follow-up showed all bypasses remained open. The surgical applications, operative techniques, problem-solving aspects, and development of new instruments are described. Potentially, these suggestions may enhance the surgical confidence and convenience to perform STA-MCA bypass surgery with a minimized approach. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy

    Directory of Open Access Journals (Sweden)

    Aysegul Kusku

    2014-07-01

    Full Text Available OBJECTIVE: Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. METHODS: Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15 mg bupivacaine 5% intratechal blockade was performed. Mean blood pressure (MBP, maximum heart rate (MHR, peripheral oxygen saturation (SpO2 and cerebral oxygen levels (rSO2 were preoperatively monitored for 60 min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. RESULTS: Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. CONCLUSION: Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did

  18. Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy.

    Science.gov (United States)

    Kusku, Aysegul; Demir, Guray; Cukurova, Zafer; Eren, Gulay; Hergunsel, Oya

    2014-01-01

    Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT) was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15mg bupivacaine 5%) intratechal blockade was performed. Mean blood pressure (MBP), maximum heart rate (MHR), peripheral oxygen saturation (SpO2) and cerebral oxygen levels (rSO2) were preoperatively monitored for 60min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did not result in deterioration of cognitive functioning

  19. [Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy].

    Science.gov (United States)

    Kusku, Aysegul; Demir, Guray; Cukurova, Zafer; Eren, Gulay; Hergunsel, Oya

    2014-01-01

    Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT) was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15mg bupivacaine 5%) intratechal blockade was performed. Mean blood pressure (MBP), maximum heart rate (MHR), peripheral oxygen saturation (SpO2) and cerebral oxygen levels (rSO2) were preoperatively monitored for 60min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did not result in deterioration of cognitive functioning

  20. Aspects of monitoring and quality assurance for radiolabeled antibodies

    International Nuclear Information System (INIS)

    Barber, D.E.

    1992-06-01

    This report provides an informational resource and guide for the US Nuclear Regulatory Commission (NRC) and NRC licensees who produce or use radiolabeled antibodies (RABs). Components of quality assurance programs related to the production and use of RABs are reviewed and evaluated, and recommendations are made on dosage calibrations, exposure control, monitoring, and personnel requirements. Special emphasis is placed on dose calibrators because these instruments are used extensively to measure the dosage of radiopharmaceuticals to be administered to patients. The difficulties of using dose calibrators to quantify dosages of beta- and alpha-emitters are discussed. The advantages and disadvantages of using other instruments are examined, and recommendations are made on the types of instruments to be used for different applications. 46 refs., 8 tabs

  1. Sudden cerebral depression detected by bispectral index monitoring in cryptococcal meningitis with elevated near-fatal cerebrospinal fluid pressure.

    Science.gov (United States)

    Matsumoto, Hironori; Annen, Suguru; Umakoshi, Kensuke; Takeba, Jun; Kikuchi, Satoshi; Nakabayashi, Yuki; Moriyama, Naoki; Ohshita, Muneaki; Aibiki, Mayuki

    2017-07-01

    An increase in cerebrospinal fluid pressure (CSFP) is usually prominent in cryptococcal meningitis, which has a high mortality rate, so aggressive management to control CSFP is crucial. In this case, a 40-year-old-man survived cryptococcal meningitis treated with continuous spinal drainage under bispectral index (BIS) monitoring. He unexpectedly showed hypertension, went into a coma, and even loss his light reflexes due to CSFP elevation. His BIS values had abruptly dropped before developing these symptoms, but dramatically recovered after lumbar puncture drainage, suggesting that BIS monitoring could reflect cerebral function changes due to CSFP alternations. Inducing continuous spinal drainage to control CSFP provided stable control of blood pressure and brain activity, which was continuously monitored by BIS, enabling us to provide prompt treatment. Cerebral depressions due to elevated CSFP may suddenly develop, so continuous spinal drainage is needed for preventing catastrophic events. Bispectral index could be useful for detecting early changes from CSFP elevation in meningitis cases with intracranial hypertension.

  2. Cerebral Blood Volume ASPECTS Is the Best Predictor of Clinical Outcome in Acute Ischemic Stroke: A Retrospective, Combined Semi-Quantitative and Quantitative Assessment.

    Directory of Open Access Journals (Sweden)

    Marina Padroni

    Full Text Available The capability of CT perfusion (CTP Alberta Stroke Program Early CT Score (ASPECTS to predict outcome and identify ischemia severity in acute ischemic stroke (AIS patients is still questioned.62 patients with AIS were imaged within 8 hours of symptom onset by non-contrast CT, CT angiography and CTP scans at admission and 24 hours. CTP ASPECTS was calculated on the affected hemisphere using cerebral blood flow (CBF, cerebral blood volume (CBV and mean transit time (MTT maps by subtracting 1 point for any abnormalities visually detected or measured within multiple cortical circular regions of interest according to previously established thresholds. MTT-CBV ASPECTS was considered as CTP ASPECTS mismatch. Hemorrhagic transformation (HT, recanalization status and reperfusion grade at 24 hours, final infarct volume at 7 days and modified Rankin scale (mRS at 3 months after onset were recorded.Semi-quantitative and quantitative CTP ASPECTS were highly correlated (p<0.00001. CBF, CBV and MTT ASPECTS were higher in patients with no HT and mRS ≤ 2 and inversely associated with final infarct volume and mRS (p values: from p<0.05 to p<0.00001. CTP ASPECTS mismatch was slightly associated with radiological and clinical outcomes (p values: from p<0.05 to p<0.02 only if evaluated quantitatively. A CBV ASPECTS of 9 was the optimal semi-quantitative value for predicting outcome.Our findings suggest that visual inspection of CTP ASPECTS recognizes infarct and ischemic absolute values. Semi-quantitative CBV ASPECTS, but not CTP ASPECTS mismatch, represents a strong prognostic indicator, implying that core extent is the main determinant of outcome, irrespective of penumbra size.

  3. Continuous monitoring of cerebral oxygen saturation in elderly patients undergoing major abdominal surgery minimizes brain exposure to potential hypoxia.

    Science.gov (United States)

    Casati, Andrea; Fanelli, Guido; Pietropaoli, Paolo; Proietti, Rodolfo; Tufano, Rosalba; Danelli, Giorgio; Fierro, Giuseppe; Fierro, Giovanni; De Cosmo, Germano; Servillo, Giovanni

    2005-09-01

    Elderly patients are more prone than younger patients to develop cerebral desaturation because of the reduced physiologic reserve that accompanies aging. To evaluate whether monitoring cerebral oxygen saturation (rSO(2)) minimizes intraoperative cerebral desaturation, we prospectively monitored rSO(2) in 122 elderly patients undergoing major abdominal surgery with general anesthesia. Patients were randomly allocated to an intervention group (the monitor was visible and rSO(2) was maintained at > or =75% of preinduction values; n = 56) or a control group (the monitor was blinded and anesthesia was managed routinely; n = 66). Cerebral desaturation (rSO(2) reduction <75% of baseline) was observed in 11 patients of the treatment group (20%) and 15 patients of the control group (23%) (P = 0.82). Mean (95% confidence intervals) values of mean rSO(2) were higher (66% [64%-68%]) and the area under the curve below 75% of baseline (AUCrSO2(2)< 75% of baseline) was lower (0.4 min% [0.1-0.8 min%]) in patients of the treatment group than in patients of the control group (61% [59%-63%] and 80 min% [2-144 min%], respectively; P = 0.002 and P = 0.017). When considering only patients developing intraoperative cerebral desaturation, a lower Mini Mental State Elimination (MMSE) score was observed at the seventh postoperative day in the control group (26 [25-30]) than in the treatment group (28 [26-30]) (P = 0.02), with a significant correlation between the AUCrSO(2) < 75% of baseline and postoperative decrease in MMSE score from preoperative values (r(2)= 0.25, P = 0.01). Patients of the control group with intraoperative cerebral desaturation also experienced a longer time to postanesthesia care unit (PACU) discharge (47 min [13-56 min]) and longer hospital stay (24 days [7-53] days) compared with patients of the treatment group (25 min [15-35 min] and 10 days [7-23 days], respectively; P = 0.01 and P = 0.007). Using rSO(2) monitoring to manage anesthesia in elderly patients

  4. Noninvasive quantitative measurement of cerebral blood flow with [sup 123]I-IMP; Lung monitoring method

    Energy Technology Data Exchange (ETDEWEB)

    Oguchi, Kazuhiro; Kasuga, Toshio; Sone, Shusuke; Nakanishi, Fumiko; Ito, Atsuko (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine); Tanizaki, Yoshio

    1993-06-01

    In order to perform a less invasive determination of regional cerebral blood flow (rCBF) using N-isopropyl-p-[[sup 123]I] iodoamphetamine (I-123-IMP), we used the lung clearance curve as a substitute for the arterial blood activity curve as an input function. We assumed that a major portion of the intravenously injected I-123-IMP initially accumulates in the lung and then is gradually cleared from the lung pool to enter the systemic circulation. In this case lung clearance could be considered nearly equal to the integral of arterial blood activity shown during the examination. We used a single probe detector to obtain the lung clearance curve as the difference between sequential lung activity and peak lung activity. The absolute value of the sequential change in arterial blood activity was estimated from the differentiated lung clearance curve compared with the arterial blood activity that was estimated by actual blood sampling once during the examination. The rCBF was calculated by the thus estimated arterial blood activity curve and brain activity by SPECT image using the microsphere model. The values of rCBF obtained by this method were similar to those obtained by the continuous arterial sampling method, and this lung monitoring method was thought to be applicable to clinical use. (author).

  5. Cerebral microdialysis for protein biomarker monitoring in the neurointensive care setting

    Directory of Open Access Journals (Sweden)

    Lars Tomas Hillered

    2014-12-01

    Full Text Available Cerebral microdialysis (MD was introduced as a neurochemical monitoring tool in the early 1990s and is currently well established for the sampling of low molecular weight biomarkers of energy metabolic perturbation and cellular distress in the neurointensive care (NIC setting. There is now a growing interest in MD for intracerebral sampling of protein biomarkers of secondary injury mechanisms in acute traumatic and neurovascular brain injury in the NIC community. The initial enthusiasm over the opportunity to sample protein biomarkers with high molecular weight cut-off (MWCO MD catheters has dampened somewhat with the emerging realization of inherent problems with this methodology including protein adhesion, protein-protein interaction and biofouling, leading to unstable MD catheter performance (i.e. fluid recovery and extraction efficiency. This review will focus on the results of a multidisciplinary collaborative effort, within the Uppsala Berzelii Centre for Neurodiagnostics during the past several years, to study the features of the complex process of high MWCO MD for protein biomarkers. This research has led to new methodology showing robust in vivo performance with optimized fluid recovery and improved extraction efficiency, allowing for more accurate biomarker monitoring. In combination with evolving analytical methodology allowing for multiplex biomarker analysis in ultra-small MD samples a new opportunity opens up for high-resolution temporal mapping of secondary injury cascades, such as neuroinflammation and other cell injury reactions directly in the injured human brain. Such data may provide an important basis for improved characterization of complex injuries, e.g. traumatic and neurovascular brain injury, and help in defining targets and treatment windows for neuroprotective drug development

  6. Continuous EEG monitoring in the intensive care unit: beta scientific and management scientific aspects

    NARCIS (Netherlands)

    Sanders, P.M.H.; van Putten, Michel Johannes Antonius Maria; Jarm, T.; Kramar, P.; Zupanic, A.

    2007-01-01

    Due to various technological advances, it is now possible to continuously monitor critically ill patients using EEG, including the extraction of various quantitative features. In this study, several beta scientific and management scientific aspects of the implementation and use of cEEg on the ICU

  7. [Correlation between indices of 24-h monitoring of blood pressure and disturbed venous cerebral outflow in hypertensive patients].

    Science.gov (United States)

    Afanas'eva, N L; Mordovin, V F; Semke, G V; Luk'ianenok, P I

    2008-01-01

    To study relations between disturbances of cerebral venous circulation and parameters of 24-h blood pressure monitoring in hypertensive patients. A total of 72 patients aged 28 to 60 years with essential hypertension of stage II have undergone 24-h blood pressure monitoring and MR-venography of the brachiocephalic veins on a low-field MR-tomograph using 2D TOF angiography. Symptoms of disturbed cerebral venous circulation were found in 60% patients. Major venous collectors were asymmetric in 79.2% patients, 40.3% had marked asymmetry, 14% had severe asymmetry. Disturbances of venous outflow significantly more frequently occurred in non-dippers and night-peakers as well as in high variability of blood pressure. Patients with marked asymmetry of venous collectors had elevated nocturnal systolic and diastolic blood pressure, high load indices of nocturnal systolic and diastolic pressure, a low degree of nocturnal fall of blood pressure. Disturbance of venous cerebral outflow in hypertensive patients is closely related with alterations of a circadian profile of blood pressure: circadian index of blood pressure, variability of blood pressure.

  8. [Hemodynamic and methabolic aspects of sodium nitroprusside pharmacodynamics during buccal administration in patients with arterial hypertension of cerebral ischemic genesis].

    Science.gov (United States)

    Vizir, V A; Kechin, I L; Fedorova, E P

    2006-01-01

    The authors presented in the article efficiency of new formulation of Natrium Nitroprusodum used buccaly in patients with cerebral-ischemic form of arterial hypertention and stage II hypertention. It has been shown both in an acute experiment and after monothrerapy having been used. The medication proved to have positive effect on brachiocephalic vessel blood flow indices in patients of both groups using pulse doplergraphy. The use of Natrium Nitroprussidum used buccaly in patients with cerebral-ischemic form of arterial hypertention and hyportensive disease differentiates in terms of indices characterising the formation, transport and utilisation of energetic products, products of POL and antioxidant ferments.

  9. Cerebral oxygenation in contusioned vs. nonlesioned brain tissue: monitoring of PtiO2 with Licox and Paratrend.

    Science.gov (United States)

    Sarrafzadeh, A S; Kiening, K L; Bardt, T F; Schneider, G H; Unterberg, A W; Lanksch, W R

    1998-01-01

    Brain tissue PO2 in severely head injured patients was monitored in parallel with two different PO2-microsensors (Licox and Paratrend). Three different locations of sensor placement were chosen: (1) both catheters into non lesioned tissue (n = 3), (2) both catheters into contusioned tissue (n = 2), and (3) one catheter (Licox) into pericontusional versus one catheter (Paratrend) into non lesioned brain tissue (n = 2). Mean duration of PtiO2-monitoring with both microsensors in parallel was 68.1 hours. Brain tissue PO2 varied when measured in lesioned and nonlesioned tissue. In non lesioned tissue both catheters closely correlated (delta Licox/Paratrend: mean PtiO2 delta lesioned/non lesioned: mean PtiO2: 10.3 mm Hg). In contusioned brain tissue PtiO2 was always below the "hypoxic threshold" of 10 mm Hg, independent of the type of microsensor used. During a critical reduction in cerebral perfusion pressure (PO2, only increased PtiO2 when measured in pericontusional and nonlesioned brain. To recognize critical episodes of hypoxia or ischemia, PtiO2-monitoring of cerebral oxygenation is recommended in nonlesioned brain tissue.

  10. Monitoring variables affecting positron emission tomography measurements of cerebral blood flow in anaesthetized pigs

    DEFF Research Database (Denmark)

    Alstrup, Aage Kristian Olsen; Zois, Nora Elisabeth; Simonsen, Mette

    2018-01-01

    Background Positron emission tomography (PET) imaging of anaesthetized pig brains is a useful tool in neuroscience. Stable cerebral blood flow (CBF) is essential for PET, since variations can affect the distribution of several radiotracers. However, the effect of physiological factors regulating...

  11. Monitoring variables affecting positron emission tomography measurements of cerebral blood flow in anaesthetized pigs

    DEFF Research Database (Denmark)

    Alstrup, Aage Kristian Olsen; Zois, Nora Elisabeth; Simonsen, Mette

    Background: Positron emission tomography (PET) imaging of anaesthetised pig brains is a useful tool in neuroscience. Stable cerebral blood flow (CBF) is essential for PET, since variations can affect the kinetics of several radiotracers. However, the impact of physiological factors regulating CBF...

  12. The effectiveness of cerebral oxygenation monitoring during arthroscopic shoulder surgery in the beach chair position: a randomized blinded study.

    Science.gov (United States)

    Cox, Ryan M; Jamgochian, Grant C; Nicholson, Kristen; Wong, Justin C; Namdari, Surena; Abboud, Joseph A

    2018-04-01

    Beach chair positioning for shoulder surgery is associated with measurable cerebral desaturation events (CDEs) in up to 80% of patients. Near-infrared spectroscopy (NIRS) technology allows real-time measurement of cerebral oxygenation and may minimize the frequency of CDEs. The purpose of this study was to investigate the incidence of CDEs when anesthetists were aware of and blinded to NIRS monitoring and to determine the short-term cognitive effects of surgery in the beach chair position. NIRS was used to monitor cerebral oxygenation saturation in 41 consecutive patients undergoing arthroscopic shoulder surgery in the beach chair position. Patients were randomized to 2 groups, anesthetists aware of or blinded to NIRS data. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive function preoperatively, immediately postoperatively, and at 2 and 6 weeks postoperatively. Overall, 7 (17.5%) patients experienced a CDE, 5 (25%) in the aware group and 2 (10%) in the blinded group. There was no significant difference in MoCA scores between the aware and blinded groups preoperatively (27.9.1 vs. 28.2; P = .436), immediately postoperatively (26.1 vs. 26.2; P = .778), 2 weeks postoperatively (28.0 vs. 28.1; P = .737), or 6 weeks postoperatively (28.5 vs. 28.4; P = .779). There was a correlation of NIRS with systolic blood pressure (r = 0.448), diastolic blood pressure (r = 0.708), and mean arterial pressure (r = 0.608). In our series, the incidence of CDEs was much lower than previously reported and was not lowered by use of NIRS. Patients did not have significant cognitive deficits after arthroscopic surgery in the beach chair position, and there was a correlation between NIRS and intraoperative brachial blood pressure. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Twenty-Four-Hour Real-Time Continuous Monitoring of Cerebral Edema in Rabbits Based on a Noninvasive and Noncontact System of Magnetic Induction

    Science.gov (United States)

    Li, Gen; Ma, Ke; Sun, Jian; Jin, Gui; Qin, Mingxin; Feng, Hua

    2017-01-01

    Cerebral edema is a common disease, secondary to craniocerebral injury, and real-time continuous monitoring of cerebral edema is crucial for treating patients after traumatic brain injury. This work established a noninvasive and noncontact system by monitoring the magnetic induction phase shift (MIPS) which is associated with brain tissue conductivity. Sixteen rabbits (experimental group n = 10, control group, n = 6) were used to perform a 24 h MIPS and intracranial pressure (ICP) simultaneously monitored experimental study. For the experimental group, after the establishment of epidural freeze-induced cerebral edema models, the MIPS presented a downward trend within 24 h, with a change magnitude of −13.1121 ± 2.3953°; the ICP presented an upward trend within 24 h, with a change magnitude of 12–41 mmHg. The ICP was negatively correlated with the MIPS. In the control group, the MIPS change amplitude was −0.87795 ± 1.5146 without obvious changes; the ICP fluctuated only slightly at the initial value of 12 mmHg. MIPS had a more sensitive performance than ICP in the early stage of cerebral edema. These results showed that this system is basically capable of monitoring gradual increases in the cerebral edema solution volume. To some extent, the MIPS has the potential to reflect the ICP changes. PMID:28282851

  14. Monitored course at distance Nuclear Medicine: Introduction of Basic Physics Aspects. Preliminary results

    International Nuclear Information System (INIS)

    Lopez Diaz, A.; San Pedro, A.P.; Petrirena, G.

    2007-01-01

    Full text: This project try to evaluated the use of specialized multimedia product for a monitored education at distance of personnel who start to be close related with Nuclear Medicine Techniques like nurse, surgeons, specialized physician, oncologist, etc. The multimedia product included two items: Introduction to Nuclear Medicine Techniques and Basic aspects of radiation physics. Each item contents an audio visual conference (Power Point) and a charter (PDF): with theoretic aspects, understand verification questions and self-evaluation activities. The product need only a PC compatible with window 98 (or more advanced version), and 130MBy of memory spaced for archive. In order to verify the effectiveness of the distance course, we tested its results in 4 specialists: 1 nurse, 1 radio-pharmacist, 1 cardiologist and 1 neurologist. After consult and clarify their doubts, a final test was applied in order to check the knowledge acquired. With 100 point of maximum score and 60-point minimum to pass, the test contented 2 types of questions: true or false choice (with 50 aspects to verify, 1.5 point/ correct answer) and many correct choices (5 questions, 5 point/correct answer). The average result was 91.5 points/ students (89.5- 94 points); the four students pass the test with very good degree of comprehension (1 very good and 3 excellent). The course was polled about the quality of the material and their comprehension degree, asking the student to make suggestions if were needed. The average evaluation was 94 points (91-95 points). The suggestions made were: increase the number of examples and practical sequences, the understand verification questions and include monitored practical exercise. Conclusion: the product can be useful for a monitored education at distance of personnel who start to be related with Nuclear Medicine Techniques. Recommendation: The program should be enrich with the suggested things and extend to other important items like: radiation protection

  15. A technique for continuous bedside monitoring of global cerebral energy state

    DEFF Research Database (Denmark)

    Peter Jakobsen, Rasmus; Halfeld Nielsen, Troels; Granfeldt, Asger

    2016-01-01

    whether the LP ratio obtained from microdialysis of cerebral venous blood may be used as a surrogate marker of global cerebral energy state. METHODS: Six female pigs were anesthetized and vital parameters were recorded. Microdialysis catheters were placed in the left parietal lobe, the superior sagittal...... ratio obtained from the intracerebral and intravenous catheters immediately increased during the period of hemorrhagic shock while the LP ratio in the arterial blood remained close to normal levels. At the end of the experiment, median LP ratio (interquartile range) obtained from the intracerebral......, intravenous, and intra-arterial microdialysis catheters were 846 (243-1990), 309 (103-488), and 27 (21-31), respectively. There was a significant difference in the LP ratio obtained from the intravenous location and the intra-arterial location (P 

  16. ICT and the future of healthcare: Aspects of pervasive health monitoring.

    Science.gov (United States)

    Haluza, Daniela; Jungwirth, David

    2018-01-01

    Along with the digital revolution, information and communication technology applications are currently transforming the delivery of health and social care services. This paper investigates prevailing opinions toward future technology-based healthcare solutions among Austrian healthcare professionals. During a biphasic online Delphi survey, panelists rated expected outcomes of two future scenarios describing pervasive health monitoring applications. Experts perceived that the scenarios were highly innovative, but only moderately desirable, and that their implementation could especially improve patients' knowledge, quality of healthcare, and living standard. Contrarily, monetary aspects, technical prerequisites, and data security were identified as key obstacles. We further compared the impact of professional affiliation. Clearly, opinions toward pervasive healthcare differed between the interest groups, medical professionals, patient advocates, and administrative personnel. These data suggest closer collaborations between stakeholder groups to harmonize differences in expectations regarding pervasive health monitoring.

  17. Cerebral hemodynamics in patients with obstructive sleep apnea syndrome monitored with near-infrared spectroscopy (NIRS) during positive airways pressure (CPAP) therapy: a pilot study

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    In obstructive sleep apnea syndrome (OSA) the periodic reduction or cessation of breathing due to narrowing or occlusion of the upper airway during sleep leads to daytime symptoms and increased cardiovascular risk, including stroke. The higher risk of stroke is related to the impairment in cerebral vascular autoregulation. Continuous positive airways pressure (CPAP) therapy at night is the most effective treatment for OSA. However, there is no suitable bedside monitoring method evaluating the treatment efficacy of CPAP therapy, especially to monitor the recovery of cerebral hemodynamics. NIRS is ideally suited for non-invasive monitoring the cerebral hemodynamics during sleep. In this study, we will for first time assess dynamic changes of cerebral hemodynamics during nocturnal CPAP therapy in 3 patients with OSA using NIRS. We found periodic oscillations in HbO2, HHb, tissue oxygenation index (TOI) and blood volume associated with periodic apnea events without CPAP in all OSA patients. These oscillations were gradually attenuated and finally eliminated with the stepwise increments of CPAP pressures. The oscillations were totally eliminated in blood volume earlier than in other hemodynamic parameters. These results suggested that 1) the cerebral hemodynamic oscillations induced by OSA events can effectively be attenuated by CPAP therapy, and 2) blood flow and blood volume recovered first during CPAP therapy, followed by the recovery of oxygen consumption. Our study suggested that NIRS is a useful tool to evaluate the efficacy of CPAP therapy in patients with OSA bedside and in real time.

  18. Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO2) in seven patients with out-of-hospital cardiac arrest.

    Science.gov (United States)

    Hirose, Tomoya; Shiozaki, Tadahiko; Nomura, Junji; Hamada, Yasuto; Sato, Keiichi; Katsura, Kazuya; Ehara, Naoki; Wakai, Akinori; Shimizu, Kentaro; Ohnishi, Mitsuo; Hayashida, Sumito; Sadamitsu, Daikai; Shimazu, Takeshi

    2016-08-31

    In recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. However, serial changes of cerebral rSO2 in pre-hospital settings are unclear. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest (OHCA) in the pre-hospital setting. We recently developed a portable rSO2 monitor that is small (170 × 100 × 50 mm in size and 600 g in weight) enough to carry in pre-hospital settings. The sensor is attached to the patient's forehead by the ELT (Emergency Life-saving Technician), and it monitors rSO2 continuously. From June 2013 through August 2014, serial changes in cerebral rSO2 in seven patients were evaluated. According to the results of the serial changes in rSO2, four patterns of rSO2 change were found, as follows. Type 1: High rSO2 (around about 60 %) type (n = 1). Initial electrocardiogram was ventricular fibrillation and ROSC (return of spontaneous circulation) could be diagnosed in pre-hospital setting. Her outcome at discharge was Good Recovery (GR). Type 2: Low rSO2 (around about 45-50 %) type (n = 3). They did not get ROSC even once. Type 3: Gradually decreasing rSO2 type (n = 2): ROSC could be diagnosed in hospital, but not in pre-hospital setting. Their outcomes at discharge were not GR. Type 4: other type (n = 1). In this patient with ROSC when ELT started cerebral rSO2 measurement, cerebral rSO2 was 67.3 % at measurement start, it dropped gradually to 54.5 %, and then rose to 74.3 %. The cerebral oxygenation was impaired due to possible cardiac arrest again, and after that, ROSC led to the recovery of cerebral blood flow. We could measure serial changes in cerebral rSO2 in seven patients with OHCA in the pre-hospital setting. Our data suggest that pre-hospital monitoring of cerebral rSO2 might lead to a new resuscitation strategy.

  19. Cerebral near-infrared spectroscopy monitoring for prevention of brain injury in very preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Greisen, Gorm; Als-Nielsen, Bodil

    2017-01-01

    or air leaks. The quality of evidence for all comparisons discussed above was assessed as very low apart from all-cause mortality and adverse events: these were assessed as low and moderate, respectively. The validity of all comparisons is hampered by a small sample of randomised infants, risk of bias...... due to lack of blinding, and indirectness of outcomes. Authors' conclusions: The only eligible randomised clinical trial did not demonstrate any consistent effects of NIRS plus a guideline on the assessed clinical outcomes. The trial was, however, only powered to detect difference in cerebral...

  20. Optimal Placement of Cerebral Oximeter Monitors to Avoid the Frontal Sinus as Determined by Computed Tomography.

    Science.gov (United States)

    Gregory, Alexander J; Hatem, Muhammed A; Yee, Kevin; Grocott, Hilary P

    2016-01-01

    To determine the optimal location to place cerebral oximeter optodes to avoid the frontal sinus, using the orbit of the skull as a landmark. Retrospective observational study. Academic hospital. Fifty adult patients with previously acquired computed tomography angiography scans of the head. The distance between the superior orbit of the skull and the most superior edge of the frontal sinus was measured using imaging software. The mean (SD) frontal sinus height was 16.4 (7.2) mm. There was a nonsignificant trend toward larger frontal sinus height in men compared with women (p = 0.12). Age, height, and body surface area did not correlate with frontal sinus height. Head circumference was positively correlated (r = 0.32; p = 0.03) to frontal sinus height, with a low level of predictability based on linear regression (R(2) = 0.10; p = 0.02). Placing cerebral oximeter optodes>3 cm from the superior rim of the orbit will avoid the frontal sinus in>98% of patients. Predicting the frontal sinus height based on common patient variables is difficult. Additional studies are required to evaluate the recommended height in pediatric populations and patients of various ethnic backgrounds. The clinical relevance of avoiding the frontal sinus also needs to be further elucidated. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Protocol to monitor trade agreement food-related aspects: the Fiji case study.

    Science.gov (United States)

    Ravuvu, Amerita; Friel, Sharon; Thow, Anne Marie; Snowdon, Wendy; Wate, Jillian

    2017-04-26

    Despite the growing rates of obesity and diet-related non-communicable diseases, globally, public health attention has only relatively recently turned to the links between trade agreements and the nutritional risks associated with it. Specific trade agreements appear to have played an influential role in the volume and types of foods entering different countries, yet there is currently no systematic and objective monitoring of trade agreements for their impacts on food environments. Recently, INFORMAS was set up to monitor and benchmark food environments, government policies and private sector actions within countries and globally. One of its projects/modules focuses on trade policy and in particular the food-related aspects of trade agreements. This paper describes the INFORMAS trade protocol, an approach to collecting food-related information about four domains of trade: trade in goods; trade in services and foreign direct investment; domestic supports, and policy space. Specifically, the protocol is tested in Fiji. The development and testing of this protocol in Fiji represents the first effort to set out a framework and process for objectively monitoring trade agreements and their impacts on national food supply and the wider food environment. It has shown that entry into WTO trade agreements contributed to the nutrition transition in Fiji through the increased availability of imported foods with varying nutritional quality. We observed an increase in imports of both healthy and less healthy foods. The application of the monitoring protocol also highlights challenges for data collection associated with each trade domain that should be considered for future data collection and analysis in other low and middle income countries. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Human and organisational aspects of remote patient monitoring in residential care homes.

    Science.gov (United States)

    Bratan, Tanja; Choudrie, Jyoti; Clarke, Malcolm; Jones, Russell

    2007-01-01

    Demographic changes in the population, with a growing proportion of elderly people, make the efficient and effective provision of healthcare for this age group an increasingly important issue. We examine the organisational and human aspects of introducing a Remote Patient Monitoring (RPM) system that uses wireless and broadband networks into three residential care homes in the UK. Stakeholders were identified, and semi-structured one-to-one interviews were carried out in order to identify issues deemed most important to each group. The work is novel, as it requires examination of the issues of communication between healthcare workers in several primary and secondary care organisations. The key finding was the need to identify the changes in working practice and interpersonal communication. A key factor in particular was the change in relationships: staff in the remote centre needing to learn to seek support when reporting and requesting assistance for a problem; and for the staff at the health centres to respond appropriately.

  3. Epileptic Seizure Detection and Prediction Based on Continuous Cerebral Blood Flow Monitoring – a Review

    Directory of Open Access Journals (Sweden)

    Senay Tewolde

    2015-01-01

    Full Text Available Epilepsy is the third most common neurological illness, affecting 1% of the world’s population. Despite advances in medicine, about 25 to 30% of the patients do not respond to or cannot tolerate the severe side effects of medical treatment, and surgery is not an option for the majority of patients with epilepsy. The objective of this article is to review the current state of research on seizure detection based on cerebral blood flow (CBF data acquired by thermal diffusion flowmetry (TDF, and CBF-based seizure prediction. A discussion is provided on the applications, advantages, and disadvantages of TDF in detecting and localizing seizure foci, as well as its role in seizure prediction. Also presented are an overview of the present challenges and possible future research directions (along with methodological guidelines of the CBF-based seizure detection and prediction methods.

  4. Proton magnetic resonance spectroscopy to monitor the concentration changes of cerebral metabolites after TIPS implantation

    International Nuclear Information System (INIS)

    Naegele, T.; Seeger, U.; Seitz, D.; Klose, U.; Mayer, J.; Grodd, W.; Voigt, K.; Pereira, P.; Miller, S.; Huppert, P.; Kaiser, S.; Eisold, M.

    1999-01-01

    Methods: We examined 10 cirrhotic patients (Child B, C) before and 3-20 days after TIPS implantation. Clinical examination was performed by a senior hepatologist. Localized MR spectra were acquired in parieto-occipital gray/white matter using a short echo time (TE=5 ms) STEAM sequence. Results: After TIPS we found an increase of Glx/(Cr+PCr) of 13%-40% and a decrease of ml(Cr+PCr) of 6%-46% with a positive (Glx: r=0.71) respectively negative (ml: r=-0.59) correlation to the reduction of the PSPG. 7/10 patients with a reduction of the PSPG of more than 9 mmHg (9-17 mmHg) showed a clinical impairment of their HE. Conclusions: Short echo time cerebral MRS allows detection of finest HE specific metabolite changes and can therefore contribute positively to an individually optimized reduction of the PSPG during TIPS implantation. (orig.) [de

  5. Effects of Hippotherapy on Psychosocial Aspects in Children With Cerebral Palsy and Their Caregivers: A Pilot Study.

    Science.gov (United States)

    Jang, Chul Hwan; Joo, Min Cheol; Noh, Se Eung; Lee, Sang Yeol; Lee, Dae Bo; Lee, Sung Ho; Kim, Ho Kyun; Park, Hyo In

    2016-04-01

    To investigate the effects of hippotherapy on psychosocial and emotional parameters in children with cerebral palsy (CP) and their caregivers. Eight children with CP were recruited (three males and five females; mean age, 7.3 years; Gross Motor Function Classification System levels 1-3). Hippotherapy sessions were conducted for 30 minutes once weekly for 10 consecutive weeks in an indoor riding arena. The Gross Motor Function Measure (GMFM), Pediatric Balance Scale (PBS), and the Korean version of the Modified Barthel Index were evaluated. All children were evaluated by the Children's Depression Inventory, Trait Anxiety Inventory for Children, State Anxiety Inventory for Children, Rosenberg Self Esteem Scale, and the Korean-Satisfaction with Life Scale (K-SWLS). Their caregivers were evaluated with the Beck Depression Inventory, the Beck Anxiety Inventory, and the K-SWLS. We assessed children and their caregivers with the same parameters immediately after hippotherapy. Significant improvements on the GMFM, dimension E in the GMFM, and the PBS were observed after hippotherapy compared with the baseline assessment (phippotherapy program. Hippotherapy was safe and effectively improved gross motor and balance domains in children with CP. However, no improvements were observed in psychosocial or emotional parameters.

  6. Influence of antihypertensive therapy on cerebral perfusion in patients with metabolic syndrome: relationship with cognitive function and 24-h arterial blood pressure monitoring.

    Science.gov (United States)

    Efimova, Nataliya Y; Chernov, Vladimir I; Efimova, Irina Y; Lishmanov, Yuri B

    2015-08-01

    To investigate the regional cerebral blood flow, cognitive function, and parameters of 24-h arterial blood pressure monitoring in patients with metabolic syndrome before and after combination antihypertensive therapy. The study involved 54 patients with metabolic syndrome (MetS) investigated by brain single-photon emission computed tomography, 24-h blood pressure monitoring (ABPM), and comprehensive neuropsychological testing before and after 24 weeks of combination antihypertensive therapy. Patients with metabolic syndrome had significantly poorer regional cerebral blood flow compared with control group: by 7% (P = 0.003) in right anterior parietal cortex, by 6% (P = 0.028) in left anterior parietal cortex, by 8% (P = 0.007) in right superior frontal lobe, and by 10% (P = 0.00002) and 7% (P = 0.006) in right and left temporal brain regions, correspondingly. The results of neuropsychological testing showed 11% decrease in mentation (P = 0.002), and 19% (P = 0.011) and 20% (P = 0.009) decrease in immediate verbal and visual memory in patients with MetS as compared with control group. Relationships between the indices of ABPM, cerebral perfusion, and cognitive function were found. Data showed an improvement of regional cerebral blood flow, ABPM parameters, and indicators of cognitive functions after 6 months of antihypertensive therapy in patients with MetS. The study showed the presence of diffuse disturbances in cerebral perfusion is associated with cognitive disorders in patients with metabolic syndrome. Combination antihypertensive treatment exerts beneficial effects on the 24-h blood pressure profile, increases cerebral blood flow, and improves cognitive function in patients with MetS. © 2015 John Wiley & Sons Ltd.

  7. Real time monitoring of pulsatile change in hemoglobin concentrations of cerebral tissue by a portable tissue oximeter with a 10-Hz sampling rate

    Science.gov (United States)

    Shiga, Toshikazu; Chihara, Eiichi; Tanabe, Kazuhisa; Tanaka, Yoshifumi; Yamamoto, Katsuyuki

    1998-01-01

    A portable CW tissue oximeter of a 10-Hz sampling rate was developed for examination of pulsatile components of the output signals as a mean of checking the signal reliability during long-term monitoring. Feasible studies were performed on a healthy subject. Changes in Hb and HbO2 signals of cerebral tissue were continuously measured by placing a photoprobe on the forehead during 6-hour sleep. Pulsatile changes in Hb and HbO2 were steadily observed over a whole period of the recording. The phase relation of pulsation in Hb and HbO2 was almost inverse. Not only information for reliable monitoring but also physiological parameters with respect to cerebral circulation and metabolism could be obtained by measuring the pulsatile components.

  8. Monitoring of regional cerebral blood flow by single photon emission tomography of I123-N-isopropyl-iodoamphetamine in epileptics

    International Nuclear Information System (INIS)

    Magistretti, P.L.; Uren, R.F.; Parker, J.A.; Royal, H.D.; Front, D.; Kolodny, G.M.

    1983-01-01

    In some patients with epileptic disorders it is difficult to accurately localize the seizure focus especially in the case of deep lesions. In an attempt to provide better localization of such foci we have used single photon emission tomography (SPECT) of a new radiopharmaceutical I 123 -N-isopropyl-iodoamphetamine (IMP) to measure regional cerebral blood flow (RCBF) in the ictal and interictal phases. Eight patients were studied. The location of the seizure focus was determined by intraoperative corticography operative findings and pathology in 5 patients and by neuropsychological testing and long-term EEG monitoring in the other three. The SPECT scan accurately localized the seizure focus in all patients. This modality also allowed the functional state of the seizure focus to be assessed. In five of the thirteen studies there was increased RCBF at the seizure focus. On four of these occasions the patients reported symptoms typical of their seizures. In the asymptomatic patient the focally increased RCBF corresponded with a very active superficial epileptic focus on EEG. These preliminary results suggest that SPECT scans of RCBF, will have considerable utility in the management of epileptics. This is particularly the case as the necessary instrumentation is already available in many hospitals, thus minimizing the cost of widespread application

  9. "Cognitive activity" monitored by non-invasive measurement of cerebral blood flow velocity and its application to the investigation of cerebral dominance.

    Science.gov (United States)

    Markus, H S; Boland, M

    1992-12-01

    We have developed a method of non-invasively detecting language lateralisation by measuring the increase in middle cerebral artery blood flow velocity occurring during a word association task, using transcranial Doppler ultrasonography. All exclusively right handed subjects (N = 12) showed a relative increase in left sided flow velocity during the task; mean rise was 4.04% on the left, and -0.03% on the right (p 5%) in left, compared with right, hemisphere flow velocity, and three showing only small differences between left and right sides, possibly reflecting bilateral language representation. This technique offers potential not only in studying patterns of cerebral dominance, but also in studying cognitive responses to other stimuli.

  10. Indexed bibliography on tritium: its sources and projections, behavior, measurement and monitoring techniques, health physics aspects, and waste management

    International Nuclear Information System (INIS)

    Dixon, M.N.; Holoway, C.F.; Houser, B.L.; Jacobs, D.G.

    1975-08-01

    References are presented to the world literature on sources of tritium in the environment, the migration of tritium in the environment and uptake by biological materials, monitoring methods, health aspects, and radioactive waste management. Subject, author, and permuted title indexes are included. (U.S.)

  11. Harmonisation (legal, dosimetric, quality aspects) of individual monitoring, and integration of monitoring for external and internal exposures (EURADOS working group)

    International Nuclear Information System (INIS)

    Lopez, M.A.; Currivan, L.; Falk, R.; Olko, P.; Wernli, C.; Castellani, C.M.; Dijk, J.W.E. van

    2003-01-01

    The EURADOS Working Group II on 'Harmonisation of individual monitoring' consists of experts from almost all EU Member States and Newly Associated States (NAS), involved in tasks related to the assessment of doses for internal and external radiation. The final objective is to achieve harmonisation in individual monitoring for occupational exposures. Sub-group 2 activities are focused on investigating how the results from personal dosemeters for external radiation and workplace monitoring and from monitoring for internal exposure can be combined into a complete and consistent system of individual monitoring. Three questionnaires were prepared, covering Individual monitoring of external radiation (Questionnaire 1), 'Internal exposure' (Questionnaire 2) and 'Natural sources of radiation at workplace' (Questionnaire 3). With the agreement of a 'contact-person' selected in each country, the distribution of the three EURADOS 2002 questionnaires was carried out by e-mail among the dosimetry facilities of 28 European countries. The preliminary results of these actions are presented here. (author)

  12. Monitoring of Optimal Cerebral Perfusion Pressure in Traumatic Brain Injured Patients Using a Multi-Window Weighting Algorithm.

    Science.gov (United States)

    Liu, Xiuyun; Maurits, Natasha M; Aries, Marcel J H; Czosnyka, Marek; Ercole, Ari; Donnelly, Joseph; Cardim, Danilo; Kim, Dong-Joo; Dias, Celeste; Cabeleira, Manuel; Smielewski, Peter

    2017-11-15

    Methods to identify an autoregulation guided "optimal" cerebral perfusion pressure (CPPopt) for traumatic brain injury patients (TBI) have been reported through several studies. An important drawback of existing methodology is that CPPopt can be calculated only in ∼50-60% of the monitoring time. In this study, we hypothesized that the CPPopt yield and the continuity can be improved significantly through application of a multi-window and weighting calculation algorithm, without adversely affecting preservation of its prognostic value. Data of 526 severe TBI patients admitted between 2003 and 2015 were studied. The multi-window CPPopt calculation was based on automated curve fitting in pressure reactivity index (PRx)-CPP plots using data from 36 increasing length time windows (2-8 h). The resulting matrix of CPPopts was then averaged in a weighted manner. The yield, continuity, and stability of CPPopt were studied. The difference between patients' actual CPP and CPPopt (ΔCPP) was calculated and the association with outcome was analyzed. Overall, the multi-window method demonstrated more continuous and stable presentation of CPPopt in this cohort. The new method resulted in a mean (±SE) CPPopt yield of 94% ± 2.1%, as opposed to the previous single-window-based CPPopt yield of 51% ± 0.94%. The stability of CPPopt across the whole monitoring period was significantly improved by using the new algorithm (p window algorithm and outcome was similar to that for CPPopt calculated on the basis of a single window. In conclusion, this study validates the use of a new multi-window and weighting algorithm for significant improvement of CPPopt yield in TBI patients. This methodological improvement is essential for its clinical application in future CPPopt trials.

  13. Preservation of Records, Knowledge and Memory across Generations (RK and M). Monitoring of Geological Disposal Facilities - Technical and Societal Aspects

    International Nuclear Information System (INIS)

    2014-01-01

    The OECD Nuclear Energy Agency (NEA) Radioactive Waste Management Committee (RWMC) Project on 'Preservation of Records, Knowledge and Memory across generations (RK and M)' (2011-2014) explores and aims to develop guidance on regulatory, policy, managerial, and technical aspects of long-term preservation of records, knowledge and memory of deep geological disposal facilities. While official responsibility for the preservation of records, knowledge and memory must remain with institutions, it is likely that local communities do or will have an important pragmatic role in maintaining the memory of a repository, e.g., by engaging at some level in its continued oversight. Monitoring - by collecting, interpreting and keeping data on a continuous basis - would serve the purpose of preserving records, knowledge and memory and continuous oversight. In order to tackle the subject it is important, on the one hand, to describe the role of monitoring in a technical perspective and, on the other, to understand the expectations of local stakeholders regarding monitoring. The present study report should therefore meet three objectives: - To present in a comprehensive way the general monitoring information, practices and approaches used in the various national geological disposal programmes and elaborated in a number of international projects; - To explore the role, needs and expectations of local communities regarding monitoring and RK and M preservation of deep geological repositories; - Based on the above review, to identify lessons learned and the rationale for monitoring geological disposal projects throughout their life-cycle stages. This report is based on two studies: an NEA internal report entitled 'Monitoring of Geological Disposal Facilities (August 2013)' which provides an overview on technical aspects of monitoring and an NEA public report entitled 'Local Communities' Expectations and Demands on Monitoring and the Preservation of Records, Knowledge and Memory of a Deep

  14. THEORETICAL AND PRACTICAL ASPECTS OF MONITORING OF REGION’S SOCIO-ECONOMIC DEVELOPMENT PROCESSES:

    Directory of Open Access Journals (Sweden)

    Valentyna Yakubiv

    2017-03-01

    Full Text Available The article defines the nature of socio-economic development processes monitoring in a region on the basis of systematization of scientific works on economics. The terms of monitoring introduction into the processes of socio-economic development of a region are defined. The difference between monitoring and standard statistic technology is explained. The fact that socio-economic processes monitoring is primarily directed at collection, examination and preparation of information for making and analyzing of economic decisions at different management levels is proved. The indicators by the direction “renewable energy and energy efficiency”, which are evaluated in the process of monitoring, are outlined. Major tasks of monitoring are defined and principles of its information basis forming are determined. Key words: decentralization, information basis, renewable energy, monitoring, region, development, socio-economic processes.

  15. Near-infrared spectroscopy is a promising noninvasive technique for monitoring the effects of feeding regimens on the cerebral and splanchnic regions.

    Science.gov (United States)

    Grometto, Alice; Pizzo, Benedetta; Strozzi, Maria Chiara; Gazzolo, Francesca; Gazzolo, Diego

    2018-02-01

    The effects of different milk and, or, administration regimens on cerebro-splanchnic perfusion are still a matter of debate. We investigated the effects of the bolus administration of breast milk or formula on cerebro-splanchnic oximetry, function and perfusion, assessed by near-infrared spectroscopy (NIRS). This observational study of 30 infants fed with breast (n = 15) or formula (n = 15) milk, and matched for gestational age and birth weight, was carried out in the neonatal intensive care unit of the C Arrigo Children's Hospital, Alessandria, Italy, a tertiary-level referral centre, from October 2015 to December 2016. NIRS monitoring parameters, such as cerebral and splanchnic oximetry, fraction of tissue oxygen extraction and the cerebral-splanchnic ratio, were recorded before, during and after feeding. Breast milk led to a significant increase in cerebro-splanchnic oximetry and tissue oxygen extraction (p < 0.001) during and after feeding, and the cerebro-splanchnic perfusion ratio was significantly higher (p < 0.001) in the breast than formula group. Our study results suggest that breast milk was better tolerated than formula, requiring lower energy expenditure and lower cerebro-splanchnic haemodynamic redistribution. The findings could prompt investigations using NIRS as a promising noninvasive tool for cerebral and splanchnic longitudinal monitoring during neonatal feeding. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  16. Framework for Structural Online Health Monitoring of Aging and Degradation of Secondary Systems due to some Aspects of Erosion

    International Nuclear Information System (INIS)

    Gribok, Andrei; Patnaik, Sobhan; Williams, Christian; Pattanaik, Marut; Kanakala, Raghunath

    2016-01-01

    This report describes the current state of research related to critical aspects of erosion and selected aspects of degradation of secondary components in nuclear power plants. The report also proposes a framework for online health monitoring of aging and degradation of secondary components. The framework consists of an integrated multi-sensor modality system which can be used to monitor different piping configurations under different degradation conditions. The report analyses the currently known degradation mechanisms and available predictive models. Based on this analysis, the structural health monitoring framework is proposed. The Light Water Reactor Sustainability Program began to evaluate technologies that could be used to perform online monitoring of piping and other secondary system structural components in commercial NPPs. These online monitoring systems have the potential to identify when a more detailed inspection is needed using real-time measurements, rather than at a pre-determined inspection interval. This transition to condition-based, risk informed automated maintenance will contribute to a significant reduction of operations and maintenance costs that account for the majority of nuclear power generation costs. There is unanimous agreement between industry experts and academic researchers that identifying and prioritizing inspection locations in secondary piping systems (for example, in raw water piping or diesel piping) would eliminate many excessive in-service inspections. The proposed structural health monitoring framework takes aim at answering this challenge by combining long-range guided wave technologies with other monitoring techniques, which can significantly increase the inspection length and pinpoint the locations that degraded the most. More widely, the report suggests research efforts aimed at developing, validating, and deploying online corrosion monitoring techniques for complex geometries, which are pervasive in NPPs.

  17. Framework for Structural Online Health Monitoring of Aging and Degradation of Secondary Systems due to some Aspects of Erosion

    Energy Technology Data Exchange (ETDEWEB)

    Gribok, Andrei [Idaho National Lab. (INL), Idaho Falls, ID (United States); Patnaik, Sobhan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Williams, Christian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Pattanaik, Marut [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kanakala, Raghunath [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    This report describes the current state of research related to critical aspects of erosion and selected aspects of degradation of secondary components in nuclear power plants. The report also proposes a framework for online health monitoring of aging and degradation of secondary components. The framework consists of an integrated multi-sensor modality system which can be used to monitor different piping configurations under different degradation conditions. The report analyses the currently known degradation mechanisms and available predictive models. Based on this analysis, the structural health monitoring framework is proposed. The Light Water Reactor Sustainability Program began to evaluate technologies that could be used to perform online monitoring of piping and other secondary system structural components in commercial NPPs. These online monitoring systems have the potential to identify when a more detailed inspection is needed using real-time measurements, rather than at a pre-determined inspection interval. This transition to condition-based, risk informed automated maintenance will contribute to a significant reduction of operations and maintenance costs that account for the majority of nuclear power generation costs. There is unanimous agreement between industry experts and academic researchers that identifying and prioritizing inspection locations in secondary piping systems (for example, in raw water piping or diesel piping) would eliminate many excessive in-service inspections. The proposed structural health monitoring framework takes aim at answering this challenge by combining long-range guided wave technologies with other monitoring techniques, which can significantly increase the inspection length and pinpoint the locations that degraded the most. More widely, the report suggests research efforts aimed at developing, validating, and deploying online corrosion monitoring techniques for complex geometries, which are pervasive in NPPs.

  18. Methodological Aspects of On-Farm Monitoring of Cropping Systems Management

    Directory of Open Access Journals (Sweden)

    Luca Bechini

    Full Text Available To conduct agro-environmental assessments at field and farm scale, detailed management data of crop and animal production systems are needed. However, this type of data is only rarely collected by public administrations. In the period 2005-2006, we made an experience of on-farm monitoring of cropping systems management, within a larger project aimed at assessing sustainability of agricultural systems in Italian Parks. In this paper, we describe and discuss the steps taken to carry out periodic face-to-face interviews in farms in the Sud Milano Agricultural Park (northern Italy. The first step was the selection of seven farms, which we identified by applying cluster analysis at a large database describing 733 farms of the Park. After having identified the most relevant agro-environmental issues in the studied area, we established a list of simple but sound indicators to evaluate the effects of agricultural management on the environment. The criteria used to select the indicators were that they should: be calculated on easily available data, not be based on direct measurements, make a synthesis of different aspects of reality, and be easily calculated and understood. The indicators selected evaluate nutrient management, fossil energy use, pesticide toxicity, soil management, and economic performance. Subsequently, we designed a data model to store input data used to calculate the indicators (farm configuration, flows of materials and money through the farm gate, animals and their rations, history of crop cultivation, crop management. The data model that we obtained is relatively complex, but adequate to store and analyse the large amount of data acquired during the two-year project. A questionnaire was developed to fully comply with the indicators selected and the data model. The questionnaire was used to carry out approximately six interviews per farm each year, with an investment of time of 1-2 hours per interview. Appropriate double checks of

  19. Evaluation of an activity monitor for the objective measurement of free-living physical activity in children with cerebral palsy.

    Science.gov (United States)

    Tang, Kit Tzu; Richardson, Alison M; Maxwell, Douglas; Spence, William D; Stansfield, Benedict W

    2013-12-01

    To explore the use of an activity monitor (AM) to objectively characterize free-living physical activity (F-LPA) in children with mobility impairment resulting from cerebral palsy (CP). First, a validation study compared outcomes from the AM with video evidence. Second, multiday F-LPA was characterized. Relationships between laboratory measures and F-LPA were explored. The evaluation study was conducted in a laboratory environment. F-LPA monitoring was conducted in the participants' free-living environment. Convenience sample of ambulatory children (N=15; 11 boys, 4 girls) aged 5 to 17 years with CP undergoing gait analysis. Not applicable. Accuracy of the AM for sitting/lying time, upright time, stepping time, and strides taken. Daily volumes of F-LPA of children with CP. AM outcomes in comparison with video-based analysis were (mean ± SD) 97.4%±2.7%, 101.1%±1.5%, 99.5%±6.6%, 105.6%±15.8%, and 103.8%±10.1% for sitting/lying time, upright time, standing time, stepping time, and stride count, respectively. Participants' daily F-LPA demonstrated considerable variation: mean standing time ± SD, 2.33±.96h/d; mean stepping time ± SD, 1.68±.86h/d; mean steps per day ± SD, 8477±4528; and mean sit-to-stand transitions per day ± SD, 76±49. Laboratory-measured cadence and mobility level were related to F-LPA, but not directly. The AM demonstrated excellent ability to determine sitting/lying and upright times in children with CP. Stepping time and stride count had lower levels of agreement with video-based analysis but were comparable to findings in previous studies. Crouch gait and toe walking had an adverse effect on outcomes. The F-LPA data provided additional information on children's performance not related to laboratory measures, demonstrating the added value of using this objective measurement technique. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. THE ASPECTS OF THE INFORMATIONAL-COMMUNICATIVE COMPETENCE’S MONITORING

    Directory of Open Access Journals (Sweden)

    Kseniya O. Morozova

    2012-12-01

    The structure of the pedagogical monitoring program, its main components such as forms, methods, criteria are described in the article. The program included special case for each component of IC-competence’s structure. The ways of the effective realization and development of monitoring the basic knowledge, skills and attitudes of the information-communication competence are determined in the work.

  1. Beyond Self-Monitoring: Understanding Non-functional Aspects of Home-based Healthcare Technology

    DEFF Research Database (Denmark)

    Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    Monitoring of health parameters in non-clinical settings is one strategy to address the increasingly aging population and age-related disabilities and diseases. However, challenges exist when introducing self-monitoring activities in people’s everyday life. An active lifestyle can challenge......-technical complexities in home-based healthcare technologies through three case studies of self-monitoring: 1) pre-eclampsia (i.e. pregnancy poisoning), 2) heart conditions, and 3) preventive care. Through the analysis seven themes emerged (people, resources, places, routines, knowledge, control and motivation) that can...... facilitate the understanding of home-based healthcare activities. We present three modes of self-monitoring use and provide a set of design recommendations for future Ubicomp designs of home-based healthcare technology....

  2. System aspect course of creation of information and analytical system of environmental monitoring and control

    Science.gov (United States)

    Reshnyak, V. I.; Sokolov, S. S.; Chernyi, S. G.; Storchak, T. V.; Tihomirov, Ya N.

    2017-10-01

    Objects of oil production have significantly changed natural landscapes of the district, breakouts of oil pipelines cause irreparable harm to the nature. Due to rather strong anthropogenous loading it was necessary to take measures for control of negative impact on the environment. Resolution No. 485-p of December 23, 2011, was accepted in 2011 at the level of the district Government. According to this resolution the local environmental monitoring has to be carried out in Yugra in the territory of areas of oil production. The monitoring purpose on the license areas of oil production is control of a condition and tracing of change tendencies in the environment. The monitoring is carried out by sampling, sample analysis in a chemical laboratory and presentation of results. The final results of the monitoring have to stimulate nature users to improve their own and use newer technologies, which will promote improvement of the environment condition.

  3. FRAMEWORK FOR STRUCTURAL ONLINE HEALTH MONITORING OF AGING AND DEGRADATION OF SECONDARY PIPING SYSTEMS DUE TO SOME ASPECTS OF EROSION

    Energy Technology Data Exchange (ETDEWEB)

    Gribok, Andrei V.; Agarwal, Vivek

    2017-06-01

    This paper describes the current state of research related to critical aspects of erosion and selected aspects of degradation of secondary components in nuclear power plants (NPPs). The paper also proposes a framework for online health monitoring of aging and degradation of secondary components. The framework consists of an integrated multi-sensor modality system, which can be used to monitor different piping configurations under different degradation conditions. The report analyses the currently known degradation mechanisms and available predictive models. Based on this analysis, the structural health monitoring framework is proposed. The Light Water Reactor Sustainability Program began to evaluate technologies that could be used to perform online monitoring of piping and other secondary system structural components in commercial NPPs. These online monitoring systems have the potential to identify when a more detailed inspection is needed using real time measurements, rather than at a pre-determined inspection interval. This transition to condition-based, risk-informed automated maintenance will contribute to a significant reduction of operations and maintenance costs that account for the majority of nuclear power generation costs. Furthermore, of the operations and maintenance costs in U.S. plants, approximately 80% are labor costs. To address the issue of rising operating costs and economic viability, in 2017, companies that operate the national nuclear energy fleet started the Delivering the Nuclear Promise Initiative, which is a 3 year program aimed at maintaining operational focus, increasing value, and improving efficiency. There is unanimous agreement between industry experts and academic researchers that identifying and prioritizing inspection locations in secondary piping systems (for example, in raw water piping or diesel piping) would eliminate many excessive in-service inspections. The proposed structural health monitoring framework takes aim at

  4. Fundamental aspects of the integration of seismic monitoring with numerical modelling.

    CSIR Research Space (South Africa)

    Mendecki, AJ

    2001-06-01

    Full Text Available Numerical modelling of rock-mass response to underground excavations is of vital importance for the decision-making process in designing and running a mine. Likewise, seismic monitoring with state-of-the-art local seismic systems is indispensable...

  5. Monitoring of cerebral blood flow autoregulation in adults undergoing sevoflurane anesthesia: a prospective cohort study of two age groups.

    Science.gov (United States)

    Goettel, Nicolai; Patet, Camille; Rossi, Ariane; Burkhart, Christoph S; Czosnyka, Marek; Strebel, Stephan P; Steiner, Luzius A

    2016-06-01

    Autoregulation of blood flow is a key feature of the human cerebral vascular system to assure adequate oxygenation and metabolism of the brain under changing physiological conditions. The impact of advanced age and anesthesia on cerebral autoregulation remains unclear. The primary objective of this study was to determine the effect of sevoflurane anesthesia on cerebral autoregulation in two different age groups. This is a follow-up analysis of data acquired in a prospective observational cohort study. One hundred thirty-three patients aged 18-40 and ≥65 years scheduled for major noncardiac surgery under general anesthesia were included. Cerebral autoregulation indices, limits, and ranges were compared in young and elderly patient groups. Forty-nine patients (37 %) aged 18-40 years and 84 patients (63 %) aged ≥65 years were included in the study. Age-adjusted minimum alveolar concentrations of sevoflurane were 0.89 ± 0.07 in young and 0.99 ± 0.14 in older subjects (P blood pressure range of 13.8 ± 9.8 mmHg in young and 10.2 ± 8.6 mmHg in older patients (P = 0.079). The lower limit of autoregulation was 66 ± 12 mmHg and 73 ± 14 mmHg in young and older patients, respectively (P = 0.075). The association between sevoflurane concentrations and autoregulatory capacity was similar in both age groups. Our data suggests that the autoregulatory plateau is shortened in both young and older patients under sevoflurane anesthesia with approximately 1 MAC. Lower and upper limits of cerebral blood flow autoregulation, as well as the autoregulatory range, are not influenced by the age of anesthetized patients. Trial registration ClinicalTrials.gov (NCT00512200).

  6. Aspects of structural health and condition monitoring of offshore wind turbines

    Science.gov (United States)

    Antoniadou, I.; Dervilis, N.; Papatheou, E.; Maguire, A. E.; Worden, K.

    2015-01-01

    Wind power has expanded significantly over the past years, although reliability of wind turbine systems, especially of offshore wind turbines, has been many times unsatisfactory in the past. Wind turbine failures are equivalent to crucial financial losses. Therefore, creating and applying strategies that improve the reliability of their components is important for a successful implementation of such systems. Structural health monitoring (SHM) addresses these problems through the monitoring of parameters indicative of the state of the structure examined. Condition monitoring (CM), on the other hand, can be seen as a specialized area of the SHM community that aims at damage detection of, particularly, rotating machinery. The paper is divided into two parts: in the first part, advanced signal processing and machine learning methods are discussed for SHM and CM on wind turbine gearbox and blade damage detection examples. In the second part, an initial exploration of supervisor control and data acquisition systems data of an offshore wind farm is presented, and data-driven approaches are proposed for detecting abnormal behaviour of wind turbines. It is shown that the advanced signal processing methods discussed are effective and that it is important to adopt these SHM strategies in the wind energy sector. PMID:25583864

  7. Some aspects on wind turbines monitoring. General considerations and loads on horizontal wind turbines

    International Nuclear Information System (INIS)

    Cuerva, A.

    1996-01-01

    The concept Monitoring applied to the Wind Energy technology is similar to the definition used in other branches of Science or Engineering, this is knowing values of variables which have to do with a mechanic system, in our case a wind turbine. These mentioned parameters may have different relationships to our wind turbine; some of them come from the environment the machine is operating in, others, are a measure of how properly the machine is working, and finally, the rest are an assessment of the systems health during its life. In this chapter we will answer questions such as: What do we need to measure? Why is Monitoring mandatory (from the different points of view of people involved in this world)? How can we measure a wind turbine depending on our objectives (Technic, tools, guidance, recommendations, etc.)? And finally What can we expect in the near future? The author wants the reader to keep the idea in mind that Monitoring means the richest and most accurate knowledge on wind turbine's operation (Its environment, performances or health). This is the first step that allows us to optimize the operation mode of the machine and improve it (design, manufacturing, even the used modeling tools). When there is so much money involved, this fact becomes a must. (Author)

  8. Psycho-social aspects of personal health monitoring: a descriptive literature review.

    Science.gov (United States)

    Muehlan, Holger; Schmidt, Silke

    2013-01-01

    We aimed at providing a short review on already published studies addressing psycho-social issues of personal health monitoring (PHM). Both core questions addressed within this review are: What is the impact of PHM on intended psycho-social and health-related outcomes? And which psycho-social issues affected by or related to PHM have already been investigated? This descriptive review based on a literature search using various databases (Psycinfo, Psyndex, Pubmed, SSCI). Resulting 428 abstracts were coded regarding their psycho-social content. Inspection of results was carried out along the relevance of the papers regarding psycho-social issues. Research in PHM focuses on telemonitoring and smart home applications: Tele-monitoring studies are directed to outcome-related questions, smart home studies to feasibility issues. Despite of technological matters, comparability of both systems in psycho-social issues is lacking. Tele-monitoring has been proven for impact on patient groups with chronic diseases, yet smart home still lacks evidence in health-related and psycho-social matters. Smart home applications have been investigated with respect to attitudes, perceptions and concerns of end-users, telemonitoring regarding acceptance and adherence.

  9. Some aspects on wind turbines monitoring. General considerations and loads on horizontal wind turbines

    Energy Technology Data Exchange (ETDEWEB)

    Cuerva, A.

    1996-12-01

    The concept Monitoring applied to the Wind Energy technology is similar to the definition used in other branches of Science or Engineering, this is knowing values of variables which have to do with a mechanic system, in our case a wind turbine. These mentioned parameters may have different relationships to our wind turbine; some of them come from the environment the machine is operating in, others, are a measure of how properly the machine is working, and finally, the rest are an assessment of the ``system`s health`` during its ``life``. In this chapter we will answer questions such as: What do we need to measure? Why is Monitoring mandatory (from the different points of view of people involved in this world)? How can we measure a wind turbine depending on our objectives (Technic, tools, guidance, recommendations, etc)? And finally What can we expect in the near future?. The author wants the reader to keep the idea in mind that Monitoring means the richest and most accurate knowledge on wind turbine`s operation (Its environment, performances of health). This is the first step that allows us to optimize the operation mode of the machine and improve it (design, manufacturing, even the used modeling tools). When there is so much money involved, this fact becomes a must. (Author)

  10. Aspects of structural health and condition monitoring of offshore wind turbines.

    Science.gov (United States)

    Antoniadou, I; Dervilis, N; Papatheou, E; Maguire, A E; Worden, K

    2015-02-28

    Wind power has expanded significantly over the past years, although reliability of wind turbine systems, especially of offshore wind turbines, has been many times unsatisfactory in the past. Wind turbine failures are equivalent to crucial financial losses. Therefore, creating and applying strategies that improve the reliability of their components is important for a successful implementation of such systems. Structural health monitoring (SHM) addresses these problems through the monitoring of parameters indicative of the state of the structure examined. Condition monitoring (CM), on the other hand, can be seen as a specialized area of the SHM community that aims at damage detection of, particularly, rotating machinery. The paper is divided into two parts: in the first part, advanced signal processing and machine learning methods are discussed for SHM and CM on wind turbine gearbox and blade damage detection examples. In the second part, an initial exploration of supervisor control and data acquisition systems data of an offshore wind farm is presented, and data-driven approaches are proposed for detecting abnormal behaviour of wind turbines. It is shown that the advanced signal processing methods discussed are effective and that it is important to adopt these SHM strategies in the wind energy sector.

  11. Middle latency auditory-evoked potential index monitoring of cerebral function to predict functional outcome after emergency craniotomy in patients with brain damage.

    Science.gov (United States)

    Tsurukiri, Junya; Nagata, Katsuhiro; Hoshiai, Akira; Oomura, Taishi; Jimbo, Hiroyuki; Ikeda, Yukio

    2015-10-20

    At present, no satisfactory reports on the monitoring of cerebral function to predict functional outcomes after brain damage such as traumatic brain injury (TBI) and stroke. The middle latency auditory-evoked potential index (MLAEPi) monitor (aepEX plus®, Audiomex, UK) is a mobile MLAEP monitor measuring the degree of consciousness that is represented by numerical values. Hence, we hypothesized that MLAEPi predicts neurological outcome after emergency craniotomy among patients with disturbance of consciousness (DOC), which was caused by brain damage. The afore-mentioned patients who underwent emergency craniotomy within 12 h of brain damage and were subsequently monitored using MLAEPi were enrolled in this study. DOC was defined as an initial Glasgow Coma Scale score craniotomy. Neurological outcome was evaluated before discharge using a cerebral performance category (CPC) score and classified into three groups: favorable outcome group for a CPC score of 1 or 2, unfavorable outcome group for a score of 3 or 4, and brain dead (BD) group for a score of 5. Thirty-two patients were included in this study (17 with TBIs and 15 with acute stroke). Regarding outcome, 10 patients had a favorable outcome, 15 had an unfavorable outcome, and 7 were pronounced BD. MLAEPi was observed to be significantly higher on day 5 than that observed immediately after craniotomy in cases of favorable or unfavorable outcome (63 ± 3.5 vs. 36 ± 2.5 in favorable outcome; 63 ± 3.5 vs. 34 ± 1.8 in unfavorable outcome). MLAEPi was significantly lower in BD patients than in those with a favorable or unfavorable outcome on day 3 (24 ± 4.2 in BD vs. 52 ± 5.2 and 45 ± 2.7 in favorable and unfavorable outcome, respectively) and after day 4. MLAEPi was significantly higher in patients with a favorable outcome than in those with a favorable or unfavorable outcome after day 6 (68 ± 2.3 in favorable outcome vs. 48 ± 2.3 in unfavorable outcome). We believe that MLAEPi satisfactorily denotes

  12. Development of near-infrared spectroscopy for monitoring cerebral regional blood oxygenation and volume in the human newborn

    Science.gov (United States)

    Lehr, H. P.; Wickramasinghe, Yappa A.; Rolfe, Peter J.

    1997-08-01

    Human newborns can suffer from neuro-developmental abnormalities, when they are born as preterms. With near infrared spectroscopy (NIRS) it is possible to investigate any brain disease occurring together with these neuro- abnormalities. The specific absorption properties of haemoglobin and oxygenated haemoglobin in the near infrared region allow to measure the oxygenation status and several other variables. Local variations in cerebral blood volume (CBV) and blood oxygenation is important for a better understanding of these abnormalities.

  13. More frequent, more costly? Health economic modelling aspects of monitoring glaucoma patients in England.

    Science.gov (United States)

    Boodhna, Trishal; Crabb, David P

    2016-10-22

    Chronic open angle glaucoma (COAG) is an age-related eye disease causing irreversible loss of visual field (VF). Health service delivery for COAG is challenging given the large number of diagnosed patients requiring lifelong periodic monitoring by hospital eye services. Yet frequent examination better determines disease worsening and speed of VF loss under treatment. We examine the cost-effectiveness of increasing frequency of VF examinations during follow-up using a health economic model. Two different VF monitoring schemes defined as current practice (annual VF testing) and proposed practice (three VF tests per year in the first 2 years after diagnosis) were examined. A purpose written health economic Markov model is used to test the hypothesis that cost effectiveness improves by implementing proposed practice on groups of patients stratified by age and severity of COAG. Further, a new component of the model, estimating costs of visual impairment, was added. Results were derived from a simulated cohort of 10000 patients with quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) used as main outcome measures. An ICER of £21,392 per QALY was derived for proposed practice improving to a value of £11,382 once savings for prevented visual impairment was added to the model. Proposed practice was more cost-effective in younger patients. Proposed practice for patients with advanced disease at diagnosis generated ICERs > £60,000 per QALY; these cases would likely be on the most intensive treatment pathway making clinical information on speed of VF loss redundant. Sensitivity analysis indicated results to be robust in relation to hypothetical willingness to pay threshold identified by national guidelines, although greatest uncertainty was allied to estimates of implementation and visual impairment costs. Increasing VF monitoring at the earliest stages of follow-up for COAG appears to be cost-effective depending on reasonable

  14. More frequent, more costly? Health economic modelling aspects of monitoring glaucoma patients in England

    Directory of Open Access Journals (Sweden)

    Trishal Boodhna

    2016-10-01

    Full Text Available Abstract Background Chronic open angle glaucoma (COAG is an age-related eye disease causing irreversible loss of visual field (VF. Health service delivery for COAG is challenging given the large number of diagnosed patients requiring lifelong periodic monitoring by hospital eye services. Yet frequent examination better determines disease worsening and speed of VF loss under treatment. We examine the cost-effectiveness of increasing frequency of VF examinations during follow-up using a health economic model. Methods Two different VF monitoring schemes defined as current practice (annual VF testing and proposed practice (three VF tests per year in the first 2 years after diagnosis were examined. A purpose written health economic Markov model is used to test the hypothesis that cost effectiveness improves by implementing proposed practice on groups of patients stratified by age and severity of COAG. Further, a new component of the model, estimating costs of visual impairment, was added. Results were derived from a simulated cohort of 10000 patients with quality-adjusted life years (QALYs and incremental cost-effectiveness ratios (ICERs used as main outcome measures. Results An ICER of £21,392 per QALY was derived for proposed practice improving to a value of £11,382 once savings for prevented visual impairment was added to the model. Proposed practice was more cost-effective in younger patients. Proposed practice for patients with advanced disease at diagnosis generated ICERs > £60,000 per QALY; these cases would likely be on the most intensive treatment pathway making clinical information on speed of VF loss redundant. Sensitivity analysis indicated results to be robust in relation to hypothetical willingness to pay threshold identified by national guidelines, although greatest uncertainty was allied to estimates of implementation and visual impairment costs. Conclusion Increasing VF monitoring at the earliest stages of follow-up for COAG

  15. A novel multimodal computational system using near-infrared spectroscopy to monitor cerebral oxygenation during assisted ventilation in CDH patients.

    Science.gov (United States)

    Cruz, Stephanie M; Akinkuotu, Adesola C; Rusin, Craig G; Cass, Darrell L; Lee, Timothy C; Welty, Stephen E; Olutoye, Oluyinka O

    2016-01-01

    The aim of this study was to create a computational simulator to serve as an early alert system for cerebral hypoxemia prior to the onset of clinical symptoms. Neonates with congenital diaphragmatic hernia (Jan 2010-Dec 2014) were recruited to collect continuous measurements of cerebral tissue oxygen saturation (cStO2) using a near-infrared spectroscopy (NIRS) device (FORE-SIGHT®, CASMED). Clinicians were blinded to NIRS data and treated infants based on pre-established clinical protocols. Charts were reviewed retrospectively to identify clinical events of hypoxemia (spontaneous, sustained decrease in preductal SpO2<85% leading to ventilator changes). We developed a computational algorithm that determined baseline values, variability and event data for each patient. Twenty-three of 36 patients enrolled met data criteria. The algorithm anticipated an event at least 15 minutes prior to the event in 77% of cases, with an average pre-event detection of 47 minutes (range 16-122 minutes). Post-event StO2 (SpO2<85%) was determined to be 63.7% ± 11.7. In this computational model, the sensitivity to distinguish low states of cerebral perfusion was 94% with a specificity of 96%. We have developed a computational algorithm with an early warning system that has the potential of being translated into a real-time clinical interface that may improve management of neonates. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Radioactivity in the scrap recycling process: Radiation protection aspects and experimental monitoring problems

    International Nuclear Information System (INIS)

    Sacco, D.; Ruggeri, F.; Bindi, G.; Bonanni, A.; Casciardi, S.; Delia, R.; Loppa, A.; Rossi, P.; Venturini, L.

    1996-01-01

    The steel scrap recycling by steel mill is increasing moved by profits and by purpose of protection of environmental resources. Besides the use of radioactive sources in several fields (medical, industrial and in scientific researches) on one hand, and the disposal of made radioactive materials from nuclear reactors on the other one, makes the likelihood no more negligible that some radionuclides could be found, accidental y or fraudulently, in steel recycling scrap. Radiation protection problems for surveillance both employees in the production cycle and of people and environment in general arose. First of all, we characterize different type of radioactive materials that can found in scraps, pointing out the potential hazards from exposure of workers and people and from environmental contamination, related to physical and chemical specifications of the involved radionuclides. Some suitable monitoring equipment for scrap recycling facilities are discussed, related to the different step of production cycle (transport, storage, manipulation and melting). At last experimental data, taken in some periods of the monitoring campaign made at the Italian border on imported scraps, are presented. (author)

  17. Reference values for three channels of amplitude-integrated EEG using the Brainz BRM3 cerebral function monitor in normal term neonates: a pilot study.

    Science.gov (United States)

    Gupta, Nimisha; Pappas, Athina; Thomas, Ronald; Shankaran, Seetha

    2015-03-01

    Amplitude-integrated electroencephalography (EEG) is a form of continuous EEG using a select number of electrodes (2-4), which can be used for bedside monitoring of brain functions in critically ill neonates. There is a paucity of normative amplitude-integrated EEG data for term healthy neonates especially for unilateral channels that are available for newer cerebral function monitors. To define absolute amplitudes for all three available channels and also to determine if route of delivery or presence of a caput succedaneum would affect amplitude-integrated EEG amplitude voltages. This is a prospective observational study of 80 healthy term neonates (gestational age ≥ 38 weeks) who had three-channel amplitude-integrated EEG recorded for 90 minutes within 12 hours of birth using the Brainz BRM3 cerebral function monitor. Median maximum and median minimum voltages obtained were 16.96 μV and 8.13 μV for the cross-cerebral (CC), 14.42 μV and 7.13 μV for the right unilateral, and 13.16 μV and 6.51 μV for the left unilateral aEEG channels, respectively. There were no statistically significant difference amplitude voltages for any channel based on route of delivery. The presence of a caput succedaneum was associated with a decrease in the median and mean of the maximum and minimum amplitude voltages for CC channel. Median maximum and median minimum voltages for the CC channel among the caput and normal scalp examination groups were 14.62 μV vs 17.27 μV (P = 0.022) and 7.21 μV vs 8.24 μV (P = 0.004), respectively. Similarly, mean maximum and mean minimum voltages for the CC channel were 15.42 μV vs 17.59 μV (P = 0.038) and 7.27 μV vs 8.25 μV (P = 0.005) in the caput and normal scalp examination groups, respectively. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  19. Geometric Aspects of Ground Augmentation of Satellite Networks for the Needs of Deformation Monitoring

    Science.gov (United States)

    Protaziuk, Elżbieta

    2016-06-01

    Satellite measurements become competitive in many tasks of engineering surveys, however, in many requiring applications possibilities to apply such solutions are still limited. The possibility to widely apply satellite technologies for displacements measurements is related with new challenges; the most important of them relate to increasing requirements concerning the accuracy, reliability and continuity of results of position determination. One of the solutions is a ground augmentation of satellite network, which intention is to improve precision of positioning, ensure comparable accuracy of coordinates and reduce precision fluctuations over time. The need for augmentation of GNSS is particularly significant in situations: where the visibility of satellites is poor because of terrain obstacles, when the determined position is not precise enough or a satellites constellation does not allow for reliable positioning. Ground based source/sources of satellite signal placed at a ground, called pseudosatellites, or pseudolites were intensively investigated during the last two decades and finally were developed into groundbased, time-synchronized transceivers, that can transmit and receive a proprietary positioning signal. The paper presents geometric aspects of the ground based augmentation of the satellite networks using various quality measures of positioning geometry, which depends on access to the constellation of satellites and the conditions of the observation environment. The issue of minimizing these measures is the key problem that allows to obtain the position with high accuracy. For this purpose, the use of an error ellipsoid is proposed and compared with an error ellipse. The paper also describes the results of preliminary accuracy analysis obtained at test area and a comparison of various measures of the quality of positioning geometry.

  20. Experimental Aspects in the Vibration-Based Condition Monitoring of Large Hydrogenerators

    Directory of Open Access Journals (Sweden)

    Geraldo Carvalho Brito Junior

    2017-01-01

    Full Text Available Based on experimental observations on a set of twenty 700 MW hydrogenerators, compiled from several technical reports issued over the last three decades and collected from the reprocessing of the vibration signals recorded during the last commissioning tests, this paper shows that the accurate determination of the journal bearings operating conditions may be a difficult task. It shows that the outsize bearing brackets of large hydrogenerators are subject to substantial dimensional changes caused by external agents, like the generator electromagnetic field and the bearing cooling water temperature. It also shows that the shaft eccentricity of a journal bearing of a healthy large hydrogenerator, operating in steady-state condition, may experience unpredictable, sudden, and significant changes without apparent reasons. Some of these phenomena are reproduced in ordinary commissioning tests or may be noticed even during normal operation, while others are rarely observed or are only detected through special tests. These phenomena modify journal bearings stiffness and damping, changing the hydrogenerator dynamics, creating discrepancies between theoretical predictions and experimental measurements, and making damage detection and diagnostics difficult. Therefore, these phenomena must be analyzed and considered in the application of vibration-based condition monitoring to these rotating machines.

  1. Monitoring cerebral hemodynamics with transcranial Doppler ultrasound during cognitive and exercise testing in adults following unilateral stroke.

    Science.gov (United States)

    Watt, Brian P; Burnfield, Judith M; Truemper, Edward J; Buster, Thad W; Bashford, Gregory R

    2012-01-01

    An observational study was performed as a preliminary investigation into the use of transcranial Doppler ultrasound (TCD) for recording cerebral hemodynamic changes during multiple tasks. TCD is a method of measuring cerebral blood flow (CBF) using ultrasound transducers in contact with the surface of the head. Using the maximum flow envelope of the Doppler spectrum returning from the middle cerebral artery (MCA), standard clinical flow indices can be calculated and displayed in real time providing information concerning perturbations in CBF and their potential cause. These indices as well as flow velocity measurements have been recognized as useful in measuring changes in responses to various stimulus that can be used to indicate cardiovascular health. For this study, the pulsatility index (PI) and resistivity index (RI) were chosen since they indicate composite changes indicative of vasoconstriction and vasodilatation which are normal hemodynamic responses under appropriate conditions. A total of eleven participants were recruited to take part in this study. Nine of these individuals had no known disability (Controls); two had experienced unilateral cerebrovascular accidents (Strokes) in the ipsilateral MCA distribution. Maximum velocity envelopes of the spectral Doppler data were recorded using a fixation device designed to stabilize two ultrasound probes (2 MHz) to sample the bilateral MCAs CBF. These measures were performed separately while the subject performed four activities: 1) rest, 2) cognitive challenge, 3) cardiovascular exercise, and 4) simultaneous exercise and cognitive challenge. Cardiovascular parameters were calculated from the data by extracting maximum (Vs) and minimum flow velocities (Vd), PI, RI, and time signatures for each cardiac cycle. The data for all participants shows significant changes in cardiovascular parameters between states of rest and exercise, as well as slight trends across time. Although the data are preliminary, they show

  2. [Epidemiology, follow-up, monitoring and other aspects of inflammatory bowel disease].

    Science.gov (United States)

    García-López, Santiago

    2015-09-01

    There are no important new data on the aetiology of inflammatory bowel disease. However, some new data were presented on the possible importance of certain nutrients or drugs in the genesis of the disease, as well as other data related to genetic features and their relationship with the microbiota. A highly interesting study suggested the strong potential of serological studies in predicting the course of Crohn's disease. The value of magnetic resonance imaging and the potential of low-radiation-dose tomography were reaffirmed in the monitoring and follow-up of patients and their treatments. Studies also confirmed the utility confirmed of new (and more comfortable) methods of home measurement of faecal calprotectin levels. In individualized therapy, attempts are being made to increase the practical application of new results on anti-TNF levels and their antibodies, for example, by identifying the utility of non-trough levels. We believe that the results presented on the impact of the disease on patients themselves were especially important, from their own perspective and in diverse setting. This impact is important both for patients (not only because of the repercussions of the disease on their quality of life but also on their mental health, disability, stress, and financial situation, etc.) and for their families. Finally, interesting results were presented of well-performed studies on colorectal cancer prevention in inflammatory bowel disease. These results confirm chromoendoscopy as a key technique but suggest that technological advances could change this situation, thus simplifying prevention. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  3. Cerebral oximetry monitoring in the management of severe hypoxaemia associated with transposition of the great arteries with balloon atrial septostomy.

    Science.gov (United States)

    Pérez Moreno, J C; Nájera Losada, D C; Sanabria Carretero, P; Paredes Lacave, Á; Benito Bartolomé, F

    2018-01-21

    Transposition of the great arteries (D-TGA) is one of the most common congenital heart diseases requiring neonatal surgical intervention. In the desperately ill neonate with TGA and the resultant hypoxaemia, acidemia, and congestive heart failure, improvement is often obtained with balloon atrial septostomy (BAS). Current methods employed to evaluate oxygen delivery and tissue consumption are frequently nonspecific. Near infrared spectroscopy (NIRS) allows a continuous non-invasive measurement of tissue oxygenation which reflects perfusion status in real time. Because little is known about the direct effect of BAS on the neonatal brain and on cerebral oxygenation, we measured the effectiveness of BAS in two patients with D-TGA using NIRS before and after BAS. We concluded BAS improves cerebral oxygen saturation in neonates with D-TGA. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Rodent stroke induced by photochemical occlusion of proximal middle cerebral artery: Evolution monitored with MR imaging and histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Chen Feng [Department of Radiology, Faculty of Medicine, Catholic University of Leuven (Belgium); Department of Radiology, Zhong Da Hospital, Southeast University, Nanjing (China); Suzuki, Yasuhiro [Department of Molecular and Vascular Biology, Faculty of Medicine, Catholic University of Leuven (Belgium); Department of Pharmacology, Hamamashu University, Hamamashu (Japan); Nagai, Nobuo [Department of Molecular and Vascular Biology, Faculty of Medicine, Catholic University of Leuven (Belgium); Jin, Lixin [Department of Radiology, Faculty of Medicine, Catholic University of Leuven (Belgium); Yu Jie [Department of Radiology, Faculty of Medicine, Catholic University of Leuven (Belgium); Wang Huaijun [Department of Radiology, Faculty of Medicine, Catholic University of Leuven (Belgium); Marchal, Guy [Department of Radiology, Faculty of Medicine, Catholic University of Leuven (Belgium); Ni Yicheng [Department of Radiology, Faculty of Medicine, Catholic University of Leuven (Belgium)]. E-mail: Yicheng.Ni@med.kuleuven.ac.be

    2007-07-15

    Purpose: To longitudinally investigate stroke in rats after photothrombotic occlusion of proximal middle cerebral artery (MCA) with magnetic resonance imaging (MRI) in correlation with histopathology. Materials and methods: Forty-two rats were subjected to photochemical MCA occlusion and MRI at 1.5 T, and sacrificed in seven groups (n = 6 each) at the following time points: 1, 3, 6 and 12 h, and at day 1, 3 and 9. T2-weighted (T2WI) and diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) map was performed in all rats. Contrast-enhanced T1-weighted imaging (CE-T1WI) was compared to intravital staining with Evans blue in one group for assessing blood-brain barrier (BBB) integrity. The brain was stained histochemically with triphenyl tetrazolium chloride (TTC) and processed for pathological assessment. The evolutional changes of relative lesion volume, signal intensity (SI), and the BBB integrity on MRI with corresponding histopathology were evaluated. Results: The ischemic lesion volume reached a maximum around 12 h to day 1 as visualized successively by DWI, ADC map and T2WI, implicating the evolving pathology from cytotoxic edema through vasogenic edema to tissue death. The ADC of brain infarction underwent a significant reversion after 12 h, reflecting the colliquative necrosis. On CE-T1WI, BBB leakage peaked at 6 h and at day 3 with a transitional partial recovery around 24 h. The infarct volume on T2WI, DWI and ADC map matched well with that on TTC staining at 12 h and at day 1 (p > 0.05). Conclusion: The evolution of the present photothrombotic stroke model in rats could be characterized by MRI. The obtained information may help longitudinal studies of cerebral ischemia and anti-stroke agents using the same model.

  5. Comparative evaluation of the cerebral state index/sup TM/ and bispectral index/sup TM/ monitoring during propofol-remifentanil anesthesia for open heart surgery

    International Nuclear Information System (INIS)

    Shahbazi, S.; Saem, J.

    2007-01-01

    The Cerebral State index (CSI) is a new index based on electroencephalogram to monitor depth of anesthesia. Transferring guidelines for titration of the Bispectral index (BIS) to the CSI depends on their compatibility. We compared the relationship between BIS and CSI values during propofol-remifentanil anesthesia. Forty one adult patients about to have open heart surgeries were enrolled. The skin was prepped and electrodes of both monitors were applied according to the manufacturers recommendations. The anesthesia was induced by midazolam, propofol, remifentanil and pancuronium and maintained by propofol and remifentanil and 50% nitrous oxide in oxygen. The BIS and CSI values were recorded in 37 pre-determined milestones during the operation and the anesthetic drugs were adjusted according to clinical signs of light anesthesia regardless of the CSI or BIS values. The BIS and CSI values decreased progressively from pre induction values of 93.15 (55-100) and 88.86 (52-100) to post induction values of 38.72 (16-71) and 40.27 (5-69), respectively. These values showed good linear correlation during laryngoscopy, before and after surgical incision and during CPB; R=0.695 with determination coefficient of 0.483. We found a good correlation between BIS and CSI values. Our results might serve as a blue print for a rational translation of BIS into CSI values. (author)

  6. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning - Autism and Developmental Disabilities Monitoring Network, USA, 2008.

    Science.gov (United States)

    Christensen, Deborah; Van Naarden Braun, Kim; Doernberg, Nancy S; Maenner, Matthew J; Arneson, Carrie L; Durkin, Maureen S; Benedict, Ruth E; Kirby, Russell S; Wingate, Martha S; Fitzgerald, Robert; Yeargin-Allsopp, Marshalyn

    2014-01-01

    The aim of this study was to report the prevalence and characteristics of children with cerebral palsy (CP). Children with CP (n=451) were ascertained by the Autism and Developmental Disabilities Monitoring (ADDM) Network, a population-based, record-review surveillance system monitoring CP in four areas of the USA. Prevalence was calculated as the number of children with CP among all 8-year-old children residing in these areas in 2008. Motor function was categorized by Gross Motor Function Classification System level and walking ability. Co-occurring autism spectrum disorders (ASD) and epilepsy were ascertained using ADDM Network surveillance methodology. The period prevalence of CP for 2008 was 3.1 per 1000 8-year-old children (95% confidence interval 2.8-3.4). Approximately 58% of children walked independently. Co-occurring ASD frequency was 6.9% and was higher (18.4%) among children with non-spastic CP, particularly hypotonic CP. Co-occurring epilepsy frequency was 41% overall, did not differ by ASD status or CP subtype, and was highest (67%) among children with limited or no walking ability. The prevalence of CP in childhood from US surveillance data has remained relatively constant, in the range of 3.1 to 3.6 per 1000, since 1996. The higher frequency of ASD in non-spastic than in spastic subtypes of CP calls for closer examination. © 2013 Mac Keith Press.

  7. Monitoring of the microhemodynamic in an aggressive clinical behavior of cerebral hemorrhage using dynamic light scattering techniques

    Science.gov (United States)

    Vilensky, M. A.; Semyachkina-Glushkovskaya, O. V.; Timoshina, P. A.; Berdnikova, V. A.; Kuznetsova, Y. V.; Semyachkin-Glushkovsky, I. A.; Agafonov, D. N.; Tuchin, V. V.

    2012-06-01

    This paper presents the results of experimental study of full field laser speckle imaging due to cortex microcirculation state monitoring for laboratory rats under conditions of stroke and the introduction of agents. Three groups of experimental animals from five animals in each group were studied. The behavior of blood flow, studied by speckle imaging technique, matched the expected physiological response to an impact.

  8. Simultaneous monitoring of static and dynamic intracranial pressure parameters from two separate sensors in patients with cerebral bleeds: comparison of findings

    Directory of Open Access Journals (Sweden)

    Eide Per

    2012-09-01

    Full Text Available Abstract Background We recently reported that in an experimental setting the zero pressure level of solid intracranial pressure (ICP sensors can be altered by electrostatics discharges. Changes in the zero pressure level would alter the ICP level (mean ICP; whether spontaneous changes in mean ICP happen in clinical settings is not known. This can be addressed by comparing the ICP parameters level and waveform of simultaneous ICP signals. To this end, we retrieved our recordings in patients with cerebral bleeds wherein the ICP had been recorded simultaneously from two different sensors. Materials and Methods: During a time period of 10 years, 17 patients with cerebral bleeds were monitored with two ICP sensors simultaneously; sensor 1 was always a solid sensor while Sensor 2 was a solid -, a fluid - or an air-pouch sensor. The simultaneous signals were analyzed with automatic identification of the cardiac induced ICP waves. The output was determined in consecutive 6-s time windows, both with regard to the static parameter mean ICP and the dynamic parameters (mean wave amplitude, MWA, and mean wave rise time, MWRT. Differences in mean ICP, MWA and MWRT between the two sensors were determined. Transfer functions between the sensors were determined to evaluate how sensors reproduce the ICP waveform. Results Comparing findings in two solid sensors disclosed major differences in mean ICP in 2 of 5 patients (40%, despite marginal differences in MWA, MWRT, and linear phase magnitude and phase. Qualitative assessment of trend plots of mean ICP and MWA revealed shifts and drifts of mean ICP in the clinical setting. The transfer function analysis comparing the solid sensor with either the fluid or air-pouch sensors revealed more variable transfer function magnitude and greater differences in the ICP waveform derived indices. Conclusions Simultaneous monitoring of ICP using two solid sensors may show marked differences in static ICP but close to identity

  9. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

  10. Cerebral vasculitis

    International Nuclear Information System (INIS)

    Greenan, T.J.; Grossman, R.I.

    1990-01-01

    This paper reviews retrospectively MR, CT, and angiographic findings in patients with cerebral vasculitis in order to understand the strengths and weaknesses of the various imaging modalities, as well as the spectrum of imaging abnormalities in this disease entity. Studies were retrospectively reviewed in 12 patients with cerebral vasculitis proved by means of angiography and/or brain biopsy

  11. Cerebral Vasculitis

    Directory of Open Access Journals (Sweden)

    Fariborz Khorvash

    2017-02-01

    Full Text Available Introduction: Vasculitis is an inflammation systems may be involved of blood vessels due to various origins. Vessels of the peripheral and/or central nervous. Vasculitis of the CNS is rare and occurs in the context of systemic diseases or as primary angiitis of the CNS. Epidemiology: The overall incidence of primary vasculitis is about 40/1,000,000 persons [excluding giant cell (temporal arteritis, GCA]. Its incidence increases with age. The incidence of GCA is much higher (around 200/1,000,000 persons in the age group[50 years. Clinical Presentation: Clinical and pathological presentation in CNS vasculitis represents a wide spectrum. Among others, headache, cranial nerve affections, encephalopathy, seizures, psychosis, myelitis, stroke, intracranial haemorrhage and aseptic meningoencephalitis are described. Primary and secondary vasculitides leading more frequently to CNS manifestations are discussed. Primary and secondary Vasculitides: Including Giant Cell (Temporal Arteritis , Takayasu arteritis, Polyarteritis nodosa, Primary angiitis of the CNS, Wegener’s granulomatosis, and Connective tissue diseases, such as systemic lupus erythematosus (SLE, scleroderma, rheumatoid arthritis, mixed connective disease and Sjögren syndrome, are systemic immune-mediated diseases that lead to multiple organ affections. Cerebral Vasculitis: Imaging and Differential Diagnosis: Vasculitides represent a heterogeneous group of inflammatory diseases that affect blood vessel walls of varying calibers (inflammatory vasculopathy. Since the devastating symptoms of CNS vasculitis are at least partially reversible, early diagnosis and appropriate treatment are important. In order to establish a differential diagnosis clinical features, disease progression, age of onset, blood results, as well as CSF examinations have to be taken into consideration. Neuroimaging techniques, such as MRI and DSA, play a central role in the diagnosis and disease monitoring .The diagnostic

  12. Cerebral toxoplasmosis in AIDS - computerized tomography evaluation

    International Nuclear Information System (INIS)

    Alves, Regina Coeli Fonseca; Narchiori, Edson

    1999-01-01

    Cerebral toxoplasmosis is a disease that affects many AIDS's patients. FOr this paper 46 patients with confirmed cases of cerebral toxoplasmosis who did a CT scan between March, 1994 and September, 1997 were examined. Single lesions were found in 28.3% of the patients. The lesions were more frequently detected in the basal ganglia and the frontal lobes. No lesion was larger than 4 cm. As regards the contrast enhancing of the lesions on a CT scan we observed that 54.5% of the lesions had a ring-like contrast enhancing, 36.4% had a nodular contrast enhancing and 6% had a heterogeneous form. After the 21st day of treatment we noticed an improvement in the aspect of the patients'lesions. The improvement of the lesions could be seen through a reduction of the edematous halo, a reduction of the lesion size and a modification in the contrast enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility with cerebral toxoplasmosis, as well as to monitor these patients during treatment. (author)

  13. Positron Emission Tomography—Computer Tomography Scan Used as a Monitoring Tool Following Cellular Therapy in Cerebral Palsy and Mental Retardation—A Case Report

    Directory of Open Access Journals (Sweden)

    Alok Sharma

    2013-01-01

    Full Text Available Cerebral palsy (CP is one of the non-progressive neurological diseases caused by damage to the brain tissue at birth, which leads to physical, cognitive and perceptive symptoms. Even after lifelong medical and therapeutic management there are residual deficits which affect the quality of life of the patients and their families. We examined a maximally rehabilitated, 20 year old male suffering from CP and Mental Retardation (MR. He had diplegic gait and Intelligence Quotient (IQ score of 44 with affected fine motor activities, balance, speech and higher functions. Positron Emission Tomography—Computer Tomography (PET-CT scan identified frontal, temporal, parietal, occipital, left cerebellar lobes, amygdala, hippocampus, and parahippocampus as the affected areas. He was treated with cellular therapy of Autologous Bone Marrow Derived Mono-Nuclear Cells (MNCs transplantation followed by multidisciplinary rehabilitation. Six months following therapy, PET-CT scan showed significant increase in metabolic activity in all four lobes, mesial temporal structures and left cerebellar hemisphere, also supported by clinical improvement in IQ, social behavior, speech, balance and daily functioning. These findings provide preliminary evidence to support the efficacy of cellular therapy for the treatment of CP with MR. PET-CT scan can also be viewed as an impressive tool to monitor the effects of cellular therapy.

  14. The effects of chronic trans-resveratrol supplementation on aspects of cognitive function, mood, sleep, health and cerebral blood flow in healthy, young humans.

    Science.gov (United States)

    Wightman, Emma L; Haskell-Ramsay, Crystal F; Reay, Jonathon L; Williamson, Gary; Dew, Tristan; Zhang, Wei; Kennedy, David O

    2015-11-14

    Single doses of resveratrol have previously been shown to increase cerebral blood flow (CBF) with no clear effect on cognitive function or mood in healthy adults. Chronic resveratrol consumption may increase the poor bioavailability of resveratrol or otherwise potentiate its psychological effects. In this randomised, double-blind, placebo-controlled, parallel-groups study, a total of sixty adults aged between 18 and 30 years received either placebo or resveratrol for 28 d. On the 1st and 28th day of treatment, the performance of cognitively demanding tasks (serial subtractions, rapid visual information processing and 3-Back) (n 41 complete data sets) was assessed, alongside blood pressure (n 26) and acute (near-IR spectroscopy (NIRS)) and chronic (transcranial Doppler) measures of CBF (n 46). Subjective mood, sleep quality and health questionnaires were completed at weekly intervals (n 53/54). The results showed that the cognitive effects of resveratrol on day 1 were restricted to more accurate but slower serial subtraction task performance. The only cognitive finding on day 28 was a beneficial effect of resveratrol on the accuracy of the 3-Back task before treatment consumption. Subjective ratings of 'fatigue' were significantly lower across the entire 28 d in the resveratrol condition. Resveratrol also resulted in modulation of CBF parameters on day 1, as assessed by NIRS, and significantly increased diastolic blood pressure on day 28. Levels of resveratrol metabolites were significantly higher both before and after the day's treatment on day 28, in comparison with day 1. These results confirm the acute CBF effects of resveratrol and the lack of interpretable cognitive effects.

  15. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Pellicer, Adelina; Alderliesten, Thomas

    2015-01-01

    OBJECTIVE: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. DESIGN: Phase II randomised, single blinded, parallel clinical trial. SETTING: Eight tertiary neonatal intensive care unit...

  16. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Pellicer, Adelina; Alderliesten, Thomas

    2015-01-01

    OBJECTIVE: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. DESIGN: Phase II randomised, single blinded, parallel clinical trial. SETTING: Eight tertiary neonatal intensive care units...

  17. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  18. Cerebral toxoplasmosis in AIDS - computerized tomography evaluation; Toxoplasmose cerebral na SIDA - avaliacao por tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Regina Coeli Fonseca [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Hospital Universitario Antonio Pedro. Servico de Radiologia; Narchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    1999-06-01

    Cerebral toxoplasmosis is a disease that affects many AIDS's patients. FOr this paper 46 patients with confirmed cases of cerebral toxoplasmosis who did a CT scan between March, 1994 and September, 1997 were examined. Single lesions were found in 28.3% of the patients. The lesions were more frequently detected in the basal ganglia and the frontal lobes. No lesion was larger than 4 cm. As regards the contrast enhancing of the lesions on a CT scan we observed that 54.5% of the lesions had a ring-like contrast enhancing, 36.4% had a nodular contrast enhancing and 6% had a heterogeneous form. After the 21st day of treatment we noticed an improvement in the aspect of the patients'lesions. The improvement of the lesions could be seen through a reduction of the edematous halo, a reduction of the lesion size and a modification in the contrast enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility with cerebral toxoplasmosis, as well as to monitor these patients during treatment. (author)

  19. STUDENTS’ INFORMATION AND СOMMUNICATION COMPETENCE AS AN ASPECT OF MONITORING (OESD AND IEA INTERNATIONAL COMPARATIVE STUDY EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Olena O. Hrytsenchuk

    2013-12-01

    Full Text Available The article deals the experience of the The International Association for the Evaluation of Educational Achievement - IEA and the Organisation for Economic Cooperation and Development - OECD in monitoring studies of students’ information and communication competence ( IC - competence of secondary schools, presented an analysis of common approaches to monitoring studies IC - competence of pupils in Europe at the present stage. There are identified peculiarities, common trends and future development.

  20. Cerebral Hypoxia

    Science.gov (United States)

    ... off. When hypoxia lasts for longer periods of time, it can cause coma, seizures, and even brain death. In brain death, there is no measurable activity in the brain, although cardiovascular function is preserved. Life support is required for respiration. × Definition Cerebral hypoxia ...

  1. Detection of cerebral arterial gas embolism using regional cerebral oxygen saturation, quantitative electroencephalography, and brain oxygen tension in the swine

    NARCIS (Netherlands)

    Weenink, R. P.; Hollmann, M. W.; Stevens, M. F.; Kager, J.; van Gulik, T. M.; van Hulst, R. A.

    2014-01-01

    Cerebral air emboli occur as a complication of invasive medical procedures. The sensitivity of cerebral monitoring methods for the detection of air emboli is not known. This study investigates the utility of electroencephalography and non-invasively measured cerebral oxygen saturation in the

  2. Cerebral oxygen desaturation during beach chair position

    NARCIS (Netherlands)

    Moerman, Annelies T.; de Hert, Stefan G.; Jacobs, Tom F.; de Wilde, Lieven F.; Wouters, Patrick F.

    2012-01-01

    Cases of ischaemic brain damage have been reported in relatively healthy patients undergoing shoulder surgery in the beach chair position. Unrecognised cerebral hypoperfusion may have contributed to these catastrophic events, indicating that routine anaesthesia monitoring may not suffice.

  3. The incidence of and risk factors for ischemic complications after microsurgical clipping of unruptured middle cerebral artery aneurysms and the efficacy of intraoperative monitoring of somatosensory evoked potentials: A retrospective study.

    Science.gov (United States)

    Byoun, Hyoung Soo; Bang, Jae Seung; Oh, Chang Wan; Kwon, O-Ki; Hwang, Gyojun; Han, Jung Ho; Kim, Tackeun; Lee, Si Un; Jo, Seong-Rae; Kim, Dong-Gun; Park, Kyung Seok

    2016-12-01

    Ischemic complications (ICs) account for 6.7% after microsurgical clipping of unruptured intracranial aneurysms. This study aimed to evaluate the efficacy of somatosensory evoked potential (SSEP) monitoring during microsurgical clipping of unruptured middle cerebral artery (MCA) aneurysms and evaluate the incidence of and risk factors for ischemic complications after clipping of unruptured MCA aneurysms. Herein, 1208 patients with cerebral aneurysms and treated with microsurgical clipping between May 2003 and February 2015 were enrolled. Those with multiple aneurysms, history of head trauma, subarachnoid hemorrhage, bypass and/or endovascular treatment, and intraoperative rupture were excluded. Subsequently, 411 patients with single unruptured MCA aneurysms treated with simple microsurgical clipping were enrolled. Patients were divided into two groups based on the application of SSEP monitoring during surgery. The IC rate was 0.9% and 5.6% in the SSEP and non-SSEP groups, respectively. Univariate analysis revealed that age≥62.5years, aneurysm size≥4.15mm, temporary clipping, history of hyperlipidemia and stroke, and no-SSEP monitoring were risk factors for ICs. Multivariate logistic regression analysis showed that age≥62.5years (odds ratio [OR]=7.7; 95% confidence interval [95% CI]=1.5-37.7; P=0.011), previous stroke (OR=26.8, 95% CI=2.4-289.2, P=0.007), and inversely SSEP monitoring (OR=0.14, 95% CI 0.02-0.72, P=0.019) were independent risk factors for ICs. Clinicians should consider the possibility of IC during microsurgical clipping of unruptured MCA aneurysms in patient≥62.5years and/or a history of stroke. Intraoperative SSEP monitoring is an effective and feasible tool for preventing IC. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Cerebral imaging revealing Alzheimer's disease

    International Nuclear Information System (INIS)

    2011-01-01

    Cerebral imaging is the only non-invasive means of examining the brain and is essential in studying Alzheimer's disease. As a tool for early diagnosis, evaluation and treatment monitoring, this technology is at the heart of the research being done to further improve its reliability and sensitivity. (authors)

  5. Comparison of liquid crystal display monitors calibrated with gray-scale standard display function and with γ 2.2 and iPad: observer performance in detection of cerebral infarction on brain CT.

    Science.gov (United States)

    Yoshimura, Kumiko; Nihashi, Takashi; Ikeda, Mitsuru; Ando, Yoshio; Kawai, Hisashi; Kawakami, Kenichi; Kimura, Reiko; Okada, Yumiko; Okochi, Yoshiyuki; Ota, Naotoshi; Tsuchiya, Kenichi; Naganawa, Shinji

    2013-06-01

    The purpose of the study was to compare observer performance in the detection of cerebral infarction on a brain CT using medical-grade liquid crystal display (LCD) monitors calibrated with the gray-scale standard display function and with γ 2.2 and using an iPad with a simulated screen setting. We amassed 97 sample sets, from 47 patients with proven cerebral infarction and 50 healthy control subjects. Nine radiologists independently assessed brain CT on a gray-scale standard display function LCD, a γ 2.2 LCD, and an iPad in random order over 4-week intervals. Receiver operating characteristic (ROC) analysis was performed by using the continuous scale, and the area under the ROC curve (A(z)) was calculated for each monitor. The A(z) values for gray-scale standard display function LCD, γ 2.2 LCD, and iPad were 0.875, 0.884, and 0.839, respectively. The difference among the three monitors was very small. There was no significant difference between gray-scale standard display function LCD and γ 2.2 LCD. However, the A(z) value was statistically significantly smaller for the iPad than the γ 2.2 LCD (p iPad was poorer than that using the other LCDs, the difference was small. Therefore, the iPad could not substitute for other LCD monitors. However, owing to the promising potential advantages of tablet PCs, such as portability, further examination is needed into the clinical use of tablet PCs.

  6. United Cerebral Palsy

    Science.gov (United States)

    ... your local affiliate Find your local affiliate United Cerebral Palsy United Cerebral Palsy (UCP) is a trusted resource for individuals with Cerebral Palsy and other disabilities and their networks. Individuals with ...

  7. REQUIREMENTS GATHERING FOR THE PROPOSAL OF AN APPLICATION FOR MONITORING THE ASPECTS OF THE EVALUATION SYSTEM OF CAPES

    Directory of Open Access Journals (Sweden)

    Emerson Antonio Maccari

    2015-11-01

    Full Text Available The management of Graduate Programs are doing to meet the criteria of CAPES. This task has proven to be a complex activity because it is based on dynamic and heterogeneous over time parameters. The article was based on the method of action research that raised the requirements for developing a monitoring system of the requirements of the assessment system of CAPES with a view to assisting the strategic management of the graduate studies program. It was identified that this application can be incorporated into routine coordinators of programs aiming to support strategic planning in pursuit of improvement. As a result, one can glimpse a better management of scientific production indicators and training of students, these fundamental criteria for the program to fulfill its mission to society.

  8. 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.

  9. Regional cerebral blood perfusion SPECT imaging in brain ischemic injury due to cerebral hemorrhage

    International Nuclear Information System (INIS)

    Zhang Chunyin; Chen Yue; Li Zuoxiao; Tan Hua; Li Xiaohong

    2006-01-01

    Objective: To explore the clinical value of SPECT perfusion imaging in brain ischemic injury due to cerebral hemorrhage before and after treatment. Methods: Sixty cases of cerebral hemorrhage were randomly divided into nimodipine treated group and routine treated group. The volume of primary ischemic focus, changes of regional cerebral blood perfusion around hematoma and other cerebral areas were observed by SPECT imaging. Results: Volume of the primary focus was reduced apparently in both groups, but much more in nimodipine treated group (P<0.01). Also the regional cerebral blood flow in ischemic focus and remote areas increased much more in nimodipine treated group than routine treated group (P< 0.01). Conclusions: Brain SPECT imaging can sensitively reflect the regional cerebral blood flow before and after treatment. Thereby, it is useful for therapeutic monitoring. (authors)

  10. Higher accuracy of self-monitoring of blood glucose in insulin-treated patients in Germany: clinical and economical aspects.

    Science.gov (United States)

    Schnell, Oliver; Erbach, Michael; Wintergerst, Eva

    2013-07-01

    Accuracy standards of blood glucose (BG) meters are currently under review. Revised standards are expected to tighten accuracy requirements. Regarding clinical and financial impact of BG meter accuracy, very little data are available. The aim of this study was to analyze potential cost savings related to higher accuracy of glucose meters in Germany. As a model for calculation, a reduction of meter error from 20% to 5% was applied. The health economic analysis was based on four main pillars: (1) number of insulin-treated patients; (2) costs for glucose monitoring in Germany; (3) data of a modeling analysis on the impact on hypoglycemic episodes, glycosylated hemoglobin (HbA1c), and, subsequently, myocardial infarctions; and (4) costs of diabetes-related complications in Germany. A reduction of meter error from 20% to 5% was identified to be associated with a 10% reduction in severe hypoglycemic episodes and a 0.39% reduction in HbA1c, which translates into a 0.5% reduction of myocardial infarctions. According to the health economic analysis, the reduction in severe hypoglycemic episodes and myocardial infarctions led to cost savings of €24.14 per patient per year. Considering 390,000 type 1 diabetes patients or 2.3 million insulin-treated patients in Germany, these savings could be equal to a reduction in health care expenditures of more than €9.4 million and €55.5 million, respectively. Potential cost savings and clinical effects due to higher accuracy of BG meters should provide an impetus to implementation of tighter accuracy standards and development of glucose meters that provide highest possible accuracy. © 2013 Diabetes Technology Society.

  11. Non operative management of cerebral abscess

    Science.gov (United States)

    Batubara, C. A.

    2018-03-01

    Cerebral abscess is a focal intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Patients typically present with varying combinations of aheadache, progressive neurologic deficits, seizures, and evidence of infection. Computed Tomography and Magnetic Resonance Imagingare the most important diagnostic tools in diagnosing cerebral abscess. The treatment of cerebral abscess has been a challenge. Small cerebralabscesses (managed by the use of intravenous mannitol (or hypertonic saline) and dexamethasone. Acute seizures should be terminated with the administration of intravenous benzodiazepines or by intravenous fosphenytoin. Anticonvulsants prophylaxis must be initiated immediately and continued at least one year due to high risk in the cerebral abscesses. Easier detection of underlying conditions, monitoring of the therapeutic progress, and recognition of complications have probably contributed to the improved prognosis.

  12. Cerebral angiography

    Science.gov (United States)

    ... ECG) monitors your heart activity during the test. Sticky patches, called leads, will be placed on your ... in blood flow. Sometimes, a computer removes the bones and tissues on the images being viewed, so ...

  13. Cerebral palsy.

    Science.gov (United States)

    Kent, Ruth M

    2013-01-01

    Cerebral palsy affects movement and posture causing activity limitation; it is a lifelong condition, with foreseeable complications. There are evidence-based interventions that will prevent participation restriction. Childhood interventions are generally delivered within multidisciplinary rehabilitation programs. Sadly young adults are often not transferred to an appropriate multidisciplinary adult neurodisability service. An unexplained neurological deterioration should warrant further investigation. Pain is an important underreported symptom and musculoskeletal complaints are prevalent. Disabled adults have less participation socially, in employment, marriage, and independent living related to health problems, discrimination, or lack of access to information, support, and equipment. Evidence-based interventions include a variety of modalities at all International Classification of Functioning, Disability, and Health levels to include support and adaptations. Rehabilitation interventions that have been shown to be effective include surgery in childhood, ankle-foot orthoses, strength training, and electrical stimulation. Management of spasticity is beneficial and has an evidence base. Orthotics and casting are also used. Systematic reviews of upper limb therapies also show the benefit of physical therapy exercise, strengthening, fitness training, and constraint therapy. Occupational therapy has a weaker evidence base than in other disabling conditions but many modalities are transferable. Speech therapy is effective although no specific intervention is better. Psychological wellbeing interventions, including improving self-efficacy, health knowledge, and coping skills, are beneficial. Management of continence, nutrition, and fatigue promote wellbeing. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. The influence of the combined antihypertensive therapy on the results of daily monitoring of blood pressure and cerebral blood flow in patients with hypertension and ischemic stroke in history.

    Directory of Open Access Journals (Sweden)

    E. Yu. Turna

    2013-08-01

    Full Text Available hemodynamics, combination antihypertensive therapy. The aim of our study was to investigate the effect of different variants of combined antihypertensive therapy on the dynamics of the circadian rhythm of blood pressure and cerebral blood flow in patients with hypertension and ischemic stroke in history. Materials and methods. In the study group - 75 patients (male and female, age 60,85±0,96 with stage 1 and 2 of hypertension and ischemic stroke in history who were randomized into two groups (gr: A - 37 patients, administered combination of olmesartan and hydrochlorothiazide in therapeutic doses, gr. B - 38 patients, administered of olmesartan and amlodipine combination. And comparison group - 30 patient with stage II 1 and 2 degree. All patients underwent blood pressure monitoring, Doppler examination of the cerebral blood vessels. Estimation of the ABP and cerebral hemodynamics in the study group were conducted at baseline and one year on antihypertensive therapy. Statistical analysis was performed using variation statistics with package «Statistica 10". Results: After year therapy we have evaluated the effects of studied antihypertensive drug combinations. It was found that in group A daily average of SBP and DBP were 118,8 ± 1,23 and 74,95 ± 0,94 mm Hg. Art., Group B - 121,2 ± 1,28 and 72,16 ± 1,2 mm Hg. Art. respectively (p> 0.05, indicating a comparable antihypertensive effect combinations of olmesartan + amlodipine and olmesartan + hydrochlorothiazide. The combination OLM + AML reduced variability of systolic blood pressure per day by 5 points (before treatment was 17,38 ± 0,72, after therapy - 12,41 ± 0,53, p 0.05. In comparative evaluation of the effectiveness of combined antihypertensive therapy in groups A and B showed statistically significant decrease pulse pressure per day, daytime and night-time in group A during therapy with OLM + HCTZ (pulse pressure per night in group A before treatment was 57,24 ± 1,87 mm Hg, during

  15. Medida da diferença artério-venosa de oxigênio na monitorização de pacientes com hemorragia subaracnóidea por aneurisma cerebral Measurement of arteriovenous oxygen difference in the monitoring of patients with subarachnoid haemorrhage due to cerebral aneurysm

    Directory of Open Access Journals (Sweden)

    Ronaldo Sérgio Santana Pereira

    1997-01-01

    Full Text Available A diferença artério-venosa de oxigênio (DAVO2, pelo fato de estar relacionada com o metabolismo cerebral, reflete alterações que ocorrem em determinadas situações patológicas, entre elas as causadas pela hemorragia subaracnóidea espontânea (HSAE. Com a finalidade de avaliar a relação entre alterações na DAVO2 com o quadro clínico e a evolução de pacientes com HSAE, devido à ruptura de aneurisma cerebral, este método foi utilizado em 30 pacientes portadores desta patologia, admitidos na Unidade de Neurocirurgia do HBDF. A HSAE foi confirmada por CT de crânio em 17 pacientes e por punção lombar em 13. Dezoito pacientes foram admitidos com Hunt & Hess (H&H I ou II, sete com H&H III e cinco com H&H IV ou V. A medida da DAVO2 baseou-se na equação de Fick e os resultados clínicos foram avaliados pela escala de seqüelas de Glasgow. Dezenove pacientes apresentaram DAVO2 normais (inicialmente e durante a evolução, sendo que três faleceram; cinco tiveram valores de DAVO2 sempre baixos e três faleceram; os restantes seis pacientes tiveram valores da DAVO2 sempre elevados e dois faleceram. Os pacientes com DAVO2 normais tiveram melhor evolução clínica e índice de mortalidade menor, quando comparados com os pacientes com valores anormais da DAVO2 (pThe arterious venous oxygen difference (AVDO2 due to the close relationship with cerebral metabolic rate of oxygen and cerebral blood flow shows metabolic alterations that occur in some pathological situations in the brain including subarachnoid haemorrhage. The AVDO2 was calculated by the Fick equation and the results evaluated by the Glasgow outcome scale. Measurements of arteriojugular oxygen difference were carried out in 30 patients with subarachnoid haemorrhage due to rupture of intracranial aneurysms, as an attempt to monitor the relationship between changes in AVDO2, clinical picture, and evolution of the patients. The subarachnoid haemorrhage was diagnosed by CT scan in

  16. Anestesia e paralisia cerebral Anestesia y parálisis cerebral Anesthesia and cerebral palsy

    Directory of Open Access Journals (Sweden)

    Március Vinícius M Maranhão

    2005-12-01

    riesgo, fisiopatología, cuadro clínico, diagnóstico, terapéuticas utilizadas bien como evaluación pre-operatoria, medicación pre-anestésica, manoseo intra y posoperatorio, analgesia posoperatoria y dolor crónico. CONCLUSIONES: El anestesista desempeña un papel importante en la disminución de la morbidez y mortalidad anestésico-quirúrgica en pacientes portadores de parálisis cerebral. El conocimiento de la fisiopatología de los diferentes tipos de parálisis cerebral bien como de las enfermedades asociadas y sus terapéuticas es imprescindible, pues permite al anestesista anticipar y precaver complicaciones intra y posoperatorias en este tipo de paciente.BACKGROUND AND OBJECTIVES: Cerebral palsy (CP is a non-progressive disease induced by CNS injury, which leads to patients' motor impairment. CP patients are often submitted to surgical procedures due to usual diseases and some surgical situations related with CP. The aim of this article was to review cerebral palsy aspects of interest to anesthesiologists to allow an adequate pre, intra and postoperative management of these patients. CONTENTS: This article addresses cerebral palsy aspects such as etiology, classification, risk factors, pathophysiology, clinical presentation, diagnosis and therapies and, in addition to preoperative evaluation, preanesthetic medication, intra and postoperative management, postoperative analgesia and chronic pain. CONCLUSIONS: Anesthesiologists play an important role in decreasing anesthetic-surgical morbidity and mortality of cerebral palsy patients. The understanding of different aspects of cerebral palsy pathophysiologies, in addition to those of associated diseases and their therapies is paramount, because it allows anesthesiologists to anticipate and prevent intra and postoperative complications in this type of patient.

  17. A problemática do cuidador familiar do portador de acidente vascular cerebral La problemática del cuidador familiar con el portador de accidente cerebral vascular The problematic aspects of the family caregiver of people who suffered strokes

    Directory of Open Access Journals (Sweden)

    Luciene Miranda de Andrade

    2009-03-01

    Full Text Available Objetivou-se identificar a problemática da família de pessoas acometidas de acidente vascular cerebral hospitalizadas e discutir as dificuldades do cuidador familiar para o cuidado no âmbito domiciliar. A amostra constou de 154 famílias de pacientes internados em um hospital da rede pública de saúde, Fortaleza-CE. Conforme os resultados denotam, a maioria dos cuidadores são mulheres, 104 (67,5%; 122 casos (79,2% apresentam comprometimento familiar e alterações na vida diária em 115 dos acompanhantes (74,7%; 150 (97,4% não receberam orientações acerca dos cuidados, mas 143 (92,9% sentem-se seguros para acompanhá-los. O sentimento predominante foi a tristeza, 125 (81,2%, e as dúvidas principais foram: alimentação, 64 (41,6%, administração de medicamentos, 49 (29,9%, e possíveis complicações clínicas após a alta, 49 (29,9%. Estes resultados alertam para o papel do enfermeiro como educador, não somente na prevenção das doenças crônico-degenerativas, mas, também, na orientação aos cuidadores familiares sobre os cuidados dispensados após a alta hospitalar.El objetivo fue identificar la problemática de la familia de personas acometidas de accidente vascular cerebral hospitalizadas y discutir las dificultades del cuidador familiar en el ámbito domiciliar. La muestra fue constituida por 154 familias de pacientes internados en un hospital de la red pública de salud, en Fortaleza, CE. Conforme los resultados denotan, la mayoría de los cuidadores son mujeres, 104 (67,5%, 122 casos (79,2% presentan comprometimiento familiar y alteraciones en la vida diaria en 115 de los acompañantes (74,7%; 150 (97,4% no recibieron orientaciones acerca de los cuidados; sin embargo 143 (92,9% se sienten seguros para acompañarlos. El sentimiento predominante fue la tristeza, 125 (81,2%, y las dudas principales fueron: alimentación, 64 (41,6%, administración de medicamentos, 49 (29,9%, y posibles complicaciones clínicas después del

  18. Monitoring ferumoxide-labelled neural progenitor cells and lesion evolution by magnetic resonance imaging in a model of cell transplantation in cerebral ischaemia [v2; ref status: indexed, http://f1000r.es/30c

    Directory of Open Access Journals (Sweden)

    Rachael A Panizzo

    2014-03-01

    Full Text Available Efficacy of neural stem/progenitor cell (NPC therapies after cerebral ischaemia could be better evaluated by monitoring in vivo migration and distribution of cells post-engraftment in parallel with analysis of lesion volume and functional recovery. Magnetic resonance imaging (MRI is ideally placed to achieve this, but still poses several challenges. We show that combining the ferumoxide MRI contrast agent Endorem with protamine sulphate (FePro improves iron oxide uptake in cells compared to Endorem alone and is non-toxic. Hence FePro complex is a better contrast agent than Endorem for monitoring NPCs. FePro complex-labelled NPCs proliferated and differentiated normally in vitro, and upon grafting into the brain 48 hours post-ischaemia they were detected in vivo by MRI. Imaging over four weeks showed the development of a confounding endogenous hypointense contrast evolution at later timepoints within the lesioned tissue. This was at least partly due to accumulation within the lesion of macrophages and endogenous iron. Neither significant NPC migration, assessed by MRI and histologically, nor a reduction in the ischaemic lesion volume was observed in NPC-grafted brains.  Crucially, while MRI provides reliable information on engrafted cell location early after an ischaemic insult, pathophysiological changes to ischaemic lesions can interfere with cellular imaging at later timepoints.

  19. Monitoring ferumoxide-labelled neural progenitor cells and lesion evolution by magnetic resonance imaging in a model of cell transplantation in cerebral ischaemia [v1; ref status: indexed, http://f1000r.es/20l

    Directory of Open Access Journals (Sweden)

    Rachael A Panizzo

    2013-11-01

    Full Text Available Efficacy of neural stem/progenitor cell (NPC therapies after cerebral ischaemia could be better evaluated by monitoring in vivo migration and distribution of cells post-engraftment in parallel with analysis of lesion volume and functional recovery. Magnetic resonance imaging (MRI is ideally placed to achieve this, but still poses several challenges. We show that combining the ferumoxide MRI contrast agent Endorem with protamine sulphate (FePro improves iron oxide uptake in cells compared to Endorem alone and is non-toxic. Hence FePro complex is a better contrast agent than Endorem for monitoring NPCs. FePro complex-labelled NPCs proliferated and differentiated normally in vitro, and upon grafting into the brain 48 hours post-ischaemia they were detected in vivo by MRI. Imaging over four weeks showed the development of a confounding endogenous hypointense contrast evolution at later timepoints within the lesioned tissue. This was at least partly due to accumulation within the lesion of macrophages and endogenous iron. Neither significant NPC migration, assessed by MRI and histologically, nor a reduction in the ischaemic lesion volume was observed in NPC-grafted brains.  Crucially, while MRI provides reliable information on engrafted cell location early after an ischaemic insult, pathophysiological changes to ischaemic lesions can interfere with cellular imaging at later timepoints.

  20. Use of a dynamic foot pressure index to monitor the effects of treatment for equinus gait in children with cerebral palsy.

    Science.gov (United States)

    Bennett, Damien; Walsh, Mike; O'Sullivan, Rory; Gallagher, Joseph; O'Brien, Tim; Newman, Christopher John

    2007-01-01

    The purpose of this study is to introduce and describe a newly developed index using foot pressure analysis to quantify the degree of equinus gait in children with cerebral palsy before and after injection with botulinum toxin. Data were captured preinjection and 12 weeks postinjection. Ten children aged 2(1/2) to 6(1/2) years took part (5 boys and 5 girls). Three of them had a diagnosis of spastic diplegia and 7 of congenital hemiplegia. In total, 13 limbs were analyzed. After orientation and segmentation of raw pedobarographic data, we determined a dynamic foot pressure index graded 0 to 100 that quantified the relative degree of heel and forefoot contact during stance. These data were correlated (Pearson correlation) with clinical measurements of dorsiflexion at the ankle (on a slow and fast stretch) and video observation (using the Observational Gait Scale). Pedobarograph data were strongly correlated with both the Observational Gait Scale scores (R = 0.79, P spasticity (R = 0.70, P spasticity and good correlation with video observations seems to indicate this technique's potential validity. When manipulated and segmented appropriately, and with the development of a simple ordinal index, we found that foot pressure data provided a useful tool in tracking changes in patients with spastic equinus.

  1. Effects of reactive oxygen species on metabolism monitored by longitudinal 1H single voxel MRS follow-up in patients with mitochondrial disease or cerebral tumors

    International Nuclear Information System (INIS)

    Constans, J M; Collet, S; Hossu, G; Courtheoux, P; Guillamo, J S; Lechapt-Zalcman, E; Valable, S; Lacombe, S; Houee Levin, C; Gauduel, Y A; Dou, W; Ruan, S; Barre, L; Rioult, F; Derlon, J M; Chapon, F; Fong, V; Kauffmann, F

    2011-01-01

    Free radicals, or Reactive Oxygen Species (ROS), have an effect on energy and glycolytic metabolism, mitochondrial function, lipid metabolism, necrosis and apoptosis, cell proliferation, and infiltration. These changes could be monitored longitudinally (every 4 months over 6 years) in humans with glial brain tumors (low and high grade) after therapy, using conventional magnetic resonance imaging (MRI) and spectroscopy (MRS) and MR perfusion. Some examples of early clinical data from longitudinal follow-up monitoring in humans of energy and glycolytic metabolism, lipid metabolism, necrosis, proliferation, and infiltration measured by conventional MRI, MRS and perfusion, and positron emission tomography (PET) are shown in glial brain tumors after therapy. Despite the difficulty, the variability and unknown factors, these repeated measurements give us a better insight into the nature of the different processes, tumor progression and therapeutic response.

  2. Probability of walking in children with cerebral palsy in Europe

    DEFF Research Database (Denmark)

    Beckung, E.; Hagberg, G.; Uldall, P.

    2008-01-01

    : The collaboration Surveillance of Cerebral Palsy in Europe provides a powerful means of monitoring trends in cerebral palsy and its functional consequences. The proportion of nonwalking in children with cerebral palsy seems to be rather stable over years and across centers despite the changes that have occurred......OBJECTIVES: The purpose of this work was to describe walking ability in children with cerebral palsy from the Surveillance of Cerebral Palsy in Europe common database through 21 years and to examine the association between walking ability and predicting factors. PATIENTS AND METHODS: Anonymous data...... on 10042 children with cerebral palsy born between 1976 and 1996 were gathered from 14 European centers; 9012 patients were eligible for the analyses. RESULTS: Unaided walking as the primary way of walking at 5 years of age was reported for 54%, walking with assistive devices was reported for 16...

  3. Severe cerebral desaturation during shoulder arthroscopy in the beach-chair position

    DEFF Research Database (Denmark)

    Dippmann, Christian; Winge, Søren; Nielsen, Henning Bay

    2010-01-01

    During shoulder arthroscopy in the beach-chair position, cerebral ischemia may be a serious complication because prolonged hypotension may affect regional cerebral oxygen supply. We present the cases of 2 patients in whom a reduction in mean arterial pressure after anesthesia provoked a decrease...... cerebral oxygenation. During surgery in the beach-chair position, hypotension must be avoided, and in all patients regional, cerebral oxygenation should be monitored and optimized....

  4. Highlighting intracranial pressure monitoring in patients with severe acute brain trauma Ressaltando a monitorização da pressão intracraniana em pacientes com traumatismo cerebral agudo grave

    Directory of Open Access Journals (Sweden)

    Antonio L. E Falcão

    1995-09-01

    Full Text Available Intracranial pressure (ICP monitoring was carried out in 100 patients with severe acute brain trauma, primarily by means of a subarachnoid catheter. Statistical associations were evaluated between maximum ICP values and: 1 Glasgow Coma Scale (GCS scores; 2 findings on computed tomography (CT scans of the head; and 3 mortality. A significant association was found between low GCS scores (3 to 5 and high ICP levels, as well as between focal lesions on CT scans and elevated ICP. Mortality was significantly higher in patients with ICP > 40 mm Hg than in those with ICP Monitorização da pressão intracraniana (PIC foi adotada em 100 pacientes com traumatismo cerebral agudo grave, usando-se preferencialmente um catéter subaracnóide. Associações estatísticas foram avaliadas entre valores máximos de PIC e : 1 número de pontos na Escala de Coma de Glasgow (ECG; 2 achados na tomografia computadorizada (TC da cabeça; e 3 mortalidade. Encontrou-se associação significante entre baixo número de pontos (3 a 5 na ECG e PIC elevada, assim como entre lesões focais na TC e hipertensão intracraniana. A mortalidade foi significantemente maior em pacientes com PIC > 40 mm Hg do que naqueles com PIC < 20 mm Hg.

  5. Present status and future challenges of electroencephalography- and magnetic resonance imaging-based monitoring in preclinical models of focal cerebral ischemia.

    Science.gov (United States)

    Moyanova, Slavianka G; Dijkhuizen, Rick M

    2014-03-01

    Animal models are useful tools for better understanding the mechanisms underlying neurological deterioration after an ischemic insult as well as subsequent evolution of changes and recovery of functions. In response to the updated requirements for preclinical investigations of stroke to include relevant functional measurement techniques and biomarker endpoints, we here review the state of knowledge on application of some translational electrophysiological and neuroimaging methods, and in particular, electroencephalography monitoring and magnetic resonance imaging in rodent models of ischemic stroke. This may lead to improvement of diagnostic methods and identification of new therapeutic targets, which would considerably advance the translational value of preclinical stroke research. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Respiratory challenge MRI: Practical aspects

    Directory of Open Access Journals (Sweden)

    Fiona C. Moreton

    2016-01-01

    Full Text Available Respiratory challenge MRI is the modification of arterial oxygen (PaO2 and/or carbon dioxide (PaCO2 concentration to induce a change in cerebral function or metabolism which is then measured by MRI. Alterations in arterial gas concentrations can lead to profound changes in cerebral haemodynamics which can be studied using a variety of MRI sequences. Whilst such experiments may provide a wealth of information, conducting them can be complex and challenging. In this paper we review the rationale for respiratory challenge MRI including the effects of oxygen and carbon dioxide on the cerebral circulation. We also discuss the planning, equipment, monitoring and techniques that have been used to undertake these experiments. We finally propose some recommendations in this evolving area for conducting these experiments to enhance data quality and comparison between techniques.

  7. Cerebral microcirculation during experimental normovolaemic anaemia

    Directory of Open Access Journals (Sweden)

    Judith eBellapart

    2016-02-01

    Full Text Available Anaemia is accepted amongst critically ill patients as an alternative to elective blood transfusion. This practice has been extrapolated to head injury patients with only one study comparing the effects of mild anaemia on neurological outcome. There are no studies quantifying microcirculation during anaemia. Experimental studies suggest that anaemia leads to cerebral hypoxia and increased rates of infarction, but the lack of clinical equipoise when testing the cerebral effects of transfusion amongst critically injured patients, supports the need of experimental studies. The aim of this study was to quantify cerebral microcirculation and the potential presence of axonal damage in an experimental model exposed to normovolaemic anaemia, with the intention of describing possible limitations within management practices in critically ill patients. Under non-recovered anaesthesia, six Merino sheep were instrumented using an intracardiac transeptal catheter to inject coded microspheres into the left atrium to ensure systemic and non-chaotic distribution. Cytometric analyses quantified cerebral microcirculation at specific regions of the brain. Amyloid precursor protein staining was used as an indicator of axonal damage. Animals were exposed to normovolaemic anaemia by blood extractions from the indwelling arterial catheter with simultaneous fluid replacement through a venous central catheter. Simultaneous data recording from cerebral tissue oxygenation, intracranial pressure and cardiac output was monitored. A regression model was used to examine the effects of anaemia on microcirculation with a mixed model to control for repeated measures. Homogeneous and normal cerebral microcirculation with no evidence of axonal damage was present in all cerebral regions, with no temporal variability, concluding that acute normovolaemic anaemia does not result in short term effects on cerebral microcirculation in the ovine brain.

  8. Fluctuations in Cerebral Hemodynamics

    National Research Council Canada - National Science Library

    Latka, Miroslaw

    2003-01-01

    We demonstrate that the scaling properties of intracranial pressure (ICP) fluctuations and fluctuations of blood flow velocity in middle cerebral arteries are characterized by two scaling exponents...

  9. Cerebral arteriovenous malformation

    Science.gov (United States)

    ... Alternative Names AVM - cerebral; Arteriovenous hemangioma; Stroke - AVM; Hemorrhagic stroke - AVM Patient Instructions Brain surgery - discharge Headache - what to ask your doctor Stereotactic ...

  10. Rapid Cerebral Hemodynamic Modulation during Set Shifting: Evidence of Time-Locked Associations with Cognitive Control in Females

    Science.gov (United States)

    Schuepbach, Daniel; Huizinga, Mariette; Duschek, Stefan; Grimm, Simone; Boeker, Heinz; Hell, Daniel

    2009-01-01

    Set shifting provokes specific alterations of cerebral hemodynamics in basal cerebral arteries. However, no gender differences have been reported. In the following functional transcranial Doppler study, we introduced cerebral hemodynamic modulation to the aspects of set shifting during Wisconsin Card Sorting Test (WCST). Twenty-one subjects…

  11. X-linked creatine transporter deficiency: clinical aspects and pathophysiology

    NARCIS (Netherlands)

    van de Kamp, J.M.; Mancini, G.M.; Salomons, G.S.

    2014-01-01

    Creatine transporter deficiency was discovered in 2001 as an X-linked cause of intellectual disability characterized by cerebral creatine deficiency. This review describes the current knowledge regarding creatine metabolism, the creatine transporter and the clinical aspects of creatine transporter

  12. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Feelings Expert Answers Q&A Movies & More for Teens Teens site Sitio para adolescentes Body Mind Sexual Health ... Educators Search English Español Cerebral Palsy KidsHealth / For Teens / Cerebral Palsy What's in this article? What Is ...

  13. Cerebral Palsy (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español Cerebral Palsy KidsHealth / For Kids / Cerebral Palsy What's in this article? What's CP? ...

  14. Impaired cerebral autoregulation and brain injury in newborns with hypoxic-ischemic encephalopathy treated with hypothermia.

    Science.gov (United States)

    Massaro, An N; Govindan, R B; Vezina, Gilbert; Chang, Taeun; Andescavage, Nickie N; Wang, Yunfei; Al-Shargabi, Tareq; Metzler, Marina; Harris, Kari; du Plessis, Adre J

    2015-08-01

    Impaired cerebral autoregulation may contribute to secondary injury in newborns with hypoxic-ischemic encephalopathy (HIE). Continuous, noninvasive assessment of cerebral pressure autoregulation can be achieved with bedside near-infrared spectroscopy (NIRS) and systemic mean arterial blood pressure (MAP) monitoring. This study aimed to evaluate whether impaired cerebral autoregulation measured by NIRS-MAP monitoring during therapeutic hypothermia and rewarming relates to outcome in 36 newborns with HIE. Spectral coherence analysis between NIRS and MAP was used to quantify changes in the duration [pressure passivity index (PPI)] and magnitude (gain) of cerebral autoregulatory impairment. Higher PPI in both cerebral hemispheres and gain in the right hemisphere were associated with neonatal adverse outcomes [death or detectable brain injury by magnetic resonance imaging (MRI), P NIRS-MAP monitoring of cerebral autoregulation can provide an ongoing physiological biomarker that may help direct care in perinatal brain injury. Copyright © 2015 the American Physiological Society.

  15. Cerebral haematocrit measurement

    International Nuclear Information System (INIS)

    Loutfi, Issa.

    1987-01-01

    Regional cerebral haematocrit was measured in a group of sixteen subjects by the single-photon emission computerized tomography method. This group included three normal subjects as controls and thirteen patients affected with ischaemic cerebral disease presenting clinically with transient ischaemic attacks-six patients - or recent cerebral stroke - seven patients. Two intravenous radioactive tracers - technetium-99m labelled autologous red blood cells and Tc-99m human serum albumin were used. Cerebral tomographic imaging was performed using a rotating scintillation camera. The values of cerebral haematocrit obtained, taken as a ratio to venous haematocrit, range between 0.65-0.88 in the subjects studied. As a general finding in normal subjects and in patients with transient ischaemic attacks, no significant difference between right and left hemispheric haematocrit value was noted. However, in the group of patients affected with stroke, a significant difference in the right versus left hemispheric Hct was observed in 3 patients, the higher Hct value corresponding to the affected side. The clinical implication is on the emphasis of cerebral Hct measurement when the measurement of cerebral blood flow or volume is sought. Also the variation in regional Hct value observed in patients with stroke, above mentioned, points to a regulation mechanism of the blood composition for optimal oxygen delivery to the brain that is impaired in these patients. 14 refs. (Author)

  16. Bedside Evaluation of Cerebral Energy Metabolism in Severe Community-Acquired Bacterial Meningitis

    DEFF Research Database (Denmark)

    Rom Poulsen, Frantz; Schulz, Mette; Jacobsen, Anne

    2015-01-01

    BACKGROUND: Mortality and morbidity have remained high in bacterial meningitis. Impairment of cerebral energy metabolism probably contributes to unfavorable outcome. Intracerebral microdialysis is routinely used to monitor cerebral energy metabolism, and recent experimental studies indicate...... that this technique may separate ischemia and non-ischemic mitochondrial dysfunction. The present study is a retrospective interpretation of biochemical data obtained in a series of patients with severe community-acquired meningitis. METHODS: Cerebral energy metabolism was monitored in 15 patients with severe...... community-acquired meningitis utilizing intracerebral microdialysis and bedside biochemical analysis. According to previous studies, cerebral ischemia was defined as lactate/pyruvate (LP) ratio >30 with intracerebral pyruvate level

  17. BIS monitor findings during self-hypnosis.

    Science.gov (United States)

    Burkle, Christopher M; Jankowski, Christopher J; Torsher, Laurence C; Rho, Edwin H; Degnim, Amy C

    2005-12-01

    We describe BIS values for a patient undergoing breast surgery under self-hypnosis in order to access the value of global surface EEG measures occurring during this process. Following verbal consent, a BIS(TM) monitor (Aspect Medical, Newton MA) was placed and values measured while the patient performed self-hypnosis for a simple mastectomy and sentinel node biopsy. Thirty-nine minutes after incision the BIS value decreased transiently to 72 followed by several other transient decreases, the lowest of which was 59. Values remained at approximately 90 throughout most of the operative period. The BIS value returned to baseline after completion of the operation. Our findings support the hypothesis that hypnosis is a dynamic cerebral process incorporating many changes within brain activation centers and one distinct from dissociative patterns seen under anesthesia. Current algorithms employed by the BIS(TM) monitor add little to the management of patients utilizing hypnosis for analgesia.

  18. MRI of acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, Osamu; Sato, Shuji; Suzuki, Takashi; Endo, Shunro; Takaku, Akira.

    1989-01-01

    Sequential changes of magnetic resonance imaging (MRI) in sixteen patients with acute cerebral infarction are studied in comparison with the findings of computed tomography (CT). The sixteen patients were examined within 36 hours from the onset of syptoms on resistive type MRI (0.15T) using T1 weighted image (IR2000/500) and T2 weighted image (SE2000/80), and on CT. In general, large infarcted lesions of the cortexsubcortex seemed to be visualized earlier than small lesions of the basal ganglia and brainstem. In 8 patients, the infarcted lesions were detected on MRI earlier than on CT. For example, early detecting time within 12 hours were 2, 6, 7, and 10 hours after onset. In two patients of this group, lesions were detected on T2 weighted image earlier than on T1-weighted image. In two cases, small lesions of the brainstem were detected only on MRI. The size of abnormal findings gradually developed and reached a maximum on days 5 to 7 sequentially. The difference between infarction and perifocal edema was not clear even on MRI. The changes gradually subsided and assumed a stable size after about 2 months. Contrast enhancement effect was observed in four patients. In two of these cases, the signal intensity of T2-weighted imaging was decreased just at the region which was enhanced with contrast medium. MRI is useful for early diagnosis of ischemic cerebral infarction, and may eludidate some aspects of the pathophysiology of ischemic stroke.

  19. Some aspects of the occurrence and behaviour of the crane Grus grus in Poland in light of pre-investment wind-farm monitoring

    Directory of Open Access Journals (Sweden)

    Busse Przemysław

    2016-12-01

    Full Text Available Ornithological pre-investment monitoring at planned wind farm sites is a standard and obligatory procedure in Poland and other EU countries. Pre-investment wind farm monitoring has a very important ‘side effect’ to its main goal (the safety of bird populations, namely the collection of valuable avifaunistic data from many localities that most probably would never be studied if not for the obligation to prepare environmental reports when wind energy investments are planned. The main aim of this paper is to show what we can learn from obligatory pre-investment monitoring when the standard field monitoring procedure and unified evaluation methodology are used. As an example the Common Crane Grus grus was selected, as a bird listed in Annex 1 of Directive 2009/147/EC and easy to identify and count. The data were collected at 155 controlled monitoring sites all over Poland, but mainly along the Baltic coast and in the Masurian Lake District. The methodology of the data collection and evaluation of results was strictly according to a paper by Busse (2013. The presentation of the results includes the numerical distribution of cranes in all seasons and some details of their behaviour - observations of birds on the ground and those using the air space: below the future rotor swept area of the wind turbines, at the rotor swept height, and flying above it. The estimated collision rates vary depending on the area, season and local heights of movements. It was concluded that such an evaluation of data already collected could be helpful in evaluating a particular site in comparison with other, previously studied localities.

  20. Neonatal Cerebral Sinovenous Thrombosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-04-01

    Full Text Available The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT were studied in 42 children, using neurology clinic records (1986-2005 at Indiana University School of Medicine.

  1. Cerebral Manifestations of Preeclampsia

    NARCIS (Netherlands)

    I.A. Brussé (Ingrid)

    2016-01-01

    textabstractThis thesis intends to describe and explain the course of clinical neurophysiological and neuropsychological parameters in patients with hypertensive disorders in pregnancy. We aimed to improve knowledge on cerebral pathophysiological mechanisms of preeclampsia related to signs and

  2. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    International Nuclear Information System (INIS)

    Asari, Syoji; Satoh, Toru; Sakurai, Masaru; Yamamoto, Yuji; Sadamoto, Kazuhiko.

    1981-01-01

    1. Cerebral arteries and veins were demonstrated by multiplane computed cerebral angiotomography [combination of axial, modified coronal, half axial (Towne), and semisagittal planes]. The vessels which were demonstrated by various planes were as follows: Axial plane: Willis ring, middle cerebral arteries (horizontal and insular portions), anterior cerebral arteries (Horizontal and ascending portions), posterior cerebral arteries, basal vein of Rosenthal, internal cerebral veins (and the subependymal veins which join the ICV), and vein of Galen. Coronal plane: intermal carotid arteries (supraclinoid portion), anterior cerebral arteries (horizontal portion), middle cerebral arteries (horizontal and insular portions), lenticulostriate arteries, basal vein of Rosenthal (and the subependymal veins which join this vessel), internal cerebral veins, and vein of Galen. Half axial plane (Towne projection): basilar artery, vertebral arteries, posterior cerebral arteries, superior cerebellar arteries, middle cerebral arteries (horizontal portion), and anterior cerebral arteries (horizontal and ascending portions). Semisagittal plane: internal carotid artery (supraclinoid portion), posterior communicating artery, posterior carebral artery, superior cerebellar artery, internal cerebral vein, basal vein of Rosenthal, vein of Galen, and straight shinus. 2. A detailed knowledge of normal cerebrovascular structures acquired by computed tomography (CT) is essential in detecting and more precisely localizing lesions such as cerebrovascular disease, neoplasm or abscess, in differentiating these lesions from the normal contrast-enhanced structures, and in understanding the spatial relationship between the mass lesion and the neighboring vessels. In addition, it will be possible to discover such asymptomatic cerebrovascular diseases as non-ruptured aneurysms, arteriovenous malformations, and Moyamoya disease by means of computed cerebral angiotomography. (author)

  3. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  4. Embodying Investigations of Cerebral Palsy

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke

    to understand what it means for persons to live with CP and then figure out how we should help them . Based on his method of open - minded cognitive science, Martiny presents data on neuro - physiological, psychological and social aspects of living with CP. From this theoretical work, Martiny develops......The main question of Kristian Martiny’s dissertation is: how do we help persons living with the brain damage, cerebral palsy (CP)? This question is as complex and difficult to answer as any healthcare question. Martiny argues that we need to ‘open up’ how we do ( cognitive ) science in order...... an embodied - based model of intervention for CP, focusing on the experience of self control as a way to help people with CP. In addition, a theatre performance, Humane Liquidation , and a documentary film, Natural Disorder, are developed so as to both communicate what it means to live with CP and empower...

  5. Nanomedicine in cerebral palsy

    Science.gov (United States)

    Balakrishnan, Bindu; Nance, Elizabeth; Johnston, Michael V; Kannan, Rangaramanujam; Kannan, Sujatha

    2013-01-01

    Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. PMID:24204146

  6. Measurement of brain edema by noninvasive cerebral electrical impedance in patients with massive hemispheric cerebral infarction.

    Science.gov (United States)

    Lou, Jin He; Wang, Jian; Liu, Li Xu; He, Lan Ying; Yang, Hao; Dong, Wei Wei

    2012-01-01

    Malignant cerebral infarction often occurs in patients with massive cerebral infarction. Monitoring brain edema is therefore helpful to make correct clinical decisions. Our previous studies have confirmed that cerebral electrical impedance (CEI) can sensitively reflect the brain edema after stroke. The CEI was measured consecutively by a noninvasive brain edema monitor in 69 patients with massive hemispheric cerebral infarction (MHCI). The results of the CEI were converted into the perturbation index (PI). The characteristics of dynamic changes of the CEI after MHCI were analyzed. Receiver-operating characteristics analysis was used to calculate predictive values for PI and other known parameters including NIHSS score and infarct volume. (1) The overall rate of positive CEI was 88.4% (61/69) in all patients with MHCI. (2) The PI on the infarct side increased significantly within 24 h after stroke onset and reached a peak level 3-5 days after stroke onset (p brain edema in patients with MHCI. Monitoring the CEI may help to predict malignant MHCI and guide treatment decisions. Copyright © 2012 S. Karger AG, Basel.

  7. Comprehensive cognitive and cerebral hemodynamic evaluation after cranioplasty.

    Science.gov (United States)

    Coelho, Fernanda; Oliveira, Arthur Maynart; Paiva, Wellingson Silva; Freire, Fabio Rios; Calado, Vanessa Tome; Amorim, Robson Luis; Neville, Iuri Santana; de Andrade, Almir Ferreira; Bor-Seng-Shu, Edson; Anghinah, Renato; Teixeira, Manoel Jacobsen

    2014-01-01

    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.

  8. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  9. Intraoperative monitoring of an aspect of executive functions: administration of the Stroop test in 9 adult patients during awake surgery for resection of frontal glioma.

    Science.gov (United States)

    Wager, Michel; Du Boisgueheneuc, Foucaud; Pluchon, Claudette; Bouyer, Coline; Stal, Veronique; Bataille, Benoit; Guillevin, Carole Menuel; Gil, Roger

    2013-06-01

    Awake brain surgery allows extensive intraoperative monitoring of not only motor and sensory functions and language but also executive functions. To administer the Stroop test intraoperatively to avoid dramatic side effects such as akinetic mutism and to monitor executive functions in an attempt to optimize the benefit/risk balance of surgery. A series of 9 adult patients with frontal glioma were operated on for gross tumor resection under local anesthesia. All procedures involved the anterior cingulate cortex (ACC). Three types of response to the Stroop test were observed: 3 patients had a Stroop effect only for stimulation of the contralateral ACC; 3 patients had a Stroop effect for stimulation of the ipsilateral ACC; and 3 patients had no Stroop effect. Preoperative and postoperative neuropsychological and surgical results are presented and discussed. Stimulation sites eliciting a Stroop effect are compared with published image-based data, and insight provided by these surgical data regarding ACC function and plasticity is discussed. No operative complication related to intraoperative administration of the Stroop test was observed. Administration of the Stroop test during resection of gliomas involving the ACC in adult patients is an option for intraoperative monitoring of executive functions during awake surgery. Globally, these results suggest functional compensation, mediated by plasticity mechanisms, by contralateral homologous regions of the ACC in adult patients with frontal glioma.

  10. 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

  11. Methodological aspects of breath hydrogen (H2) analysis. Evaluation of a H2 monitor and interpretation of the breath H2 test

    DEFF Research Database (Denmark)

    Rumessen, J J; Kokholm, G; Gudmand-Høyer, E

    1987-01-01

    The reliability of end-expiratory hydrogen (H2) breath tests were assessed and the significance of some important pitfalls were studied, using a compact, rapid H2-monitor with electrochemical cells. The H2 response was shown to be linear and stable. The reproducibility of the breath collection...... technique was determined in 20 patients following ingestion of lactulose. The increment between consecutive means of duplicate samples indicative of a significant rise of H2 concentration never exceeded 10 p.p.m., the mean coefficient of variation of the duplicate samples was below 5%. Fasting H2 levels...

  12. Global cerebral edema and brain metabolism after subarachnoid hemorrhage.

    Science.gov (United States)

    Helbok, Raimund; Ko, Sang-Bae; Schmidt, J Michael; Kurtz, Pedro; Fernandez, Luis; Choi, H Alex; Connolly, E Sander; Lee, Kiwon; Badjatia, Neeraj; Mayer, Stephan A; Claassen, Jan

    2011-06-01

    Global cerebral edema is common among patients with poor-grade subarachnoid hemorrhage and is associated with poor outcome. Currently no targeted therapy exists largely due to an incomplete understanding of the underlying mechanisms. This is a prospective observational study including 39 consecutive patients with poor-grade subarachnoid hemorrhage with multimodal neuromonitoring. Levels of microdialysate lactate-pyruvate ratio, episodes of cerebral metabolic crisis (lactate-pyruvate ratio >40 and brain glucose cerebral perfusion pressure, and transcranial Doppler sonography flow velocities were analyzed. Median age was 54 years (range, 45 to 61 years) and 62% were female. Patients with global cerebral edema on admission (n=24 [62%]) had a higher incidence of metabolic crisis in the first 12 hours of monitoring (n=15 [15% versus 2%], Pcerebral edema. There was no difference in brain tissue oxygen tension or cerebral perfusion pressure between the groups; however, in patients with global cerebral edema, a higher cerebral perfusion pressure was associated with lower lactate-pyruvate ratio (Pcerebral edema is associated with early brain metabolic distress.

  13. 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...

  14. Duplicated middle cerebral artery

    Science.gov (United States)

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion. PMID:22140405

  15. Diaschisis with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Slater, R.; Reivich, M.; Goldberg, H.; Banka, R.; Greenberg, J.

    1977-01-01

    Fifteen patients admitted to Philadelphia General Hospital with acute strokes had repeated measurements of cerebral blood flow measured by the /sup 133/X inhalation method. A progressive decline in cerebral blood flow in both hemispheres was observed during the first week after infarction in twelve of these patients. This decline could be partially explained by loss of autoregulation, but could not be correlated with level of consciousness, clinical status of PCO2. This progressive decline in flow in the non-ischemic hemisphere indicates a process more complex than a simple destruction of axonal afferants to neurons as implied by the term diaschisis. The flow changes in the non-ischemic hemisphere are likely caused by a combination of the immediate effects of decreased neuronal stimulation modified by loss of autoregulation, release of vasoactive substances, cerebral edema, and other factors.

  16. Neuroimaging of cerebral vasculitis

    International Nuclear Information System (INIS)

    Wengenroth, M.; Saam, T.; Haehnel, S.

    2016-01-01

    Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [de

  17. Cerebral fat embolism

    International Nuclear Information System (INIS)

    Sakamoto, Toshihisa; Sawada, Yusuke; Yukioka, Tetsuo; Nishide, Kazuyuki; Yoshioka, Toshiharu

    1982-01-01

    A case of cerebral fat embolism is reported. A 18-year-old patient with multiple bone fractures was in semiconma immediately after an injury. Brain CT showed no brain swelling or intracranial hematoma. Hypoxemia and alcoholemia were noted on admission, which returned to normal without improvement of consciousness level. In addition, respiratory symptoms with positive radiographic changes, tachycardia, pyrexia, sudden drop in hemoglobin level, and sudden thrombocytopenia developed. These symptoms were compatible with Gurd's criteria of systemic fat embolism. Eight days after injury, multiple low density areas appeared on CT and disappeared within the subsequent two weeks, and subdural effusion with cerebral atrophy developed. These CT findings were not considered due to cerebral trauma. Diagnosis of cerebral fat embolism was made. The subdural effusion was drained. Neurologic and pulmonary recoveries took place slowly and one month following the injury the patient became alert and exhibited fully coordinated limb movement. The CT scans of the present case well corresponded with hitherto reported pathological findings. Petechiae in the white matter must have developed on the day of injury, which could not be detected by CT examination. It is suggested that some petechial regions fused to purpuras and then gradually resolved when they were detected as multiple low density areas on CT. CT in the purpuras phase would have shown these lesions as high density areas. These lesions must have healed with formation of tiny scars and blood pigment which were demonstrated as the disappearance of multiple low density areas by CT examination. Cerebral atrophy and subsequent subdural effusion developed as a result of demyelination. The patient took the typical clinical course of cerebral fat embolism and serial CT scans served for its assessment. (author)

  18. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    Focal cerebral ischemia due to occlusion of a major cerebral artery is the cause of ischemic stroke which is a major reason of mortality, morbidity and disability in the populations of the developed countries. In the seven studies summarized in the thesis focal ischemia in rats induced by occlusion...... in the penumbra is recruited in the infarction process leading to a progressive growth of the infarct. The penumbra hence constitutes an important target for pharmacological treatment because of the existence of a therapeutic time window during which treatment with neuroprotective compounds may prevent...

  19. Is cerebral hemorrhage approaching?

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Hirokazu; Suzuki, Yukiko; Yoneyama, Takumi; Hamasuna, Ryouichi; Fujime, Kenichi; Goya, Tomokazu [Junwakai Memorial Hospital, Miyazaki (Japan)

    2001-09-01

    In Junwakai Memorial Hospital, from May, 2000 to April, 2001, 1042 patients underwent MRI examination to detect intracerebral microbleed (MB). This series included 481 hypertensive cases and 109 intra-cerebral and cerebellar hemorrhage patients. MB was identified by MRI GRASS image that detects hemosiderin with high sensitivity. The occurrence of MB is high in men and increased with the age. The hypertensive patients showed increased frequency of MB in proportion to the duration of hypertension. Almost all of the symptomatic cerebral and cerebellar hemorrhage cases showed multiple MBs except for massive hemorrhagic lesions. Therefore, MB can be an antecedant feature of the inpending symptomatic intracerebral and cerebellar hemorrhages. (author)

  20. Cerebral near infrared spectroscopy oximetry in extremely preterm infants : Phase II randomised clinical trial

    NARCIS (Netherlands)

    Hyttel-Sorensen, Simon; Pellicer, Adelina; Alderliesten, Thomas; Austin, Topun; Van Bel, Frank; Benders, Manon; Claris, Olivier; Dempsey, Eugene; Franz, Axel R.; Fumagalli, Monica; Gluud, Christian; Grevstad, Berit; Hagmann, Cornelia; Lemmers, Petra; Van Oeveren, Wim; Pichler, Gerhard; Plomgaard, Anne Mette; Riera, Joan; Sanchez, Laura; Winkel, Per; Wolf, Martin; Greisen, Gorm

    2015-01-01

    Objective: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. Design: Phase II randomised, single blinded, parallel clinical trial. Setting Eight tertiary neonatal intensive care units in

  1. Changes in intracranial pressure gradients between the cerebral hemispheres in patients with intracerebral hematomas in one cerebral hemisphere.

    Science.gov (United States)

    Qiu, Wusi; Jiang, Qizhou; Xiao, Guoming; Wang, Weiming; Shen, Hong

    2014-01-01

    Intracranial-pressure (ICP) monitoring is useful for patients with increased ICP following hemorrhagic stroke. In this study, the changes in pressure gradients between the two cerebral hemispheres were investigated after hemorrhagic stroke of one side, and after a craniotomy. Twenty-four patients with acute cerebral hemorrhages and intracerebral hematomas who exhibited mass effect and midline shift to the contralateral side on computed tomography were selected for this study. After admission, both sides of the cranium were drilled, and optical fiber sensors were implanted to monitor the brain parenchyma pressure (BPP) in both cerebral hemispheres. All patients underwent surgical hematoma evacuations. The preoperative and postoperative BPP data from both cerebral hemispheres were collected at various time points and compared pairwise. There were statistically significant differences (P 0.05). The posteroperative BPPs of both hemispheres were statistically significantly lower than preoperative recordings. BPP sensors should be applied to the injured cerebral hemisphere, because this becomes the source of increased ICP. Hematoma evacuation surgery effectively decreases ICP and eliminates pressure gradients between the two cerebral hemispheres, consequently enabling brain shift correction.

  2. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Kino, Masao; Anno, Izumi; Yano, Yuhiko; Anno, Yasuro.

    1980-01-01

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  3. Exercise and heat stress: cerebral challenges and consequences

    DEFF Research Database (Denmark)

    Nybo, Lars

    2007-01-01

    This review deals with new aspects of exercise in the heat as a challenge that not only influences the locomotive and cardiovascular systems, but also affects the brain. Activation of the brain during such exercise is manifested in the lowering of the cerebral glucose to oxygen uptake ratio, the ...

  4. Home Literacy Environment: Characteristics of Children with Cerebral Palsy

    Science.gov (United States)

    Peeters, Marieke; Verhoeven, Ludo; van Balkom, Hans; de Moor, Jan

    2009-01-01

    Background: Various aspects of the home literacy environment are considered to stimulate the emergent literacy development in children without disabilities. It is important to gain insight into the home literacy environment of children with cerebral palsy given that they have been shown to have difficulty acquiring literacy skills. Aims: The aims…

  5. [Importance of the study of cerebral blood flow and regional oxygen consumption in cerebral ischemia].

    Science.gov (United States)

    Clanet, M

    1987-06-18

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two threshold lies a "penumbra zone". This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO2), oxygen extraction (EO2) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO2 and often a decrease in CMRO2, whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO2, EO2 and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis. Arteriopathic dementia probably does not result from chronic ischaemia of the cerebral parenchyma.

  6. Geophysical and Geochemical Aspects of Pressure and CO2 Saturation Modeling due to Migration of Fluids into the Above Zone Monitoring Interval of a Geologic Carbon Storage Site

    Science.gov (United States)

    Zhang, L.; Namhata, A.; Dilmore, R. M.; Bromhal, G. S.

    2016-12-01

    An increasing emphasis on the industrial scale implementation of CO2 storage into geological formations has led to the development of whole-system models to evaluate performance of candidate geologic storage sites, and the environmental risk associated with them. The components of that engineered geologic system include the storage reservoir, primary and secondary seals, and the overlying formations above primary and secondary seals (above-zone monitoring interval, AZMI). Leakage of CO2 and brine through the seal to the AZMI may occur due to the presence of natural or induced fractures in the seal. In this work, an AZMI model that simulates pressure and CO2 saturation responses through time to migration of fluids (here, CO2 and brine) from the primary seal to the AZMI is developed. A hypothetical case is examined wherein CO2 is injected into a storage reservoir for 30 years and a heterogeneous primary seal exists above the reservoir with some permeable zones. The total simulation period is 200 years (30 years of CO2 injection period and 170 years of post CO2 injection period). Key geophysical parameters such as permeability of the AZMI, thickness of the AZMI and porosity of the AZMI have significant impact on pressure evolution in the AZMI. arbitrary Polynomial Chaos (aPC) Expansion analysis shows that permeability of the AZMI has the most significant impact on pressure build up in the AZMI above the injection well at t=200 years, followed by thickness of the AZMI and porosity of the AZMI. Geochemical reactions have no impact on pressure and CO2 saturation evolution in the AZMI during the CO2 injection period. After the CO2 injection stops, precipitation of secondary minerals (e.g., amorphous silica and kaolinite) at the CO2 plume/brine interface in the AZMI formation may cause permeability reduction of the AZMI, which restrains horizontal migration of CO2 in the AZMI.

  7. Cerebral venous thrombosis

    NARCIS (Netherlands)

    Silvis, Suzanne M.; de Sousa, Diana Aguiar; Ferro, José M.; Coutinho, Jonathan M.

    2017-01-01

    Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults. Data from large international registries published in the past two decades have greatly improved our knowledge about the epidemiology, clinical manifestations and prognosis of CVT. The presentation of symptoms is

  8. Cardiopulmonary-cerebral resuscitation

    African Journals Online (AJOL)

    The brain is the organ most sensitive to hypoxia. The brain cannot store oxygen and has a very limited capacity for anaerobic metabolism. Permanent brain damage will thus result after three to four minutes of total hypoxia at normal temperatures. Should cerebral blood flow be restored after such an incident, the patient may ...

  9. CASE REPORT Cerebral schistosomiasis

    African Journals Online (AJOL)

    0b013e3182704d1e]. 5. Sanelli PC, Lev MH, Gonzalez RG, Schaefer PW. Unique linear and nodular MR enhancement pattern in schistosomiasis of the central nervous system: Report of three patients. AJR 2001;177(6):1471-1474. Cerebral schistosomiasis.

  10. Obesity and type 2 diabetes : cardiovascular and cerebral aspects

    NARCIS (Netherlands)

    Widya, R.L.

    2017-01-01

    The prevalence of obesity, defined as a body mass index (BMI) > 30 kg/m2, is increasing to epidemic proportions. In 2014, 11% of men and 15% of women worldwide were obese. Thus, more than half a billion adults worldwide are classed as obese. The fundamental cause of obesity is an imbalance between

  11. Recurrent cerebral thrombosis

    International Nuclear Information System (INIS)

    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru

    1992-01-01

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.)

  12. Praxial disorders in focal lesions of cerebral hemispheres

    Directory of Open Access Journals (Sweden)

    Jorge Murillo Duran

    2007-11-01

    Full Text Available The purpose of this work is to analyze paraxial difficulties i.e, functional disorders in movementresulting from cerebral tissue lesions. In accordance with the literature on the subject, the following definition, the following definition of apraxia has been accepted: “Apraxia is inability in properly executing kinetic tasks without impairment or loss of motor or sensory functions or ataxia with would condition such inability”. “Proper execution” used in this definition concerns not only the effect of the action but also means of its realization. “Kinetic tasks” signify all aspects of motor activity defined by instructions, irrespective of the type of instruction (verbal or gestures, and regardless of whether it required −in the final effect− imitating the movement of the investigator or whether they were performed independently. The methodology has been based in the principle on Luria’s works.Deliberations on praxial disorders were based on investigation results embracing 90 patients with focal cerebral lesions. In fifty cases, changes were localized in the left cerebral hemisphere, in forty cases−in the right hemisphere. The summing up the results concerning a global comparison between cerebral hemispheres, indicate the following regularities: Results achieved made it possible to form the opinion that not all of the generally accepted tests investigating praxia in persons with cerebral lesions are solved faultlessly by healthy individuals; thus, a faulty execution should not always be regarded as a sign of pathological functioning of the cerebral tissue as a result of lesion.

  13. Role of Histamine and Its Receptors in Cerebral Ischemia

    Science.gov (United States)

    2012-01-01

    Histamine is recognized as a neurotransmitter or neuromodulator in the brain, and it plays a major role in the pathogenic progression after cerebral ischemia. Extracellular histamine increases gradually after ischemia, and this may come from histaminergic neurons or mast cells. Histamine alleviates neuronal damage and infarct volume, and it promotes recovery of neurological function after ischemia; the H1, H2, and H3 receptors are all involved. Further studies suggest that histamine alleviates excitotoxicity, suppresses the release of glutamate and dopamine, and inhibits inflammation and glial scar formation. Histamine may also affect cerebral blood flow by targeting to vascular smooth muscle cells, and promote neurogenesis. Moreover, endogenous histamine is an essential mediator in the cerebral ischemic tolerance. Due to its multiple actions, affecting neurons, glia, vascular cells, and inflammatory cells, histamine is likely to be an important target in cerebral ischemia. But due to its low penetration of the blood-brain barrier and its wide actions in the periphery, histamine-related agents, like H3 antagonists and carnosine, show potential for cerebral ischemia therapy. However, important questions about the molecular aspects and pathophysiology of histamine and related agents in cerebral ischemia remain to be answered to form a solid scientific basis for therapeutic application. PMID:22860191

  14. Parálisis cerebral Cerebral palsy

    Directory of Open Access Journals (Sweden)

    Jorge Malagon Valdez

    2007-01-01

    Full Text Available El término parálisis cerebral (PC engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia mental, trastornos del lenguaje, audición, visión, déficit de la atención que mejoran el pronóstico de manera significativa. El pronóstico también depende de la gravedad del padecimiento y de las manifestaciones asociadas.The term cerebral palsy (CP, is used for a great number of clinical neurological syndromes. The syndromes are characterized by having a common cause, motor defects. It is important, because they can cause a brain damage by presenting motor defects and some associated deficiencies, such as mental deficiency, epilepsy, language and visual defects and pseudobulbar paralysis, with the nonevolving fact. Some authors prefer using terms such as "non-evolving encephalopathies". In the treatment the utility of prevention programs of early stimulation and special rehabilitation methods, and treatment of associated deficiencies such as epilepsy, mental deficiency, language, audition and visual problems, and the attention deficit improve the prognosis in an important way. The prognosis depends on the severity of the disease and the associated manifestations.

  15. Implementation of cerebral microdialysis at a community-based hospital: A 5-year retrospective analysis.

    Science.gov (United States)

    Chen, Jeff W; Rogers, Shana L; Gombart, Zoe J; Adler, David E; Cecil, Sandy

    2012-01-01

    Cerebral microdialysis (MD) provides valuable information about brain metabolism under normal and pathologic conditions. The CMA 600 microdialysis analyzer received US Food and Drug Administration (FDA) approval for clinical use in the United States in 2005. Since then, cerebral MD has been increasingly utilized nationally in the multimodal monitoring of traumatic brain injury (TBI), stroke, aneurysmal subarachnoid hemorrhage, and brain tumors. We describe a 5-year, single-institutional experience using cerebral MD at a community-based hospital, Legacy Emanuel Medical Center (LEMC). Implications for the adoption and utility of MD in medical centers with limited resources are discussed. This is a retrospective chart review and data analysis of 174 consecutive patients who had cerebral MD as part of multimodal brain monitoring. All cerebral MD catheters were placed by board-certified, attending neurosurgeons at LEMC. Clinical severity in the TBI patients was reported using initial Glasgow Coma Scale (GCS); radiologic severity was graded with the Marshall CT grading scale. Measures of the risks of MD placement included post-placement hemorrhage, cerebral infection, and dislodgement. Between July 2005 and July 2010, 248 cerebral MD catheters were placed in 174 patients undergoing multimodal brain monitoring. One hundred and eighty-five catheters were placed at the time of open craniotomy. None were associated with cranial infection. Patients ranged in age from 5 months to 90 years, with a mean of 49 years. The male to female ratio was 1.4:1. The underlying pathologies were: TBI (126), cerebral vascular accident (24), aneurysmal subarachnoid hemorrhage (17), and tumor (7). Cerebral MD was readily implemented in a community-based hospital. No cerebral hemorrhages or infections were attributed to cerebral MD. Examples of how MD may be a useful adjunct in the clinical decision making of patients with brain injuries are presented.

  16. Spectrum of Visual Impairment in Cerebral Venous Thrombosis: Importance of Tailoring Therapies Based on Pathophysiology.

    Science.gov (United States)

    Aaron, Sanjith; Arthur, Anupriya; Prabakhar, A T; Mannam, Pavitra; Shyamkumar, N K; Mani, Sunithi; Mathew, Vivek; Peter, Jeyanthi; Sivadasan, Ajith; Alexander, Anika; Karthik, M; Benjamin, Rohith Ninan; Alexander, Mathew

    2017-01-01

    Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts. Apart from using systemic anticoagulants to attempt recanalization and drugs with carbonic anhydrase inhibitor activity to reduce the ICPs, treatment modalities employed to save vision were (1) recanalization by local thrombolysis, stenting, or mechanical devices; (2) cerebrospinal fluid diversion procedures such as theco-periotoneal shunting; (3) optic nerve sheath fenestration; and (4) specific treatment for conditions such as dural AV fistula occurring as a late complication. CVT can cause visual impairment through different pathophysiological mechanisms. Depending on the mechanism, treatment strategies need to be tailored. Furthermore, very close monitoring is needed both in the acute and in the follow-up period, as new pathophysiological mechanisms can arise, compromising the vision. This may require a different treatment approach. Literature on this aspect of CVT is lacking.

  17. Nutrition in neurological disability in paediatrics: cerebral palsy

    African Journals Online (AJOL)

    The learning objectives of the case study were: • To discuss the growth monitoring of children with cerebral palsy. (CP). Which growth charts should, or could, be used? • To discuss the nutritional recommendations of infants and children with CP. • To discuss the possible drug-nutrient interactions and the nutrition-related ...

  18. A New Technology for Detecting Cerebral Blood Flow

    DEFF Research Database (Denmark)

    Schytz, Henrik W; Guo, Song; Jensen, Lars T

    2012-01-01

    There is a need for real-time non-invasive, continuous monitoring of cerebral blood flow (CBF) during surgery, in intensive care units and clinical research. We investigated a new non-invasive hybrid technology employing ultrasound tagged near infrared spectroscopy (UT-NIRS) that may estimate...

  19. Cognitive function and cerebral emboli after primary hip arthroplasty.

    Science.gov (United States)

    Gray, A C; Torrens, L; Howie, C R; Christie, J; Robinson, C M

    2008-01-01

    Transcranial Doppler ultrasound has been used to detect cerebral emboli after hip arthroplasty. The cognitive effects of these embolic events are unclear. The aim of this study was to assess cognitive change after primary cemented hip arthroplasty using a range of neuropsychological tests and to measure intraoperative cerebral embolic load. Twenty primary cemented total hip arthroplasties underwent a series of cognitive tests before and at four days after surgery. A range of validated tests assessed: global cognitive function; verbal fluency and speed; immediate and delayed memory recall; attention and mental processing speeds. Intra-operative transcranial Doppler ultrasound monitoring of the middle cerebral artery for embolic signals was also performed. A one-sample Wilcoxon signed-rank test compared median cognitive results post-pre surgery and a Mann-Whitney U test established if there was a cognitive difference between those patients who had detectable cerebral emboli and those who did not. Scatter plot graphs were also used to establish any correlation between the embolic load and clinical cognitive dysfunction. A significant (pmental processing speed, visual searching and sustained and divided attention following surgery. Intra-operative cerebral embolic signals were detected in 11 out of 20 patients and the majority occurred with femoral component cementation and hip reduction. There was no difference in cognitive dysfunction between those patients who had detectable cerebral embolic signals and those who did not and there appeared to be no direct correlation between the size of the embolic load and the level of cognitive dysfunction.

  20. Analysis of cranial CT-scan findings in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Wada, F.; Andoh, T.; Une, K.; Takamatsu, T. (Kitakyushu Municipal Sogo-Ryoiku Center (Japan))

    1981-06-01

    CT-scan findings of 87 cerebral palsied children were studied. They consist of 23 cases of spastic quadriplegia, 9 cases of diplegia, 12 cases of paraplegia, 24 cases of athetosis and mixed type, and 19 cases of hemiplegia. In the former four types, ventricular dilatation and cortical atrophy were measured and abnormal changes in cerebral substance and cerebellar atrophy were observed. Spastic quadriplegia showed most intense changes in every aspect of the abnormalities, while paraplegia had almost normal appearance. Athetosis and mixed type had moderate changes. Hemiplegia always showed asymmetrical view on CT-scan, dilatation of lateral ventricle or atrophy of hemisphere in contralateral side being observed.

  1. Genetics of Cerebral Vasospasm

    Directory of Open Access Journals (Sweden)

    Travis R. Ladner

    2013-01-01

    Full Text Available Cerebral vasospasm (CV is a major source of morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH. It is thought that an inflammatory cascade initiated by extravasated blood products precipitates CV, disrupting vascular smooth muscle cell function of major cerebral arteries, leading to vasoconstriction. Mechanisms of CV and modes of therapy are an active area of research. Understanding the genetic basis of CV holds promise for the recognition and treatment for this devastating neurovascular event. In our review, we summarize the most recent research involving key areas within the genetics and vasospasm discussion: (1 Prognostic role of genetics—risk stratification based on gene sequencing, biomarkers, and polymorphisms; (2 Signaling pathways—pinpointing key inflammatory molecules responsible for downstream cellular signaling and altering these mediators to provide therapeutic benefit; and (3 Gene therapy and gene delivery—using viral vectors or novel protein delivery methods to overexpress protective genes in the vasospasm cascade.

  2. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  3. Cerebral palsy and aging

    OpenAIRE

    Haak, Peterson; Lenski, Madeleine; Hidecker, Mary Jo Cooley; Li, Min; Paneth, Nigel

    2009-01-01

    Cerebral palsy (CP), the most common major disabling motor disorder of childhood, is frequently thought of as a condition that affects only children. Deaths in children with CP, never common, have in recent years become very rare, unless the child is very severely and multiply disabled. Thus, virtually all children assigned the diagnosis of CP will survive into adulthood. Attention to the adult with CP has been sparse, and the evolution of the motor disorder as the individual moves through ad...

  4. Radiopharmaceuticals for cerebral studies

    International Nuclear Information System (INIS)

    Leon Cabana, Alba

    1994-01-01

    For obtain good brain scintillation images in nuclear medicine must be used several radiopharmaceuticals. Cerebral studies give a tumors visual image as well as brain anomalities detection and are helpful in the diagnostic diseases . Are described in this work: a cerebrum radiopharmaceuticals classification,labelled compounds proceeding and Tc 99m good properties in for your fast caption, post administration and blood purification for renal way

  5. Plasticidad cerebral y lenguaje

    OpenAIRE

    Moreno-Torres Sánchez, Ignacio; Berthier-Torres, Marcelo Luis

    2012-01-01

    Hace pocos años se daba por sentado que la recuperación del lenguaje tras una lesión cerebral era imposible, al igual que adquirir la lengua materna más allá de los tres primeros años de vida. Sin embargo, las últimas indagaciones muestran que nuestra capacidad de aprender es mucho mayor.

  6. Cerebral blood oxygenation measurements in neonates with optoacoustic technique

    Science.gov (United States)

    Herrmann, Stephen; Petrov, Irene Y.; Petrov, Yuriy; Richardson, C. Joan; Fonseca, Rafael A.; Prough, Donald S.; Esenaliev, Rinat O.

    2017-03-01

    Cerebral hypoxia is a major contributor to neonatal/infant mortality and morbidity including severe neurological complications such as mental retardation, cerebral palsy, motor impairment, and epilepsy. Currently, no technology is capable of accurate monitoring of neonatal cerebral oxygenation. We proposed to use optoacoustics for this application by probing the superior sagittal sinus (SSS), a large central cerebral vein. We developed and built a multi-wavelength, optical parametric oscillator (OPO) and laser diode optoacoustic systems for measurement of SSS blood oxygenation in the reflection mode through open anterior or posterior fontanelles and in the transmission mode through the skull in the occipital area. In this paper we present results of initial tests of the laser diode system for neonatal cerebral oxygenation measurements. First, the system was tested in phantoms simulating neonatal SSS. Then, using the data obtained in the phantoms, we optimized the system's hardware and software and tested it in neonates admitted in the Neonatal Intensive Care Unit. The laser diode system was capable of detecting SSS signals in the reflection mode through the open anterior and posterior fontanelles as well as in the transmission mode through the skull with high signal-to-noise ratio. Using the signals measured at different wavelengths and algorithms developed for oxygenation measurements, the laser diode system provided real-time, continuous oxygenation monitoring with high precision at all these locations.

  7. Cerebral sex dimorphism and sexual orientation.

    Science.gov (United States)

    Manzouri, Amirhossein; Savic, Ivanka

    2018-03-01

    The neurobiology of sexual orientation is frequently discussed in terms of cerebral sex dimorphism (defining both functional and structural sex differences). Yet, the information about possible cerebral differences between sex-matched homo and heterosexual persons is limited, particularly among women. In this multimodal MRI study, we addressed these issues by investigating possible cerebral differences between homo and heterosexual persons, and by asking whether there is any sex difference in this aspect. Measurements of cortical thickness (Cth), subcortical volumes, and functional and structural resting-state connections among 40 heterosexual males (HeM) and 40 heterosexual females (HeF) were compared with those of 30 homosexual males (HoM) and 30 homosexual females (HoF). Congruent with previous reports, sex differences were detected in heterosexual controls with regard to fractional anisotropy (FA), Cth, and several subcortical volumes. Homosexual groups did not display any sex differences in FA values. Furthermore, their functional connectivity was significantly less pronounced in the mesial prefrontal and precuneus regions. In these two particular regions, HoM also displayed thicker cerebral cortex than other groups, whereas HoF did not differ from HeF. In addition, in HoM the parietal Cth showed "sex-reversed" values, not observed in HoF. Homosexual orientation seems associated with a less pronounced sexual differentiation of white matter tracts and a less pronounced functional connectivity of the self-referential networks compared to heterosexual orientation. Analyses of Cth suggest that male and female homosexuality are not simple analogues of each other and that differences from heterosexual controls are more pronounced in HoM. © 2017 Wiley Periodicals, Inc.

  8. Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects)

    International Nuclear Information System (INIS)

    Lechevalier, B.; Petit, M.C.; Eustache, F.; Lambert, J.; Chapon, F.; Viader, F.

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation

  9. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  10. Cerebral malformations without antenatal diagnosis

    International Nuclear Information System (INIS)

    Girard, Nadine J.

    2010-01-01

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  11. Critical cerebral perfusion pressure at high intracranial pressure measured by induced cerebrovascular and intracranial pressure reactivity.

    Science.gov (United States)

    Bragin, Denis E; Statom, Gloria L; Yonas, Howard; Dai, Xingping; Nemoto, Edwin M

    2014-12-01

    The lower limit of cerebral blood flow autoregulation is the critical cerebral perfusion pressure at which cerebral blood flow begins to fall. It is important that cerebral perfusion pressure be maintained above this level to ensure adequate cerebral blood flow, especially in patients with high intracranial pressure. However, the critical cerebral perfusion pressure of 50 mm Hg, obtained by decreasing mean arterial pressure, differs from the value of 30 mm Hg, obtained by increasing intracranial pressure, which we previously showed was due to microvascular shunt flow maintenance of a falsely high cerebral blood flow. The present study shows that the critical cerebral perfusion pressure, measured by increasing intracranial pressure to decrease cerebral perfusion pressure, is inaccurate but accurately determined by dopamine-induced dynamic intracranial pressure reactivity and cerebrovascular reactivity. Cerebral perfusion pressure was decreased either by increasing intracranial pressure or decreasing mean arterial pressure and the critical cerebral perfusion pressure by both methods compared. Cortical Doppler flux, intracranial pressure, and mean arterial pressure were monitored throughout the study. At each cerebral perfusion pressure, we measured microvascular RBC flow velocity, blood-brain barrier integrity (transcapillary dye extravasation), and tissue oxygenation (reduced nicotinamide adenine dinucleotide) in the cerebral cortex of rats using in vivo two-photon laser scanning microscopy. University laboratory. Male Sprague-Dawley rats. At each cerebral perfusion pressure, dopamine-induced arterial pressure transients (~10 mm Hg, ~45 s duration) were used to measure induced intracranial pressure reactivity (Δ intracranial pressure/Δ mean arterial pressure) and induced cerebrovascular reactivity (Δ cerebral blood flow/Δ mean arterial pressure). At a normal cerebral perfusion pressure of 70 mm Hg, 10 mm Hg mean arterial pressure pulses had no effect on

  12. Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

    International Nuclear Information System (INIS)

    Clanet, M.

    1987-01-01

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO 2 ), oxygen extraction (EO 2 ) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO 2 and often a decrease in CMRO 2 , whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO 2 , EO 2 and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis [fr

  13. Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Clanet, M.

    1987-06-18

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO/sub 2/), oxygen extraction (EO/sub 2/) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO/sub 2/ and often a decrease in CMRO/sub 2/, whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO/sub 2/, EO/sub 2/ and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis.

  14. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...... dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...

  15. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

    Stokum, Jesse A; Gerzanich, Volodymyr; Simard, J Marc

    2016-03-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. © The Author(s) 2015.

  16. What You Should Know about Cerebral Aneurysms

    Science.gov (United States)

    ... Month Infographic Stroke Hero F.A.S.T. Quiz What You Should Know About Cerebral Aneurysms Updated:Nov ... About Cerebral Aneurysms Diagnosis and Symptoms Damage Treatments What is a cerebral aneurysm? An aneurysm is a ...

  17. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

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

    2013-01-01

    OBJECTIVE: To test the hypothesis that preeclampsia is associated with impaired dynamic cerebral autoregulation. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (determined by noninvasive

  18. Hypocapnia and cerebral hypoperfusion in orthostatic intolerance

    Science.gov (United States)

    Novak, V.; Spies, J. M.; Novak, P.; McPhee, B. R.; Rummans, T. A.; Low, P. A.

    1998-01-01

    BACKGROUND AND PURPOSE: Orthostatic and other stresses trigger tachycardia associated with symptoms of tremulousness, shortness of breath, dizziness, blurred vision, and, often, syncope. It has been suggested that paradoxical cerebral vasoconstriction during head-up tilt might be present in patients with orthostatic intolerance. We chose to study middle cerebral artery (MCA) blood flow velocity (BFV) and cerebral vasoregulation during tilt in patients with orthostatic intolerance (OI). METHODS: Beat-to-beat BFV from the MCA, heart rate, CO2, blood pressure (BP), and respiration were measured in 30 patients with OI (25 women and 5 men; age range, 21 to 44 years; mean age, 31.3+/-1.2 years) and 17 control subjects (13 women and 4 men; age range, 20 to 41 years; mean age, 30+/-1.6 years); ages were not statistically different. These indices were monitored during supine rest and head-up tilt (HUT). We compared spontaneous breathing and hyperventilation and evaluated the effect of CO2 rebreathing in these 2 positions. RESULTS: The OI group had higher supine heart rates (Pfailed to show an increment. Among the cerebrovascular indices, all BFVs (systolic, diastolic, and mean) decreased significantly more, and cerebrovascular resistance (CVR) was increased in OI patients (Pindices were improved within 2 minutes of CO2 rebreathing. The relationships between CO2 and BFV and heart rate were well described by linear regressions, and the slope was not different between control subjects and patients with OI. CONCLUSIONS: Cerebral vasoconstriction occurs in OI during orthostasis, which is primarily due to hyperventilation, causing significant hypocapnia. Hypocapnia and symptoms of orthostatic hypertension are reversible by CO2 rebreathing.

  19. [Studying cerebral perfusion using magnetic susceptibility techniques: technique and applications].

    Science.gov (United States)

    Guzmán-de-Villoria, J A; Fernández-García, P; Mateos-Pérez, J M; Desco, M

    2012-01-01

    Perfusion MRI makes it possible to evaluate the cerebral microvasculature through changes in signal due to a tracer passing through blood vessels. The most commonly used technique is based on the magnetic susceptibility of gadolinium in T2*-weighted sequences, and the most commonly evaluated parameters are cerebral blood volume, cerebral blood flow, and mean transit time. Diverse technical aspects, like the sequence used, and the dose and speed of contrast material injection, must be taken into account in perfusion MRI studies. It is also essential to consider possible sources of error like contrast material leaks due to changes in the permeability of the blood-brain barrier. The most widely used clinical applications of perfusion MRI include the determination of the degree of aggressiveness of gliomas, the differentiation of some histological types of tumors or pseudotumors, and the evaluation of the penumbral area in acute ischemia. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  20. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

    Hessel, Trine W; Hyttel-Sorensen, Simon; Greisen, Gorm

    2014-01-01

    AIM: To compare absolute values of regional cerebral tissue oxygenation (cStO2 ) during haemodynamic transition after birth and repeatability during steady state for two commercial near-infrared spectroscopy (NIRS) devices. METHODS: In a prospective observational study, the INVOS 5100C and FORE......: The INVOS and FORE-SIGHT cStO2 estimates showed oxygenation-level-dependent difference during birth transition. The better repeatability of FORE-SIGHT could be due to the lower response to change in saturation....

  1. Cerebral venous thrombosis.

    Science.gov (United States)

    Ameri, A; Bousser, M G

    1992-02-01

    Neuroimagining facilities allow early recognition of cerebral venous thrombosis (CVT), which now appears far more common than previously assumed. The diagnosis remains difficult because of a wide spectrum of clinical presentation and a highly variable mode of onset. Numerous conditions (presently mostly noninfectious) can cause or predispose to CVT, which therefore requires an extensive etiologic work-up. The functional and vital prognosis is much better than classically thought with, in noninfectious CVT, a fatality rate of less than 10% and a complete recovery in over 70%. Although spontaneous recovery is possible, the efficacy of heparin is now well established.

  2. Sleep disorders in children with cerebral palsy: An integrative review.

    Science.gov (United States)

    Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A

    2016-12-01

    Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Cerebral aneurysms – an audit

    African Journals Online (AJOL)

    Enrique

    Abstract. We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloem- fontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hun- dred and twenty-three government patients, diagnosed with cerebral aneurysms during the period.

  4. Syncope, cerebral perfusion, and oxygenation

    NARCIS (Netherlands)

    van Lieshout, Johannes J.; Wieling, Wouter; Karemaker, John M.; Secher, Niels H.

    2003-01-01

    During standing, both the position of the cerebral circulation and the reductions in mean arterial pressure (MAP) and cardiac output challenge cerebral autoregulatory (CA) mechanisms. Syncope is most often associated with the upright position and can be provoked by any condition that jeopardizes

  5. Esophageal eosinophilia in pediatric patients with cerebral palsy.

    Science.gov (United States)

    Nápolis, Ana Carolina Ramos de; Alves, Flavia Araujo; Rezende, Erica Rodrigues Mariano de Almeida; Segundo, Gesmar Rodrigues Silva

    2015-01-01

    To describe the clinical picture, test results, and clinical evolution of patients with cerebral palsy associated with diagnosis of eosinophilic esophagitis, monitored at tertiary centre. Cross-sectional, retrospective and descriptive study that evaluated the medical records data of pediatric patients with diagnosis of cerebral palsy and eosinophilic esophagitis in a tertiary center of pediatric gastroenterology between August 2005 and August 2013. Seven out of 131 patients with cerebral palsy had the diagnosis of eosinophilic esophagitis. The mean age at diagnosis of eosinophilic esophagitis was 52.3 months and the mean number of eosinophils in esophagus was 35 per high-power field. Symptoms more frequent were recurrent vomiting and disphagia. Endoscopic alterations found were mucosal thickening, vertical lines, mucosal opacificacion and white plaques. The frequency of eosinophilic esophagitis found was higher than in general pediatric population. The investigation of eosinophilic esophagitis should be done regularly in those patients, once this entity could overlap other gastrointestinal diseases.

  6. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  7. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.

    1998-01-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  8. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I. [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  9. Cerebral cartography and connectomics.

    Science.gov (United States)

    Sporns, Olaf

    2015-05-19

    Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamics of functional brain connectivity, the definition of areal parcellations and their hierarchical organization into large-scale networks, the extension of whole-brain connectivity to cellular-scale networks, and the mapping of structure/function relations in empirical recordings and computational models. Successfully addressing these challenges will require extensions of methods and tools from network science to the mapping and analysis of human brain connectivity data. The emerging view that the brain is more than a collection of areas, but is fundamentally operating as a complex networked system, will continue to drive the creation of ever more detailed and multi-modal network maps as tools for on-going exploration and discovery in human connectomics. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  10. Zoonotic and histo-pathological aspects of various Toxoplasma ...

    African Journals Online (AJOL)

    Zoonotic and histo-pathological aspects of various Toxoplasma gondii strains in female rats. ... African Journal of Infectious Diseases ... The present investigation dealt with the concept, and focused on studying the susceptibility of female rats to cerebral and uterine toxoplasmosis, with reference to diversity of T. gondii ...

  11. Cerebral metastases from malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, G. (Royal Prince Alfred Hospital, Sydney (Australia). Department of Radiation Oncology Royal Prince Alfred Hospital, Sydney (Australia). Sydney Melanoma Unit); Firth, I. (Royal Prince Alfred Hospital, Sydney (Australia). Department of Medical Oncology); Coates, A. (Royal Prince Alfred Hospital, Sydney (Australia). Department of Radiation Oncology Royal Prince Alfred Hospital, Sydney (Australia). Sydney Melanoma Unit)

    1993-03-01

    A retrospective study was undertaken of factors affecting survival in 129 patients with cerebral metastases from malignant melanoma referred to the Department of Radiation Oncology from June '82-January '90. Their ages ranged from 19-83 years and the time interval form diagnosis of the primary tumour to development of cerebral metastases ranged from 1 month-17 years. Cerebral metastases were apparently solitary in 59 (46%) and multiple in 70 (54%) patients. Craniotomy with resection of tumour was performed in 49 patients, of whom 24 had a solitary cerebral metastasis as the only evidence of disease Most patients (94%) received radiotherapy-course. Median survival of the whole group after detection of cerebral metastases was 5 months (range <1-87+). Univariate analysis indicated that a solitary cerebral metastasis, absence of extracranial disease and tumour resection predicted improved survival, but only surgical intervention was of independent prognostic significance in a multivariate analysis. The effect of cranial irradiation on survival could not be assessed, but the dose of radiation did not influence survival. Of the 10 patients who survived for more than 2 years, 8 had total resection of a solitary cerebral metastasis. (author). 25 refs., 3 figs., 3 tabs.

  12. The influence of hyperthermia on intracranial pressure, cerebral oximetry and cerebral metabolism in traumatic brain injury

    Science.gov (United States)

    Nyholm, Lena; Howells, Tim; Lewén, Anders; Hillered, Lars; Enblad, Per

    2017-01-01

    Background Hyperthermia is a common secondary insult in traumatic brain injury (TBI). The aim was to evaluate the relationship between hyperthermia and intracranial pressure (ICP), and if intracranial compliance and cerebral blood flow (CBF) pressure autoregulation affected that relationship. The relationships between hyperthermia and cerebral oximetry (BtipO2) and cerebral metabolism were also studied. Methods A computerized multimodality monitoring system was used for data collection at the neurointensive care unit. Demographic and monitoring data (temperature, ICP, blood pressure, microdialysis, BtipO2) were analyzed from 87 consecutive TBI patients. ICP amplitude was used as measure of compliance, and CBF pressure autoregulation status was calculated using collected blood pressure and ICP values. Mixed models and comparison between groups were used. Results The influence of hyperthermia on intracranial dynamics (ICP, brain energy metabolism, and BtipO2) was small, but individual differences were seen. Linear mixed models showed that hyperthermia raises ICP slightly more when temperature increases in the groups with low compliance and impaired CBF pressure autoregulation. There was also a tendency (not statistically significant) for increased BtipO2, and for increased pyruvate and lactate, with higher temperature, while the lactate/pyruvate ratio and glucose were stable. Conclusions The major finding was that the effects of hyperthermia on intracranial dynamics (ICP, brain energy metabolism, and BtipO2) were not extensive in general, but there were exceptional cases. Hyperthermia treatment has many side effects, so it is desirable to identify cases in which hyperthermia is dangerous. Information from multimodality monitoring may be used to guide treatment in individual patients. PMID:28463046

  13. Natriuretic peptides and cerebral hemodynamics

    DEFF Research Database (Denmark)

    Guo, Song; Barringer, Filippa; Zois, Nora Elisabeth

    2014-01-01

    in decompensated disease. In contrast, their biological effects on the cerebral hemodynamics are poorly understood. In this mini-review, we summarize the hemodynamic effects of the natriuretic peptides with a focus on the cerebral hemodynamics. In addition, we will discuss its potential implications in diseases...... where alteration of the cerebral hemodynamics plays a role such as migraine and acute brain injury including stroke. We conclude that a possible role of the peptides is feasible as evaluated from animal and in vitro studies, but more research is needed in humans to determine the precise response...

  14. Cerebral Vasculitis Complicating Pneumococcal Meningitis

    Directory of Open Access Journals (Sweden)

    Ahmed Khedher

    2018-03-01

    Full Text Available Introduction: Cerebral vasculitis is an uncommon life-threatening complication of community-acquired bacterial meningitis. Patient and methods: We report the case of a 64-year-old woman with pneumococcal meningitis who developed parainfectious vasculitis causing ischaemic brain damage. Cerebral magnetic resonance imaging (MRI confirmed the diagnosis. Clinical and radiological recovery after delayed addition of corticosteroid was achieved. Discussion: This report shows that the onset of neurological deficits following pneumococcal meningitis can be caused by cerebral vasculitis. Underdosing with antibiotics and delayed adjunctive dexamethasone seem to favour this complication. There are no guidelines for treatment but high doses of steroids led to resolution in this case.

  15. Cerebral white matter hypoplasia

    International Nuclear Information System (INIS)

    Dietrich, R.B.; Shields, W.D.; Sankar, R.

    1990-01-01

    This paper demonstrates the MR imaging findings in children with cerebral white matter hypoplasia (CWMH). The MR studies of four children, aged 3-7 y (mean age, 2.3 y) with a diagnosis of CWMH were reviewed. In all cases multiplanar T1-weighted and T2-weighted spin-echo images were obtained. All children had similar histories of severe developmental delay and nonprogressive neurologic deficits despite normal gestational and birth histories. In two cases there was a history of maternal cocaine abuse. Autopsy correlation was available in one child. The MR images of all four children demonstrated diffuse lack of white matter and enlarged ventricles but normal-appearing gray matter. The corpus callosum, although completely formed, was severely thinned. There was no evidence of gliosis or porencephaly, and the distribution of myelin deposition was normal for age in all cases. Autopsy finding in one child correlated exactly with the MR finding

  16. Cerebral toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    Christ, F.; Steudel, H.; Klotz, D.; Bonn Univ.; Bonn Univ.

    1986-01-01

    Since 1982 (Hauser and co-workers), literature has reported focal cerebral tissue charges in AIDS patients whose diagnosis was unclear at first but which could be identified finally as florid toxoplasmosis encephalitis by biopsy and autopsy. It was found that the value of otherwise reliable serological tests (KBR, Sabin-Feldmann tests, etc.) is questionable in patients with severely impaired or incompetent immune systems, and, in particular, that a negative or uncharacteristic test result may not preclude any opportunistic infection process. Furthermore, isolation of Toxoplasma gondii or specific antibodies from the cerebrospinal fluid will be successful in exceptional cases only. In patients with AIDS or lymphadenopathy syndrome, the differential diagnosis will have to include - first and foremost - reactivated toxoplasma infection (not newly acquired, as a rule) if central neurological symptoms occur. (orig.) [de

  17. Complicated Sporadic Cardiac Myxomas: A Second Recurrence and Myxomatous Cerebral Aneurysms in One Patient

    Directory of Open Access Journals (Sweden)

    Mazen E. Iskandar

    2013-01-01

    Full Text Available A second recurrence of an excised nonfamilial cardiac myxoma is rare. Myxomatous cerebral aneurysms as a complication of cardiac myxomas are equally rare. A unique case of a patient with a total of 4 myxomas over a 20-year interval is presented. Her most recent presentation was a second recurrence of a left atrial myxoma, a de novo right atrial myxoma, and multiple cerebral myxomatous aneurysms. The challenging reconstruction of the normal anatomy was achieved with the use of porcine extracellular matrix patches. A diagnostic cerebral angiogram was later performed, and the aneurysms will be monitored for growth and possible intervention.

  18. Implementation of cerebral microdialysis at a community-based hospital: A 5-year retrospective analysis

    OpenAIRE

    Chen, Jeff W.; Rogers, Shana L.; Gombart, Zoe J.; Adler, David E.; Cecil, Sandy

    2012-01-01

    Background: Cerebral microdialysis (MD) provides valuable information about brain metabolism under normal and pathologic conditions. The CMA 600 microdialysis analyzer received US Food and Drug Administration (FDA) approval for clinical use in the United States in 2005. Since then, cerebral MD has been increasingly utilized nationally in the multimodal monitoring of traumatic brain injury (TBI), stroke, aneurysmal subarachnoid hemorrhage, and brain tumors. We describe a 5-year, single-institu...

  19. [Cerebrovascular fiberoptic catheter oximetry in an intracranial pressure model in swine. New aspects of a clinical routine].

    Science.gov (United States)

    Menzel, M; Rieger, A; Roth, S; Sanchin, L; Soukup, J; Hennig, C; Furka, H; Burkert, W; Radke, J

    1997-02-01

    The reliability of continuous fibreoptic oximetry in cerebral venous blood and its correlation with intracranial and cerebral perfusion pressures (pressure-volume curve) were examined in an experimental porcine study. The pressure in the infratentorial compartment of 13 domestic pigs (18-24 kg) was gradually increased by inflating a Fogarty balloon catheter placed on the surface of the right cerebellar hemisphere and below the tentorium. Single volumes of 0.4 ml saline were injected into the inflatable balloon at 1-min intervals up to a total volume of 7 ml. Intracranial pressure (ICP), arterial blood pressure, cerebral perfusion pressure (CPP), and cerebral venous saturation measured continuously by fibreoptic oximetry and intermittent blood-gas analyses (SjO2 superior sagittal sinus) were monitored during balloon inflation. All data were down-loaded onto a PC and evaluated off-line by a commercial statistical software package. Over the whole pressure-volume curve, two phases of SjO2 behaviour were registered by continuous fibreoptic oximetry (Oximetrix 3, Abbott) (Fig. 1). CPP ranges of less than 50% reduction from the initial value showed a linear correlation (rmittl. = 0.712, P < 0.01) between both parameters (CPP-SjO2). In CPP ranges below a crucial point of about 50 mmHg no such correlation was found (rmittl = 0.176, P < 0.5). In contrast, in 3 pigs a very good correlation was found between CPP and SjO2 over the whole pressure-volume curve as measured by blood-gas analyses of samples from the cerebrovenous catheter (rmittl. = 0.84, P < 0.05). We conclude that in physiological CPP ranges down to 50 mmHg, SjO2 measurement is a reliable method of detecting oxygen desaturation in cerebrovenous blood. Below that CPP value, the fibreoptic catheter showed repeated false-high oxygen saturation values. The accuracy of SjO2 measurement seems to depend on sufficient cerebral blood flow (CBF): with decreasing CBF the amount of cerebral venous outflow is diminished. We

  20. Learn More About Cerebral Palsy

    Centers for Disease Control (CDC) Podcasts

    2008-03-30

    This podcast describes the causes, preventions, types, and signs and symptoms of cerebral palsy.  Created: 3/30/2008 by National Center on Birth Defects and Developmental Disabilities.   Date Released: 3/21/2008.

  1. Cerebral spinal fluid (CSF) collection

    Science.gov (United States)

    ... ency/article/003428.htm Cerebral spinal fluid (CSF) collection To use the sharing features on this page, please enable JavaScript. Cerebrospinal fluid (CSF) collection is a test to look at the fluid ...

  2. Cerebral Cavernous Malformation and Hemorrhage

    Science.gov (United States)

    ... Text Size: SMALL • LARGE Cerebral Cavernous Angioma and Hemorrhage By Jack Hoch; Reviewed by Dr. Issam Awad ... for years, the mechanism by which these lesions hemorrhage remains poorly understood. Hemorrhage Types Since cavernous angiomas ...

  3. Hydrocephalus in cerebral venous thrombosis

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; van den Berg, René; Troost, Dirk; Majoie, Charles B.; Stam, Jan; Coutinho, Jonathan M.

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and

  4. Cerebral candidiasis. Computed tomography appearance

    International Nuclear Information System (INIS)

    Chaabane, M.; Ladeb, M.F.; Bouhaouala, M.H.; Ben Hammouda, M.; Ataalah, R.; Gannouni, A.; Krifa, H.

    1989-01-01

    A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodefinciency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. (orig.)

  5. Cerebral candidiasis. Computed tomography appearance

    Energy Technology Data Exchange (ETDEWEB)

    Chaabane, M.; Ladeb, M.F.; Bouhaouala, M.H.; Ben Hammouda, M.; Ataalah, R.; Gannouni, A.; Krifa, H.

    1989-07-01

    A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodefinciency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. (orig.).

  6. Parálisis cerebral :

    OpenAIRE

    Giral Lamenca, Mónica

    2015-01-01

    Se aborda el tema de la parálisis cerebral definiendo qué es, clasificando los tipos de parálisis dependiendo de la afectación y las características principales. Se explican algunos de sus tratamientos, se dan sistemas alternativos y/o aumentativos de comunicación para un alumno con PC (parálisis cerebral).

  7. Relative activity of cerebral subcortical gray matter in varying states of attention and awareness in normal subjects and patient studies

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, M.; Chen, C.T.; Levy, J.; Wagner, N.; Spire, J.P.; Jacobsen, J.; Meltzer, H.; Metz, J.; Beck, R.N.

    1985-05-01

    An important aspect of the study of brain function involves measurement of the relationships; between activities in the subcortical gray matter of the caudate and of the thalamus; and between these structures and functional cortical areas. The authors have studied these relationships in 22 subjects under different conditions of activation, sleep and sensory deprivation using a PET VI system and F-18-2DG to determine regional cerebral metabolism. Subject activating conditions were maintained throughout the period of equilibration of F-18-2DG and E.E.G.'s were monitored. Multiple tomographic slices of 1-2 million counts were obtained simultaneously with slice separation of 14mm and each plane parallel to the cantho-meatal line. In activated and non-activated awake conditions for normal subjects, left and right thalmus-to-caudate ratios were similar and greater than unity. This relationship was maintained in non-REM sleep, but was reversed and divergent in REM sleep and sensory deprivation; this was also evident in 3/4 narcoleptics awake and asleep in non-REM and REM and 2/3 schizophrenics and affective disorder, subjects. This approach appears to have potential for characterizating normal and disordered regional cerebral function.

  8. Relative activity of cerebral subcortical gray matter in varying states of attention and awareness in normal subjects and patient studies

    International Nuclear Information System (INIS)

    Cooper, M.; Chen, C.T.; Levy, J.; Wagner, N.; Spire, J.P.; Jacobsen, J.; Meltzer, H.; Metz, J.; Beck, R.N.

    1985-01-01

    An important aspect of the study of brain function involves measurement of the relationships; between activities in the subcortical gray matter of the caudate and of the thalamus; and between these structures and functional cortical areas. The authors have studied these relationships in 22 subjects under different conditions of activation, sleep and sensory deprivation using a PET VI system and F-18-2DG to determine regional cerebral metabolism. Subject activating conditions were maintained throughout the period of equilibration of F-18-2DG and E.E.G.'s were monitored. Multiple tomographic slices of 1-2 million counts were obtained simultaneously with slice separation of 14mm and each plane parallel to the cantho-meatal line. In activated and non-activated awake conditions for normal subjects, left and right thalmus-to-caudate ratios were similar and greater than unity. This relationship was maintained in non-REM sleep, but was reversed and divergent in REM sleep and sensory deprivation; this was also evident in 3/4 narcoleptics awake and asleep in non-REM and REM and 2/3 schizophrenics and affective disorder, subjects. This approach appears to have potential for characterizating normal and disordered regional cerebral function

  9. Changes in hemodynamic parameters and cerebral saturation during supraventricular tachycardia.

    Science.gov (United States)

    Hershenson, Jared A; Ro, Pamela S; Miao, Yongjie; Tobias, Joseph D; Olshove, Vincent; Naguib, Aymen N

    2012-02-01

    Induced supraventricular tachycardia (SVT) during electrophysiology studies (EPS) can be associated with hemodynamic changes. Traditionally, invasive arterial blood pressure has been used for continuous monitoring of these changes. This prospective study evaluated the efficacy of near-infrared spectroscopy (NIRS) monitoring during SVT. The use of NIRS has expanded with evidence of its accuracy and benefit in detecting cerebral hypoperfusion. This study aimed first to determine the hemodynamic changes associated with electrophysiology testing for SVT and second to determine whether the hemodynamic changes are associated with similar changes in the cerebral saturation as determined by NIRS. The study enrolled 30 patients 5-20 years of age with a history of SVT who underwent an EPS. The demographic data included age, gender, weight, height, and type of SVT. Hemodynamic data (invasive blood pressure and heart rate), NIRS, bispectral index (BIS), end-tidal carbon dioxide, and pulse oximetry were collected before and during three episodes of induced SVT. The linear correlation coefficient (r) was measured to calculate the relationship of the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) to the changes in NIRS values during the SVT episodes. Data from 22 patients were collected. The induction of SVT was associated mainly with a change in SBP and a less prominent change in DBP and MAP from baseline. The changes in hemodynamic status were associated with minimal changes in cerebral saturations, as evidenced by an average absolute change in NIRS of SVT during electrophysiology testing is associated with hemodynamic changes, mainly in SBP. In this study, these hemodynamic changes resulted in a minimal decrease in cerebral perfusion, as evidenced by minimal changes in the cerebral saturation measured by NIRS (0.7% from baseline). Although the changes in the cerebral saturation were minimal, these changes were

  10. Cerebral palsy dysphagia: a systematic review

    Directory of Open Access Journals (Sweden)

    Edênia da Cunha Menezes

    Full Text Available ABSTRACT Cerebral palsy (CP encompasses a group of definitive and non-progressive conditions, with a non-progressive character and its installation in neonatal period. Motor disorders caused by CP may lead to changes in swallowing, resulting in limitations in the activities that are attributed to non-progressive disorders that do not reach the developing child's brain. This article reviews the clinical aspects of dysphagia in CP and the treatments in the area. Only papers published in the period from 2009 to 2017 were considered, using a methodological strategy for electronic search in the databases SciELO-Brazil, Lilacs and Medline/Pubmed. The present research analyzed 24 articles, regarding the year of publication, sample and instruments used, verifying that Speech Therapists and other staff involved in the improvement and rehabilitation of cognitive functions have provided better rehabilitation conditions, despite the need for more therapy and diagnostic studies.

  11. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

    Rathnasamy, Gurugirijha; Ling, Eng-Ang; Kaur, Charanjit

    2014-12-01

    Cerebral edema/brain edema refers to the accumulation of fluid in the brain and is one of the fatal conditions that require immediate medical attention. Cerebral edema develops as a consequence of cerebral trauma, cerebral infarction, hemorrhages, abscess, tumor, hypoxia, and other toxic or metabolic factors. Based on the causative factors cerebral edema is differentiated into cytotoxic cerebral edema, vasogenic cerebral edema, osmotic and interstitial cerebral edema. Treatment of cerebral edema depends on timely diagnosis and medical assistance. Pragmatic treatment strategies such as antihypertensive medications, nonsteroidal anti-inflammatory drugs, barbiturates, steroids, glutamate and N-methyl-D-aspartate receptor antagonists and trometamol are used in clinical practice. Although the above mentioned treatment approaches are being used, owing to the complexity of the mechanisms involved in cerebral edema, a single therapeutic strategy which could ameliorate cerebral edema is yet to be identified. However, recent experimental studies have suggested that melatonin, a neurohormone produced by the pineal gland, could be an effective alternative for treating cerebral edema. In animal models of stroke, melatonin was not only shown to reduce cerebral edema but also preserved the blood brain barrier. Melatonin's beneficial effects were attributed to its properties, such as being a potent anti-oxidant, and its ability to cross the blood brain barrier within minutes after its administration. This review summarizes the beneficial effects of melatonin when used for treating cerebral edema.

  12. Aspects on the Physiological and Biochemical Foundations of Neurocritical Care

    Directory of Open Access Journals (Sweden)

    Carl-Henrik Nordström

    2017-06-01

    Full Text Available Neurocritical care (NCC is a branch of intensive care medicine characterized by specific physiological and biochemical monitoring techniques necessary for identifying cerebral adverse events and for evaluating specific therapies. Information is primarily obtained from physiological variables related to intracranial pressure (ICP and cerebral blood flow (CBF and from physiological and biochemical variables related to cerebral energy metabolism. Non-surgical therapies developed for treating increased ICP are based on knowledge regarding transport of water across the intact and injured blood–brain barrier (BBB and the regulation of CBF. Brain volume is strictly controlled as the BBB permeability to crystalloids is very low restricting net transport of water across the capillary wall. Cerebral pressure autoregulation prevents changes in intracranial blood volume and intracapillary hydrostatic pressure at variations in arterial blood pressure. Information regarding cerebral oxidative metabolism is obtained from measurements of brain tissue oxygen tension (PbtO2 and biochemical data obtained from intracerebral microdialysis. As interstitial lactate/pyruvate (LP ratio instantaneously reflects shifts in intracellular cytoplasmatic redox state, it is an important indicator of compromised cerebral oxidative metabolism. The combined information obtained from PbtO2, LP ratio, and the pattern of biochemical variables reveals whether impaired oxidative metabolism is due to insufficient perfusion (ischemia or mitochondrial dysfunction. Intracerebral microdialysis and PbtO2 give information from a very small volume of tissue. Accordingly, clinical interpretation of the data must be based on information of the probe location in relation to focal brain damage. Attempts to evaluate global cerebral energy state from microdialysis of intraventricular fluid and from the LP ratio of the draining venous blood have recently been presented. To be of clinical relevance

  13. Cerebral trypanosomiasis and AIDS

    Directory of Open Access Journals (Sweden)

    Antunes Apio Claudio Martins

    2002-01-01

    Full Text Available A 36 year-old black female, complaining of headache of one month's duration presented with nausea, vomiting, somnolence, short memory problems, loss of weight, and no fever history. Smoker, intravenous drugs abuser, promiscuous lifestyle. Physical examination: left homonimous hemianopsia, left hemiparesis, no papilledema, diffuse hyperreflexia, slowness of movements. Brain CT scan: tumor-like lesion in the splenium of the corpus calosum, measuring 3.5 x 1.4 cm, with heterogeneous enhancing pattern, sugesting a primary CNS tumor. Due to the possibility of CNS infection, a lumbar puncture disclosed an opening pressure of 380 mmH(20; 11 white cells (lymphocytes; glucose 18 mg/dl (serum glucose 73 mg/dl; proteins 139 mg/dl; presence of Trypanosoma parasites. Serum Elisa-HIV tests turned out to be positive. Treatment with benznidazole dramatically improved clinical and radiographic picture, but the patient died 6 weeks later because of respiratory failure. T. cruzi infection of the CNS is a rare disease, but we have an increasing number of cases in HIV immunecompromised patients. Diagnosis by direct observation of CSF is uncommon, and most of the cases are diagnosed by pathological examination. It is a highly lethal disease, even when properly diagnosed and treated. This article intends to include cerebral trypanosomiasis in the differential diagnosis of intracranial space-occupying lesions, especially in immunecompromised patients from endemic regions.

  14. [Emotions and situations of communication in children and adolescents with frontal cerebral lesions].

    Science.gov (United States)

    Delanoë, A; Dardier, V; Deleau, M; Le Maner-Idrissi, G; Reilly, J; Cattelotte, V; Jardel, D; Laurent-Vannier, A; Pinochet, C; Tsimba, V

    2007-10-01

    Following cerebral lesions, especially right and frontal cerebral lesions, patients often have difficulties in social cognition. Emotional skills are often impaired. Adults with cerebral lesions have difficulty identifying facial emotional expressions and attributing emotions in situations of communication. However, few studies have involved children and adolescents with cerebral lesions. Our first goal was to determine whether the performance in emotional tasks of young patients with frontal cerebral lesions is as impaired as that of adults, and the second goal was to study the role of emotional cues in pragmatic aspects of language. The study involved 7 children and adolescents with frontal cerebral lesions but no aphasia and 7 control subjects. We used two emotional tasks: one to assess the ability to identify facial emotional expressions, and one to assess the ability to attribute emotions in situations of communication. The control and experimental groups did not differ significantly in identifying and attributing emotions. A further analysis of responses revealed that the patients were more impaired than controls in attributing complex emotions. As well, the patients tended to produce more justifications based on irrelevant elements than the controls. Our first data have shown that the children and adolescents with frontal cerebral lesions retain the ability to analyse emotions in situations of communication but have subtle difficulty in analysing emotional cues in social situations.

  15. Application of non-invasive cerebral electrical impedance measurement on brain edema in patients with cerebral infarction.

    Science.gov (United States)

    He, Lan Ying; Wang, Jian; Luo, Yong; Dong, Wei Wei; Liu, Li Xu

    2010-09-01

    To investigate the change of brain edema in patients with cerebral infarction by non-invasive cerebral electrical impedance (CEI) measurements. An invariable secure current at a frequency of 50 kHz and an intensity of 0.1 mA was given into a person's brain. CEI values of the bilateral hemisphere of 200 healthy volunteers and 107 patients with cerebral infarction were measured by non-invasive brain edema monitor. The results of perturbative index (PI) converted from CEI were compared with the volumes of brain edema, which were calculated by an image analysing system according to magnetic resonance imaging or computed tomography. (1) In the healthy volunteers, PI values in the left and right hemisphere were 7.98 +/- 0.95 and 8.02 +/- 0.71 respectively, and there was no significant difference between the two sides (p>0.05). Age, gender and different measuring times did not obviously affect PI values (p>0.05). (2) In the cerebral infarction group, CEI measurements were more sensitive to the volumes of lesion, which were more than 20 ml. The positive ratio of PI was higher when the volumes of infarction were >20 ml (80.0%): the ratio of PI was 75.9% when the volumes of infarction were 20-50 ml and it was 83.3% when the volumes of lesion were more than 50 ml. PI was lower when the volumes were less than 20 ml. (3) PI of the infarction side increased obviously 3-5 days after onset; the difference of two sides was the most significant. There was a positive correlation between PI of the infarction side and volume of infarction. PI may be a sensitive parameter for non-invasive monitoring of the change of brain edema in patients with cerebral infarction. CEI is a valuable method for the early detection of brain edema.

  16. Cerebral Metabolic Changes Related to Oxidative Metabolism in a Model of Bacterial Meningitis Induced by Lipopolysaccharide

    DEFF Research Database (Denmark)

    Munk, Michael; Rom Poulsen, Frantz; Larsen, Lykke

    2018-01-01

    BACKGROUND: Cerebral mitochondrial dysfunction is prominent in the pathophysiology of severe bacterial meningitis. In the present study, we hypothesize that the metabolic changes seen after intracisternal lipopolysaccharide (LPS) injection in a piglet model of meningitis is compatible...... with mitochondrial dysfunction and resembles the metabolic patterns seen in patients with bacterial meningitis. METHODS: Eight pigs received LPS injection in cisterna magna, and four pigs received NaCl in cisterna magna as a control. Biochemical variables related to energy metabolism were monitored by intracerebral...... dysfunction with increasing cerebral LPR due to increased lactate and normal pyruvate, PbtO2, and ICP. The metabolic pattern resembles the one observed in patients with bacterial meningitis. Metabolic monitoring in these patients is feasible to monitor for cerebral metabolic derangements otherwise missed...

  17. Aspects related to 'emission trading'

    International Nuclear Information System (INIS)

    Tutuianu, Ovidiu

    1999-01-01

    The paper presents the aspects of international GHG (greenhouse gases) emission trading, such as: quality of GHG emission data, possible partners, monitoring activity, market mechanisms and difficulties. The following conclusions are drown: - debates on international trade with GHG emissions are currently in a very early stage; - actions are possible and feasible, particularly after Kyoto Conference, as versatile mechanism (besides the Joint Implementation Projects) which have in view the lowering of the global emission costs in different zones of the planet; - difficulties concerning monitoring, reporting and verification, practically preclude implementing a system of emission trading covering all the GHG, all the sources and reservoirs; - an international viable system of emission trading could initiate with a limited number of participants and consideration of only emission categories easy to be confined and surveyed; - existence of a national market and corresponding institutions for monitoring which could booster an international system development

  18. 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

  19. Hypertension and the post-carotid endarterectomy cerebral hyperperfusion syndrome.

    Science.gov (United States)

    Bouri, S; Thapar, A; Shalhoub, J; Jayasooriya, G; Fernando, A; Franklin, I J; Davies, A H

    2011-02-01

    Cerebral hyperperfusion syndrome is a preventable cause of stroke after carotid endarterectomy (CEA). It manifests as headache, seizures, hemiparesis or coma due to raised intracranial pressure or intracerebral haemorrhage (ICH). There is currently no consensus on whether to control blood pressure, blood pressure thresholds associated with cerebral hyperperfusion syndrome, choice of anti-hypertensive agent(s) or duration of treatment. A systematic review of the PubMed database (1963-2010) was performed using appropriate search terms according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 36 studies were identified as fitting a priori inclusion criteria. Following CEA, the incidence of severe hypertension was 19%, that of cerebral hyperperfusion 1% and ICH 0.5%. The postoperative mean systolic blood pressure of patients, who went on to develop cerebral hyperperfusion syndrome, was 164 mmHg (95% confidence interval (CI) 150-178 mmHg) and the cumulative incidence of cases rose appreciably above a postoperative systolic blood pressure of 150 mmHg. The mean systolic blood pressure of cerebral hyperperfusion cases was 189 mmHg (95% CI 183-196 mmHg) at presentation. The incidence of cerebral hyperperfusion in the first week was 92% with a median time to presentation of 5 days (interquartile range (IQR) 3-6 days). 36% of patients presented with seizures 31% with hemiparesis and 33% with both. The proportion of patients with severe hypertension was significantly higher in cases than in post-CEA controls (p hypertension as a risk factor for ICH. There is currently level-3 evidence for the prevention of ICH through control of postoperative blood pressure. From the available data, we suggest a definition for cerebral hyperperfusion syndrome, blood pressure thresholds, duration of monitoring and a postoperative blood pressure control strategy for validation in a prospective study. The implications of this are that one in

  20. Aspects and Polymorphism in AspectJ

    DEFF Research Database (Denmark)

    Lorenz, David Harel; Ernst, Erik

    2003-01-01

    There are two important points of view on inclusion or subtype polymorphism in object-oriented programs, namely polymorphic access and dynamic dispatch. These features are essential for object-oriented programming, and it is worthwhile to consider whether they are supported in aspect......-oriented programming (AOP). In AOP, pieces of crosscutting behavior are extracted from the base code and localized in aspects, losing as a result their polymorphic capabilities while introducing new and unexplored issues. In this paper, we explore what kinds of polymorphism AOP languages should support, using Aspect......J as the basis for the presentation. The results are not exclusive to AspectJ---aspectual polymorphism may make aspects in any comparable AOSD language more expressive and reusable across programs, while preserving safety....

  1. Cerebral Sinovenous Thrombosis

    Directory of Open Access Journals (Sweden)

    Rebecca Ichord

    2017-07-01

    Full Text Available Cerebral sinovenous thrombosis (CSVT is a rare but serious cerebrovascular disorder affecting children from the newborn period through childhood and adolescence. The incidence is estimated at 0.6/100,000/year, with 30–50% occurring in newborns. Causes are diverse and are highly age dependent. Acute systemic illness is the dominant risk factor among newborns. In childhood CSVT, acute infections of the head and neck such as mastoiditis are most common, followed by chronic underlying diseases such as nephrotic syndrome, cancer, and inflammatory bowel disease. Signs and symptoms are also age related. Seizures and altered mental status are the commonest manifestations in newborns. Headache, vomiting, and lethargy, sometimes with 6th nerve palsy, are the most common symptoms in children and adolescents. Recent multicenter cohort studies from North America and Europe have provided updated information on risk factors, clinical presentations, treatment practices, and outcomes. While systemic anticoagulation is the most common specific treatment used, there are wide variations and many uncertainties even among experts concerning best practice. The treatment dilemma is especially pronounced for neonatal CSVT. This is due in part to the higher prevalence of intracranial hemorrhage among newborns on the one hand, and the clear evidence that newborns suffer greater long-term neurologic morbidity on the other hand. With the advent of widespread availability and acceptance of acute endovascular therapy for arterial ischemic stroke, there is renewed interest in this therapy for children with CSVT. Limited published evidence exists regarding the benefits and risks of these invasive therapies. Therefore, the authors of current guidelines advise reserving this therapy for children with progressive and severe disease who have failed optimal medical management. As research focused on childhood cerebrovascular disease continues to grow rapidly, the future prospects

  2. 11 Things to Know about Cerebral Palsy

    Science.gov (United States)

    ... Button Past Emails 11 Things to Know about Cerebral Palsy Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir Cerebral palsy (CP) is the most common motor disability in ...

  3. Neurological aspects of eclampsia

    Directory of Open Access Journals (Sweden)

    Jovanović Dejana

    2003-01-01

    Full Text Available The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn’t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.

  4. NEYROPSYCHOLOGICAL CONSECUENCES OF CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    ANA MARÍA NAVARRO MELENDRO

    2005-01-01

    Full Text Available Cerebral Palsy is defined as a movement alteration result of a non progressive damage witch is permanent in anencephalon that has not acquired its final maturation. Patients that suffer cerebral palsy present learning disabilities,that varies between being completely normal to severe as a consequence of memory, gnosis, praxis, perceptive andlanguage impairments. Nevertheless the consequences of this disease are not always predictable. This paper pretendsto make a description of the cognitive and behavioral deficits that overcomes along with the manifestation of thecerebral palsy and its possible treatment. We used a complete neuropsychological battery to evaluate a 7 years oldpatient who was diagnosed of cerebral palsy and spastic diplegia finding some cognitive impairment in fields such asmnesic, gnosic and attention processes.

  5. Deep Cerebral Vein Thrombosis: A Clinical Masquerader

    OpenAIRE

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-01-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially ...

  6. Effects of Hyperglycemia and Effects of Ketosis on Cerebral Perfusion, Cerebral Water Distribution, and Cerebral Metabolism

    Science.gov (United States)

    Glaser, Nicole; Ngo, Catherine; Anderson, Steven; Yuen, Natalie; Trifu, Alexandra; O’Donnell, Martha

    2012-01-01

    Diabetic ketoacidosis (DKA) may cause brain injuries in children. The mechanisms responsible are difficult to elucidate because DKA involves multiple metabolic derangements. We aimed to determine the independent effects of hyperglycemia and ketosis on cerebral metabolism, blood flow, and water distribution. We used magnetic resonance spectroscopy to measure ratios of cerebral metabolites (ATP to inorganic phosphate [Pi], phosphocreatine [PCr] to Pi, N-acetyl aspartate [NAA] to creatine [Cr], and lactate to Cr) and diffusion-weighted imaging and perfusion-weighted imaging to assess cerebral water distribution (apparent diffusion coefficient [ADC] values) and cerebral blood flow (CBF) in three groups of juvenile rats (hyperglycemic, ketotic, and normal control). ATP-to-Pi ratio was reduced in both hyperglycemic and ketotic rats in comparison with controls. PCr-to-Pi ratio was reduced in the ketotic group, and there was a trend toward reduction in the hyperglycemic group. No significant differences were observed in NAA-to-Cr or lactate-to-Cr ratio. Cortical ADC was reduced in both groups (indicating brain cell swelling). Cortical CBF was also reduced in both groups. We conclude that both hyperglycemia and ketosis independently cause reductions in cerebral high-energy phosphates, CBF, and cortical ADC values. These effects may play a role in the pathophysiology of DKA-related brain injury. PMID:22498698

  7. Neutronic and thermalhydraulic aspects

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, J.B. [CEA Centre d`Etudes de Saclay, 91 - Gif-sur-Yvette (France). Dept. de Mecanique et de Technologie; Bergeonneau, P. [CEA Centre d`Etudes de Cadarache, 13 - Saint-Paul-lez-Durance (France). Dept. d`Etudes des Reacteurs

    1995-12-31

    Precise computation of neutron flux in the core of a nuclear reactor represents one of the basic aspects of reactor design and operation. Neutron flux is computed by solving Boltzmann`s linear equation. Anyway, the direct solution of the equation involves too great a number of operations for practical application, leading up to TeraFlops or even PetaFlops supercomputing capabilities. Physical and mathematical models are then required to handle the extensive variety of configurations encountered. Numerical methods must be adapted to the rapid evolution of computer power, as also computer architecture: sequential, vector or parallel. Physical and mathematical models must allow for very fast estimation for online control and monitoring, adequate quantification for industrial studies and high-precision, best estimate computations. Coupling of neutronics to mechanics and two-phase flow thermohydraulics must be implemented in order to improve the accuracy in best-estimate computation schemes and to take into account the transient behaviour of the plant during normal operation or incidents. In this field of continuous improvement, the new methods applied in Reactor Physics lead obviously to good results and provide the improvements required in the future for the needs of efficiency, safety and advanced fuel cycle. This trend and the ``evolutionary`` implementation in large and modular software systems will be illustrated by the example of the SAPHYR system. (authors). 3 tabs.

  8. Treaty Monitoring

    DEFF Research Database (Denmark)

    Canty, M.; Jasani, B.; Lingenfelder, I.

    2009-01-01

    This volume provides the reader with an overview of the state-of-the-art Earth Observation (EO) related research that deals with national and international security. An interdisciplinary approach was adopted in this book in order to provide the reader with a broad understanding on the uses...... of remote sensing technologies. The book therefore comprises management aspects (issues and priorities of security research, crisis response), applied methodologies and process chains (treaty monitoring, estimation of population densities and characteristics, border permeability models, damage assessment...

  9. Analyses of cerebral microdialysis in patients with traumatic brain injury: relations to intracranial pressure, cerebral perfusion pressure and catheter placement

    Directory of Open Access Journals (Sweden)

    Wanecek Michael

    2011-03-01

    Full Text Available Abstract Background Cerebral microdialysis (MD is used to monitor local brain chemistry of patients with traumatic brain injury (TBI. Despite an extensive literature on cerebral MD in the clinical setting, it remains unclear how individual levels of real-time MD data are to be interpreted. Intracranial pressure (ICP and cerebral perfusion pressure (CPP are important continuous brain monitors in neurointensive care. They are used as surrogate monitors of cerebral blood flow and have an established relation to outcome. The purpose of this study was to investigate the relations between MD parameters and ICP and/or CPP in patients with TBI. Methods Cerebral MD, ICP and CPP were monitored in 90 patients with TBI. Data were extensively analyzed, using over 7,350 samples of complete (hourly MD data sets (glucose, lactate, pyruvate and glycerol to seek representations of ICP, CPP and MD that were best correlated. MD catheter positions were located on computed tomography scans as pericontusional or nonpericontusional. MD markers were analyzed for correlations to ICP and CPP using time series regression analysis, mixed effects models and nonlinear (artificial neural networks computer-based pattern recognition methods. Results Despite much data indicating highly perturbed metabolism, MD shows weak correlations to ICP and CPP. In contrast, the autocorrelation of MD is high for all markers, even at up to 30 future hours. Consequently, subject identity alone explains 52% to 75% of MD marker variance. This indicates that the dominant metabolic processes monitored with MD are long-term, spanning days or longer. In comparison, short-term (differenced or Δ changes of MD vs. CPP are significantly correlated in pericontusional locations, but with less than 1% explained variance. Moreover, CPP and ICP were significantly related to outcome based on Glasgow Outcome Scale scores, while no significant relations were found between outcome and MD. Conclusions The

  10. Recent Experiences with Severe and Cerebral Malaria

    African Journals Online (AJOL)

    1974-06-29

    Jun 29, 1974 ... Malaria admissions. Cerebral malaria ... Cerebral signs. Haemoglobin below 10 g/100 ml (not all tested). Enlarged tender liver or jaundice, or both ... articl~ by H. Smitskamp and F. H. Wolthuis entitled 'New concepts in treatment of malaria with malignant tertian cerebral involvement' which appeared in the ...

  11. Cerebral Syphilitic Gumma in Immunocompetent Man, Japan.

    Science.gov (United States)

    Kodama, Tatsuya; Sato, Hidenori; Osa, Morichika; Fujikura, Yuji; Kawana, Akihiko

    2018-02-01

    Although cerebral syphilitic gummas are generally considered to be rare manifestations of tertiary syphilis, many reports exist of early cerebral syphilitic gumma. Our finding of cerebral syphilitic gumma in an HIV-negative man within 5 months after syphilis infection suggests that this condition should be considered in syphilis patients who have neurologic symptoms.

  12. Cerebral vasculitis associated with cocaine abuse

    International Nuclear Information System (INIS)

    Kaye, B.R.; Fainstat, M.

    1987-01-01

    A case of cerebral vasculitis in a previously healthy 22-year-old man with a history of cocaine abuse is described. Cerebral angiograms showed evidence of vasculitis. A search for possible causes other than cocaine produced no results. The authors include cocaine with methamphetamines, heroin, and ephedrine as illicit drugs that can cause cerebral vasculitis

  13. Cerebral toksoplasmose primaert diagnosticeret som tumor

    DEFF Research Database (Denmark)

    Cortsen, M E; Skøt, J; Skriver, E B

    1992-01-01

    Three cases of cerebral toxoplasmosis as the presenting manifestation of AIDS are reported. The initial diagnoses were brain tumors because of the cerebral mass lesions which resembled glioblastoma. In the light of the increasing occurrence of AIDS, attention is drawn to cerebral toxoplasmosis...

  14. Neuroevolutional Approach to Cerebral Palsy and Speech.

    Science.gov (United States)

    Mysak, Edward D.

    Intended for cerebral palsy specialists, the book emphasizes the contribution that a neuroevolutional approach to therapy can make to habilitation goals of the child with cerebral palsy and applies the basic principles of the Bobath approach to therapy. The first section discusses cerebral palsy as a reflection of disturbed neuro-ontogenisis and…

  15. Energy Monitoring

    DEFF Research Database (Denmark)

    Hansen, Claus T.; Madsen, Dines; Christiensen, Thomas

    Energy measurement has become an important aspect of our daily lives since we have learned that energy consumption, is one of the main source of global warming. Measuring instruments varies from a simple watt-meter to more sophisticated microprocessor control devices. The negative effects...... that fossil fuels induce on our environment has forced us to research renewable energy such as sunlight, wind etc. This new environmental awareness has also helped us to realize the importance of monitoring and controlling our energy use. The main purpose in this research is to introduce a more sophisticated...... but affordable way to monitor energy consumption of individuals or groups of home appliances. By knowing their consumption the utilization can be regulated for more efficient use. A prototype system has been constructed to demonstrate our idea....

  16. Cerebral MR imaging in vasculitis

    International Nuclear Information System (INIS)

    Ott, D.; Geissler, A.; Peter, H.H.

    1990-01-01

    This paper evaluates the diagnostic sensitivity and specificity of MR imaging for the detection of cerebral involvement in vasculitis. Seventy-six patient with proved systematic vasculitis and two with isolated cerebral vasculitis were examined. Half of them had central nervous system symptoms. T2-weighted sequences were performed at 2 T in most cases. All but two symptomatic and one-third of the asymptomatic patients showed pathologic changes in the white matter. The distribution and shape of lesions depend on the caliber of the involved vessel. In small-vessel vasculitis, the distribution was mostly subcortical, the average size was 0.5--10 mm, and lesions were predominantly round

  17. Features to validate cerebral toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Carolina da Cunha Correia

    2013-06-01

    Full Text Available Introduction Neurotoxoplasmosis (NT sometimes manifests unusual characteristics. Methods We analyzed 85 patients with NT and AIDS according to clinical, cerebrospinal fluid, cranial magnetic resonance, and polymerase chain reaction (PCR characteristics. Results In 8.5%, focal neurological deficits were absent and 16.4% had single cerebral lesions. Increased sensitivity of PCR for Toxoplasma gondii DNA in the central nervous system was associated with pleocytosis and presence of >4 encephalic lesions. Conclusions Patients with NT may present without focal neurological deficit and NT may occur with presence of a single cerebral lesion. Greater numbers of lesions and greater cellularity in cerebrospinal fluid improve the sensitivity of PCR to T gondii.

  18. The CT manifestations and clinical analysis of traumatic cerebral infarction in children

    International Nuclear Information System (INIS)

    Zhang Tianbo; Lin Shunfa; Huang Xiaohui; Xiao Zhe; Lu Sifang

    2004-01-01

    Objective: To evaluate pathogenesis, CT manifestations, diagnosis and treatment, and prognosis of traumatic cerebral infarction in children. Methods: Axial head CT scanning was performed in 35 cases, meanwhile the treatment included vessel dilatation, anti-spasm, nerve nourishment and anti-coagulation. Results: The traumatic cerebral infarction in children was commonly located in the basal ganglia. CT scan revealed low dense lesions in all cases. 33 patients out of 35 convalesced gradually, when no anomaly was shown on CT. The rest 2 patients improved, whose lesions decreased in size on CT images. Conclusion: The major pathophysiology of traumatic cerebral infarction in children is occlusion of cerebral microcirculation and convulsion of vein after trauma. CT scan and follow-up are of great value in monitoring the damages. Early diagnosis and treatment result in good prognosis

  19. In vivo cerebral blood flow autoregulation studies using rheoencephalography

    Science.gov (United States)

    Bodo, M.; Pearce, F.; Garcia, A.; Van Albert, S.; Settle, T.; Szebeni, J.; Baranyi, L.; Hartings, J.; Armonda, R.

    2010-04-01

    Acute management of patients with traumatic brain/blast injury is a challenge. To minimize secondary injury and improve outcome, it is critical to detect neurological deterioration early, when it is potentially reversible. One potential monitoring method is cerebral electrical impedance (rheoencephalography-REG) because of its non-invasiveness and good time resolution. Reported here are the results of cerebral blood flow (CBF) manipulations comparing electroencephalogram (EEG) with REG (both intra-cerebral) and measuring with surface and skull REG electrodes. Our hypothesis was that REG would reflect spreading depression and CBF autoregulation. Animal experiments were performed using one rat (four trials with intracerebral electrodes), monkeys (n=8, with surface electrodes) and pigs (n = 24 pigs with skull electrodes; 57 trials, 19 types of liposomes). Challenges included intracranial pressure (ICP) elevation, liposome infusion, and hemorrhage. Data were stored on a PC and evaluated off line. CBF autoregulation was evaluated both by visual inspection and by a Matlab script. These studies confirmed that REG reflects CBF autoregulation and that REG is useful for detecting spreading depression (SD), vasospasm and the lower limit of CBF autoregulation. These findings have clinical relevance for use in noninvasive neuro-monitoring in the neurosurgery intensive care and during transportation of patients with brain injury.

  20. Detection of Cerebral Hemorrhage in Rabbits by Time-Difference Magnetic Inductive Phase Shift Spectroscopy

    Science.gov (United States)

    Pan, Wencai; Yan, Qingguang; Qin, Mingxin; Jin, Gui; Sun, Jian; Ning, Xu; Zhuang, Wei; Peng, Bin; Li, Gen

    2015-01-01

    Cerebral hemorrhage, a difficult issue in clinical practice, is often detected and studied with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). However, these expensive devices are not readily available in economically underdeveloped regions, and hence are unable to provide bedside and emergency on-site monitoring. The magnetic inductive phase shift (MIPS) is an emerging technology that may become a new tool to detect cerebral hemorrhage and to serve as an inexpensive partial substitute to medical imaging. In order to study a wider band of cerebral hemorrhage MIPS and to provide more useful information for measuring cerebral hemorrhage, we established a cerebral hemorrhage magnetic induction phase shift spectroscopy (MIPSS) detection system. Thirteen rabbits with five cerebral hemorrhage states were studied using a single coil-coil within a 1 MHz-200 MHz frequency range in linear sweep. A feature band (FB) with the highest detection sensitivity and the greatest stability was selected for further analysis and processing. In addition, a maximum conductivity cerebrospinal fluid (CSF) MRI was performed to verify and interpret the MIPSS result. The average phase shift change induced by a 3 ml injection of autologous blood under FB was -7.7503° ± 1.4204°, which was considerably larger than our previous work. Data analysis with a non-parametric statistical Friedman M test showed that in the FB, MIPSS could distinguish the five states of cerebral hemorrhage in rabbits, with a statistical significance of phemorrhage severity from a single set of measurements. The results illustrate that the MIPSS detection method is able to provide a new possibility for real-time monitoring and diagnosis of the severity of cerebral hemorrhage. PMID:26001112

  1. What is cerebral small vessel disease?

    International Nuclear Information System (INIS)

    Onodera, Osamu

    2011-01-01

    An accumulating amount of evidence suggests that the white matter hyperintensities on T 2 weighted brain magnetic resonance imaging predict an increased risk of dementia and gait disturbance. This state has been proposed as cerebral small vessel disease, including leukoaraiosis, Binswanger's disease, lacunar stroke and cerebral microbleeds. However, the concept of cerebral small vessel disease is still obscure. To understand the cerebral small vessel disease, the precise structure and function of cerebral small vessels must be clarified. Cerebral small vessels include several different arteries which have different anatomical structures and functions. Important functions of the cerebral small vessels are blood-brain barrier and perivasucular drainage of interstitial fluid from the brain parenchyma. Cerebral capillaries and glial endfeet, take an important role for these functions. However, the previous pathological investigations on cerebral small vessels have focused on larger arteries than capillaries. Therefore little is known about the pathology of capillaries in small vessel disease. The recent discoveries of genes which cause the cerebral small vessel disease indicate that the cerebral small vessel diseases are caused by a distinct molecular mechanism. One of the pathological findings in hereditary cerebral small vessel disease is the loss of smooth muscle cells, which is an also well-recognized finding in sporadic cerebral small vessel disease. Since pericytes have similar character with the smooth muscle cells, the pericytes should be investigated in these disorders. In addition, the loss of smooth muscle cells may result in dysfunction of drainage of interstitial fluid from capillaries. The precise correlation between the loss of smooth muscle cells and white matter disease is still unknown. However, the function that is specific to cerebral small vessel may be associated with the pathogenesis of cerebral small vessel disease. (author)

  2. The Neurological Hand Deformity Classification for children with cerebral palsy.

    Science.gov (United States)

    Georgiades, Melissa; Elliott, Catherine; Wilton, Judith; Blair, Eve; Blackmore, Marie; Garbellini, Simon

    2014-12-01

    The purpose of this study was to evaluate the reliability of the Neurological Hand Deformity Classification and use it to describe changes in hand deformity over time in children with cerebral palsy. We identified 114 video clips of 26 children with cerebral palsy, aged 1-18 years (mean = 8.4, SD = 4.2), performing upper-limb tasks at multiple time points (n = 3-8) at least 6 months apart. Using the Neurological Hand Deformity Classification, three observers classified hand deformity in the video clips. Inter- and intra-observer reliabilities were estimated using Fleiss and Cohen's kappa (κ) and the temporal changes in classification of hand deformity were investigated. Inter- and intra-observer reliability respectively were κ = 0.87 and κ = 0.91. Hand deformity was identified in all children at all time points, even before the age of 2 years. Ten children did not change hand classification, wrist flexion increased in eight, and eight showed changes from wrist flexion to extension or vice versa. The Neurological Hand Deformity Classification is a reliable tool to classify hand deformity in children with cerebral palsy. For more than one-third of children hand deformity classification did not change. For the remaining children, two patterns of change in hand deformity over time were identified. It is recommended that children with cerebral palsy involving their upper limbs be monitored regularly. This is the first study to document longitudinal changes in hand deformity in children with cerebral palsy. © 2014 Occupational Therapy Australia.

  3. Application of Blood-Brain Barrier Permeability Imaging in Global Cerebral Edema.

    Science.gov (United States)

    Ivanidze, J; Kallas, O N; Gupta, A; Weidman, E; Baradaran, H; Mir, D; Giambrone, A; Segal, A Z; Claassen, J; Sanelli, P C

    2016-09-01

    Blood-brain barrier permeability is not routinely evaluated in the clinical setting. Global cerebral edema occurs after SAH and is associated with BBB disruption. Detection of global cerebral edema using current imaging techniques is challenging. Our purpose was to apply blood-brain barrier permeability imaging in patients with global cerebral edema by using extended CT perfusion. Patients with SAH underwent CTP in the early phase after aneurysmal rupture (days 0-3) and were classified as having global cerebral edema or nonglobal cerebral edema using established noncontrast CT criteria. CTP data were postprocessed into blood-brain barrier permeability quantitative maps of PS (permeability surface-area product), K(trans) (volume transfer constant from blood plasma to extravascular extracellular space), Kep (washout rate constant of the contrast agent from extravascular extracellular space to intravascular space), VE (extravascular extracellular space volume per unit of tissue volume), VP (plasmatic volume per unit of tissue volume), and F (plasma flow) by using Olea Sphere software. Mean values were compared using t tests. Twenty-two patients were included in the analysis. Kep (1.32 versus 1.52, P cerebral edema compared with nonglobal cerebral edema while VE (0.81 versus 0.39, P cerebral edema. Kep is an important indicator of altered blood-brain barrier permeability in patients with decreased blood flow, as Kep is flow-independent. Further study of blood-brain barrier permeability is needed to improve diagnosis and monitoring of global cerebral edema. © 2016 by American Journal of Neuroradiology.

  4. Study of the Dynamics of Transcephalic Cerebral Impedance Data during Cardio-Vascular Surgery

    International Nuclear Information System (INIS)

    Atefi, S R; Seoane, F; Lindecrantz, K

    2013-01-01

    Postoperative neurological deficits are one of the risks associated with cardio vascular surgery, necessitating development of new techniques for cerebral monitoring. In this study an experimental observation regarding the dynamics of transcephalic Electrical Bioimpedance (EBI) in patients undergoing cardiac surgery with and without extracorporeal circulation (ECC) was conducted to investigate the potential use of electrical Bioimpedance for cerebral monitoring in cardio vascular surgery. Tetrapolar transcephalic EBI measurements at single frequency of 50 kHz were recorded prior to and during cardio vascular surgery. The obtained results show that the transcephalic impedance decreases in both groups of patients as operation starts, however slight differences in these two groups were also observed with the cerebral impedance reduction in patients having no ECC being less common and not as pronounced as in the ECC group. Changes in the cerebral impedance were in agreement with changes of haematocrit and temperature. The origin of EBI changes is still unexplained however these results encourage us to continue investigating the application of electrical bioimpedance cerebral monitoring clinically.

  5. Cerebral cuterebrosis in a dog.

    Science.gov (United States)

    Sartin, E A; Hendrix, C M; Dillehay, D L; Nicholls, B

    1986-11-15

    A second instar Cuterebra larva was found in the thickened meninges of a 6-week-old female Doberman Pinscher at necropsy. The dog appeared blind and had chewing fits before death. Cerebral cuterebrosis in the dog is uncommon. This report briefly discusses the pathogenesis of the condition.

  6. Ocular defects in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Katoch Sabita

    2007-01-01

    Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.

  7. MR imaging of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saginoya, Toshiyuki [Urasoe General Hospital, Okinawa (Japan); Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide [and others

    1996-06-01

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  8. Neuropathology of Acquired Cerebral Trauma.

    Science.gov (United States)

    Bigler, Erin D.

    1987-01-01

    To help educators understand the cognitive and behavioral sequelae of cerebral injury, the neuropathology of traumatic brain injury and the main neuropathological features resulting from trauma-related brain damage are reviewed. A glossary with definitions of 37 neurological terms is appended. (Author/DB)

  9. Cerebral blood-flow tomography

    DEFF Research Database (Denmark)

    Lassen, N A; Henriksen, L; Holm, S

    1983-01-01

    Tomographic maps of local cerebral blood flow (CBF) were obtained with xenon-133 and with isopropyl-amphetamine-iodine-123 (IMP) in 11 subjects: one normal, two tumor cases, and eight cerebrovascular cases. A highly sensitive four-face, rapidly rotating, single-photon emission tomograph was used....

  10. Discovering Early Aspects

    NARCIS (Netherlands)

    Baniassad, E.; Clements, P.; Araujo, J.; Moreira, A; Rashid, A.; Tekinerdogan, B.

    2006-01-01

    Traditionally, aspect-oriented software development (AOSD) has focused on the software life cycle's implementation phase: aspects are identified and captured mainly in code. But aspects are evident earlier in the life cycle, such as during requirements gathering and architecture development.

  11. Epigenetics and cerebral organoids

    DEFF Research Database (Denmark)

    Forsberg, Sheena Louise; Ilieva, Mirolyuba; Maria Michel, Tanja

    2018-01-01

    Autism spectrum disorders (ASD) affect 1 in 68 children in the US according to the Centers for Disease Control and Prevention (CDC). It is characterized by impairments in social interactions and communication, restrictive and repetitive patterns of behaviors, and interests. Owing to disease...... also play a role. Some studies indicate a set of candidate genes with different DNA methylation profiles in ASD compared to healthy individuals. Thus epigenetic alterations could help bridging the gene-environment gap in deciphering the underlying neurobiology of autism. However, epigenome...... of the art concerning knowledge on epigenetic changes in autism and how new, cutting edge expertise based on three-dimensional (3D) stem cell technology models (brain organoids) can contribute in elucidating the multiple aspects of disease mechanisms....

  12. Cerebral edema in drug addicts

    Directory of Open Access Journals (Sweden)

    Daruši Dragana J.

    2014-01-01

    Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the

  13. Features of cerebral hemodynamics and vascular autoregulation in chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    O.A. Kozyolkin

    2013-08-01

    Full Text Available Introduction. The problem of cerebrovascular diseases in Ukraine and the world is one of the urgent problems of modern clinical medicine. The most wide-spread such a disease is chronic ischemic attack. These aspects determine the relevance of studying the problem of vascular diseases of the brain. The role of disturbances of cerebral hemodynamics is important in the formation of chronic cerebral ischemia. Recent years, the importance of the development of vascular disease is provided by endothelial dysfunction. The endothelium synthesizes active substances. The most significant of these ones is nitric oxide. Substrate for the synthesis of nitric oxide is L-arginine. High level of L-arginine in plasma leads to nonspecific vasodilatation. Thus, the use of L-arginine is promising in the treatment of patients with chronic cerebral ischemia. The purpose of the study. Improvement of diagnostic and therapeutic interventions for patients with DE II by examining the clinical, hemodynamic features and application of L-arginine in the treatment . Materials and methods. The study involved 84 patients. 62 of these patients are sick with dyscirculatory encephalopathy II stage (DE against the background of cerebral arteriosclerosis, hypertension . The groups of patients who were treated with L-arginine (20 patients and control group (18 patients were formed. The following studies were performed for the patients: clinical and neuropsychological examination and duplex scanning of brachiocephalic, transcranial vessels by duplex-triplex scanner LOGIQ C- 5 Premium. Results. The clinical situation of the main group and the control group treatment represents such syndromes: syndrome of headache (88.71 %, vestibular ( 74.19 % , asthenia ( 58.06 %, mild ( 30.65 % and moderate (69, 35% cognitive impairment. While analyzing the hemodynamic performance of the study group a statistically significant increasing of linear flow velocity (LFV in all basins, cerebrovascular

  14. Contraceptives and cerebral thrombosis: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Kreiner, Svend

    2002-01-01

    Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis......Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis...

  15. [Advances in genetic research of cerebral palsy].

    Science.gov (United States)

    Wang, Fang-Fang; Luo, Rong; Qu, Yi; Mu, De-Zhi

    2017-09-01

    Cerebral palsy is a group of syndromes caused by non-progressive brain injury in the fetus or infant and can cause disabilities in childhood. Etiology of cerebral palsy has always been a hot topic for clinical scientists. More and more studies have shown that genetic factors are closely associated with the development of cerebral palsy. With the development and application of various molecular and biological techniques such as chromosome microarray analysis, genome-wide association study, and whole exome sequencing, new achievements have been made in the genetic research of cerebral palsy. Chromosome abnormalities, copy number variations, susceptibility genes, and single gene mutation associated with the development of cerebral palsy have been identified, which provides new opportunities for the research on the pathogenesis of cerebral palsy. This article reviews the advances in the genetic research on cerebral palsy in recent years.

  16. Health physics aspects of 252Cf

    International Nuclear Information System (INIS)

    Bhagwat, A.M.

    1974-01-01

    After briefly describing the methods of production, radioactive, chemical and biological properties of californium-252, its health physics aspects are reviewed in detail. Its external and internal radiation hazards can be minimised through control of radiation and contamination and proper shield design. Use of various shielding materials is evaluated. The following aspects are also discussed : (1) radiation detectors for neutrons and gamma radiation (2) personnel monitoring techniques (3) bioassay and (4) storage and transportation. (M.G.B.)

  17. Daily rhythm of cerebral blood flow velocity

    Directory of Open Access Journals (Sweden)

    Spielman Arthur J

    2005-03-01

    Full Text Available Abstract Background CBFV (cerebral blood flow velocity is lower in the morning than in the afternoon and evening. Two hypotheses have been proposed to explain the time of day changes in CBFV: 1 CBFV changes are due to sleep-associated processes or 2 time of day changes in CBFV are due to an endogenous circadian rhythm independent of sleep. The aim of this study was to examine CBFV over 30 hours of sustained wakefulness to determine whether CBFV exhibits fluctuations associated with time of day. Methods Eleven subjects underwent a modified constant routine protocol. CBFV from the middle cerebral artery was monitored by chronic recording of Transcranial Doppler (TCD ultrasonography. Other variables included core body temperature (CBT, end-tidal carbon dioxide (EtCO2, blood pressure, and heart rate. Salivary dim light melatonin onset (DLMO served as a measure of endogenous circadian phase position. Results A non-linear multiple regression, cosine fit analysis revealed that both the CBT and CBFV rhythm fit a 24 hour rhythm (R2 = 0.62 and R2 = 0.68, respectively. Circadian phase position of CBT occurred at 6:05 am while CBFV occurred at 12:02 pm, revealing a six hour, or 90 degree difference between these two rhythms (t = 4.9, df = 10, p Conclusion In conclusion, time of day variations in CBFV have an approximately 24 hour rhythm under constant conditions, suggesting regulation by a circadian oscillator. The 90 degree-phase angle difference between the CBT and CBFV rhythms may help explain previous findings of lower CBFV values in the morning. The phase difference occurs at a time period during which cognitive performance decrements have been observed and when both cardiovascular and cerebrovascular events occur more frequently. The mechanisms underlying this phase angle difference require further exploration.

  18. Cerebral blood flow autoregulation in experimental liver failure

    DEFF Research Database (Denmark)

    Dethloff, T.J.; Larsen, F.S.; Knudsen, Gitte Moos

    2008-01-01

    Patients with acute liver failure (ALF) display impairment of cerebral blood flow (CBF) autoregulation, which may contribute to the development of fatal intracranial hypertension, but the pathophysiological mechanism remains unclear. In this study, we examined whether loss of liver mass causes...... impairment of CBF autoregulation. Four rat models were chosen, each representing different aspects of ALF: galactosamine (GlN) intoxication represented liver necrosis, 90% hepatectomy (PHx90) represented reduction in liver mass, portacaval anastomosis (PCA) represented shunting of blood...... edema/high ICP. Nor does portacaval shunting or hyperammonemia impair autoregulation. Rather, massive liver necrosis and reduced liver mass are associated with loss of CBF autoregulation Udgivelsesdato: 2008/5...

  19. CT to delineate hip pathology in cerebral palsy

    International Nuclear Information System (INIS)

    Mahboubi, S.; Horstmann, H.

    1987-01-01

    Surgical intervention for cerebral palsy hip dislocation or subluxation is frequently undertaken without a full comprehension of the three-dimensional aspects of the femoral-acetabular complex. CT with a modified technique allows more accurate measurement of the angle of femoral anteversion. In this exhibit the authors compare the modified technique with the old technique. Details of femoral had deficits, acetabular configuration, the arc of the acetabulum, the relative position of the femoral head within the acetabulum, and the soft tissue interposed between the femoral head and the acetabulum are well demonstrated with the new technique

  20. Cerebral Oxygenation During the First Days of Life in Preterm and Term Neonates : Differences Between Different Brain Regions

    NARCIS (Netherlands)

    Wijbenga, Rianne G.; Lemmers, Petra M. A.; van Bel, Frank

    2011-01-01

    Near-infrared spectroscopy is a noninvasive method for monitoring brain oxygenation. The aim of the study was to investigate differences between cerebral oxygenation in different brain regions in newborns. In a prospective study, we monitored simultaneously left and right frontoparietal and

  1. Cerebral haemodynamic response to somatosensory stimulation in near-term fetal sheep.

    Science.gov (United States)

    Nakamura, S; Walker, D W; Wong, F Y

    2017-02-15

    blood pressure and cerebral perfusion as monitored by laser Doppler flowmetry always showed small, but coincident increases following median nerve stimulation regardless of the type of response detected by the NIRS in the contralateral cortex. Hypercapnia significantly increased the baseline total haemoglobin and deoxyhaemoglobin, and in 7 of 8 fetal sheep positively increased the changes in contralateral total haemoglobin and oxyhaemoglobin in response to the 7.8 s stimulus train, compared to the response recorded during normocapnia. These results show that activity-driven changes in cerebral perfusion and oxygen delivery are present in the fetal brain, and persist even during periods of hypercapnia-induced cerebral vasodilatation. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

  2. Cerebral haemodynamic response to somatosensory stimulation in near‐term fetal sheep

    Science.gov (United States)

    Nakamura, S.; Walker, D. W.

    2016-01-01

    change. Mean arterial blood pressure and cerebral perfusion as monitored by laser Doppler flowmetry always showed small, but coincident increases following median nerve stimulation regardless of the type of response detected by the NIRS in the contralateral cortex. Hypercapnia significantly increased the baseline total haemoglobin and deoxyhaemoglobin, and in 7 of 8 fetal sheep positively increased the changes in contralateral total haemoglobin and oxyhaemoglobin in response to the 7.8 s stimulus train, compared to the response recorded during normocapnia. These results show that activity‐driven changes in cerebral perfusion and oxygen delivery are present in the fetal brain, and persist even during periods of hypercapnia‐induced cerebral vasodilatation. PMID:27805787

  3. Cerebral blood flow and cerebral oxygen metabolism in thalamic hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Yasui, Nobuyuki; Asakura, Ken

    1987-12-01

    Cerebral blood flow (CBF), cerebral oxygen consumption (CMRO/sub 2/), oxygen extraction fraction (OEF) and cerebral blood volume (CBV) were studied in 20 cases of thalamic hemorrhage using positron CT and /sup 15/O labeled gas steady-state inhalation method. CBF reduction was limited around the thalamus in the small sized hematoma. CBF were significantly diminished in the mean cortical, parietal, temporal, basal ganglia and thalamic area ipsilateral and cerebellar cortex contralateral to the medium sized hematoma. There was bilateral and diffuse CBF reduction in the large sized hematoma which was caused by increased intracranial pressure. CMRO/sub 2/ value were similary changed as CBF. OEF change showed within normal limit. Diffuse CBV reduction was observed in the large sized hematoma. This reduction was the result of decreased vascular bed caused by mass effect of the hematoma and hydrocephalus. Effect of surgical treatment such as ventricular drainage and hematoma evacuation were also discussed in correlation to CBF in some case using positron and single photon ECT.

  4. Gait in elderly with cerebral small vessel disease.

    Science.gov (United States)

    de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Bloem, Bastiaan R; Zwiers, Marcel P; de Leeuw, Frank-Erik

    2010-08-01

    Gait disorders are common in the elderly and are related to loss of functional independence and death. White matter lesions (WMLs) may be related, but only a minority of individuals with WMLs has gait disorders. Probably other factors are involved, including location and the independent effect of frequently coinciding lacunar infarcts, the other aspect of cerebral small vessel disease. The aim of our study was to investigate the effect of both the severity and location of both WMLs and lacunar infarcts on gait. Four hundred thirty-one independently living, nondemented elderly aged between 50 and 85 years with cerebral small vessel disease were included in this analysis and underwent MRI scanning. The number and location of lacunar infarcts were rated and WML volume was assessed by manual segmentation with automated delineating of different regions. Gait was assessed quantitatively with an electronic walkway as well as the semiquantitatively Tinetti and Timed-Up-and-Go test. WMLs and lacunar infarcts were both independently associated with most gait parameters with stride length as the most sensitive parameter related to WMLs. WMLs in the sublobar (basal ganglia/internal capsule) and limbic areas and lacunar infarcts in the frontal lobe and thalamus were related to a lower velocity. Cerebral small vessel disease is related to gait disturbances. Because small vessel disease may, in part, be preventable, it should be regarded as a potentially important target for postponing gait impairment.

  5. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    DeLand, F.H.

    1975-01-01

    Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

  6. CEREBRAL PALSY. PRENTICE-HALL FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

    Science.gov (United States)

    CHANCE, BURTON, JR.; MCDONALD, EUGENE T.

    THIS INTRODUCTORY TEXT ON CEREBRAL PALSY IS DIVIDED INTO TWO SECTIONS. THE FIRST SECTION OF THE BOOK CONTAINS INFORMATION ABOUT UNDERSTANDING THE MEANING OF CEREBRAL PALSY, PROGRAMS FOR THOSE WITH CEREBRAL PALSY, THE NEUROLOGICAL BASES, ETIOLOGY, AND DIAGNOSIS, AND THE CLASSIFICATION OF CEREBRAL PALSY. PROBLEMS OFTEN ASSOCIATED WITH CEREBRAL PALSY…

  7. AspectKE*

    DEFF Research Database (Denmark)

    Yang, Fan; Masuhara, Hidehiko; Aotani, Tomoyuki

    2010-01-01

    mechanism for pointcuts, so that pointcuts can uniformly specify join points based on both static and dynamic information about the program. Our implementation strategy performs fundamental static analysis at load-time, so as to retain runtime overheads minimal. We implemented a compiler for Aspect......Enforcing security policies to distributed systems is difficult, in particular, when a system contains untrusted components. We designed AspectKE*, a distributed AOP language based on a tuple space, to tackle this issue. In AspectKE*, aspects can enforce access control policies that depend...... on future behavior of running processes. One of the key language features is the predicates and functions that extract results of static program analysis, which are useful for defining security aspects that have to know about future behavior of a program. AspectKE* also provides a novel variable binding...

  8. Cerebral visual impairment in children.

    Science.gov (United States)

    Dutton, G N; Jacobson, L K

    2001-12-01

    Much of the brain is devoted to vision. Damage causes visual problems ranging from profound impairment, to cognitive visual problems only. A child with cerebral blindness may have intact perception of movement. The principal cognitive visual pathways comprise the dorsal and the ventral streams. The dorsal stream runs between the occipital lobes (which process incoming visual data), the posterior parietal lobes (which process the whole visual scene and give attention to component parts), the motor cortex (which facilitates movement through the visual scene) and the frontal cortex (which directs attention to chosen parts of the visual scene). The ventral stream runs between the occipital lobes and the temporal lobes (which enable recognition of people and objects, facilitate route finding and serve visual memory). Damage to these pathways disrupts these functions in a variety of combinations. This paper reviews cerebral visual impairment in children, the differential diagnosis and the management. Copyright 2002 Elsevier Science Ltd.

  9. Apraxia in deep cerebral lesions.

    OpenAIRE

    Agostoni, E; Coletti, A; Orlando, G; Tredici, G

    1983-01-01

    In a series of 50 patients with cerebrovascular lesions (demonstrated with CT scan), seven patients had lesions located in the basal ganglia and/or thalamus. All these seven patients were apractic. Ideomotor apraxia was present in all patients; five also had constructional apraxia, and one had bucco-facial apraxia. None of the patients had utilisation apraxia. These observations indicated that apraxia is not only a "high cerebral (cortical) function", but may depend also on the integrity of s...

  10. Cerebral hyperperfusion following carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Sørensen, O

    1987-01-01

    , occurred in the low pressure ratio group, while the hemispheric asymmetry on average was unchanged in the high pressure ratio group. This relative hyperemia was most pronounced 2 to 4 days following reconstruction. The marked hyperemia, absolute as well as relative, in patients with a low ICA/CCA pressure...... ratio suggests a temporary impairment of autoregulation. Special care should be taken to avoid postoperative hypertension in such patients, who typically have preoperative hypoperfusion, to avoid the occurrence of cerebral edema or hemorrhage....

  11. Methodological appraisal of SPECT measurements of cerebral blood volume and cerebral tissue hematocrit. Chapter 25

    International Nuclear Information System (INIS)

    Sakai, Fumihiko

    1988-01-01

    In this communication a critical appraisal is given of the method for measuring cerebral blood volume (CBV) and cerebral hematocrit employing single-photon emission computed tomography (SPECT). 2 refs

  12. Arachidonic Acid and Cerebral Ischemia Risk: A Systematic Review of Observational Studies

    Directory of Open Access Journals (Sweden)

    Mai Sakai

    2014-11-01

    Full Text Available Background: Arachidonic acid (ARA is a precursor of various lipid mediators. ARA metabolites such as thromboxane A2 cause platelet aggregation and vasoconstriction, thus may lead to atherosclerotic disease. It is unclear whether dietary ARA influences the ARA-derived lipid mediator balance and the risk for atherosclerotic diseases, such as cerebral ischemia. Considering the function of ARA in atherosclerosis, it is reasonable to focus on the atherothrombotic type of cerebral ischemia risk. However, no systematic reviews or meta-analyses have been conducted to evaluate the effect of habitual ARA exposure on cerebral ischemia risk. We aimed to systematically evaluate observational studies available on the relationship between ARA exposure and the atherothrombotic type of cerebral ischemia risk in free-living populations. Summary: The PubMed database was searched for articles registered up to June 24, 2014. We designed a PubMed search formula as follows: key words for humans AND brain ischemia AND study designs AND ARA exposure. Thirty-three articles were reviewed against predefined criteria. There were 695 bibliographies assessed from the articles that included both ARA and cerebral ischemia descriptions. Finally, we identified 11 eligible articles and categorized them according to their reporting and methodological quality. We used the Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE checklist to score the reporting quality. The methodological quality was qualitatively assessed based on the following aspects: subject selection, ARA exposure assessment, outcome diagnosis, methods for controlling confounders, and statistical analysis. We did not conduct a meta-analysis due to the heterogeneity among the studies. All eligible studies measured blood ARA levels as an indicator of exposure. Our literature search did not identify any articles that evaluated dietary ARA intake and tissue ARA as assessments of

  13. Arachidonic Acid and Cerebral Ischemia Risk: A Systematic Review of Observational Studies.

    Science.gov (United States)

    Sakai, Mai; Kakutani, Saki; Tokuda, Hisanori; Suzuki, Toshihide; Kominami, Masaru; Egawa, Kahori; Saito, Kayo; Rogi, Tomohiro; Kawashima, Hiroshi; Shibata, Hiroshi; Sasaki, Satoshi

    2014-01-01

    Arachidonic acid (ARA) is a precursor of various lipid mediators. ARA metabolites such as thromboxane A2 cause platelet aggregation and vasoconstriction, thus may lead to atherosclerotic disease. It is unclear whether dietary ARA influences the ARA-derived lipid mediator balance and the risk for atherosclerotic diseases, such as cerebral ischemia. Considering the function of ARA in atherosclerosis, it is reasonable to focus on the atherothrombotic type of cerebral ischemia risk. However, no systematic reviews or meta-analyses have been conducted to evaluate the effect of habitual ARA exposure on cerebral ischemia risk. We aimed to systematically evaluate observational studies available on the relationship between ARA exposure and the atherothrombotic type of cerebral ischemia risk in free-living populations. The PubMed database was searched for articles registered up to June 24, 2014. We designed a PubMed search formula as follows: key words for humans AND brain ischemia AND study designs AND ARA exposure. Thirty-three articles were reviewed against predefined criteria. There were 695 bibliographies assessed from the articles that included both ARA and cerebral ischemia descriptions. Finally, we identified 11 eligible articles and categorized them according to their reporting and methodological quality. We used the Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE) checklist to score the reporting quality. The methodological quality was qualitatively assessed based on the following aspects: subject selection, ARA exposure assessment, outcome diagnosis, methods for controlling confounders, and statistical analysis. We did not conduct a meta-analysis due to the heterogeneity among the studies. All eligible studies measured blood ARA levels as an indicator of exposure. Our literature search did not identify any articles that evaluated dietary ARA intake and tissue ARA as assessments of exposure. Seven of the 11 eligible articles

  14. Behcet's disease with cerebral vasculitis

    International Nuclear Information System (INIS)

    Scardamaglia, L.; Desmond, P.M.; Gonzales, M.F.; Bendrups, A.; Brodtmann, A.

    2001-01-01

    The case presented illustrates the diagnostic dilemma off neurological involvement in Behcet's disease and other inflammatory diseases. 'Psychiatric' symptoms were present for 2 years without abnormalities on SPECT or MRI and without CSF pleocytosis. Even at the time of fitting, no CSF abnormalities were observed. The preceding psychiatric presentations may have been due to cerebral vasculitis that was exacerbated by withdrawal of steroids. Magnetic resonance imaging is currently the most sensitive imaging modality. Lesions are usually in the brainstem, cerebellum, basal ganglia region or periventricular white matter, and the pons and the mesencephalon are commonly affected. In our patient there was no diencephalic or brainstem involvement. The inflammatory process can appear as a very large lesion, with gadolinium enhancement and significant mass effect, as in our patient. Brain magnetic resonance imaging. Postgadolinium-diethylenetriamine pentaacetic acid, axial image shows two large lesions in the right frontal lobe, with the larger, posterior lesion demonstrating vivid ring enhancement. A central nodule is isodense, with the cerebral white matter within the larger lesion. Surrounding low T 1 signal involves the hemispheric white matter without cortical extension and is consistent with vasogenic oedema. Minor mass effect is demonstrated with bowing of the anterior falx cerebri to the left. Biopsy shows prominent fibrinoid necrosis in small calibre postcapillary venules and cerebral white matter. There are surrounding acute and chronic inflammatory cells and nuclear debris, consistent with vasculitis

  15. Ventricular Volume Load Reveals the Mechanoelastic Impact of Communicating Hydrocephalus on Dynamic Cerebral Autoregulation.

    Directory of Open Access Journals (Sweden)

    Christina Haubrich

    Full Text Available Several studies have shown that the progression of communicating hydrocephalus is associated with diminished cerebral perfusion and microangiopathy. If communicating hydrocephalus similarly alters the cerebrospinal fluid circulation and cerebral blood flow, both may be related to intracranial mechanoelastic properties as, for instance, the volume pressure compliance. Twenty-three shunted patients with communicating hydrocephalus underwent intraventricular constant-flow infusion with Hartmann's solution. The monitoring included transcranial Doppler (TCD flow velocities (FV in the middle (MCA and posterior cerebral arteries (PCA, intracranial pressure (ICP, and systemic arterial blood pressure (ABP. The analysis covered cerebral perfusion pressure (CPP, the index of pressure-volume compensatory reserve (RAP, and phase shift angles between Mayer waves (3 to 9 cpm in ABP and MCA-FV or PCA-FV. Due to intraventricular infusion, the pressure-volume reserve was exhausted (RAP 0.84+/-0.1 and ICP was increased from baseline 11.5+/-5.6 to plateau levels of 20.7+/-6.4 mmHg. The ratio dRAP/dICP distinguished patients with large 0.1+/-0.01, medium 0.05+/-0.02, and small 0.02+/-0.01 intracranial volume compliances. Both M wave phase shift angles (r = 0.64; p<0.01 and CPP (r = 0.36; p<0.05 displayed a gradual decline with decreasing dRAP/dICP gradients. This study showed that in communicating hydrocephalus, CPP and dynamic cerebral autoregulation in particular, depend on the volume-pressure compliance. The results suggested that the alteration of mechanoelastic characteristics contributes to a reduced cerebral perfusion and a loss of autonomy of cerebral blood flow regulation. Results warrant a prospective TCD follow-up to verify whether the alteration of dynamic cerebral autoregulation may indicate a progression of communicating hydrocephalus.

  16. Ventricular Volume Load Reveals the Mechanoelastic Impact of Communicating Hydrocephalus on Dynamic Cerebral Autoregulation.

    Science.gov (United States)

    Haubrich, Christina; Czosnyka, Marek; Diehl, Rolf; Smielewski, Peter; Czosnyka, Zofia

    2016-01-01

    Several studies have shown that the progression of communicating hydrocephalus is associated with diminished cerebral perfusion and microangiopathy. If communicating hydrocephalus similarly alters the cerebrospinal fluid circulation and cerebral blood flow, both may be related to intracranial mechanoelastic properties as, for instance, the volume pressure compliance. Twenty-three shunted patients with communicating hydrocephalus underwent intraventricular constant-flow infusion with Hartmann's solution. The monitoring included transcranial Doppler (TCD) flow velocities (FV) in the middle (MCA) and posterior cerebral arteries (PCA), intracranial pressure (ICP), and systemic arterial blood pressure (ABP). The analysis covered cerebral perfusion pressure (CPP), the index of pressure-volume compensatory reserve (RAP), and phase shift angles between Mayer waves (3 to 9 cpm) in ABP and MCA-FV or PCA-FV. Due to intraventricular infusion, the pressure-volume reserve was exhausted (RAP) 0.84+/-0.1 and ICP was increased from baseline 11.5+/-5.6 to plateau levels of 20.7+/-6.4 mmHg. The ratio dRAP/dICP distinguished patients with large 0.1+/-0.01, medium 0.05+/-0.02, and small 0.02+/-0.01 intracranial volume compliances. Both M wave phase shift angles (r = 0.64; pcommunicating hydrocephalus, CPP and dynamic cerebral autoregulation in particular, depend on the volume-pressure compliance. The results suggested that the alteration of mechanoelastic characteristics contributes to a reduced cerebral perfusion and a loss of autonomy of cerebral blood flow regulation. Results warrant a prospective TCD follow-up to verify whether the alteration of dynamic cerebral autoregulation may indicate a progression of communicating hydrocephalus.

  17. Whole blood viscosity and cerebral blood flow velocities in obese hypertensive or obese normotensive adolescents.

    Science.gov (United States)

    Akcaboy, Meltem; Nazliel, Bijen; Goktas, Tayfun; Kula, Serdar; Celik, Bülent; Buyan, Necla

    2018-01-26

    Obesity affects all major organ systems and leads to increased morbidity and mortality. Whole blood viscosity is an important independent regulator of cerebral blood flow. The aim of the present study was to evaluate the effect of whole blood viscosity on cerebral artery blood flow velocities using transcranial Doppler ultrasound in pediatric patients with obesity compared to healthy controls and analyze the effect of whole blood viscosity and blood pressure status to the cerebral artery blood flow velocities. Sixty patients with obesity diagnosed according to their body mass index (BMI) percentiles aged 13-18 years old were prospectively enrolled. They were grouped as hypertensive or normotensive according to their ambulatory blood pressure monitoring. Whole blood viscosity and middle cerebral artery velocities by transcranial Doppler ultrasound were studied and compared to 20 healthy same aged controls. Whole blood viscosity values in hypertensive (0.0619±0.0077 poise) and normotensive (0.0607±0.0071 poise) groups were higher than controls (0.0616±0.0064 poise), with no significance. Middle cerebral artery blood flow velocities were higher in the obese hypertensive (73.9±15.0 cm/s) and obese normotensive groups (75.2±13.5 cm/s) than controls (66.4±11.5 cm/s), but with no statistical significance. Physiological changes in blood viscosity and changes in blood pressure did not seem to have any direct effect on cerebral blood flow velocities, the reason might be that the cerebral circulation is capable of adaptively modulating itself to changes to maintain a uniform cerebral blood flow.

  18. Cerebral hemorrhage without manifest motor paralysis

    International Nuclear Information System (INIS)

    Taketani, Torao; Dohi, Ichiro; Miyazaki, Tadahiko; Handa, Akihisa

    1982-01-01

    Before the introduction of computerized tomography (CT) there were some cases of intracerebral bleeding who were wrongly diagnosed as hypertensive encephalopathy or senile psychosis. We here report 5 cases who did not show any sign of motor paralysis. The clinical aspects of these cases were nausea and vomiting with dizziness (case 1), nausea and vomiting with slight headache (case 2), agnosia of left side with several kinds of disorientation (case 3), nausea and vomiting (case 4), and visual disturbance of right, lower quadrant (case 5). All of these cases showed no motor paralysis or abnormal reflex activities. By examination with CT each of them exhibited a high density area in the subcortical area of the right parietal lobe, the subcortical area of the right occipital lobe, the right temporal and parietal lobe, rather small portion of the left putamen and external capsule, and the subcortical area of left occipital lobe, respectively. Patients of cerebral hemorrhage without motor or sensory disturbances might often be taken for some psychic abnormality. We here have emphasized the importance of CT in such a group of patients. But for this technique, most of them would not be given adequate treatment and might be exposed to lifethreatening situations. (author)

  19. Cerebral Edema and Cerebral Hemorrhages in Interleukin-10-Deficient Mice Infected with Plasmodium chabaudi

    OpenAIRE

    Sanni, Latifu A.; Jarra, William; Li, Ching; Langhorne, Jean

    2004-01-01

    During a Plasmodium chabaudi infection in interleukin-10 (IL-10) knockout mice, there is greater parasite sequestration, more severe cerebral edema, and a high frequency of cerebral hemorrhage compared with infection of C57BL/6 mice. Anti-tumor necrosis factor alpha treatment ameliorated both cerebral edema and hemorrhages, suggesting that proinflammatory responses contributed to cerebral complications in infected IL-10−/− mice.

  20. Hygiene and Industrial Security Program: General aspects

    International Nuclear Information System (INIS)

    1988-01-01

    This Venezuelan standard establishes the aspects that must be included in the elaboration and monitoring of an Hygiene and Industrial Security Program (Prevention of Accidents and Occupational Diseases Program). It is applicable to any type of exploitation company, or any kind of task (in nature or importance) where people work, no matter the number workers [es

  1. Effect of fetal brainsparing on the early neonatal cerebral circulation.

    Science.gov (United States)

    Scherjon, S A; Oosting, H; Kok, J H; Zondervan, H A

    1994-01-01

    The effect of antenatal brainsparing on subsequent neonatal cerebral blood flow velocity (CBFV) was studied in very preterm infants. CBFV was determined, using a pulsed Doppler technique, both in the fetal and neonatal period. Neonatally, blood pressure and transcutaneous carbon dioxide tension (TcPCO2) was monitored simultaneously; daily cranial ultrasound examinations were performed. In infants with evidence of brainsparing a higher mean value of CBFV and a different pattern of changes of CBFV during the first week of life was demonstrated compared with infants with normal fetal cerebral haemodynamics. No differences were found in blood pressure and TcPCO2. The incidence of intracranial haemorrhages and of ischaemic echo-dense lesions was also the same for both groups. In a multivariate statistical model gestational age, antepartum brainsparing, and TcPCO2 all contributed significantly in explanation of variation in CBFV. It is speculated that a different setting of cerebral autoregulation related to differences in gestational age or to brainsparing might explain the difference in changes found in neonatal CBFV. PMID:8092862

  2. Critical Care Management of Cerebral Edema in Brain Tumors.

    Science.gov (United States)

    Esquenazi, Yoshua; Lo, Victor P; Lee, Kiwon

    2017-01-01

    Cerebral edema associated with brain tumors is extremely common and can occur in both primary and metastatic tumors. The edema surrounding brain tumors results from leakage of plasma across the vessel wall into the parenchyma secondary to disruption of the blood-brain barrier. The clinical signs of brain tumor edema depend on the location of the tumor as well as the extent of the edema, which often exceeds the mass effect induced by the tumor itself. Uncontrolled cerebral edema may result in increased intracranial pressure and acute herniation syndromes that can result in permanent neurological dysfunction and potentially fatal herniation. Treatment strategies for elevated intracranial pressure consist of general measures, medical interventions, and surgery. Alhough the definitive treatment for the edema may ultimately be surgical resection of the tumor, the impact of the critical care management cannot be underestimated and thus patients must be vigilantly monitored in the intensive care unit. In this review, we discuss the pathology, pathophysiology, and clinical features of patients presenting with cerebral edema. Imaging findings and treatment modalities used in the intensive care unit are also discussed. © The Author(s) 2015.

  3. Therapeutic approaches to cerebral vasospasm complicating ruptured aneurysm

    Directory of Open Access Journals (Sweden)

    Mohamed Barbarawi

    2009-10-01

    Full Text Available Cerebral vasospasm is a serious complication of ruptured aneurysm. In order to avoid short- and long-term effects of cerebral vasospasm, and as there is no single or optimal treatment modality employed, we have instituted a protocol for the prevention and treatment of vasospasm in patients suffering aneurysmal sub-arachnoid hemorrhage (SAH. We then reviewed the effectiveness of this protocol in reducing the mortality and morbidity rate in our institution. In this study we present a retrospective analysis of 52 cases. Between March 2004 and December 2008 52 patients were admitted to our service with aneurysmal SAH. All patients commenced nimodipine, magnesium sulphate (MgSO4 and triple H therapy. Patients with significant reduction in conscious level were intubated, ventilated and sedated. Intracranial pressure (ICP monitoring was used for intubated patients. Sodium thiopental coma was induced for patients with refractory high ICP; angiography was performed for diagnosis and treatment. Balloon angioplasty was performed if considered necessary. Using this protocol, only 13 patients (25% developed clinical vaso-spasm. Ten of them were given barbiturates to induce coma. Three patients underwent transluminal balloon angioplasty. Four out of 52 patients (7.7% died from severe vasospasm, 3 patients (5.8% became severely disabled, and 39 patients (75% were discharged in a condition considered as either normal or near to their pre-hemorrhage status. Our results confirm that the aforementioned protocol for treatment of cerebral vasospasm is effective and can be used safely.

  4. Wingspan stent for symptomatic stenosis of middle cerebral artery

    International Nuclear Information System (INIS)

    Guo Xinbin; Zhang Jianning; Li Xudong; Huang Ying; Fan Yimu

    2010-01-01

    Objective: To evaluate the safety and feasibility of Wingspan stent for patients with symptomatic M1 stenosis of middle cerebral artery (MCA). Methods: Thirty-two cases with recurrent symptomatic MCA stenosis resistant to medical therapy treated by self-expanding stent were reviewed retrospectively [average (49 ± 19) years old, 13 women]. All patients underwent angioplasty and stenting with the Gateway balloon-Wingspan stent system. After 6 months, all patients were followed up by telephone or clinic, and advised followed up with DSA or TCD. Results: Thirty-two patients were successfully stented during the first treatment session. The mean degree of stenosis reduced from (76.5 ± 15.4)% to (19.3 ± 9.2)%. The number of complicating subarachnoid hemorrhage was one, and occlusion occurred on one patients related to balloon angioplasty. During a follow-up of 6 months, there was no recurrence of transient ischemic attack or stroke in 32 available patients. Cerebral hemodynamics using transcranial Doppler monitoring were normal in 19 follow-up patients. Six-month angiographic follow-up was obtained in 5 patients, demonstrating good patency in 5 stenting vessels. The other patients refused to perform TCD or DSA. Conclusions: Wingspan stent for symptomatic stenosis of middle cerebral artery appears to be a safe and feasible under strict control of periperformeral project. However further study is needed to evaluate the long-term effect. (authors)

  5. Dental characteristics of children with cerebral palsy

    OpenAIRE

    Stevanović Radoje; Jovičić Olivera

    2004-01-01

    Cerebral palsy is one of the commonest children's physical handicaps with frequency of 1.5-3/1000. Beside many other disturbances, these children may have serious disorders caused by dental diseases. Concerning this fact, the objective of our study was to examine children with cerebral palsy in our country and determine condition of dental health and suggest adequate protective measures. A total of 116 children, 3-18 years old, with cerebral palsy were examined and the results were compared t...

  6. Cerebral Palsy. Fact Sheet = La Paralisis Cerebral. Hojas Informativas Sobre Discapacidades.

    Science.gov (United States)

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet on cerebral palsy is written in both English and Spanish. First, it provides a definition of cerebral palsy and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy:…

  7. A study on the pathogenesis of human cerebral malaria and cerebral babesiosis

    Directory of Open Access Journals (Sweden)

    Masamichi Aikawa

    1992-01-01

    Full Text Available Cerebral complications are important, but poorly understood pathological features of infections caused by some species of Plasmodium and Babesia. Patients dying from P. falciparum were classified as cerebral or non-cerebral cases according to the cerebral malaria coma scale. Light microscopy revealed that cerebral microvessels of cerebral malaria patients were field with a mixture of parazited and unparazited erythrocytes, with 94% of the vessels showing parasitized red blood cell (PRBC sequestration. Some degree of PRBC sequestration was also found in non-cerebral malaria patients, but the percentage of microvessls with sequestered PRBC was only 13% Electron microscopy demonstrated knobs on the membrane of PRBC that formed focal junctions with the capillary endothelium. A number of host cell molecules such as CD36, thrombospondim (TSP and intracellular adhesion molecule I (ICAM-1 may function as endothelial cell surfacereports for P. falciparum-infected erythrocytes. Affinity labeling of CD36 and TSP to the PRBC surface showed these molecules specifically bind to the knobs. Babesia bovis infected erythrocytes procedure projections of the erythrocyte membrane that are similar to knobs. When brain tissue from B. bovis-infected cattle was examined, cerebral capillaries were packed with PRBC. Infected erythrocytes formed focal attachments with cerebral endothelial cells at the site of these knob-like projections. These findings indicate that cerebral pathology caused by B. bovis is similar to human cerebral malaria. A search for cytoadherence proteins in the endothelial cells may lead to a better understanding of the pathogenisis of cerebral babesiosis.

  8. Lipopolysaccharide infusion enhances dynamic cerebral autoregulation without affecting cerebral oxygen vasoreactivity in healthy volunteers

    DEFF Research Database (Denmark)

    Berg, Ronan Mg; Plovsing, Ronni R; Evans, Kevin A

    2013-01-01

    Sepsis may be associated with disturbances in cerebral oxygen transport and cerebral haemodynamic function, thus rendering the brain particularly susceptible to hypoxia. The purpose of this study was to assess the impact of isocapnic hypoxia and hyperoxia on dynamic cerebral autoregulation in a h...

  9. Cerebral oxygen metabolism and cerebral blood flow in man during light sleep (stage 2)

    DEFF Research Database (Denmark)

    Madsen, P L; Schmidt, J F; Holm, S

    1991-01-01

    . They differ in respect of arousal threshold as a stronger stimulus is required to awaken a subject from deep sleep as compared to light sleep. Our results suggest that during non-rapid eye movement sleep cerebral metabolism and thereby cerebral synaptic activity is correlated to cerebral readiness rather than...

  10. Aspect-Oriented Programming

    NARCIS (Netherlands)

    Bergmans, Lodewijk; Videira Lopes, Cristina; Moreira, Ana; Demeyer, Serge

    1999-01-01

    Aspect-oriented programming is a promising idea that can improve the quality of software by reduce the problem of code tangling and improving the separation of concerns. At ECOOP'97, the first AOP workshop brought together a number of researchers interested in aspect-orientation. At ECOOP'98, during

  11. Lexical and Grammatical Aspect

    NARCIS (Netherlands)

    van Hout, Angeliek; Lidz, Jeffrey; Snyder, William; Pater, Joe

    The temporality of a given situation ‘out there in the world’ can be described in many ways. Tense and aspect offer the essential parameters. Lexical aspect characterizes event descriptions; a situation with a sleeping child can be referred to as a state of affairs (be asleep) or as a happening

  12. Acute cerebral vascular accident associated with hyperperfusion

    International Nuclear Information System (INIS)

    Soin, J.S.; Burdine, J.A.

    1976-01-01

    Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133 Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

  13. Deep Cerebral Vein Thrombosis: A Clinical Masquerader.

    Science.gov (United States)

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-04-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially treated as meningoencephalitis. A timely advised brain imaging helped in making the diagnosis and patient recovered completely after institution of anticoagulation.

  14. Stimulation-induced cerebral glycolytic glucose metabolism

    International Nuclear Information System (INIS)

    Ackermann, R.F.; Lear, J.L.

    1989-01-01

    The authors have developed a method to estimate the relative amounts of cerebral oxidative and glycolytic glucose metabolism with sequentially administered radiolabeled fluorode-oxyglucose (FDG) and 6-glucose (GLU). Cerebral FDG metabolite concentration was found to reflect total glucose metabolism. Cerebral GLU metabolite concentration, however, was found to reflect mainly oxidative metabolism, because of significant fraction of the radiolabel was lost through lactate production and diffusion from the brain with glycolysis. The authors applied the method to normal rats, to seizing rats, and to optically stimulated rats. Normal cerebral glucose metabolism was primarily oxidative, but stimulation caused profound increases in glycolysis in activated brain regions

  15. Inconsistent detection of changes in cerebral blood volume by near infrared spectroscopy in standard clinical tests.

    Science.gov (United States)

    Canova, D; Roatta, S; Bosone, D; Micieli, G

    2011-06-01

    The attractive possibility of near infrared spectroscopy (NIRS) to noninvasively assess cerebral blood volume and oxygenation is challenged by the possible interference from extracranial tissues. However, to what extent this may affect cerebral NIRS monitoring during standard clinical tests is ignored. To address this issue, 29 healthy subjects underwent a randomized sequence of three maneuvers that differently affect intra- and extracranial circulation: Valsalva maneuver (VM), hyperventilation (HV), and head-up tilt (HUT). Putative intracranial ("i") and extracranial ("e") NIRS signals were collected from the forehead and from the cheek, respectively, and acquired together with cutaneous plethysmography at the forehead (PPG), cerebral blood velocity from the middle cerebral artery, and arterial blood pressure. Extracranial contribution to cerebral NIRS monitoring was investigated by comparing Beer-Lambert (BL) and spatially resolved spectroscopy (SRS) blood volume indicators [the total hemoglobin concentration (tHb) and the total hemoglobin index, (THI)] and by correlating their changes with changes in extracranial circulation. While THIe and tHbe generally provided concordant indications, tHbi and THIi exhibited opposite-sign changes in a high percentage of cases (VM: 46%; HV: 31%; HUT: 40%). Moreover, tHbi was correlated with THIi only during HV (P < 0.05), not during VM and HUT, while it correlated with PPG in all three maneuvers (P < 0.01). These results evidence that extracranial circulation may markedly affect BL parameters in a high percentage of cases, even during standard clinical tests. Surface plethysmography at the forehead is suggested as complementary monitoring helpful in the interpretation of cerebral NIRS parameters.

  16. Cerebral ischemia produced by four-vessel occlusion in the rat: a quantitative evaluation of cerebral blood flow

    International Nuclear Information System (INIS)

    Furlow, T.W. Jr.

    1982-01-01

    Cerebral ischemia was produced in the rat by simultaneous occlusion of the vertebral and carotid arteries according to the method of Pulsinelli and Brierley (Stroke 10: 267, 1979). Local cerebral blood flow (CBF) was determined by polarographic and autoradiographic techniques. Hydrogen-clearance measurements showed that mean CBF fell in four monitored regions of the hemispheres to between 0.11 and 0.18 ml/g/min, being least in deep rostal gray, intermediate in superficial gray, and greatest in deep caudal gray. However, individual animals had local CBF in excess of 0.20 and even 0.30 ml/g/min, and no animal showed zero CBF. When animals were rendered hypotensive (MABP of 50 Torr) during vascular occlusion, mean CBF ranged between 0.03 and 0.10 ml/g/min in the same regional order. With hypotension, total arrest of flow occurred. Autoradiographic data confirmed the above findings and indicated adequate CBF to the lower brainstem. During vascular occlusion, sufficient CBF may be present ot sustain cerebral tissue as in animals with a well developed spinal circulation or an inadvertently patent vertebral artery

  17. Cerebral ischemia produced by four-vessel occlusion in the rat: a quantitative evaluation of cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Furlow, T.W. Jr.

    Cerebral ischemia was produced in the rat by simultaneous occlusion of the vertebral and carotid arteries according to the method of Pulsinelli and Brierley (Stroke 10: 267, 1979). Local cerebral blood flow (CBF) was determined by polarographic and autoradiographic techniques. Hydrogen-clearance measurements showed that mean CBF fell in four monitored regions of the hemispheres to between 0.11 and 0.18 ml/g/min, being least in deep rostal gray, intermediate in superficial gray, and greatest in deep caudal gray. However, individual animals had local CBF in excess of 0.20 and even 0.30 ml/g/min, and no animal showed zero CBF. When animals were rendered hypotensive (MABP of 50 Torr) during vascular occlusion, mean CBF ranged between 0.03 and 0.10 ml/g/min in the same regional order. With hypotension, total arrest of flow occurred. Autoradiographic data confirmed the above findings and indicated adequate CBF to the lower brainstem. During vascular occlusion, sufficient CBF may be present ot sustain cerebral tissue as in animals with a well developed spinal circulation or an inadvertently patent vertebral artery.

  18. An analysis of cerebral blood flow from middle cerebral arteries during cognitive tasks via functional transcranial Doppler recordings.

    Science.gov (United States)

    Li, Meng; Huang, Hanrui; Boninger, Michael L; Sejdić, Ervin

    2014-07-01

    Functional transcranial Doppler (fTCD) is a useful medical imaging technique to monitor cerebral blood flow velocity (CBFV) in major cerebral arteries. In this paper, CBFV changes in the right and left middle cerebral arteries (MCA) caused by cognitive tasks, such as word generation tasks and mental rotation tasks, were examined using fTCD. CBFV recordings were collected from 20 healthy subjects (10 females, 10 males). We obtained both the raw CBFV signal and the envelope CBFV signal, which is the maximal velocity to gain more information about the changes and hemisphere lateralization in cognitive tasks compared to the resting state. Time, frequency, time-frequency, and information-theoretic features were calculated and compared. Sex effects were also taken into consideration. The results of our analysis demonstrated that the raw CBFV signal contained more descriptive information than the envelope signals. Furthermore, both types of cognitive tasks produced higher values in most signal features. Geometric tasks were more distinguished from the rest-state than verbal tasks and the lateralization was exhibited in right MCA during geometric tasks. Our results show that the raw CBFV signals provided valuable information when studying the effects of cognitive tasks and lateralization in the MCA. Copyright © 2014 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

  19. Cerebral Oxygenation and Acceleration in Pediatric and Neonatal Interfacility Transport.

    Science.gov (United States)

    Valente, Michael E; Sherif, Judy A; Azen, Colleen G; Pham, Phung K; Lowe, Calvin G

    2016-01-01

    The purpose of this study is to measure peak acceleration forces during interfacility transport; examine whether drops in cerebral oxygenation occurred; and test the associations between cerebral oxygenation, acceleration, and patient positioning. A cerebral oximeter (INVOS-5100C; Somanetics, Minneapolis, MN) monitored regional saturation of oxygen (rSO2 [cerebral oxygenation]) in pediatric and neonatal patients (N = 24) transported between facilities by ground ambulance, helicopter, or fixed wing aircraft. An accelerometer (GP1; SENSR, Georgetown, TX) bolted to the isolette or gurney recorded z-axis (aligned with the spine) accelerations. The z-axis peak accelerations (absolute values of g) by transport type were as follows: ground ambulance takeoff mean = 0.16 and landing mean = 0.08, helicopter takeoff mean = 0.16 and landing mean = 0.05, fixed wing aircraft takeoff mean = 0.14 and landing mean = 0.20. During takeoff, 2 of 7 patients in the head-to-front of vehicle position experienced rSO2 drop. During landing, 4 of 13 patients in the head-to-back of vehicle position experienced rSO2 drop. There were no significant associations of rSO2 drop during takeoff and landing with patient positioning or with z-axis peak acceleration. Acceleration forces of pediatric and neonatal interfacility transport are small and comparable in magnitude. The relationship between rSO2 drop and patient positioning was not significant in this pilot study. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  20. Treatment of the Spasticity in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Ajša Meholjić-Fetahović

    2008-11-01

    Full Text Available Botulinum toxin is a natural purified protein and one of the strongest biological poisons - neurotoxin. It is produced by the bacterium Clostridium botulinum. Its medical usage started in USA in 1981 and in Europe in 1992. There are seven different immune types of the toxin: A, B, C1, D, E, F and G. Toxin types A and B are used to decrease muscular spasticity. Botulinum toxin prevents the formation of acetylcholine from cholinergic nerve tissues in muscles, which in the end irreversibly destroys neuromuscular synapses. It is called temporary local chemodenervation. It does not affect the synthesis of acetylcholine.As it affects neuromuscular bond it also affects one of the symptoms of cerebral palsy - spasticity Decreasing the spasticity of children with cerebral palsy leads to the improvement of conscious movements, muscles are less toned, passive mobility is improved, orthosis tolerance is also improved, and the child is enabled to perform easier and better motor functions such as crawling, standing and walking. Since the action of Botulinum toxin is limited to 2-6 months, new neural collaterals are formed and neuromuscular conductivity is reestablished which in the end once again develops a muscular spasm. This leads to a conclusion that botulinum toxin should again be applied into spastic muscles.It is very important for good effect of Botulinum toxin to set the goals of the therapy in advance. The goals include improvement of a function, prevention of contractions and deformities, ease of care and decrease of pain for children with cerebral palsy. After application of botulinum toxin, it is necessary to perform adequate and intensive physical treatment with regular monitoring of effects.This work shows a case of a boy with spastic form of cerebral palsy. After being habilitated using Vojta therapy and Bobath concept and the conduct of certain physical procedures, botulinum toxin is administered into his lower limbs’ muscles and

  1. Cerebral haemodynamics in preterm infants after exposure to dexamethasone

    Science.gov (United States)

    Pellicer, A.; Gaya, F.; Stiris, T.; Quero, J.; Cabanas, F.

    1998-01-01

    AIM—To determine changes in brain haemodynamics produced by dexamethasone; to evaluate the pathophysiological conditions involved in the effect of dexamethasone.
METHODS—A prospective study was made of 12 ventilated preterm infants who received dexamethasone (0.25 mg/kg/12 hours) for ongoing chronic lung disease or extubation failure. Cerebral blood flow (CBF), absolute cerebral blood volume (CBV), and cerebral blood volume changes (ΔCBV) were estimated by near infrared spectroscopy, before and 10, 30, 60, 120, 180 and 240 minutes after the first, third, and fifth doses of dexamethasone. All patients were monitored continuously using pulse oximetry, transcutaneous blood gases, and blood pressure.
RESULTS—There were significant short term changes in ΔCBV on each day of the study; ΔCBV increased significantly at 240 minutes compared with values before the first dose, and from 120 minutes onward during the third and fifth doses. However, mean CBV values averaged over 240 minutes after the first, third, and fifth doses did not vary. Mean CBF values averaged over 240 minutes increased progressively up to the fifth dose (significant differences between the first and fifth dose). The short term changes in CBF consisted of a significant increase 60 minutes after dexamethasone administration compared with the before and 10 minute values in every study. Blood pressure was significantly higher in the third and fifth doses than in the first dose. Blood pressure showed no short term changes. There was no correlation between CBF and blood pressure changes. TcPCO2 (transcutaneous PCO2) decreased significantly throughout the study period, with the average mean value in the fifth dose significantly lower than in the first dose. Nevertheless, no short term changes in TcPCO2 were observed.
CONCLUSIONS—Postnatal systemic dexamethasone administration produced significant changes in cerebral haemodynamics that seemed to be related to both a direct effect on regional

  2. TREATMENT OF THE SPASTICITY IN CHILDREN WITH CEREBRAL PALSY

    Science.gov (United States)

    Meholjić-Fetahović, Ajša

    2007-01-01

    Botulinum toxin is a natural purified protein and one of the strongest biological poisons - neurotoxin. It is produced by the bacterium Clostridium botulinum. Its medical usage started in USA in 1981 and in Europe in 1992. There are seven different immune types of the toxin: A, B, C1, D, E, F and G. Toxin types A and B are used to decrease muscular spasticity. Botulinum toxin prevents the formation of acetylcholine from cholinergic nerve tissues in muscles, which in the end irreversibly destroys neuromuscular synapses. It is called temporary local chemodenervation. It does not affect the synthesis of acetylcholine. As it affects neuromuscular bond it also affects one of the symptoms of cerebral palsy - spasticity Decreasing the spasticity of children with cerebral palsy leads to the improvement of conscious movements, muscles are less toned, passive mobility is improved, orthosis tolerance is also improved, and the child is enabled to perform easier and better motor functions such as crawling, standing and walking. Since the action of Botulinum toxin is limited to 2-6 months, new neural collaterals are formed and neuromuscular conductivity is reestablished which in the end once again develops a muscular spasm. This leads to a conclusion that botulinum toxin should again be applied into spastic muscles. It is very important for good effect of Botulinum toxin to set the goals of the therapy in advance. The goals include improvement of a function, prevention of contractions and deformities, ease of care and decrease of pain for children with cerebral palsy. After application of botulinum toxin, it is necessary to perform adequate and intensive physical treatment with regular monitoring of effects. This work shows a case of a boy with spastic form of cerebral palsy. After being habilitated using Vojta therapy and Bobath concept and the conduct of certain physical procedures, botulinum toxin is administered into his lower limbs’ muscles and kinezitherapy intensified

  3. Oxidative stress in cerebral small vessel disease. Role of reactive species.

    Science.gov (United States)

    Grochowski, Cezary; Litak, Jakub; Kamieniak, Piotr; Maciejewski, Ryszard

    2018-01-01

    Cerebral small vessel disease (CSVD) is a wide term describing the condition affecting perforating arterial branches as well as arterioles, venules, and capillaries. Cerebral vascular net is one of the main targets of localised oxidative stress processes causing damage to vasculature, changes in the blood flow and blood-brain barrier and, in consequence, promoting neurodegenerative alterations in the brain tissue. Numerous studies report the fact of oxidation to proteins, sugars, lipids and nucleic acids, occurring in most neurodegenerative diseases mainly in the earliest stages and correlations with the development of cognitive and motor disturbances. The dysfunction of endothelium can be caused by oxidative stress and inflammatory mechanisms as a result of reactions and processes generating extensive reactive oxygen species (ROS) production such as high blood pressure, oxidised low density lipoproteins (oxLDL), very low density lipoproteins (vLDL), diabetes, homocysteinaemia, smoking, and infections. Several animal studies show positive aspects of ROS, especially within cerebral vasculature.

  4. [Application of stroke rehabilitation unit in municipal hospitals during the acute phase of cerebral infarction].

    Science.gov (United States)

    Wang, Zhi-min; Wang, Peng; Chen, Jie; Luo, Dan-hong; Shen, Wang-ming

    2008-07-01

    To evaluate the efficacy of stroke rehabilitation unit in municipal hospitals during the acute phase of cerebral infarction. 77 acute cerebral infarction patients were randomly assigned to stroke rehabilitation unit group and 73 to ordinary group. The NIH stroke scale (NIHSS), activities of daily living (ADL) Barthel index and average hospitalized time were compared in two groups before and after the treatment. The average NIHSS in two groups before treatment were 9.26 and 9.12 respectively (P > 0.05) but became 2.62 and 7.64 after treatment (P 0.05) but 87.26 and 64.20 after the treatment (P rehabilitation unit being applied in the acute phase of cerebral infarction, it showed positive results in the following aspects as: improving the neurological function, capabilities of managing daily life, and also shortening the days of hospitalization.

  5. Continuous EEG Monitoring in Aneurysmal Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Friberg, Christian Kærsmose; Wellwood, Ian

    2015-01-01

    BACKGROUND: Continuous EEG (cEEG) may allow monitoring of patients with aneurysmal subarachnoid hemorrhage (SAH) for delayed cerebral ischemia (DCI) and seizures, including non-convulsive seizures (NCSz), and non-convulsive status epilepticus (NCSE). We aimed to evaluate: (a) the diagnostic...

  6. Regional cerebral blood flow in neuropediatrics

    International Nuclear Information System (INIS)

    Junik, R.

    2001-01-01

    Single photon emission computed tomography can effectively and non-invasively measure regional blood flow. Mostly used 99mTc-HMPAO is a safe brain imaging agent for pediatric applications. The radiation dose is acceptable. Knowledge of the normal rCBF pattern, including normal asymmetries and variations due to age, is necessary prerequisite for the evaluation and reporting of the results of 99mTc-HMPAO brain SPECT studies in clinical practice. The interpretation of he rCBF study in a child requires knowledge of normal brain maturation. The aim of the present review is to focus on the contribution to clinical developmental neurology of SPECT The clinical use of SPECT in developmental neurology are epilepsy, brain death, acute neurological loss including stroke, language disorders, cerebral palsy, high-risk neonates, hypertension due to renovascular disease, traumatic brain injury, migraine, anorexia nervosa, autism, Gilles de la Tourette syndrome, attention deficit disorder-hyperactivity, and monitoring therapy. Sedation is not routinely used, rather each child is evaluated. However, drug sedation is mandatory in some uncooperative children. (author)

  7. Cerebral oxygen metabolism and cerebral blood flow in man during light sleep (stage 2)

    DEFF Research Database (Denmark)

    Madsen, P L; Schmidt, J F; Holm, S

    1991-01-01

    We measured cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) during light sleep (stage 2) in 8 young healthy volunteers using the Kety-Schmidt technique with 133Xe as the inert gas. Measurements were performed during wakefulness and light sleep as verified by standard....... They differ in respect of arousal threshold as a stronger stimulus is required to awaken a subject from deep sleep as compared to light sleep. Our results suggest that during non-rapid eye movement sleep cerebral metabolism and thereby cerebral synaptic activity is correlated to cerebral readiness rather than...

  8. Construction of a Cerebral Hemorrhage Test System Operated in Real-time

    Science.gov (United States)

    Li, Gen; Sun, Jian; Ma, Ke; Yan, Qingguang; Zheng, Xiaolin; Qin, Mingxin; Jin, Gui; Ning, Xu; Zhuang, Wei; Feng, Hua; Huang, Shiyuwei

    2017-02-01

    The real-time monitoring and evaluation of the severity and progression of cerebral hemorrhage is essential to its intensive care and its successful emergency treatment. Based on magnetic induction phase shift technology combined with a PCI data acquisition system and LabVIEW software, this study established a real-time monitoring system for cerebral hemorrhage. To test and evaluate the performance of the system, the authors performed resolution conductivity experiments, salted water simulation experiments and cerebral hemorrhage experiments in rabbits and found that when the conductivity difference was 0.73 S/m, the phase difference was 13.196°. The phase difference change value was positively proportional to the volume of saline water, and the conductivity value was positively related to the phase difference of liquid under the same volume conditions. After injecting 3 mL blood into six rabbits, the average change in the blood phase difference was -2.03783 ± 0.22505°, and it was positively proportional to the volume of blood, which was consistent with the theoretical results. The results show that the system can monitor the progressive development of cerebral hemorrhage in real-time and has the advantages of low cost, small size, high phase accuracy, and good clinical application potentiality.

  9. Cerebral haemodynamics during carotid cross-clamping.

    Science.gov (United States)

    Pistolese, G R; Ippoliti, A; Appolloni, A; Ronchey, S; Faraglia, V

    1993-03-01

    Carotid artery cross-clamping ischaemia during carotid endarterectomy (CEA) causes 5-30% of perioperative neurological deficits. This study was performed to identify possible clinical situations at higher risk for carotid cross-clamping ischaemia. 606 consecutive patients underwent CEA and were retrospectively studied; they were grouped according to risk factors, presence of associated vascular diseases, clinical pattern, angiographic and CT scan findings. Stump pressure measurement was provided in all patients, perioperative monitoring during CEA was performed by electroencephalogram (EEG) in 469 (77%) and somatosensorial evoked potentials (SEP) in 137 (23%). Local anaesthesia was used in 88 (14.5%) patients. Ischaemic changes during carotid cross-clamping were registered in 118 patients (19.5%). The incidence of cross-clamping ischaemia was then related to different factors; it affected 5.6% of asymptomatics, 25.4% of patients with fixed stroke and 38.5% of those with stenosis and contralateral occlusion. Angiographic and clinical correlation showed that patients with more severe lesions are mostly affected by clamping ischaemia (up to 55% in those with stroke and stenosis with contralateral occlusion). Age, hypertension and diabetes do not significantly affect incidence of ischaemic changes. Positive CT scan increased this risk; statistical relevance was found in regard to patients with unilateral or bilateral stenosis and in those with transient ischaemic attacks. A higher risk can be expected for subjects with more severe clinical and instrumental findings, even if no patients can be considered completely at risk or risk free. Perioperative monitoring is always mandatory and is of great importance in detecting ischaemic changes and preventing cerebral damage using a temporary intraluminal shunt.

  10. Clinical correlations in cerebral palsy.

    Science.gov (United States)

    Minciu, Ioana

    2012-12-01

    Cerebral palsy (CP) is a group of persistent (but not necessarily unchanged), movement, posture, muscle tone and motor skills disorders non-progressive, with early onset, due to non-progressive impairments, occurring on an immature brain or a brain under development (prenatal, perinatal, postnatal during the first 3-4 years of life). It is associated to a variable extent with: cognitive disorders, epilepsy, sensory deficits, behaviour disorders. The study of the correlations between the clinical forms/subtypes of CP, comorbidities, and severity of functional impairment. It is a retrospective trial aimed only at patients with the diagnosis of cerebral palsy admitted at Paediatric Neurology Clinic of the "Alexandru Obregia" Clinical Hospital in 2010.Results, discussions and conclusions: Patients with cerebral palsy corresponding with the criteria for inclusion: 379. The spastic CP type has prevailed. Comorbidities like mental retardation, epilepsy, and ophthalmic disorders were found with greater frequency than in the studies in the literature.The unilateral spastic form was statistically correlated with slight functional impairment (GMFCS I), with the absence of comorbidities or mild mental retardation, or with focal epilepsy when there is epilepsy. The bilateral spastic, tetraparetic and dyskinetic forms were correlated significantly with severe functional impairment (GMFCS IV, V), with profound or severe retardation, microcephaly, swallowing disorders, statural, ponderal hypotrophy, blindness and epilepsy. The bilateral spastic paraparetic form, which in the literature is mentioned as having fewer associated disorders (for example strabismus, slight retardation), when there is severe functional impairment, it may have the same comorbidities as the tetraparetic form (similar to the cases studied in the hospital). Comorbidities are the main admission cause and it correlates with the severity and prognosis.

  11. Hemodynamic Intervention of Cerebral Aneurysms

    Science.gov (United States)

    Meng, Hui

    2005-11-01

    Cerebral aneurysm is a pathological vascular response to hemodynamic stimuli. Endovascular treatment of cerebral aneurysms essentially alters the blood flow to stop them from continued growth and eventual rupture. Compared to surgical clipping, endovascular methods are minimally invasive and hence rapidly gaining popularity. However, they are not always effective with risks of aneurysm regrowth and various complications. We aim at developing a Virtual Intervention (VI) platform that allows: patient-specific flow calculation and risk prediction as well as recommendation of tailored intervention based on quantitative analysis. This is a lofty goal requiring advancement in three areas of research: (1). Advancement of image-based CFD; (2) Understanding the biological/pathological responses of tissue to hemodynamic factors in the context of cerebral aneurysms; and (3) Capability of designing and testing patient-specific endovascular devices. We have established CFD methodologies based on anatomical geometry obtained from 3D angiographic or CT images. To study the effect of hemodynamics on aneurysm development, we have created a canine model of a vascular bifurcation anastomosis to provide the hemodynamic environment similar to those in CA. Vascular remodeling was studied using histology and compared against the flow fields obtained from CFD. It was found that an intimal pad, similar to those frequently seen clinically, developed at the flow impingement site, bordering with an area of `groove' characteristic of an early stage of aneurysm, where the micro environment exhibits an elevated wall shear stresses. To further address the molecular mechanisms of the flow-mediated aneurysm pathology, we are also developing in vitro cell culture systems to complement the in vivo study. Our current effort in endovascular device development focuses on novel stents that alters the aneurysmal flow to promote thrombotic occlusion as well as favorable remodeling. Realization of an

  12. Multiple cerebral aneurysms of middle cerebral artery. Case report

    Directory of Open Access Journals (Sweden)

    D.A. Nica1, Tatiana Rosca1, A. Dinca2, M. Stroi3, Mirela Renta4, A.V. Ciurea5

    2010-11-01

    Full Text Available Multiple cerebral aneurysms present awide variation in incidence with averages of13% at angiographic studies and 22.7% atautopsy.High blood pressue, cigarette smoking,stress and possible also age and female sexseem to be risk factors for multipleintracranial aneurysms (MIAn in patientsof working age who have suffered asubarachnoid hemorrhage (SAH.Aneurysms were situated on the same sidein one-third of the patients with twoaneurysms and the most common site wasthe middle cerebral artery (MCA. Tomanage these challenging lesionsneurosurgeons must use all availableinnovations and advances, includingdiagnostic, technical and perioperativeadjuncts. The author presents a case ofmiddle age female, with two saccularaneurysms situated on the same side (rightMCA, who was operated in our clinic, 20days after first SAH episode, I grade onHunt/Hess scale. The angio MRI wasperformed before, and control DSangiography after operation. After pterionalapproach, the author used themagnification, microsurgical technics,temporal clip, and two permanent Yasargilcurved clips. A postoperative good recoveryenable the patient go to work and drive onemonth later.

  13. Flow structures in cerebral aneurysms

    OpenAIRE

    Gambaruto, Alberto M; João, Ana

    2012-01-01

    Mechanical properties of blood flow are commonly correlated to a wide range of cardiovascular diseases. In this work means to describe and characterise the flow field in the free-slip and no-slip domains are discussed in the context of cerebral aneurysms, reconstructed from in-vivo medical imaging. The approaches rely on a Taylor series expansion of the velocity field to first order terms that leads to a system of ODEs, the solution to which locally describes the motion of the flow. On perfor...

  14. Schizencephaly/congenital cerebral clefts

    International Nuclear Information System (INIS)

    Friedman, H.; Naidich, T.P.

    1987-01-01

    Schizencephaly (from the Greek meaning ''split brain''), is a term developed in the 1940s to explain symmetric clefts in the brain seen at autopsy in children with histories of severe neurologic defects. Use of the term has been expanded to include a variety of cerebral clefts. A review of the experience at Children's Memorial Hospital as well as case materials made available to the authors are presented, including CT, MR imaging, and US findings. Theories of etiology and pathogenesis of these congenital clefts, associated anomalies, and the spectrum of appearance of these clefts are discussed

  15. Blood free Radicals Concentration Determined by Electron Paramagnetic Resonance Spectroscopy and Delayed Cerebral Ischemia Occurrence in Patients with Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Ewelina, Grzywna; Krzysztof, Stachura; Marek, Moskala; Krzysztof, Kruczala

    2017-12-01

    Pathophysiology of delayed cerebral ischemia and cerebral vasospasm following aneurysmal subarachnoid hemorrhage is still poorly recognized, however free radicals are postulated as one of the crucial players. This study was designed to scrutinize whether the concentration of free radicals in the peripheral venous blood is related to the occurrence of delayed cerebral ischemia associated with cerebral vasospasm. Twenty-four aneurysmal subarachnoid hemorrhage patients and seven patients with unruptured intracranial aneurysm (control group) have been studied. Free radicals in patients' blood have been detected by the electron paramagnetic resonance (CMH.HCl spin probe, 150 K, ELEXSYS E500 spectrometer) on admission and at least 72 h from disease onset. Delayed cerebral ischemia monitoring was performed by daily neurological follow-up and transcranial color coded Doppler. Delayed cerebral ischemia observed in six aneurysmal subarachnoid hemorrhage patients was accompanied by cerebral vasospasm in all six cases. No statistically significant difference in average free radicals concentration between controls and study subgroups was noticed on admission (p = .3; Kruskal-Wallis test). After 72 h free radicals concentration in delayed cerebral ischemia patients (3.19 ± 1.52 mmol/l) differed significantly from the concentration in aneurysmal subarachnoid hemorrhage patients without delayed cerebral ischemia (0.65 ± 0.37 mmol/l) (p = .012; Mann-Whitney test). These findings are consistent with our assumptions and seem to confirm the role of free radicals in delayed cerebral ischemia development. Preliminary results presented above are promising and we need perform further investigation to establish whether blood free radicals concentration may serve as the biomarker of delayed cerebral ischemia associated with cerebral vasospasm.

  16. What are the best animal models for testing early intervention in cerebral palsy?

    Directory of Open Access Journals (Sweden)

    Gavin John Clowry

    2014-12-01

    Full Text Available Interventions to treat cerebral palsy should be initiated as soon as possible in order to restore the nervous system to the correct developmental trajectory. One drawback to this approach is that interventions have to undergo exceptionally rigorous assessment for both safety and efficacy prior to use in infants. Part of this process should involve research using animals but how good are our animal models? Part of the problem is that cerebral palsy is an umbrella term that covers a number of conditions. There are also many causal pathways to cerebral palsy, such as periventricular white matter injury in premature babies, perinatal infarcts of the middle cerebral artery or generalised anoxia at the time of birth, indeed multiple causes, including intra-uterine infection or a genetic predisposition to infarction, may need to interact to produce a clinically significant injury. In this review we consider which animal models best reproduce certain aspects of the condition, and the extent to which the multifactorial nature of cerebral palsy has been modelled. The degree to which the corticospinal system of various animals models human corticospinal system function and development is also explored. Where attempts have already been made to test early intervention in animal models, the outcomes are evaluated in light of the suitability of the model.

  17. Molecular aspects of toxicology

    National Research Council Canada - National Science Library

    Hathway, D. E

    1984-01-01

    The subject matter of this book is organized into chapters that deal wwith separate subjects and, whilst this treatment reveals the structure of molecular aspects of toxicology, it inevitably incurs...

  18. General safety aspects

    International Nuclear Information System (INIS)

    1998-01-01

    In this part next aspects are described: (1) Priority to safety; (2) Financial and human resources;; (3) Human factor; (4) Operator's quality assurance system; (5) Safety assessment and Verification; (6) Radiation protection and (7) Emergency preparedness

  19. Risk Factors for Cerebral Venous Thrombosis

    NARCIS (Netherlands)

    Silvis, Suzanne M.; Middeldorp, Saskia; Zuurbier, Susanna M.; Cannegieter, Suzanne C.; Coutinho, Jonathan M.

    2016-01-01

    Cerebral venous thrombosis (CVT) is a rare thrombotic disorder involving the cerebral veins and dural sinuses. In contrast to more common sites of venous thromboembolism (VTE), such as the legs and lungs, CVT mainly affects young adults and children, and women are affected three times more often

  20. Venous Thromboembolic Events After Cerebral Vein Thrombosis

    NARCIS (Netherlands)

    Miranda, Bruno; Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando; Scoditti, Umberto

    2010-01-01

    Background and Purpose-After cerebral vein and dural sinus thrombosis (CVT), there is an increased risk of further venous thromboembolic events (VTEs). Time to a second cerebral or systemic venous thrombotic event and risk factors for recurrence have not been investigated in large prospective

  1. ORIGINAL ARTICLES Endovascular treatment of cerebral ...

    African Journals Online (AJOL)

    ORIGINAL ARTICLES. Endovascular treatment of cerebral aneurysms - a cost analysis. David Le Feuvre, Allan Taylor. Objectives. To determine if endovascular treatment of cerebral aneurysms is cost effective when compared with conventional surgical treatment. Design. A retrospective study. Subjects. Seventeen patients ...

  2. Spontaneous peripheral gangrene following severe cerebral malaria

    African Journals Online (AJOL)

    ... phalanges of the right index and middle fingers and the distal phalanges of the great, second and middle toes of the right foot following cerebral malaria. Until now, there has been only five such cases of peripheral gangrene associated with 'cerebral' malaria reported in literature and all these were all from Southeast Asia.

  3. Time patterns in multiple acute cerebral infarcts.

    Science.gov (United States)

    Novotny, Vojtech; Khanevski, Andrej N; Thomassen, Lars; Waje-Andreassen, Ulrike; Naess, Halvor

    2017-12-01

    Background Multiple acute cerebral infarcts in different arterial territories may be caused by several emboli concurrently or successively. Aim and/or hypothesis We hypothesized that the time from stroke onset to magnetic resonance imaging may shed light on underlying mechanisms of multiple acute cerebral infarcts. Methods This is a prospective observational cohort study involving 2697 ischemic stroke patients conducted at Haukeland University Hospital between February 2006 and October 2013. Only patients with diffusion-weighted imaging lesions in more than one arterial territory (left or right anterior circulation or posterior circulation) were included. The time from stroke onset to magnetic resonance imaging was registered and correlated with the etiology of multiple acute cerebral infarcts in each patient. Results We reviewed 2697 consecutive patients and 2220 (82%) underwent magnetic resonance imaging. Among these 2125 (96%) had diffusion-weighted imaging lesions. We found 187 multiple acute cerebral infarct patients who were then included in the study. There was positive correlation (0.20; p time to magnetic resonance imaging and frequency of multiple acute cerebral infarcts caused by internal carotid stenosis. There was no correlation (-.02) between time to magnetic resonance imaging and frequency of multiple acute cerebral infarcts caused by cardiogenic embolism. Conclusions Multiple acute cerebral infarcts associated with cardiogenic embolism seem to happen concurrently as a shower of emboli whereas multiple acute cerebral infarcts associated with internal carotid artery stenosis seem to occur successively separated by hours or days.

  4. Asymptomatic cerebral hemorrhage detected by MRI

    International Nuclear Information System (INIS)

    Shinohara, Y.; Nakajima, Y.; Ohsuga, H.; Yamamoto, M.

    1991-01-01

    In a period of nearly three years, 2757 patients have undergone magnetic resonance scans of the brain. The purpose of this study was to elucidate the incidence and the cause of asymptomatic cerebral hemorrhage among the patients who had been diagnosed as having apparent cerebral hemorrhage. (author). 2 refs.; 1 tab

  5. Fatal cerebral oedema in adult diabetic ketoacidosis.

    NARCIS (Netherlands)

    Haringhuizen, A.; Tjan, D.H.; Grool, A.; Vugt, R. van; Zante, A.R. van

    2010-01-01

    In this report, a case of adult onset fatal cerebral oedema as a rare complication of diabetic ketoacidosis (DKA) is described and confirmed at post-mortem pathological examination. The pathogenesis of cerebral oedema due to DKA is still unknown. Potential mechanisms include the administration of

  6. Neurotransmitter Receptor Binding in Bovine Cerebral Microvessels

    Science.gov (United States)

    Peroutka, Stephen J.; Moskowitz, Michael A.; Reinhard, John F.; Synder, Solomon H.

    1980-05-01

    Purified preparations of microvessels from bovine cerebral cortex contain substantial levels of alpha-adrenergic, beta-adrenergic, and histamine 1 receptor binding sites but only negligible serotonin, muscarinic cholinergic, opiate, and benzodiazepine receptor binding. Norepinephrine and histamine may be endogenous regulators of the cerebral microcirculation at the observed receptors.

  7. MRI of sickle cell cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zimmerman, R.A.; Goldberg, H.I.; Bilaniuk, L.T.; Hackney, D.B.; Johnson, M.; Grossman, R.I.; Hecht-Leavitt, C.; Gill, F.

    1987-05-01

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT.

  8. Acute hypoxia increases the cerebral metabolic rate

    DEFF Research Database (Denmark)

    Vestergaard, Mark Bitsch; Lindberg, Ulrich; Aachmann-Andersen, Niels Jacob

    2016-01-01

    The aim of the present study was to examine changes in cerebral metabolism by magnetic resonance imaging of healthy subjects during inhalation of 10% O2 hypoxic air. Hypoxic exposure elevates cerebral perfusion, but its effect on energy metabolism has been less investigated. Magnetic resonance im...

  9. Mobility Experiences of Adolescents with Cerebral Palsy

    Science.gov (United States)

    Palisano, Robert J.; Shimmell, Lorie J.; Stewart, Debra; Lawless, John J.; Rosenbaum, Peter L.; Russell, Dianne J.

    2009-01-01

    The purpose of this study was to describe how youth with cerebral palsy experience mobility in their daily lives using a phenomenological approach. The participants were 10 youth with cerebral palsy, 17 to 20 years of age, selected using purposeful sampling with maximum variation strategies. A total of 14 interviews were completed. Transcripts…

  10. MRI of sickle cell cerebral infarction

    International Nuclear Information System (INIS)

    Zimmerman, R.A.; Goldberg, H.I.; Bilaniuk, L.T.; Hackney, D.B.; Johnson, M.; Grossman, R.I.; Hecht-Leavitt, C.; Gill, F.; Pennsylvania Univ., Philadelphia

    1987-01-01

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

  11. MANAGEMENT OF CHILDREN WITH CEREBRAL PALSY

    African Journals Online (AJOL)

    Enrique

    The neurological lesion causing cerebral palsy (CP) is static, but the clinical con- dition changes ... Is it cerebral palsy? There must be evidence of an upper motor neuron (UMN) lesion, with brisk reflexes and possibly clonus; there should also be increased tone or persist- ent primitive ..... are at high risk for hip dislocation.

  12. Animal models of cerebral arterial gas embolism

    NARCIS (Netherlands)

    Weenink, Robert P.; Hollmann, Markus W.; van Hulst, Robert A.

    2012-01-01

    Cerebral arterial gas embolism is a dreaded complication of diving and invasive medical procedures. Many different animal models have been used in research on cerebral arterial gas embolism. This review provides an overview of the most important characteristics of these animal models. The properties

  13. Foundational aspects of security

    DEFF Research Database (Denmark)

    Chatzikokolakis, Konstantinos; Mödersheim, Sebastian Alexander; Palamidessi, Catuscia

    2014-01-01

    This Special Issue of the Journal of Computer Security focuses on foundational aspects of security, which in recent years have helped change much of the way we think about and approach system security.......This Special Issue of the Journal of Computer Security focuses on foundational aspects of security, which in recent years have helped change much of the way we think about and approach system security....

  14. Comprehensive handbook of iodine: nutritional, biochemical, pathological and therapeutic aspects

    National Research Council Canada - National Science Library

    Preedy, Victor R; Burrow, Gerard N; Watson, Ronald R

    2009-01-01

    ... for Monitoring Effects of Iodine/Thyroid Status in Populations Inge Bülow Pedersen and Peter Laurberg 3 15 29 39 47 55 65 Section 2: General Aspects of Iodine Sources and Intakes in the Diet, Mai...

  15. Adenomatous polyposis coli is required for early events in the normal growth and differentiation of the developing cerebral cortex

    Directory of Open Access Journals (Sweden)

    Price David J

    2009-01-01

    Full Text Available Abstract Background Adenomatous polyposis coli (Apc is a large multifunctional protein known to be important for Wnt/β-catenin signalling, cytoskeletal dynamics, and cell polarity. In the developing cerebral cortex, Apc is expressed in proliferating cells and its expression increases as cells migrate to the cortical plate. We examined the consequences of loss of Apc function for the early development of the cerebral cortex. Results We used Emx1Cre to inactivate Apc specifically in proliferating cerebral cortical cells and their descendents starting from embryonic day 9.5. We observed reduction in the size of the mutant cerebral cortex, disruption to its organisation, and changes in the molecular identity of its cells. Loss of Apc leads to a decrease in the size of the proliferative pool, disrupted interkinetic nuclear migration, and increased apoptosis. β-Catenin, pericentrin, and N-cadherin proteins no longer adopt their normal high concentration at the apical surface of the cerebral cortical ventricular zone, indicating that cell polarity is disrupted. Consistent with enhanced Wnt/β-catenin signalling resulting from loss of Apc we found increased levels of TCF/LEF-dependent transcription and expression of endogenous Wnt/β-catenin target genes (Axin2 (conductin, Lef1, and c-myc in the mutant cerebral cortex. In the Apc mutant cerebral cortex the expression of transcription factors Foxg1, Pax6, Tbr1, and Tbr2 is drastically reduced compared to normal and many cells ectopically express Pax3, Wnt1, and Wt1 (but not Wnt2b, Wnt8b, Ptc, Gli1, Mash1, Olig2, or Islet1. This indicates that loss of Apc function causes cerebral cortical cells to lose their normal identity and redirect to fates normally found in more posterior-dorsal regions of the central nervous system. Conclusion Apc is required for multiple aspects of early cerebral cortical development, including the regulation of cell number, interkinetic nuclear migration, cell polarity, and

  16. CT findings in patients with cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Konno, K. (Akita Univ. (Japan))

    1982-01-01

    Clinical findings and CT findings in 73 cases of cerebral palsy were studied. The causes of cerebral palsy were presumed to be as follows: abnormal cerebral development (36%), asphyxial delivery (34%), and immature delivery (19%), etc. CT findings were abnormal in 58% of the 73 cases, 83% of the spastic tetraplegia patients and all of the spastic hemiplegia patients showed abnormal CT findings. All the patients with spastic monoplegia presented normal CT findings. In 75% of the spastic hemiplegia cases, the CT abnormalities were due to cerebral parenchymal abnormality such as porencephaly and regional low absorption. In cases of spastic tetraplegia, cerebral parenchymal abnormality was found only in 10%. Cortical atrophy was found only in 15 of the 73 cases, whereas central atrophy was found in 36 cases.

  17. Dorsiflexor muscle-group thickness in children with cerebral palsy: Relation to cross-sectional area

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Magnusson, Peter; Jensen, Bente Rona

    2009-01-01

    If the thickness and cross-sectional area of the dorsiflexor muscle group are related in children with cerebral palsy, measurements of muscle thickness may be used to monitor changes in muscle size due to training or immobilisation in these patients. We assessed the validity and reliability.......001), and the reliability of the muscle-thickness measurements was high in the healthy subjects (ICC_{2.1} = 0.94, standard error of measurement = 0.04 cm). The dorsiflexor muscle-thickness was 22% less in the affected compared to the non-affected leg in children with hemiplegic cerebral palsy (P ..., the dorsiflexor cross-sectional area was 32% less in the affected compared to the non-affected leg (P = 0.002). Measurements of dorsiflexor muscle-thickness can be reliably obtained, and they reflect dorsiflexor cross-sectional area in children with cerebral palsy....

  18. Cerebral Magnetic Resonance Spectroscopy Demonstrates Long-Term Effect of Bone Marrow Transplantation in α-Mannosidosis

    DEFF Research Database (Denmark)

    Danielsen, Else R; Lund, Allan M; Thomsen, Carsten

    2013-01-01

    α-Mannosidosis, OMIM #248500, is an autosomal recessive lysosomal storage disease caused by acidic α-mannosidase deficiency. Treatment options include bone marrow transplantation (BMT) and, possibly in the future, enzyme replacement therapy. Brain magnetic resonance spectroscopy (MRS) enables non......-invasive monitoring of cerebral treatment effect. Accumulated cerebral mannose-containing oligosaccharides were demonstrated by MRS in a patient who at age 2 years and 11 months received a BMT from a haploidentical non-carrier sibling. The cerebral mannose-containing oligosaccharides had disappeared as early as 9......½ months after BMT. MRS furthermore demonstrated the persistent treatment effect at regular intervals up to 5½ years after BMT. MRS is a non-invasive tool that can demonstrate the effect of BMT treatment. Likewise, MRS may be used to demonstrate the cerebral effect of other potential treatments...

  19. Intraoperative multi-exposure speckle imaging of cerebral blood flow.

    Science.gov (United States)

    Richards, Lisa M; Kazmi, Sm Shams; Olin, Katherine E; Waldron, James S; Fox, Douglas J; Dunn, Andrew K

    2017-09-01

    Multiple studies have demonstrated that laser speckle contrast imaging (LSCI) has high potential to be a valuable cerebral blood flow monitoring technique during neurosurgery. However, the quantitative accuracy and sensitivity of LSCI is limited, and highly dependent on the exposure time. An extension to LSCI called multi-exposure speckle imaging (MESI) overcomes these limitations, and was evaluated intraoperatively in patients undergoing brain tumor resection. This clinical study ( n = 8) recorded multiple exposure times from the same cortical tissue area spanning 0.5-20 ms, and evaluated images individually as single-exposure LSCI and jointly using the MESI model. This study demonstrated that the MESI estimates provided the broadest flow sensitivity for sampling the flow magnitude in the human brain, closely followed by the shorter exposure times. Conservation of flow analysis on vascular bifurcations was used to validate physiological accuracy, with highly conserved flow estimates (flow changes after tissue cautery. Results from this study demonstrate that intraoperative MESI can be performed with high quantitative accuracy and sensitivity for cerebral blood flow monitoring.

  20. Cerebral Metabolic Changes Related to Oxidative Metabolism in a Model of Bacterial Meningitis Induced by Lipopolysaccharide.

    Science.gov (United States)

    Munk, M; Poulsen, F R; Larsen, L; Nordström, C H; Nielsen, T H

    2018-03-05

    Cerebral mitochondrial dysfunction is prominent in the pathophysiology of severe bacterial meningitis. In the present study, we hypothesize that the metabolic changes seen after intracisternal lipopolysaccharide (LPS) injection in a piglet model of meningitis is compatible with mitochondrial dysfunction and resembles the metabolic patterns seen in patients with bacterial meningitis. Eight pigs received LPS injection in cisterna magna, and four pigs received NaCl in cisterna magna as a control. Biochemical variables related to energy metabolism were monitored by intracerebral microdialysis technique and included interstitial glucose, lactate, pyruvate, glutamate, and glycerol. The intracranial pressure (ICP) and brain tissue oxygen tension (PbtO 2 ) were also monitored along with physiological variables including mean arterial pressure, blood glucose, lactate, and partial pressure of O 2 and CO 2 . Pigs were monitored for 60 min at baseline and 240 min after LPS/NaCl injection. After LPS injection, a significant increase in cerebral lactate/pyruvate ratio (LPR) compared to control group was registered (p = 0.01). This increase was due to a significant increased lactate with stable and normal values of pyruvate. No significant change in PbtO 2 or ICP was registered. No changes in physiological variables were observed. The metabolic changes after intracisternal LPS injection is compatible with disturbance in the oxidative metabolism and partly due to mitochondrial dysfunction with increasing cerebral LPR due to increased lactate and normal pyruvate, PbtO 2 , and ICP. The metabolic pattern resembles the one observed in patients with bacterial meningitis. Metabolic monitoring in these patients is feasible to monitor for cerebral metabolic derangements otherwise missed by conventional intensive care monitoring.

  1. Evaluation of cerebral blood flow, cerebral metabolism and cerebral function by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Tanaka, Chuzo; Higuchi, Toshihiro; Umeda, Masahiro; Naruse, Shoji; Horikawa, Yoshiharu; Ueda, Satoshi; Furuya, Seiichi.

    1995-01-01

    The magnetic resonance (MR) method has the unique potentiality of detecting cerebral metabolites, cerebral blood flow and brain functions in a noninvasive fashion. We have developed several MR techniques to detect these cerebral parameters with the use of clinical MRI scanners. By modifying the MR spectroscopy (MRS) technique, both 31 P- and 1 H-MRS data can be obtained from multiple, localized regions (multi-voxel method) of the brain, and the distribution of each metabolite in the brain can be readily visualized by metabolite mapping. The use of diffusion weighted images (DWI) permits visualization of the anisotropy of water diffusion in white matter, and based on the difference of diffusion coefficiency, the differential diagnosis between epidermoid tumor and arachnoid cyst can be made. By employing dynamic-MRI (Dyn-MRI) with Gd-DTPA administration, it is possible to examine the difference in blood circulation between brain tumor tissue and normal tissue, as well as among different types of brain tumors. By using magnetization transfer contrast (MTC) imaging, it has become possible to detect brain tumors, and with a small dose of Gd-DTPA, to visualize the vascular system. Functional MRI (fMRI) visualizes the activated brain by using conventional gradient echo technique on conventional MRI scanners. This method has the unique characteristic of detecting a brain function with high spatial and temporal resolution by using the intrinsic substance. Moreover, the localization of motor and sensory areas was detected by noninvasive means within few minutes. The fMRI procedure will be used in the future to analyze the higher and complex brain functions. In conclusion, multi-modality MR is a powerful technique that is useful for investigating the pathogenesis of many diseases, and provides a noninvasive analytic modality for studying brain function. (author)

  2. [Negative symptoms and cerebral imaging].

    Science.gov (United States)

    Kaladjian, A; Belzeaux, R; Adida, M; Azorin, J-M

    2015-12-01

    A number of neuroanatomical and neurofonctional abnormalities have been evidenced by cerebral imaging studies in patients suffering from schizophrenia. Nevertheless, those specifically associated with the negative symptoms of this disease are still insufficiently known. This work is a review of selected studies that have assessed the brain correlates of negative symptoms in schizophrenia. Approaches using structural imaging have highlighted reduction of gray matter density or cortical thickness associated with negative symptoms, which is rather sparsely distributed within the frontal and temporal regions, localized nevertheless more particularly in the frontal medial and orbitofrontal areas, as well as the amygdalo-hippocampic complex. These deficits are concurrent with a loss of integrity of the principal paths of white matter tracts between frontal and limbic regions. On the other hand, neurofonctional abnormalities associated with negative symptoms involve especially the frontal areas and limbic striatum. A disturbed functioning within the fronto-striatal loops, related to a striatal dopaminergic deficit, may represent a potential explanatory hypothesis of the negative symptoms of schizophrenia, as suggested by studies using Positron Emission Tomography on this topic or neuroimaging studies on the effects of antipsychotics. A better identification of the cerebral abnormalities associated with the negative dimension of schizophrenia, with regard to the lateralization of these abnormalities or to their changes during the course of the disease, could offer new therapeutic modalities for the treatment of this dimension which, until now, remains few responsive to conventional pharmacological treatments. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Radiotherapy in primary cerebral lymphoma

    International Nuclear Information System (INIS)

    Legros, L.; Benezery, K.; Lagrange, J.L.

    1999-01-01

    Primary cerebral lymphoma is a rare disease with an unfavorable prognosis. Whole brain radiotherapy has been the standard treatment, but neither the optimal radiation fields nor optimal dose level of the regimen are as yet firmly establisheD. From this review of the literature, it seems that the whole brain must be treated, and a boost to the area of the primary site must be discussed. With regard to dose, the radiation dose-response relationship is not clearly proven. Yet, a minimum dose of 40 Gy is necessary, and the maximum dose is set at 50 Gy because of late neurological sequelae. Because of the poor prognosis of this disease and the risk of late sequelae, other avenues have been explored. Chemotherapy has been studied, seem to have a survival advantage and combinations of radiotherapy and chemotherapy, especially with high-dose methotrexate. Because primary cerebral lymphoma is an uncommon disease, randomized clinical trials that compare radiotherapy alone to chemotherapy plus radiotherapy may not be feasible. Finally, even if chemotherapy seems to have a survival advantage, the regimen of chemotherapy is still a matter of debate. (authors)

  4. Neuroimaging patterns of cerebral hyperperfusion

    Science.gov (United States)

    Semenov, S.; Portnov, Yu; Semenov, A.; Korotkevich, A.; Kokov, A.

    2017-08-01

    Cerebral hyperperfusion syndrome (CHS) after revascularization is a rare phenomenon associated with post-ischemic (reactive) hyperemia and acute pathological hyperperfusion. First described on perfusion CT as a very often moderate CBF increase, MTT/TTP decrease within 30% like a temporary effect, according to a short-time deterioration of neurological symptoms (vestibular ataxia - 58%, vegetative dysfunction - 100%, asthenic syndrome - 100%) in early postoperative period in patients with cardiac ischemia who had undergone coronary artery bypass surgery. The acute pathological hyperperfusion carotid revascularization is a casuistic phenomenon with two- or three-fold CBV and MTT/TTP increase and high hemorrhage risk. Besides, we detected similar exchanges via perfusion CT called benign hyperemia, which marks extension of MTT/TTP and an increase of CBV from 27% to 48% (average 30%), but with normal CBF-parameters, indicating that venous stasis in acute venous ischemic stroke due cerebral venous sinus-trombosis (68%), only 6% in cardioembolic stroke and appears never in arterial stroke. Territorial coincidence registered for perifocal of necrosis zones of benign hyperemia and vasogenic edema accompanied on MRI (DWI, ADC). Secondary hemorrhagic transformation registered for primary non-hemorrhagic venous stroke in 27%, only in 9% for arterial stroke and in 60% for cardioembolic stroke. Probably, congestion is an increasingly predisposing factor secondary hemorrhaging than necrosis.

  5. Intrathecal baclofen treatment in dystonic cerebral palsy: a randomized clinical trial: the IDYS trial.

    Science.gov (United States)

    Bonouvrié, Laura A; Becher, Jules G; Vles, Johannes S H; Boeschoten, Karin; Soudant, Dan; de Groot, Vincent; van Ouwerkerk, Willem J R; Strijers, Rob L M; Foncke, Elisabeth; Geytenbeek, Joke; van de Ven, Peter M; Teernstra, Onno; Vermeulen, R Jeroen

    2013-10-28

    Dystonic cerebral palsy is primarily caused by damage to the basal ganglia and central cortex. The daily care of these patients can be difficult due to dystonic movements. Intrathecal baclofen treatment is a potential treatment option for dystonia and has become common practice. Despite this widespread adoption, high quality evidence on the effects of intrathecal baclofen treatment on daily activities is lacking and prospective data are needed to judge the usefulness and indications for dystonic cerebral palsy. The primary aim of this study is to provide level one clinical evidence for the effects of intrathecal baclofen treatment on the level of activities and participation in dystonic cerebral palsy patients. Furthermore, we hope to identify clinical characteristics that will predict a beneficial effect of intrathecal baclofen in an individual patient. A double blind placebo-controlled multi-center randomized clinical trial will be performed in 30 children with dystonic cerebral palsy. Patients aged between 4 and 25 years old with a confirmed diagnosis of dystonic cerebral palsy, Gross Motor Functioning Classification System level IV or V, with lesions in the cerebral white matter, basal ganglia or central cortex and who are eligible for intrathecal baclofen treatment will be included. Group A will receive three months of continuous intrathecal baclofen treatment and group B will receive three months of placebo treatment, both via an implanted pump. After this three month period, all patients will receive intrathecal baclofen treatment, with a follow-up after nine months. The primary outcome measurement will be the effect on activities of and participation in daily life measured by Goal Attainment Scaling. Secondary outcome measurements on the level of body functions include dystonia, spasticity, pain, comfort and sleep-related breathing disorders. Side effects will be monitored and we will study whether patient characteristics influence outcome. The results of

  6. Dopamine therapy does not affect cerebral autoregulation during hypotension in newborn piglets.

    Directory of Open Access Journals (Sweden)

    Vibeke Ramsgaard Eriksen

    Full Text Available Hypotensive neonates who have been treated with dopamine have poorer neurodevelopmental outcome than those who have not been treated with dopamine. We speculate that dopamine stimulates adrenoceptors on cerebral arteries causing cerebral vasoconstriction. This vasoconstriction might lead to a rightward shift of the cerebral autoregulatory curve; consequently, infants treated with dopamine would have a higher risk of low cerebral blood flow at a blood pressure that is otherwise considered "safe".In anaesthetized piglets, perfusion of the brain, monitored with laser-doppler flowmetry, and cerebral venous saturation was measured at different levels of hypotension. Each piglet was studied in two phases: a phase with stepwise decreases in MAP and a phase with stepwise increases in MAP. We randomized the order of the two phases, whether dopamine was given in the first or second phase, and the infusion rate of dopamine (10, 25, or 40 μg/kg/min. In/deflation of a balloon catheter, placed in vena cava, induced different levels of hypotension. At each level of hypotension, fluctuations in MAP were induced by in/deflations of a balloon catheter in descending aorta.During measurements, PaCO2 and arterial saturation were stable. MAP levels ranged between 14 and 82 mmHg. Cerebral autoregulation (CA capacity was calculated as the ratio between %-change in cerebrovascular resistance and %-change in MAP induced by the in/deflation of the arterial balloon. A breakpoint in CA capacity was identified at a MAP of 38±18 mmHg without dopamine and at 44±18, 31±14, and 24±14 mmHg with dopamine infusion rates of 10, 25, and 40 μg/kg/min (p = 0.057. Neither the index of steady-state cerebral perfusion nor cerebral venous saturation were affected by dopamine infusion.Dopamine infusion tended to improve CA capacity at low blood pressures while an index of steady-state cerebral blood flow and cerebral venous saturation were unaffected by dopamine infusion. Thus

  7. Brain tissue oxygenation-guided management of diabetic ketoacidosis induced cerebral edema*.

    Science.gov (United States)

    O'Brien, Nicole F; Mella, Cesar

    2012-11-01

    Type 1 diabetes mellitus is the most common chronic disease of childhood. Diabetic ketoacidosis is a well-known complication of diabetes mellitus and can be associated with devastating cerebral edema resulting in severe long-term neurologic disability. Despite the significant morbidity and mortality associated with this condition, relatively few treatments are recommended for these patients. The authors present two patients in which they used both intracranial pressure and brain tissue oxygenation monitoring to manage diabetic ketoacidosis-associated cerebral edema with favorable neurologic outcomes. Pediatric intensive care unit in a tertiary care teaching hospital. Two children presented to the emergency room with vague complaints and were found to have diabetic ketoacidosis. During treatment, both patients became comatose with head computed tomography scans revealing diffuse cerebral edema and herniation syndrome. Intracranial pressure and brain tissue oxygenation monitors were placed to guide therapy. Multiple episodes of brain tissue hypoxia were noted in both patients. Intracranial pressure control with intubation, sedation, and hyperosmolar therapy improved episodes of decreased brain tissue oxygenation associated with intracranial hypertension. Brain tissue oxygenation was also noted to be significantly less than the target value on several occasions even when intracranial pressure was controlled and an age-appropriate cerebral perfusion pressure goal was met. Augmentation of cerebral perfusion pressure above age-appropriate goal with fluid boluses and inotropic agents increased brain tissue oxygenation in these instances. Both children had very low Glasgow Coma Scale scores at admission, but ultimately had favorable neurologic outcomes. Multimodal neuromonitoring of both intracranial pressure and brain tissue oxygenation during episodes of clinically apparent diabetic ketoacidosis-associated cerebral edema allows for the detection and treatment of episodes

  8. Factors affecting cerebral oxygenation in hemodialysis patients: cerebral oxygenation associates with pH, hemodialysis duration, serum albumin concentration, and diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Kiyonori Ito

    Full Text Available Patients undergoing hemodialysis (HD often develop cerebral disease complications. Furthermore, cerebral regional saturation of oxygen (rSO2 was previously reported to be significantly lower in HD patients than in healthy subjects. We aimed to identify the factors affecting the cerebral rSO2 in HD patients.Fifty-four HD patients (38 men and 16 women; mean age, 67.7 ± 1.2 years, HD duration, 6.5 ± 1.9 years were recruited. Cerebral rSO2 was monitored at the forehead before HD using an INVOS 5100C (Covidien Japan, Tokyo, Japan.The rSO2 levels were significantly lower in HD patients compared with healthy controls (49.5 ± 1.7% vs. 68.9 ± 1.6%, p <0.001. Multiple regression analysis showed that cerebral rSO2 independently associated with pH (standardized coefficient: -0.35, HD duration (standardized coefficient: -0.33, and serum albumin concentration (standardized coefficient: 0.28. Furthermore, the rSO2 was significantly lower in HD patients with diabetes mellitus (DM, compared with patients without DM (46.8 ± 1.7% vs. 52.1 ± 1.8%, p <0.05.In HD patients, cerebral rSO2 was affected by multiple factors, including pH, HD duration, and serum albumin concentration. Furthermore, this is the first report describing significantly lower levels of rSO2 in HD patients with DM than in those without DM.

  9. Alterations in autonomic function and cerebral hemodynamics to orthostatic challenge following a mountain marathon.

    Science.gov (United States)

    Murrell, Carissa; Wilson, Luke; Cotter, James D; Lucas, Samuel; Ogoh, Shigehiko; George, Keith; Ainslie, Philip N

    2007-07-01

    We examined potential mechanisms (autonomic function, hypotension, and cerebral hypoperfusion) responsible for orthostatic intolerance following prolonged exercise. Autonomic function and cerebral hemodynamics were monitored in seven athletes pre-, post- (marathon [42.2 km; cumulative gain approximately 1,000 m; approximately 15 degrees C; completion time, 261 +/- 27 (SD) min]. In each condition, middle cerebral artery blood velocity (MCAv), blood pressure (BP), heart rate (HR), and cardiac output (Modelflow) were measured continuously before and during a 6-min stand. Measurements of HR and BP variability and time-domain analysis were used as an index of sympathovagal balance and baroreflex sensitivity (BRS). Cerebral autoregulation was assessed using transfer-function gain and phase shift in BP and MCAv. Hypotension was evident following the marathon during supine rest and on standing despite increased sympathetic and reduced parasympathetic control, and elevations in HR and cardiac output. On standing, following the marathon, there was less elevation in normalized low-frequency HR variability (P marathon. These findings indicate that following prolonged exercise, hypotension and postural reductions in autonomic function or baroreflex control, or both, rather than a compromise in cerebral autoregulation, may place the brain at risk of hypoperfusion. Such changes may be critical factors in collapse following prolonged exercise.

  10. Combined Cerebral and Renal Near-Infrared Spectroscopy After Congenital Heart Surgery.

    Science.gov (United States)

    Gil-Anton, Javier; Redondo, Silvia; Garcia Urabayen, Diego; Nieto Faza, Manuel; Sanz, Irene; Pilar, Javier

    2015-08-01

    The maintenance of an adequate oxygen supply to tissues after congenital heart surgery is essential for good outcomes. The objective of this study was to assess the usefulness of near-infrared spectroscopy (NIRS) for estimating central venous oxygen saturation (ScvO2) using both cerebral and renal measurements, explore its relation with cardiac output measurements and check its ability to detect low cardiac output. A prospective observational pilot study was conducted in patients weighing <10 kg undergoing cardiopulmonary bypass surgery. Spectroscopy probes were placed on the forehead and renal area, and serial cardiac output measurements were obtained by femoral transpulmonary thermodilution over the first 24 h after surgery. In the 15 patients studied, ScvO2 was correlated with cerebral (r = 0.58), renal (r = 0.60) and combined (r = 0.71) measurements. Likewise, the systolic index was correlated with the NIRS signals: cerebral (r = 0.60), renal (r = 0.50) and combined (r = 0.66). Statistically significant differences were found in the NIRS measures registered in the 29 low cardiac output events detected by thermodilution: cerebral: 62 % (59-65) versus 69 % (63-76); renal: 83 % (70-89) versus 89 % (83-95); and combined 64 % (60-69) versus 72 % (67-76). In our series, combined cerebral and renal monitoring was correlated with central venous oxygen saturation and cardiac output; low cardiac output detection associated a different spectroscopy pattern.

  11. ASPECTS (Alberta Stroke Program Early CT Score) Assessment of the Perfusion-Diffusion Mismatch.

    Science.gov (United States)

    Lassalle, Louis; Turc, Guillaume; Tisserand, Marie; Charron, Sylvain; Roca, Pauline; Lion, Stephanie; Legrand, Laurence; Edjlali, Myriam; Naggara, Olivier; Meder, Jean-François; Mas, Jean-Louis; Baron, Jean-Claude; Oppenheim, Catherine

    2016-10-01

    Rapid and reliable assessment of the perfusion-weighted imaging (PWI)/diffusion-weighted imaging (DWI) mismatch is required to promote its wider application in both acute stroke clinical routine and trials. We tested whether an evaluation based on the Alberta Stroke Program Early CT Score (ASPECTS) reliably identifies the PWI/DWI mismatch. A total of 232 consecutive patients with acute middle cerebral artery stroke who underwent pretreatment magnetic resonance imaging (PWI and DWI) were retrospectively evaluated. PWI-ASPECTS and DWI-ASPECTS were determined blind from manually segmented PWI and DWI volumes. Mismatch-ASPECTS was defined as the difference between PWI-ASPECTS and DWI-ASPECTS (a high score indicates a large mismatch). We determined the mismatch-ASPECTS cutoff that best identified the volumetric mismatch, defined as VolumeTmax>6s/VolumeDWI≥1.8, a volume difference≥15 mL, and a VolumeDWImismatch-ASPECTS ≥2 best identified a volumetric mismatch, with a sensitivity of 0.93 (95% confidence interval, 0.89-0.98) and a specificity of 0.82 (95% confidence interval, 0.74-0.89). The mismatch-ASPECTS method can detect a true mismatch in patients with acute middle cerebral artery stroke. It could be used for rapid screening of patients with eligible mismatch, in centers not equipped with ultrafast postprocessing software. © 2016 American Heart Association, Inc.

  12. INTRACRANIAL PRESSURE MONITORING

    Directory of Open Access Journals (Sweden)

    Retno Widiyanthi

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Intracranial pressure is total of pressure that is produced by brain, blood, and cerebrospinal fluid/CSF in the tight cranial space. As a respon to intracranial pressure increasing, compensation begin by movement of CSF from ventricle to cerebral subarachnoidal space, and increase the absorption of CSF. Increasing of ICP usually caused by increasing of brain volume (cerebral oedem, blood (intracranial bleeding, space occupying lesion, or CSF (hidrocephalus. Indication in ICP monitoring can be seen from : neurological criteria, abnormal CT-scan result when admission, normal CT-scan result, but had more two risk factors. According to the procedure that must be done, there are two methods in ICP monitoring: invasive ICP monitoring methodes and non-invasive measuring method. Increasing of ICP will decrease the compliance of brain, pulsation of artery more clearly, and the component of vein is lost. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  13. Actinomicose cerebral: observação anatomo-clinica e revisão da literatura brasileira Cerebral actinomycosis: case report and review of the Brazilian literature

    Directory of Open Access Journals (Sweden)

    Luciano de Souza Queiroz

    1975-12-01

    Full Text Available Os autores relatam a observação anátomo-clínica de um paciente de 33 anos, com síndrome de hipertensão intracraniana e hemiparesia à direita. O líquido cefalorraqueano revelava discreta hipercitose linfomonocitária. A autópsia mostrou três abscessos cerebrais, com edema difuso mais intenso no hemisfério cerebral esquerdo, sem leptomeningite purulenta. O exame histopatológico demonstrou grãos actinomicóticos nos abscessos cerebrais e pulmonares. A literatura brasileira sobre neuroactinomicose é analisada, com encontro de seis casos, publicados entre 1934 e 1946. São discutidos aspectos clínicos e anátomo-patológicos relevantes dos casos nacionais.A case of central nervous system actinomycosis is reported. A 33-year-old male complained of headache, vomiting and blurred vision lasting for eight days prior to admission. On examination, a right hemiparesis, as well an intracranial hypertension were detected. The cerebrospinal fluid showed mild lymphomononuclear hypercytosis. Necropsy disclosed three abscess in the cerebral hemispheres, in addition to moderate cerebral edema on the left side but without purulent leptomeningitis. Actinomyces filaments and granules were demonstrated in the cerebral and lung abscesses. The Brazilian literature on actinomycosis is reviewed and six published cases with nervous system involvement were found. Relevant clinical and anatomical aspects of the cases and of the present one are discussed.

  14. Effect of corilagin on cerebral ischaemia/reperfusioninduced ...

    African Journals Online (AJOL)

    Purpose: To evaluate the neuroprotective effects of corilagin in cerebral ischaemia-induced cerebral injury in a rat model. Methods: Cerebral ischaemia was induced by middle cerebral artery occlusion (MCAO). The animals were separated into five groups, including a control group that underwent surgery without inserting a ...

  15. Organisational aspects of care.

    Science.gov (United States)

    Bloomfield, Jacqueline; Pegram, Anne

    2015-03-04

    Organisational aspects of care, the second essential skills cluster, identifies the need for registered nurses to systematically assess, plan and provide holistic patient care in accordance with individual needs. Safeguarding, supporting and protecting adults and children in vulnerable situations; leading, co-ordinating and managing care; functioning as an effective and confident member of the multidisciplinary team; and managing risk while maintaining a safe environment for patients and colleagues, are vital aspects of this cluster. This article discusses the roles and responsibilities of the newly registered graduate nurse. Throughout their education, nursing students work towards attaining this knowledge and these skills in preparation for their future roles as nurses.

  16. Advances in Monitoring the Economy

    NARCIS (Netherlands)

    R. Segers (René)

    2009-01-01

    textabstractMonitoring involves the collection, analysis and evaluation of information over time. For many professionals, monitoring is a central aspect of their work. For example, policy- makers closely watch the e®ects of their current policies to set the right course for reform. Likewise,

  17. Cerebral Hypoperfusion Precedes Nausea During Centrifugation

    Science.gov (United States)

    Serrador, Jorge M.; Schlegel, Todd T.; Black, F. Owen; Wood, Scott J.

    2004-01-01

    Nausea and motion sickness are important operational concerns for aviators and astronauts. Understanding underlying mechanisms associated with motion sickness may lead to new treatments. The goal of this work was to determine if cerebral blood flow changes precede the development of nausea in motion sick susceptible subjects. Cerebral flow velocity in the middle cerebral artery (transcranial Doppler), blood pressure (Finapres) and end-tidal CO2 were measured while subjects were rotated on a centrifuge (250 degrees/sec). Following 5 min of rotation, subjects were translated 0.504 m off-center, creating a +lGx centripetal acceleration in the nasal-occipital plane. Ten subjects completed the protocol without symptoms while 5 developed nausea (4 while 6ff-center and 1 while rotating on-center). Prior to nausea, subjects had significant increases in blood pressure (+13plus or minus 3 mmHg, P less than 0.05) and cerebrovascular resistance (+46 plus or minus 17%, P less than 0.05) and decreases in cerebral flow velocity both in the second (-13 plus or minus 4%) and last minute (-22 plus or minus 5%) before symptoms (P less than 0.05). In comparison, controls demonstrated no change in blood pressure or cerebrovascular resistance in the last minute of off-center rotation and only a 7 plus or minus 2% decrease in cerebral flow velocity. All subjects had significant hypocapnia (-3.8 plus or minus 0.4 mmHg, P less than 0.05), however this hypocapnia could not fully explain the cerebral hypoperfusion associated with the development of nausea. These data indicate that reductions in cerebral blood flow precede the development of nausea. Further work is necessary to determine what role cerebral hypoperfusion plays in motion sickness and whether cerebral hypoperfusion can be used to predict the development of nausea in susceptible individuals.

  18. The future of cerebral surgery: a kaleidoscope of opportunities.

    Science.gov (United States)

    Elder, James B; Hoh, Daniel J; Oh, Bryan C; Heller, A Chris; Liu, Charles Y; Apuzzo, Michael L J

    2008-06-01

    The emerging future of cerebral surgery will witness the refined evolution of current techniques, as well as the introduction of numerous novel concepts. Clinical practice and basic science research will benefit greatly from their application. The sum of these efforts will result in continued minimalism and improved accuracy and efficiency of neurosurgical diagnostic and therapeutic methodologies.Initially, the refinement of current technologies will further enhance various aspects of cerebral surgery. Advances in computing power and information technology will speed data acquisition, storage, and transfer. Miniaturization of current devices will impact diverse areas, such as modulation of endoscopy and endovascular techniques. The increased penetrance of surgical technologies such as stereotactic radiosurgery, neuronavigation, intraoperative imaging, and implantable electrodes for neurodegenerative disorders and epilepsy will enhance the knowledge and experience in these areas and facilitate refinements and advances in these technologies. Further into the future, technologies that are currently relatively remote to surgical events will fundamentally alter the complexity and scale at which a neurological disease may be treated or investigated. Seemingly futuristic concepts will become ubiquitous in the daily experience of the neurosurgeon. These include diverse fields such as nanotechnology, virtual reality, and robotics. Ultimately, combining advances in multiple fields will yield progress in diverse realms such as brain tumor therapy, neuromodulation for psychiatric diseases, and neuroprosthetics. Operating room equipment and design will benefit from each of the aforementioned advances. In this work, we discuss new developments in three parts. In Part I, concepts in minimalism important for future cerebral surgery are discussed. These include concrete and abstract ideas in miniaturization, as well as recent and future work in microelectromechanical systems and

  19. The changes and significance of serum inflammatory factors and hemodynamics in patients with acute cerebral infarction

    Directory of Open Access Journals (Sweden)

    Xiao-Wei Lu

    2016-01-01

    Full Text Available Objective: To investigate the changes of serum inflammatory factors and hemodynamics in patients with acute cerebral infarction and its clinical significance. Methods: A total of 55 cases of acute cerebral infarction (ACI patients as observation group, and cases of healthy physical examination were selected as the observation group, and 55 healthy persons as control group. ELISA method was used to detect inflammatory cytokines interleukin-6 (IL-6, interleukin-8 (IL-8, C-reactive protein (CRP and tumor necrosis factor (TNF-α level, WA- 880 heart and brain integrated digital hemodynamic monitor to detect bilateral carotid artery blood flow velocity, blood flow and peripheral resistance. Results: The serum levels of IL-8, CRP, IL-6 and TNF-α were higher in the observation group than in the control group, the difference was statistically significant (P<0.05. The blood flow velocity and blood flow velocity in the observation group were significantly lower than those in the control group. The difference was statistically significant (IL-8. With the increase of infarct size, serum IL-6, CRP, P<0.05 and TNF-α increased significantly (P<0.05. Conclusions: The changes of serum inflammatory factors and hemodynamic indexes can be used to judge the early cerebral infarction and the size of the infarct size of the index, the clinical dynamic monitoring of its changes in patients with acute cerebral infarction and the severity of the prognosis and the prognosis of the important significance of the judgment.

  20. Serum cystatin C and cerebral microbleeds in patients with acute cerebral stroke.

    Science.gov (United States)

    Zhang, Jin-Biao; Jü, Xiao-Hua; Wang, Jing; Sun, Hai-Rong; Li, Fang

    2014-02-01

    Recent studies have shown that kidney dysfunction is associated with cerebral microbleeds (CMB). Cystatin C is a more useful measurement than creatinine-based estimating equations for evaluating kidney function. The purpose of this study was to clarify the relationship between cystatin C levels and CMB in patients with acute cerebral stroke. This cross-sectional study included a total of 485 patients with acute ischemic stroke and 129 patients with cerebral hemorrhage. The serum levels of cystatin C were significantly higher in acute cerebral stroke patients with CMB than in those without (pstroke. The odds ratio (95% confidence interval) in patients with acute cerebral infarction and cerebral hemorrhage were 2.92 (1.81-6.93) and 2.98 (1.76-6.97), respectively. The present study suggests that elevated levels of cystatin C are associated with the presence of CMB in acute stroke patients, independent of conventional risk factors. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Orthopedic management of spasticity in cerebral palsy.

    Science.gov (United States)

    Novacheck, Tom F; Gage, James R

    2007-09-01

    This article summarizes our experience with cerebral palsy. The primary and secondary deformities that occur with cerebral palsy are described, followed by a brief overview of the nature and role of gait analysis in the treatment of gait problems in cerebral palsy. The concept of lever-arm dysfunction is introduced. Our current treatment program is then presented and subsequently illustrated by two case examples. Finally, an outcomes analysis of a group of patients with spastic diplegia treated with selective dorsal rhizotomy is presented to illustrate our current method of evaluating treatment outcomes and the need for team management in the treatment of this complex condition.

  2. Validation of a Cerebral Palsy Register

    DEFF Research Database (Denmark)

    Topp, Monica; Langhoff-Roos, Jens; Uldall, P.

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  3. The serpentine mitral valve and cerebral embolism

    Directory of Open Access Journals (Sweden)

    Ker James

    2011-02-01

    Full Text Available Abstract Valvular strands, well-delineated filiform masses, attached to cardiac valve edges are associated with cerebral embolism and stroke. Strokes, caused by emboli from valvular strands, tend to occur among younger persons. In this case report a valvular strand, giving a peculiar serpentine appearance to the mitral valve is described. This mitral valvular strand was the only explanation for an episode of cerebral embolism, presenting with a transient right sided hemiparesis. It is proposed that a randomized study involving combined treatment with aspirin and clopidogrel is warranted in young patients with valvular strands, presenting with a first episode of cerebral embolism.

  4. Lifetime costs of cerebral palsy

    DEFF Research Database (Denmark)

    Kruse, Marie; Michelsen, Susan Ishøy; Flachs, Esben Meulengracht

    2009-01-01

    This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs...... in 2000. The prevalence of CP in eastern Denmark was approximately 1.7 per 1000. Information on productivity and the use of health care was retrieved from registers. The lifetime cost of CP was about euro860 000 for men and about euro800 000 for women. The largest component was social care costs......, particularly during childhood. A sensitivity analysis found that alterations in social care costs had a small effect, whereas lowering the discount rate from 5 to 3 per cent markedly increased total lifetime costs. Discounting decreases the value of costs in the future compared with the present. The high...

  5. [Cerebral artery thrombosis in pregnancy].

    Science.gov (United States)

    Charco Roca, L M; Ortiz Sanchez, V E; Hernandez Gutierrez-Manchon, O; Quesada Villar, J; Bonmatí García, L; Rubio Postigo, G

    2015-11-01

    A 28 year old woman, ASA I, who, in the final stages of her pregnancy presented with signs of neural deficit that consisted of distortion of the oral commissure, dysphagia, dysarthria, and weakness on the left side of the body. She was diagnosed with thrombosis in a segment of the right middle cerebral artery which led to an ischemic area in the right frontal lobe. Termination of pregnancy and conservative treatment was decided, with good resolution of the symptoms. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Standardisation of cerebral MR imaging

    International Nuclear Information System (INIS)

    Assheuer, J.; Lanta, L.; Longerich, U.J.J.; Sievert, T.; Mai, J.K.

    1990-01-01

    The complex three-dimensional organisation of the human brain, as well as the numerous variables involved in modern imaging techniques, make it necessary to introduce guidelines for the interpretation of the topographical localisation and allocation of normal cerebral structures and pathological processes. In a historical overview of the methods used for precise localisation we introduce some models that can be used as diagnostic aids. As supporting means in the MRI we suggest the standardisation of the imaging by application of this model. The methodological procedures of its use in the MRI are shown in detail. Finally the advantages and disadvantages of this model are discussed with regard to its possible applications in imaging systems such as MR. The image standardisations for intra-, interindividual and intermethodical comparison in routine investigations are emphasised in particular. (orig.) [de

  7. A case of cerebral cryptococcosis

    International Nuclear Information System (INIS)

    Yamagami, Tatsuhito; Nomura, Takayoshi; Imagawa, Kenji; Asai, Akira; Kawasaki, Michiro

    1984-01-01

    A 66-year-old female was admitted to our hospital with chief complaint of vertigo, gait disturbance and dysarthria. These symptoms started about one year before admission and worsened. Vomiting and urinary incontinence appeared. Neurological examination revealed left cerebellar ataxia and dysarthria. In plain CT (computerized tomography) irregular ill-defined low density area was noted in the cerebellar vermis and bilateral cerebellar hemispheres. And slight ventricular dilatation was found. Irregular shape of ring-like enhancement corresponding to capsule and patchy or mottled enhancement inside the tumor were seen. Suboccipital craniectomy was performed and yellowish necrotic tumor with hard capsule was removed. Histological diagnosis was not neoplasm or tuberculoma. Postoperatively liver function progressively worsened. She died due to disseminated intravascular coagulation. Autopsy revealed typical liver cirrhosis without malignant change. 3.0 x 2.5 cm sized, slightly hard, yellowish lesion was found on upper part of cerebellar hemispheres. This had extremely necrotic tissue and a great number of cryptococcus neoformans were found. And other intracranial lesion was not confirmed. Finding of pulmonary cryptococcosis was not gained. Our case is very rare because of solitary cerebellar abscess and absence of meningitic episode or pulmonary cryptococcosis. There are three types of inflammation in cerebral cryptococcosis. The commonest manifestation is the meningitic type, the second mode is granulomatous lesion and the third and the least presentation is intracranial abscess formatior. CT reveals various finidngs according to clinical stage. CT findings are those of meningitis, meningoencephalitis, granuloma and abscess. Cryptococcal granuloma or abscess often simulates brain abscess, glioma and metastatic brain tumor. We discussed CT findings of cerebral cryptococcosis and examined the CT number of our case. (J.P.N.)

  8. Cerebral palsy in preterm infants

    Directory of Open Access Journals (Sweden)

    Demeši-Drljan Čila

    2016-01-01

    Full Text Available Background/Aim. Cerebral palsy (CP is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS. Results. More than half of the children with CP were born prematurely (54.4%. Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001. In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049, children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0% affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032. Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike

  9. Role of Aquaporin-4 in Cerebral Edema and Stroke

    OpenAIRE

    Zador, Zsolt; Stiver, Shirley; Wang, Vincent; Manley, Geoffrey T.

    2009-01-01

    Cerebral edema plays a central role in the pathophysiology of many diseases of the central nervous system (CNS) including ischemia, trauma, tumors, inflammation, and metabolic disturbances. The formation of cerebral edema results in an increase in tissue water content and brain swelling which, if unchecked, can lead to elevated intracranial pressure (ICP), reduced cerebral blood flow, and ultimately cerebral herniation and death. Despite the clinical significance of cerebral edema, the mechan...

  10. Toxicological aspects of water

    International Nuclear Information System (INIS)

    Garcia Puertas, P.

    1991-01-01

    Different toxicological aspects of water have been studied, remarking the activity of various chemical substances in the organism. These substances are divided in: trace metals (Sb, As, Cd, Zn, Cu, Cr, Fe, Mn, Hg, Ni, Pb, Se), other contaminants (CN-, polycyclic aromatic hydrocarbons, phenols, pesticides, detergents) and radioactivity. Finally, some considerations on this subject are made [es

  11. The Ultradense Middle Cerebral Artery: A specific sign of Cerebral Lipiodol Embolization.

    Science.gov (United States)

    Cox, Mougnyan; Hurst, Robert; Vossough, Arastoo

    2018-02-03

    Cerebral lipiodol embolization is a rare but known complication of lymphatic embolization for plastic bronchitis. The classic imaging finding on a noncontrast head CT is multiple small areas of hyperdensity within the cerebral hemispheres, which represent lipiodol deposition in the brain. We report a case of lipiodol deposition in the middle cerebral artery following lymphatic embolization, producing an 'ultradense' vessel sign on noncontrast CT. Copyright © 2018. Published by Elsevier Inc.

  12. Configuration of Risk Monitor System by PLant Defense-In.Depth Monitor and Relability Monitor

    DEFF Research Database (Denmark)

    Yoshikawa, Hidekazu; Lind, Morten; Yang, Ming

    2012-01-01

    monitor derived from the four aspects of (i) design principle of nuclear safety to realize DiD concept, (ii) definition of risk and risk to be monitored, (iii) severe accident phenomena as major risk, (iv) scheme of risk ranking, and (v) dynamic risk display. In this paper, the overall frame...

  13. Clinical significance of determination of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction

    International Nuclear Information System (INIS)

    Huang Fujuan; Shen Airong; Yang Yongqing

    2010-01-01

    Objective: To study the clinical significance of changes of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction. Methods: Plasma NPY levels (with RIA) and serum lipid profile (with biochemistry) were determined in (1) 48 patients with acute cerebral hemorrhage (2) 46 patients with acute cerebral infarction and (3) controls.Results Plasma NPY levels in both patients with cerebral hemorrhage and patients with cerebral infarction were significantly higher than those in controls (P 0.05). Conclusion: NPY played important roles in the development and pathogenesis of cerebral vascular accidents. Lipid profile changes was the basic etiological factor. (authors)

  14. CT classification and clinical prognosis of cerebral infarction in the area of middle cerebral artery

    International Nuclear Information System (INIS)

    Konno, Jyoji

    1983-01-01

    Computerized tomographies (CT) were repeatedly scanned on 70 patients with cerebral infarction in the middle cerebral artery. Low density area (LDA) was measured with HounFsfield's Unit (HU) and studied on the progressive changes. Classification of LDA was attempted and studied on correlation with mass effect, contrast enhancement, angiographical findings, clinical symptoms and prognosis. It was considered that important points of diagnosis of cerebral infarction were timing of examination of CT and determination of LDA with HUF. It was also thought that CT classification of LDA was usefull to estimate prognosis of the patients with cerebral infarction. (author)

  15. Comparison of Cerebral Oxygen Saturation and Cerebral Perfusion Computed Tomography in Cerebral Blood Flow in Patients with Brain Injury.

    Science.gov (United States)

    Trofimov, Alexey O; Kalentiev, George; Voennov, Oleg; Grigoryeva, Vera

    2016-01-01

    The purpose of this study was to determine the relationship between cerebral tissue oxygen saturation and cerebral blood volume in patients with traumatic brain injury. Perfusion computed tomography of the brain was performed in 25 patients with traumatic brain injury together with simultaneous SctO2 level measurement using cerebral near-infrared oxymetry. The mean age of the injured persons was 34.5±15.6 years (range 15-65); 14 men, 11 women. The Injury Severity Score (ISS) values were 44.4±9.7 (range 25-81). The Glasgow Coma Score (GCS) mean value before the study was 10.6±2.1 (range 5-13). SctO2 ranged from 51 to 89%, mean 62±8.2%. Cerebral blood volume (CBV) values were 2.1±0.67 ml/100 g (min 1.1; max 4.3 ml/100 g). Cerebral blood flow (CBF) was 31.99±13.6 ml/100 g×min. Mean transit time (MTT) values were 5.7±4.5 s (min 2.8; max 34.3 s). The time to peak (TTP) was 22.2±3.1 s. A statistically significant correlation was found between SctO2 level and cerebral blood volume (CBV) level (R=0.9; pbrain tissue oxygenation and other parameters of brain perfusion.

  16. [Current aspects of handedness].

    Science.gov (United States)

    Reiss, M; Reiss, G

    1999-12-23

    Handedness is one example of many forms of behavioural lateralization seen in humans. Left-handedness has existed in a small subset of the human population, approximately 8%, since the origin of man. The incidence of left-handedness is usually reported to be consistent among human populations. Sinistrality is more common in males than in females. A vast range of testing techniques have been used to assess handedness. There are preference and performance tests. Writing hand and self-report are two of the most popular techniques. There is a strong evidence that the dominance of language functions in the cerebral cortex is different in left-handed from that in right-handed people. An understanding of handedness may provide valuables clues as to how the brain becomes organized the way it is. Several theories have been advanced over the years to explain the genesis of handedness and, in particular, left-handedness. Theories have ranged from genetic models to socio-cultural theories. Other authors suggested a pathological origin of left-handedness in man. Left-handedness runs in families and adoption studies suggests a genetic rather than an environmental origin. However, monozygotic twins appear to be substantially discordant. A polygenetic explanation which takes environmental influences into consideration is probably called for.

  17. Thrombotic distal middle cerebral artery occlusion produced by topical FeCl3 application: a novel model suitable for intravital microscopy and thrombolysis studies

    OpenAIRE

    Karatas, Hulya; Erdener, Sefik Evren; Gursoy-Ozdemir, Yasemin; Gurer, Gunfer; Soylemezoglu, Figen; Dunn, Andrew K; Dalkara, Turgay

    2011-01-01

    Intravital or multiphoton microscopy and laser-speckle imaging have become popular because they allow live monitoring of several processes during cerebral ischemia. Available rodent models have limitations for these experiments; e.g., filament occlusion of the proximal middle cerebral artery (MCA) is difficult to perform under a microscope, whereas distal occlusion methods may damage the MCA and the peri-arterial cortex. We found that placement of a 10% FeCl3-soaked filter paper strip (0.3 × ...

  18. Effect of generalised sympathetic activation by cold pressor test on cerebral haemodynamics in healthy humans.

    Science.gov (United States)

    Roatta, S; Micieli, G; Bosone, D; Losano, G; Bini, R; Cavallini, A; Passatore, M

    1998-07-15

    There is no general agreement regarding several aspects of the role of the sympathetic system on cerebral haemodynamics such as extent of effectiveness, operational range and site of action. This study was planned to identify the effect of a generalised sympathetic activation on the cerebral haemodynamics in healthy humans before it is masked by secondary corrections, metabolic or myogenic in nature. A total of 35 healthy volunteers aged 20-35 underwent a 5 min lasting cold pressor test (CPT) performed on their left hand. The cerebral blood flow (CBF) velocity in the middle cerebral arteries and arterial blood pressure were recorded with transcranial Doppler sonography and with a non-invasive finger-cuff method, respectively. The ratio of arterial blood pressure to mean blood velocity (ABP/Vm) and Pulsatility Index (PI) were calculated throughout each trial. CPT induced an increase in mean ABP (range 2-54 mmHg depending on the subject) and only a slight, though significant, increase in blood velocity in the middle cerebral artery (+2.4 and +4.4% on ipsi- and contralateral side, respectively). During CPT, the ratio ABP/Vm increased and PI decreased in all subjects on both sides. These changes began simultaneously with the increase in blood pressure. The increase in ABP/Vm ratio is attributed to an increase in the cerebrovascular resistance, while the concomitant reduction in PI is interpreted as due to the reduction in the compliance of the middle cerebral artery. The results suggest that generalised increases in the sympathetic discharge, causing increases in ABP, can prevent concomitant increases in CBF by acting on both small resistance and large compliant vessels. This effect is also present when a slight increase in blood pressure occurs, which suggests a moderate increase in the sympathetic discharge, i.e. when ABP remains far below the upper limit of CBF autoregulation.

  19. Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy.

    Science.gov (United States)

    Kane, Kyra J; Lanovaz, Joel; Bisaro, Derek; Oates, Alison; Musselman, Kristin E

    2016-01-01

    Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function-the Obstacles and Curb tests-relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy. A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test-retest reliability. At fast speeds, all tests showed discriminative validity (pspina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81-0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73-0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test-retest reliability for tests performed at fast speeds rather than self-selected speeds. The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test-retest reliability for children with spina bifida/cerebral palsy.

  20. Luminosity monitor

    International Nuclear Information System (INIS)

    Underwood, D. G.

    1998-01-01

    Luminosity monitors are needed in each experiment doing spin physics at RHIC. They concentrate on the luminosity aspects here because, for example, with a 10 -3 raw asymmetry in an experiment, an error of 10 -4 in the luminosity is as significant as a 10% polarization error. Because luminosity is a property of how two beams overlap, the luminosity at an interaction region must be measured at that interaction region in order to be relevant to the experiment at that interaction region. The authors will have to do the physics and the luminosity measurements by using labels on the event sums according to the polarization labels on the colliding bunches. Most likely they will not have independent polarization measurement on each bunch, but only on all the filled bunches in a ring, or perhaps all the bunches that are actually used in an experiment. Most analyses can then be handled by using the nine combinations gotten from three kinds of bunches in each ring, +, - and empty bunches. The empty bunches are needed to measure beam-gas background, (and some, like six in a row, are needed for the beam abort). Much of the difficulty comes from the fact that they must use a physics process to represent the luminosity. This process must have kinematic and geometric cuts both to reduce systematics such as beam-gas backgrounds, and to make it representative of the part of the interaction diamond from which the physics events come

  1. Anthropometry of children with cerebral palsy at the Lagos University Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Titilayo Olubunmi Adekoje

    2016-01-01

    Full Text Available Background: Cerebral palsy (CP is one the most common causes of disability among children in developing countries and is often associated with poor growth. The assessment of growth and nutrition of children is an important aspect of health monitoring and is one of the determinants of child survival. Aim: To assess the nutritional status of children with CP as seen in Lagos University Teaching Hospital (LUTH. Subjects and Methods: A prospective case-control study was conducted on children with CP attending the weekly pediatric neurology clinic of the LUTH between April 2005 and March 2006. Controls were apparently healthy children being followed up at the children′s out-patient clinic of LUTH for acute illness that had resolved. Anthropometric measurements of weight, length/height, mid-upper arm circumference, and skinfold thickness were taken according to the protocols recommended by the International Society of the Advancement of Kinanthropometry. Statistical Analysis: EPI-INFO (version 6.04 was used for analysis. Chi-square test was used to determine associations. Student′s t-test was used to compare means of patients and matched controls. Probability P < 0.05 were taken as statistically significant. Results: The controls had higher weight than the patients with mean weight (standard deviation of 13.7 (4.8 kg, and 12.0 (4.5 kg, respectively (P = 0.01. There were also statistically significant differences in the subscapular and biceps skinfold measurements between the patient and control groups (P = 0.00004 and 0.000008, respectively. Twenty-four (25.8% and 5 (5.4% of the patients had moderate and severe undernutrition compared to 6 (6.1% and none, respectively, in the control group (P = 0.00005. Conclusion: Children with CP had significantly lower mean anthropometric parameters and were more malnourished compared with the control group of children matched for age, sex, and social class.

  2. Experience of endovascular treatment of occlusion-stenotic lesions of cerebral arteries

    Directory of Open Access Journals (Sweden)

    Cherednichenko Yu.V.

    2016-03-01

    Full Text Available Objective — to evaluate the efficacy of endovascular techniques in the treatment of occlusion and stenotic lesions of the brachiocephalic and cerebral arteries, to define the ways of complications prevention. Materials and methods. 594 patients with occlusion and stenotic lesions of the brachiocephalic and cerebral arteries were operated by endovascular methods in endovascular center of Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov. 688 endovascular operations were carried out. Most part of the operations are carotid stenting (423 operations. All of these operations were carried out with the usage of different types of antiembolic protection systems: distal, proximal or their combination. Intracranial segments of cerebral arteries were operated in 43 cases. 169 operations of stenting of vertebral arteries in extracranial segments were performed. Subclavian arteries and brachiocephal truncus were operated in 53 cases. Results. Total removal of stenosis was achieved in 588 cases (98.99%. 509 patients (85.69% of cases had improvement in neurological status (on a scale NIHHS, Mrs., MoCA. 77 (12.96% patients had no deterioration of neurological status. Postoperative mortality was 1.01%. Common level of other complications was 4.3 %: cerebral complications - 2.7%. Discussion. The results of the endovascular treatment of occlusion and stenotic lesions of the cerebral arteries show high efficacy and low complication level. The ways of reduction complications level are identified. They are in a differentiated selection of antiembolic protection method, endovascular treatment planning, based on monitoring of changes in the brain hemoperfusion, the emphasis is on the use of the special neurologic deviсes. Conclusions. Endovascular treatment of occlusion and stenotic lesions of the cerebral arteries is effective with a small risk of complications. Risk can be reduced further by the differential choice of antiembolic protection

  3. Middle cerebral artery blood velocity during running

    DEFF Research Database (Denmark)

    Lyngeraa, Tobias; Pedersen, Lars Møller; Mantoni, T

    2013-01-01

    Running induces characteristic fluctuations in blood pressure (BP) of unknown consequence for organ blood flow. We hypothesized that running-induced BP oscillations are transferred to the cerebral vasculature. In 15 healthy volunteers, transcranial Doppler-determined middle cerebral artery (MCA......) blood flow velocity, photoplethysmographic finger BP, and step frequency were measured continuously during three consecutive 5-min intervals of treadmill running at increasing running intensities. Data were analysed in the time and frequency domains. BP data for seven subjects and MCA velocity data....... During running, rhythmic oscillations in arterial BP induced by interference between HR and step frequency impact on cerebral blood velocity. For the exercise as a whole, average MCA velocity becomes elevated. These results suggest that running not only induces an increase in regional cerebral blood flow...

  4. Cerebral ganglioglioma and neurofibromatosis type I

    International Nuclear Information System (INIS)

    Parizel, P.M.; Hauwe, L. van den; Schepper, A.M. de; Martin, J.J.; Vyve, M. van

    1991-01-01

    We report the occurrence of a left frontal lobe ganglioglioma in a patient with neurofibromatosis type I (von Recklinghausen's disease) and conclude that the occurrence of a cerebral ganglioglioma in a patient with neurofibromatosis must probably be considered coincidental. (orig.)

  5. Somatosensory discrimination deficits following pediatric cerebral malaria.

    Science.gov (United States)

    Dugbartey, A T; Spellacy, F J; Dugbartey, M T

    1998-09-01

    Pathologic studies of central nervous system damage in human falciparum malaria indicate primary localization in the cerebral white matter. We report a sensory-perceptual investigation of 20 Ghanaian children with a recent history of cerebral malaria who were age-, gender-, and education-matched with 20 healthy control subjects. Somatosensory examinations failed to show any evidence of hemianesthesia, pseudohemianesthesia, or extinction to double simultaneous tactile stimulation. While unilateral upper limb testing revealed intact unimanual tactile roughness discrimination, bimanual tactile discrimination, however, was significantly impaired in the cerebral malaria group. A strong negative correlation (r = -0.72) between coma duration and the bimanual tactile roughness discrimination test was also found. An inefficiency in the integrity of callosal fibers appear to account for our findings, although alternative subcortical mechanisms known to be involved in information transfer across the cerebral hemispheres may be compromised as well.

  6. Cerebral cysticercosis in a cat : clinical communication

    Directory of Open Access Journals (Sweden)

    E.V. Schwan

    2002-07-01

    Full Text Available The metacestode of Taenia solium, Cysticercus cellulosae, was recovered from the brain of a cat showing central nervous clinical signs ante mortem. This is the first record of cerebral cysticercosis in a cat in South Africa.

  7. Gluconeogenesis and fasting in cerebral malaria

    NARCIS (Netherlands)

    van Thien, H.; Ackermans, M. T.; Weverling, G. J.; Dang Vinh, T.; Endert, E.; Kager, P. A.; Sauerwein, H. P.

    2004-01-01

    BACKGROUND: In healthy subjects after an overnight fast, glucose production is for approximately 50% derived from glycogenolysis. If the fast is prolonged, glucose production decreases due to a decline in glycogenolysis, while gluconeogenesis remains stable. In cerebral malaria, glucose production

  8. The Frequency of Cerebral Microembolism in Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Masoud Mehrpour

    2010-11-01

    Full Text Available ABSTRACT Introduction: Stroke is more common in patients with cerebral microembolisms. Frequency of cerebral microembolisms (high intensity transient signals, HITS in acute myocardial infarction has been reported about 17%. The factors that influence on microembolism after myocardial infarction (MI are not definitive. Type of MI, Ejection fraction, Hx of Streptokinase is the factors that were studied. Methods: During three years we studied the frequency of cerebral microembolisms in AMI patients, we studied forty patients with microembolism as a case group and ninety patients without microembolism as a control group. We detected microembolism in patients by transcranial doppler study within 72 houre after myocardial infarction. Two-dimensional echocardiogram was performed for all patients during hospitalization. Excluding criteria were prosthetic heart valves, carotid stenosis >50% and poor window for TCD monitoring. Results: number of patients who had history of receiving SK were significantly more common in case group in comparison to control group. OR 2.4 CI(1.1-5.2 The frequency was more prevalent in anterolateral MI in comparison to inferior MI.OR=3.3 CI(1.4-7.4. Ejection fraction has no significant effect on frequency of microembolism. OR 0.5 CI(0.2-1.3.Hypokinesia is also a risk factor for increasing risk of microembolism. OR 4.5 CI(1.4.13.8 Discussion: frequency of microembolism has been increased in patients with history of streptokinase or in the type of Anterolateral MI or wall motion abnormality, so we should be careful for risk of microembolism in this groups.

  9. Applications of cerebral MRI in neonatology

    International Nuclear Information System (INIS)

    Prayer, D.

    2000-01-01

    Magnetic resonance tomography (MRT) has become the most important method in the workup of infantile cerebral complications after primary sonography. Cerebral MR examination and image interpretation during the infantile period require extensive knowledge of morphological manifestations, their pathophysiological background, and frequency. The choice of imaging parameters and image interpretation is demonstrated in infarctions and hemorrhages of the mature and immature brain. A review of the main differential diagnoses is also given. The relevance of MR spectroscopy and fetal MRI is discussed. (orig.) [de

  10. Treatment of Spasticity in Cerebral Palsy

    OpenAIRE

    Gül Mete Civelek; Ayçe Atalay

    2016-01-01

    The cerebral palsy diagnosis is a clinical one and it includes motor development delay, abnormal muscle tone and hyperreflexia. Muscle weakness, spasticity, loss of coordination, the continuation of the primitive reflexes and non-developed normal motor control are often seen in children with cerebral palsy. Spasticity is the velocity dependent increase in the resistance against passive muscle stretching. Spasticity treatment program should be established after detailed evaluation of degree an...

  11. Chronic cerebral ischemia, neuroplasticity, possibilities of therapy

    Directory of Open Access Journals (Sweden)

    E. I. Chukanova

    2017-01-01

    Full Text Available The paper presents current views on the pathogenetic mechanisms of cerebral ischemia. It discusses the role of neurotrophins in the processes of neuroplasticity. Experimental and clinical studies of the neuropeptide drug Cerebrolysin are reviewed. The authors describe in detail the results of the clinical trial and a health economic analysis of the effects of Cerebrolysin on the time course of clinical changes, progression, and risk of exacerbations in patients with chronic cerebral ischemia. 

  12. Hyperdense lesions in CT of cerebral toxoplasmosis

    International Nuclear Information System (INIS)

    Quinones Tapia, D.; Ramos Amador, A.; Monereo Alonso, A.

    1994-01-01

    We report a case of cerebral toxoplasmosis in a patient with stage IV C 1 AIDS who presented hyperdense CT images 13 days after beginning antitoxoplasma treatment. These lesions could be caused by calcifications or blood. The attenuation values lead us to believe that they are calcium. Intracranial calcification in adult cerebral toxoplasmosis is an uncommon finding. Its presence in AIDS patients should not suggest any etiology other than toxoplasmosis. (Author) 16 refs

  13. Detection of acute cerebral hemorrhage in rabbits by magnetic induction

    Energy Technology Data Exchange (ETDEWEB)

    Sun, J.; Jin, G.; Qin, M.X. [College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing (China); Wan, Z.B. [Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing (China); Wang, J.B.; Wang, C.; Guo, W.Y. [College of Electronic Engineering, Xidian University, Xi' an, China, College of Electronic Engineering, Xidian University, Xi' an (China); Xu, L.; Ning, X.; Xu, J.; Pu, X.J.; Chen, M.S. [College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing (China); Zhao, H.M. [Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing (China)

    2014-02-17

    Acute cerebral hemorrhage (ACH) is an important clinical problem that is often monitored and studied with expensive devices such as computed tomography, magnetic resonance imaging, and positron emission tomography. These devices are not readily available in economically underdeveloped regions of the world, emergency departments, and emergency zones. We have developed a less expensive tool for non-contact monitoring of ACH. The system measures the magnetic induction phase shift (MIPS) between the electromagnetic signals on two coils. ACH was induced in 6 experimental rabbits and edema was induced in 4 control rabbits by stereotactic methods, and their intracranial pressure and heart rate were monitored for 1 h. Signals were continuously monitored for up to 1 h at an exciting frequency of 10.7 MHz. Autologous blood was administered to the experimental group, and saline to the control group (1 to 3 mL) by injection of 1-mL every 5 min. The results showed a significant increase in MIPS as a function of the injection volume, but the heart rate was stable. In the experimental (ACH) group, there was a statistically significant positive correlation of the intracranial pressure and MIPS. The change of MIPS was greater in the ACH group than in the control group. This high-sensitivity system could detect a 1-mL change in blood volume. The MIPS was significantly related to the intracranial pressure. This observation suggests that the method could be valuable for detecting early warning signs in emergency medicine and critical care units.

  14. Feasibility and test-retest reliability of measuring lower-limb strength in young children with cerebral palsy

    NARCIS (Netherlands)

    Van Vulpen, L. F.; de Groot, Sonja; Becher, J. G.; De Wolf, G. S.; Dallmeijer, A. J.

    2013-01-01

    BACKGROUND: Quantifying leg muscle strength in young children with cerebral palsy (CP) is essential for identifying muscle groups for treatment and for monitoring progress. AIM: To study the feasibility, intratester reliability and the optimal test design (number of test occasions and repetitions)

  15. Feasibility and test-retest reliability of measuring lower‑limb strength in young children with cerebral palsy

    NARCIS (Netherlands)

    van Vulpen, L. F.; de Groot, S.; Becher, J. G.; de Wolf, G. S.; Dallmeijer, A. J.

    2013-01-01

    Quantifying leg muscle strength in young children with cerebral palsy (CP) is essential for identifying muscle groups for treatment and for monitoring progress. To study the feasibility, intratester reliability and the optimal test design (number of test occasions and repetitions) of measuring

  16. Characteristics of time-varying intracranial pressure on blood flow through cerebral artery: A fluid-structure interaction approach.

    Science.gov (United States)

    Syed, Hasson; Unnikrishnan, Vinu U; Olcmen, Semih

    2016-02-01

    Elevated intracranial pressure is a major contributor to morbidity and mortality in severe head injuries. Wall shear stresses in the artery can be affected by increased intracranial pressures and may lead to the formation of cerebral aneurysms. Earlier research on cerebral arteries and aneurysms involves using constant mean intracranial pressure values. Recent advancements in intracranial pressure monitoring techniques have led to measurement of the intracranial pressure waveform. By incorporating a time-varying intracranial pressure waveform in place of constant intracranial pressures in the analysis of cerebral arteries helps in understanding their effects on arterial deformation and wall shear stress. To date, such a robust computational study on the effect of increasing intracranial pressures on the cerebral arterial wall has not been attempted to the best of our knowledge. In this work, fully coupled fluid-structure interaction simulations are carried out to investigate the effect of the variation in intracranial pressure waveforms on the cerebral arterial wall. Three different time-varying intracranial pressure waveforms and three constant intracranial pressure profiles acting on the cerebral arterial wall are analyzed and compared with specified inlet velocity and outlet pressure conditions. It has been found that the arterial wall experiences deformation depending on the time-varying intracranial pressure waveforms, while the wall shear stress changes at peak systole for all the intracranial pressure profiles. © IMechE 2015.

  17. The Dual Role of Cerebral Autoregulation and Collateral Flow in the Circle of Willis After Major Vessel Occlusion.

    Science.gov (United States)

    Kennedy McConnell, Flora; Payne, Stephen

    2017-08-01

    Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady-state model of the cerebral arterial network was created. Structural variants of the circle of Willis that present particular risk of stroke were recreated by using a network model coupled with: 1) a steady-state physiological model of cerebral autoregulation; and 2) one wherein the cerebral vascular bed was modeled as a passive resistance. Simulations were performed in various conditions of internal carotid and vertebral artery occlusion. Collateral flow alone is unable to ensure adequate blood flow ([Formula: see text] normal flow) to the cerebral arteries in several common variants during internal carotid artery occlusion. However, compared to a passive model, cerebral autoregulation is better able to exploit available collateral flow and maintain flows within [Formula: see text] of baseline. This is true for nearly all configurations. Hence, autoregulation is a crucial facilitator of collateral flow through the circle of Willis. Impairment of this response during ischemia will severely impact cerebral blood flows and tissue survival, and hence, autoregulation should be monitored in this situation.

  18. Behavioural aspects of terrorism.

    Science.gov (United States)

    Leistedt, Samuel J

    2013-05-10

    Behavioural and social sciences are useful in collecting and analysing intelligence data, understanding terrorism, and developing strategies to combat terrorism. This article aims to examine the psychopathological concepts of terrorism and discusses the developing roles for behavioural scientists. A systematic review was conducted of studies investigating behavioural aspects of terrorism. These studies were identified by a systematic search of databases, textbooks, and a supplementary manual search of references. Several fundamental concepts were identified that continue to influence the motives and the majority of the behaviours of those who support or engage in this kind of specific violence. Regardless of the psychological aspects and new roles for psychiatrists, the behavioural sciences will continue to be called upon to assist in developing better methods to gather and analyse intelligence, to understand terrorism, and perhaps to stem the radicalisation process. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. CT findings of early acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hoon; Choi, Woo Suk; Ryu, Kyung Nam [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1992-11-15

    The CT findings of the acute cerebral infarction are well known. However the CT findings of early stroke within 24 hours of the onset have not been sufficiently reported. The purpose of this study is to evaluate early acute cerebral infarction on CT within 24 hours after ictus. The early and accurate CT diagnosis could lead to the appropriate therapy and improved outcome of the patients. Authors retrospectively analyzed 16 patients with early acute cerebral infarction. Acute cerebral infarction was confirmed by follow-up CT in 11 patients, SPECT in 4 patients, and MRI in 1 patient. The CT findings of early acute cerebral infarction include effacement of cortical sulci or cistern (n = 16, 100%), hyperattenuation of MCA (n = 3), obscuration of lentiform nucleus (n = 6), loss of insular ribbon (n = 6) and subtle low density in hemisphere (n = 5). The most frequent finding was effacement of cortical sulci in our study, and it was thought to be the most important sign of early acute cerebral infarction.

  20. Purine Metabolism in Acute Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ye. V. Oreshnikov

    2008-01-01

    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  1. Is fasting necessary for elective cerebral angiography?

    Science.gov (United States)

    Kwon, O-K; Oh, C W; Park, H; Bang, J S; Bae, H-J; Han, M K; Park, S-H; Han, M H; Kang, H-S; Park, S-K; Whang, G; Kim, B-C; Jin, S-C

    2011-05-01

    In order to prevent unexpected events such as aspiration pneumonia, cerebral angiography has been performed under fasting in most cases. We investigated prospectively the necessity of fasting before elective cerebral angiography. The study is an open-labeled clinical trial without random allocation. In total, 2554 patients who underwent elective cerebral angiography were evaluated on development of nausea, vomiting, and pulmonary aspiration during and after angiography. Potential risks and benefits associated with fasting were provided in written documents and through personal counseling to patients before the procedure. The patients chose their fasting or nonfasting option. No restriction in diet was given after angiography. The patients were observed for 24 hours. Nausea and vomiting during and within 1 hour after angiography was considered as a positive event associated with cerebral angiography. The overall incidence of nausea and vomiting during and within 1 hour after angiography was 1.05% (27/2554 patients). There was no patient with pulmonary aspiration. No statistical difference in nausea and vomiting development between the fasting and the diet groups was found. The incidence of nausea and vomiting associated with cerebral angiography is low and not affected by diet or fasting. Pulmonary aspiration had no difference between the diet and the fasting group. Our study suggests that fasting may not be necessary for patients who undergo elective cerebral angiography.

  2. MARKETING MIX THEORETICAL ASPECTS

    OpenAIRE

    Margarita Išoraitė

    2016-01-01

    Aim of article is to analyze marketing mix theoretical aspects. The article discusses that marketing mix is one of the main objectives of the marketing mix elements for setting objectives and marketing budget measures. The importance of each element depends not only on the company and its activities, but also on the competition and time. All marketing elements are interrelated and should be seen in the whole of their actions. Some items may have greater importance than others; it depends main...

  3. Futurological aspects of globalisation

    OpenAIRE

    Kostić Aleksandar V.

    2013-01-01

    The author examines futurological aspects of globalization having in mind various models of historical processes. He describes the changes as "futuroshock", thus presenting a dilemma whether the changes are only a momentum or a pre-planned concept. He especially stresses the Toffler’s conclusion that turns a new page in futurology - examining the dangers that follow the changes. According to him, predictions are made with the help of practically all the sciences in two basic directions: explo...

  4. Aspects of B physics

    Energy Technology Data Exchange (ETDEWEB)

    Gaillard, M.K.

    1987-10-14

    Various aspects of weak decays are commented on. Probing of the standard model and of phenomena beyond the standard model are discussed, followed by a theoretical view of B mesons and some experimental observations on B mesons. The point is made that any data on B decay would be interesting in that it would provide powerful new constraints in analyses of the standard model and extensions thereof. (LEW)

  5. Criminal Aspects of Pornography

    OpenAIRE

    Svoboda, Filip

    2015-01-01

    Criminal Aspects of Pornography Summary The main purpose of this thesis is to introduce the phenomenon of pornography in terms of criminal law, to point out flaws in the current relevant criminal legislation in the Czech Republic and to propose a possible solution in a form of potential legislative changes. The thesis is composed of five chapters. The first chapter deals with definition issue of vague legal term of "pornography" and other related terms ("child pornography", "hardcore pornogra...

  6. ETHICAL ASPECTS OF SUSTAINABILITY

    OpenAIRE

    Amantova-Salmane, Liene

    2015-01-01

    Ethics can be defined as a reflection on nature and a definition of “the good”. Individuals value qualities and things dissimilarly, most visibly, but they also value their goods in different ways, in different relations to each other, for different reasons, and to different ends. These differences are very applicable to sustainability. In other words, sustainability cannot be achieved without attention to its ethical dimensions. The aim of this research is to examine the ethical aspects of s...

  7. LNG project - contractual aspects

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Bruno Almeida

    2008-07-01

    This paper intends to provide from the legal point of view an outline of the main challenges of a LNG project in the upstream, regulatory aspects, liquefaction, financing and midstream through a basic checklist; an overview of the contractual complexity of a LNG project; some basic discussion of particular LNG contract clauses; and a comparative analysis between the classic clauses of a Gas Transportation Agreement (GTA) through a gas pipeline and LNG logistic. (author)

  8. Psychosocial Aspects of Obesity.

    Science.gov (United States)

    Beck, Amy R

    2016-01-01

    This article is the sixth in a series of the comorbidities of childhood obesity and reviews psychosocial aspects with a focus on weight-based victimization and discrimination stemming from weight bias and stigma. Outcomes from these bullying and discriminatory experiences are pervasive and impact youth across all settings, including school. Lastly, this article provides recommendations on how to reduce bias and stigma to better serve these students in the school environment. © 2015 The Author(s).

  9. An electromyographic study of abdominal muscle activity in children with spastic cerebral palsy

    OpenAIRE

    Saviour Adjenti; Graham Louw; Jennifer Jelsma; Marianne Unger

    2017-01-01

    Background: Inadequate knowledge in the recruitment patterns of abdominal muscles in individuals with spastic-type cerebral palsy (STCP). Objectives: To determine whether there is any difference between the neuromuscular activity (activation pattern) of the abdominal muscles in children with STCP and those of their typically developing (TD) peers. Method: The NORAXAN® electromyography (EMG) was used to monitor the neuromuscular activity in abdominal muscles of individuals with STCP (n =...

  10. Enhancing cerebral perfusion with external counterpulsation after ischaemic stroke: how long does it last?

    Science.gov (United States)

    Xiong, Li; Lin, Wenhua; Han, Jinghao; Chen, Xiangyan; Leung, Thomas; Soo, Yannie; Wong, Ka Sing

    2016-05-01

    External counterpulsation (ECP) is a non-invasive method used to augment cerebral perfusion in ischaemic stroke. We aimed to investigate time-course effects on blood pressure elevation and cerebral blood flow augmentation induced by ECP in ischaemic stroke. Patients with acute unilateral ischaemic stroke and large artery occlusive disease were recruited to receive 35 daily 1 h ECP treatment sessions. Serial transcranial Doppler monitoring of bilateral middle cerebral arteries was performed on days 3, 5, 7, 10, 14, 21, 28 and 35 after stroke onset. Flow velocity changes before, during and after ECP and continuous beat-to-beat blood pressure data were recorded. The cerebral augmentation index (CAI) is the increase in the percentage of the middle cerebral artery mean flow velocity during ECP compared with baseline. The CAI in patients with stroke was significantly higher on the ipsilateral side and on the contralateral side on day 3 (ipsilateral CAI, 9.3%; contralateral CAI, 7.2%), day 5 (7.0%; 6.7%), day 7 (6.8%; 6.0%), day 10 (6.0%; 5.1%), day 14 (4.7%; 2.6%) and day 21 (4.1%; 2.2%) after stroke onset than that in controls (-2.0%) (all pstroke. Differences in the percentage increase in the mean blood pressure did not change significantly over time in patients with stroke. Blood pressure elevation persists throughout ECP treatment, which consists of 35 sessions. However, cerebral blood flow augmentation may last at least 3 weeks and then appears to return to baseline 1 month after acute stroke onset. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. The effect of the beach-chair position angle on cerebral oxygenation during shoulder surgery.

    Science.gov (United States)

    Songy, Chad E; Siegel, Eric R; Stevens, Mark; Wilkinson, John T; Ahmadi, Shahryar

    2017-09-01

    Although the safety of the beach-chair position (BCP) is widely accepted, rare devastating neurologic complications have been reported and attributed to cerebral hypoperfusion. Cerebral oxygenation (regional oxygen saturation [rSO 2 ]) can be monitored noninvasively using near-infrared spectroscopy. The purpose of this study was to determine the effect of BCP angle on cerebral oxygenation in patients undergoing shoulder surgery in the BCP. Fifty patients undergoing shoulder arthroscopy were prospectively enrolled to participate. Following induction of general anesthesia, each patient's rSO 2 was recorded at 0° of elevation and again at 30°, 45°, 60°, and 80° of elevation. Mean rSO 2 values and mean differences in rSO 2 were reported. An average total decrease of 5% in rSO 2 was seen when comparing 0° with 80° (P chair angles of 0° versus 30° (P chair angle, leading to a linear decline in rSO 2 as the BCP increased (regression slope of -0.060%/°, P <.001). No patient's cerebral oxygenation dropped greater than 20% from baseline. Neither body mass index nor American Society of Anesthesiologists score had a significant impact on the relation of rSO 2 to BCP angle. The average drop in rSO 2 is significantly less than the threshold of 20% used as an identifier for a cerebral deoxygenation event. This study illustrates the direct effect the BCP angle has on cerebral oxygenation. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  12. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

    Directory of Open Access Journals (Sweden)

    Henning Bay Nielsen

    2014-03-01

    Full Text Available Near-infrared spectroscopy (NIRS is used to monitor regional cerebral oxygenation (rScO2 during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed i to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and ii to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and Embase database were searched from inception until April 30, 2013 and inclusion criteria were intraoperative NIRS determined rScO2 in adult patients undergoing non-cardiac surgery. The type of surgery and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparascopic surgery with the patient placed in anti-Tredelenburg’s position. Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery, major orthopedic and abdominal surgery the occurrence of postoperative cognitive dysfunction might be related to intraoperative cerebral desaturation. In conclusion, certain non-cardiac surgical procedures is associated with an increased risk for the occurrence of regional cerebral oxygenation. Evidence for an association between cerebral desaturation and postoperative outcome parameters other than cognitive dysfunction needs to be established.

  13. Ventilation onset prior to umbilical cord clamping (physiological-based cord clamping improves systemic and cerebral oxygenation in preterm lambs.

    Directory of Open Access Journals (Sweden)

    Graeme R Polglase

    Full Text Available As measurement of arterial oxygen saturation (SpO2 is common in the delivery room, target SpO2 ranges allow clinicians to titrate oxygen therapy for preterm infants in order to achieve saturation levels similar to those seen in normal term infants in the first minutes of life. However, the influence of the onset of ventilation and the timing of cord clamping on systemic and cerebral oxygenation is not known.We investigated whether the initiation of ventilation, prior to, or after umbilical cord clamping, altered systemic and cerebral oxygenation in preterm lambs.Systemic and cerebral blood-flows, pressures and peripheral SpO2 and regional cerebral tissue oxygenation (SctO2 were measured continuously in apnoeic preterm lambs (126±1 day gestation. Positive pressure ventilation was initiated either 1 prior to umbilical cord clamping, or 2 after umbilical cord clamping. Lambs were monitored intensively prior to intervention, and for 10 minutes following umbilical cord clamping.Clamping the umbilical cord prior to ventilation resulted in a rapid decrease in SpO2 and SctO2, and an increase in arterial pressure, cerebral blood flow and cerebral oxygen extraction. Ventilation restored oxygenation and haemodynamics by 5-6 minutes. No such disturbances in peripheral or cerebral oxygenation and haemodynamics were observed when ventilation was initiated prior to cord clamping.The establishment of ventilation prior to umbilical cord clamping facilitated a smooth transition to systemic and cerebral oxygenation following birth. SpO2 nomograms may need to be re-evaluated to reflect physiological management of preterm infants in the delivery room.

  14. Ventilation onset prior to umbilical cord clamping (physiological-based cord clamping) improves systemic and cerebral oxygenation in preterm lambs.

    Science.gov (United States)

    Polglase, Graeme R; Dawson, Jennifer A; Kluckow, Martin; Gill, Andrew W; Davis, Peter G; Te Pas, Arjan B; Crossley, Kelly J; McDougall, Annie; Wallace, Euan M; Hooper, Stuart B

    2015-01-01

    As measurement of arterial oxygen saturation (SpO2) is common in the delivery room, target SpO2 ranges allow clinicians to titrate oxygen therapy for preterm infants in order to achieve saturation levels similar to those seen in normal term infants in the first minutes of life. However, the influence of the onset of ventilation and the timing of cord clamping on systemic and cerebral oxygenation is not known. We investigated whether the initiation of ventilation, prior to, or after umbilical cord clamping, altered systemic and cerebral oxygenation in preterm lambs. Systemic and cerebral blood-flows, pressures and peripheral SpO2 and regional cerebral tissue oxygenation (SctO2) were measured continuously in apnoeic preterm lambs (126±1 day gestation). Positive pressure ventilation was initiated either 1) prior to umbilical cord clamping, or 2) after umbilical cord clamping. Lambs were monitored intensively prior to intervention, and for 10 minutes following umbilical cord clamping. Clamping the umbilical cord prior to ventilation resulted in a rapid decrease in SpO2 and SctO2, and an increase in arterial pressure, cerebral blood flow and cerebral oxygen extraction. Ventilation restored oxygenation and haemodynamics by 5-6 minutes. No such disturbances in peripheral or cerebral oxygenation and haemodynamics were observed when ventilation was initiated prior to cord clamping. The establishment of ventilation prior to umbilical cord clamping facilitated a smooth transition to systemic and cerebral oxygenation following birth. SpO2 nomograms may need to be re-evaluated to reflect physiological management of preterm infants in the delivery room.

  15. Criminal Aspects of Artificial Abortion

    OpenAIRE

    Hartmanová, Leona

    2016-01-01

    Criminal Aspects of Artificial Abortion This diploma thesis deals with the issue of artificial abortion, especially its criminal aspects. Legal aspects are not the most important aspects of artificial abortion. Social, ethical or ideological aspects are of the same importance but this diploma thesis cannot analyse all of them. The main issue with artificial abortion is whether it is possible to force a pregnant woman to carry a child and give birth to a child when she cannot or does not want ...

  16. Gamma ray spectroscopy monitoring method and apparatus

    Science.gov (United States)

    Stagg, William R; Policke, Timothy A

    2017-05-16

    The present invention relates generally to the field of gamma ray spectroscopy monitoring and a system for accomplishing same to monitor one or more aspects of various isotope production processes. In one embodiment, the present invention relates to a monitoring system, and method of utilizing same, for monitoring one or more aspects of an isotope production process where the monitoring system comprises: (A) at least one sample cell; (B) at least one measuring port; (C) at least one adjustable collimator device; (D) at least one shutter; and (E) at least one high resolution gamma ray spectrometer.

  17. Cerebral oxygen extraction, oxygen consumption, and regional cerebral blood flow during the aura phase of migraine

    DEFF Research Database (Denmark)

    Friberg, L; Olesen, Jes; Lassen, N A

    1994-01-01

    The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism.......The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism....

  18. The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy

    NARCIS (Netherlands)

    Einspieler, C; Cioni, G; Paolicelli, PB; Bos, AF; Dressler, A; Ferrari, F; Roversi, MF; Prechtl, HFR

    Qualitative abnormalities of spontaneous motor activity in new-borns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed

  19. Cardiovascular and Postural Control Interactions during Hypergravity: Effects on Cerebral Autoregulation in Males and Females

    Science.gov (United States)

    Goswami, Nandu; Blaber, Andrew; Bareille, Marie-Pierre; Beck, Arnaud; Avan, Paul; Bruner, Michelle; Hinghofer-Szalkay, Helmut

    2012-07-01

    Orthostatic intolerance remains a problem upon return to Earth from the microgravity environment of spaceflight. A variety of conditions including hypovolemia, cerebral vasoconstriction, cerebral or peripheral vascular disease, or cardiac arrhythmias may result in syncope if the person remains upright. Current research indicates that there is a greater dependence on visual and somatosensory information at the beginning of space flight with a decreased otolith gain during prolonged space flight (Herault et al., 2002). The goal of the research is to further our understanding of the fundamental adaptive homeostatic mechanisms involved in gravity related changes in cardiovascular and postural function. Cardiovascular, cerebrovascular, and postural sensory motor control systems in male and female participants before, during, and after exposure to graded levels of hyper-G were investigated. Hypotheses: 1) Activation of skeletal muscle pump will be directly related to the degree of orthostatic stress. 2) Simultaneous measurement of heart rate, blood pressure and postural sway will predict cardio-postural stability. Blood pressure and heart rate (means and variability), postural sway, center of pressure (COP), baroreflex function, calf blood flow, middle cerebral artery blood flow, non-invasive intracranial pressure measurements, and two-breath CO2 were measured. Results from the study will be used to provide an integrated insight into mechanisms of cardio-postural control and cerebral autoregulation, which are important aspects of human health in flights to Moon, Mars and distant planets.

  20. Severe pulmonary oedema following therapeutic embolization with Onyx for cerebral arteriovenous malformation

    International Nuclear Information System (INIS)

    Murugesan, C.; Saravanan, Sundararaj; Rajkumar, John; Prasad, Jagadish; Banakal, Sanjay; Muralidhar, Kanchi

    2008-01-01

    Acute respiratory distress syndrome (ARDS) is characterized by sudden onset of respiratory distress, infiltrates on radiographs consistent with pulmonary oedema, hypoxaemia and increased work in breathing. Infiltrates on radiographs are bilateral, but may be patchy or diffuse and fluffy or dense. It is associated with absence of left heart failure and a PaO 2 /FiO 2 ratio of ≤200. Ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide (DMSO), which was approved by the US FDA in July 2005, is used as an embolic agent for cerebral arteriovenous malformation (AVM). It is a biocompatible liquid polymer that precipitates and solidifies on contact with blood, thus forming a soft and spongy embolus. We report a case of ARDS following therapeutic embolization with ethylene vinyl alcohol copolymer for cerebral AVM under general anaesthesia. Experienced perioperative physicians adopted standard anaesthetic technique and monitoring for this procedure. Acute respiratory distress and hypoxaemia developed in the patient following extubation of the trachea. Infiltrates seen on postprocedural chest radiographs were consistent with pulmonary oedema. DMSO, the solvent for the ethylene vinyl alcohol copolymer, is excreted via the lungs after administration and we postulate that DMSO was the possible cause of ARDS in this patient. Monitoring of haemodynamic parameters (invasive blood pressure, electrocardiography) and ventilatory parameters (ETCO 2 , SpO 2 , airway pressure monitoring) are important in the recognition of this possible event. One should be vigilant and anticipate this complication following therapeutic embolization with ethylene vinyl alcohol polymer for the treatment of cerebral AVM. (orig.)

  1. Noninvasive, optoacoustic detection and characterization of intra- and extracranial hematomas and cerebral hypoxia

    Science.gov (United States)

    Petrov, Andrey; Prough, Donald S.; Petrov, Yuriy; Petrov, Irene Y.; Robertson, Claudia S.; Asokan, Vasantha; Agbor, Adaeze; Esenaliev, Rinat O.

    2015-03-01

    Early diagnosis of intracranial hematomas is necessary to improve outcome in patients with traumatic brain injury (TBI). CT and MRI can diagnose intracranial hematomas, but cannot be used until the patient arrives at a major healthcare facility, resulting in delayed diagnosis. Near infrared spectroscopy may suggest the presence of unilateral intracranial hematomas, but provides minimal information on hematoma type and location due to limitations associated with strong light scattering. We have used optoacoustics (which combines high endogenous optical contrast with the resolution of ultrasound) to diagnose hematomas and monitor cerebral oxygenation. We performed animal and clinical studies on detection and characterization of hematomas and on monitoring cerebral hypoxia by probing the superior sagittal sinus (SSS). Recently, we built a medical grade, multi-wavelength, OPO-based optoacoustic system tunable in the near infrared spectral range. We developed new patient interfaces for noninvasive, transcranial measurements in the transmission mode in the presence of dense hair and used it in patients with TBI. The optoacoustic system was capable of detecting and characterizing intra- and extracranial hematomas. SSS blood oxygenation was measured as well with the new interface. The obtained results indicate that the optoacoustic system in the transmission mode provides detection and characterization of hematomas in TBI patients, as well as cerebral venous blood oxygenation monitoring. The transmission mode approach can be used for optoacoustic brain imaging, tomography, and mapping in humans.

  2. Effects of pectin liquid on gastroesophageal reflux disease in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Shimizu Nobuzo

    2008-04-01

    Full Text Available Abstract Background The use of thickeners is a standard therapy for decreasing episodes of regurgitation or vomiting in infants. However, it remains to be investigated whether thickener is effective for vomiting and/or chronic respiratory symptoms in children with cerebral palsy. Methods We enrolled 18 neurologically impaired children caused by cerebral palsy, with gastroesophageal reflux disease. In the first part of this study (pH monitoring, subjects were randomly allocated to two groups: fed with a high-pectin diet [enteral formula: pectin liquid = 2:1 (v/v], or a low-pectin diet [enteral formula: pectin liquid = 3:1 (v/v]. Two-channel esophageal pH monitoring was performed over 48 h. In the second part (clinical trial, subjects were fed a high- or low-pectin diet and non-pectin diet for 4 weeks in a crossover manner. Nurses recorded the feeding volume, number of episodes of vomiting, volume of gastric residue, episodes of cough and wheeze, frequency of using oxygen for dyspnea, and the day when the child could return to school. Cough and wheeze were recorded as a cough-score. Results The median value for the % time pH Conclusion Pectin liquid partially decreased gastroesophageal reflux as measured by eshophageal pH monitoring, and might improve vomiting and respiratory symptoms in children with cerebral palsy. Trial registration ISRCTN19787793

  3. Cerebral air embolism after ERCP.

    Science.gov (United States)

    Trabanco, Sonia; Pardo, Sara; Williams, Mónica; Diaz, Javier; Ruiz, Cristina

    2017-02-01

    Digestive endoscopic procedures have become increasingly common diagnostic and therapeutic procedures in hospitals. Generally they are safe procedures and complications, though infrequent, can occur and are potentially lethal. As the number of procedures performed increases, the complications arising are likely to become more frequent, so it is advisable to bear this in mind when establishing early diagnosis and treatment. Cerebral air embolism is a rare complication after a digestive endoscopic procedure, although in the case of endoscopic retrograde cholangiopancreatography (ERCP), may be as high as 10%. In such cases there are usually local circumstances exist favoring the entry of air into the bloodstream, and in some cases it is the presence of a patent foramen ovale that favors the passage of air into the arterial system. The clinical signs and symptoms will depend on the speed and volume of the air infused and on the territory affected, and in some cases the consequences may be fatal. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Cerebral oxygenation in preterm infants.

    Science.gov (United States)

    Fyfe, Karinna L; Yiallourou, Stephanie R; Wong, Flora Y; Odoi, Alexsandria; Walker, Adrian M; Horne, Rosemary S C

    2014-09-01

    Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P preterm compared with term infants at 2 to 4 weeks, in both positions (P preterm infants in the prone position at 2 to 3 months (P position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk. Copyright © 2014 by the American Academy of Pediatrics.

  5. Cerebral sino-venous thrombosis

    International Nuclear Information System (INIS)

    Sayama, Ichiro; Kobayashi, Tsunesaburo; Nakajima, Kenji

    1982-01-01

    Three cases of cerebral sino-venous thrombosis were reported. Repeated CT findings were studied and discussed on account of the treatments for those pathologic conditions. Those of studied cases are; a 22-year-old postpartum woman, a 42-year-old woman with irregular vaginal bleeding, and a 26-year-old man with severe reactive emesis after drinking alcohol. They were treated conservatively. Case 1 died in its acute stage. In the remaining ones, each had an uneventful recovery. CT scan findings of them manifested their exact clinical conditions. These findings were devided into two categories, one was direct signs expressed sino-venous occlusion, the other was indirect signs which appeared as a result of these occlusion. Direct signs cannot always get in every cases with sino-venous occlusion, but as for indirect signs, we can get various changes corresponding to the time taken CT photoes, and they are useful to decide appropriate treatments at that time. Considering suitable treatments for this disease, it is necessary to select most suitable ones according to their pathologic conditions, which may be precisely drawn with CT scans. (J.P.N.)

  6. Cerebral CT of ischaemic lesions

    International Nuclear Information System (INIS)

    Aulich, A.

    1981-01-01

    The diagnosis of stroke must first be established by clinical examination. CT has proved useful for confirmation of the diagnosis and provides a global intracranial picture of morphological changes in cerebral vascular diseases. A hemorrhage can be recognized with certainty at the first CT examination as the cause of the stroke, but in the detection of a lesion due to ischemia an important role is played by the correct choice of the time of examination, and in some cases also of the check-up with contrast medium. The differential diagnosis between infarct in the acute stage and encephalitis or gliomas of low-grade malignity can be difficult. A decision can often only be made after a series of examinations. Postmalacial conditions are often difficult to differentiate from defects due to other causes, such as hemorrhage, head injury, postoperative states and after encephalitis. A knowledge of the anamnesis and the clinical findings is indispensable for CT evaluation. In assessing the prognosis before vascular surgery on the extracranial brain-supplying vessels the performance of a CT examination should be advised. A warning is given against the use of CT as a screening method. (orig.) [de

  7. Hemorrhagic stroke and cerebral paragonimiasis.

    Science.gov (United States)

    Xia, Yong; Ju, Yan; Chen, Jing; You, Chao

    2014-11-01

    We retrospectively analyzed the clinical and imaging characteristics, diagnosis, and treatment outcomes of 10 patients with hemorrhagic cerebral paragonimiasis (CP), and we evaluated the influence of Paragonimus infection on cerebrovascular damage. Ten patients (7 male and 3 female; median age 15.7 years, range 4-46 years) with hemorrhagic CP were diagnosed between April 2009 and January 2013. All patients underwent the head computed tomography scans and 9 patients underwent MRI examinations. Four patients underwent computed tomographic angiography, magnetic resonance angiography, and digital subtraction angiography. Liquid-based cytological examination of cerebrospinal fluid was performed in 7 patients. Follow-up examinations were performed for 9 cases for a period of 12 to 62 months. Hemorrhagic CP accounted for 37% of CP cases (10/27). No patients were initially diagnosed with CP. The major symptoms of hemorrhagic CP included acute headache, vomiting, hemiparalysis, epilepsy, blurred vision, sensory impairment, and tinnitus. Four cases were surgically treated. Most symptoms markedly improved, but fine motor dysfunction and mental dysfunction remained in 3 surgical patients. Hemorrhagic stroke typically occurred during the acute stage and in the early stages of further Paragonimus migration. Delay of treatment increased the risk of initial and recurrent stroke. © 2014 American Heart Association, Inc.

  8. Therapeutic Aspects of Art Education.

    Science.gov (United States)

    Lowenfield, Viktor

    1987-01-01

    Recognition of the handicapped child's isolation from the environment is the basis for creative art therapy across handicapping conditions (physical disabilities, mental retardation, emotional disturbance, deafness, Blindness, speech impairment, cerebral palsy). Detachment may be overcome by self expression through drawings, paintings, and…

  9. Cerebral oxygen metabolism and cerebral blood flow in man during light sleep (stage 2)

    DEFF Research Database (Denmark)

    Madsen, P L; Schmidt, J F; Holm, S

    1991-01-01

    We measured cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) during light sleep (stage 2) in 8 young healthy volunteers using the Kety-Schmidt technique with 133Xe as the inert gas. Measurements were performed during wakefulness and light sleep as verified by standard...... polysomnography. Unlike our previous study in man showing a highly significant 25% decrease in CMRO2 during deep sleep (stage 3-4) we found a modest but statistically significant decrease of 5% in CMRO2 during stage 2 sleep. Deep and light sleep are both characterized by an almost complete lack of mental activity....... They differ in respect of arousal threshold as a stronger stimulus is required to awaken a subject from deep sleep as compared to light sleep. Our results suggest that during non-rapid eye movement sleep cerebral metabolism and thereby cerebral synaptic activity is correlated to cerebral readiness rather than...

  10. Control modeling and Chinese acupuncture treatment on cerebral circulation.

    Science.gov (United States)

    Yang, Li; Sui, Jinxue; Shi, Hongzhi

    2015-01-01

    Cerebral hemodynamic parameters are related to the occurrence and development of the cerebral vascular diseases. This paper proposes a new possible method for control treatment on cerebral circulation network diseases. Cerebral circulation is taken as a kind of fluid network that should be controlled. The acupuncture treatment in traditional Chinese medicine is used as an actuator, whose design principle is changing the artery pressure and resistance of the cerebral circulation to increase the blood flow, so as to achieve the purpose of treating cerebral circulation diseases. Clinical data of acupuncture and moxibustion treatment has also preliminarily proved the correctness of this method.

  11. AspectJ in action practical aspect-oriented programming

    CERN Document Server

    Laddad, Ramnivas

    2003-01-01

    A guide to aspect-oriented programming and the AspectJ language, this book provides code examples that enable quick implementation of functionality in a system. Thorough introductions to AOP and AspectJ will help developers learn or advance their knowledge of AspectJ. Examples of everyday situations in which AspectJ solutions can be applied, such as logging, policy enforcement, resource pooling, business logic, thread-safety, authentication and authorization, and transaction management are provided. In addition, design patterns and idioms are covered, as is business rule implementation. The latest technologies, such as JEES, JAAS, and log4j, are explained and connected with AspectJ.

  12. Monitoring of Engineering Applications

    CERN Document Server

    Osborne, A M; Eck, C; Ferran, M; Flockhart, Ronald Bruce; Guijarro, M; Saiz, P; Puzynin, V

    2001-01-01

    This paper presents a license monitoring system implemented at CERN in the Computing for Engineering (CE) group of the Information Technology (IT) division. The system gathers statistics on the use of the different software products supported by the group on both Windows and Unix platforms. The web is used for all aspects of the project; data presentation and associated interfaces. The system is completely automated. Manual intervention is required only when there are new products to be monitored. Certain technical details of this work have been reported elsewhere .

  13. Endotoxemia reduces cerebral perfusion but enhances dynamic cerebrovascular autoregulation at reduced arterial carbon dioxide tension*

    DEFF Research Database (Denmark)

    Brassard, Patrice; Kim, Yu-Sok; van Lieshout, Johannes

    2012-01-01

    OBJECTIVE:: The administration of endotoxin to healthy humans reduces cerebral blood flow but its influence on dynamic cerebral autoregulation remains unknown. We considered that a reduction in arterial carbon dioxide tension would attenuate cerebral perfusion and improve dynamic cerebral autoreg...

  14. Association of Lead Levels and Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Neha Bansal MD

    2017-03-01

    Full Text Available Background: Cerebral palsy is a common motor disability in childhood. Raised lead levels affect cognition. Children with cerebral palsy may have raised lead levels, further impairing their residual cognitive motor and behavioral abilities. Environmental exposure and abnormal eating habits may lead to increased lead levels. Aims and Objectives: To measure blood lead levels in children with cerebral palsy and compare them with healthy neurologically normal children. To correlate blood lead levels with environmental factors. Material and Methods: Design: Prospective case-control study. Setting: Tertiary care hospital. Participants: Cases comprised 34 children with cerebral palsy, and controls comprised 34 neurologically normal, age- and sex-matched children. Methods: Clinical and demographic details were recorded as per proforma. Detailed environmental history was recorded to know the source of exposure to lead. These children were investigated and treated as per protocol. Venous blood was collected in ethylenediaminetetraacetic acid vials for analysis of blood lead levels. Lead levels were estimated by Schimadzu Flame AA-6800 (atomic absorption spectrophotometer. Data were analyzed using SPSS version 17. P < .05 was taken as significant. Results: Mean blood lead levels were 9.20 ± 8.31 µg/dL in cerebral palsy cases and 2.89 ± 3.04 µg/dL in their controls (P < .001. Among children with cerebral palsy, 19 (55.88% children had blood lead levels ≥5 µg/dL. Lead levels in children with pica were 12.33 ± 10.02 µg/dL in comparison to children with no history of pica, 6.70 ± 4.60 µg/dL (P = .029. No correlation was found between hemoglobin and blood lead levels in cases and controls. Conclusion: In our study, blood lead levels are raised in children with cerebral palsy. However, further studies are required to show effects of raised levels in these children.

  15. PRETERM BIRTH ASSOCIATION WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-04-01

    Full Text Available INTRODUCTION: Cerebral palsy ( CP is a group of permanent movement disorders that appear in early childhood. Preterm birth is the birth of baby before 37 completed weeks, a full term birth is birth at 37 to 42 weeks of gestation . AIM: To show the extent of association of preterm deliveries as a risk factor in development of cerebral palsy. MATERIALS AND METHODS: This r etrospective cohort study was conducted by eliciting history from the mothers of 99 cerebral palsy children who w ere treated in Rani Chandra Mani Devi Hospital, Visakhapatnam, Andhra Pradesh, India. De tailed history was taken from the mothers of 99 cerebral palsy children who were treated in this hospital. History regarding the period of gestation at which the child was born (preterm or full term, any previous history of pre - term delivery or abortions, was obtained from the mothers and the data analyzed . RESULTS: From this study it was observed the proportional association of pre - term births to cerebral palsy is 33 out 99 i.e., about 33.33%, Of these 33 cerebral palsy children highest association being with birth at 28 wks gestation (51 %. This study also shows th at the mothers with a previous history of preterm delivery have 14.4 times higher risk of subsequent pre term delivery; those with previous history of abortions have 5.7 times risk of pre - term delivery than mothers without such history. CONCLUSION: From th is study it was concluded that the pre - term birth plays a major role as a risk factor in the development of cerebral palsy with mothers having previous pre term delivery and previous abortions adding further to this risk.

  16. Strategic Aspects of Bundling

    International Nuclear Information System (INIS)

    Podesta, Marion

    2008-01-01

    The increase of bundle supply has become widespread in several sectors (for instance in telecommunications and energy fields). This paper review relates strategic aspects of bundling. The main purpose of this paper is to analyze profitability of bundling strategies according to the degree of competition and the characteristics of goods. Moreover, bundling can be used as price discrimination tool, screening device or entry barriers. In monopoly case bundling strategy is efficient to sort consumers in different categories in order to capture a maximum of surplus. However, when competition increases, the profitability on bundling strategies depends on correlation of consumers' reservations values. (author)

  17. Radiographic aspects of xeroradiography

    International Nuclear Information System (INIS)

    Rao, G.U.V.; Fatouros, P.P.

    1980-01-01

    The quality of a conventional radiographic image can be characterized in terms of five basic parameters; density, contrast, latitude, resolution and noise. Since xeroradiographic images exhibit very limited broad area contrasts, and image formation is predominantly due to edge enhancement, a straightforward description of image quality using the same five parameters is not adequate. A detailed study was made of the radiographic aspects of xeroradiography with special reference to mammography, and a summary of major findings to date with appropriate references to published papers is presented

  18. Analytic aspects of convexity

    CERN Document Server

    Colesanti, Andrea; Gronchi, Paolo

    2018-01-01

    This book presents the proceedings of the international conference Analytic Aspects in Convexity, which was held in Rome in October 2016. It offers a collection of selected articles, written by some of the world’s leading experts in the field of Convex Geometry, on recent developments in this area: theory of valuations; geometric inequalities; affine geometry; and curvature measures. The book will be of interest to a broad readership, from those involved in Convex Geometry, to those focusing on Functional Analysis, Harmonic Analysis, Differential Geometry, or PDEs. The book is a addressed to PhD students and researchers, interested in Convex Geometry and its links to analysis.

  19. Radiological aspects of Arthroplasties

    International Nuclear Information System (INIS)

    Garcia, Sara Eugenia; Barragan, John Henry; Narvaez, Jorge Andres

    2008-01-01

    The development of new surgical techniques, of new prosthetic materials, and the increase in life expectancy with greater coverage of health services has ugmented the performance of hip replacements in our country. The radiologist should be familiar with the different surgical techniques and prosthetic devices, the evaluation of its components and associated complications. The most frequently performed arthroplasties are: shoulder, elbow, hip and knee replacement. This article reviews the most frequent prosthetic devices used, the radiological aspects of arthroplasties and their most common complications.

  20. Cerebral Amyloid Angiopathy: A Case Report and Literature ...

    Directory of Open Access Journals (Sweden)

    Orkide Kutlu

    2015-03-01

    Full Text Available Cerebral amyloid angiopathy (CAA is a condition characterized by accumulation of amyloid-beta peptide in the walls of the small and medium-sized arteries of the brain and leptomeninges. This condition disrupts the structure of the vessel wall and makes it prone to bleeding. This is an important cause of intracerebral hemorrhage in elderly accompanying to Alzheimer’s disease or to a familial syndrome. Clinically, it usually presents with spontaneous lobar hemorrhage, as well as transient neurological signs, seizures, cognitive disorders, headache, incidental findings like microhaemorrhages and hemosiderosis observed on magnetic resonance (MR imaging. Herein, we report a hypertensive patient diagnosed with CAA who presented with the complaints of balance disorder while walking. CAA should be suspected in patients with lobar hemorrhage aged 65 years and over. Surgical treatment should not be performed because it could worsen the condition. Clinical improvement can be expected from supportive management, monitoring hypertension, and steroid - immunosuppressive therapies.

  1. SOYBEAN - MOLECULAR ASPECTS OF BREEDING

    Directory of Open Access Journals (Sweden)

    Aleksandra Sudarić

    2012-12-01

    Full Text Available The book Soybean: Molecular Aspects of Breeding focuses recent progress in our understanding of the genetics and molecular biology of soybean. This book is divided into four parts and contains 22 chapters. Part I, Molecular Biology and Biotechnology focuses advances in molecular biology and laboratory procedures that have been developed recently to manipulate DNA. Part II, Breeding for abiotic stress covers proteomics approaches form as a powerful tool for investigating the molecular mechanisms of the plant responses to various types of abiotic stresses. Part III, Breeding for biotic stress addresses issues related to application of molecular based strategies in order to increase soybean resistance to various biotic factors. Part IV, Recent Technology reviews recent technologies into the realm of soybean monitoring, processing and product use. While the information accumulated in this book is of primary interest for plant breeders, valuable insights are also offered to agronomists, molecular biologists, physiologists, plant pathologists, food scientists and students. The book is a result of efforts made by many experts from different countries (USA, Japan, Croatia, Serbia, China, Canada, Malawi, Iran, Hong Kong, Brasil, Mexico.

  2. Safety system status monitoring

    International Nuclear Information System (INIS)

    Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

    1984-03-01

    The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide

  3. Safety system status monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

    1984-03-01

    The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide.

  4. Monitoring asthma in children.

    Science.gov (United States)

    Pijnenburg, Mariëlle W; Baraldi, Eugenio; Brand, Paul L P; Carlsen, Kai-Håkon; Eber, Ernst; Frischer, Thomas; Hedlin, Gunilla; Kulkarni, Neeta; Lex, Christiane; Mäkelä, Mika J; Mantzouranis, Eva; Moeller, Alexander; Pavord, Ian; Piacentini, Giorgio; Price, David; Rottier, Bart L; Saglani, Sejal; Sly, Peter D; Szefler, Stanley J; Tonia, Thomy; Turner, Steve; Wooler, Edwina; Lødrup Carlsen, Karin C

    2015-04-01

    The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist in various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma. 22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus. This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised. Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence. Copyright ©ERS 2015.

  5. Historical Aspects of Echinococcosis.

    Science.gov (United States)

    Eckert, J; Thompson, R C A

    2017-01-01

    Echinococcosis is a zoonosis whose history dates back to antiquity. This article provides an overview on the general history of echinococcosis, including the elucidation of Echinococcus life cycles and the long controversy on the aetiology of the cystic and alveolar forms of echinococcosis (CE and AE), lasting about 100years since the middle of the 19th century. Furthermore, selected historical aspects of some fields of echinococcosis research are discussed and compared with our current knowledge, such as geographic distribution and epidemiology of CE (Echinococcus granulosus) and AE (Echinococcus multilocularis), clinical aspects and pathology, diagnosis in humans and animals, treatment (with focus on chemotherapy), control and basic research. A short paragraph is devoted to the neotropical forms of echinococcosis, caused by Echinococcus vogeli and Echinococcus oligarthrus. In this context the achievements of some ancestral pioneers of echinococcosis research are particularly highlighted and appreciated. Finally, the role of associations, international organizations (World Health Organization and others) and international working groups in echinococcosis research and control is briefly outlined. The retrospective reveals both the admirable achievements of our ancestors and the scientific progress of more recent times. But, it also shows the gaps in our knowledge, skills and resources that we need to control or even eradicate echinococcosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Diabetic patients: Psychological aspects.

    Science.gov (United States)

    Adili, Fatemeh; Larijani, Bagher; Haghighatpanah, Mohammadreza

    2006-11-01

    This study was undertaken to consider the psychological aspect of diabetes with regard to improving clinical outcomes. The review was limited to literature reports on the causes, solutions, and treatments of some common psychological problems known to complicate diabetes management. A literature search was undertaken using Pub-Med, CINAHL, Proquest, Elsevier, Blackwell Synergy, Ovid, Ebsco, Rose net, and Google websites, including studies published in English journals between 1995 and 2006. Therefore about 88 articles were selected based on the inclusion criteria. In earlier studies, relatively little empirical research was found to substantiate the effect of psychological counseling in complicated diabetes. The greatest deficits were seen in areas of mental health, self-esteem parent impact, and family cohesion. There were some different factors, which influence the psychological aspect of diabetic patients, such as age, gender, place of living, familial and social support, motivation, energy, life satisfaction, and lifestyle. There are various types of solutions for coping with the psychological problems in diabetic clients. The most essential solution lies in educating the patients and healthcare providers on the subject. Before initiating each educational intervention, a thorough assessment would be crucial. Treatment plans may benefit from cognitive behavior therapy (CBT), behavior family therapy, improving family communication, problem-solving skills, and providing motivation for diabetic patients. Moreover, it seems that the close collaboration between diabetologists and psychologists would be fruitful.

  7. Slow pseudoperiodic lateralized epileptiform discharges in nonconvulsive status epilepticus in a patient with cerebral palsy and a large central meningioma

    Directory of Open Access Journals (Sweden)

    Y.Z. Imam

    2014-01-01

    Full Text Available The presence of cerebral palsy and that of slow growing brain tumors are risk factors for convulsive and nonconvulsive status epilepticus. Nonconvulsive status epilepticus (NCSE needs electroencephalographic (EEG monitoring to be confirmed as it may be clinically subtle. Furthermore, it may present with a variety of ictal EEG morphologies. We report a case of a patient with cerebral palsy and a large central meningioma. Electroencephalogram showed a slow pattern of periodic lateralized epileptiform discharges (PLEDs (a pattern considered as being situated in the ictal–interictal continuum on an alpha background. The patient was treated for NCSE successfully with benzodiazepines followed by up-titration of his antiepileptic drug doses.

  8. Ultrasound tagged near infrared spectroscopy does not detect hyperventilation-induced reduction in cerebral blood flow

    DEFF Research Database (Denmark)

    Lund, Anton; Secher, Niels H.; Hirasawa, Ai

    2016-01-01

    Introduction: Continuous non-invasive monitoring of cerebral blood flow (CBF) may be important during anaesthesia and several options are available. We evaluated the CerOx monitor that employs ultrasound tagged near infrared spectroscopy to estimate changes in a CBF index (CFI).Methods: Seven...... by transcranial Doppler. Blood flow in the internal and external carotid artery (ICAf and ECAf) was determined using duplex ultrasonography and forehead skin blood flow (SkBF) and oxygenation (SskinO2) by laser Doppler and white light spectroscopy.Results: During hyperventilation MCAvmean and ICAf decreased by 44...

  9. Testing impact of perinatal inflammation on cerebral autoregulation in preterm neonates

    DEFF Research Database (Denmark)

    Hahn, Gitte Holst

    2013-01-01

    ). This mismatch has formed the basis for an ongoing explanatory study. Based on the findings in the present thesis we conclude the following: Our non-invasive method has potential use in clinical research. However, low precision hampers its clinical application. In preterm infants with perinatal inflammation...... us to evaluate the precision and validity of this method. We monitored 22 preterm neonates and demonstrated that reliable detection of impaired cerebral autoregulation requires several hours of monitoring. However, weighting measurements with large variations in blood pressure in favour of those...

  10. Strategy and Aspects of Monitoring / Control Strictly in Coordinated Subsystems

    Directory of Open Access Journals (Sweden)

    William José Borges

    2012-06-01

    Full Text Available This paper aims to discuss the approach structures of the strictly coordinated theoretical framework developed by Zylbersztajn and Farina (1999 as an expanded perspective of the firm, taking into account the food supply chains as an extension of the nexus of contracts proposed by Coase (1937 and taken up by Williamson (1985. The structures stand out as strictly coordinated. Zylbersztajn and Farina (1999 turn to identifying points of common interests that encourage firms to promote contracts between themselves in a strictly coordinated way, considering the degree of asset specificity involved in the transaction and the competitive forces that determine the search for strategic positioning organizations to achieve sustainable superior results.

  11. Mechanisms of Astrocyte-Mediated Cerebral Edema

    Science.gov (United States)

    Stokum, Jesse A.; Kurland, David B.; Gerzanich, Volodymyr; Simard, J. Marc

    2014-01-01

    Cerebral edema formation stems from disruption of blood brain barrier (BBB) integrity and occurs after injury to the CNS. Due to the restrictive skull, relatively small increases in brain volume can translate into impaired tissue perfusion and brain herniation. In excess, cerebral edema can be gravely harmful. Astrocytes are key participants in cerebral edema by virtue of their relationship with the cerebral vasculature, their unique compliment of solute and water transport proteins, and their general role in brain volume homeostasis. Following the discovery of aquaporins, passive conduits of water flow, aquaporin 4 (AQP4) was identified as the predominant astrocyte water channel. Normally, AQP4 is highly enriched at perivascular endfeet, the outermost layer of the BBB, whereas after injury, AQP4 expression disseminates to the entire astrocytic plasmalemma, a phenomenon termed dysregulation. Arguably, the most important role of AQP4 is to rapidly neutralize osmotic gradients generated by ionic transporters. In pathological conditions, AQP4 is believed to be intimately involved in the formation and clearance of cerebral edema. In this review, we discuss aquaporin function and localization in the BBB during health and injury, and we examine post-injury ionic events that modulate AQP4- dependent edema formation. PMID:24996934

  12. Cerebral cortical registration of subliminal visceral stimulation.

    Science.gov (United States)

    Kern, Mark K; Shaker, Reza

    2002-02-01

    Although brain registration of subliminal somatic stimulations such as masked visual stimuli and their influence on electrical and hemodynamic measures of cerebral activity have been reported previously, there have been no reports on cerebral cortical registration of subliminal visceral stimulation. Because studies evaluating the consequences of subliminal somatic stimulation have shown that subliminal stimulation can effect behavior, it is conceivable that such subliminal messages from the intestine could potentially influence intestinal sensory/motor function or effect the perception/interpretation of sensory signals originating from the gut. We studied the cerebral cortical functional magnetic resonance imaging (fMRI) response to subliminal, liminal, and supraliminal rectal distention in healthy volunteers. Study findings indicate that subliminal afferent signals originating from the gut are registered in the cerebral cortex without reaching the level of awareness. Locations of cortical activity caused by intestinal subliminal stimulation are similar to those of liminal and supraliminal stimulation but their intensity and volume are significantly lower (P Subliminal afferent signals originating from the gut are registered in the cerebral cortex and induce changes in measures of brain activity, such as hemodynamic changes detectable by fMRI.

  13. Elevated Intracranial Pressure and Cerebral Edema following Permanent MCA Occlusion in an Ovine Model

    Science.gov (United States)

    Wells, Adam J.; Vink, Robert; Helps, Stephen C.; Knox, Steven J.; Blumbergs, Peter C.; Turner, Renée J.

    2015-01-01

    Introduction Malignant middle cerebral artery (MCA) stroke has a disproportionately high mortality due to the rapid development of refractory space-occupying cerebral edema. Animal models are essential in developing successful anti-edema therapies; however to date poor clinical translation has been associated with the predominately used rodent models. As such, large animal gyrencephalic models of stroke are urgently needed. The aim of the study was to characterize the intracranial pressure (ICP) response to MCA occlusion in our recently developed ovine stroke model. Materials and Methods 30 adult female Merino sheep (n = 8–12/gp) were randomized to sham surgery, temporary or permanent proximal MCA occlusion. ICP and brain tissue oxygen were monitored for 24 hours under general anesthesia. MRI, infarct volume with triphenyltetrazolium chloride (TTC) staining and histology were performed. Results No increase in ICP, radiological evidence of ischemia within the MCA territory but without space-occupying edema, and TTC infarct volumes of 7.9+/-5.1% were seen with temporary MCAO. Permanent MCAO resulted in significantly elevated ICP, accompanied by 30% mortality, radiological evidence of space-occupying cerebral edema and TTC infarct volumes of 27.4+/-6.4%. Conclusions Permanent proximal MCAO in the sheep results in space-occupying cerebral edema, raised ICP and mortality similar to human malignant MCA stroke. This animal model may prove useful for pre-clinical testing of anti-edema therapies that have shown promise in rodent studies. PMID:26121036

  14. Does Vasopressin Exacerbate Cerebral Edema in Patients with Severe Traumatic Brain Injury?

    Science.gov (United States)

    Allen, Casey J; Subhawong, Ty K; Hanna, Mena M; Chelala, Lydia; Bullock, M Ross; Schulman, Carl I; Proctor, Kenneth G

    2018-01-01

    Arginine vasopressin (AVP) is often used as an alternative pressor to catecholamines (CATs). However, unlike CATs, AVP is a powerful antidiuretic that could promote edema. We tested the hypothesis that AVP promoted cerebral edema and/or increased requirements for osmotherapy, relative to those who received CATs, for cerebral perfusion pressure (CPP) management after traumatic brain injury (TBI). This is a retrospective review of 286 consecutive TBI patients with intracranial pressure monitoring at a single institution from September 2008 to January 2015. Cerebral edema was quantitated using CT attenuation in prespecified areas of gray and white matter. To maintain CPP >60 mm Hg, 205 patients required no vasopressors, 41 received a single CAT, 12 received AVP, and 28 required both. Those who required no pressors were generally less injured; required less hyperosmolar therapy and less total fluid; and had lower plasma Na, lower intracranial pressure, less edema, and lower mortality (all P Edema; daily mean, minimum, and maximum Na levels; and mortality were similar with AVP versus CATs, but the daily requirement of mannitol and 3 per cent NaCl were reduced by 45 and 35 per cent (both P cerebral edema compared with CATs.

  15. Elevated Intracranial Pressure and Cerebral Edema following Permanent MCA Occlusion in an Ovine Model.

    Science.gov (United States)

    Wells, Adam J; Vink, Robert; Helps, Stephen C; Knox, Steven J; Blumbergs, Peter C; Turner, Renée J

    2015-01-01

    Malignant middle cerebral artery (MCA) stroke has a disproportionately high mortality due to the rapid development of refractory space-occupying cerebral edema. Animal models are essential in developing successful anti-edema therapies; however to date poor clinical translation has been associated with the predominately used rodent models. As such, large animal gyrencephalic models of stroke are urgently needed. The aim of the study was to characterize the intracranial pressure (ICP) response to MCA occlusion in our recently developed ovine stroke model. 30 adult female Merino sheep (n = 8-12/gp) were randomized to sham surgery, temporary or permanent proximal MCA occlusion. ICP and brain tissue oxygen were monitored for 24 hours under general anesthesia. MRI, infarct volume with triphenyltetrazolium chloride (TTC) staining and histology were performed. No increase in ICP, radiological evidence of ischemia within the MCA territory but without space-occupying edema, and TTC infarct volumes of 7.9+/-5.1% were seen with temporary MCAO. Permanent MCAO resulted in significantly elevated ICP, accompanied by 30% mortality, radiological evidence of space-occupying cerebral edema and TTC infarct volumes of 27.4+/-6.4%. Permanent proximal MCAO in the sheep results in space-occupying cerebral edema, raised ICP and mortality similar to human malignant MCA stroke. This animal model may prove useful for pre-clinical testing of anti-edema therapies that have shown promise in rodent studies.

  16. Quantification of modulated blood oxygenation levels in single cerebral veins by investigating their MR signal decay

    Energy Technology Data Exchange (ETDEWEB)

    Sedlacik, Jan [St. Jude Children' s Research Hospital, Memphis, TN (United States). Div. of Translational Imaging Research; University Clinics Jena (Germany). Medical Physics Group; Rauscher, Alexander [University Clinics Jena (Germany). Medical Physics Group; British Columbia Univ., Vancouver (Canada). MRI Research Centre; Reichenbach, Juergen R. [University Clinics Jena (Germany). Medical Physics Group

    2009-07-01

    The transverse magnetization of a single vein and its surrounding tissue is subject to spin dephasing caused by the local magnetic field inhomogeneity which is induced by the very same vessel. This phenomenon can be approximated and simulated by applying the model of an infinitely long and homogeneously magnetized cylinder embedded in a homogeneous tissue background. It is then possible to estimate the oxygenation level of the venous blood by fitting the simulated magnetization-time-course to the measured signal decay. In this work we demonstrate the ability of this approach to quantify the blood oxygenation level (Y) of small cerebral veins in vivo, not only under normal physiologic conditions (Y{sub native}=0.5-0.55) but also during induced changes of physiologic conditions which affect the cerebral venous blood oxygenation level. Changes of blood's oxygenation level induced by carbogen (5% CO{sub 2}, 95% O{sub 2}) and caffeine were observed and quantified, resulting in values of Y{sub carbogen}=0.7 and Y{sub caffeine}=0.42, respectively. The proposed technique may ultimately help to better understand local changes in cerebral physiology during neuronal activation by quantifying blood oxygenation in veins draining active brain areas. It may also be beneficial in clinical applications where it may improve diagnosis of cerebral pathologies as well as monitoring of responses to therapy. (orig.)

  17. Monitor III

    International Nuclear Information System (INIS)

    Grisham, D.L.; Lambert, J.E.

    1986-01-01

    Monitor III is a totally portable version of the Monitor I and II systems in use at the Clinton P. Anderson Meson Physics Facility (LAMPF) since 1976. The Monitor III system differs from the other systems in that it is capable of operating in any location accessible by truck. Although Monitor III was designed primarily for the handling and disposal of radioactive materials, it is also capable of performing the more sophisticated operations normally performed by the other Monitor systems. The development and operational capabilities of the Monitor remote handling system have been thoroughly reported since 1978. This paper reports on the commissioning of a new system with unique capabilities

  18. Early Aspects: Aspect-Oriented Requirements Engineering and Architecture Design

    NARCIS (Netherlands)

    Tekinerdogan, B.; Moreira, Ana; Araújo, João; Clements, Paul

    2004-01-01

    This paper reports on the third Early Aspects: Aspect-Oriented Requirements Engineering and Architecture Design Workshop, which has been held in Lancaster, UK, on March 21, 2004. The workshop included a presentation session and working sessions in which the particular topics on early aspects were

  19. Capabilities of perfusion ASPECTS in predicting the efficiency of intravenous thrombolytic therapy

    Directory of Open Access Journals (Sweden)

    A. A. Kulesh

    2017-01-01

    Full Text Available Perfusion computed tomography (PCT is increasingly used to diagnose ischemic stroke (IS, as well as to identify candidates for thrombolytic therapy (TLT. The feasibility of using this technique in all patients within the therapeutic window has not yet been established. Objective: to investigate cerebral blood flow according to PCT findings and its relationship to clinical and instrumental indicators and functional status of patients who had received TLT in the acute period of IS.Patients and methods. 62 patients with acute IS who had received TLT were examined. All the patients underwent clinical, laboratory, and instrumental examinations and PCT, by assessing cerebral blood volume (CBV, cerebral blood flow (CBF, and mean transit time (MTT in 10 brain regions in accordance with the Alberta Score Program Early CT Score (ASPECTS. The total result of perfusion ASPECTS was calculated separately for CBV, CBF and MTT, as well as combinations of these parameters. The penumbra size was calculated as CBV minus MTT (CBV - MTT ASPECTS, the infarct core size was measured as CBV + MTT ASPECTS.Results. There was an increase in MTT in most regions of interest of the affected hemisphere as compared to the intact one and a predominance of reversible perfusion disorders. The averaged penumbra size constituted three zones according to ASPECTS. No relationship was found between ASPECTS scores and time after the onset of symptoms prior to hospital admission. Perfusion parameters, particularly penumbra size (CBV - MTT, were associated with the degree of stenosis in the contralateral common carotid artery, body mass index, and blood triglyceride level. Cerebral blood flow indices were also influenced by red blood cell counts and heart ejection fraction. The scores of the perfusion scales were correlated with those of the non-contrast scale. The data of the investigated ASPECTS variants correlated with the level of neurological deficit in patients, its course, and the

  20. MACROECONOMIC ASPECTS OF COMPETITIVENESS

    Directory of Open Access Journals (Sweden)

    Oleg Hooke

    2017-09-01

    Full Text Available In the process of globalization of world economic processes, the role of individual national economies increases, comparative advantages of the development of a country are formed, and their competitiveness is ensured. That is why it is worth emphasizing the importance of increasing the competitiveness of each individual country, based on its internal capacity. In a broad aspect, the competitiveness of the national economy is perceived as the ability of the country to ensure the balance of its external proportions and to avoid those constraints imposed by the foreign economic sphere, to self-organizing the improvement of their world economic ties. The competitiveness of the economy at the macro level is associated with the duration of the cycle of reproduction of the main productive assets and, accordingly, the jobs, productive forces of society and determined by the overall economic efficiency of investment. The criteria of competitiveness of the national economy are the growth of social productivity of labor, increase of social and economic efficiency of production and standard of living of the population. The competitiveness of the national economy determines sustainable socio-economic development of the country, as well as sustainable development predetermines the competitiveness of not only the country, but also all its levels. Scientific results are obtained using special methods of research of economic objects and phenomena, that is, based on the correlation and regressive, comparative analysis (establishing the relationship between the indicator factor, as well as economic modeling. Findings. Generalizing analysis and the importance of the macroeconomic aspect of competitiveness were used in the research paper, which will allow to better respond to the economic situation, in accordance with the trends of the “green” transformation of the economy; which in turn will solve important problems of the development and implementation of its