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Sample records for cerebral oximetry values

  1. Cerebral Oximetry in Cardiac Surgery

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    A. N. Shepelyuk

    2012-01-01

    Full Text Available Based on the data of numerous current references, the review describes different neuromonitoring methods during cardiac surgery under extracorporeal circulation. It shows that it is important and necessary to make neuromonitoring for the early diagnosis and prevention of neurological complications after cardiac surgery. Particular attention is given to cerebral oximetry; the possibilities and advantages of this technique are described. Correction of cerebral oximetric values is shown to improve survival rates and to reduce the incidence of postoperative complications. Lack of cerebral oximetry monitoring denudes a clinician of important information and possibilities to optimize patient status and to prevent potentially menacing complications, which allows one to conclude that it is necessary to use cerebral oximetry procedures within neu-romonitoring in cardiac surgery. Key words: extracorporeal circulation, cerebral oximetry, neurological dysfunction, cerebral oxygenation.

  2. Cerebral oximetry in preterm infants

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    Greisen, Gorm; Andresen, Bjørn; Plomgaard, Anne Mette

    2016-01-01

    Preterm birth constitutes a major cause of death before 5 years of age and it is a major cause of neurodevelopmental impairment across the world. Preterm infants are most unstable during the transition between fetal and newborn life during the first days of life and most brain damage occurs...... in this period. The brain of the preterm infant is accessible for tissue oximetry by near-infrared spectroscopy. Cerebral oximetry has the potential to improve the long-term outcome by helping to tailor the support of respiration and circulation to the individual infant's needs, but the evidence is still lacking....... The goals for research include testing the benefit and harms of cerebral oximetry in large-scale randomized trials, improved definition of the hypoxic threshold, better understanding the effects of intensive care on cerebral oxygenation, as well as improved precision of oximeters and calibration among...

  3. Baseline cerebral oximetry values depend on non-modifiable patient characteristics.

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    Valencia, Lucía; Rodríguez-Pérez, Aurelio; Ojeda, Nazario; Santana, Romen Yone; Morales, Laura; Padrón, Oto

    2015-12-01

    The aim of the present study was to evaluate baseline regional cerebral oxygen saturation (rSO2) values and identify factors influencing preoperative rSO2 in elective minor surgery. Observational analysis post-hoc. Observational post-hoc analysis of data for the patient sample (n=50) of a previously conducted clinical trial in patients undergoing tumourectomy for breast cancer or inguinal hernia repair. Exclusion criteria included pre-existing cerebrovascular diseases, anaemia, baseline pulse oximetry values were recorded while the patient breathed room air, using the INVOS 5100C monitor™ (Covidien, Dublin, Ireland). Thirty-seven women (72%) and 13 men (28%) 48 ± 13 years of age were enrolled in this study. Baseline rSO2 was 62.01 ± 10.38%. Baseline rSO2 was significantly different between men (67.6 ± 11.2%) and women (60 ± 9.4%), (P=0.023). There were also differences between baseline rSO2 and ASA physical status (ASA I: 67.6 ± 10.7%, ASA II: 61.6 ± 8.4%, ASA III: 55.8 ± 13.9%, P=0.045). Baseline rSO2 had a positive correlation with body weight (r=0.347, P=0.014) and height (r=0.345, P=0.014). We also found significant differences in baseline rSO2 among patients with and without chronic renal failure (P=0.005). No differences were found in any other studied variables. Non-modifiable patient characteristics (ASA physical status, sex, chronic renal failure, body weight and height) influence baseline rSO2. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  4. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

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    Hyttel-Sorensen, 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...

  5. The evaluation of cerebral oxygenation by oximetry in patients with ischaemic stroke.

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    Demet G

    2000-04-01

    Full Text Available AIMS: To evaluate the clinical significance of estimation of the regional cerebral oxygen saturation (rSO2 in the patients with ischaemic stroke by the cerebral oximetry during acute, sub-acute and chronic phases. SUBJECTS AND METHODS: In this prospective study, 24 patients with ischaemic stroke in the middle cerebral artery territory were included. A detailed clinical examination and appropriate laboratory investigations were carried out. The rSO2 was determined by oximetery (INVOS 3100-SD bilaterally on the first, third, seventh, and fifteenth days. The blood pressure, the peripheral capillary oxygen saturation and the arterial blood gas values were noted too. the changes were evaluated along with Glasgow coma scale (GCS using unpaired student t-test and one way ANOVA test. RESULTS: There were significant differences between the rSO2 values in acute, subacute and chronic phases on the side of the lesion (p value < 0.05. The values of oxygen saturation gradually increased throughout the chronic phase. These values showed a positive correlation with GCS, but the results were not significant statistically. The rSO2 values were also significantly higher on the non-lesional side than those on the lesion side in the acute phase (p= 0.0034, the discrepancy disappeared during the sub-acute and chronic phases. CONCLUSION: Cerebral oximetry can be used as a measure to evaluate the cerebral oxygenation during the various phases of ischaemic stroke. It has a potential to serve as a useful marker for detection of cerebral oxygenation imbalances, to judge the effectiveness of the management and for the follow-up of patients with ischaemic stroke.

  6. Clinical use of cerebral oximetry in extremely preterm infants is feasible

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    Hyttel-Sørensen, Simon; Austin, Topun; van Bel, Frank

    2013-01-01

    The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS...

  7. Clinical use of cerebral oximetry in extremely preterm infants is feasible

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Austin, Topun; van Bel, Frank

    2013-01-01

    The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS oxi...

  8. 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

  9. Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management.

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    Sarıtaş, Aykut; Çinleti, Burcu Acar; Zincircioğlu, Çiler; Uzun, Uğur; Köse, Işıl; Şenoğlu, Nimet

    2018-04-09

    The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA. This study was performed on surviving adult comatose patients after CA treated with TTM. The average scores of rSO 2 was measured at 6h intervals for the first 2days and once a day for the following 3days with a NIRS device during TTM. The CPC scale was used to define the neurologic outcomes of patients. We compared the correlations of rSO 2 values between good (CPC 1-2) and poor (CPC 3-5) neurologic outcomes in CA patients. There was no statistically significant difference identified between the prognosis groups in terms of rSO 2 , CPR durations, hemoglobin values and admission body temperature (p>0.05). When the variation in rSO 2 values over time is investigated, though there was no significant difference between the good and poor prognosis groups, it appeared to fall in the first 6h in both prognosis groups. The median NT-proBNP and lactate values were observed to be higher in the poor prognosis group. There is no significant correlation between rSO 2 values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area. Copyright © 2018. Published by Elsevier Inc.

  10. Regional Cerebral Oximetry During Cardiopulmonary Resuscitation: Useful or Useless?

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    Genbrugge, Cornelia; Dens, Jo; Meex, Ingrid; Boer, Willem; Eertmans, Ward; Sabbe, Marc; Jans, Frank; De Deyne, Cathy

    2016-01-01

    Approximately 375,000 people annually experience sudden cardiac arrest (CA) in Europe. Most patients who survive the initial hours and days after CA die of postanoxic brain damage. Current monitors, such as electrocardiography and end-tidal capnography, provide only indirect information about the condition of the brain during cardiopulmonary resuscitation (CPR). In contrast, cerebral near-infrared spectroscopy provides continuous, noninvasive, real-time information about brain oxygenation without the need for a pulsatile blood flow. It measures transcutaneous cerebral tissue oxygen saturation (rSO2). This information could supplement currently used monitors. Moreover, an evolution in rSO2 monitoring technology has made it easier to assess rSO2 in CA conditions. We give an overview of the literature regarding rSO2 measurements during CPR and the current commercially available devices. We highlight the feasibility of cerebral saturation measurement during CPR, its role as a quality parameter of CPR, predictor of return of spontaneous circulation (ROSC) and neurologic outcome, and its monitoring function during transport. rSO2 is feasible in the setting of CA and has the potential to measure the quality of CPR, predict ROSC and neurologic outcome, and monitor post-CA patients during transport. The literature shows that rSO2 has the potential to serve multiple roles as a neuromonitoring tool during CPR and also to guide neuroprotective therapeutic strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Cerebral Oxygenation of the Cortex and Striatum following Normobaric Hyperoxia and Mild Hypoxia in Rats by EPR Oximetry using Multi-Probe Implantable Resonators

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    Hou, Huagang; Li, Hongbin; Dong, Ruhong; Mupparaju, Sriram; Khan, Nadeem; Swartz, Harold

    2013-01-01

    Multi-site electron paramagnetic resonance (EPR) oximetry, using multi-probe implantable resonators, was used to measure the partial pressure of oxygen (pO2) in the brains of rats following normobaric hyperoxia and mild hypoxia. The cerebral tissue pO2 was measured simultaneously in the cerebral cortex and striatum in the same rats before, during, and after normobaric hyperoxia and mild hypoxia challenges. The baseline mean tissue pO2 values (±SE) were not significantly different between the cortex and striatum. During 30 min of 100% O2 inhalation, a statistically significant increase in tissue pO2 of all four sites was observed, however, the tissue pO2 of the striatum area was significantly higher than in the forelimb area of the cortex. Brain pO2 significantly decreased from the baseline value during 15 min of 15% O2 challenge. No differences in the recovery of the cerebral cortex and striatum pO2 were observed when the rats were allowed to breathe 30% O2. It appears that EPR oximetry using implantable resonators can provide information on pO2 under the experimental conditions needed for such a study. The levels of pO2 that occurred in these experiments are readily resolvable by multi-site EPR oximetry with multi-probe resonators. In addition, the ability to simultaneously measure the pO2 in several areas of the brain provides important information that could potentially help differentiate the pO2 changes that can occur due to global or local mechanisms. PMID:21445770

  12. Predicting blood transfusion using automated analysis of pulse oximetry signals and laboratory values.

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    Shackelford, Stacy; Yang, Shiming; Hu, Peter; Miller, Catriona; Anazodo, Amechi; Galvagno, Samuel; Wang, Yulei; Hartsky, Lauren; Fang, Raymond; Mackenzie, Colin

    2015-10-01

    Identification of hemorrhaging trauma patients and prediction of blood transfusion needs in near real time will expedite care of the critically injured. We hypothesized that automated analysis of pulse oximetry signals in combination with laboratory values and vital signs obtained at the time of triage would predict the need for blood transfusion with accuracy greater than that of triage vital signs or pulse oximetry analysis alone. Continuous pulse oximetry signals were recorded for directly admitted trauma patients with abnormal prehospital shock index (heart rate [HR] / systolic blood pressure) of 0.62 or greater. Predictions of blood transfusion within 24 hours were compared using Delong's method for area under the receiver operating characteristic (AUROC) curves to determine the optimal combination of triage vital signs (prehospital HR + systolic blood pressure), pulse oximetry features (40 waveform features, O2 saturation, HR), and laboratory values (hematocrit, electrolytes, bicarbonate, prothrombin time, international normalization ratio, lactate) in multivariate logistic regression models. We enrolled 1,191 patients; 339 were excluded because of incomplete data; 40 received blood within 3 hours; and 14 received massive transfusion. Triage vital signs predicted need for transfusion within 3 hours (AUROC, 0.59) and massive transfusion (AUROC, 0.70). Pulse oximetry for 15 minutes predicted transfusion more accurately than triage vital signs for both time frames (3-hour AUROC, 0.74; p = 0.004) (massive transfusion AUROC, 0.88; p transfusion prediction (3-hour AUROC, 0.84; p transfusion AUROC, 0.91; p blood transfusion during trauma resuscitation more accurately than triage vital signs or pulse oximetry analysis alone. Results suggest automated calculations from a noninvasive vital sign monitor interfaced with a point-of-care laboratory device may support clinical decisions by recognizing patients with hemorrhage sufficient to need transfusion. Epidemiologic

  13. Prognostic value of nocturnal pulse oximetry in patients with heart failure.

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    Rivera-López, Ricardo; Jordán-Martínez, Laura; López-Fernández, Silvia; Rivera-Fernandez, Ricardo; Tercedor, Luis; Sáez-Roca, Germán

    2018-05-23

    To analyze the prognostic value of nocturnal hypoxemia measured with portable nocturnal pulse-oximetry in patients hospitalized due to heart failure and its relation to mortality and hospital readmission. We included 38 patients who were admitted consecutively to our unit with the diagnosis of decompensated heart failure. Pulse-oximetry was considered positive for hypoxemia when more than 10 desaturations per hour were recorded during sleep. Follow-up was performed for 30.3 (standard deviation [SD] 14.2) months, the main objective being a combined endpoint of all-cause mortality and hospital readmission due to heart failure. The average age was 70.7 (SD 10.7) years, 63.3% were males. Pulse-oximetry was considered positive for hypoxemia in 27 (71%) patients. Patients with positive pulse-oximetry had the most frequent endpoint (9.1% [1] vs. 61.5% [16], P = 0.003). After multivariate analysis, continuous nocturnal hypoxemia was related to the combined endpoint (HR = 8.37, 1.19-68.4, P = 0.03). Patients hospitalized for heart failure and nocturnal hypoxemia measured with portable pulse-oximeter have an increased risk of hospital readmission and death. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Forbidden word entropy of cerebral oximetric values predicts postoperative neurocognitive decline in patients undergoing aortic arch surgery under deep hypothermic circulatory arrest

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    Anna Dubovoy

    2017-01-01

    Full Text Available Purpose: Up to 53% of cardiac surgery patients experience postoperative neurocognitive decline. Cerebral oximetry is designed to detect changes in cerebral tissue saturation and therefore may be useful to predict which patients are at risk of developing neurocognitive decline. Methods: This is a retrospective analysis of a prospective study originally designed to determine if treatment of cerebral oximetry desaturation is associated with improvement in postoperative cognitive dysfunction in patients undergoing aortic reconstruction under deep hypothermic circulatory arrest. Cognitive function was measured, preoperatively and 3 months postoperatively, with 15 neuropsychologic tests administered by a psychologist; the individual test scores were summed and normalized. Bilateral cerebral oximetry data were stored and analyzed using measures of entropy. Cognitive decline was defined as any decrease in the summed normalized score from baseline to 3 months. Results: Seven of 17 (41% patients suffered cognitive decline. There was no association between baseline cerebral oximetry and postoperative cognitive dysfunction. Nor were changes in oximetry values associated with cognitive decline. However, cognitive decline was associated with loss of forbidden word entropy (FwEn (correlation: Rho ρ = 0.51, P = 0.037 for left cerebral oximetry FwEn and ρ = 0.54, P = 0.025 for right cerebral oximetry FwEn. Conclusion: Postoperative cognitive decline was associated with loss of complexity of the time series as shown by a decrease in FwEn from beginning to end of the case. This suggests that regulation of cerebral oximetry is different between those who do and those who do not develop cognitive decline.

  15. Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants.

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    Banerjee, J; Leung, T S; Aladangady, N

    2016-06-01

    Preterm infants frequently receive blood transfusion (BT) and the aim of this study was to measure the effect of BT on cerebral blood flow and oxygenation in preterm infants in relation to chronological age. Preterm infants undergoing intensive care recruited to three chronological age groups: 1 to 7 (Group 1; n=20), 8 to 28 (Group 2; n=21) & ≥29days of life (Group 3; n=18). Pre and post-BT anterior cerebral artery (ACA) time averaged mean velocity (TAMV) and superior vena cava (SVC) flow were measured. Cerebral Tissue Haemoglobin Index (cTHI) and Oxygenation Index (cTOI) were measured from 15-20min before to 15-20min post-BT using NIRS. Vital parameters and blood pressure were measured continuously. Mean BP increased significantly, and there was no significant change in vital parameters following BT. Pre-BT ACA TAMV was higher in Group 2 and 3 compared to Group 1 (pBlood transfusion increased cTOI and cTHI and decreased ACA TAMV in all groups. PDA had no impact on the baseline cerebral oximetry and blood flow as well as changes following blood transfusion. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Cerebral oximetry during preoperative resuscitation in elderly patients with hip fracture

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    Clemmesen, C G; Pedersen, L M; Hougaard, S

    2018-01-01

    This study explores the association between postadmission and intraoperative cerebral oxygenation (ScO2), reflecting systemic perfusion, and postoperative mortality and delirium. Forty elderly (age > 65 years) patients with hip fractures were included in this prospective observational study. The ...

  17. Comparison of oxygen saturation values and measurement times by pulse oximetry in various parts of the body.

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    Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Khorshid, Leyla

    2011-11-01

    The aim of this study, which included 40 patients, was to compare the values pulse oximetry and the measurement times in various regions of the body. Data were analyzed using intraclass correlation coefficient test and paired-sample test. The confidence power value was found to be .81 for the comparison of oxygen saturation values by arterial blood gas analysis and measurement by the forehead probe. It was found that the time for oxygen saturation measurement using the forehead probe was shorter than those using the finger and toe probes. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Transcutaneous oximetry measurements of the leg: comparing different measuring equipment and establishing values in healthy young adults.

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    Trinks, Tobias P; Blake, Denise F; Young, Derelle A; Thistlethwaite, Ken; Vangaveti, Venkat N

    2017-06-01

    Transcutaneous oximetry measurement (TCOM) is a non-invasive method of determining oxygen tension at the skin level using heated electrodes. To compare TCOM values generated by different machines and to establish lower limb TCOM values in a cohort of healthy individuals younger than 40 years of age. Sixteen healthy, non-smoking volunteers aged 18 to 39 years were recruited. TCOM was obtained at six locations on the lower leg and foot using three different Radiometer machines. Measurements were taken with subjects lying supine, breathing air. Except for one sensor site, there were no statistical differences in measurements obtained by the different TCOM machines. There was no statistical difference in measurements comparing left and right legs. Room air TCOM values for the different lower leg sites were (mean (SD) in mmHg): lateral leg 61.5 (9.2); lateral ankle 61.1 (9.7); medial ankle 59.1 (10.8); foot, first and second toe 63.4 (10.6); foot, fifth toe 59.9 (13.2) and plantar foot 74.1 (8.8). The overall mean TCOM value for the lower limb was 61 (10.8; 95% confidence intervals 60.05-62.0) mmHg. Lower-leg TCOM measurements using different Radiometer TCOM machines were comparable. Hypoxia has been defined as lower-leg TCOM values of less than 40 mmHg in non-diabetic patients and this is supported by our measurements. The majority (96.9%) of the lower leg TCOM values in healthy young adults are above the hypoxic threshold.

  19. Optical characterization of two-layered turbid media for non-invasive, absolute oximetry in cerebral and extracerebral tissue.

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    Bertan Hallacoglu

    Full Text Available We introduce a multi-distance, frequency-domain, near-infrared spectroscopy (NIRS method to measure the optical coefficients of two-layered media and the thickness of the top layer from diffuse reflectance measurements. This method features a direct solution based on diffusion theory and an inversion procedure based on the Levenberg-Marquardt algorithm. We have validated our method through Monte Carlo simulations, experiments on tissue-like phantoms, and measurements on the forehead of three human subjects. The Monte Carlo simulations and phantom measurements have shown that, in ideal two-layered samples, our method accurately recovers the top layer thickness (L, the absorption coefficient (µ a and the reduced scattering coefficient (µ' s of both layers with deviations that are typically less than 10% for all parameters. Our method is aimed at absolute measurements of hemoglobin concentration and saturation in cerebral and extracerebral tissue of adult human subjects, where the top layer (layer 1 represents extracerebral tissue (scalp, skull, dura mater, subarachnoid space, etc. and the bottom layer (layer 2 represents cerebral tissue. Human subject measurements have shown a significantly greater total hemoglobin concentration in cerebral tissue (82±14 µM with respect to extracerebral tissue (30±7 µM. By contrast, there was no significant difference between the hemoglobin saturation measured in cerebral tissue (56%±10% and extracerebral tissue (62%±6%. To our knowledge, this is the first time that an inversion procedure in the frequency domain with six unknown parameters with no other prior knowledge is used for the retrieval of the optical coefficients and top layer thickness with high accuracy on two-layered media. Our absolute measurements of cerebral hemoglobin concentration and saturation are based on the discrimination of extracerebral and cerebral tissue layers, and they can enhance the impact of NIRS for cerebral hemodynamics and

  20. [Value of transcutaneous staged dynamic oximetry of stage II arteritis of the leg].

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    Grard, C; Desmytterre, J; Vinckier, L; Hatron, P Y; Roux, J P; Warembourg, H; Devulder, B

    1990-03-01

    The clinical and prognostic value of transcutaneous oxygen pressure measurements at rest has been established in Leriche Stage III and IV occlusive peripheral arterial disease but is controversial in Stage II because there is an overlap of transcutaneous pO2 (Tc pO2) values with those of normal subjects. The authors report the results of Tc pO2 measurements during exercise testing in a group of patients with Stage II occlusive arterial disease of the lower limbs. Seventy-eight patients with an average age of 53 years (range 40 to 65 years) whose claudication perimeter and site of pain had been carefully assessed and who had also recently undergone Doppler arterial examination and arteriography and 35 control subjects with an average age of 54 years (range 45 to 70 years) were studied. The Tc pO2 was continuously measured with a multimodular Kontron Supermon at 4 different sites simultaneously: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot Tc pO2/precordial Tc pO2 X 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. The RTO in normal subjects remained at the upper limits of the resting value throughout exercise and then returned slowly to basal values during the recovery phase.(ABSTRACT TRUNCATED AT 250 WORDS)

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

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

    2018-05-01

    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.

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

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    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

  3. Pulse oximetry: fundamentals and technology update

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    Nitzan M

    2014-07-01

    Full Text Available Meir Nitzan,1 Ayal Romem,2 Robert Koppel31Department of Physics/Electro-Optics, Jerusalem College of Technology, Jerusalem, Israel; 2Pulmonary Institute, Shaare Zedek Medical Center, Jerusalem, Israel; 3Neonatal/Perinatal Medicine, Cohen Children's Medical Center of New York/North Shore-LIJ Health System, New Hyde Park, NY, United StatesAbstract: Oxygen saturation in the arterial blood (SaO2 provides information on the adequacy of respiratory function. SaO2 can be assessed noninvasively by pulse oximetry, which is based on photoplethysmographic pulses in two wavelengths, generally in the red and infrared regions. The calibration of the measured photoplethysmographic signals is performed empirically for each type of commercial pulse-oximeter sensor, utilizing in vitro measurement of SaO2 in extracted arterial blood by means of co-oximetry. Due to the discrepancy between the measurement of SaO2 by pulse oximetry and the invasive technique, the former is denoted as SpO2. Manufacturers of pulse oximeters generally claim an accuracy of 2%, evaluated by the standard deviation (SD of the differences between SpO2 and SaO2, measured simultaneously in healthy subjects. However, an SD of 2% reflects an expected error of 4% (two SDs or more in 5% of the examinations, which is in accordance with an error of 3%–4%, reported in clinical studies. This level of accuracy is sufficient for the detection of a significant decline in respiratory function in patients, and pulse oximetry has been accepted as a reliable technique for that purpose. The accuracy of SpO2 measurement is insufficient in several situations, such as critically ill patients receiving supplemental oxygen, and can be hazardous if it leads to elevated values of oxygen partial pressure in blood. In particular, preterm newborns are vulnerable to retinopathy of prematurity induced by high oxygen concentration in the blood. The low accuracy of SpO2 measurement in critically ill patients and newborns

  4. Influence of Ventilation Strategies and Anesthetic Techniques on Regional Cerebral Oximetry in the Beach Chair Position: A Prospective Interventional Study with a Randomized Comparison of Two Anesthetics.

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    Picton, Paul; Dering, Andrew; Alexander, Amir; Neff, Mary; Miller, Bruce S; Shanks, Amy; Housey, Michelle; Mashour, George A

    2015-10-01

    Beach chair positioning during general anesthesia is associated with cerebral oxygen desaturation. Changes in cerebral oxygenation resulting from the interaction of inspired oxygen fraction (FIO2), end-tidal carbon dioxide (PETCO2), and anesthetic choice have not been fully evaluated in anesthetized patients in the beach chair position. This is a prospective interventional within-group study of patients undergoing shoulder surgery in the beach chair position that incorporated a randomized comparison between two anesthetics. Fifty-six patients were randomized to receive desflurane or total intravenous anesthesia with propofol. Following induction of anesthesia and positioning, FIO2 and minute ventilation were sequentially adjusted for all patients. Regional cerebral oxygenation (rSO2) was the primary outcome and was recorded at each of five set points. While maintaining FIO2 at 0.3 and PETCO2 at 30 mmHg, there was a decrease in rSO2 from 68% (SD, 12) to 61% (SD, 12) (P positioning. The combined interventions of increasing FIO2 to 1.0 and increasing PETCO2 to 45 mmHg resulted in a 14% point improvement in rSO2 to 75% (SD, 12) (P position. There was no significant interaction effect of the anesthetic at the study intervention points. Increasing FIO2 and PETCO2 resulted in a significant increase in rSO2 that overcomes desaturation in patients anesthetized in the beach chair position and that appears independent of anesthetic choice.

  5. Pulse oximetry in bronchiolitis: is it needed?

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    Hendaus MA

    2015-10-01

    Full Text Available Mohamed A Hendaus,1,2 Fatima A Jomha,3 Ahmed H Alhammadi,1,2 1Department of Pediatrics, General Pediatrics Division, Hamad Medical Corporation, 2Weill-Cornell Medical College, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon Abstract: Infants admitted to health-care centers with acute bronchiolitis are frequently monitored with a pulse oximeter, a noninvasive method commonly used for measuring oxygen saturation. The decision to hospitalize children with bronchiolitis has been largely influenced by pulse oximetry, despite its questionable diagnostic value in delineating the severity of the illness. Many health-care providers lack the appropriate clinical fundamentals and limitations of pulse oximetry. This deficiency in knowledge might have been linked to changes in the management of bronchiolitis. The aim of this paper is to provide the current evidence on the role of pulse oximetry in bronchiolitis. We discuss the history, fundamentals of operation, and limitations of the apparatus. A search of the Google Scholar, Embase, Medline, and PubMed databases was carried out for published articles covering the use of pulse oximetry in bronchiolitis. Keywords: bronchiolitis, children, monitor, oxygen

  6. The value of computed tomography in cerebral syphilis

    International Nuclear Information System (INIS)

    Godt, P.; Stoeppler, L.; Wischer, U.; Schroeder, H.H.

    1979-01-01

    The computed tomographic findings of three patients with cerebral syphilis, including cerebral gumma, which regressed completely under penicillin therapy, syphilitic angiitis with cerebral infarction, and syphilitic cerebral atrophy, are reported CT is unable to provide specific diagnostic data for these conditions. The etiology can be clarified only by taking into consideration the clinical findings and course, the serological results, and the result of therapy. (orig.) [de

  7. Performance evaluation of photoacoustic oximetry imaging systems using a dynamic blood flow phantom with tunable oxygen saturation

    Science.gov (United States)

    Vogt, William C.; Zhou, Xuewen; Andriani, Rudy; Wear, Keith A.; Garra, Brian S.; Pfefer, Joshua

    2018-02-01

    Photoacoustic Imaging (PAI) is an emerging technology with strong potential for broad clinical applications from breast cancer detection to cerebral monitoring due to its ability to compute maps of blood oxygen saturation (SO2) distribution in deep tissues using multispectral imaging. However, no well-validated consensus test methods currently exist for evaluating oximetry-specific performance characteristics of PAI devices. We have developed a phantombased flow system capable of rapid SO2 adjustment to serve as a test bed for elucidation of factors impacting SO2 measurement and quantitative characterization of device performance. The flow system is comprised of a peristaltic pump, membrane oxygenator, oxygen and nitrogen gas, and in-line oxygen, pH, and temperature sensors that enable real-time estimation of SO2 reference values. Bovine blood was delivered through breast-relevant tissue phantoms containing vessel-mimicking fluid channels, which were imaged using a custom multispectral PAI system. Blood was periodically drawn for SO2 measurement in a clinical-grade CO-oximeter. We used this flow phantom system to evaluate the impact of device parameters (e.g.,wavelength-dependent fluence corrections) and tissue parameters (e.g. fluid channel depth, blood SO2, spectral coloring artifacts) on oximetry measurement accuracy. Results elucidated key challenges in PAI oximetry and device design trade-offs, which subsequently allowed for optimization of system performance. This approach provides a robust benchtop test platform that can support PAI oximetry device optimization, performance validation, and clinical translation, and may inform future development of consensus test methods for performance assessment of photoacoustic oximetry imaging systems.

  8. Spectrophotometric retinal oximetry in pigs

    DEFF Research Database (Denmark)

    Traustason, Sindri; Kiilgaard, Jens Folke; Karlsson, Robert

    2013-01-01

    PURPOSE: To assess the validity of spectrophotometric retinal oximetry, by comparison to blood gas analysis and intra-vitreal measurements of partial pressure of oxygen (pO2). METHODS: Female domestic pigs were used for all experiments (n=8). Oxygen fraction in inspired air was changed using...... a mixture of room air, pure oxygen and pure nitrogen, ranging from 5% to 100% oxygen. Femoral arterial blood gas analysis and retinal oximetry was performed at each level of inspiratory oxygen fraction. Retinal oximetry was performed using a commercial instrument, the Oxymap Retinal Oximeter T1 (Oxymap ehf...... arterial oxygen saturation and the optical density ratio over retinal arteries revealed an approximately linear relationship (R(2) = 0.74, p = 3.4 x 10(-9)). In order to test the validity of applying the arterial calibration to veins, we compared non-invasive oximetry measurements to invasive pO2...

  9. In vivo electron paramagnetic resonance oximetry and applications in the brain

    Directory of Open Access Journals (Sweden)

    John M Weaver

    2017-01-01

    Full Text Available Molecular oxygen (O2 is essential to brain function and mechanisms necessary to regulate variations in delivery or utilization of O2 are crucial to support normal brain homeostasis, physiology and energy metabolism. Any imbalance in cerebral tissue partial pressure of O2 (pO2 levels may lead to pathophysiological complications including increased reactive O2 species generation leading to oxidative stress when tissue O2 level is too high or too low. Accordingly, the need for oximetry methods, which assess cerebral pO2 in vivo and in real time, is imperative to understand the role of O2 in various metabolic and disease states, including the effects of treatment and therapy options. In this review, we provide a brief overview of the common in vivo oximetry methodologies for measuring cerebral pO2 . We discuss the advantages and limitations of oximetry methodologies to measure cerebral pO2 in vivo followed by a more in-depth review of electron paramagnetic resonance oximetry spectroscopy and imaging using several examples of current electron paramagnetic resonance oximetry applications in the brain.

  10. Value of three-dimensional computed tomography in screening cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Tamaki; Sugiura, Yusuke; Suzuki, Atsushi; Yamagata, Yoshitaka [Hyogo Medical Coll. (Japan)

    1997-10-01

    We performed three-dimensional computed tomography (3D-CT) in 6 patients of cerebral aneurysm. Prior cerebral angiography showed a total of 17 aneurysms. 3D-CT alone detected 10 cerebral aneurysm (59%). It was possible to identify aneurysms larger than 10 mm even when located near the circle of Willis. It was difficult to identify aneurysms when smaller than 7 mm regardless of their location. 3D-CT was of limited value in detecting cerebral aneurysms, particularly when located near the circle of Willis with complex vascular network. As cases of oculomotor palsy may be caused by lesions other than cerebral aneurysm, we advocate that 3D-CT be performed after magnetic resonance imaging (MRI) in screening cases of suspected cerebral aneurysm. (author)

  11. Diagnostic value of dynamic CT in early cerebral infarct

    International Nuclear Information System (INIS)

    Huang, K.-M.; Shih, T.T.F.

    1989-01-01

    The authors have tried to demonstrate early cerebral infarct by dynamic CT scanning without any CT change. They also have tried to find a correlation between the clinical outcome and the hemodynamic change of the damaged brain tissue supplied by the occluded vessels. (author) 14 refs.; 3 figs

  12. 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.

  13. 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

  14. Interleaving cerebral CT perfusion with neck CT angiography. Pt. I. Proof of concept and accuracy of cerebral perfusion values

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Marcel T.H.; Meijer, Frederick J.A.; Woude, Willem-Jan van der; Smit, Ewoud J.; Ginneken, Bram van; Prokop, Mathias; Manniesing, Rashindra [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 9101, Nijmegen (Netherlands)

    2017-06-15

    We present a novel One-Step-Stroke protocol for wide-detector CT scanners that interleaves cerebral CTP with volumetric neck CTA (vCTA). We evaluate whether the resulting time gap in CTP affects the accuracy of CTP values. Cerebral CTP maps were retrospectively obtained from 20 patients with suspicion of acute ischemic stroke and served as the reference standard. To simulate a 4 s gap for interleaving CTP with vCTA, we eliminated one acquisition at various time points of CTP starting from the bolus-arrival-time(BAT). Optimal timing of the vCTA was evaluated. At the time point with least errors, we evaluated elimination of a second time point (6 s gap). Mean absolute percentage errors of all perfusion values remained below 10 % in all patients when eliminating any one time point in the CTP sequence starting from the BAT. Acquiring the vCTA 2 s after reaching a threshold of 70HU resulted in the lowest errors (mean <3.0 %). Eliminating a second time point still resulted in mean errors <3.5 %. CBF/CBV showed no significant differences in perfusion values except MTT. However, the percentage errors were always below 10 % compared to the original protocol. Interleaving cerebral CTP with neck CTA is feasible with minor effects on the perfusion values. (orig.)

  15. Potential value of serial cerebral SPECT scanning in the evaluation of psychiatric illness

    International Nuclear Information System (INIS)

    Notardonato, H.; Gonzalez-Avilez, A.; Van Heertum, R.L.; O'Connell, R.A.; Yudd, A.P.

    1989-01-01

    Cerebral SPECT imaging has the potential to make an important contribution to clinical psychiatry. Cerebral SPECT scanning, stimulated by the work with PET, is readily available and much less expensive than PET. This paper reports a case demonstrating the potential value of cerebral SPECT scanning with I-123 IMP, specifically in the serial evaluation of a schizophrenic patient with auditory hallucinations. The initial scan revealed focal areas of increased uptake in the caudate nuclei of the basal ganglia, and in the right temporal lobe. After pharmacological treatment with clinical improvement, the follow-up SPECT scan demonstrated significant improvement in the distribution of the radiopharmaceutical

  16. Pulse oximetry for perioperative monitoring

    DEFF Research Database (Denmark)

    Pedersen, Tom; Nicholson, Amanda; Hovhannisyan, Karen

    2014-01-01

    or infectious complications were detected in the two groups. The duration of hospital stay was a median of five days in both groups, and equal numbers of in-hospital deaths were reported in the two groups. Continuous pulse oximetry has the potential to increase vigilance and decrease pulmonary complications...

  17. Contrast enhancement of cerebral infarcts. Incidence and clinical value in different states of cerebral infarction

    International Nuclear Information System (INIS)

    Skriver, E.B.; Olsen, T.S.

    1982-01-01

    Information obtained from CT scan after contrast administration was evaluated in 59 consecutive stroke patients. CT scans before and after contrast administration were performed 3 days and 2 1/2 weeks after stroke. A plain CT scan was repeated 6 months later. Contrast enhancement was practically not seen on the first examination, but was seen in 46% on the second examination. There was a close relationship between the occurrence of contrast enhancement and the so called fogging effect. Contrast scanning gave additional information only when this effect was present. Plain CT scans 3 days after stroke were superior to contrast scans taken at any time for detecting and visualizing cerebral infarcts. (orig.)

  18. Clinical value of homodynamic numerical simulation applied in the treatment of cerebral aneurysm.

    Science.gov (United States)

    Zhang, Hailin; Li, Li; Cheng, Chongjie; Sun, Xiaochuan

    2017-12-01

    Our objective was to evaluate the clinical value of numerical simulation in diagnosing cerebral aneurysm based on the analysis of numerical simulation of hemodynamic model. The experimental method used was the numerical model of cerebral aneurysm hemodynamic, and the numerical value of blood flow at each point was analyzed. The results showed that, the wall shear stress (WSS) value on the top of CA1 was significantly lower than that of the top (Pvalue of each point on the CA2 tumor was significantly lower than that of tumor neck (Pvalue on the tumor top and tumor neck between CA1 and CA2 had no significant difference (P>0.05); the unsteady index of shear (UIS) value at the points of 20 had distinctly changed, the wave range was 0.6-1.5; the unsteady index of pressure value of every point was significantly lower than UIS value, the wave range was 0.25-0.40. In conclusion, the application of cerebral aneurysm hemodynamic research can help doctors to diagnose cerebral aneurysm more precisely and to grasp the opportunity of treatment during the formulating of the treatment strategies.

  19. Threshold values of ankle dorsiflexion and gross motor function in 60 children with cerebral palsy

    DEFF Research Database (Denmark)

    Rasmussen, Helle M; Svensson, Joachim; Thorning, Maria

    2018-01-01

    Background and purpose - Threshold values defining 3 categories of passive range of motion are used in the Cerebral Palsy follow-Up Program to guide clinical decisions. The aim of this study was to investigate the threshold values by testing the hypothesis that passive range of motion in ankle...... dorsiflexion is associated with gross motor function and that function differs between the groups of participants in each category. Patients and methods - We analyzed data from 60 ambulatory children (aged 5-9 years) with spastic cerebral palsy. Outcomes were passive range of motion in ankle dorsiflexion...... with flexed and extended knee and gross motor function (Gait Deviation Index, Gait Variable Score of the ankle, peak dorsiflexion during gait, 1-minute walk, Gross Motor Function Measure, the Pediatric Quality of Life Inventory Cerebral Palsy Module, and Pediatric Outcomes Data Collection Instrument). Results...

  20. [transcutaneous oximetry--between theory and practice].

    Science.gov (United States)

    Zulec, Mirna

    2014-10-01

    Transcutaneous oximetry is a procedure used to measure the pressure of oxygen in tissue and to determine oxygenation level. It is essential to determine the state of microcirculation and is used to assess the necessity and level of amputation and the effect of revascularization procedures, as a predictor of wound healing and hyperbaric oxygen therapy (HBOT) effectiveness tool. The measurement is done by the application electrode measuring point and the result is measured in mm Hg. Tissue with adequate oxygen level has a value greater than 50 mm Hg. Values between 20 and 40 mm Hg are considered hypoxic, while those below 20 mm Hg indicate extreme hypoxia. In Croatia, TcPO2 is commonly used for HBOT assessment but there is the need of broader application to objectify and facilitate procedures in the care of persons with impaired microcirculation.

  1. Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, Valentina, E-mail: valentina-izzo@virgilio.it; Meloni, Marco, E-mail: meloni.marco@libero.it [University of Tor Vergata, Department of Systems Medicine (Italy); Fabiano, Sebastiano, E-mail: sebas575@yahoo.it; Morosetti, Daniele, E-mail: danielemorosetti@hotmail.com [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Giurato, Laura, E-mail: lauragiurato@yahoo.it [University of Tor Vergata, Department of Systems Medicine (Italy); Chiaravalloti, Antonio, E-mail: antoniochiaravalloti@hotmail.it [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Ruotolo, Valeria, E-mail: valeriaruotolo@virgilio.it [University of Tor Vergata, Department of Systems Medicine (Italy); Gandini, Roberto, E-mail: roberto.gandini@fastwebnet.it [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Uccioli, Luigi, E-mail: luccioli@yahoo.com [University of Tor Vergata, Department of Systems Medicine (Italy)

    2017-01-15

    PurposeTo demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.MethodsFrom our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.ResultsWe selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.ConclusionWhen a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.

  2. Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel

    International Nuclear Information System (INIS)

    Izzo, Valentina; Meloni, Marco; Fabiano, Sebastiano; Morosetti, Daniele; Giurato, Laura; Chiaravalloti, Antonio; Ruotolo, Valeria; Gandini, Roberto; Uccioli, Luigi

    2017-01-01

    PurposeTo demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.MethodsFrom our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.ResultsWe selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.ConclusionWhen a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.

  3. Cerebral and cerebellar ADC values during a migraine attack

    International Nuclear Information System (INIS)

    Degirmenci, Bumin; Haktanir, Alpay; Albayrak, Ramazan; Acar, Murat; Yaman, Mehmet

    2007-01-01

    We investigated the diffusion-weighted MRI changes, apparent diffusion coefficient (ADC) values, and conventional MRI findings in specific brain areas during migraine attacks in patients with and without aura. Included in the study were 22 patients (2 male, 20 female) aged between 17 and 49 years who were diagnosed as having migraine according to the diagnostic criteria of the International Headache Society. Also included in the study were 18 age- and sex-matched healthy volunteers. Hyperintense lesions were evaluated in conventional MR images. Heavily diffusion-weighted images, ADC maps, and segmented ADC maps generated for regional ADC (rADC) measurements, were also studied. ADC values from specific brain areas were used with appropriate region of interests (ROI). Migraine with aura was diagnosed in 13 patients and migraine without aura was diagnosed in 9 patients. A total of 23 hyperintense lesions within the periventricular white matter and deep white matter were detected in five patients (21.8%). All of these hyperintense lesions were seen in migraine patients with aura. In only one patient did a hyperintense lesion show an increased diffusion pattern on diffusion-weighted images and ADC maps. One hyperintense lesion was detected in the control group (5.5%). There was no significant difference in ADC values between the migraine and control groups. T2-weighted hyperintense lesions were significantly more frequent in migraine patients especially in those with aura than in the control group. No diffusion alterations in diffusion-weighted images were detected in the infra- and supratentorial brain areas during migraine attacks in patients with and without aura. (orig.)

  4. Cerebral and cerebellar ADC values during a migraine attack

    Energy Technology Data Exchange (ETDEWEB)

    Degirmenci, Bumin; Haktanir, Alpay; Albayrak, Ramazan; Acar, Murat [University of Kocatepe, Department of Radiology, Faculty of Medicine, Afyon (Turkey); Yaman, Mehmet [University of Kocatepe, Department of Neurology, Faculty of Medicine, Afyon (Turkey)

    2007-05-15

    We investigated the diffusion-weighted MRI changes, apparent diffusion coefficient (ADC) values, and conventional MRI findings in specific brain areas during migraine attacks in patients with and without aura. Included in the study were 22 patients (2 male, 20 female) aged between 17 and 49 years who were diagnosed as having migraine according to the diagnostic criteria of the International Headache Society. Also included in the study were 18 age- and sex-matched healthy volunteers. Hyperintense lesions were evaluated in conventional MR images. Heavily diffusion-weighted images, ADC maps, and segmented ADC maps generated for regional ADC (rADC) measurements, were also studied. ADC values from specific brain areas were used with appropriate region of interests (ROI). Migraine with aura was diagnosed in 13 patients and migraine without aura was diagnosed in 9 patients. A total of 23 hyperintense lesions within the periventricular white matter and deep white matter were detected in five patients (21.8%). All of these hyperintense lesions were seen in migraine patients with aura. In only one patient did a hyperintense lesion show an increased diffusion pattern on diffusion-weighted images and ADC maps. One hyperintense lesion was detected in the control group (5.5%). There was no significant difference in ADC values between the migraine and control groups. T2-weighted hyperintense lesions were significantly more frequent in migraine patients especially in those with aura than in the control group. No diffusion alterations in diffusion-weighted images were detected in the infra- and supratentorial brain areas during migraine attacks in patients with and without aura. (orig.)

  5. Tissue oximetry: a comparison of mean values of regional tissue saturation, reproducibility and dynamic range of four NIRS-instruments on the human forearm

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Sorensen, Line C; Riera, Joan

    2011-01-01

    We compared absolute values of regional tissue hemoglobin saturation (StO(2)), reproducibility, and dynamic range of four different instruments on the forearm of adults. The sensors were repositioned 10 times on each subject. Dynamic range was estimated by exercise with subsequent arterial occlus...

  6. Oximetry using multispectral imaging: theory and application

    Science.gov (United States)

    MacKenzie, Lewis E.; Harvey, Andrew R.

    2018-06-01

    Multispectral imaging (MSI) is a technique for measurement of blood oxygen saturation in vivo that can be applied using various imaging modalities to provide new insights into physiology and disease development. This tutorial aims to provide a thorough introduction to the theory and application of MSI oximetry for researchers new to the field, whilst also providing detailed information for more experienced researchers. The optical theory underlying two-wavelength oximetry, three-wavelength oximetry, pulse oximetry, and multispectral oximetry algorithms are described in detail. The varied challenges of applying MSI oximetry to in vivo applications are outlined and discussed, covering: the optical properties of blood and tissue, optical paths in blood vessels, tissue auto-fluorescence, oxygen diffusion, and common oximetry artefacts. Essential image processing techniques for MSI are discussed, in particular, image acquisition, image registration strategies, and blood vessel line profile fitting. Calibration and validation strategies for MSI are discussed, including comparison techniques, physiological interventions, and phantoms. The optical principles and unique imaging capabilities of various cutting-edge MSI oximetry techniques are discussed, including photoacoustic imaging, spectroscopic optical coherence tomography, and snapshot MSI.

  7. Reliability of pulse oximetry during cardiopulmonary resuscitation in a piglet model of neonatal cardiac arrest.

    Science.gov (United States)

    Hassan, Mohammad Ahmad; Mendler, Marc; Maurer, Miriam; Waitz, Markus; Huang, Li; Hummler, Helmut D

    2015-01-01

    Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during cardiopulmonary resuscitation (CPR). In a prospective cohort study in 30 healthy newborn piglets, cardiac arrest was induced, and thereafter each piglet received CPR for 20 min. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2). Arterial blood was analyzed for functional oxygenation (SaO2) every 2 min. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%. Bias values were decreased at the baseline measurements (mean: 2.5 ± 4.6%) with higher precision and accuracy compared with values across the experiment. Two minutes after cardiac arrest, there was a marked decrease in precision and accuracy as well as an increase in bias up to 13 ± 34%, reaching a maximum of 45.6 ± 28.3% after 10 min over a mean SaO2 range of 29-58%. Pulse oximetry showed increased bias and decreased accuracy and precision during CPR in a model of neonatal cardiac arrest. We recommend further studies to clarify the exact mechanisms of these false readings to improve reliability of pulse oximetry during the marked desaturation and hypoperfusion found during CPR. © 2014 S. Karger AG, Basel.

  8. Peripheral tissue oximetry

    DEFF Research Database (Denmark)

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

    2014-01-01

    Estimation of regional tissue oxygenation (rStO2) by near infrared spectroscopy enables non-invasive end-organ oxygen balance monitoring and could be a valuable tool in intensive care. However, the diverse absolute values and dynamics of different devices, and overall poor repeatability of measur......Estimation of regional tissue oxygenation (rStO2) by near infrared spectroscopy enables non-invasive end-organ oxygen balance monitoring and could be a valuable tool in intensive care. However, the diverse absolute values and dynamics of different devices, and overall poor repeatability......, and response to changing oxygenation by the down slope of rStO2 during vascular occlusion in the respective arm. 10 healthy adults, 21-29 years old, with double skinfolds on the forearm less than 10 mm participated. The median rStO2 was 70.7% (interquartile range (IQR) 7.7%), 68.4% (IQR 8.4%), and 64.6% (IQR 4...

  9. Optimal filter bandwidth for pulse oximetry

    Science.gov (United States)

    Stuban, Norbert; Niwayama, Masatsugu

    2012-10-01

    Pulse oximeters contain one or more signal filtering stages between the photodiode and microcontroller. These filters are responsible for removing the noise while retaining the useful frequency components of the signal, thus improving the signal-to-noise ratio. The corner frequencies of these filters affect not only the noise level, but also the shape of the pulse signal. Narrow filter bandwidth effectively suppresses the noise; however, at the same time, it distorts the useful signal components by decreasing the harmonic content. In this paper, we investigated the influence of the filter bandwidth on the accuracy of pulse oximeters. We used a pulse oximeter tester device to produce stable, repetitive pulse waves with digitally adjustable R ratio and heart rate. We built a pulse oximeter and attached it to the tester device. The pulse oximeter digitized the current of its photodiode directly, without any analog signal conditioning. We varied the corner frequency of the low-pass filter in the pulse oximeter in the range of 0.66-15 Hz by software. For the tester device, the R ratio was set to R = 1.00, and the R ratio deviation measured by the pulse oximeter was monitored as a function of the corner frequency of the low-pass filter. The results revealed that lowering the corner frequency of the low-pass filter did not decrease the accuracy of the oxygen level measurements. The lowest possible value of the corner frequency of the low-pass filter is the fundamental frequency of the pulse signal. We concluded that the harmonics of the pulse signal do not contribute to the accuracy of pulse oximetry. The results achieved by the pulse oximeter tester were verified by human experiments, performed on five healthy subjects. The results of the human measurements confirmed that filtering out the harmonics of the pulse signal does not degrade the accuracy of pulse oximetry.

  10. The prognostic value of cerebral oxygenation and retrograde pressure during carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    А. А. Карпенко

    2016-08-01

    Full Text Available Aim: The study aimed to determine the predictive value of retrograde pressure (RP indicators and cerebral oxygenation in the evaluation of ischemic brain damage during carotid endarterectomy (CEA.Methods: This nonrandomized, prospective pilot study included 87 patients with asymptomatic stenosis greater than 70% who underwent carotid endarterectomy under general anesthesia. Brain tolerance to ischemia was determined by measuring and evaluating RP (∆rSO2 and cerebral oxygenation (rSO2 during a trial clamping of the carotid artery. Depending on the degree of reduction of cerebral oxygenation from the baseline (∆rSO2 during a trial clamping of the carotid artery, patients were divided into 3 groups: the first group (n = 35 - ∆rSO2 <9.9%, the second group (n = 35 - ∆rSO2 from 10 to 19.9%, the third group (n = 14 - ∆rSO2 ≥ 20%. The primary end-point of the study was to obtain the AUC value exceeding 0.70, which could mean a high predictive quality of research methods. Results: There were no perioperative strokes or myocardial infarctions during the study. Average time of carotid artery clamping was 28 (26-30 minutes. 3 patients who received temporary shunts were excluded from the study because of a simultaneous decrease in the rSO2 and ∆rSO2 indicators. It was found out that S-100 and NSE protein concentration in all groups did not significantly differ at different stages (p> 0.05. A temporary shutdown of blood flow in the carotid artery during CEA is accompanied by significant elevation of cerebral damage markers (S100, NSE concentration with their subsequent restoration at 3 days after surgery. ROC - analysis revealed that none of the methods for assessing cerebral ischemic tolerance (RP, ∆rSO2 and rSO2 is precise enough (AUC > 0.7 to predict brain injury during carotid endarterectomy. Satisfactory, but a poor quality (AUC< 0.7 of predicting an increase in the reference values of S-100 protein neuromarkers was demonstrated by

  11. Clinical reference value of retinal microvascular changes in patients with cerebral microbleeds

    Directory of Open Access Journals (Sweden)

    Ji-Yuan Guo

    2014-12-01

    Full Text Available AIM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds(CMBsand discuss its clinical significance. METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76.3±11.2 years old. For all patients, functions of liver and kidney, blood-lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent(RAE, retinal venular equivalent(RVE, retinal vein diameter ratio(AVRand arteriovenous crossing sign(AVNwere identified, CMBs were classified with cerebral MRI. All the data were processed by SPSS statistical software. RESULTS: The central retinal arteriolar equivalent(CRAE, central retinal venular equivalent(CRVEand AVR values in the eyes were found no statistical difference(PPCOCLUSION: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.

  12. The cerebral blood flow measurement without absolute input function value for PET O-15 injection method

    International Nuclear Information System (INIS)

    Matsuda, Tadashige

    2004-01-01

    This paper shows the method of the measurement for the region of interest's (ROI's) cerebral blood flow (CBF) using PET data and the input function without the absolute density value of the radio activity. The value of the input function and the output function are fixed from the clinical data by regression analysis. The input function and the output function are transformed by the Fourier transform. The transfer function of the differential equation of the compartment model is got by these Fourier transforms. The CBF can be estimated by the transfer function regression analysis. Results are compared between the proposal and conventional methods. (author)

  13. A National Trial on Differences in Cerebral Perfusion Pressure Values by Measurement Location.

    Science.gov (United States)

    McNett, Molly M; Bader, Mary Kay; Livesay, Sarah; Yeager, Susan; Moran, Cristina; Barnes, Arianna; Harrison, Kimberly R; Olson, DaiWai M

    2018-04-01

    Cerebral perfusion pressure (CPP) is a key parameter in management of brain injury with suspected impaired cerebral autoregulation. CPP is calculated by subtracting intracranial pressure (ICP) from mean arterial pressure (MAP). Despite consensus on importance of CPP monitoring, substantial variations exist on anatomical reference points used to measure arterial MAP when calculating CPP. This study aimed to identify differences in CPP values based on measurement location when using phlebostatic axis (PA) or tragus (Tg) as anatomical reference points. The secondary study aim was to determine impact of differences on patient outcomes at discharge. This was a prospective, repeated measures, multi-site national trial. Adult ICU patients with neurological injury necessitating ICP and CPP monitoring were consecutively enrolled from seven sites. Daily MAP/ICP/CPP values were gathered with the arterial transducer at the PA, followed by the Tg as anatomical reference points. A total of 136 subjects were enrolled, resulting in 324 paired observations. There were significant differences for CPP when comparing values obtained at PA and Tg reference points (p Differences remained significant in repeated measures model when controlling for clinical factors (mean CPP-PA = 80.77, mean CPP-Tg = 70.61, p identified as adequate with PA values, yet inadequate with CPP values measured at the Tg. Findings identify numerical differences for CPP based on anatomical reference location and highlight importance of a standard reference point for both clinical practice and future trials to limit practice variations and heterogeneity of findings.

  14. Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Wildgruber, Moritz; Wolf, Oliver; Weiss, Wolfgang; Berger, Hermann; Lutzenberger, Werner; Eckstein, Hans-Henning; Heider, Peter

    2007-01-01

    Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous oximetry values dropped significantly at the end of the procedure and returned close to the baseline levels at 2 and 4 weeks after angioplasty. Ankle-brachial-indices and transcutaneous oximetry were positively correlated before (r = 0.3833, p = 0.009) as well as 4 weeks after angioplasty (r = 0.4596, p = 0.001). Immediately after radiological interventions, ankle-brachial-indices and transcutaneous oximetry are not positively correlated. In patients undergoing angiography only, transcutaneous oximetry levels drop significantly immediately after angiography and remain at decreased levels even at 4 weeks after intervention. Conclusion: Transcutaneous oximetry as parameter of the microcirculation is positively correlated with ankle-brachial-index as parameter of the macrocirculation before and at 4 weeks after angioplasty. Intraarterial angiography leads to a sudden decrease in skin microcirculation without affecting macrocirculation. As indicated by a lack of recovery in transcutaneous oximetry levels after 4 weeks, angiography alone results in a prolonged impaired microcirculation which may

  15. Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation.

    Directory of Open Access Journals (Sweden)

    Marie-Philippine Clair

    Full Text Available Extracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2 on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions.This was a prospective study in infants < 3 months of age admitted to a pediatric intensive care unit and requiring ECMO support.The assessment of cerebral perfusion was made by continuous StcO2 monitoring using near-infrared spectroscopy (NIRS sensors placed on the two temporo-parietal regions. Neurological lesions were identified by MRI or transfontanellar echography.Thirty-four infants <3 months of age were included in the study over a period of 18 months. The ECMO duration was 10±7 days. The survival rate was 50% (17/34 patients, and the proportion of brain injuries was 20% (7/34 patients. The mean StcO2 during ECMO in the non-survivors was reduced in both hemispheres (p = 0.0008 right, p = 0.03 left compared to the survivors. StcO2 was also reduced in deceased or brain-injured patients compared to the survivors without brain injury (p = 0.002.StcO2 appears to be a strong prognostic factor of survival and of the presence of cerebral lesions in young infants during ECMO.

  16. EVALUATION OF CONDITION OF THE PULP BY PULSE OXIMETRY.

    Directory of Open Access Journals (Sweden)

    Dimitar Kosturkov

    2015-12-01

    Full Text Available Purpose: To conduct pulse oximetry (PO and electric pulp test (EPT on intact frontal teeth in clinically healthy patients aged between 18 and 25 years who do not have periodontal disease. Material/Methods: To achieve the aim 1058 teeth of 31 patients were studied. The following inclusion criteria for the study were set: 1. Age – 18-25 years. 2. Clinically healthy patient, who does not have any systemic diseases, do not take any medicine systematically. 3. Intact frontal teeth – without carious lesions, restorations or root canal treatment. 4. Lack of periodontal disease. Research was conducted with a pulse oximeter Contec™ - CMS60D and a custom made probe holder. Results: Average values obtained by pulse oximetry in upper jaw vary between 83% and 85%. In lower jaw – between 82% and 85%. 99% is the maximum and 48% is the minimum registered value. The average value of the measurement of all the teeth is 84%. The average saturation measured on the small finger of the right hand of the patient is 98%. The average value of EPT for all teeth is 4 μA. The maximum measured value is 20 μA, and the minimum - 1 μA. Conclusions: 1. Adequate study of the pulp includes two complementary methods – electric pulp test (evaluation of innervation and pulse oximetry (assessment of pulp microcirculation. 2. Teeth that are larger in size have larger values of PO and EPT, which is in direct relation to the size of their pulp chamber. 3. The total saturation, measured in the little finger of the right hand is greater than the one of the teeth.

  17. Photonic textiles for pulse oximetry.

    Science.gov (United States)

    Rothmaier, Markus; Selm, Bärbel; Spichtig, Sonja; Haensse, Daniel; Wolf, Martin

    2008-08-18

    Biomedical sensors, integrated into textiles would enable monitoring of many vitally important physiological parameters during our daily life. In this paper we demonstrate the design and performance of a textile based pulse oximeter, operating on the forefinger tip in transmission mode. The sensors consisted of plastic optical fibers integrated into common fabrics. To emit light to the human tissue and to collect transmitted light the fibers were either integrated into a textile substrate by embroidery (producing microbends with a nominal diameter of 0.5 to 2 mm) or the fibers inside woven patterns have been altered mechanically after fabric production. In our experiments we used a two-wavelength approach (690 and 830 nm) for pulse wave acquisition and arterial oxygen saturation calculation. We have fabricated different specimens to study signal yield and quality, and a cotton glove, equipped with textile based light emitter and detector, has been used to examine movement artifacts. Our results show that textile-based oximetry is feasible with sufficient data quality and its potential as a wearable health monitoring device is promising.

  18. Confidence limits for regional cerebral blood flow values obtained with circular positron system, using krypton-77

    International Nuclear Information System (INIS)

    Meyer, E.; Yamamoto, Y.L.; Thompson, C.J.

    1978-01-01

    The 90% confidence limits have been determined for regional cerebral blood flow (rCBF) values obtained in each cm 2 of a cross section of the human head after inhalation of radioactive krypton-77, using the MNI circular positron emission tomography system (Positome). CBF values for small brain tissue elements are calculated by linear regression analysis on the semi-logarithmically transformed clearance curve. A computer program displays CBF values and their estimated error in numeric and gray scale forms. The following typical results have been obtained on a control subject: mean CBF in the entire cross section of the head: 54.6 + - 5 ml/min/100 g tissue, rCBF for small area of frontal gray matter: 75.8 + - 9 ml/min/100 g tissue. Confidence intervals for individual rCBF values varied between + - 13 and + - 55% except for areas pertaining to the ventricular system where particularly poor statistics have been obtained. Knowledge of confidence limits for rCBF values improves their diagnostic significance, particularly with respect to the assessment of reduced rCBF in stroke patients. A nomogram for convenient determination of 90% confidence limits for slope values obtained in linear regression analysis has been designed with the number of fitted points (n) and the correlation coefficient (r) as parameters. (author)

  19. The selective value of computed tomography of the brain in Cerebritis due to systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Gaylis, N.B.; Altman, R.D.; Ostrov, S.; Quencer, R.

    1982-01-01

    Systemic lupus erythematosus (SLE) and steroid effects on the brain were measured by computed tomography (CT). Of 14 patients with SLE cerebritis, 10 (71%) had marked cortical atrophy and 4 (29%) minimal atrophy. None were normal by CT. Controls included 22 patients with SLE without cerebritis receiving cortiocosteroids; this group had normal CT scans in 16 (73%) and minimal cortical atrophy in the remaining 6 (27%). Follow-up CT on 5 patients with cerebritis was unchanged. CT of the brain is a minimally invasive technique for documenting SLE cerebritis. CT may also help differentiate cerebritis from the neuropsychiatric side effects of corticosteroids

  20. A flexible infrared sensor for tissue oximetry

    DEFF Research Database (Denmark)

    Petersen, Søren Dahl; Thyssen, Anders; Engholm, Mathias

    2013-01-01

    We present a flexible infrared sensor for use in tissue oximetry with the aim of treating prematurely born infants. The sensor will detect the oxygen saturation in brain tissue through near infrared spectroscopy. The sensor itself consists of several individual silicon photo detectors fully...

  1. Assessing diabetic foot ulcer development risk with hyperspectral tissue oximetry

    Science.gov (United States)

    Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

    2011-02-01

    Foot ulceration remains a serious health concern for diabetic patients and has a major impact on the cost of diabetes treatment. Early detection and preventive care, such as offloading or improved hygiene, can greatly reduce the risk of further complications. We aim to assess the use of hyperspectral tissue oximetry in predicting the risk of diabetic foot ulcer formation. Tissue oximetry measurements are performed during several visits with hyperspectral imaging of the feet in type 1 and 2 diabetes mellitus subjects that are at risk for foot ulceration. The data are retrospectively analyzed at 21 sites that ulcerated during the course of our study and an ulceration prediction index is developed. Then, an image processing algorithm based on this index is implemented. This algorithm is able to predict tissue at risk of ulceration with a sensitivity and specificity of 95 and 80%, respectively, for images taken, on average, 58 days before tissue damage is apparent to the naked eye. Receiver operating characteristic analysis is also performed to give a range of sensitivity/specificity values resulting in a Q-value of 89%.

  2. Effects of Changes in Arterial Carbon Dioxide and Oxygen Partial Pressures on Cerebral Oximeter Performance.

    Science.gov (United States)

    Schober, Andrew; Feiner, John R; Bickler, Philip E; Rollins, Mark D

    2018-01-01

    Cerebral oximetry (cerebral oxygen saturation; ScO2) is used to noninvasively monitor cerebral oxygenation. ScO2 readings are based on the fraction of reduced and oxidized hemoglobin as an indirect estimate of brain tissue oxygenation and assume a static ratio of arterial to venous intracranial blood. Conditions that alter cerebral blood flow, such as acute changes in PaCO2, may decrease accuracy. We assessed the performance of two commercial cerebral oximeters across a range of oxygen concentrations during normocapnia and hypocapnia. Casmed FORE-SIGHT Elite (CAS Medical Systems, Inc., USA) and Covidien INVOS 5100C (Covidien, USA) oximeter sensors were placed on 12 healthy volunteers. The fractional inspired oxygen tension was varied to achieve seven steady-state levels including hypoxic and hyperoxic PaO2 values. ScO2 and simultaneous arterial and jugular venous blood gas measurements were obtained with both normocapnia and hypocapnia. Oximeter bias was calculated as the difference between the ScO2 and reference saturation using manufacturer-specified weighting ratios from the arterial and venous samples. FORE-SIGHT Elite bias was greater during hypocapnia as compared with normocapnia (4 ± 9% vs. 0 ± 6%; P oxygen saturation and mixed venous oxygen tension, as well as increased oxygen extraction across fractional inspired oxygen tension levels (P oxygen extraction (P < 0.0001). Changes in PaCO2 affect cerebral oximeter accuracy, and increased bias occurs with hypocapnia. Decreased accuracy may represent an incorrect assumption of a static arterial-venous blood fraction. Understanding cerebral oximetry limitations is especially important in patients at risk for hypoxia-induced brain injury, where PaCO2 may be purposefully altered.

  3. The prognostic value of cortical magnetic stimulation in acute middle cerebral artery infarction compared to other parameters

    NARCIS (Netherlands)

    Timmerhuis, Th.P.J.; Hageman, G.; Oosterloo, Sebe J.; Rozeboom, A.R.

    1996-01-01

    The prognostic value of magnetic evoked potentials (MEP), somatosensory evoked potentials (SSEP), age and radiological parameters was determined in 50 patients with acute middle cerebral artery infarction. We performed MEP and SSEP within 4 days and after 6 weeks and 3 months of the infarction and

  4. 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 ...

  5. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    BACKGROUND: Preterm infants are at 8 times higher risk than term infants for pre- and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants. METHODS: In a register-based stu...

  6. Resistive indices of cerebral arteries in very preterm infants : values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; Raets, Marlou M A; Camfferman, Fleur A; Vos, Rik H J; van Rosmalen, Joost; Reiss, Irwin K M; Govaert, Paul; Dudink, Jeroen

    BACKGROUND: Little is known about cerebral artery resistive index values in infants born extremely preterm. OBJECTIVE: To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks' gestation, and to compare resistive index in these

  7. Improvement of Infrared Detectors for Tissue Oximetry using Black Silicon Nanostructures

    DEFF Research Database (Denmark)

    Petersen, Søren Dahl; Davidsen, Rasmus Schmidt; Alcala, Lucia R.

    2014-01-01

    We present a nanostructured surface, made of dry etched black silicon, which lowers the reflectance for light incident at all angles. This surface is fabricated on infrared detectors used for tissue oximetry, where the detection of weak diffuse light signals is important. Monte Carlo simulations...... performed on a model of a neonatal head shows that approximately 60% of the injected light will be diffuse reflected. However, the change in diffuse reflected light due to the change in cerebral oxygenation is very low and the light will be completely isotropic scattered. The reflectance of the black...... in quantum efficiency for both normal incident light and light incident at 38°....

  8. Assessment value of transcranial Doppler hemodynamic typing for prognosis of patients with acute middle cerebral artery infarction

    Directory of Open Access Journals (Sweden)

    Jing Xie

    2016-08-01

    Full Text Available Objective: To analyze the assessment value of transcranial Doppler hemodynamic typing for prognosis of patients with acute middle cerebral artery infarction. Methods: A total of 54 cases of patients with acute middle cerebral artery infarction who received treatment in our hospital from January 2014 to June 2015 were included for study, and according to different types, they were divided into total occlusion group 17 cases, partial occlusion group 28 cases and nonocclusion group 9 cases. Differences in levels of infarction-related proteins, coagulation-related indicators, illness-related factors, etc in circulating blood of three groups were compared, and the correlation of middle cerebral arterial systolic velocity (Vs and diastolic velocity (Vd with above indicators was further analyzed. Results: Vs and Vd values of non-occlusion group were higher than those of total occlusion group and partial occlusion group, and Vs and Vd values of partial occlusion group were higher than those of total occlusion group; serum Gelsolin, PT, APTT and TT values of non-occlusion group were higher, SAA, Apo- CⅡ, HbA1c, GSP, A毬, HSP70, FIB, D-D, Copeptin, P-selectin, PTX3, TPO and FFA values were lower, and compared with partial occlusion group and total occlusion group, differences were significant; Gelsolin, PT, APTT and TT values of partial occlusion group were higher than those of total occlusion group, and SAA, Apo- CⅡ, HbA1c, GSP, A毬, HSP70, FIB, D-D, Copeptin, P-selectin, PTX3, TPO and FFA values were lower than those of total occlusion group; middle cerebral arterial Vs and Vd values were directly proportional to Gelsolin, PT, APTT and TT values, and inversely proportional to SAA, Apo- CⅡ, HbA1c, GSP, A毬, HSP70, FIB, D-D, Copeptin, P-selectin, PTX3, TPO and FFA values. Conclusions: Transcranial Doppler hemodynamic typing can be the reliable way to judge the severity of acute middle cerebral artery infarction, and has great value in assessing

  9. Quantifying cerebral hypoxia by near-infrared spectroscopy tissue oximetry

    DEFF Research Database (Denmark)

    Rasmussen, Martin B.; Eriksen, Vibeke R.; Andresen, Bjørn

    2017-01-01

    Tissue oxygenation estimated by near-infrared spectroscopy (NIRS) is a volume-weighted mean of the arterial and venous hemoglobin oxygenation. In vivo validation assumes a fixed arterial-to-venous volume-ratio (AV-ratio). Regulatory cerebro-vascular mechanisms may change the AV-ratio. We used...

  10. [Cerebral oximetry in pulmonary thromboendarterectomy with circulatory arrest].

    Science.gov (United States)

    Catalán Escudero, P; González Román, A; Serra Ruiz, C N; Barbero Mielgo, M; García Fernández, J

    2014-02-01

    Pulmonary thromboendarterectomy is an uncommon procedure and should be performed with circulatory arrest. One of the major concerns is the postoperative central neurological injuries. Perioperative brain oxygen monitoring is advisable in this surgical procedure for the early detection of brain hypoperfusion episodes and their intensity as well as any other postoperative episodes that can deteriorate the neurological outcome. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  11. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

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

    2015-01-01

    blinded to group allocation. RESULTS: The 86 infants randomised to the NIRS group had a median burden of hypoxia and hyperoxia of 36.1%hours (interquartile range 9.2-79.5%hours) compared with 81.3 (38.5-181.3) %hours in the control group, a reduction of 58% (95% confidence interval 35% to 73%, P....001). In the experimental group the median burden of hypoxia was 16.6 (interquartile range 5.4-68.1) %hours, compared with 53.6 (17.4-171.3) %hours in the control group (P=0.0012). The median burden of hyperoxia was similar between the groups: 1.2 (interquartile range 0.3-9.6) %hours in the experimental group compared...... oxygenation using NIRS in combination with a dedicated treatment guideline during the first 72 hours of life (experimental) compared with blinded NIRS oxygenation monitoring with standard care (control). MAIN OUTCOME MEASURES: The primary outcome measure was the time spent outside the target range of 55...

  12. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    BACKGROUND: Preterm infants are at 8 times higher risk than term infants for pre- and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants. METHODS: In a register-based study.......01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p Pregnancy...

  13. Age-matched normal values and topographic maps for regional cerebral blood flow measurements by Xe-133 inhalation

    International Nuclear Information System (INIS)

    Matsuda, H.; Maeda, T.; Yamada, M.; Gui, L.X.; Tonami, N.; Hisada, K.

    1984-01-01

    The relationship between normal aging and regional cerebral blood flow (rCBF) computed as initial slope index (ISI) by Fourier method was investigated in 105 right-handed healthy volunteers (132 measurements) by Xe-133 inhalation method, and age-matched normal values were calculated. Mean brain ISI values showed significant negative correlation with advancing age (r . 0.70, p less than 0.001), and the regression line and its 95% confidence interval was Y . -0.32 (X - 19) + 63.5 +/- 11.2 (19 less than or equal to X less than or equal to 80). Regional ISI values also showed significant negative correlations for the entire brain (p less than 0.001). The regional reductions of ISI values with advancing age were significantly greater in the regional distribution of the middle cerebral arteries bilaterally, compared with regions in the distribution of the other arteries (p less than 0.05). Therefore, measured rCBF values for patients must be compared to age-matched normal values for mean hemispheric and each region examined. Two kinds of topographic maps, brain map showing rCBF compared to age-matched normal values and showing hemispheric differences were made by dividing patient's values by the 95% confidence limits for age-matched normal values and displaying laterality index calculated as follows, respectively. (formula; see text) These maps were useful for evaluating significantly decreased or increased regions and regional hemispheric differences

  14. Measurement of cerebral blood flow with /sup 133/Xe inhalation and dynamic single photon emission computer tomography. Normal values

    Energy Technology Data Exchange (ETDEWEB)

    Rootwelt, K; Dybevold, S; Nyberg-Hansen, R; Russell, D

    1986-01-01

    Cerebral blood flow was studied by /sup 133/Xe inhalation tomography in 25 healthy subjects. Mean age was 41 years and range 23-66 years. Mean hemispheric CBF at rest was 59.8 ml/100 g/min, and cerebellar flow 60.8 ml/100 g/min. The distribution of CBF values was skewed and approximated a log normal distribution. Estimated lower and upper normal reference range limits calculated as mean (log) = - 2 S.D. (log) were 47-74 ml/100 g/min. Women had approximately 5 ml/100 g/min higher CBF values than men, corresponding to the difference in hematocrit. Neither in men or women was there any tendency to age dependent reduction or increase in flow. In both sexes hemispheric regional CBF (rCBF) was asymmetric with higher flow values in the right cerebral hemisphere; particularly in the anterior distribution territory of the middle cerebral artery. Emotional activation as a consequence of the study conditions is assumed to be the cause of this observed asymmetry. Cerebellar flow was not assymetric. No significant difference in cerebellar or hemispheric CBF was found when a second study followed the first by 3-15 months, PCO/sub 2/ correction of flow improved reproducibility. Acetazolamide responses are reported.

  15. Measurement of cerebral blood flow with 133Xe inhalation and dynamic single photon emission computer tomography. Normal values

    International Nuclear Information System (INIS)

    Rootwelt, Kjell; Dybevold, Synnoeve; Nyberg-Hansen, Rolf; Russell, David

    1986-01-01

    Cerebral blood flow was studied by 133 Xe inhalation tomography in 25 healthy subjects. Mean age was 41 years and range 23-66 years. Mean hemispheric CBF at rest was 59.8 ml/100 g/min, and cerebellar flow 60.8 ml/100 g/min. The distribution of CBF values was skewed and approximated a log normal distribution. Estimated lower and upper normal reference range limits calculated as mean (log) = - 2 S.D. (log) were 47-74 ml/100 g/min. Women had approximately 5 ml/100 g/min higher CBF values than men, corresponding to the difference in hematocrit. Neither in men or women was there any tendency to age dependent reduction or increase in flow. In both sexes hemispheric regional CBF (rCBF) was asymmetric with higher flow values in the right cerebral hemisphere; particularly in the anterior distribution territory of the middle cerebral artery. Emotional activation as a consequence of the study conditions is assumed to be the cause of this observed asymmetry. Cerebellar flow was not assymetric. No significant difference in cerebellar or hemispheric CBF was found when a second study followed the first by 3-15 months, PCO 2 correction of flow improved reproducibility. Acetazolamide responses are reported. (author)

  16. Pulse oximetry: a potential aid in endodontic diagnosis?

    Science.gov (United States)

    Caplan, Dan

    2010-06-01

    Pulse oximetry: review of a potential aid in endodontic diagnosis. Jafarzadeh H, Rosenberg PA. J Endod 2009;35(3):329-33. Dan Caplan, DDS, PhD. This article provided a description of pulse oximetry, its use in patient care settings, and its potential for use in endodontic diagnosis. Information not available. Comprehensive literature review. Level 3: Other evidence. Not applicable.

  17. Applications and diagnostic value of cerebral scintiscanning using 123I-amphetamine

    International Nuclear Information System (INIS)

    Eibach, E.; Feine, U.; Kaiser, W.; Diener, H.C.; Petersen, D.

    1985-01-01

    123 I-IMP is a new radiopharmaceutical for direct cerebral scintiscanning, characterized by its ability to cross the blood-brain barrier and its accumulation in the brain. Present clinical indications are illustrated by examples (disturbances of cerebral blood flow, epilepsy, organic psychosyndrome). Single photon emission computerized tomography (SPECT) permits imaging in three planes (cantho-meatal, frontal, sagittal), although it lacks the morphological quality of TCT or NMR images. The new substance may open up new perspectives in neurophysiology and neuropharmacology. (orig.) [de

  18. Applications and diagnostic value of cerebral scintiscanning using /sup 123/I-amphetamine

    Energy Technology Data Exchange (ETDEWEB)

    Eibach, E.; Feine, U.; Kaiser, W.; Diener, H.C.; Petersen, D.

    1985-02-01

    /sup 123/I-IMP is a new radiopharmaceutical for direct cerebral scintiscanning, characterized by its ability to cross the blood-brain barrier and its accumulation in the brain. Present clinical indications are illustrated by examples (disturbances of cerebral blood flow, epilepsy, organic psychosyndrome). Single photon emission computerized tomography (SPECT) permits imaging in three planes (cantho-meatal, frontal, sagittal), although it lacks the morphological quality of TCT or NMR images. The new substance may open up new perspectives in neurophysiology and neuropharmacology.

  19. Wearable oximetry for harsh environments

    Science.gov (United States)

    2017-02-23

    averages were computed using a 2nd- order Kalman filter [26]. The Kalman filter was applied within local 5-minute data windows in both the forward...to produce distributions that are approximately normally distributed [25]. In each iteration, values with absolute deviations from the Kalman filter ...Firefighters, first responders, warfighters, and explorers must often operate in environmental extremes of temperature (hot or cold), humidity

  20. Computed tomographic volumetry of cerebral liquor by semiautomatic contour recognition and gray value histogram analysis

    International Nuclear Information System (INIS)

    Tschammler, A.; Middendorf, C.; Luedinghausen, M. v.; Wittenberg, G.; Krahe, T.

    1996-01-01

    A program (VAC, Siemens) using selfmade, anthropomorphous phantomas to measure semiautomatically the volume of the cerebral liquor in CT scans of the whole skull was tested. Cerebral tissue was simulated by ellipsoid bodies made from Agar and Nal which were placed in a human skull. Volumes of the ventricular and subarachnoidal liquor could be defined arbitrarily. A correlation coefficient of r>=0.9 using a slice thickness of 1-5 mm was found (thickness 8 mm: r=0.75). The volume of the cerebral liquor was underestimated by 25-68%. Separate measurements of the ventricular and subarachnoidal liquor spaces showed a high accuracy of the measurements done in the ventricles (r=0.997, y=0.996x-1). The volume of the subarachnoidal liquor was not detected completely due to partial volume effects which were seen especially in the basal and apical scans. The program VAC is useful for the semiautomatic measurement of the volume of the ventricles. The assessment of the subarachnoidal liquor is limited to semiquantitative results. (orig./MG) [de

  1. Multisite EPR oximetry from multiple quadrature harmonics.

    Science.gov (United States)

    Ahmad, R; Som, S; Johnson, D H; Zweier, J L; Kuppusamy, P; Potter, L C

    2012-01-01

    Multisite continuous wave (CW) electron paramagnetic resonance (EPR) oximetry using multiple quadrature field modulation harmonics is presented. First, a recently developed digital receiver is used to extract multiple harmonics of field modulated projection data. Second, a forward model is presented that relates the projection data to unknown parameters, including linewidth at each site. Third, a maximum likelihood estimator of unknown parameters is reported using an iterative algorithm capable of jointly processing multiple quadrature harmonics. The data modeling and processing are applicable for parametric lineshapes under nonsaturating conditions. Joint processing of multiple harmonics leads to 2-3-fold acceleration of EPR data acquisition. For demonstration in two spatial dimensions, both simulations and phantom studies on an L-band system are reported. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Feasibility of Pulse Oximetry Pre-discharge Screening ...

    African Journals Online (AJOL)

    Feasibility of Pulse Oximetry Pre-discharge Screening Implementation for detecting Critical Congenital heart Lesions in newborns in a secondary-level maternity hospital in the Western Cape, South Africa: The 'POPSICLe' study.

  3. Cerebral scintigraphy in dogs using gallium 67. Value in the investigation of experimental brain tumors

    International Nuclear Information System (INIS)

    Joffre, J.-F.

    1975-01-01

    The possibility of inducing experimental brain tumors in dogs by intracerebral inoculation of Rous sarcoma virus led to the development of an early diagnosis procedure without any danger for the carrier animal. Already widely used in humans, cerebral gammagraphy, used in dogs in the conditions developed, perfectly satisfy the requirements of harmlessness, precision and reliability. Scintiscans are taken 48 hours after injection of two mCi of carrier-free Ga 67 citrate. Profile and front patterns are obtained by means of a gamma camera connected to an on-line data processing system. Thirteen examinations were carried out under general anesthesia. Three dogs exhibiting positive scintiscan patterns revealed at the autopsy tumors ranging in size from a hazelnut to a walnut. The remaining animals gave negative or dubious patterns, and none of them revealed a tumor larger in size than a pea. The results obtained in this study are encouraging, and it is felt that this method can enable valid diagnosis of the presence of cerebral neoplasias in dogs, provided they are sufficiently large [fr

  4. Identifying individual sleep apnea/hypoapnea epochs using smartphone-based pulse oximetry.

    Science.gov (United States)

    Garde, Ainara; Dekhordi, Parastoo; Ansermino, J Mark; Dumont, Guy A

    2016-08-01

    Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis. We propose to extract features characterizing pulse oximetry (SpO2 and pulse rate variability [PRV], a surrogate measure of heart rate variability) to create a multivariate logistic regression model that identifies epochs containing apnea/hypoapnea events. Overnight pulse oximetry was collected using a smartphone-based pulse oximeter, simultaneously with standard PSG from 160 children at the British Columbia Children's hospital. The sleep technician manually scored all apnea/hypoapnea events during the PSG study. Based on these scores we labeled each epoch as containing or not containing apnea/hypoapnea. We randomly divided the subjects into training data (40%), used to develop the model applying the LASSO method, and testing data (60%), used to validate the model. The developed model was assessed epoch-by-epoch for each subject. The test dataset had a median area under the receiver operating characteristic (ROC) curve of 81%; the model provided a median accuracy of 74% sensitivity of 75%, and specificity of 73% when using a risk threshold similar to the percentage of apnea/hypopnea epochs. Thus, providing a detailed epoch-by-epoch analysis with at-home pulse oximetry alone is feasible with accuracy, sensitivity and specificity values above 73% However, the performance might decrease when analyzing subjects with a low number of apnea/hypoapnea events.

  5. Diagnostic approach of cerebral metastases. Some considerations on the value of gamma-angio encephalography

    International Nuclear Information System (INIS)

    Laferriere, Nicole.

    1975-01-01

    Following the intravenous administration of 10 to 12mCi of sup(99m)Tc-DTPA, an investigation is performed using a gamma camera with its associated interface equipment for computer processing of data. During the vascular phase, rapide sequential pictures are taken every 2 or 3 seconds for about 20 seconds. Various views of the early and delayed diffusion phases, make possible to follow the course of the pathologic focus. A typical aspect of cerebral metastase scanning is described. After a first normal or decreased vascular phase, an accumulation of radioactivity in an homogeneous focus with clear margin is observed, showing a progressive course of isotope uptake. Such a focus appearing only during the second phase suggests a lesion with poor vascularisation. Metastases appearing during the first phase, and increasing during the second phase suggests the presence of intense reactive edema [fr

  6. Value of the computerized axial tomography for early diagnosis of cranio cerebral trauma

    International Nuclear Information System (INIS)

    Rodriguez Cheong, Maricel; Dosouto Infante, Vivian; Rosales Fargie, Yamile

    2010-01-01

    A descriptive and cross-sectional study was conducted in 62 patients with cranio cerebral trauma admitted to 'Saturnino Lora' Provincial Teaching Hospital of Santiago de Cuba, from January 2005 to May 2006, in whom computerized axial tomography indicated at the emergency room was performed with the purpose of evaluating the effectiveness of this radiographic technique for early diagnosis of the injury. In the case material there was neither association between the source and imaging results, nor between the age and sex. The main clinical manifestations were vomiting, headache and motor deficit as well as frontal location, intraparenchymatous hematoma (the latter as the most common image finding) and the hyperdense area as tomographic pattern. The survival was of 91,9%

  7. Reliability of Pulse Oximetry during Progressive Hypoxia, Cardiopulmonary Resuscitation, and Recovery in a Piglet Model of Neonatal Hypoxic Cardiac Arrest.

    Science.gov (United States)

    Hassan, Mohammad Ahmad; Weber, Claudia; Waitz, Markus; Huang, Li; Hummler, Helmut D; Mendler, Marc Robin

    2017-01-01

    Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during progressive hypoxia, cardiac arrest, cardiopulmonary resuscitation (CPR), and after return of spontaneous circulation (ROSC). Thirty-three newborn piglets were exposed to hypoxia until asystole occurred and then resuscitated until ROSC. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2) with one sensor applied to the wrist of the right forelimb (FL) and another to the thigh of the left hind limb (HL). Arterial functional oxygen saturation (SaO2) was measured at baseline and at predefined intervals during each phase of the experiment. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%. Bias values were lower at the baseline measurements (-3.7 ± 2.3% in FL and -4.1 ± 3.4% in HL) as well as after ROSC (1.5 ± 4.2% in FL and 0.2 ± 4.6% in HL) with higher precision and accuracy than during other experiment phases. During hypoxia induction, cardiac arrest, and CPR, there was a marked decrease in precision and accuracy as well as an increase in bias up to 43 ± 26 and 56 ± 27% in FL and HL, respectively, over a range of SaO2 from 13 to 51%. Pulse oximetry showed increased bias and decreased accuracy and precision during marked hypoxemia in a model of neonatal hypoxic cardiac arrest. © 2017 S. Karger AG, Basel.

  8. Advanced Pulse Oximetry System for Remote Monitoring and Management

    Science.gov (United States)

    Pak, Ju Geon; Park, Kee Hyun

    2012-01-01

    Pulse oximetry data such as saturation of peripheral oxygen (SpO2) and pulse rate are vital signals for early diagnosis of heart disease. Therefore, various pulse oximeters have been developed continuously. However, some of the existing pulse oximeters are not equipped with communication capabilities, and consequently, the continuous monitoring of patient health is restricted. Moreover, even though certain oximeters have been built as network models, they focus on exchanging only pulse oximetry data, and they do not provide sufficient device management functions. In this paper, we propose an advanced pulse oximetry system for remote monitoring and management. The system consists of a networked pulse oximeter and a personal monitoring server. The proposed pulse oximeter measures a patient's pulse oximetry data and transmits the data to the personal monitoring server. The personal monitoring server then analyzes the received data and displays the results to the patient. Furthermore, for device management purposes, operational errors that occur in the pulse oximeter are reported to the personal monitoring server, and the system configurations of the pulse oximeter, such as thresholds and measurement targets, are modified by the server. We verify that the proposed pulse oximetry system operates efficiently and that it is appropriate for monitoring and managing a pulse oximeter in real time. PMID:22933841

  9. Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?

    Science.gov (United States)

    Salusjärvi, Johannes M; Carpelan-Holmström, Monika A; Louhimo, Johanna M; Kruuna, Olli; Scheinin, Tom M

    2018-03-01

    An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak. The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital. Patient material consisted of 422 patients undergoing elective left-sided colorectal surgery. The patients were operated by one of the three surgeons. All of the operations were partial or total resections of the left side of the colon with a colorectal anastomosis. The intraoperative colonic oxygen saturation was measured with pulse oximetry from the colonic wall, and the values were analyzed with respect to post-operative complications. 2.3 times more operated anastomotic leaks occurred when the colonic StO 2 was ≤ 90% (11/129 vs 11/293). The mean colonic StO 2 was 91.1 in patients who developed an operated anastomotic leak and 93.0 in patients who did not. With logistic regression analysis, the risk of operated anastomotic leak was 4.2 times higher with StO 2 values ≤ 90%. Low intraoperative colonic StO 2 values are associated with the occurrence of anastomotic leak. Despite its handicaps, the method seems to be useful in assessing anastomotic viability.

  10. Value of botulinum toxin injections preceding a comprehensive rehabilitation period for children with spastic cerebral palsy: A cost-effectiveness study

    NARCIS (Netherlands)

    F.C. Schasfoort (Fabiënne); A.J. Dallmeijer (Annet); R.F. Pangalila (Robert); C. Catsman (Coriene); H.J. Stam (Henk); J.G. Becher (Jules); E.W. Steyerberg (Ewout W.); S. Polinder (Suzanne); J.B.J. Bussmann (Hans); H.L.D. Horemans (Herwin); E.M. Sneekes (E.); Bolster, E. (Eline); Viola, I. (Irma); Beek, K. (Karlijn) van; J.M.A. Verheijden (Johannes)

    2018-01-01

    textabstractObjective: Despite the widespread use of botulinum toxin in ambulatory children with spastic cerebral palsy, its value prior to intensive physiotherapy with adjunctive casting/orthoses remains unclear. Design: A pragmatically designed, multi-centre trial, comparing the effectiveness of

  11. Pulse oximetry : technology to reduce child mortality in developing countries

    NARCIS (Netherlands)

    Duke, T.; Subhi, R.; Peel, D.; Frey, B.

    The causes of hypoxaemia in children include the commonest causes of childhood illness: pneumonia and other acute respiratory infections, and neonatal illness, particularly sepsis, low birthweight, birth asphyxia and aspiration syndromes. The systematic use of pulse oximetry to monitor and treat

  12. Vessel calibre and haemoglobin effects on pulse oximetry

    International Nuclear Information System (INIS)

    McEwen, M P; Reynolds, K J; Bull, G P

    2009-01-01

    Despite its success as a clinical monitoring tool, pulse oximetry may be improved with respect to the need for empirical calibration and the reports of biases in readings associated with peripheral vasoconstriction and haemoglobin concentration. To effect this improvement, this work aims to improve the understanding of the photoplethysmography signal—as used by pulse oximeters—and investigates the effect of vessel calibre and haemoglobin concentration on pulse oximetry. The digital temperature and the transmission of a wide spectrum of light through the fingers of 57 people with known haemoglobin concentrations were measured and simulations of the transmission of that spectrum of light through finger models were performed. Ratios of pulsatile attenuations of light as used in pulse oximetry were dependent upon peripheral temperature and on blood haemoglobin concentration. In addition, both the simulation and in vivo results showed that the pulsatile attenuation of light through fingers was approximately proportional to the absorption coefficients of blood, only when the absorption coefficients were small. These findings were explained in terms of discrete blood vessels acting as barriers to light transmission through tissue. Due to the influence of discrete blood vessels on light transmission, pulse oximeter outputs tend to be dependent upon haemoglobin concentration and on the calibre of pulsing blood vessels—which are affected by vasoconstriction/vasodilation. The effects of discrete blood vessels may account for part of the difference between the Beer–Lambert pulse oximetry model and empirical calibration

  13. Quantitative evaluation of photoplethysmographic artifact reduction for pulse oximetry

    Science.gov (United States)

    Hayes, Matthew J.; Smith, Peter R.

    1999-01-01

    Motion artefact corruption of pulse oximeter output, causing both measurement inaccuracies and false alarm conditions, is a primary restriction in the current clinical practice and future applications of this useful technique. Artefact reduction in photoplethysmography (PPG), and therefore by application in pulse oximetry, is demonstrated using a novel non-linear methodology recently proposed by the authors. The significance of these processed PPG signals for pulse oximetry measurement is discussed, with particular attention to the normalization inherent in the artefact reduction process. Quantitative experimental investigation of the performance of PPG artefact reduction is then utilized to evaluate this technology for application to pulse oximetry. While the successfully demonstrated reduction of severe artefacts may widen the applicability of all PPG technologies and decrease the occurrence of pulse oximeter false alarms, the observed reduction of slight artefacts suggests that many such effects may go unnoticed in clinical practice. The signal processing and output averaging used in most commercial oximeters can incorporate these artefact errors into the output, while masking the true PPG signal corruption. It is therefore suggested that PPG artefact reduction should be incorporated into conventional pulse oximetry measurement, even in the absence of end-user artefact problems.

  14. Prognostic value of intraventricular bleeding in spontaneous intraparenchymal cerebral hemorrhage of small volume: a prospective cohort study.

    Science.gov (United States)

    Fortes Lima, Telmo Tiburcio; Prandini, Mirto Nelso; Gallo, Pasquale; Cavalheiro, Sérgio

    2012-04-01

    The literature is controversial on whether intraventricular bleeding has a negative impact on the prognosis of spontaneous intracerebral hemorrhage. Nevertheless, an association between intraventricular bleeding and spontaneous intracerebral hemorrhage volumes has been consistently reported. To evaluate the prognostic value of intraventricular bleeding in deep intraparenchymal hypertensive spontaneous hemorrhage with a bleeding volume bleeding was calculated by the LeRoux scale. Clinical data, including neurological complications, were collected daily during hospitalization. Neurological outcome was evaluated 30 days after the event by using the Glasgow outcome scale. Patients were assigned to 1 of 3 groups according to intraventricular bleeding: Control, no intraventricular bleeding; LR 1, intraventricular bleeding with LeRoux scale scores of 1 to 8; or LR 2, intraventricular bleeding with LeRoux scale scores >8. There were no significant differences among groups concerning age, mean blood pressure, and time from onset to brain CT scan. Patients with greater intraventricular bleeding presented lower initial Glasgow coma scale scores, increased ventricular index and width of temporal horns, increased number of clinical and neurological complications, and longer hospitalization. Furthermore, their relative risk for unfavorable clinical outcome was 1.9 (95% confidence interval 1.25-2.49). Intraventricular bleeding with a LeRoux scale score >8 appears to have a negative effect on deep spontaneous intraparenchymal cerebral hemorrhage of small volume.

  15. The OXIMAPA Study: Hypertension Control by ABPM and Association with Sleep Apnea Syndrome by Pulse Oximetry.

    Science.gov (United States)

    Maricoto, Tiago; Silva, Eurico Alves Rodrigues; Damião, Pedro; Bastos, José Mesquita

    2017-02-27

    Ambulatory blood pressure monitoring by automatic device is the best blood pressure evaluation method and sleep apnea syndrome is the leading cause of poor control. Oximetry allows screening these individuals but its usefulness has been poorly explored in Primary Health Care. The aim was to evaluate the blood pressure control at the office and with ambulatory blood pressure monitoring by automatic device and to relate it to sleep apnea syndrome. We selected a sample of 50 participants, representative of 3036 hypertensive patients. The variables were: blood pressure value at the office and blood pressure with ambulatory blood pressure monitoring by automatic device; presence of criteria of sleep apnea syndrome in oximetry. The prevalence of uncontrolled blood pressure was 56% on office evaluation and 68% on ambulatory blood pressure monitoring by automatic device. It was found: 36% of daytime hypertension, 52% nocturnal hypertension, 40% non-dipper profile, 16% of white coat hypertension and 28% masked hypertension. The prevalence of sleep apnea syndrome was 16%. Blood pressure in ambulatory blood pressure monitoring by automatic device and blood pressure in office showed no statistically significant association (p = 0.761). We found a statistically significant association between sleep apnea syndrome and daytime hypertension (p = 0.019) and non-dipper profile (p = 0.005). Ambulatory blood pressure monitoring by automatic device detected more 12% of uncontrolled hypertension than office blood pressure. Sleep apnea syndrome is strongly associated with uncontrolled hypertension and oximetry may be a good screening method, but should be studied further.

  16. Assessment of anastomotic reliability with pulse oximetry in graded intestinal ischemia: an experimental study in dogs.

    Science.gov (United States)

    Türkyilmaz, Z; Sönmez, K; Başaklar, A C; Demiroğullari, B; Numanoğlu, V; Ekingen, G; Dursun, A; Altin, M A; Kale, N

    1997-12-01

    Pulse oximetry has been proposed as an appropriate and feasible technique in the assessment of intestinal ischemia in recent years. In this study the authors aimed to assess the reliability of anastomoses in the dog small intestine in which there is graded irreversible ischemia as measured by pulse oxymeter. In a control group of four dogs, without any devascularization, three small bowel anastomoses were formed in each dog. The study group consisted of 12 dogs. In each animal three intestinal segments with different levels of ischemia were created by ligating the marginal vessels proximally and distally in sequence beginning from the midpoint of the segmental vascular arcade. Preanastomotic pulse oximeter readings between 80% and 90% were assigned to mild ischemia, 70% and 80% to moderate, and 60% and 70% to severe ischemia group. Pulse oximetry measurements were obtained from probes applied to the antimesenteric serosal surfaces at the midpoint of small intestinal segments. A total of 48 intestinal segments (12 nonischemic in the control group and 36 with three different levels of ischemia in the study group) were transected in the midpoint and anastomosed in double layers. Postanastomotic SaO2 values were also noted. The anastomoses were evaluated 48 hours later macroscopically if there was any leakage, and biopsy specimens were obtained for histopathologic ischemic gradings. All results were studied statistically. Histopathologic grades between each group were statistically different (P .05), worsening as the level of ischemia increased. Pre- and postanastomotic pulse oximetry measurements correlated very well with the histological gradings (r = -0.90, P anastomoses) in severe ischemia groups. In the moderate ischemia group with an average preanastomotic pulse reading of 76.75%, each of the leaking anastomoses had a postanastomotic pulse measurement of lower than 70%. The finding that the difference between histopathologic grades of control and mild ischemia

  17. Clinical value of proton magnetic resonance spectroscopy for differentiating recurrent or residual brain tumor from delayed cerebral necrosis

    International Nuclear Information System (INIS)

    Taylor, June S.; Langston, James W.; Reddick, Wilburn E.; Kingsley, Peter B.; Ogg, Robert J.; Pui, Margaret H.; Kun, Larry E.; Jenkins, Jesse J.; Gang, Chen; Ochs, Judith J.; Sanford, Robert A.; Heideman, Richard L.

    1996-01-01

    Purpose: Delayed cerebral necrosis (DN) is a significant risk for brain tumor patients treated with high-dose irradiation. Although differentiating DN from tumor progression is an important clinical question, the distinction cannot be made reliably by conventional imaging techniques. We undertook a pilot study to assess the ability of proton magnetic resonance spectroscopy ( 1 H MRS) to differentiate prospectively between DN or recurrent/residual tumor in a series of children treated for primary brain tumors with high-dose irradiation. Methods and Materials: Twelve children (ages 3-16 years), who had clinical and MR imaging (MRI) changes that suggested a diagnosis of either DN or progressive/recurrent brain tumor, underwent localized 1 H MRS prior to planned biopsy, resection, or other confirmatory histological procedure. Prospective 1 H MRS interpretations were based on comparison of spectral peak patterns and quantitative peak area values from normalized spectra: a marked depression of the intracellular metabolite peaks from choline, creatine, and N-acetyl compounds was hypothesized to indicate DN, and median-to-high choline with easily visible creatine metabolite peaks was labeled progressive/recurrent tumor. Subsequent histological studies identified the brain lesion as DN or recurrent/residual tumor. Results: The patient series included five cases of DN and seven recurrent/residual tumor cases, based on histology. The MRS criteria prospectively identified five out of seven patients with active tumor, and four out of five patients with histologically proven DN correctly. Discriminant analysis suggested that the primary diagnostic information for differentiating DN from tumor lay in the normalized MRS peak areas for choline and creatine compounds. Conclusions: Magnetic resonance spectroscopy shows promising sensitivity and selectivity for differentiating DN from recurrent/progressive brain tumor. A novel diagnostic index based on peak areas for choline and

  18. Utility of the Pediatric Sleep Questionnaire and Pulse Oximetry as Screening Tools in Pediatric Patients with Suspected Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Jose A. Peña-Zarza

    2012-01-01

    Full Text Available Objective. To assess the screening tools in snoring patients. Material and Methods. A retrospective review of data was conducted from children between 2 and 15 years old who were referred on suspicion of obstructive sleep apnea-hypopnea (OSAH between June 2008 and June 2011. We excluded patients with significant comorbidities. Pediatric Sleep Questionnaire (PSQ, physical exam (PE, and pulse-oximetry data were collected and correlated with the results of the nightly polygraph at home. Results. We selected 98 patients. The 22-item version of the PSQ had sensitivity of 96% and specificity of 36.8%. The overall value of the clinic predictor of OSAH (PSQ and PE together exhibited an increased specificity 57.6% with 94.6% of sensitivity. The nocturnal home oximetry method used alone was very specific, 92.1%, but had a lower sensitivity, 77.1%. The set of clinical assessment tools used together with pulse-oximetry screening provided excellent specificity 98.1% and a positive predictive value 94.1% globally. The performance of this screening tool is related with the severity of OSAH and accuracy is better in moderate and severe cases. Conclusion. The combination of clinical assessment and pulse-oximetry screening can provide a sufficient diagnostic approach for pediatric patients with suspected OSAH at least in moderate and severe cases.

  19. Examination of Pulse Oximetry Tracings to Detect Obstructive Sleep Apnea in Patients with Advanced Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Adrienne S Scott

    2014-01-01

    Full Text Available Nocturnal hypoxemia and obstructive sleep apnea (OSA are common comorbidities in patients with chronic obstructive pulmonary disease (COPD. The authors sought to develop a strategy to interpret nocturnal pulse oximetry and assess its capacity for detection of OSA in patients with stage 3 to stage 4 COPD. A review of consecutive patients with COPD who were clinically prescribed oximetry and polysomnography was conducted. OSA was diagnosed if the polysomnographic apnea-hypopnea index was >15 events/h. Comprehensive criteria were developed for interpretation of pulse oximetry tracings through iterative validation and interscorer concordance of ≥80%. Criteria consisted of visually identified desaturation ‘events’ (sustained desaturation ≥4%, 1 h time scale, ‘patterns’ (≥3 similar desaturation/saturation cycles, 15 min time scale and the automated oxygen desaturation index. The area under the curve (AUC, sensitivity, specificity and accuracy were calculated. Of 59 patients (27 male, 31 had OSA (53%. The mean forced expiratory volume in 1 s was 46% of predicted (range 21% to 74% of predicted and 52% of patients were on long-term oxygen therapy. Among 59 patients, 35 were correctly identified as having OSA or not having OSA, corresponding to an accuracy of 59%, with a sensitivity and specificity of 59% and 60%, respectively. The AUC was 0.57 (95% CI 0.55 to 0.59. Using software-computed desaturation events (hypoxemia ≥4% for ≥10 s indexed at ≥15 events/h of sleep as diagnostic criteria, sensitivity was 60%, specificity was 63% and the AUC was 0.64 (95%CI 0.62 to 0.66. No single criterion demonstrated important diagnostic utility. Pulse oximetry tracing interpretation had a modest diagnostic value in identifying OSA in patients with moderate to severe COPD.

  20. The Feasibility and Validity of a Remote Pulse Oximetry System for Pulmonary Rehabilitation: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jonathan Tang

    2012-01-01

    Full Text Available Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease. However, access to these services is limited especially in rural and remote areas. Telerehabilitation has the potential to deliver pulmonary rehabilitation programs to these communities. The aim of this study was threefold: to establish the technical feasibility of transmitting real-time pulse oximetry data, determine the validity of remote measurements compared to conventional face-to-face measures, and evaluate the participants’ perception of the usability of the technology. Thirty-seven healthy individuals participated in a single remote pulmonary rehabilitation exercise session, conducted using the eHAB telerehabilitation system. Validity was assessed by comparing the participant's oxygen saturation and heart rate with the data set received at the therapist’s remote location. There was an 80% exact agreement between participant and therapist data sets. The mean absolute difference and Bland and Altman’s limits of agreement fell within the minimum clinically important difference for both oxygen saturation and heart rate values. Participants found the system easy to use and felt confident that they would be able to use it at home. Remote measurement of pulse oximetry data for a pulmonary rehabilitation exercise session was feasible and valid when compared to conventional face-to-face methods.

  1. The value of MRI in the diagnosis of cerebral infection. Die Bedeutung der Kernspintomographie in der Diagnostik zerebraler Infektionen

    Energy Technology Data Exchange (ETDEWEB)

    Glathe, S.; Heindel, W.; Steinbrich, W. (Koeln Univ. (Germany, F.R.). Inst. fuer Radiologische Diagnostik)

    1989-09-01

    Amongst 1.345 MR examinations of the skull 49 patients were suspected of a cerebral infection. With a knowledge of the clinical situation, the abnormal findings were classified according to their localization, number, extent and distribution. The final diagnoses included meningitis, meningo-encephalitis, and abscesses of varying etiology. CT was carried out in 29 patients; it was found that MRI was more sensitive and able to show the lesion at an earlier stage (sensitivity 90% compared with 66%). Observations of proton density and relaxation time combined with morphological criteria and clinical history reduced differential diagnoses. On the other hand, the changes due to intracranial infections lead to an inflammatory reaction that may be similar to the findings in degenerative or even tumorous cerebral lesions. This explains why twelve patients with abnormal MRI findings were erroneously diagnosed as having cerebral infections. (orig.).

  2. Effect of bupivacaine and adjuvant drugs for regional anesthesia on nerve tissue oximetry and nerve blood flow

    Directory of Open Access Journals (Sweden)

    Wiesmann T

    2018-01-01

    Full Text Available Thomas Wiesmann,1 Stefan Müller,1,2 Hans-Helge Müller,3 Hinnerk Wulf,1 Thorsten Steinfeldt1,4 1Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital Marburg, Philipps University, Marburg, 2Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen, Justus-Liebig-University, Giessen, 3Institute of Medical Biometry and Epidemiology, Philipps University, Marburg, 4Department of Anesthesiology and Intensive Care Medicine, Diakoniekrankenhaus Schwäbisch Hall, Schwäbisch Hall, Germany Background: Nerve blood flow has a critical role in acute and chronic pathologies in peripheral nerves. Influences of local anesthetics and adjuvants on tissue perfusion and oxygenation are deemed as relevant factors for nerve damage after peripheral regional anesthesia. The link between low tissue perfusion due to local anesthetics and resulting tissue oxygenation is unclear.Methods: Combined tissue spectrophotometry and laser-Doppler flowmetry were used to assess nerve blood flow in 40 surgically exposed median nerves in pigs, as well as nerve tissue oximetry for 60 min. After baseline measurements, test solutions saline (S, bupivacaine (Bupi, bupivacaine with epinephrine (BupiEpi, and bupivacaine with clonidine (BupiCloni were applied topically.Results: Bupivacaine resulted in significant decrease in nerve blood flow, as well as tissue oximetry values, compared with saline control. Addition of epinephrine resulted in a rapid, but nonsignificant, reduction of nerve blood flow and extensive lowering of tissue oximetry levels. The use of clonidine resulted in a reduction of nerve blood flow, comparable to bupivacaine alone (relative blood flow at T60 min compared with baseline, S: 0.86 (0.67–1.18, median (25th–75th percentile; Bupi: 0.33 (0.25–0.60; BupiCloni: 0.43 (0.38–0.63; and BupiEpi: 0.41(0.30–0.54. The use of adjuvants did not result in any relevant impairment of tissue oximetry

  3. Finger blood content, light transmission, and pulse oximetry errors.

    Science.gov (United States)

    Craft, T M; Lawson, R A; Young, J D

    1992-01-01

    The changes in light emitting diode current necessary to maintain a constant level of light incident upon a photodetector were measured in 20 volunteers at the two wavelengths employed by pulse oximeters. Three states of finger blood content were assessed; exsanguinated, hyperaemic, and normal. The changes in light emitting diode current with changes in finger blood content were small and are not thought to represent a significant source of error in saturation as measured by pulse oximetry.

  4. Advances in Probes and Methods for Clinical EPR Oximetry

    Science.gov (United States)

    Hou, Huagang; Khan, Nadeem; Jarvis, Lesley A.; Chen, Eunice Y.; Williams, Benjamin B.; Kuppusamy, Periannan

    2015-01-01

    EPR oximetry, which enables reliable, accurate, and repeated measurements of the partial pressure of oxygen in tissues, provides a unique opportunity to investigate the role of oxygen in the pathogenesis and treatment of several diseases including cancer, stroke, and heart failure. Building on significant advances in the in vivo application of EPR oximetry for small animal models of disease, we are developing suitable probes and instrumentation required for use in human subjects. Our laboratory has established the feasibility of clinical EPR oximetry in cancer patients using India ink, the only material presently approved for clinical use. We now are developing the next generation of probes, which are both superior in terms of oxygen sensitivity and biocompatibility including an excellent safety profile for use in humans. Further advances include the development of implantable oxygen sensors linked to an external coupling loop for measurements of deep-tissue oxygenations at any depth, overcoming the current limitation of 10 mm. This paper presents an overview of recent developments in our ability to make meaningful measurements of oxygen partial pressures in human subjects under clinical settings. PMID:24729217

  5. Determination of blood volume by pulse CO-oximetry

    International Nuclear Information System (INIS)

    Lalande, S; Kelsey, J W; Joyner, M J; Johnson, B D

    2012-01-01

    The objective of this study was to determine whether changes in carboxyhaemoglobin (COHb) saturation following carbon monoxide (CO) rebreathing can be accurately detected by pulse CO-oximetry in order to determine blood volume. Noninvasive measurements of carboxyhaemoglobin saturation (SpCO) were continuously monitored by pulse CO-oximetry before, during and following 2 min of CO rebreathing. Reproducibility and accuracy of noninvasive blood volume measurements were determined in 16 healthy non-smoking individuals (15 males, age: 28 ± 2 years, body mass index: 25.4 ± 0.6 kg m −2 ) through comparison with blood volume measurements calculated from invasive measurements of COHb saturation. The coefficient of variation for noninvasive blood volume measurements performed on separate days was 15.1% which decreases to 9.1% when measurements were performed on the same day. Changes in COHb saturation and SpCO following CO rebreathing were strongly correlated (r = 0.90, p < 0.01), resulting in a significant correlation between invasive and noninvasive blood volume measurements (r = 0.83, p = 0.02). Changes in SpCO following CO rebreathing can be accurately detected by pulse CO-oximetry, which could potentially provide a simplified, convenient and reproducible method to rapidly determine blood volume in healthy individuals

  6. Monitoring Oxygen Levels in Orthotopic Human Glioma Xenograft Following Carbogen Inhalation and Chemotherapy by Implantable Resonator Based Oximetry

    Science.gov (United States)

    Hou, Huagang; Nemani, Venkata Krishnamurthy; Du, Gaixin; Montano, Ryan; Song, Rui; Gimi, Barjor; Swartz, Harold M.; Eastman, Alan; Khan, Nadeem

    2014-01-01

    Hypoxia is a critical hallmark of glioma, and significantly compromises treatment efficacy. Unfortunately, techniques for monitoring glioma pO2 to facilitate translational research are lacking. Furthermore, poor prognoses of patients with malignant glioma, in particular glioblastoma multiforme, warrant effective strategies that can inhibit hypoxia and improve treatment outcome. EPR oximetry using implantable resonators was implemented for monitoring pO2 in normal cerebral tissue and U251 glioma in mice. Breathing carbogen (95% O2 + 5% CO2) was tested for hyperoxia in the normal brain and glioma xenografts. A new strategy to inhibit glioma growth by rationally combining gemcitabine and MK-8776, a cell cycle checkpoint inhibitor, was also investigated. The mean pO2 of left and right hemisphere were approximately 56 – 69 mmHg in the normal cerebral tissue of mice. The mean baseline pO2 of U251 glioma on the first and fifth day of measurement was 21.9 ± 3.7 and 14.1 ± 2.4 mmHg, respectively. The mean brain pO2 including glioma increased by at least 100% on carbogen inhalation, although the response varied between the animals over days. Treatment with gemcitabine + MK-8776 significantly increased pO2 and inhibited glioma growth assessed by MRI. In conclusion, EPR oximetry with implantable resonators can be used to monitor the efficacy of carbogen inhalation and chemotherapy on orthotopic glioma in mice. The increase in glioma pO2 of mice breathing carbogen can be used to improve treatment outcome. The treatment with gemcitabine + MK-8776 is a promising strategy that warrants further investigation. PMID:25111969

  7. Monitoring oxygen levels in orthotopic human glioma xenograft following carbogen inhalation and chemotherapy by implantable resonator-based oximetry.

    Science.gov (United States)

    Hou, Huagang; Krishnamurthy Nemani, Venkata; Du, Gaixin; Montano, Ryan; Song, Rui; Gimi, Barjor; Swartz, Harold M; Eastman, Alan; Khan, Nadeem

    2015-04-01

    Hypoxia is a critical hallmark of glioma, and significantly compromises treatment efficacy. Unfortunately, techniques for monitoring glioma pO2 to facilitate translational research are lacking. Furthermore, poor prognosis of patients with malignant glioma, in particular glioblastoma multiforme, warrant effective strategies that can inhibit hypoxia and improve treatment outcome. EPR oximetry using implantable resonators was implemented for monitoring pO2 in normal cerebral tissue and U251 glioma in mice. Breathing carbogen (95% O2 + 5% CO2 ) was tested for hyperoxia in the normal brain and glioma xenografts. A new strategy to inhibit glioma growth by rationally combining gemcitabine and MK-8776, a cell cycle checkpoint inhibitor, was also investigated. The mean pO2 of left and right hemisphere were ∼56-69 mmHg in the normal cerebral tissue of mice. The mean baseline pO2 of U251 glioma on the first and fifth day of measurement was 21.9 ± 3.7 and 14.1 ± 2.4 mmHg, respectively. The mean brain pO2 including glioma increased by at least 100% on carbogen inhalation, although the response varied between the animals over days. Treatment with gemcitabine + MK-8776 significantly increased pO2 and inhibited glioma growth assessed by MRI. In conclusion, EPR oximetry with implantable resonators can be used to monitor the efficacy of carbogen inhalation and chemotherapy on orthotopic glioma in mice. The increase in glioma pO2 of mice breathing carbogen can be used to improve treatment outcome. The treatment with gemcitabine + MK-8776 is a promising strategy that warrants further investigation. © 2014 UICC.

  8. Retinal Oximetry with Scanning Laser Ophthalmoscope in Infants.

    Directory of Open Access Journals (Sweden)

    Wouter B Vehmeijer

    Full Text Available Dual wavelength retinal oximetry has been developed for adults, but is not available for infants. Retinal oximetry may provide insight into the pathophysiology of oxygen-mediated diseases like retinopathy of prematurity. More insight in the oxygen metabolism of the retina in infants may provide valuable clues for better understanding and subsequent prevention or treatment of the disease. The measurements of oxygen saturation are obtained with two fundus images simultaneously captured in two different wavelengths of light. The comparison in light absorption of oxygenated and deoxygenated hemoglobin can be used to estimate the oxygen saturation within the retinal vessels by means of a software algorithm. This study aims to make retinal oximetry available for neonates. The first step towards estimating retinal oxygen saturation is determining the optical density ratio. Therefore, the purpose of this study is to image healthy newborn infants with a scanning laser ophthalmoscope and determine the optical density ratio for retinal oximetry analysis.Images of the retina of full-term healthy infants were obtained with an SLO, Optomap 200Tx (Optos, with two laser wavelengths (532nm and 633nm. The infant lay face down on the lower arm of the parent, while the parent supported the chest and chin with one hand, and stabilized the back with the other hand. No mydriatics or eyelid specula were used during this study. The images were analyzed with modified Oxymap Analyzer software for calculation of the Optical Density Ratio (ODR and vessel width. The ODR is inversely and approximately linearly related to the oxygen saturation. Measurements were included from the superotemporal vessel pair. A paired t-test was used for statistical analysis.Fifty-nine infants, (58% female, were included with mean gestational age of 40 ± 1.3 weeks (mean ± SD and mean post-natal age of 16 ± 4.8 days. A total of 28 images were selected for retinal oximetry analysis. The ODR was

  9. Assessment of automated analysis of portable oximetry as a screening test for moderate-to-severe sleep apnea in patients with chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Ana M Andrés-Blanco

    Full Text Available The coexistence of obstructive sleep apnea syndrome (OSAS and chronic obstructive pulmonary disease (COPD leads to increased morbidity and mortality. The development of home-based screening tests is essential to expedite diagnosis. Nevertheless, there is still very limited evidence on the effectiveness of portable monitoring to diagnose OSAS in patients with pulmonary comorbidities.To assess the influence of suffering from COPD in the performance of an oximetry-based screening test for moderate-to-severe OSAS, both in the hospital and at home.A total of 407 patients showing moderate-to-high clinical suspicion of OSAS were involved in the study. All subjects underwent (i supervised portable oximetry simultaneously to in-hospital polysomnography (PSG and (ii unsupervised portable oximetry at home. A regression-based multilayer perceptron (MLP artificial neural network (ANN was trained to estimate the apnea-hypopnea index (AHI from portable oximetry recordings. Two independent validation datasets were analyzed: COPD versus non-COPD.The portable oximetry-based MLP ANN reached similar intra-class correlation coefficient (ICC values between the estimated AHI and the actual AHI for the non-COPD and the COPD groups either in the hospital (non-COPD: 0.937, 0.909-0.956 CI95%; COPD: 0.936, 0.899-0.960 CI95% and at home (non-COPD: 0.731, 0.631-0.808 CI95%; COPD: 0.788, 0.678-0.864 CI95%. Regarding the area under the receiver operating characteristics curve (AUC, no statistically significant differences (p >0.01 between COPD and non-COPD groups were found in both settings, particularly for severe OSAS (AHI ≥30 events/h: 0.97 (0.92-0.99 CI95% non-COPD vs. 0.98 (0.92-1.0 CI95% COPD in the hospital, and 0.87 (0.79-0.92 CI95% non-COPD vs. 0.86 (0.75-0.93 CI95% COPD at home.The agreement and the diagnostic performance of the estimated AHI from automated analysis of portable oximetry were similar regardless of the presence of COPD both in-lab and at

  10. Clinical value of virtual three-dimensional instrument and cerebral aneurysm models in the interventional preoperative simulation

    International Nuclear Information System (INIS)

    Wei Xin; Xie Xiaodong; Wang Chaohua

    2007-01-01

    Objective: To establish virtual three-dimensional instrument and cerebral aneurysm models by using three-dimensional moulding software, and to explore the effect of the models in interventional preoperative simulation. Methods: The virtual individual models including cerebral arteries and aneurysms were established by using the three-dimensional moulding software of 3D Studio MAX R3 based on standard virtual cerebral aneurysm models and individual DSA image. The virtual catheter, guide wire, stent and coil were also established. The study of interventional preoperative simulation was run in personal computer, and included 3 clinical cases. Results: The simulation results of the working angle and the moulding angle of the head of catheter and guide wire in 3 cases were identical with that of operation results. The simulation results of the requirement of number and size of coil in 1 case of anterior communicating aneurysm and 1 case of posterior communicating aneurysm were identical with that of operation results. The simulation results of coil for aneurysmal shape in 1 case of giant internal carotid artery aneurysm were more than 2 three-dimensional coils with size of 3 mm x 3 cm from the operation results, and the position of the second coil in aneurysmal neck was adjusted according to the results of real-time simulation. The results of retrospective simulation of operation procedure indicated that the simulation methods for regular and small aneurysms could become a routine simulation means but more simulation experience was needed to build up for the giant aneurysms. Conclusions: The virtual three-dimensional instrument and cerebral aneurysm models established by the general software provided a new study method for neuro-interventional preoperative simulation, and it played an important guidance role in developing neuro-interventional operation. (authors)

  11. Regional Distribution of Cerebral Blood Flow in childhood Measured by '99mTc-HMPAO SPECT: Reference Values of Semiquantitative Indices and Effect of Age

    International Nuclear Information System (INIS)

    Kim, Sang Eun; Lee, Dong Soo; Chung, June Key

    1991-01-01

    Regional cerebral blood flow (rCBF) was evaluated in 12 children ranging in age from 2.7 to 10.0 yr using 99m Tc-HMPAO SPECT. For quantitative analysis, 13 pairs of homologous regions of interest (ROIs) were created on three attenuation-corrected 18,8 mm thick transverse slices matching the cerebral cortical regions, deep gray matter, cerebellar hemisphere, and vascular territories, and the semiquantitative indices including 'right to left ratio [(mean count/voxel of homologous right ROI) /(mean count/voxel of homologous left ROI)] and regional index '(RI) [(mean count/voxel of a ROI)/(mean count/voxel of all ROIs of each hemisphere)] were calculated. Mean values of right to left ratios of homologous regions ranged from 0.984 to 1.028 in children under 5 yr (group 1) and from 0.982 to 1.012 in children between 5 and 10 yr (group 2), and the mean value ±2 S.D. for each region did not exceed 11%. and 12% in group 1 and group 2, respective]y. There were no statistically significant differences between the RIs of the homologous right and left regions. Significant differences of RIs were found both between vascular regions (p<0,0005 for group 1, and p=0,0001 for group 2) and between regions of cerebral cortices (p<0,0005 for group 1, and p<0,005 for group 2) with a relatively high value in the occipital cortex and the lower values in the cerebellum and deep gray matter among the regions of cerebral cortices in both groups. There were no significant differences between the Rls of corresponding regions of group 1 and group 2, except a significantly higher value of right deep gray matter in group 2 than in group 1 (p=0.0301). The RIs of the superior frontal cortex and deep gray matter showed to be positively correlated with age (superior frontal cortex; right: rs=0.5254, p=0.0814, left: rs=0.5919, p=0.0496/deep gray matter; right: rs=0.8246, p=0.0062, left: rs=0.6266, p=0,0377). The results suggest that the rCBF pattern of children approaches that of adults in an occipito

  12. Pulse oximetry in family practice: indications and clinical observations in patients with COPD.

    NARCIS (Netherlands)

    Schermer, T.R.J.; Leenders, J.L.H.; Veen, H. in 't; Bosch, W.J.H.M. van den; Wissink, A.; Smeele, I.J.M.; Chavannes, N.H.

    2009-01-01

    PURPOSE: To establish situations in which family physicians (FPs) consider pulse oximetry a valuable addition to their clinical patient assessment; to explore pulse oximetry results (SpO(2)) when used by FPs in patients with chronic obstructive pulmonary disease (COPD); to explore associations

  13. Evaluation of peripheral microcirculation improvement of foot after tarsal tunnel release in diabetic patients by transcutaneous oximetry.

    Science.gov (United States)

    Trignano, Emilio; Fallico, Nefer; Chen, Hung-Chi; Faenza, Mario; Bolognini, Alfonso; Armenti, Andrea; Santanelli Di Pompeo, Fabio; Rubino, Corrado; Campus, Gian Vittorio

    2016-01-01

    According to recent studies, peripheral nerve decompression in diabetic patients seems to not only improve nerve function, but also to increase microcirculation; thus decreasing the incidence of diabetic foot wounds and amputations. However, while the postoperative improvement of nerve function is demonstrated, the changes in peripheral microcirculation have not been demonstrated yet. The aim of this study is to assess the degree of microcirculation improvement of foot after the tarsal tunnel release in the diabetic patients by using transcutaneous oximetry. Twenty diabetic male patients aged between 43 and 72 years old (mean age 61.2 years old) suffering from diabetic peripheral neuropathy with superimposed nerve compression underwent transcutaneous oximetry (PtcO2) before and after tarsal tunnel release by placing an electrode on the skin at the level of the dorsum of the foot. Eight lower extremities presented diabetic foot wound preoperatively. Thirty-six lower extremities underwent surgical release of the tibialis posterior nerve only, whereas four lower extremities underwent the combined release of common peroneal nerve, anterior tibialis nerve, and posterior tibialis nerve. Preoperative values of transcutaneous oximetry were below the critical threshold, that is, lower than 40 mmHg (29.1 ± 5.4 mmHg). PtcO2 values at one month after surgery (45.8 ± 6.4 mmHg) were significantly higher than the preoperative ones (P = 0.01). The results of postoperative increase in PtcO2 values demonstrate that the release of the tarsal tunnel determines a relevant increase in microcirculation in the feet of diabetic patients. © 2015 Wiley Periodicals, Inc.

  14. In vivo evidence of methamphetamine induced attenuation of brain tissue oxygenation as measured by EPR oximetry

    International Nuclear Information System (INIS)

    Weaver, John; Yang, Yirong; Purvis, Rebecca; Weatherwax, Theodore; Rosen, Gerald M.; Liu, Ke Jian

    2014-01-01

    Abuse of methamphetamine (METH) is a major and significant societal problem in the US, as a number of studies have suggested that METH is associated with increased cerebrovascular events, hemorrhage or vasospasm. Although cellular and molecular mechanisms involved in METH-induced toxicity are not completely understood, changes in brain O 2 may play an important role and contribute to METH-induced neurotoxicity including dopaminergic receptor degradation. Given that O 2 is the terminal electron acceptor for many enzymes that are important in brain function, the impact of METH on brain tissue pO 2 in vivo remains largely uncharacterized. This study investigated striatal tissue pO 2 changes in male C57BL/6 mice (16–20 g) following METH administration using EPR oximetry, a highly sensitive modality to measure pO 2 in vivo, in situ and in real time. We demonstrate that 20 min after a single injection of METH (8 mg/kg i.v.), the striatal pO 2 was reduced to 81% of the pretreatment level and exposure to METH for 3 consecutive days further attenuated striatal pO 2 to 64%. More importantly, pO 2 did not recover fully to control levels even 24 h after administration of a single dose of METH and continual exposure to METH exacerbates the condition. We also show a reduction in cerebral blood flow associated with a decreased brain pO 2 indicating an ischemic condition. Our findings suggests that administration of METH can attenuate brain tissue pO 2 , which may lead to hypoxic insult, thus a risk factor for METH-induced brain injury and the development of stroke in young adults. - Highlights: • Explored striatal tissue pO 2 in vivo after METH administration by EPR oximetry. • pO 2 was reduced by 81% after a single dose and 64% after 3 consecutive daily doses. • pO 2 did not recover fully to control levels even 24 h after a single dose. • Decrease in brain tissue pO 2 may be associated with a decrease in CBF. • Administration of methamphetamine may lead to hypoxic

  15. In vivo evidence of methamphetamine induced attenuation of brain tissue oxygenation as measured by EPR oximetry

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, John, E-mail: jmweaver@salud.unm.edu [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Yang, Yirong [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Purvis, Rebecca [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Weatherwax, Theodore [Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Rosen, Gerald M. [Center for Biomedical Engineering and Technology, University of Maryland, Baltimore, MD 21201 (United States); Center for EPR Imaging In Vivo Physiology, University of Maryland, Baltimore, MD 21201 (United States); Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD 21201 (United States); Liu, Ke Jian [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States)

    2014-03-01

    Abuse of methamphetamine (METH) is a major and significant societal problem in the US, as a number of studies have suggested that METH is associated with increased cerebrovascular events, hemorrhage or vasospasm. Although cellular and molecular mechanisms involved in METH-induced toxicity are not completely understood, changes in brain O{sub 2} may play an important role and contribute to METH-induced neurotoxicity including dopaminergic receptor degradation. Given that O{sub 2} is the terminal electron acceptor for many enzymes that are important in brain function, the impact of METH on brain tissue pO{sub 2}in vivo remains largely uncharacterized. This study investigated striatal tissue pO{sub 2} changes in male C57BL/6 mice (16–20 g) following METH administration using EPR oximetry, a highly sensitive modality to measure pO{sub 2}in vivo, in situ and in real time. We demonstrate that 20 min after a single injection of METH (8 mg/kg i.v.), the striatal pO{sub 2} was reduced to 81% of the pretreatment level and exposure to METH for 3 consecutive days further attenuated striatal pO{sub 2} to 64%. More importantly, pO{sub 2} did not recover fully to control levels even 24 h after administration of a single dose of METH and continual exposure to METH exacerbates the condition. We also show a reduction in cerebral blood flow associated with a decreased brain pO{sub 2} indicating an ischemic condition. Our findings suggests that administration of METH can attenuate brain tissue pO{sub 2}, which may lead to hypoxic insult, thus a risk factor for METH-induced brain injury and the development of stroke in young adults. - Highlights: • Explored striatal tissue pO{sub 2}in vivo after METH administration by EPR oximetry. • pO{sub 2} was reduced by 81% after a single dose and 64% after 3 consecutive daily doses. • pO{sub 2} did not recover fully to control levels even 24 h after a single dose. • Decrease in brain tissue pO{sub 2} may be associated with a decrease in

  16. Repeated assessment of orthotopic glioma pO2 by multi-site EPR oximetry: A technique with the potential to guide therapeutic optimization by repeated measurements of oxygen

    Science.gov (United States)

    Khan, Nadeem; Mupparaju, Sriram; Hou, Huagang; Williams, Benjamin B.; Swartz, Harold

    2011-01-01

    Tumor hypoxia plays a vital role in therapeutic resistance. Consequently, measurements of tumor pO2 could be used to optimize the outcome of oxygen-dependent therapies, such as, chemoradiation. However, the potential optimizations are restricted by the lack of methods to repeatedly and quantitatively assess tumor pO2 during therapies, particularly in gliomas. We describe the procedures for repeated measurements of orthotopic glioma pO2 by multi-site electron paramagnetic resonance (EPR) oximetry. This oximetry approach provides simultaneous measurements of pO2 at more than one site in the glioma and contralateral cerebral tissue. The pO2 of intracerebral 9L, C6, F98 and U251 tumors, as well as contralateral brain, were measured repeatedly for five consecutive days. The 9L glioma was well oxygenated with pO2 of 27 - 36 mm Hg, while C6, F98 and U251 glioma were hypoxic with pO2 of 7 - 12 mm Hg. The potential of multi-site EPR oximetry to assess temporal changes in tissue pO2 was investigated in rats breathing 100% O2. A significant increase in F98 tumor and contralateral brain pO2 was observed on day 1 and day 2, however, glioma oxygenation declined on subsequent days. In conclusion, EPR oximetry provides the capability to repeatedly assess temporal changes in orthotopic glioma pO2. This information could be used to test and optimize the methods being developed to modulate tumor hypoxia. Furthermore, EPR oximetry could be potentially used to enhance the outcome of chemoradiation by scheduling treatments at times of increase in glioma pO2. PMID:22079559

  17. Value of botulinum toxin injections preceding a comprehensive rehabilitation period for children with spastic cerebral palsy: A cost-effectiveness study.

    Science.gov (United States)

    Schasfoort, Fabienne; Dallmeijer, Annet; Pangalila, Robert; Catsman, Coriene; Stam, Henk; Becher, Jules; Steyerberg, Ewout; Polinder, Suzanne; Bussmann, Johannes

    2018-01-10

    Despite the widespread use of botulinum toxin in ambulatory children with spastic cerebral palsy, its value prior to intensive physiotherapy with adjunctive casting/orthoses remains unclear. A pragmatically designed, multi-centre trial, comparing the effectiveness of botulinum toxin + intensive physiotherapy with intensive physiotherapy alone, including economic evaluation. Children with spastic cerebral palsy, age range 4-12 years, cerebral palsy-severity Gross Motor Function Classification System levels I-III, received either botulinum toxin type A + intensive physiotherapy or intensive physiotherapy alone and, if necessary, ankle-foot orthoses and/or casting. Primary outcomes were gross motor func-tion, physical activity levels, and health-related quality-of-life, assessed at baseline, 12 (primary end-point) and 24 weeks (follow-up). Economic outcomes included healthcare and patient costs. Intention-to-treat analyses were performed with linear mixed models. There were 65 participants (37 males), with a mean age of 7.3 years (standard deviation 2.3 years), equally distributed across Gross Motor Function Classification System levels. Forty-one children received botulinum toxin type A plus intensive physio-therapy and 24 received intensive physiotherapy treatment only. At primary end-point, one statistically significant difference was found in favour of intensive physiotherapy alone: objectively measured percentage of sedentary behaviour (-3.42, 95% confidence interval 0.20-6.64, p=0.038). Treatment costs were significantly higher for botulinum toxin type A plus intensive physiotherapy (8,963 vs 6,182 euro, p=0.001). No statistically significant differences were found between groups at follow-up. The addition of botulinum toxin type A to intensive physiotherapy did not improve the effectiveness of rehabilitation for ambulatory children with spastic cerebral palsy and was also not cost-effective. Thus botulinum toxin is not recommended for use in improving gross

  18. Predictive Value of Dynamic Cerebral Autoregulation Assessment in Surgical Management of Patients with High-Grade Carotid Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Vladimir B. Semenyutin

    2017-11-01

    Full Text Available Dynamic cerebral autoregulation (DCA capacity along with the degree of internal carotid artery (ICA stenosis and characteristics of the plaque can also play an important role in selection of appropriate treatment strategy. This study aims to classify the patients with severe ICA stenosis according to preoperative state of DCA and to assess its dynamics after surgery. Thirty-five patients with severe ICA stenosis having different clinical type of disease underwent reconstructive surgery. DCA was assessed with transfer function analysis (TFA by calculating phase shift (PS between Mayer waves of blood flow velocity (BFV and blood pressure (BP before and after operation. In 18 cases, regardless of clinical type, preoperative PS on ipsilateral side was within the normal range and did not change considerably after surgery. In other 17 cases preoperative PS was reliably lower both in patients with symptomatic and asymptomatic stenosis. Surgical reconstruction led to restoration of impaired DCA evidenced by significant increase of PS in postoperative period. Our data suggest that regardless clinical type of disease various state of DCA may be present in patients with severe ICA stenosis. This finding can contribute to establishing the optimal treatment strategy, and first of all for asymptomatic patients. Patients with compromised DCA should be considered as ones with higher risk of stroke and first candidates for reconstructive surgery.

  19. The value of multi ultra high-b-value DWI in grading cerebral astrocytomas and its association with aquaporin-4.

    Science.gov (United States)

    Tan, Yan; Zhang, Hui; Wang, Xiao-Chun; Qin, Jiang-Bo; Wang, Le

    2018-06-01

    To investigate the value of multi-ultrahigh-b-value diffusion-weighted imaging (UHBV-DWI) in differentiating high-grade astrocytomas (HGAs) from low-grade astrocytomas (LGAs), analyze its association with aquaporin (AQP) expression. 40 astrocytomas divided into LGAs (N = 15) and HGAs (N = 25) were studied. Apparent diffusion coefficient (ADC) and UHBV-ADC values in solid parts and peritumoral edema were compared between LGAs and HGAs groups by the t-test. Using receiver operating characteristic curves to identify the better parameter. Using real time polymerase chain reaction to assess AQP messenger ribonucleic acid (mRNA). Using spearman correlation analysis to assess the correlation of AQP mRNA with each parameter. ADC values in solid parts of HGAs were significantly lower than LGAs (p = 0.02), while UHBV-ADC values of HGAs were significantly higher than LGAs (p  0.05); ADC value showed a negative correlation with AQP4 mRNA (r = -0.357; p = 0.024). UHBV-ADC value positively correlated with the AQP4 mRNA (r = 0.646; p value may be related with the AQP4 mRNA levels. UHBV-DWI could be of value in the assessment of astrocytoma. Advances in knowledge: UHBV-DWI generated by multi UHBV could have particular value for astrocytoma grading, and the level of AQP4 mRNA might be potentially linked to the change of UHBV-DWI parameter, and we might find the exact reason for the difference of UHBV-ADC between the LGAs and HGAs.

  20. In vivo evidence of methamphetamine induced attenuation of brain tissue oxygenation as measured by EPR oximetry

    Science.gov (United States)

    Weaver, John; Yang, Yirong; Purvis, Rebecca; Weatherwax, Theodore; Rosen, Gerald M.; Liu, Ke Jian

    2014-01-01

    Abuse of methamphetamine (METH) is a major and significant societal problem in the US, as a number of studies have suggested that METH is associated with increased cerebrovascular events, hemorrhage or vasospasm. Although cellular and molecular mechanisms involved in METH-induced toxicity are not completely understood, changes in brain O2 may play an important role and contribute to METH-induced neurotoxicity including dopaminergic receptor degradation. Given that O2 is the terminal electron acceptor for many enzymes that are important in brain function, the impact of METH on brain tissue pO2 in vivo remains largely uncharacterized. This study investigated striatal tissue pO2 changes in male C57BL/6 mice (16–20g) following METH administration using EPR oximetry, a highly sensitive modality to measure pO2 in vivo, in situ and in real time. We demonstrate that 20 min after a single injection of METH (8 mg/kg i.v.), the striatal pO2 was reduced to 81% of the pretreatment level and exposure to METH for 3 consecutive days further attenuated striatal pO2 to 64%. More importantly, pO2 did not recover fully to control levels even 24 hrs after administration of a single dose of METH. and continual exposure to METH exacerbates the condition. We also show a reduction in cerebral blood flow associated with a decreased brain pO2 indicating an ischemic condition. Our findings suggests that administration of METH can attenuate brain tissue pO2, which may lead to hypoxic insult, thus a risk factor for METH-induced brain injury and the development of stroke in young adults. PMID:24412707

  1. New laser system for highly sensitive clinical pulse oximetry

    Science.gov (United States)

    Hamza, Mostafa; Hamza, Mohammad

    1996-04-01

    This paper describes the theory and design of a new pulse oximeter in which laser diodes and other compact laser sources are used for the measurement of oxygen saturation in patients who are at risk of developing hypoxemia. The technique depends upon illuminating special sites of the skin of the patient with radiation from modulated laser sources at selected wavelengths. The specific laser wavelengths are chosen based on the absorption characteristics of oxyhemoglobin, reduced hemoglobin and other interfering sources for obtaining more accurate measurements. The laser radiation transmitted through the tissue is detected and signal processing based on differential absorption laser spectroscopy is done in such a way to overcome the primary performance limitations of the conventionally used pulse oximetry. The new laser pulse oximeter can detect weak signals and is not affected by other light sources such as surgical lamps, phototherapy units, etc. The detailed description and operating characteristics of this system are presented.

  2. Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yoon Seong; Ahn, Sung Soo; Lee, Seung-Koo [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, College of Medicine, Seoul (Korea, Republic of); Chang, Jong Hee; Kang, Seok-Gu [Yonsei University College of Medicine, Department of Neurosurgery, Seoul (Korea, Republic of); Kim, Se Hoon [Yonsei University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Zhou, Jinyuan [Johns Hopkins University School of Medicine, Division of MRI Research, Department of Radiology, Baltimore, MD (United States)

    2017-08-15

    To evaluate the added value of amide proton transfer (APT) imaging to the apparent diffusion coefficient (ADC) from diffusion tensor imaging (DTI) and the relative cerebral blood volume (rCBV) from perfusion magnetic resonance imaging (MRI) for discriminating between high- and low-grade gliomas. Forty-six consecutive adult patients with diffuse gliomas who underwent preoperative APT imaging, DTI and perfusion MRI were enrolled. APT signals were compared according to the World Health Organization grade. The diagnostic ability and added value of the APT signal to the ADC and rCBV for discriminating between low- and high-grade gliomas were evaluated using receiver operating characteristic (ROC) analyses and integrated discrimination improvement. The APT signal increased as the glioma grade increased. The discrimination abilities of the APT, ADC and rCBV values were not significantly different. Using both the APT signal and ADC significantly improved discrimination vs. the ADC alone (area under the ROC curve [AUC], 0.888 vs. 0.910; P = 0.007), whereas using both the APT signal and rCBV did not improve discrimination vs. the rCBV alone (AUC, 0.927 vs. 0.923; P = 0.222). APT imaging may be a useful imaging biomarker that adds value to the ADC for discriminating between low- and high-grade gliomas. (orig.)

  3. Multi-infarct dementia and Alzheimer disease, contribution of cerebral circulation ultrasonography to pathogenesis and differential diagnosis. Value of microembolisation.

    Science.gov (United States)

    Pancak, Jaroslav; Wagnerova, Helena; Škultéty Szárazová, Andrea; Blaho, Andrej; Durovsky, Ondrej; Durovska, Judita

    2016-01-01

    Dementias are one of the most serious health and socioeconomic issues. Multi-infarct dementia (MID) and Alzheimer´s type dementia (AD) exhibit differences in cerebrovascular blood flow velocity profiles and in presence of microemboli, detected by transcranial Doppler sonography. A group of 77 persons was divided into 4 subgroups: 1. subgroup of patients with MID (n=19; 10 male and 9 female, mean age was 74.32±8.30 years); 2. subgroup of patients with AD (n=19; 11 male and 8 female, mean age was 70.37±87.85 years); 3. subgroup of patients with hypertension (n=19; 11 male and 8 female, age adjusted) and 4. sex and age adjusted control group (CG) of 20 persons without hypertension or other serious risk factors. The duplex ultrasonographic examination of extracranial and intracranial circulation was preceded by neurologic, neuropsychological and psychiatric examination. The presence of microemboli was determined using Multi Dop X2 device (maker DWL), 60 minutes monitoring. All patients underwent brain computer tomography (CT) or magnetic resonance imaging (MRI). We found significantly higher incidence (68.4%, p=0.5267) of asymptomatic microemboli in ACM in the group of patients with MID compared to the AD group, the group of patients with hypertension and CG. The occurrence of "asymptomatic" emboli in the middle cerebral artery in patients with multi-infarct dementia is higher in the current study. Although these microemboli do not cause immediate symptoms, the evidence suggests, that they may be a risk factor for cognitive impairment, especially for multi-infarct dementia.

  4. Intrauterine Methylene Blue Injection Influences the Accuracy of Pulse Oximetry Readings

    Directory of Open Access Journals (Sweden)

    Fuh-Cheng Yeh

    2005-12-01

    Conclusions: Intraoperative administration of methylene blue may induce false low readings on pulse oximetry. The patient was not hypoxemic. If there is any doubt, arterial blood gas analysis should be done to ensure that the patient is well oxygenated.

  5. 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 ...

  6. An assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery

    International Nuclear Information System (INIS)

    Teng, Zhongzhao; Graves, Martin J.; Gillard, Jonathan H.; Peng, Wenjia; Zhan, Qian; Zhang, Xuefeng; Liu, Qi; Chen, Shiyue; Tian, Xia; Chen, Luguang; Lu, Jianping; Brown, Adam J.

    2016-01-01

    Although certain morphological features depicted by high resolution, multi-contrast magnetic resonance imaging (hrMRI) have been shown to be different between culprit and non-culprit middle cerebral artery (MCA) atherosclerotic lesions, the incremental value of hrMRI to define culprit lesions over stenosis has not been assessed. Patients suspected with MCA stenosis underwent hrMRI. Lumen and outer wall were segmented to calculate stenosis, plaque burden (PB), volume (PV), length (PL) and minimum luminal area (MLA). Data from 165 lesions (112 culprit and 53 non-culprit) in 139 individuals were included. Culprit lesions were larger and longer with a narrower lumen and increased PB compared with non-culprit lesions. More culprit lesions showed contrast enhancement. Both PB and MLA were better indicators than stenosis in differentiating lesion types (AUC were 0.649, 0.732 and 0.737 for stenosis, PB and MLA, respectively). Combinations of PB, MLA and stenosis could improve positive predictive value (PPV) and specificity significantly. An optimal combination of stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm 2 produced a PPV = 85.7 %, negative predictive value = 54.1 %, sensitivity = 69.6 %, specificity = 75.5 %, and accuracy = 71.5 %. hrMRI plaque imaging provides incremental information to luminal stenosis in identifying culprit lesions. (orig.)

  7. Malaria cerebral Cerebral malaria

    Directory of Open Access Journals (Sweden)

    Carlos Hugo Zapata Zapata

    2003-03-01

    Full Text Available La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC. Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia.

  8. Cerebral Oximetry for the Prediction of Neurological Dysfunction in Cardiosurgical Patients

    Directory of Open Access Journals (Sweden)

    A. N. Shepelyuk

    2011-01-01

    Full Text Available Objective: to study the efficiency of intraoperative transeosophageal echocardiography in the detection of indications for and contraindications to early activation in the operating room after myocardial revascularization under extracorporeal circulation. Subject and methods. One hundred and eighty-six patients aged 55.0±0.6 years were examined. A Sonos Agilent 5500 apparatus and a multipurpose Omni-2 transducer were used for ultrasound study. Left ventricular ejection fraction was determined in the four-chamber (Simpson and transgastric views (visualization of the left ventricle in cross-section at the level of the papillary muscles. To identify impaired myocardial contractility hindering immediate activation, the authors analyzed the data of examining 142 patients who might undergo tracheal extubation in the operating room. A decreased left ventricular ejection fraction of less than 50% in the transgastric view was considered to be a contraindication to activation. The sensitivity of echocardiography in the differential diagnosis of acute myocardial infarction _ was studied in 44 patients with echocardiographic signs of acute myocardial ischemic lesion. Results. A left ventricular ejection fraction of less than 50% (41.5±2.2% in the transgastric view was a refusal criterion for immediate patient activation. This group of patients, as compared with those having a left ventricular ejection fraction of 60.1±1.7%, had a longer duration of inotropic therapy (45.2±2.1 and 13±1.1 hrs; p<0.05 and a more prolonged length of postoperative intensive care unit stay (36.2±1.7 and 18.8±0.75 hrs; p<0.05. The correlation coefficient between the left ventricular ejection fraction at the end of surgery and the duration of inotropic therapy was 0.51 (p<0.0001 and that with an intensive care unit stay was 0.48 (p=0.00018. Among the patients with electrocardiographic signs of acute myocardial ischemic lesion, ultrasound study did not confirm the diagnosis in 65.9% of cases, which allowed early activation to be performed without complications. Acute akinesis of the left ventricular walls in 93.8% was a sign of acute myocardial infarction verified later on by X-ray contrast and laboratory studies. Conclusion. Transeosophageal echocardiographic monitoring is a highly effective diagnostic technique that can detect patients with left ventricular systolic dysfunction and verify acute ischemia and infarction of the myocardium, which substantially increases the safety of patient activation in the operating room after myocardial revascularization. Key words: ultrasound monitoring, transeosophageal echocardiography, early tracheal extubation, early activation of cardiosurgical patients, myocardial revascularization, aortocoronary bypass surgery.

  9. Cerebral microangiopathies

    International Nuclear Information System (INIS)

    Linn, Jennifer

    2011-01-01

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  10. EPR Oximetry for Investigation of Hyperbaric O2 Pre-treatment for Tumor Radiosensitization.

    Science.gov (United States)

    Williams, Benjamin B; Hou, Huagang; Coombs, Rachel; Swartz, Harold M

    A number of studies have reported benefits associated with the application of hyperbaric oxygen treatment (HBO) delivered immediately prior to radiation therapy. While these studies provide evidence that pre-treatment with HBO may be beneficial, no measurements of intratumoral pO2 were carried out and they do not directly link the apparent benefits to decreased hypoxic fractions at the time of radiation therapy. While there is empirical evidence and some theoretical basis for HBO to enhance radiation therapy, without direct and repeated measurements of its effects on pO2, it is unlikely that the use of HBO can be understood and optimized for clinical applications. In vivo EPR oximetry is a technique uniquely capable of providing repeated direct measurements of pO2 through a non-invasive procedure in both animal models and human patients. In order to evaluate the ability of pretreatment with HBO to elevate tumor pO2, a novel small animal hyperbaric chamber system was constructed that allows simultaneous in vivo EPR oximetry. This chamber can be placed within the EPR magnet and is equipped with a variety of ports for multiplace gas delivery, thermoregulation, delivery of anesthesia, physiologic monitoring, and EPR detection. Initial measurements were performed in a subcutaneous RIF-1 tumor model in C3H/HeJ mice. The mean baseline pO2 value was 6.0 ± 1.2 mmHg (N = 7) and responses to two atmospheres absolute pressure HBO varied considerably across subjects, within tumors, and over time. When an increase in pO2 was observed, the effect was transient in all but one case, with durations lasting from 5 min to over 20 min, and returned to baseline levels during HBO administration. These results indicate that without direct measurements of pO2 in the tissue of interest, it is likely to be difficult to know the effects of HBO on actual tissue pO2.

  11. Value of the quantity and distribution of subarachnoid haemorrhage on CT in the localization of ruptured cerebral aneurysm

    International Nuclear Information System (INIS)

    Karttunen, A.I.; Jartti, P.H.; Haapea, M.; Ukkola, V.A.; Sajanti, J.

    2003-01-01

    Computed tomography (CT) is the 'gold standard' for detecting subarachnoid haemorrhage (SAH) and digital subtraction angiography (DSA) for visualising the vascular pathology. We studied retrospectively 180 patients with subarachnoid haemorrhage (SAH) who underwent first non-enhanced computed tomography (CT), then digital subtraction angiography (DSA) and finally operative aneurysm clipping. Our aim was to assess if the location of the ruptured aneurysm could be predicted on the basis of the quantity and distribution of haemorrhage on the initial CT scan. 180 patients with SAH were retrospectively studied. All the CT and DSA examinations were performed at the same hospital. CT was performed within 24 hours after the initial haemorrhage. DSA was performed alter the CT, within 48 hours after the initial haemorrhage. Two neuroradiologists, blind to the DSA results, analysed and scored independently the quantity and distribution of the haemorrhage and predicted the site of the ruptured aneurysm on the basis of the non-enhanced CT. DSA provided the location of the ruptured aneurysm. All the patients were operated upon, and the location of the ruptured aneurysm was determined. The overall reliability value (r,-value) between the two neuroradiologists for locating all ruptured aneurysms was 0.780. The corresponding value for the right MCA was 0.911, that for the left MCA 0.877 and that for the AcoA 0.736. Not all of the rc-values were calculated, either because the location of the rupture was constant or because the number of ruptures in the vessel was too small. Subarachnoid haemorrhage with a parenchymal hematoma is an excellent predictor of the site of the ruptured aneurysm with a statistical significance of p = 0.003. The quantity and pattern of the blood clot an CT within the day of onset of SAH is a reliable and quick cool for locating a ruptured MCA or AcoA aneurysm. It is not, however, reliable for locating other ruptured aneurysms. Subarachnoid haemorrhage with a

  12. Wavelength selection method with standard deviation: application to pulse oximetry.

    Science.gov (United States)

    Vazquez-Jaccaud, Camille; Paez, Gonzalo; Strojnik, Marija

    2011-07-01

    Near-infrared spectroscopy provides useful biological information after the radiation has penetrated through the tissue, within the therapeutic window. One of the significant shortcomings of the current applications of spectroscopic techniques to a live subject is that the subject may be uncooperative and the sample undergoes significant temporal variations, due to his health status that, from radiometric point of view, introduce measurement noise. We describe a novel wavelength selection method for monitoring, based on a standard deviation map, that allows low-noise sensitivity. It may be used with spectral transillumination, transmission, or reflection signals, including those corrupted by noise and unavoidable temporal effects. We apply it to the selection of two wavelengths for the case of pulse oximetry. Using spectroscopic data, we generate a map of standard deviation that we propose as a figure-of-merit in the presence of the noise introduced by the living subject. Even in the presence of diverse sources of noise, we identify four wavelength domains with standard deviation, minimally sensitive to temporal noise, and two wavelengths domains with low sensitivity to temporal noise.

  13. Oximetry and indications for tracheotomy for amyotrophic lateral sclerosis.

    Science.gov (United States)

    Bach, John Robert; Bianchi, Carlo; Aufiero, Elaine

    2004-11-01

    To explore the use of oximetry as a guide for using respiratory aids and tracheotomy in the treatment of patients with amyotrophic lateral sclerosis (ALS). A retrospective review of all ALS patients presenting to a neuromuscular disease clinic since 1996. Patients who were symptomatic for nocturnal hypoventilation were prescribed noninvasive ventilation (NIV). Patients with assisted cough peak flows of NIV and MAC and the duration of normalization were recorded. When the baseline was not or could not be normalized, the time to acute respiratory failure and tracheotomy or death were recorded. Twenty-five patients became dependent on NIV, including 13 patients who received NIV continuously for a mean (+/- SD) period of 19.7 +/- 16.9 months, without desaturation (group 1). For another 76 patients, the daytime baseline Spo(2) level decreased to NIV/MAC (group 2) for a mean duration of 11.1 +/- 8.7 months before desaturation reoccurred for 27 patients. Of the latter patients, 11 underwent tracheotomy, 14 died in NIV or MAC. The long-term use of NIV and MAC, and the avoidance of tracheotomy is dependent on glottic function rather than on inspiratory or expiratory muscle failure.

  14. In-vitro model for evaluation of pulse oximetry

    Science.gov (United States)

    Vegfors, Magnus; Lindberg, Lars-Goeran; Lennmarken, Claes; Oberg, P. Ake

    1991-06-01

    An in vitro model with blood circulating in a silicon tubing system and including an artificial arterial bed is an important tool for evaluation of the pulse oximetry technique. The oxygen saturation was measured on an artificial finger using a pulse oximeter (SpO2) and on blood samples using a hemoximeter (SaO2). Measurements were performed at different blood flows and at different blood hematocrits. An increase in steady as well as in pulsatile blood flow was followed by an increase in pulse oximeter readings and a better agreement between SpO2 and SaO2 readings. After diluting the blood with normal saline (decreased hematocrit) the agreement was further improved. These results indicate that the pulse oximeter signal is related to blood hematocrit and the velocity of blood. The flow-related dependance of SpO2 was also evaluated in a human model. These results provided evidence that the pulse oximeter signal is dependent on vascular changes.

  15. [The source and factors that influence tracheal pulse oximetry signal].

    Science.gov (United States)

    Fan, Xiao-hua; Wei, Wei; Wang, Jian; Mu, Ling; Wang, Li

    2010-03-01

    To investigate the source and factors that influence tracheal pulse oximetry signal. The adult mongrel dog was intubated after anesthesia. The tracheal tube was modified by attaching a disposable pediatric pulse oximeter to the cuff. The chest of the dog was cut open and a red light from the tracheal oximeter was aligned with the deeper artery. The changes in tracheal pulse oxygen saturation (SptO2) signal were observed after the deeper artery was blocked temporarily. The photoplethysmography (PPG) and readings were recorded at different intracuff pressures. The influence of mechanical ventilation on the signal was also tested and compared with pulse oxygen saturation (SpO2). The SptO2 signal disappeared after deeper artery was blocked. The SptO2 signal changed with different intracuff pressures (P signal appeared under 20-60 cm H2O of intracuff pressure than under 0-10 cm H2O of intracuff pressure(P signal under a condition with mechanical ventilation differed from that without mechanical ventilation (P signal is primarily derived from deeper arteries around the trachea, not from the tracheal wall. Both intracuff pressures and mechanical ventilation can influence SptO2 signal. The SptO2 signal under 20-60 cm H2O of intracuff pressure is stronger than that under 0-10 em H2O of intracuff pressure. Mechanical ventilation mainly changes PPG.

  16. Laser Doppler Flowmetry and Transcutaneous Oximetry in Chronic Skin Ulcers: A Comparative Evaluation.

    Science.gov (United States)

    Raposio, Edoardo; Bertozzi, Nicolò; Moretti, Rebecca; Grignaffini, Eugenio; Grieco, Michele P

    2017-07-01

    Laser Doppler Flowmetry (LDF) and transcutaneous oximetry (TcpO2) are established methods for investigating cutaneous perfusion. To date, no study previously performed has compared data obtained from these 2 methodologies in cases of chronic cutaneous ulcers. Laser Doppler Flowmetry and TcpO2 were performed in 25 consecutive outpatients with chronic lower limb ulcers (group A, experimental; 9 women and 16 men; mean age 67 years [range, 52-81 years]) and 25 age- and sex-matched healthy control subjects (group B, control) enrolled for the study. Ulcer aetiologies included 12 peripheral arterial occlusive disease, 9 chronic venous insufficiencies, and 4 pressure ulcers. Data were analyzed with Shapiro-Wilk and Wilcoxon-Mann-Whitney tests. A statistically significant difference (P < .05) was found between LDF values of the 2 groups. No statistically significant differences were found between the 2 groups regarding the TcpO2 measurements. The data confirmed the soundness of LDF while investigating local perfusion in patients with chronic cutaneous ulcers. The same diagnostic accuracy was not obtained by means of TcpO2.

  17. Parental preference and perspectives on continuous pulse oximetry in infants and children with bronchiolitis

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2018-04-01

    Full Text Available Mohamed A Hendaus,1,2 Suzan Nassar,3 Bassil A Leghrouz,3 Ahmed H Alhammadi,1,2 Mohammed Alamri4 1Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar; 2Department of Clinical Pediatrics, Weill Cornell Medicine, Doha, Qatar; 3Department of Pediatrics, Hamad General Corporation, Doha, Qatar; 4Pediatric Emergency Center, Hamad General Corporation, Doha, Qatar Objective: The purpose of the study was to investigate parental preference of continuous pulse oximetry in infants and children with bronchiolitis. Materials and methods: A cross-sectional prospective study was conducted at Hamad Medical Corporation in Qatar. Parents of infants and children <24 months old and hospitalized with bronchiolitis were offered an interview survey. Results: A total of 132 questionnaires were completed (response rate 100%. Approximately 90% of participants were 20–40 years of age, and 85% were females. The mean age of children was 7.2±5.8 months. Approximately eight in ten parents supported the idea of continuous pulse oximetry in children with bronchiolitis. Almost 43% of parents believed that continuous pulse-oximetry monitoring would delay their children’s hospital discharge. Interestingly, approximately 85% of caregivers agreed that continuous pulse oximetry had a good impact on their children’s health. In addition, around one in two of the participants stated that good bedside examinations can obviate the need for continuous pulse oximetry. Furthermore, 80% of parents believed that continuous pulse-oximetry monitoring would give the health-care provider a good sense of security regarding the child’s health. Finally, being a male parent was associated with significantly increased risk of reporting unnecessary fatigue, attributed to the sound of continuous pulse oximetry (P=0.031. Conclusion: Continuous pulse-oximetry monitoring in children with bronchiolitis was perceived as reassuring for parents. Involving parents

  18. Design of pulse oximetry signal based on personal computer for detection oxygen saturation

    International Nuclear Information System (INIS)

    Umi Salamah; Margi Sasono

    2015-01-01

    The lack or excess of oxygen in the blood will cause healthy and body system disorder. At certain level, the disease can lead to death. For that reason, the information about oxygen saturation in blood becomes important to be identified. One of the devices used to monitor the blood oxygen saturation is pulse oximetry. This research attempt to designed Pulse Oximetry based on personal computer using red LED and infrared as its light source, while the light sensor using photodiode. The designed Pulse Oximetry is a non-invasive instrumentation which LED drivers is placed on the fingertips. The LED light goes through the finger will be a signal that is fed to the photodiode and will be converted into digital signals by ADC (Analog to Digital Converter) and will be processed further by a personal computer to display the pulse oximetry graphics. This study uses Delphi 7, Microsoft Excel, and Mt Lab as its software.This designed pulse oximetry has been tested in two peoples: sample A, male 38 years; and sample B, a woman 23 years old. Oxygen saturation of sample A is 80.75, while the sample B is 90.75. (author)

  19. A Meta-Analysis about the Screening Role of Pulse Oximetry for Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Caiju Du

    2017-01-01

    Full Text Available Objective. The opinions about the application of pulse oximetry in diagnosis of congenital heart disease (CHD were debatable. We performed this meta-analysis to confirm the diagnostic role of pulse oximetry screening for CHD. Methods. Relevant articles were searched in the databases of Pubmed, Embase, Google Scholar, and Chinese National Knowledge Infrastructure (CNKI up to April 2017. Data was processed in the MetaDiSc 1.4 software. Pooled sensitivity and specificity with 95% confidence interval (95% CI were calculated to explain the diagnostic role of pulse oximetry screening for CHD. I2⩾50% or p<0.05 indicated significant heterogeneity. Area under curve (AUC of summary receiver operating characteristics (SROC was calculated to assess its diagnostic accuracy. The robustness of overall results was evaluated by sensitivity analysis. Publication bias was evaluated by Deek’s funnel plot. Results. 22 eligible articles were selected. Pooled sensitivity and specificity were 0.69 (0.67–0.72 and 0.99 (0.99-0.99, respectively. The corresponding AUC was 0.9407, suggesting high diagnostic accuracy of pulse oximetry screening for CHD. Sensitivity analysis demonstrated that the pooled results were robust. Deek’s funnel plot seemed to be symmetrical. Conclusions. Pulse oximetry screening could be used to diagnose CHD. It shows high diagnosis specificity and accuracy.

  20. Evaluation of Masimo signal extraction technology pulse oximetry in anaesthetized pregnant sheep.

    Science.gov (United States)

    Quinn, Christopher T; Raisis, Anthea L; Musk, Gabrielle C

    2013-03-01

    Evaluation of the accuracy of Masimo signal extraction technology (SET) pulse oximetry in anaesthetized late gestational pregnant sheep. Prospective experimental study. Seventeen pregnant Merino ewes. Animals included in study were late gestation ewes undergoing general anaesthesia for Caesarean delivery or foetal surgery in a medical research laboratory. Masimo Radical-7 pulse oximetry (SpO(2) ) measurements were compared to co-oximetry (SaO(2) ) measurements from arterial blood gas analyses. The failure rate of the pulse oximeter was calculated. Accuracy was assessed by Bland & Altman's (2007) limits of agreement method. The effect of mean arterial blood pressure (MAP), perfusion index (PI) and haemoglobin (Hb) concentration on accuracy were assessed by regression analysis. Forty arterial blood samples paired with SpO(2) and blood pressure measurements were obtained. SpO(2) ranged from 42 to 99% and SaO(2) from 43.7 to 99.9%. MAP ranged from 24 to 82 mmHg, PI from 0.1 to 1.56 and Hb concentration from 71 to 114 g L(-1) . Masimo pulse oximetry measurements tended to underestimate oxyhaemoglobin saturation compared to co-oximetry with a bias (mean difference) of -2% and precision (standard deviation of the differences) of 6%. Accuracy appeared to decrease when SpO(2) was oximeter function during extreme hypotension and hypoxaemia. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  1. RANCANG BANGUN PULSE OXIMETRY MENGGUNAKAN ARDUINO SEBAGAI DETEKSI KEJENUHAN OKSIGEN DALAM DARAH

    Directory of Open Access Journals (Sweden)

    Umi Salamah

    2016-12-01

    Full Text Available Kekurangan atau kelebihan oksigen dalam darah akan menimbulkan penyakit dan gangguan kerja tubuh. Pada tingkat tertentu, penyakit tersebut dapat meninbulkan resiko kematian. Oleh karena itu, informasi tentang kejenuhan oksigen dalam darah menjadi hal yang penting untuk dideteksi. Salah satu insturmentasi yang digunakan untuk memantau kejenuhan oksigen dalam darah adalah dengan pulse oximetry. Dalam penelitian ini dirancang bangun pulse oximetry berbasis personal computer menggunakan LED merah dan inframerah sebagai sumber cahaya sedang sensor cahaya yang digunakan adalah fotodioda. Pulse oximetry yang dirancang adalah instrumentasi non invasive yang mana driver LED diletakkan pada ujung jari. Cahaya LED yang terserap jari akan menjadi sinyal yang diumpankan ke fotodioda yang selanjutnya sinyal tersebut akan diubah menjadi sinyal digital oleh Arduino dan diproses lebih lanjut oleh personal computer untuk menampilkan grafik pulse oximetry tersebut. Perangkat lunak untuk mengolah data keluaran Arduino menggunakan Delphi 7, Microsoft Exel dan Mat Lab sebagai perangkat lunaknya. Hasil penelitian ini diperoleh sinyal Photopletysmography (PPG Ujung Jari yang representatif  dengan sinyal PPG referensi. Pengujian pulse oximetry yang telah dirancang adalah 16 dengan sampel uji random. Dari sampel tersebut, diperoleh 13 sampel uji berada pada prosentase kejenuhan oksigen normal dan 3 sampel uji berada pada prosentase kejenuhan oksigen tidak normal.

  2. An in vivo investigation of photoplethysmographic signals and preliminary pulse oximetry estimation from the bowel using a new fiberoptic sensor.

    Science.gov (United States)

    Hickey, Michelle; Samuels, Neal; Randive, Nilesh; Langford, Richard M; Kyriacou, Panayiotis A

    2011-05-01

    The continuous monitoring of splanchnic organ oxygen saturation could make the early detection of inadequate tissue oxygenation feasible, reducing the risk of hypoperfusion, severe ischemia, multiple organ failure, and, ultimately, death. Current methods for assessing splanchnic perfusion have not been widely accepted for use in the clinical care environment. In an attempt to overcome the limitations of the current techniques, a new fiberoptic photoplethysmographic (PPG)/pulse oximetry sensor was developed as a means of assessing splanchnic organ perfusion during surgery in humans. A new fiberoptic splanchnic pulse oximeter and an optically identical fiberoptic finger pulse oximeter have been developed. Simultaneous PPG signals and preliminary estimates of arterial oxygen saturation from the bowel (small and large) and finger were obtained in 17 patients (3 men and 14 women) undergoing open laparotomy. Good quality PPG signals were obtained from the small and large bowel and from the finger in all patients (lower 95% confidence limit for the proportion was 0.64). Comparisons of blood oxygen saturation values acquired when using the splanchnic and the finger fiberoptic sensors and a commercial finger pulse oximeter indicated that there was no statistically significant difference between them (all P>0.454). A Bland and Altman plot of the difference between blood oxygen saturation values from the bowel fiberoptic pulse oximeter and the fiberoptic finger pulse oximeter against their mean showed that the limits of agreement between the 2 pulse oximeters were -3.8% and 4.2% for small bowel measurements, and -3.4% and 4.3% for large bowel measurements. The 95% prediction interval for the difference between the 2 devices was between -4.2% and 4.7%. This study demonstrated that good quality PPG signals can be obtained from the bowel using a new fiberoptic sensor. Further evaluation is required to determine whether fiberoptic pulse oximetry of the bowel may provide a

  3. Simultaneous use of intrapartum fetal pulse oximetry and amnioinfusion in meconium stained amniotic fluid.

    Science.gov (United States)

    Halvax, László; Szabó, István; Vizer, Miklós; Csermely, Tamás; Ertl, Tibor

    2002-09-10

    Fetal pulse oximetry is a minimally invasive, simple technique which continuously helps to reflect in utero well-being. The presence of meconium in the amniotic fluid may be a clinical sign of fetal hypoxaemia. Amnioinfusion has a beneficial effect on the incidence of meconium aspiration syndrome (MAS), and the presence of meconium below the level of the vocal cords. We studied the impact of amnioinfusion combined with fetal pulse oximetry on the incidence of meconium aspiration syndrome and operative delivery. The retrospective analysis revealed that the presence of meconium below the level of vocal cords was significantly reduced. The frequency of cesarean section is decreased, however, it did not reach statistical significance. Fetal pulse oximetry may be used in combination with amnioinfusion and cardiotocography (CTG) to reduce the risk of meconium aspiration syndrome and the number of instrumental deliveries and improve perinatal outcome. Copyright 2002 Elsevier Science Ireland Ltd.

  4. Pulse Oximetry and Auscultation for Congenital Heart Disease Detection.

    Science.gov (United States)

    Hu, Xiao-Jing; Ma, Xiao-Jing; Zhao, Qu-Ming; Yan, Wei-Li; Ge, Xiao-Ling; Jia, Bing; Liu, Fang; Wu, Lin; Ye, Ming; Liang, Xue-Cun; Zhang, Jing; Gao, Yan; Zhai, Xiao-Wen; Huang, Guo-Ying

    2017-10-01

    Pulse oximetry (POX) has been confirmed as a specific screening modality for critical congenital heart disease (CCHD), with moderate sensitivity. However, POX is not able to detect most serious and critical cardiac lesions (major congenital heart disease [CHD]) without hypoxemia. In this study, we investigated the accuracy and feasibility of the addition of cardiac auscultation to POX as a screening method for asymptomatic major CHD. A multicenter prospective observational screening study was conducted at 15 hospitals in Shanghai between July 1, 2012, and December 31, 2014. Newborns with either an abnormal POX or cardiac auscultation were defined as screen positive. All screen-positive newborns underwent further echocardiography. False-negative results were identified by clinical follow-up, parents' feedback, and telephone review. We assessed the accuracy of POX plus cardiac auscultation for the detection of major CHD. CHD screening was completed in all 15 hospitals, with a screening rate of 94.0% to 99.8%. In total, 167 190 consecutive asymptomatic newborn infants were screened, of which 203 had major CHD (44 critical and 159 serious). The sensitivity of POX plus cardiac auscultation was 95.5% (95% confidence interval 84.9%-98.7%) for CCHD and 92.1% (95% confidence interval 87.7%-95.1%) for major CHD. The false-positive rate was 1.2% for detecting CCHD and 1.1% for detecting major CHD. In our current study, we show that using POX plus cardiac auscultation significantly improved the detection rate of major CHD in the early neonatal stage, with high sensitivity and a reasonable false-positive rate. It provides strong evidence and a reliable method for neonatal CHD screening. Copyright © 2017 by the American Academy of Pediatrics.

  5. 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

  6. 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...

  7. Lung vital capacity and oxygen saturation in adults with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Lampe R

    2014-12-01

    Full Text Available Renée Lampe,1,2 Tobias Blumenstein,2 Varvara Turova,2 Ana Alves-Pinto2 1Markus Würth Stiftungsprofessur, Technical University of Munich, Munich, Germany; 2Research Unit for Cerebral Palsy and Children Neuroorthopaedics of the Buhl-Strohmaier Foundation, Orthopedic Department of the Clinic “rechts der Isar” of the Technical University of Munich, Munich, Germany Background: Individuals with infantile cerebral palsy have multiple disabilities. The most conspicuous syndrome being investigated from many aspects is motor movement disorder with a spastic gait pattern. The lung function of adults with spasticity attracts less attention in the literature. This is surprising because decreased thoracic mobility and longstanding scoliosis should have an impact on lung function. With increasing age and the level of disability, individuals become susceptible to lung infections and reflux illness, and these are accompanied by increased aspiration risk. This study examined, with different methods, to what extent adults with congenital cerebral palsy and acquired spastic paresis – following traumatic brain injury – showed restriction of lung function. It also assessed the contribution of disability level on this restriction.Methods: The oxygen saturation of 46 adults with a diagnosis of cerebral palsy was measured with an oximeter. Lung vital capacity was measured with a mobile spirometer and excursion of the thorax was clinically registered. The gross motor function levels and the presence or absence of scoliosis were determined.Results: A significantly positive correlation between lung vital capacity and chest expansion was established. Both the lung vital capacity and the thorax excursion decreased with increases in gross motor function level. Oxygen saturation remained within the normal range in all persons, in spite of reduced values of the measured lung parameters. No statistically significant dependency between lung vital capacity and oxygen

  8. In vivo colocalization of 2-nitroimidazole EF5 fluorescence intensity and electron paramagnetic resonance oximetry in mouse tumors

    International Nuclear Information System (INIS)

    Mahy, Pierre; Bast, Marc de; Gallez, Bernard; Gueulette, John; Koch, Cameron J.; Scalliet, Pierre; Gregoire, Vincent

    2003-01-01

    Background and purpose: The primary objective of this study was to establish in vivo the relationship between 2-2-nitro-1H-imidazol-1yl-N-(2,2,3,3,3-pentafluoropropyl)-acetamide (EF5) adduct formation and intratumoral oxygen concentrations measured by electron paramagnetic resonance (EPR) in a tumor model mimicking a clinical situation. The secondary objective was an attempt to calibrate in situ the immunofluorescence (IF) signal with EPR oximetry. Materials and methods: IM syngeneic fibrosarcoma (NFSA) bearing C3H mice were used. Three days after injection of a paramagnetic charcoal into the tumor, the mice were anesthetized, injected with the hypoxic marker EF5, and monitored every 20 min for 3 h with a low-frequency EPR spectrometer. Animals were allowed to breath either under 21 or 100% O 2 . Tumors were then harvested, frozen, cut into sections including the charcoal and processed for EF5 adducts detection using monoclonal antibodies. Slices were viewed with a fluorescence microscope and 190x140 μm areas surrounding the charcoal were digitized and analyzed with the NIH-Image and Adobe Photoshop TM software. The fluorescence intensity (FI) was measured in the whole pictures and in strips of 10 μm around the charcoal. Results: EF5 binding increased with decreasing pO 2 , most substantially at pO 2 below 5 mm Hg. Baseline (ambient air) pO 2 reached 3.2±2.1 mm Hg in NFSA tumors. It increased to 9.8±3.2 mm Hg under 100% O 2 . A statistically significant correlation was observed on an individual tumor basis between the FI in the first 10 μm strip around the charcoal and the pO 2 determined by EPR oximetry (Wilcoxon signed rank test: P 2 in an in vivo environment under biologically-relevant pO 2 values of less than 10 mm Hg

  9. Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.

    Science.gov (United States)

    Guillory, Charleta; Gong, Alice; Livingston, Judith; Creel, Liza; Ocampo, Elena; McKee-Garrett, Tiffany

    2017-07-01

    Objective  Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design  Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results  The nurses' knowledge assessment improved from 71 to 92.5% ( p  educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Feasibility of pulse oximetry for assessment of infants born in community based midwifery care

    NARCIS (Netherlands)

    Smit, M.; Ganzeboom, A.; Dawson, J.A.; Walther, F.J.; Bustraan, J.; van Roosmalen, Jos; te Pas, A.B.

    2014-01-01

    To evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. Design: a prospective, observational study of infants born after midwifery supervised (home) births. Setting: 27 midwives from seven practices providing primary care in (home)

  11. High quantum efficiency annular backside silicon photodiodes for reflectance pulse oximetry in wearable wireless body sensors

    DEFF Research Database (Denmark)

    Duun, Sune Bro; Haahr, Rasmus Grønbek; Hansen, Ole

    2010-01-01

    The development of annular photodiodes for use in a reflectance pulse oximetry sensor is presented. Wearable and wireless body sensor systems for long-term monitoring require sensors that minimize power consumption. We have fabricated large area 2D ring-shaped silicon photodiodes optimized...

  12. Evaluating the Use of Tissue Oximetry to Decrease Intensive Unit Monitoring for Free Flap Breast Reconstruction.

    Science.gov (United States)

    Ricci, Joseph A; Vargas, Christina R; Ho, Olivia A; Lin, Samuel J; Tobias, Adam M; Lee, Bernard T

    2017-07-01

    Postoperative free flap care has historically required intensive monitoring for 24 hours in an intensive care unit. Continuous monitoring with tissue oximetry has allowed earlier detection of vascular compromise, decreasing flap loss and improving salvage. This study aims to identify whether a fast-track postoperative paradigm can be safely used with tissue oximetry to decrease intensive monitoring and costs. All consecutive microsurgical breast reconstructions performed at a single institution were reviewed (2008-2014) and cases requiring return to the operating room were identified. Data evaluated included patient demographics, the take back time course, and complications of flap loss and salvage. A cost-benefit analysis was performed to analyse the utility of a postoperative intensive monitoring setting. There were 900 flaps performed and 32 required an unplanned return to the operating room. There were 16 flaps that required a reexploration within the first 24 hours; the standard length of intensive unit monitoring. After 4 hours, there were 7 flaps (44%) detected by tissue oximetry for reexploration. After 15 hours of intensive monitoring postoperatively, cost analysis revealed that the majority (15/16; 94%) of failing flaps had been identified and the cost of identifying each subsequent failing flap exceeded the cost of another hour of intensive monitoring. The postoperative paradigm for microsurgical flaps has historically required intensive unit monitoring. Using tissue oximetry, a fast-track pathway can reduce time spent in an intensive monitoring setting from 24 to 15 hours with significant cost savings and minimal risk of missing a failing free flap.

  13. An Electronic Patch for Wearable Health Monitoring by Reflectance Pulse Oximetry

    DEFF Research Database (Denmark)

    Haahr, Rasmus Grønbek; Duun, Sune Bro; Toft, Mette H.

    2012-01-01

    photodiode to enable low power consumption by the light emitting components. The Electronic Patch has a disposable part of soft adhesive hydrocolloid polymer and a reusable part of hard polylaurinlactam. The disposable part contains the battery. The reusable part contains the reflectance pulse oximetry...

  14. REFLECTANCE PULSE OXIMETRY AT THE FOREHEAD IMPROVES BY PRESSURE ON THE PROBE

    NARCIS (Netherlands)

    DASSEL, ACM; GRAAFF, R; SIKKEMA, M; ZIJLSTRA, WG; AARNOUDSE, JG

    In this study, we investigated the possibility of improving reflectance (back-scatter) pulse oximetry measurements by pressure applied to the probe. Optimal signal detection, with the probe applied to an easily accessible location, is important to prevent erroneous oxygen saturation readouts. At the

  15. Electron paramagnetic resonance and dynamic nuclear polarization of char suspensions: surface science and oximetry

    DEFF Research Database (Denmark)

    Clarkson, R B; Odintsov, B M; Ceroke, P J

    1998-01-01

    ; they can be calibrated and used for oximetry. Biological stability and low toxicity make chars good sensors for in vivo measurements. Scalar and dipolar interactions of water protons at the surfaces of chars may be utilized to produce dynamic nuclear polarization (DNP) of the nuclear spin population...

  16. Detecting obstructive sleep apnea in children by self-affine visualization of oximetry.

    Science.gov (United States)

    Garde, Ainara; Dekhordi, Parastoo; Petersen, Christian L; Ansermino, J Mark; Dumont, Guy A

    2017-07-01

    Obstructive sleep apnea (OSA), characterized by cessations of breathing during sleep due to upper airway collapse, can affect the healthy growth and development of children. The gold standard for OSA diagnosis, polysomnography(PSG), is expensive and resource intensive, resulting in long waiting lists to perform a PSG. Previously, we investigated the time-frequency analysis of blood oxygen saturation (SpO 2 ) to screen for OSA. We used overnight pulse oximetry from 146 children, collected using a smartphone-based pulse oximeter (Phone Oximeter), simultaneously with standard PSG. Sleep technicians manually scored PSG and provided the average of apnea/hypoapnea events per hour (AHI). In this study, we proposed an alternative method for analyzing SpO 2 , in which a set of contracting transformations form a self-affine set with a 2D attractor, previously developed for qualitative visualization of the photoplethysmogram and electroencephalogram. We applied this technique to the overnight SpO 2 signal from individual patients and extracted features based on the distribution of points (radius and angle) in the visualization. The cloud of points in children without OSA (NonOSA) was more confined than in children with OSA, which was reflected by more empty pixels (radius and angles). The maximum value, skewness and standard deviation of the distribution of points located at different radius and angles were significantly (Bonferroni corrected) higher in NonOSA compared to OSA children. To detect OSA defined at different levels (AHI≥5, AHI≥10 and AHI≥15), three multivariate logistic regression models were implemented using a stepwise feature selection and internally validated through bootstrapping. The models (AHI≥5, AHI≥10, AHI≥15), consisting of 3, 4 and 1 features respectively, provided a bootstrap-corrected AUC of 73%, 81%, 73%. Thus, applying this visualization to nocturnal SpO 2 could yield both visual and quantitative information that might be useful for

  17. Comparison of cerebral tissue oxygenation values in full term and preterm newborns by the simultaneous use of two near-infrared spectroscopy devices: an absolute and a relative trending oximeter

    Science.gov (United States)

    Szczapa, Tomasz; Karpiński, Łukasz; Moczko, Jerzy; Weindling, Michael; Kornacka, Alicja; Wróblewska, Katarzyna; Adamczak, Aleksandra; Jopek, Aleksandra; Chojnacka, Karolina; Gadzinowski, Janusz

    2013-08-01

    The aim of this study is to compare a two-wavelength light emitting diode-based tissue oximeter (INVOS), which is designed to show trends in tissue oxygenation, with a four-wavelength laser-based oximeter (FORE-SIGHT), designed to deliver absolute values of tissue oxygenation. Simultaneous values of cerebral tissue oxygenation (StO2) are measured using both devices in 15 term and 15 preterm clinically stable newborns on the first and third day of life. Values are recorded simultaneously in two periods between which oximeter sensor positions are switched to the contralateral side. Agreement between StO2 values before and after the change of sensor position is analyzed. We find that mean cerebral StO2 values are similar between devices for term and preterm babies, but INVOS shows StO2 values spread over a wider range, with wider standard deviations than shown by the FORE-SIGHT. There is relatively good agreement with a bias up to 3.5% and limits of agreement up to 11.8%. Measurements from each side of the forehead show better repeatability for the FORE-SIGHT monitor. We conclude that performance of the two devices is probably acceptable for clinical purposes. Both performed sufficiently well, but the use of FORE-SIGHT may be associated with tighter range and better repeatability of data.

  18. Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound

    Directory of Open Access Journals (Sweden)

    Setyo Handryastuti

    2018-03-01

    Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice. Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP. Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjects’ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist. Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice. Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.

  19. [Cerebral aspergillosis].

    Science.gov (United States)

    Tattevin, P; Jauréguiberry, S; Gangneux, J-P

    2004-05-01

    The brain is almost always a localization of invasive aspergillosis, after hematogenous spread from pulmonary aspergillosis. Brain aspergilosis is not rare and is one of the worst prognosis factors of invasive aspergillosis. The incidence of this severe mycosis is currently on the rise due to the development of major immunosuppressive treatments. Brain aspergillosis is noteworthy for its vascular tropism, leading to infectious cerebral vasculitis, mainly involving thalamoperforating and lenticulostriate arteries, with a high frequency of thalamic or basal nuclei lesions. Extra-neurologic features that suggest this diagnosis are: i) risk factors for invasive aspergillosis (major or prolonged neutropenia, hematologic malignancies, prolonged corticosteroid treatment, bone marrow or solid organ transplant, AIDS); ii) persistent fever not responding to presumptive antibacterial treatment; iii) respiratory signs (brain aspergillosis is associated with pulmonary aspergillosis in 80 to 95 p. 100 of cases). Perspectives. Two recent major improvements in brain aspergillosis management must be outlined: i) for diagnostic purposes, the development of testing for Aspergillus antigenemia (a non-invasive procedure with good diagnostic value for invasive aspergillosis); ii) for therapeutic purposes, the demonstration that voriconazole is better than amphotericin B in terms of clinical response, tolerance and survival, for all types of invasive aspergillosis, the benefit being probably even greater in case of brain aspergillosis because of the good diffusion of voriconazole into the central nervous system. Brain aspergillosis is a severe emerging opportunistic infection for which diagnostic and therapeutic tools have recently improved. Thus, this diagnostic must be suspected early, especially in the immunocompromised patient, in the event of respiratory symptoms and when the brain lesions are localized in the central nuclei and the thalamus.

  20. Clinical value of detection on ser um monocyte chemotactant protein-1 and vascular endothelial cadher in levels in patients with acute cerebral infarction

    Directory of Open Access Journals (Sweden)

    Xia Zhou

    2016-11-01

    Full Text Available Objective: To study the correlation of serum monocyte chemotactant protein-1 (MCP-1 and vascular endothelia cadherin (VE-cadherin levels in patients with acute cerebral infarction, and nerve injury molecules, interleukins and matrix metalloproteinases. Methods: A total of 86 patients with acute cerebral infarction treated in our hospital from April 2012 to October 2015 were selected as the observation group and 50 healthy subjects in the same period treated in our hospital were selected as the control group. The serums were collected and the contents of MCP-1, VE-cadherin, heart-type fatty acid binding protein (H-FABP, S100 calcium binding protein B (S100B, neuron-specific enolase (NSE, interleukin-lb (IL-1b, IL-6, IL-17, IL-18, matrix metalloproteinase-2 (MMP2, MMP3 and MMP9 were measured. Results: The serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL- 6, IL-17, IL-18, MMP2, MMP3 and MMP9 in observation group were significantly higher than those of control group. Carotid artery plaque formation and unstable plaque properties will increase the serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in patients with cerebral infarction. The serum levels of MCP-1, VE-cadherin and the contents of H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 were positively correlated. Conclusions: The serum levels of VE-cadherin and MCP-1 were significantly increased in patients with acute cerebral infarction. MCP-1 and VE-cadherin can increase the secretion of interleukins and matrix metalloproteinases, which can result in the carotid artery plaque formation, unstable plaque properties and the injury of nerve function.

  1. The use of overnight pulse oximetry and phoniatrics parameters in the screening protocol of obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Yassin Soliman Bahgat

    2012-10-01

    Conclusions: Polysomnography is the current golden standard test for diagnosis and evaluation of degree of OSA. Overnight pulse oximetry offers an inexpensive method of screening for and diagnosing OSAHS. Oximetry alone allowed confident recognition of moderate and severe cases of OSAHS. Acoustic analysis of snoring sounds and voice in patients with snoring and/or OSAHS is useful as a screening or supportive method with other investigations to diagnose the site of upper airway obstruction during sleep.

  2. [Cerebral protection].

    Science.gov (United States)

    Cattaneo, A D

    1993-09-01

    Cerebral protection means prevention of cerebral neuronal damage. Severe brain damage extinguishes the very "human" functions such as speech, consciousness, intellectual capacity, and emotional integrity. Many pathologic conditions may inflict injuries to the brain, therefore the protection and salvage of cerebral neuronal function must be the top priorities in the care of critically ill patients. Brain tissue has unusually high energy requirements, its stores of energy metabolites are small and, as a result, the brain is totally dependent on a continuous supply of substrates and oxygen, via the circulation. In complete global ischemia (cardiac arrest) reperfusion is characterized by an immediate reactive hyperemia followed within 20-30 min by a delayed hypoperfusion state. It has been postulated that the latter contributes to the ultimate neurologic outcome. In focal ischemia (stroke) the primary focus of necrosis is encircled by an area (ischemic penumbra) that is underperfused and contains neurotoxic substances such as free radicals, prostaglandins, calcium, and excitatory neurotransmitters. The variety of therapeutic effort that have addressed the question of protecting the brain reflects their limited success. 1) Barbiturates. After an initial enthusiastic endorsement by many clinicians and years of vigorous controversy, it can now be unequivocally stated that there is no place for barbiturate therapy following resuscitation from cardiac arrest. One presumed explanation for this negative statement is that cerebral metabolic suppression by barbiturates (and other anesthetics) is impossible in the absence of an active EEG. Conversely, in the event of incomplete ischemia EEG activity in usually present (albeit altered) and metabolic suppression and hence possibly protection can be induced with barbiturates. Indeed, most of the animal studies led to a number of recommendations for barbiturate therapy in man for incomplete ischemia. 2) Isoflurane. From a cerebral

  3. Clinical study on the value of combining neuropsychological tests with auditory event-related potential P300 for cognitive assessment in elderly patients with cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Xiao-ling ZHAO

    2016-11-01

    Full Text Available Objective To investigate the value of combining neuropsychological tests with auditory event-related potential (ERP P300 for cognitive assessment in elderly patients with cerebral small vessel disease (cSVD.  Methods A total of 183 elderly patients with cSVD were enrolled in this study. They were divided into 3 groups according to brain MRI: lacunar infarct (LACI group (N = 62, white matter hyperintensity (WMH group (N = 60 and LACI + WMH group (N = 61. A total of 50 brain MRI normal persons were selected as control group. Montreal Cognitive Assessment (MoCA, Chinese version was used to evaluate the cognitive function, and the amplitude and latency of P300 were measured in each group.  Results Compared with control group, the MoCA total score in LACI, WMH and LACI + WMH groups were significantly lower (P = 0.042, 0.015, 0.000, and the score in LACI + WMH group was significantly lower than that in LACI and WMH groups (P = 0.001, 0.042. In the eight cognitive domains of MoCA scale, the visual space and executive function (P = 0.006, 0.041, 0.035, delayed memory (P = 0.006, 0.012, 0.048, language (P = 0.001, 0.032, 0.047 and calculation (P = 0.009, 0.001, 0.003 in LACI + WMH group were significantly lower than those in control, LACI and WMH groups. The delayed memory in LACI group was significantly lower than that in control group (P = 0.037. The delayed memory (P = 0.005 and language (P = 0.047 in WMH group were significantly lower than those in control group. Compared with control group, the amplitudes of P300 (P = 0.025, 0.033, 0.000 in LACI, WMH and LACI + WMH groups were significantly decreased, and the latencies (P = 0.018, 0.000, 0.000 were significantly prolonged. The amplitude of P300 in LACI + WMH group was significantly lower than that in LACI and WMH groups (P = 0.041, 0.018, and the latency was significantly prolonged (P = 0.000, 0.022.  Conclusions Elderly patients of cSVD all suffer from different degrees of cognitive impairment

  4. Electron paramagnetic resonance and dynamic nuclear polarization of char suspensions: surface science and oximetry

    International Nuclear Information System (INIS)

    Clarkson, R.B.; Odintsov, B.M.; Ceroke, P.J.; Ardenkjaer-Larsen, J.H.; Fruianu, M.; Belford, R.L.

    1998-01-01

    Carbon chars have been synthesized in our laboratory from a variety of starting materials, by means of a highly controlled pyrolysis technique. These chars exhibit electron paramagnetic resonance (EPR) line shapes which change with the local oxygen concentration in a reproducible and stable fashion; they can be calibrated and used for oximetry. Biological stability and low toxicity make chars good sensors for in vivo measurements. Scalar and dipolar interactions of water protons at the surfaces of chars may be utilized to produce dynamic nuclear polarization (DNP) of the 1 H nuclear spin population in conjunction with electron Zeeman pumping. Low-frequency EPR, DNP and DNP-enhanced MRI all show promise as oximetry methods when used with carbon chars. (author)

  5. A unique case of pulmonary artery catheter bleeding from the oximetry connection port

    Directory of Open Access Journals (Sweden)

    Suman Rajagopalan

    2014-12-01

    Full Text Available Pulmonary artery catheter is an invasive monitor usually placed in high-risk cardiac surgical patients to optimize the cardiac functions. We present this case of blood oozing from the oximetry connection port of the pulmonary artery catheter that resulted in the inability to monitor continuous cardiac output requiring replacement of the catheter. The cause of this abnormal bleeding was later confirmed to be due to a manufacturing defect.

  6. Comparison of NIRS, laser Doppler flowmetry, photoplethysmography, and pulse oximetry during vascular occlusion challenges

    OpenAIRE

    Abay, T. Y.; Kyriacou, P. A.

    2016-01-01

    © 2016 Institute of Physics and Engineering in Medicine. Monitoring changes in blood volume, blood flow, and oxygenation in tissues is of vital importance in fields such as reconstructive surgery and trauma medicine. Near infrared spectroscopy (NIRS), laser Doppler (LDF) flowmetry, photoplethysmography (PPG), and pulse oximetry (PO) contribute to such fields due to their safe and noninvasive nature. However, the techniques have been rarely investigated simultaneously or altogether. The aim of...

  7. Optimal spacing between transmitting and receiving optical fibres in reflectance pulse oximetry

    International Nuclear Information System (INIS)

    Hickey, M; Kyriacou, P A

    2007-01-01

    Splanchnic ischaemia can ultimately lead to cellular hypoxia and necrosis, and may well contribute to the development of multiple organ failures and increased mortality. Therefore, it is of utmost importance to monitor abdominal organ blood oxygen saturation (SpO 2 ). Pulse oximetry has been widely accepted as a reliable method for monitoring oxygen saturation of arterial blood. Animal studies have also shown it to be effective in the monitoring of blood oxygen saturation in the splanchnic region. However, commercially available pulse oximeter probes are not suitable for the continuous assessment of SpO 2 in the splanchnic region. Therefore, there is a need for a new sensor technology that will allow the continuous measurement of SpO 2 in the splanchnic area pre-operatively, operatively and post-operatively. For this purpose, a new fibre optic sensor and processing system utilising the principle of reflectance pulse oximetry has been developed. The accuracy in the estimation of SpO 2 in pulse oximetry depends on the quality and amplitude of the photoplethysmographic (PPG) signal and for this reason an experimental procedure was carried out to examine the effect of the source-detector separation distance on the acquired PPG signals, and to ultimately select an optimal separation for the final design of the fibre-optic probe. PPG signals were obtained from the finger for different separation distances between the emitting and detecting fibres. Good quality PPG signals with large amplitudes and high signal-to-noise ratio were detected in the range of 3mm to 6mm. At separation distances between 1mm and 2mm, PPG signals were erratic with no resemblance to a conventional PPG signal. At separation distances greater than 6mm, the amplitudes of PPG signals were very small and not appropriate for processing. This investigation indicates the suitability of optical fibres as a new pulse oximetry sensor for estimating blood oxygen saturation (SpO 2 ) in the splanchnic region

  8. Optimal spacing between transmitting and receiving optical fibres in reflectance pulse oximetry

    Science.gov (United States)

    Hickey, M.; Kyriacou, P. A.

    2007-10-01

    Splanchnic ischaemia can ultimately lead to cellular hypoxia and necrosis, and may well contribute to the development of multiple organ failures and increased mortality. Therefore, it is of utmost importance to monitor abdominal organ blood oxygen saturation (SpO2). Pulse oximetry has been widely accepted as a reliable method for monitoring oxygen saturation of arterial blood. Animal studies have also shown it to be effective in the monitoring of blood oxygen saturation in the splanchnic region. However, commercially available pulse oximeter probes are not suitable for the continuous assessment of SpO2 in the splanchnic region. Therefore, there is a need for a new sensor technology that will allow the continuous measurement of SpO2 in the splanchnic area pre-operatively, operatively and post-operatively. For this purpose, a new fibre optic sensor and processing system utilising the principle of reflectance pulse oximetry has been developed. The accuracy in the estimation of SpO2 in pulse oximetry depends on the quality and amplitude of the photoplethysmographic (PPG) signal and for this reason an experimental procedure was carried out to examine the effect of the source-detector separation distance on the acquired PPG signals, and to ultimately select an optimal separation for the final design of the fibre-optic probe. PPG signals were obtained from the finger for different separation distances between the emitting and detecting fibres. Good quality PPG signals with large amplitudes and high signal-to-noise ratio were detected in the range of 3mm to 6mm. At separation distances between 1mm and 2mm, PPG signals were erratic with no resemblance to a conventional PPG signal. At separation distances greater than 6mm, the amplitudes of PPG signals were very small and not appropriate for processing. This investigation indicates the suitability of optical fibres as a new pulse oximetry sensor for estimating blood oxygen saturation (SpO2) in the splanchnic region.

  9. Lung cancer symptoms and pulse oximetry in the prognostic assessment of patients with lung cancer

    Directory of Open Access Journals (Sweden)

    Harada Cecilia M

    2005-07-01

    Full Text Available Abstract Background Medical oncologists continue to use performance status as a proxy for quality of life (QOL measures, as completion of QOL instruments is perceived as time consuming, may measure aspects of QOL not affected by cancer therapy, and interpretation may be unclear. The pulse oximeter is widely used in clinical practice to predict cardiopulmonary morbidity after lung resection in cancer patients, but little is known on its role outside the surgical setting. We evaluated whether the Lung Cancer Symptom Scale and pulse oximetry may contribute to the evaluation of lung cancer patients who received standard anticancer therapy. Methods We enrolled forty-one consecutive, newly diagnosed, patients with locally advanced or metastatic lung cancer in this study. We developed a survival model with the variables gender, age, histology, clinical stage, Karnofsky performance status, wasting, LCSS symptom scores, average symptom burden index, and pulse oximetry (SpO2. Results Patient and observer-rated scores were correlated, except for the fatigue subscale. The median SpO2 was 95% (range: 86 to 98, was unrelated to symptom scores, and was weakly correlated with observer cough scores. In a multivariate survival model, SpO2 > 90% and patient scores on the LCSS appetite and fatigue subscales were independent predictors of survival. Conclusion LCSS fatigue and appetite rating, and pulse oximetry should be studied further as prognostic factors in lung cancer patients.

  10. High quantum efficiency annular backside silicon photodiodes for reflectance pulse oximetry in wearable wireless body sensors

    International Nuclear Information System (INIS)

    Duun, Sune; Haahr, Rasmus G; Hansen, Ole; Birkelund, Karen; Thomsen, Erik V

    2010-01-01

    The development of annular photodiodes for use in a reflectance pulse oximetry sensor is presented. Wearable and wireless body sensor systems for long-term monitoring require sensors that minimize power consumption. We have fabricated large area 2D ring-shaped silicon photodiodes optimized for minimizing the optical power needed in reflectance pulse oximetry. To simplify packaging, backside photodiodes are made which are compatible with assembly using surface mounting technology without pre-packaging. Quantum efficiencies up to 95% and area-specific noise equivalent powers down to 30 fW Hz -1/2 cm -1 are achieved. The photodiodes are incorporated into a wireless pulse oximetry sensor system embedded in an adhesive patch presented elsewhere as 'The Electronic Patch'. The annular photodiodes are fabricated using two masked diffusions of first boron and subsequently phosphor. The surface is passivated with a layer of silicon nitride also serving as an optical filter. As the final process, after metallization, a hole in the center of the photodiode is etched using deep reactive ion etch.

  11. First day of life pulse oximetry screening to detect congenital heart defects.

    Science.gov (United States)

    Meberg, Alf; Brügmann-Pieper, Sabine; Due, Reidar; Eskedal, Leif; Fagerli, Ingebjørg; Farstad, Teresa; Frøisland, Dag Helge; Sannes, Catharina Hovland; Johansen, Ole Jakob; Keljalic, Jasmina; Markestad, Trond; Nygaard, Egil Andre; Røsvik, Alet; Silberg, Inger Elisabeth

    2008-06-01

    To evaluate the efficacy of first day of life pulse oximetry screening to detect congenital heart defects (CHDs). We performed a population-based prospective multicenter study of postductal (foot) arterial oxygen saturation (SpO(2)) in apparently healthy newborns after transfer from the delivery suite to the nursery. SpO(2) < 95% led to further diagnostic evaluations. Of 57,959 live births, 50,008 (86%) were screened. In the screened population, 35 CHDs were [corrected] classified as critical (ductus dependent, cyanotic). CHDs were prospectively registered and diagnosed in 658/57,959 (1.1%) [corrected] Of the infants screened, 324 (0.6%) failed the test. Of these, 43 (13%) had CHDs (27 critical), and 134 (41%) had pulmonary diseases or other disorders. The remaining 147 infants (45%) were healthy with transitional circulation. The median age for babies with CHDs at failing the test was 6 hours (range, 1-21 hours). For identifying critical CHDs, the pulse oximetry screening had a sensitivity rate of 77.1% (95% CI, 59.4-89.0), specificity rate of 99.4% (95% CI, 99.3-99.5), and a false-positive rate of 0.6% (95% CI, 0.5-0.7). Early pulse oximetry screening promotes early detection of critical CHDs and other potentially severe diseases. The sensitivity rate for detecting critical CHDs is high, and the false-positive rate is low.

  12. An Electronic Patch for wearable health monitoring by reflectance pulse oximetry.

    Science.gov (United States)

    Haahr, Rasmus G; Duun, Sune B; Toft, Mette H; Belhage, Bo; Larsen, Jan; Birkelund, Karen; Thomsen, Erik V

    2012-02-01

    We report the development of an Electronic Patch for wearable health monitoring. The Electronic Patch is a new health monitoring system incorporating biomedical sensors, microelectronics, radio frequency (RF) communication, and a battery embedded in a 3-dimensional hydrocolloid polymer. In this paper the Electronic Patch is demonstrated with a new optical biomedical sensor for reflectance pulse oximetry so that the Electronic Patch in this case can measure the pulse and the oxygen saturation. The reflectance pulse oximetry solution is based on a recently developed annular backside silicon photodiode to enable low power consumption by the light emitting components. The Electronic Patch has a disposable part of soft adhesive hydrocolloid polymer and a reusable part of hard polylaurinlactam. The disposable part contains the battery. The reusable part contains the reflectance pulse oximetry sensor and microelectronics. The reusable part is 'clicked' into the disposable part when the patch is prepared for use. The patch has a size of 88 mm by 60 mm and a thickness of 5 mm.

  13. The role of nocturnal oximetry in obstructive sleep apnoea-hypopnoea syndrome screening

    Directory of Open Access Journals (Sweden)

    Celestina Ventura

    2007-07-01

    Full Text Available Aim: The aim of our study was to evaluate the sensitivity and specificity of Nocturnal Oximetry (NO as a diagnostic screening tool for obstructive sleep apnoea hypopnoea syndrome (OSAHS, compared with polysomnography (PSG as the gold standard. Methodology: 63 patients with clinical suspicion of OSAHS and exclusion of respiratory disease underwent PSG and NO. We then determined NO sensitivity, specificity, positive (PPV and negative predictive values (NPV. Results: OSAHS was diagnosed in 47 patients with a mean age of 54 years. In the evaluation of the percentage of Total Sleep Time (TST with oxygen desaturation below 90%, we found significant differences between patients with OSAHS (25.4 ± 29.7% and without OSAHS (1 ± 1.5%, p<0,001. We used two cutoff points to evaluate sensitivity, specificity, positive (PPV and negative predictive values (NPV, based on the severity of O2 desaturation (StO2<90%. Using the first cutoff point we diagnosed with NO as positive all the patients with TST desaturation values ≥1% of the TST. Under these circumstances we found a sensitivity of 76.6%, a specificity of 75%, a PPV of 90% and an NPV value of 52.2% for our screening test (NO. Using the second cutoff point, we diagnosed with NO as positive all the patients with TST desaturation values ≥5% of the TST. With this method we found a sensitivity of 65.9%, a specificity of 100%, a PPV of 100% and an NPV of 50%. Conclusion: NO is a useful screening test for the diagnosis of OSAHS in patients without respiratory disease. Resumo: Objectivo: Foi objectivo deste estudo determinar a sensibilidade e a especificidade da oximetria nocturna (ON como método de screening diagnóstico para a síndroma de apneia-hipopneia obstrutiva do sono (SAHOS, utilizando como método de referência a polissonografia (PSG. Metodologia: Foram incluídos 63 doentes com suspeita clínica de SAHOS e exclusão de doença respiratória, sendo

  14. Value of conventional, and diffusion- and perfusion weighted MRI in the management of patients with unclear cerebral pathology, admitted to the intensive care unit

    International Nuclear Information System (INIS)

    Sundgren, P.C.; Reinstrup, P.; Romner, B.; Holtaas, S.; Maly, P.

    2002-01-01

    The aim of our retrospective study was to determine the extent to which diffusion- and perfusion- weighted MRI combined with conventional MRI could be helpful in the evaluation of intensive care unit (ICU) patients who have unknown or unclear cerebral pathology underlying a serious clinical condition. Twenty-one ICU patients with disparity between the findings on brain CT scan and their clinical status were studied. All patients underwent conventional MR and diffusion-weighted imaging and 14 also had MR perfusion studies. Abnormalities were present on diffusion-weighted imaging of 17 of the 21 patients and on perfusion-weighted studies of 7 of 14 patients. The MRI results changed the preliminary/working diagnosis in six patients. In eight other patients, MRI revealed additional pathology that had not been suspected clinically, and/or characterized more closely findings that had already been detected by CT or suspected clinically. MRI showed abnormalities in four of the five patients who had normal CT. MRI findings suggested a negative clinical outcome in all nine patients who subsequently died. MRI findings also suggested positive long-term outcome in five of nine patients who improved significantly as based on Glasgow and extended Glasgow outcome scales. In the three unconscious patients who had normal diffusion- and perfusion-weighted imaging the clinical outcome was good. This study suggests that MRI in seriously ill ICU patients with unclear cerebral pathology can provide information that changes, characterizes, or supports diagnoses and/or prognoses and therefore facilitates further management. (orig.)

  15. External carotid compression: a novel technique to improve cerebral perfusion during selective antegrade cerebral perfusion for aortic arch surgery.

    Science.gov (United States)

    Grocott, Hilary P; Ambrose, Emma; Moon, Mike

    2016-10-01

    Selective antegrade cerebral perfusion (SACP) involving cannulation of either the axillary or innominate artery is a commonly used technique for maintaining cerebral blood flow (CBF) during the use of hypothermic cardiac arrest (HCA) for operations on the aortic arch. Nevertheless, asymmetrical CBF with hypoperfusion of the left cerebral hemisphere is a common occurrence during SACP. The purpose of this report is to describe an adjunctive maneuver to improve left hemispheric CBF during SACP by applying extrinsic compression to the left carotid artery. A 77-yr-old male patient with a history of aortic valve replacement presented for emergent surgical repair of an acute type A aortic dissection of a previously known ascending aortic aneurysm. His intraoperative course included cannulation of the right axillary artery, which was used as the aortic inflow during cardiopulmonary bypass and also allowed for subsequent SACP during HCA. After the onset of HCA, the innominate artery was clamped at its origin to allow for SACP. Shortly thereafter, however, the left-sided cerebral oxygen saturation (SrO2) began to decrease. Augmenting the PaO2, PaCO2 and both SACP pressure and flow failed to increase left hemispheric SrO2. Following the use of ultrasound guidance to confirm the absence of atherosclerotic disease in the carotid artery, external pressure was applied partially compressing the artery. With the carotid compression, the left cerebral saturation abruptly increased, suggesting pressurization of the left cerebral hemispheric circulation and augmentation of CBF. Direct ultrasound visualization and cautious partial compression of the left carotid artery may address asymmetrical CBF that occurs with SACP during HCA for aortic arch surgery. This strategy may lead to improved symmetry of CBF and corresponding cerebral oximetry measurements during aortic arch surgery.

  16. 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.

  17. 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 ...

  18. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  19. Birth Defects: Cerebral Palsy

    Science.gov (United States)

    ... Loss > Birth defects & other health conditions > Cerebral palsy Cerebral palsy E-mail to a friend Please fill in ... this page It's been added to your dashboard . Cerebral palsy (also called CP) is a group of conditions ...

  20. Accuracy of pulse oximetry in detection of oxygen saturation in patients admitted to the intensive care unit of heart surgery: comparison of finger, toe, forehead and earlobe probes.

    Science.gov (United States)

    Seifi, Sohila; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Najafi, Farid

    2018-01-01

    Heart surgery patients are more at risk of poor peripheral perfusion, and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients. With regard to controversial studies on accuracy of the current pulse oximetry probes and lack of data related to patients undergoing heart surgery, the present study was conducted to determine accuracy of pulse oximetry probes of finger, toe, forehead and earlobe in detection of oxygen saturation in patients admitted to intensive care units for coronary artery bypass surgery. In this clinical trial, 67 patients were recruited based on convenience sampling method among those admitted to intensive care units for coronary artery bypass surgery. The SpO2 value was measured using finger, toe, forehead and earlobe probes and then compared with the standard value of arterial oxygen saturation (SaO2). Data were entered into STATA-11 software and analyzed using descriptive, inferential and Bland-Altman statistical analyses. Highest and lowest correlational mean values of SpO2 and SaO2 were related to finger and earlobe probes, respectively. The highest and lowest agreement of SpO2 and SaO2 were related to forehead and earlobe probes. The SpO2 of earlobe probes due to lesser mean difference, more limited confidence level and higher agreement ration with SaO2 resulted by arterial blood gas (ABG) analysis had higher accuracy. Thus, it is suggested to use earlobe probes in patients admitted to the intensive care unit for coronary artery bypass surgery. Registration of this trial protocol has been approved in Iranian Registry of Clinical Trials at 2018-03-19 with reference IRCT20100913004736N22. "Retrospectively registered."

  1. The value of structural MRI measurements of cerebral atrophy in predicting the rate of cognitive decline in the non-demented elderly: a GEE analysis based on data from the Vienna transdanube aging study

    International Nuclear Information System (INIS)

    Roesel, M.

    2011-01-01

    The main objective of this study was the assessment of various structural measurements of cerebral atrophy at baseline and the evaluation of their potential value in predicting future cognitive decline in a longitudinal study design. Data were drawn from the Vienna Transdanube Aging (VITA) study. Magnetic resonance images of 532 subjects aged 75-76 years at baseline were analyzed to assess 8 different cerebral atrophy markers. A population averaged model with the corresponding analytical technique of generalized estimating equations (GEE) were applied to the birth-cohort to assess associations between the MRI-based atrophy markers and 6 cognitive test scores at baseline and two follow-up investigations. Cognitive tests were comprised of the Mini Mental State Examination (MMSE), Boston Naming Test (BNT), Fuld Object Memory Evaluation (FOME), Verbal Fluency (VF) and the Trail Making Tests A and B (TMTA, TMTB). Vascular risk factors and several other covariates that were available in the VITA database were included as additional predictors in the longitudinal data analysis. Severity of right hippocampal head atrophy predicted the rate of cognitive decline in all 6 test scores. (MMSE: β =-0.507; p = 0.002, BNT: β = -1.090; p = 0.004, FOME: β = -0.291; p = 0.003, VF: β = 0.718; p = 0.025, TMTA: Exp(β) = 0.123; p [de

  2. Early Detection with Pulse Oximetry of Hypoxemic Neonatal Conditions. Development of the IX Clinical Consensus Statement of the Ibero-American Society of Neonatology (SIBEN

    Directory of Open Access Journals (Sweden)

    Augusto Sola

    2018-03-01

    Full Text Available This article reviews the development of the Ninth Clinical Consensus Statement by SIBEN (the Ibero-American of Neonatology on “Early Detection with Pulse Oximetry (SpO2 of Hypoxemic Neonatal Conditions”. It describes the process of the consensus, and the conclusions and recommendations for screening newborns with pulse oximetry.

  3. Cerebral palsy

    International Nuclear Information System (INIS)

    Truwit, C.L.; Barkovich, A.J.; Koch, T.; Ferreiro, D.

    1990-01-01

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  4. Optimal spacing between transmitting and receiving optical fibres in reflectance pulse oximetry

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, M; Kyriacou, P A [School of Engineering and Mathematical Sciences, City University, Northampton Square, London, EC1V 0HB (United Kingdom)

    2007-10-15

    Splanchnic ischaemia can ultimately lead to cellular hypoxia and necrosis, and may well contribute to the development of multiple organ failures and increased mortality. Therefore, it is of utmost importance to monitor abdominal organ blood oxygen saturation (SpO{sub 2}). Pulse oximetry has been widely accepted as a reliable method for monitoring oxygen saturation of arterial blood. Animal studies have also shown it to be effective in the monitoring of blood oxygen saturation in the splanchnic region. However, commercially available pulse oximeter probes are not suitable for the continuous assessment of SpO{sub 2} in the splanchnic region. Therefore, there is a need for a new sensor technology that will allow the continuous measurement of SpO{sub 2} in the splanchnic area pre-operatively, operatively and post-operatively. For this purpose, a new fibre optic sensor and processing system utilising the principle of reflectance pulse oximetry has been developed. The accuracy in the estimation of SpO{sub 2} in pulse oximetry depends on the quality and amplitude of the photoplethysmographic (PPG) signal and for this reason an experimental procedure was carried out to examine the effect of the source-detector separation distance on the acquired PPG signals, and to ultimately select an optimal separation for the final design of the fibre-optic probe. PPG signals were obtained from the finger for different separation distances between the emitting and detecting fibres. Good quality PPG signals with large amplitudes and high signal-to-noise ratio were detected in the range of 3mm to 6mm. At separation distances between 1mm and 2mm, PPG signals were erratic with no resemblance to a conventional PPG signal. At separation distances greater than 6mm, the amplitudes of PPG signals were very small and not appropriate for processing. This investigation indicates the suitability of optical fibres as a new pulse oximetry sensor for estimating blood oxygen saturation (SpO{sub 2}) in

  5. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Cerebral Palsy KidsHealth / For Teens / Cerebral Palsy What's in this ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  6. The relationship between cerebral oxygen saturation changes and post operative neurologic complications in patients undergoing cardiac surgery

    International Nuclear Information System (INIS)

    Negargar, S.; Mahmoudpour, A.; Taheri, R.; Sarvin, S.

    2007-01-01

    To study the relationship between cerebral oxygen saturation changes and postoperative neurologic complications. Seventy two adult patients with ASA class II, III who were scheduled for elective cardiac surgery, were randomized into three groups: Group I: with CPB (on -pump) Group II: without CPB (off- pump) Group III: valve surgery. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE). Cerebral oxygen saturation was also measured. There was no statistical difference in desaturation of more than 20% among three groups (P=0.113) but it was significant between group I and II (P=0.042). Changes of rSo/sub 2/ in different hours of surgery was significant in group I and group II (P=0.0001 in both) but it was not significant in group III ( P=0.075) . Although cerebral oximetry is a noninvasive and useful method of monitoring during cardiac surgery, it has low accuracy to determine postoperative neurologic complications. (author)

  7. Noncontact simultaneous dual wavelength photoplethysmography: A further step toward noncontact pulse oximetry

    International Nuclear Information System (INIS)

    Humphreys, Kenneth; Ward, Tomas; Markham, Charles

    2007-01-01

    We present a camera-based device capable of capturing two photoplethysmographic (PPG) signals at two different wavelengths simultaneously, in a remote noncontact manner. The system comprises a complementary metal-oxide semiconductor camera and dual wavelength array of light emitting diodes (760 and 880 nm). By alternately illuminating a region of tissue with each wavelength of light, and detecting the backscattered photons with the camera at a rate of 16 frames/wavelength s, two multiplexed PPG wave forms are simultaneously captured. This process is the basis of pulse oximetry, and we describe how, with the inclusion of a calibration procedure, this system could be used as a noncontact pulse oximeter to measure arterial oxygen saturation (S p O 2 ) remotely. Results from an experiment on ten subjects, exhibiting normal S p O 2 readings, that demonstrate the instrument's ability to capture signals from a range of subjects under realistic lighting and environmental conditions are presented. We compare the signals captured by the noncontact system to a conventional PPG signal captured concurrently from a finger, and show by means of a J. Bland and D. Altman [Lancet 327, 307 (1986); Statistician 32, 307 (1983)] test, the noncontact device to be comparable to a contact device as a monitor of heart rate. We highlight some considerations that should be made when using camera-based ''integrative'' sampling methods and demonstrate through simulation, the suitability of the captured PPG signals for application of existing pulse oximetry calibration procedures

  8. Development and initial testing of a pulse oximetry prototype for measuring dental pulp vitality

    Science.gov (United States)

    Cerqueira, M.; Ferreira, M.; Caramelo, F.

    2015-05-01

    The guiding principle of endodontic treatment is to preserve teeth while maintaining its aesthetic and functional roles. To accomplish this goal the assessment of teeth pulp vitality is very important since it will determine the procedures that should be adopted and define the therapy strategy. Currently, the most commonly tests for determining dental pulp state are the thermal and the electrical tests, which are based on nerve response and, because of that, have a relatively high rate of false positives and false negatives cases. In this work we present a simple test to be used in the clinical setting for evaluating noninvasively the existence of blood perfusion in dental pulp. This test is based on pulse oximetry principle that was devised to indirectly measure the amount of oxygen in blood. Although pulse oximetry has already demonstrated its usefulness in clinical environment its usage for the determination of dental pulp vitality has been frustrated by several factors, notably the absence of a suitable sensor to the complex shape of the various coronary teeth. We developed a suitable sensor and present the first trials with promising results, regarding the ability for distinguish teeth with and without blood perfusion.

  9. Simulation based investigation of source-detector configurations for non-invasive fetal pulse oximetry

    Directory of Open Access Journals (Sweden)

    Böttrich Marcel

    2015-09-01

    Full Text Available Transabdominal fetal pulse oximetry is a method to monitor the oxygen supply of the unborn child non-invasively. Due to the measurement setup, the received signal of the detector is composed of photons coding purely maternal and photons coding mixed fetal-maternal information. To analyze the wellbeing of the fetus, the fetal signal is extracted from the mixed component. In this paper we assess source-detector configurations, such that the mixed fetal-maternal components of the acquired signals are maximized. Monte-Carlo method is used to simulate light propagation and photon distribution in tissue. We use a plane layer and a spherical layer geometry to model the abdomen of a pregnant woman. From the simulations we extracted the fluence at the detector side for several source-detector distances and analyzed the ratio of the mixed fluence component to total fluence. Our simulations showed that the power of the mixed component depends on the source-detector distance as expected. Further we were able to visualize hot spot areas in the spherical layer model where the mixed fluence ratio reaches the highest level. The results are of high importance for sensor design considering signal composition and quality for non-invasive fetal pulse oximetry.

  10. Principle study on the signal connection at transabdominal fetal pulse oximetry

    Directory of Open Access Journals (Sweden)

    Böttrich Marcel

    2016-09-01

    Full Text Available Transabdominal fetal pulse oximetry is an approach to measure oxygen saturation of the unborn child non-invasively. The principle of pulse oximetry is applied to the abdomen of a pregnant woman, such that the measured signal includes both, the maternal and the fetal pulse curve. One of the major challenges is to extract the shape of the fetal pulse curve from the mixed signal for computation of the oxygen saturation. In this paper we analyze the principle kind of connection of the fetal and maternal pulse curves in the measured signal. A time varying finite element model is used to rebuild the basic measurement environment, including a bulk tissue and two independently pulsing arteries to model the fetal and maternal blood circuit. The distribution of the light fluence rate in the model is computed by applying diffusion equation. From the detectors we extracted the time dependent fluence rate and analyzed the signal regarding its components. The frequency spectra of the signals show peaks at the fetal and maternal basic frequencies. Additional signal components are visible in the spectra, indicating multiplicative coupling of the fetal and maternal pulse curves. We conclude that the underlying signal model of algorithms for robust extraction of the shape of the fetal pulse curve, have to consider additive and multiplicative signal coupling.

  11. Retrievable micro-inserts containing oxygen sensors for monitoring tissue oxygenation using EPR oximetry

    International Nuclear Information System (INIS)

    Dinguizli, M; Beghein, N; Gallez, B

    2008-01-01

    Tissue oxygenation is a crucial parameter in various physiopathological situations and can influence the therapeutic response of tumours. EPR oximetry is a reliable method for assessing and monitoring oxygen levels in vivo over long periods of time. Among the different paramagnetic oxygen sensors available for EPR oximetry, lithium phthalocyanine (LiPc) is a serious candidate for in vivo applications because of its narrow linewidth and its high signal-to-noise ratio. To enhance the biocompatibility of the sensors, fluoropolymer Teflon AF2400 was used to make cylindrical micro-inserts containing LiPc crystals. This new micro-pellet design has several advantages for in vivo studies, including the possibility of being able to choose the implant size, a high sensor content, the facility of in vivo insertion and complete protection with preservation of the oxygen sensor's characteristics. The response to oxygen and the kinetics of this response were tested using in vivo EPR: no differences were observed between micro-inserts and uncoated LiPc crystals. Pellets implanted in vivo in muscles conserved their responsiveness over a long period of time (∼two months), which is much longer than the few days of stability observed using LiPc crystals without protection by the implant. Finally, evaluation of the biocompatibility of the implants revealed no inflammatory reaction around the implantation area

  12. Noncontact simultaneous dual wavelength photoplethysmography: A further step toward noncontact pulse oximetry

    Science.gov (United States)

    Humphreys, Kenneth; Ward, Tomas; Markham, Charles

    2007-04-01

    We present a camera-based device capable of capturing two photoplethysmographic (PPG) signals at two different wavelengths simultaneously, in a remote noncontact manner. The system comprises a complementary metal-oxide semiconductor camera and dual wavelength array of light emitting diodes (760 and 880nm). By alternately illuminating a region of tissue with each wavelength of light, and detecting the backscattered photons with the camera at a rate of 16frames/wavelengths, two multiplexed PPG wave forms are simultaneously captured. This process is the basis of pulse oximetry, and we describe how, with the inclusion of a calibration procedure, this system could be used as a noncontact pulse oximeter to measure arterial oxygen saturation (SpO2) remotely. Results from an experiment on ten subjects, exhibiting normal SpO2 readings, that demonstrate the instrument's ability to capture signals from a range of subjects under realistic lighting and environmental conditions are presented. We compare the signals captured by the noncontact system to a conventional PPG signal captured concurrently from a finger, and show by means of a J. Bland and D. Altman [Lancet 327, 307 (1986); Statistician 32, 307 (1983)] test, the noncontact device to be comparable to a contact device as a monitor of heart rate. We highlight some considerations that should be made when using camera-based "integrative" sampling methods and demonstrate through simulation, the suitability of the captured PPG signals for application of existing pulse oximetry calibration procedures.

  13. Inaccurate pulse CO-oximetry of carboxyhemoglobin due to digital clubbing: case report.

    Science.gov (United States)

    Harlan, Nicole; Weaver, Lindell K; Deru, Kayla

    2016-01-01

    Newer pulse CO-oximeters provide a non-invasive and quick means of measuring oxyhemoglobin, carboxyhemoglobin and methemoglobin. Clubbing has been reported to cause inaccuracy in pulse oximeters. We present a case of inaccurate carboxy-hemoglobin measurement by pulse CO-oximetry due to digital clubbing. An 18-year-old man with a history of cystic fibrosis presented after a suicide attempt by inhalation of exhaust. At the initial emergency department evaluation, his blood carboxyhemoglobin was 33%. He was intubated, placed on 100% oxygen and transferred to our facility. Upon arrival, we placed three different pulse CO-oximeters on different fingers and toes. Carboxyhemoglobin levels measured by these meters ranged from 9%-11%. A venous blood gas drawn on arrival showed a carboxyhemoglobin level of 2.3% after four hours on 100% oxygen by endotracheal tube. Thirty minutes later, we checked arterial blood gas, which revealed a COHb level of 0.9%. Again, non-invasive carboxyhemoglobin measurements read 10%. The patient was treated with hyperbaric oxygen for carbon monoxide poisoning. This case suggests that non-invasive measurements of carboxyhemoglobin should be correlated with the clinic history and with an arterial or venous blood gas oximetry analysis.

  14. Lost without trace: oximetry signal dropout in preterm infants.

    Science.gov (United States)

    Lim, Kathleen; Wheeler, Kevin I; Jackson, Hamish D; Sadeghi Fathabadi, Omid; Gale, Timothy J; Dargaville, Peter A

    2015-09-01

    Oxygen saturation (SpO2) signal dropout leaves caregivers without a reliable measure to guide oxygen therapy. We studied SpO2 dropout in preterm infants on continuous positive airway pressure, noting the SpO2 values at signal loss and recovery and thus the resultant change in SpO2, and the factors influencing this parameter. In 32 infants of median gestation 26 weeks, a total of 3932 SpO2 dropout episodes were identified (1.1 episodes/h). In the episodes overall, SpO2 decreased by 1.1%, with the SpO2 change influenced by starting SpO2 (negative correlation), but not dropout duration. For episodes starting in hypoxia (SpO2 dropout, with a downward trajectory in a quarter of cases. We conclude that after signal dropout SpO2 generally recovers in a relative normoxic range. Blind FiO2 adjustments are thus unlikely to be of benefit during most SpO2 dropout episodes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Regional tumor oximetry: 19F NMR spectroscopy of hexafluorobenzene

    International Nuclear Information System (INIS)

    Hunjan, Sandeep; Mason, Ralph P.; Constantinescu, Anca; Peschke, Peter; Hahn, Eric W.; Antich, Peter P.

    1998-01-01

    Purpose: An accurate method for monitoring oxygen tension (pO 2 ) of individual tumors could be valuable for optimizing treatment plans. We have recently shown that 19 F nuclear magnetic resonance (NMR) spin-lattice relaxometry of hexafluorobenzene (HFB) provides a highly sensitive indicator of tumor oxygenation. We have now refined the methodology to provide enhanced precision, and applied the method to investigate dynamic changes in tumor oxygenation. Methods and Materials: Dunning prostate adenocarcinoma R3327-AT1 was grown in the form of pedicles on the foreback of male Copenhagen rats. When the tumors reached ≅1 cm diameter, HFB (20 μl) was administered, either centrally or peripherally, by direct intratumoral (IT) injection. Local pO 2 was determined using pulse-burst saturation recovery (PBSR) 19 F NMR spectroscopy on the basis of the spin-lattice relaxation rate, R1. Results: Interrogation of the central region of tumors provided typical values in the range pO 2 = 1.4-6.4 mmHg, with a typical stability of ±2 mmHg over a period of 20 min, when rats breathed 33% O 2 . Altering the inhaled gas to oxygen or carbogen (95% O 2 /5% CO 2 ) produced no significant change. In contrast, interrogation of tumor periphery indicated baseline pO 2 in the range 7.9-78.9 mmHg. Altering inspired gas produced significant changes (p 2 or carbogen, although the change was generally greater with carbogen. In each case, pO 2 returned to baseline within 16 min of returning the inhaled gas to baseline. Conclusion: We believe this method provides a valuable new approach with the requisite precision and accuracy to investigate tumor pO 2

  16. Cerebral oxygen delivery is reduced in newborns with congenital heart disease.

    Science.gov (United States)

    Lim, Jessie Mei; Kingdom, Theodore; Saini, Brahmdeep; Chau, Vann; Post, Martin; Blaser, Susan; Macgowan, Christopher; Miller, Steven P; Seed, Mike

    2016-10-01

    To investigate preoperative cerebral hemodynamics in newborns with congenital heart disease. We hypothesized that cerebral blood flow and oxygen delivery would be decreased in newborns with congenital heart disease compared with controls. Using a "feed-and-sleep" approach to performing neonatal magnetic resonance imaging, we measured cerebral blood flow by using a slice prescription perpendicular to the right and left internal carotid arteries and basilar artery at the level of the clivus. We calculated brain volume by segmenting a 3-dimensional steady-state free procession acquisition of the whole brain, allowing quantification of cerebral blood flow indexed to brain volume. Cerebral oxygen delivery was calculated as the product of cerebral blood flow and preductal systemic arterial oxygen content obtained via a combination of conventional pulse oximetry and laboratory analysis of venous blood samples for hemoglobin concentration. A complete set of measurements were obtained in 32 newborns with heart disease and 31 controls. There was no difference in gestational age between the heart disease and control groups. There was no difference in cerebral blood flow compared with controls (103.5 ± 34.0 vs 119.7 ± 40.4 mL/min), whereas cerebral oxygen delivery was significantly lower in the congenital heart disease subjects (1881 ± 625.7 vs 2712 ± 915.7 mLO2/min). Ten newborns with congenital heart disease had diffuse excessive high signal intensity in their white matter and 2 had white matter injury whereas another 5 had both. Newborns with unrepaired cyanotic congenital heart disease have decreased cerebral oxygen delivery due to arterial desaturation. If brain growth and development are adversely affected through oxygen conformance, our findings could have clinical implications in terms of timing of surgical repair. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  17. Sleep apnea termination decreases cerebral blood volume: a near-infrared spectroscopy case study

    Science.gov (United States)

    Virtanen, Jaakko; Noponen, Tommi; Salmi, Tapani; Toppila, Jussi; Meriläinen, Pekka

    2009-07-01

    Medical near-infrared spectroscopy (NIRS) can be used to estimate cerebral haemodynamic changes non-invasively. Sleep apnea is a common sleep disorder where repetitive pauses in breathing decrease the quality of sleep and exposes the individual to various health problems. We have measured oxygenated and deoxygenated haemoglobin concentration changes during apneic events in sleep from the forehead of one subject using NIRS and used principal component analysis to extract extracerebral and cortical haemodynamic changes from NIRS signals. Comparison of NIRS signals with EEG, bioimpedance, and pulse oximetry data suggests that termination of apnea leads to decreases in cerebral blood volume and flow that may be related to neurological arousal via neurovascular coupling.

  18. Improving pulse oximetry accuracy by removing motion artifacts from photoplethysmograms using relative sensor motion: a preliminary study

    NARCIS (Netherlands)

    Wijshoff, R.W.C.G.R.; Mischi, M.; Woerlee, P.H.; Aarts, R.M.; Van Huffel, S.; Naelaers, G.; Caicedo, A.; Bruley, D.F.; Harrison, D.K.

    2013-01-01

    To expand applicability of pulse oximetry in low-acuity ambulatory settings, the impact of motion on extracted parameters as saturation (SpO2) and pulse rate (PR) needs to be reduced. We hypothesized that sensor motion relative to the skin can be used as an artifact reference in a correlation

  19. 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

  20. Aspirin plus dipyridamole has the highest surface under the cumulative ranking curves (SUCRA) values in terms of mortality, intracranial hemorrhage, and adverse event rate among 7 drug therapies in the treatment of cerebral infarction.

    Science.gov (United States)

    Zhang, Jian-Jun; Liu, Xin

    2018-03-01

    The standardization for the clinical use of drug therapy for cerebral infarction (CI) has not yet determined in some aspects. In this paper, we discussed the efficacies of different drug therapies (aspirin, aspirin plus dipyridamole, aspirin plus clopidogrel, aspirin plus warfarin, cilostazol, warfarin, and ticlopidine) for CI. We searched databases of PubMed and Cochrane Library from the inception to April, 2017, randomized controlled trials (RCTs) met the inclusion and exclusion criteria were enrolled in this study. The network meta-analysis integrated evidences of direct and indirect comparisons to assess odd ratios (OR) and surface under the cumulative ranking curves (SUCRA) value. Thirteen eligible RCTs including 7 drug therapies were included into this network meta-analysis. The network meta-analysis results showed that CI patients who received aspirin plus dipyridamole presented lower mortality when compared with those received aspirin plus clopidogrel (OR = 0.46, 95% CI = 0.18-0.99), indicating aspirin plus dipyridamole therapy had better efficacy for CI. As for intracranial hemorrhage (ICH), stroke recurrence, and adverse event (AE) rate, there were no significant differences of efficacy among 7 drug therapies. Besides, SUCRA values demonstrated that in the 7 drug therapies, aspirin plus dipyridamole therapy was more effective than others (mortality: 80.67%; ICH: 76.6%; AE rate: 90.2%). Our findings revealed that aspirin plus dipyridamole therapy might be the optimum one for patients with CI, which could help to improve the survival of CI patients.

  1. Classification methods to detect sleep apnea in adults based on respiratory and oximetry signals: a systematic review.

    Science.gov (United States)

    Uddin, M B; Chow, C M; Su, S W

    2018-03-26

    Sleep apnea (SA), a common sleep disorder, can significantly decrease the quality of life, and is closely associated with major health risks such as cardiovascular disease, sudden death, depression, and hypertension. The normal diagnostic process of SA using polysomnography is costly and time consuming. In addition, the accuracy of different classification methods to detect SA varies with the use of different physiological signals. If an effective, reliable, and accurate classification method is developed, then the diagnosis of SA and its associated treatment will be time-efficient and economical. This study aims to systematically review the literature and present an overview of classification methods to detect SA using respiratory and oximetry signals and address the automated detection approach. Sixty-two included studies revealed the application of single and multiple signals (respiratory and oximetry) for the diagnosis of SA. Both airflow and oxygen saturation signals alone were effective in detecting SA in the case of binary decision-making, whereas multiple signals were good for multi-class detection. In addition, some machine learning methods were superior to the other classification methods for SA detection using respiratory and oximetry signals. To deal with the respiratory and oximetry signals, a good choice of classification method as well as the consideration of associated factors would result in high accuracy in the detection of SA. An accurate classification method should provide a high detection rate with an automated (independent of human action) analysis of respiratory and oximetry signals. Future high-quality automated studies using large samples of data from multiple patient groups or record batches are recommended.

  2. Pulse Oximetry

    Science.gov (United States)

    ... This is important to know because when your oxygen level is low, the cells in your body can have a hard time ... level of at least 89% to keep their cells healthy. Having an oxygen level lower than this for a short time is ...

  3. Nano-emulsions of fluorinated trityl radicals as sensors for EPR oximetry

    Science.gov (United States)

    Charlier, N.; Driesschaert, B.; Wauthoz, N.; Beghein, N.; Préat, V.; Amighi, K.; Marchand-Brynaert, J.; Gallez, B.

    2009-04-01

    This article reports the development and evaluation of two nano-emulsions (F45T-03/HFB and F15T-03/PFOB) containing fluorinated trityl radicals dissolved in perfluorocarbons. Preparation with a high-pressure homogenizer conferred sub-micronic size to both nano-emulsions. In vitro and in vivo EPR spectroscopy showed that the nano-emulsions had much greater oxygen sensitivity than the hydrophilic trityl, CT-03. In vivo experiments in rodents confirmed the ability of the nano-emulsions to follow the changes in oxygen concentration after induced ischemia. Histological evaluation of the tissue injected with the nano-emulsions revealed some acute toxicity for the F45T-03/HFB nano-emulsion but none for the F15T-03/PFOB nano-emulsion. These new formulations should be considered for further EPR oximetry experiments in pathophysiological situations where subtle changes in tissue oxygenation are expected.

  4. Pulse Oximetry Screening Adapted to a System with Home Births: The Dutch Experience

    Directory of Open Access Journals (Sweden)

    Ilona C. Narayen

    2018-03-01

    Full Text Available Neonatal screening for critical congenital heart defects is proven to be safe, accurate, and cost-effective. The screening has been implemented in many countries across all continents in the world. However, screening for critical congenital heart defects after home births had not been studied widely yet. The Netherlands is known for its unique perinatal care system with a high rate of home births (18% and early discharge after an uncomplicated delivery in hospital. We report a feasibility, accuracy, and acceptability study performed in the Dutch perinatal care system. Screening newborns for critical congenital heart defects using pulse oximetry is feasible after home births and early discharge, and acceptable to mothers. The accuracy of the test is comparable to other early-screening settings, with a moderate sensitivity and high specificity.

  5. Carbogen Enhanced Femto Oximetry Breast Cancer Diagnosis Method with High Specificity

    Science.gov (United States)

    Maglich, Bogdan C.; Shultis, J. K.; Solomon, C. J.

    2011-03-01

    As large malignant tumors are oxygen deficient (hypoxic), cancer could be diagnosed in vivo and online, by non-invasive measurement of oxygen difference between tumor and adjacent tissue. Computer simulations of noninvasive diagnosis by Femto Oximetry (FO) of hypoxia in 1 cm tumor in 10 cm breast shows that background γ 's from non hypoxic tissue will mask hypoxia. To amplify the hypoxic-to-normal O difference, air breathing will be replaced with carbogen (O2 95 % , CO2 5 %) using vasco-constrictive property whereby carbogen breathing increases O in normal tissue, while not in malignant hypoxic tumors. 90% hypoxia will be detectable by FO with specificity 99%. Our method will be tested on R3230 tumors in Fischer rats at UCI.

  6. Cerebral effects of commonly used vasopressor-inotropes: a study in newborn piglets.

    Directory of Open Access Journals (Sweden)

    Gitte H Hahn

    Full Text Available Despite widespread use in sick infants, it is still debated whether vasopressor-inotropes have direct cerebral effects that might affect neurological outcome. We aimed to test direct cerebrovascular effects of three commonly used vasopressor-inotropes (adrenaline, dopamine and noradrenaline by comparing the responses to those of nonpharmacologically induced increases in blood pressure. We also searched for reasons for a mismatch between the response in perfusion and oxygenation.Twenty-four piglets had long and short infusions of the three vasopressor-inotropes titrated to raise mean arterial blood pressure (MAP 10 mmHg in random order. Nonpharmacological increases in MAP were induced by inflation of a balloon in the descending aorta. We measured cerebral oxygenation (near-infrared spectroscopy, perfusion (laser-Doppler, oxygen consumption (co-oximetry of arterial and superior sagittal sinus blood, and microvascular heterogeneity (side stream dark field video microscopy.Vasopressor-inotropes increased cerebral oxygenation significantly less (p≤0.01 compared to non-pharmacological MAP increases, whereas perfusion was similar. Furthermore, cerebral total hemoglobin concentration increased significantly less during vasopressor-inotrope infusions (p = 0.001. These physiologic responses were identical between the three vasopressor-inotropes (p>0.05. Furthermore, they induced a mild, although insignificant increase in cerebral metabolism and microvascular heterogeneity (p>0.05. Removal of the scalp tissue did not influence the mismatch (p>0.05.We demonstrated a moderate vasopressor-inotrope induced mismatch between cerebral perfusion and oxygenation. Scalp removal did not affect this mismatch, why vasopressor-inotropes appear to have direct cerebral actions. The statistically nonsignificant increases in cerebral metabolism and/or microvascular heterogeneity may explain the mismatch. Alternatively, it may simply reflect a vasopressor

  7. Pulse oximetry findings in newborns with antenatally diagnosed congenital heart disease.

    Science.gov (United States)

    Mawson, Isabel E; Babu, Pratusha L; Simpson, John M; Fox, Grenville F

    2018-05-01

    A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of  34 weeks and birth weight > 1.8 kg. A statistically significant increase in the proportion with low admission saturations was seen using ≤ 95% saturation threshold (72% (95% CI 66-78)) compared to ≤ 92% (52% (95% CI 46-59)) and ≤ 90% (46% (95% CI 39-52)). Sub-group analysis found the proportion of neonates with low saturations varied according to the specific CCHD diagnosis with only 20-42% of neonates with aortic stenosis, coarctation of the aorta and pulmonary stenosis having saturations ≤ 95%. The proportion of neonates with low admission oxygen saturation varied by CCHD diagnosis with those without critically reduced pulmonary blood flow not having low admission saturations, in general, even using the ≤ 95% threshold which had the highest proportions of abnormal saturations. This data may assist developing Pulsox screening policies. What is Known: • The addition of pulse oximetry (Pulsox) screening to the routine newborn examination increases the sensitivity of CCHD detection. Pulsox screening is also highly specific for CCHD in asymptomatic neonates, with low false-positive rates. • Early diagnosis of CCHD improves patient outcomes in relation to both morbidity and mortality. What is New: • The proportion of affected infants with an abnormal Pulsox result varies by CCHD diagnosis and screening threshold. In our study using the ≤ 95% threshold gave the highest proportion of neonates with abnormal saturations at admission. • In general, Pulsox yield of abnormal results is low for CCHD diagnoses not associated with critically reduced pulmonary blood flow; however, increasing the Pulsox threshold increased the proportion of infants with an

  8. Pre-clinical evaluation of OxyChip for long-term EPR oximetry.

    Science.gov (United States)

    Hou, Huagang; Khan, Nadeem; Gohain, Sangeeta; Kuppusamy, M Lakshmi; Kuppusamy, Periannan

    2018-03-16

    Tissue oxygenation is a critical parameter in various pathophysiological situations including cardiovascular disease and cancer. Hypoxia can significantly influence the prognosis of solid malignancies and the efficacy of their treatment by radiation or chemotherapy. Electron paramagnetic resonance (EPR) oximetry is a reliable method for repeatedly assessing and monitoring oxygen levels in tissues. Lithium octa-n-butoxynaphthalocyanine (LiNc-BuO) has been developed as a probe for biological EPR oximetry, especially for clinical use. However, clinical applicability of LiNc-BuO crystals is hampered by potential limitations associated with biocompatibility, biodegradation, or migration of individual bare crystals in tissue. To overcome these limitations, we have embedded LiNc-BuO crystals in polydimethylsiloxane (PDMS), an oxygen-permeable biocompatible polymer and developed an implantable/retrievable form of chip, called OxyChip. The chip was optimized for maximum spin density (40% w/w of LiNc-BuO in PDMS) and fabricated in a form suitable for implantation using an 18-G syringe needle. In vitro evaluation of the OxyChip showed that it is robust and highly oxygen sensitive. The dependence of its EPR linewidth to oxygen was linear and highly reproducible. In vivo efficacy of the OxyChip was evaluated by implanting it in rat femoris muscle and following its response to tissue oxygenation for up to 12 months. The results revealed preservation of the integrity (size and shape) and calibration (oxygen sensitivity) of the OxyChip throughout the implantation period. Further, no inflammatory or adverse reaction around the implantation area was observed thereby establishing its biocompatibility and safety. Overall, the results demonstrated that the newly-fabricated high-sensitive OxyChip is capable of providing long-term measurements of oxygen concentration in a reliable and repeated manner under clinical conditions.

  9. Hyperspectral imaging with near-infrared-enabled mobile phones for tissue oximetry

    Science.gov (United States)

    Lin, Jonathan L.; Ghassemi, Pejhman; Chen, Yu; Pfefer, Joshua

    2018-02-01

    Hyperspectral reflectance imaging (HRI) is an emerging clinical tool for characterizing spatial and temporal variations in blood perfusion and oxygenation for applications such as burn assessment, wound healing, retinal exams and intraoperative tissue viability assessment. Since clinical HRI-based oximeters often use near-infrared (NIR) light, NIR-enabled mobile phones may provide a useful platform for future point-of-care devices. Furthermore, quantitative NIR imaging on mobile phones may dramatically increase the availability and accessibility of medical diagnostics for low-resource settings. We have evaluated the potential for phone-based NIR oximetry imaging and elucidated factors affecting performance using devices from two different manufacturers, as well as a scientific CCD. A broadband light source and liquid crystal tunable filter were used for imaging at 10 nm bands from 650 to 1000 nm. Spectral sensitivity measurements indicated that mobile phones with standard NIR blocking filters had minimal response beyond 700 nm, whereas one modified phone showed sensitivity to 800 nm and another to 1000 nm. Red pixel channels showed the greatest sensitivity up to 800 nm, whereas all channels provided essentially equivalent sensitivity at longer wavelengths. Referencing of blood oxygenation levels was performed with a CO-oximeter. HRI measurements were performed using cuvettes filled with hemoglobin solutions of different oxygen saturation levels. Good agreement between absorbance spectra measured with mobile phone and a CCD cameras were seen for wavelengths below 900 nm. Saturation estimates showed root-mean-squared-errors of 5.2% and 4.5% for the CCD and phone, respectively. Overall, this work provides strong evidence of the potential for mobile phones to provide quantitative spectral imaging in the NIR for applications such as oximetry, and generates practical insights into factors that impact performance as well as test methods for performance assessment.

  10. Dynamic digitized cerebral parenchymography

    International Nuclear Information System (INIS)

    Theron, J.; Alachkar, F.; Nelson, M.; Mazia, D.

    1992-01-01

    Aortic arch injections centred on the head have been performed routinely in patients with cerebral ischaemia. Digital angiograms with modified windowing (low and narrow) have been used. This 'cerebral' arch injection allows much improved analysis of the cerebral parenchymal vascularization, giving better understanding of hemispheric ischaemia and making the decision about revascularization more rational. (orig.)

  11. Effects of Milrinone continuous intravenous infusion on global cerebral oxygenation and cerebral vasospasm after cerebral aneurysm surgical clipping

    Directory of Open Access Journals (Sweden)

    Mohamed A. Ghanem

    2014-01-01

    Conclusions: Milrinone improved significantly the global cerebral oxygenation and reduced the incidence of cerebral vasospasm during the dangerous period of cerebral spasm after cerebral aneurysm clipping.

  12. The value of intraoperative ultrasound (IUS) examination for the visualization of metastatic cerebral lesions, compared with computed tomography (CT) and magnetic resonance (MRI)

    International Nuclear Information System (INIS)

    Tacikowska, M.; Szczerbicki, M.; Grzesiakowska, U.

    2001-01-01

    The purpose of this study is: 1. to assess the value of intraoperative ultrasonographic examination (IUSG) in confirming intraoperatively the presence of metastatic tumours detected preoperatively by computed tomography (CT) and magnetic resonance tomography (MRI), 2. to evaluate an accordance of the numbers, localization and dimensions of metastatic tumours recognized preoperatively (CT and MRI) with those shown by intraoperative USG, 3. to comparatively assess the images of metastatic tumours found in preoperative CT and MRI examinations and in intraoperative USG examinations. Sixteen patients were operated upon for metastatic intracranial tumours from various primary foci. All patients had diagnostic brain examinations before the operation: MRI and CT in 7 cases, only MRI in 3 cases, only CT in 6 cases. Intraoperative USG examination was done in all cases. Retrospective analysis included: 1. comparative assessment of the images of metastatic tumours in intraoperative USG versus preoperative MRI and CT findings, 2. analysis of the number, localization and dimensions of metastatic tumours detected preoperatively and in intraoperative USG examination. The comparison of the greatest dimensions of metastatic lesions measured in CT and MRI findings, and in intraoperative USG based on Student t test showed no statistically significant differences between the examinations performed, p=0.2449. No statistically significant difference were found either between the numbers of metastatic lesions detected by these methods, p=0.71830. In the analysis of the images of metastatic lesions in preoperative examinations, the non--homogenous foci with margin enhancement after administration of gadolinium or contrast medium, with inner area not enhanced (necrosis?) were found in 8 cases (10 foci lesions), and in USG in 6 cases (9 focal lesions). In one case (one lesion) USG showed that the tumour was hypo echogenic as a whole, without areola around it. Intraoperative USG examination

  13. Microembolism after cerebral angiography

    International Nuclear Information System (INIS)

    Manaka, Hiroshi; Sakai, Hideki; Nagata, Izumi

    2000-01-01

    Acute microemboli are detected more precisely with the recently developed diffusion-weighted MR imaging (DWI). We happened to obtain 24 DWIs after 350 diagnostic cerebral angiographies in 1999. DWIs after cerebral angiographies showed bright lesions in 7 patients (28%), of whom 6 had no neurological symptoms after cerebral angiography. Seven of the 24 patients had risk factors for arteriosclerosis. Only one patient had embolic events due to angiography. Microemboli related to cerebral angiographies are inevitable in some patients. Most are silent, however, we should investigate the cause of microemboli and should make cerebral angiography safer. (author)

  14. 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

  15. 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

  16. Use of pulse co-oximetry as a screening and monitoring tool in mass carbon monoxide poisoning.

    Science.gov (United States)

    Bledsoe, Bryan E; Nowicki, Kevin; Creel, James H; Carrison, Dale; Severance, Harry W

    2010-01-01

    Carbon monoxide (CO) poisoning remains a common cause of poisoning in the United States. We describe a case where responding fire department personnel encountered a sick employee with a headache at an automotive brake manufacturing plant. Using both atmospheric CO monitoring and pulse CO-oximetry technology, fire department personnel were able to diagnose the cause of the patient's illness and later identify the source of CO in the plant.

  17. Quantitative impact of small angle forward scatter on whole blood oximetry using a Beer-Lambert absorbance model.

    Science.gov (United States)

    LeBlanc, Serge Emile; Atanya, Monica; Burns, Kevin; Munger, Rejean

    2011-04-21

    It is well known that red blood cell scattering has an impact on whole blood oximetry as well as in vivo retinal oxygen saturation measurements. The goal of this study was to quantify the impact of small angle forward scatter on whole blood oximetry for scattering angles found in retinal oximetry light paths. Transmittance spectra of whole blood were measured in two different experimental setups: one that included small angle scatter in the transmitted signal and one that measured the transmitted signal only, at absorbance path lengths of 25, 50, 100, 250 and 500 µm. Oxygen saturation was determined by multiple linear regression in the 520-600 nm wavelength range and compared between path lengths and experimental setups. Mean calculated oxygen saturation differences between setups were greater than 10% at every absorbance path length. The deviations to the Beer-Lambert absorbance model had different spectral dependences between experimental setups, with the highest deviations found in the 520-540 nm range when scatter was added to the transmitted signal. These results are consistent with other models of forward scatter that predict different spectral dependences of the red blood cell scattering cross-section and haemoglobin extinction coefficients in this wavelength range.

  18. Cerebral hematocrit decreases with hemodynamic compromise in carotid artery occlusion: a PET study.

    Science.gov (United States)

    Yamauchi, H; Fukuyama, H; Nagahama, Y; Katsumi, Y; Okazawa, H

    1998-01-01

    This study investigated whether in patients with internal carotid artery occlusion the regional cerebral hematocrit correlates with cerebral hemodynamics or metabolic state and, if so, how the regional cerebral hematocrit changes in the hemodynamically compromised region. We used positron emission tomography to study seven patients with unilateral internal carotid artery occlusion and no cortical infarction in the chronic stage. The distributions of red blood cell and plasma volumes were assessed using oxygen-15-labeled carbon monoxide and copper-62-labeled human serum albumin-dithiosemicarbazone tracers, respectively. The calculated hematocrit value was compared with the hemodynamic and metabolic parameters measured with the oxygen-15 steady-state technique. In the cerebral cortex, the value of the cerebral hematocrit varied but was correlated with the hemodynamic and metabolic status. Stepwise regression analysis revealed that the large vessel hematocrit, the cerebral metabolic rate of oxygen, and the cerebral blood flow or the oxygen extraction fraction accounted for a significant proportion of variance of the cerebral hematocrit. The oxygen extraction fraction and the cerebral metabolic rate of oxygen negatively correlated with the cerebral hematocrit, whereas the cerebral blood flow correlated positively: patients with reduced blood supply relative to metabolic demand (decreased blood flow with increased oxygen extraction fraction) showed low hematocrit values. In carotid artery occlusion in the chronic stage, regional cerebral hematocrit may vary according to cerebral hemodynamics and metabolic status. Regional cerebral hematocrit may decrease with hemodynamic compromise unless oxygen metabolism concomitantly decreases.

  19. The value of qualitative and quantitative assessment of lesion to cerebral cortex signal ratio on double inversion recovery sequence in the differentiation of demyelinating plaques from non-specific T2 hyperintensities

    Energy Technology Data Exchange (ETDEWEB)

    Hamcan, Salih; Battal, Bilal; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Etlik, Ankara (Turkey); Oz, Oguzhan; Tasdemir, Serdar [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Bozkurt, Yalcin [Golcuk Military Hospital, Department of Radiology, Kocaeli (Turkey)

    2017-02-15

    To assess the usefulness of the visual assessment and to determine diagnostic value of the lesion-to-cerebral cortex signal ratio (LCSR) measurement in the differentiation of demyelinating plaques and non-specific T2 hyperintensities on double inversion recovery (DIR) sequence. DIR and fluid-attenuated inversion recovery (FLAIR) sequences of 25 clinically diagnosed multiple sclerosis (MS) patients and 25 non-MS patients with non-specific T2-hyperintense lesions were evaluated visually and LCSRs were measured by two observers independently. On DIR sequence, the calculated mean LCSR ± SD for demyelinating plaques and non-specific T2-hyperintense lesions were 1.60 ± 0.26 and 0.75 ± 0.19 for observer1, and 1.61 ± 0.27 and 0.74 ± 0.19 for observer2. LCSRs of demyelinating plaques were significantly higher than other non-specific T2-hyperintense lesions on DIR sequence. By using the visual assessment demyelinating plaques were differentiated from non-specific T2-hyperintensities with 92.8 % sensitivity, 97.5 % specificity and 95.1 % accuracy for observer1 and 92.8 % sensitivity, 95 % specificity and 93.9 % accuracy for observer2. Visual assessment and LCSR measurement on DIR sequence seems to be useful for differentiating demyelinating MS plaques from supratentorial non-specific T2 hyperintensities. This feature can be used for diagnosis of MS particularly in patients with only supratentorial T2-hyperintense lesions who are categorized as radiologically possible MS. (orig.)

  20. NMR imaging of cerebral infarction

    International Nuclear Information System (INIS)

    Takusagawa, Yoshihiko; Yamaoka, Naoki; Doi, Kazuaki; Okada, Keisei

    1987-01-01

    One hundred and five patients with cerebral infarction were studied by nuclear magnetic resonance (NMR) CT (resistive type of magnet with strength of 0.1 tesla) and X-ray CT. Pulse sequences used saturation recovery (Tr = 600 mSec), Inversion recovery (Tr = 500 mSec, Td = 300 mSec) and spin echo (Tr = 1500 mSec, Te = 40, 80, 120, 160 mSec). Fifteen cases were examined by NMR-CT within 24 hours from onset. Proton NMR imaging could not detect cerebral ischemia as early as 2 hours after onset, but except could detect the lesions in Se image the area of cerebral infarct 3 hours after onset. After 5 hours from onset image changes in SE were evident and corresponded to the area of cerebral infarct, but image changes in IR could not fully delineate the infarcted area. NMR images of 41 year-old woman with cerebral embolism by MCA trunck occlusion associated with mitral stenosis were presented, and NMR-CT was examined 10 hours, 9th and 43th days after episode of MCA occlusion. Sixty patents (64 times) with lacunar infarction were studied by NMR-CT and X-ray CT. The inversion recovery images were used mainly for detection of lesions and comparison with X-ray CT. In 160 lesions which were detected by NMR-CT or X-ray CT, could 156 lesions be detected by NMR-CT and 78 lesions by X-ray CT. Inversion recovery images were more useful for detection of lacunes than X-ray CT. Calculated T1 and T2 values prolonged with time course from onset. (author)

  1. Cerebral and lower limb near-infrared spectroscopy in adults on extracorporeal membrane oxygenation.

    Science.gov (United States)

    Wong, Joshua K; Smith, Thomas N; Pitcher, Harrison T; Hirose, Hitoshi; Cavarocchi, Nicholas C

    2012-08-01

    Percutaneous femoral venoarterial (VA) or jugular venovenous (VV) extracorporeal membrane oxygenation (ECMO) can result in delivery of hypoxic blood to the brain, coronaries, and upper extremities. Additionally, VA-ECMO by percutaneous femoral artery cannulation may compromise perfusion to the lower limbs. Use of near-infrared spectroscopy (NIRS) detects regional ischemia and warns of impending hypoxic damage. We report the first known series with standardized monitoring of this parameter in adults on ECMO. This is an institutional review board-approved single institution retrospective review of patients with NIRS monitoring on ECMO from July 2010 until June 2011. Patients were analyzed for drops in NIRS tracings below 40 or >25% from baseline. VA-ECMO and VV-ECMO were initiated by percutaneous cannulation of the femoral vessels and the internal jugular vein, respectively. Sensors were placed on the patients' foreheads and on the lower limbs. NIRS tracings were recorded, analyzed, and correlated with clinical events. Twenty patients were analyzed (median age: 47.5 years): 17 patients were placed on VA-ECMO, and three patients on VV-ECMO. The median duration on ECMO was 7 days (range 2-26). One hundred percent of patients had a significant drop in bilateral cerebral oximetry tracings resulting in hemodynamic interventions, which involved increasing pressure, oxygenation, and/or ECMO flow. In 16 patients (80%), these interventions corrected the underlying ischemia. Four patients (20%) required further diagnostic intervention for persistent decreased bilateral and/or unilateral cerebral oximetry tracings, and were found to have a cerebrovascular accident (CVA). Six (30%) patients had persistent unilateral lower limb oximetry events, which resolved upon placement or replacement of a distal perfusion cannula. No patient was found to have either lower limb ischemia or a CVA with normal NIRS tracings. Use of NIRS with ECMO is important in detecting ischemic cerebral and

  2. Hypothermia reduces cerebral metabolic rate and cerebral blood flow in newborn pigs

    International Nuclear Information System (INIS)

    Busija, D.W.; Leffler, C.W.

    1987-01-01

    The authors examined effects of hypothermia on cerebral metabolic rate and cerebral blood flow in anesthetized, newborn pigs (1-4 days old). Cerebral blood flow (CBF) was determined with 15-μm radioactive microspheres. Regional CBF ranged from 44 to 66 ml·min -1 ·100 g -1 , and cerebral metabolic rate was 1.94 ± 0.23 ml O 2 ·100 g -1 ·min -1 during normothermia (39 degree C). Reduction of rectal temperature to 34-35 degree C decreased CBF and cerebral metabolic rate 40-50%. In another group of piglets, they examined responsiveness of the cerebral circulation to arterial hypercapnia during hypothermia. Although absolute values for normocapnic and hypercapnic CBF were reduced by hypothermia and absolute values for normocapnic and hypercapnic cerebrovascular resistance were increased, the percentage changes from control in these variables during hypercapnia were similar during normothermia and hypothermia. In another group of animals that were maintained normothermic and exposed to two episodes of hypercapnia, there was no attenuation of cerebrovascular dilation during the second episode. They conclude that hypothermia reduces CBF secondarily to a decrease in cerebral metabolic rate and that percent dilator responsiveness to arterial hypercapnia is unaltered when body temperature is reduced

  3. Arterial spin-labeling MR imaging of cerebral hemorrhages

    International Nuclear Information System (INIS)

    Noguchi, Tomoyuki; Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki; Yakushiji, Yusuke; Kawashima, Masatou

    2015-01-01

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  4. Arterial spin-labeling MR imaging of cerebral hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Tomoyuki [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki [Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Yakushiji, Yusuke [Saga University, Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Kawashima, Masatou [Saga University, Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga (Japan)

    2015-11-15

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  5. Using pulse oximetry to account for high and low frequency physiological artifacts in the BOLD signal.

    Science.gov (United States)

    Verstynen, Timothy D; Deshpande, Vibhas

    2011-04-15

    The BOLD signal not only reflects changes in local neural activity, but also exhibits variability from physiological processes like cardiac rhythms and breathing. We investigated how both of these physiological sources are reflected in the pulse oximetry (PO) signal, a direct measure of blood oxygenation, and how this information can be used to account for different types of noise in the BOLD response. Measures of heart rate, respiration and PO were simultaneously recorded while neurologically healthy participants performed an eye-movement task in a 3T MRI. PO exhibited power in frequencies that matched those found in the independently recorded cardiac and respiration signals. Using the phasic and aphasic properties of these signals as nuisance regressors, we found that the different frequency components of the PO signal could be used to identify different types of physiological artifacts in the BOLD response. A comparison of different physiological noise models found that a simple, down-sampled version of the PO signal improves the estimation of task-relevant statistics nearly as well as more established noise models that may run the risk of over-parameterization. These findings suggest that the PO signal captures multiple sources of physiological noise in the BOLD response and provides a simple and efficient way of modeling these noise sources in subsequent analysis. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. The evaluation of new and isotopically labeled isoindoline nitroxides and an azaphenalene nitroxide for EPR oximetry

    Science.gov (United States)

    Khan, Nadeem; Blinco, James P.; Bottle, Steven E.; Hosokawa, Kazuyuki; Swartz, Harold M.; Micallef, Aaron S.

    2011-01-01

    Isoindoline nitroxides are potentially useful probes for viable biological systems, exhibiting low cytotoxicity, moderate rates of biological reduction and favorable Electron Paramagnetic Resonance (EPR) characteristics. We have evaluated the anionic (5-carboxy-1,1,3,3-tetramethylisoindolin-2-yloxyl; CTMIO), cationic (5-(N,N,N-trimethylammonio)-1,1,3,3-tetramethylisoindolin-2-yloxyl iodide, QATMIO) and neutral (1,1,3,3-tetramethylisoindolin-2-yloxyl; TMIO) nitroxides and their isotopically labeled analogues (2H12- and/or 2H12-15N-labeled) as potential EPR oximetry probes. An active ester analogue of CTMIO, designed to localize intracellularly, and the azaphenalene nitroxide 1,1,3,3-tetramethyl-2,3-dihydro-2-azaphenalen-2-yloxyl (TMAO) were also studied. While the EPR spectra of the unlabeled nitroxides exhibit high sensitivity to O2 concentration, deuteration resulted in a loss of superhyperfine features and a subsequent reduction in O2 sensitivity. Labeling the nitroxides with 15N increased the signal intensity and this may be useful in decreasing the detection limits for in vivo measurements. The active ester nitroxide showed approximately 6% intracellular localization and low cytotoxicity. The EPR spectra of TMAO nitroxide indicated an increased rigidity in the nitroxide ring, due to dibenzo-annulation. PMID:21665499

  7. Evaluation of pulse-oximetry oxygen saturation taken through skin protective covering

    Science.gov (United States)

    James, Jyotsna; Tiwari, Lokesh; Upadhyay, Pramod; Sreenivas, Vishnubhatla; Bhambhani, Vikas; Puliyel, Jacob M

    2006-01-01

    Background The hard edges of adult finger clip probes of the pulse oximetry oxygen saturation (POOS) monitor can cause skin damage if used for prolonged periods in a neonate. Covering the skin under the probe with Micropore surgical tape or a gauze piece might prevent such injury. The study was done to see if the protective covering would affect the accuracy of the readings. Methods POOS was studied in 50 full-term neonates in the first week of life. After obtaining consent from their parents the neonates had POOS readings taken directly (standard technique) and through the protective covering. Bland-Altman plots were used to compare the new method with the standard technique. A test of repeatability for each method was also performed. Results The Bland-Altman plots suggest that there is no significant loss of accuracy when readings are taken through the protective covering. The mean difference was 0.06 (SD of 1.39) and 0.04 (SD 1.3) with Micropore and gauze respectively compared to the standard method. The mean difference was 0.22 (SD 0.23) on testing repeatability with the standard method. Conclusion Interposing Micropore or gauze does not significantly affect the accuracy of the POOS reading. The difference between the standard method and the new method was less than the difference seen on testing repeatability of the standard method. PMID:16677394

  8. Comparison of NIRS, laser Doppler flowmetry, photoplethysmography, and pulse oximetry during vascular occlusion challenges

    International Nuclear Information System (INIS)

    Abay, T Y; Kyriacou, P A

    2016-01-01

    Monitoring changes in blood volume, blood flow, and oxygenation in tissues is of vital importance in fields such as reconstructive surgery and trauma medicine. Near infrared spectroscopy (NIRS), laser Doppler (LDF) flowmetry, photoplethysmography (PPG), and pulse oximetry (PO) contribute to such fields due to their safe and noninvasive nature. However, the techniques have been rarely investigated simultaneously or altogether. The aim of this study was to investigate all the techniques simultaneously on healthy subjects during vascular occlusion challenges. Sensors were attached on the forearm (NIRS and LDF) and fingers (PPG and PO) of 19 healthy volunteers. Different degrees of vascular occlusion were induced by inflating a pressure cuff on the upper arm. The responses of tissue oxygenation index (NIRS), tissue haemoglobin index (NIRS), flux (LDF), perfusion index (PPG), and arterial oxygen saturation (PO) have been recorded and analyzed. Moreover, the optical densities were calculated from slow varying dc PPG, in order to distinguish changes in venous blood volumes. The indexes showed significant changes (p  <  0.05) in almost all occlusions, either venous or over-systolic occlusions. However, differentiation between venous and arterial occlusion by LDF may be challenging and the perfusion index (PI) may not be adequate to indicate venous occlusions. Optical densities may be an additional tool to detect venous occlusions by PPG. (paper)

  9. Neural networks and wavelet analysis in the computer interpretation of pulse oximetry data

    Energy Technology Data Exchange (ETDEWEB)

    Dowla, F.U.; Skokowski, P.G.; Leach, R.R. Jr.

    1996-03-01

    Pulse oximeters determine the oxygen saturation level of blood by measuring the light absorption of arterial blood. The sensor consists of red and infrared light sources and photodetectors. A method based on neural networks and wavelet analysis is developed for improved saturation estimation in the presence of sensor motion. Spectral and correlation functions of the dual channel oximetry data are used by a backpropagation neural network to characterize the type of motion. Amplitude ratios of red to infrared signals as a function of time scale are obtained from the multiresolution wavelet decomposition of the two-channel data. Motion class and amplitude ratios are then combined to obtain a short-time estimate of the oxygen saturation level. A final estimate of oxygen saturation is obtained by applying a 15 s smoothing filter on the short-time measurements based on 3.5 s windows sampled every 1.75 s. The design employs two backpropagation neural networks. The first neural network determines the motion characteristics and the second network determines the saturation estimate. Our approach utilizes waveform analysis in contrast to the standard algorithms that are based on the successful detection of peaks and troughs in the signal. The proposed algorithm is numerically efficient and has stable characteristics with a reduced false alarm rate with a small loss in detection. The method can be rapidly developed on a digital signal processing platform.

  10. Reduction of motion artifact in pulse oximetry by smoothed pseudo Wigner-Ville distribution

    Directory of Open Access Journals (Sweden)

    Zhang Yuan-ting

    2005-03-01

    Full Text Available Abstract Background The pulse oximeter, a medical device capable of measuring blood oxygen saturation (SpO2, has been shown to be a valuable device for monitoring patients in critical conditions. In order to incorporate the technique into a wearable device which can be used in ambulatory settings, the influence of motion artifacts on the estimated SpO2 must be reduced. This study investigates the use of the smoothed psuedo Wigner-Ville distribution (SPWVD for the reduction of motion artifacts affecting pulse oximetry. Methods The SPWVD approach is compared with two techniques currently used in this field, i.e. the weighted moving average (WMA and the fast Fourier transform (FFT approaches. SpO2 and pulse rate were estimated from a photoplethysmographic (PPG signal recorded when subject is in a resting position as well as in the act of performing four types of motions: horizontal and vertical movements of the hand, and bending and pressing motions of the finger. For each condition, 24 sets of PPG signals collected from 6 subjects, each of 30 seconds, were studied with reference to the PPG signal recorded simultaneously from the subject's other hand, which was stationary at all times. Results and Discussion The SPWVD approach shows significant improvement (p Conclusion The results suggested that the SPWVD approach could potentially be used to reduce motion artifact on wearable pulse oximeters.

  11. Cerebral blood flow changes in cluster headache

    International Nuclear Information System (INIS)

    Norris, J.W.; Hachinski, V.C.; Cooper, P.W.

    1976-01-01

    Serial cerebral blood flod studies performed by the intra-carotid 133 Xenon method were fortuitously determined during the course of a cluster headache in a 32 year old man. The initial study was performed about 10 min after the headache began and showed values at the upper limit of normal. Twenty min after the headache started a second procedure showed that the autoregulatory response on hyperventilation was normal. Ergotamine tartrate was given intra-muscularly 23 min after the headache began and there was partial relief. A third cerebral blood flow estimation showed abnormally high values. The probable reasons for this are discussed. (author)

  12. Cerebral venous angioma

    International Nuclear Information System (INIS)

    Inagawa, Tetsuji; Taguchi, Haruyoshi; Kamiya, Kazuko; Yano, Takashi; Nakajima, Reiko

    1984-01-01

    This report presents a 27-year-old male patient who was diagnosed as having cerebral venous angioma in the postero-temporal area by CT scan and cerebral angiography. The patient improved by removing angioma with electrocoagulation of medullary veins. (Namekawa, K.)

  13. Low plasma bicarbonate predicts poor outcome of cerebral malaria ...

    African Journals Online (AJOL)

    Malaria remains a major cause of morbidity and mortality in many sub Saharan countries and cerebral malaria is widely recognised as one of its most fatal forms. We studied the predictive value of routine biochemical laboratory indices in predicting the outcome of cerebral malaria in 50 Nigerian children ages 9 months to 6 ...

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

    International Nuclear Information System (INIS)

    Yasui, Nobuyuki; Asakura, Ken

    1987-01-01

    Cerebral blood flow (CBF), cerebral oxygen consumption (CMRO 2 ), oxygen extraction fraction (OEF) and cerebral blood volume (CBV) were studied in 20 cases of thalamic hemorrhage using positron CT and 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 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. (author)

  15. Can we Replace Arterial Blood Gas Analysis by Pulse Oximetry in Neonates with Respiratory Distress Syndrome, who are Treated According to INSURE Protocol?

    Directory of Open Access Journals (Sweden)

    Pedram Niknafs

    2015-05-01

    Full Text Available Neonates with respiratory distress syndrome (RDS, who are treated according to INSURE protocol; require arterial blood gas (ABG analysis to decide on appropriate management. We conducted this study to investigate the validity of pulse oximetry instead of frequent ABG analysis in the evaluation of these patients. From a total of 193 blood samples obtained from 30 neonates <1500 grams with RDS, 7.2% were found to have one or more of the followings: acidosis, hypercapnia, or hypoxemia. We found that pulse oximetry in the detection of hyperoxemia had a good validity to appropriately manage patients without blood gas analysis. However, the validity of pulse oximetry was not good enough to detect acidosis, hypercapnia, and hypoxemia.

  16. Accuracy of noninvasive multiwave pulse oximetry compared with carboxyhemoglobin from blood gas analysis in unselected emergency department patients.

    Science.gov (United States)

    Roth, Dominik; Herkner, Harald; Schreiber, Wolfgang; Hubmann, Nina; Gamper, Gunnar; Laggner, Anton N; Havel, Christof

    2011-07-01

    Accurate and timely diagnosis of carbon monoxide (CO) poisoning is difficult because of nonspecific symptoms. Multiwave pulse oximetry might facilitate the screening for occult poisoning by noninvasive measurement of carboxyhemoglobin (COHb), but its reliability is still unknown. We assess bias and precision of COHb oximetry compared with the criterion standard blood gas analysis. This was a prospective diagnostic accuracy study according to STARD (Standards for the Reporting of Diagnostic accuracy studies) criteria, performed at a tertiary care hospital emergency department. We included all patients for whom both invasive and noninvasive measurement within 60 minutes was available, regardless of their complaints, during a 1-year period. One thousand five hundred seventy-eight subjects were studied, of whom 17 (1.1%) received a diagnosis of CO poisoning. In accordance with this limited patient cohort, we found a bias of 2.99% COHb (1.50% for smokers, 4.33% for nonsmokers) and a precision of 3.27% COHb (2.90% for smokers, 2.98% for nonsmokers), limits of agreement from -3.55% to 9.53% COHb (-4.30% to 7.30% for smokers, -1.63% to 10.29% for nonsmokers). Upper limit of normal cutoff of 6.6% COHb had the highest sensitivity in screening for CO poisoning. Smoking status and COHb level had the most influence on the deviation between measurements. Multiwave pulse oximetry was found to measure COHb with an acceptable bias and precision. These results suggest it can be used to screen large numbers of patients for occult CO poisoning. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  17. Assessment of Arterial Oxygen Saturation by Pulse Oximetry Before, During and After Electroconvulsive Therapy

    Directory of Open Access Journals (Sweden)

    SH Tarig

    2006-07-01

    Full Text Available Introduction & Objective: Electroconvulsive therapy (ECT is used widely in psychiatric practice. The goal of anesthesia for ECT is the prevention of complications such as discomfort, fractures, aspiration of gastric contents and hypoxia. However, general anesthesia can cause some adverse effects as hypoxia. Prevention and treatment of hypoxia is important due to its undesirable effects on seizure duration and cardiovascular system. This study was designed to detect the incidence and probable times of desaturation in patients receiving ECT. Materials & Methods: This prospective randomized clinical trial was carried out on 100 patients (18-50 y/o with ASA I or II who were scheduled for ECT. After pre-oxygenation and similar anesthesia induction the patients received ECT. The patients were ventilated by oxygen and face masked until the return of their spontaneous respiration with adequate tidal volume and respiratory rate. Then they were transferred to recovery room where there was no oxygen supplementation. Oxygen saturation was measured by a Nell core pulse oximeter and was recorded at six stages: before and after anesthesia induction, during ECT, after ECT, 5 minutes after entering recovery room and before leaving there. The data were analyzed by standard statistical tests using SPSS software Results: Data analysis revealed that desaturation was not noticed at any stage except for the 5th stage (5 minutes after entering recovery room, when 13% of patients developed Sao2% less than 90%. Also there was a significant difference between Sao2% of patients between this stage (5th and other stages (p<0.001. Conclusion: According to our findings, appropriate oxygen supplementation and pulse oximetry monitoring during recovery period after ECT can be recommend

  18. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  19. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    Hayakawa, Katsumi; Kanda, Toyoko; Yamori, Yuriko

    2002-01-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  20. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Going to an Occupational Therapist Scoliosis In the Band: Jens' Story Cerebral ... KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- ...

  1. Cerebral Contusions and Lacerations

    Science.gov (United States)

    ... Contusions and Lacerations Concussion Diffuse Axonal Injury Intracranial Hematomas Skull Fracture Sports-Related Concussion Cerebral contusions are ... Contusions and Lacerations Concussion Diffuse Axonal Injury Intracranial Hematomas Skull Fracture Sports-Related Concussion NOTE: This is ...

  2. Middle cerebral artery blood velocity and cerebral blood flow and O2 uptake during dynamic exercise

    DEFF Research Database (Denmark)

    Madsen, P L; Sperling, B K; Warming, T

    1993-01-01

    Results obtained by the 133Xe clearance method with external detectors and by transcranial Doppler sonography (TCD) suggest that dynamic exercise causes an increase of global average cerebral blood flow (CBF). These data are contradicted by earlier data obtained during less-well-defined conditions....... To investigate this controversy, we applied the Kety-Schmidt technique to measure the global average levels of CBF and cerebral metabolic rate of oxygen (CMRO2) during rest and dynamic exercise. Simultaneously with the determination of CBF and CMRO2, we used TCD to determine mean maximal flow velocity...... in the middle cerebral artery (MCA Vmean). For values of CBF and MCA Vmean a correction for an observed small drop in arterial PCO2 was carried out. Baseline values for global CBF and CMRO2 were 50.7 and 3.63 ml.100 g-1.min-1, respectively. The same values were found during dynamic exercise, whereas a 22% (P

  3. Cerebral venous angiomas

    International Nuclear Information System (INIS)

    Agnoli, A.L.; Hildebrandt, G.

    1985-01-01

    Clinical symptoms and radiological signs in 15 patients with cerebral venous malformations are presented and the diagnostic problems discussed. The circulation time in combination with cerebral malformations and angiomas of the scalp are described. CT findings in cases of venous malformations of the brain stem are evaluated. Spot-like enhancement, as well as sharply demarcated round shaped enhancement are characteristic for venous angiomas. Cavernous angiomas usually present as homogenous or inhomogenous round shaped enhanced areas. (Author)

  4. Cerebral cartography and connectomics

    OpenAIRE

    Sporns, Olaf

    2015-01-01

    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 dynamic...

  5. Cerebral blood flow and metabolism during sleep

    DEFF Research Database (Denmark)

    Madsen, Peter Lund; Vorstrup, S

    1991-01-01

    A review of the current literature regarding sleep-induced changes in cerebral blood flow (CBF) and cerebral metabolic rate (CMR) is presented. Early investigations have led to the notion that dreamless sleep was characterized by global values of CBF and CMR practically at the level of wakefulness......, while rapid eye movement (REM) sleep (dream sleep) was a state characterized by a dramatically increased level of CBF and possibly also of CMR. However, recent investigations firmly contradict this notion. Investigations on CBF and CMR performed during non-REM sleep, taking the effect of different...... current state identify the physiological processes involved in sleep or the physiological role of sleep....

  6. 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

  7. Synergistic combination of hyperoxygenation and radiotherapy by repeated assessments of tumor pO2 with EPR oximetry

    International Nuclear Information System (INIS)

    Hou, H.; Dong, R.; Lariviere, J.P.; Mupparaju, S.P.; Swartz, H.M.; Khan, N.

    2011-01-01

    The effect of hyperoxygenation with carbogen (95% O 2 +5% CO 2 ) inhalation on radiation-induced fibrosarcoma (RIF-1) tumor pO 2 and its consequence on growth inhibition with fractionated radiotherapy is reported. The temporal changes in the tumor pO 2 were assessed by in vivo Electron Paramagnetic Resonance (EPR) oximetry in mice breathing 30% O 2 or carbogen and the tumors were irradiated with 4 Gy/day for 5 consecutive days; a protocol that emulates the clinical application of carbogen. The RIF-1 tumors were hypoxic with a tissue pO 2 of 5-9 mmHg. Carbogen (CB) breathing significantly increased tumor pO 2 , with a maximum increase at 22.9-31.2 min on days 1-5, however, the magnitude of increase in pO 2 declined on day 5. Radiotherapy during carbogen inhalation (CB/RT) resulted in a significant tumor growth inhibition from day 3 to day 6 as compared to 30%O 2 /RT and carbogen (CB/Sham RT) groups. The results provide unambiguous quantitative information on the effect of carbogen inhalation on tumor pO 2 over the course of 5 days. Tumor growth inhibition in the CB/RT group confirms that the tumor oxygenation with carbogen was radiobiologically significant. Repeated tumor pO 2 measurements by EPR oximetry can provide temporal information that could be used to improve therapeutic outcomes by scheduling doses at times of improved tumor oxygenation. (author)

  8. PULSE OXIMETRY AS A POTENTIAL SCREENING TOOL FOR LOWER EXTREMITY ARTERIAL DISEASE IN ASYMPTOMATIC PATIENTS WITH DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Sankaran Nair Kailasanadhan

    2018-02-01

    Full Text Available BACKGROUND India, with a population greater than 1.1 billion, has the dubious distinction of having a larger number of people with diabetes than any other country in the world. It was estimated in the year. 2000 that there are 32 million diabetes patients. Diabetic foot ulcers will complicate the disease in more than 15% of these people during their life time. Foot ulcers precede more than 80% of non-traumatic lower limb amputation. Individuals with diabetes had a tenfold higher overall amputation prevalence than did people without diabetes, 2.8% versus 0.29%. MATERIALS AND METHODS A Cross sectional study was done in the department of general surgery, Government Medical College Kottayam and Diabetic Clinic, Kottayam Medical College, from April 1, 2013 to October 1, 2013. RESULTS Out of 150 patients studied 83 were males and 67 were females and 95 patients (63.3% had POVD Statically significant association was found between POVD and age, history of hypertension, hyperlipidaemia, smoking, alcoholism, duration of diabetes mellitus and family history of hypertension/diabetes and hyperlipidaemia. Sensitivity and specificity of Pulse Oximetry in diagnosing POVD is 80% and 92.7% respectively. Sensitivity and specificity of ABPI in diagnosing POVD is 77.9% and 89.1% respectively. CONCLUSION Pulse Oximetry is an accurate and efficient screening tool for POVD in patients with diabetes mellitus. It can be incorporated to regular outpatient visits of Diabetes patients for early detection of POVD.

  9. Synergistic combination of hyperoxygenation and radiotherapy by repeated assessments of tumor pO2 with EPR oximetry

    Science.gov (United States)

    HOU, Huagang; DONG, Ruhong; LARIVIERE, Jean P.; MUPPARAJU, Sriram P.; SWARTZ, Harold M.; KHAN, Nadeem

    2013-01-01

    The effect of hyperoxygenation with carbogen (95% O2 + 5% CO2) inhalation on RIF-1 tumor pO2 and its consequence on growth inhibition with fractionated radiotherapy is reported. The temporal changes in the tumor pO2 were assessed by in vivo Electron Paramagnetic Resonance (EPR) oximetry in mice breathing 30% O2 or carbogen and the tumors were irradiated with 4 Gy/day for 5 consecutive days; a protocol that emulates the clinical application of carbogen. The RIF-1 tumors were hypoxic with a tissue pO2 of 5 – 9 mm Hg. Carbogen (CB) breathing significantly increased tumor pO2, with a maximum increase at 22.9 – 31.2 min on days 1 – 5, however, the magnitude of increase in pO2 declined on day 5. Radiotherapy during carbogen inhalation (CB/RT) resulted in a significant tumor growth inhibition from day 3 to day 6 as compared to 30%O2/RT and carbogen (CB/Sham RT) groups. The results provide unambiguous quantitative information on the effect of carbogen inhalation on tumor pO2 over the course of 5 days. Tumor growth inhibition in the CB/RT group confirms that the tumor oxygenation with carbogen was radiobiologically significant. Repeated tumor pO2 measurements by EPR oximetry can provide temporal information that could be used to improve therapeutic outcomes by scheduling doses at times of improved tumor oxygenation. PMID:21799293

  10. Theoretical model for optical oximetry at the capillary level: exploring hemoglobin oxygen saturation through backscattering of single red blood cells

    Science.gov (United States)

    Liu, Rongrong; Spicer, Graham; Chen, Siyu; Zhang, Hao F.; Yi, Ji; Backman, Vadim

    2017-02-01

    Oxygen saturation (sO2) of red blood cells (RBCs) in capillaries can indirectly assess local tissue oxygenation and metabolic function. For example, the altered retinal oxygenation in diabetic retinopathy and local hypoxia during tumor development in cancer are reflected by abnormal sO2 of local capillary networks. However, it is far from clear whether accurate label-free optical oximetry (i.e., measuring hemoglobin sO2) is feasible from dispersed RBCs at the single capillary level. The sO2-dependent hemoglobin absorption contrast present in optical scattering signal is complicated by geometry-dependent scattering from RBCs. We present a numerical study of backscattering spectra from single RBCs based on the first-order Born approximation, considering practical factors: RBC orientations, size variation, and deformations. We show that the oscillatory spectral behavior of RBC geometries is smoothed by variations in cell size and orientation, resulting in clear sO2-dependent spectral contrast. In addition, this spectral contrast persists with different mean cellular hemoglobin content and different deformations of RBCs. This study shows for the first time the feasibility of, and provides a theoretical model for, label-free optical oximetry at the single capillary level using backscattering-based imaging modalities, challenging the popular view that such measurements are impossible at the single capillary level.

  11. The influence of stellate ganglion transcutaneous electrical nerve stimulation on signal quality of pulse oximetry in prehospital trauma care.

    Science.gov (United States)

    Barker, Renate; Lang, Thomas; Hager, Helmut; Steinlechner, Barbara; Hoerauf, Klaus; Zimpfer, Michael; Kober, Alexander

    2007-05-01

    Accurate monitoring of the peripheral arterial oxygen saturation has become an important tool in the prehospital emergency medicine. This monitoring requires an adequate plethysmographic pulsation. Signal quality is diminished by cold ambient temperature due to vasoconstriction. Blockade of the stellate ganglion can improve peripheral vascular perfusion and can be achieved by direct injection or transcutaneous electrical nerve stimulation (TENS) stimulation. We evaluated whether TENS on the stellate ganglion would reduce vasoconstriction and thereby improve signal detection quality of peripheral pulse oximetry. In our study, 53 patients with minor trauma who required transport to the hospital were enrolled. We recorded vital signs, including core and skin temperature before and after transport to the hospital. Pulse oximetry sensors were attached to the patient's second finger on both hands. TENS of the stellate ganglion was started on one side after the beginning of the transport. Pulse oximeter alerts, due to poor signal detection, were recorded for each side separately. On the hand treated with TENS we detected a significant reduction of alerts compared to the other side (mean alerts TENS 3.1 [1-15] versus control side 8.8 [1-28] P signal quality of pulse oximeters in the prehospital setting.

  12. 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...

  13. Cerebral hemorrhage caused by amyloid angiopathy

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Tomonaga, Masanori; Yoshimura, Masahiro; Yamanouchi, Hiroshi; Shimada, Hiroyuki.

    1985-01-01

    Cerebral hemorrhage caused by amyloid angiopathy was studied clinicopathologically, with special attention given to the CT images. Cerebral hemorrhage caused by amyloid angiopathy is characterized, by a lobar-type hemorrhage involving the cortex, with direct extension into the subarachnoid space. Multiple hemorrhages are frequent, and cortical infarctions are present as complications in elderly patients without risk factors. CT scans taken in 5 cases demonstrated lobar hemorrhages in superficial locations, frequently in multiple sites or recurrently, with surrounding edema and mass effect. A subarachnoid extension of the hemorrhage through the superficial cortex, proven pathologically in all cases, was noted by CT in 4 of the 5 cases. However, cortical infarction was not detected by CT in any case. Therefore, CT is of value in the diagnosis of cerebral hemorrhage due to amyloid angiopathy based on distinctive findings such as a lobar hemorrhage in superficial regions, with extension into the subarachnoid space, frequently in multiple sites or recurrently. (author)

  14. Rejection of Erroneous Saturation Data in Optical Pulse Oximetry in Newborn Patients

    Science.gov (United States)

    Scalise, L.; Marchionni, Paolo; Carnielli, Virgilio P.

    2011-08-01

    Pulse oximetry (PO) is extensively used in intensive care unit (ICU); this is mainly due to the fact that it is a non-invasive and real-time monitoring method. PO allows to measure arterial oxygen saturation (SaO2) and in particular hemoglobin oxygenation. Optical PO is typically realized by the use of a clip (to be applied on the ear or on the finger top) containing a couple of monochromatic LED sources and a photodiode. The main drawback with the use of PO is the presence of movement artifacts or disturbance due to optical sources and skin, causing erroneous saturation data. The aim of this work is to present the measurement procedure based on a specially developed algorithm able to reject erroneous oxygen saturation data during long lasting monitoring of patients in ICU and to compare measurement data with reference data provided by EGA. We have collected SaO2 data from a standard PO and used an intensive care unit monitor to collect data. This device was connected to our acquisition system and heart rate (HR) and SaO2 data were acquired and processed by our specially developed algorithm and directly reproduced on the PC screen for use by the clinicians. The algorithm here used for the individuation and rejection of erroneous saturation data is based on the assessment of the difference between the Heart Rate (HR) measured by respectively by the ECG and PO. We have used an emogasanalyzer (EGA) for comparison of the measured data. The study was carried out in a neonatal intensive care unit (NICU), using 817 data coming from 24 patients and the observation time was of about 10000 hours. Results show a reduction in the maximum difference between the SaO2 data measured, simultaneously, on the same patient by the EGA and by the proposed method of 14.20% and of the 4.76% in average over the 817 samples. The measurement method proposed is therefore able to individuate and eliminate the erroneous saturation data due to motion artifacts and reported by the pulse oxymeter

  15. Direct Measurements of Oxygen Gradients in Spheroid Culture System Using Electron Parametric Resonance Oximetry.

    Directory of Open Access Journals (Sweden)

    Laura M Langan

    Full Text Available Advanced in vitro culture from tissues of different origin includes three-dimensional (3D organoid micro structures that may mimic conditions in vivo. One example of simple 3D culture is spheroids; ball shaped structures typically used as liver and tumour models. Oxygen is critically important in physiological processes, but is difficult to quantify in 3D culture: and the question arises, how small does a spheroid have to be to have minimal micro-environment formation? This question is of particular importance in the growing field of 3D based models for toxicological assessment. Here, we describe a simple non-invasive approach modified for the quantitative measurement and subsequent evaluation of oxygen gradients in spheroids developed from a non-malignant fish cell line (i.e. RTG-2 cells using Electron Paramagnetic Resonance (EPR oximetry. Sonication of the paramagnetic probe Lithium phthalocyanine (LiPc allows for incorporation of probe particulates into spheroid during its formation. Spectra signal strength after incorporation of probe into spheroid indicated that a volume of 20 μl of probe (stock solution: 0.10 mg/mL is sufficient to provide a strong spectra across a range of spheroid sizes. The addition of non-toxic probes (that do not produce or consume oxygen report on oxygen diffusion throughout the spheroid as a function of size. We provide evidence supporting the use of this model over a range of initial cell seeding densities and spheroid sizes with the production of oxygen distribution as a function of these parameters. In our spheroid model, lower cell seeding densities (∼2,500 cells/spheroid and absolute size (118±32 μm allow control of factors such as pre-existing stresses (e.g. ∼ 2% normoxic/hypoxic interface for more accurate measurement of treatment response. The applied methodology provides an elegant, widely applicable approach to directly characterize spheroid (and other organoid cultures in biomedical and

  16. MRI diagnosis of the cerebral schistosomiasis

    International Nuclear Information System (INIS)

    Liu Hanqiu; Chen Yuanjun

    2002-01-01

    Objective: To discuss MRI appearance of the cerebral schistosomiasis and its clinical value through analyzing the MRI features and post-surgery pathological findings. Methods: MRI features of the cerebral schistosomiasis in 16, pathologically (n = 6) or clinically (n = 10) proved cases were analyzed retrospectively, and compared with the post-surgery pathological findings in 6 cases. Results: Single masses were found in 11 cases (11/16), and multiple masses in 5 eases (5/16), amounting to 23 masses . fifteen masses (15/23) were located in right cerebral hemisphere, including frontal lobe (n = 2), frontoparietal lobe (n = 5) , and occipitoparietal lobe (n 8), while 8 masses (8/23) in left cerebral hemisphere, including frontal lobe (n = 1), frontoparietal lobe (n = 3), and occipitoparietal lobe (n = 4). The nodular masses were isointense with the gray mass like 'island', and 12 cases (12/16) show the 'gigantic hand' form of edema around them. After IV administration of Gd-DTPA, 15 cases (15/16) revealed multiple closely spaced, intensely enhancing modules, 1-3 mm in diameter, distributed throughout the mass. Seven cases misdiagnosed by CT were revised by MRl. Conclusion: The MRI appearance of the cerebral schistosomiasis is characteristic, and MRI is the most valuable tool to diagnose it without injury

  17. Evaluation of ocular acupuncture on cerebral infarction with cerebral blood flow perfusion imaging

    International Nuclear Information System (INIS)

    Li Yuge; Gao Qinyi; Wang Shuang; Zhao Yong

    2008-01-01

    To evaluate the immediate effect of ocular acupuncture on patients, an method of SPECT image of cerebral blood flow daily stress test was established. 10 patients diagnosed as cerebral infarction by CT or MRI were tested. They all received 99 Tc m -ECD SPECT imaging at twice before and after ocular acupuncture. By means of image subtraction technique and semi-quantitative method of regional interesting area, the change of regional cerebral blood flow was observed between the two images. Under restful state perfusion of cerebral blood flow in 18 foci was low at the frontal lobe, the cerebellum, the basal ganglia and temporal lobe. After ocular acupuncture, the perfusions were obviously increased in 16 foci among them and the reactivity of the frontal lobe and the cerebellum to ocular acupuncture was higher, the average improvement rate of which was 55.15% and 53.06% respectively, lower in the basal ganglia and temporal lobe, the average improvement rate was 31.79% and 36.67% respectively. 99 Tc m -ECD SPECT cerebral perfusion image has some significant clinic value for evaluating the effect of ocular acupuncture to treating cerebral infarction. (authors)

  18. A Comparative Evaluation of EPR and OxyLite Oximetry Using a Random Sampling of pO2 in a Murine Tumor

    Science.gov (United States)

    Vikram, Deepti S.; Bratasz, Anna; Ahmad, Rizwan; Kuppusamy, Periannan

    2015-01-01

    Methods currently available for the measurement of oxygen concentrations (oximetry) in viable tissues differ widely from each other in their methodological basis and applicability. The goal of this study was to compare two novel methods, particulate-based electron paramagnetic resonance (EPR) and OxyLite oximetry, in an experimental tumor model. EPR oximetry uses implantable paramagnetic particulates, whereas OxyLite uses fluorescent probes affixed on a fiber-optic cable. C3H mice were transplanted with radiation-induced fibrosarcoma (RIF-1) tumors in their hind limbs. Lithium phthalocyanine (LiPc) microcrystals were used as EPR probes. The pO2 measurements were taken from random locations at a depth of ~3 mm within the tumor either immediately or 48 h after implantation of LiPc. Both methods revealed significant hypoxia in the tumor. However, there were striking differences between the EPR and OxyLite readings. The differences were attributed to the volume of tissue under examination and the effect of needle invasion at the site of measurement. This study recognizes the unique benefits of EPR oximetry in terms of robustness, repeatability and minimal invasiveness. PMID:17705635

  19. Valor pronóstico del mapeo cerebral en la recuperación funcional del paciente con enfermedad cerebrovascular isquémica Pronostic value of brain mapping in the functional recovery of patients with ischemic cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Freddy Torres Candebat

    2012-10-01

    Full Text Available Se efectuó un estudio descriptivo longitudinal y prospectivo de 22 pacientes con ictus isquémico, que fueron ingresados en el Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba desde enero de 2010 hasta igual mes de 2011, con vistas a establecer un pronóstico de recuperación funcional a partir del mapeo cerebral. Se realizó la valoración neurofisiológica y funcional mediante el índice de Barthel. En la serie estudiada la edad media fue de 57,2 años y predominó el sexo masculino. El mapeo cerebral se caracterizó por la presencia de actividad lenta (theta, delta y disminución de beta y alfa en regiones corticales ipsilaterales y contralaterales al territorio afectado por el foco isquémico; asimismo, la magnitud de estas alteraciones se correlacionó estrechamente con la ganancia funcional. La disminución de energía en las bandas alfa, asociada al incremento de esta en las bandas theta y delta, de tipo global, constituyeron índices de mal pronóstico rehabilitador.A longitudinal and prospective descriptive study was made in 22 patients with ischemic ictus that were admitted to "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba from January, 2010 to the same month of 2011, aimed at establishing a prognosis of functional recovery from the cerebral mapping. A neurophysiological and functional evaluation was carried out by means of Barthel index. In the studied series the mean age was 57.2 years and the male sex prevailed. Cerebral mapping was characterized by the presence of slow activity (theta, delta and beta and alpha decreases in cortical ipsilateral and contralateral regions to the territory affected by the ischemic focus; likewise, the magnitude of these changes was closely correlated with the functional gain. The energy decrease in the alpha bands associated with its increment in the theta and delta bands, of global type, constituted rates of bad rehabilitation prognosis.

  20. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: 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. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  1. Cerebral CT appearances of toxic encephalopathy of tetramine

    International Nuclear Information System (INIS)

    Zheng Wenlong; Wu Aiqin; Xu Chongyong; Ying Binyu; Hong Ruizhen

    2003-01-01

    Objective: To investigate the cerebral CT appearances of toxic encephalopathy of tetramine and improve the recognition on this disease. Methods: Four cases of toxic encephalopathy of tetramine were collected and their cerebral CT appearances were retrospectively analyzed. Results: Cerebral CT appearances in acute phase (within 8 days): (1) cerebral edema in different degree. CT abnormalities consisted of cortical hypodensities and complete loss of gray-white matter differentiation. The CT value were in 11-13 HU, and to be watery density in serious case, (2) subarachnoid hemorrhage. It demonstrated the signs of poisoning hypoxic ischemic encephalopathy in chronic phase. Conclusion: The cerebral CT appearances of toxic encephalopathy of tetramine had some character in acute phase and it can predict the serious degree of intoxication, but there was no characteristic findings in chronic phase

  2. 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...

  3. Beyond Critical Congenital Heart Disease: Newborn Screening Using Pulse Oximetry for Neonatal Sepsis and Respiratory Diseases in a Middle-Income Country.

    Science.gov (United States)

    Jawin, Vida; Ang, Hak-Lee; Omar, Asma; Thong, Meow-Keong

    2015-01-01

    Studies on pulse oximetry screening for neonatal sepsis and respiratory disease in a middle-income country are lacking. Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is an effective and life-saving strategy in developed countries. While most studies have reported false-positive results during CCHD screening, they have not elaborated on the detected disease types. We studied the effectiveness and outcomes of pulse oximetry newborn screening for non-cardiac hypoxemic diseases such as neonatal sepsis, respiratory diseases, and CCHD in a middle-income country. In a pilot study performed at the University Malaya Medical Centre (UMMC), Malaysia, all apparently healthy term newborns, delivered at UMMC were screened pre-discharge using pulse oximetry. Echocardiography was performed for newborns that had positive screening results on two separate occasions, 1-h apart. Newborns with normal echocardiograms were evaluated and treated for other non-cardiac diseases. Fifteen of 5247 term newborns had positive screening results. The median age at screening was 20 h. Thirteen newborns (0.24%) had significant non-cardiac diseases: sepsis (n = 2) and respiratory diseases (n = 11) that required hospitalization and treatment. The remaining two newborns with normal antenatal ultrasonograms had positive screening test and confirmed to have CCHD. Another 18 newborns with negative screening test were later admitted for treatment of sepsis (n = 16) and penumonia (n = 2). All newborns were treated and alive at the end of the study. The sensitivity and specificity of pulse oximetry screening for non-cardiac diseases were 42% and 99.9% respectively, and 100% and 99.7% for CCHD, respectively. Routine pulse oximetry screening test was effective in identifying newborns with CCHD and other hypoxemia illnesses, which may led to potential life-threatening condition. This study showed that the expanded use of pulse oximetry has immediate implications for low

  4. Effects of Acute Bleeding Followed by Hydroxyethyl Starch 130/0.4 or a Crystalloid on Propofol Concentrations, Cerebral Oxygenation, and Electroencephalographic and Haemodynamic Variables in Pigs

    Directory of Open Access Journals (Sweden)

    Aura Silva

    2014-01-01

    Full Text Available Bleeding changes the haemodynamics, compromising organ perfusion. In this study, the effects of bleeding followed by replacement with hydroxyethyl starch 130/0.4 (HES or lactated Ringer’s (LR on cerebral oxygenation and electroencephalogram-derived parameters were investigated. Twelve young pigs under propofol-remifentanil anaesthesia were bled 30 mL/kg and, after a 20-minute waiting period, volume replacement was performed with HES (GHES; N=6 or LR (GRL; N=6. Bleeding caused a decrease of more than 50% in mean arterial pressure (P<0.01 and a decrease in cerebral oximetry (P=0.039, bispectral index, and electroencephalogram total power (P=0.04 and P<0.01, resp., while propofol plasma concentrations increased (P<0.01. Both solutions restored the haemodynamics and cerebral oxygenation similarly and were accompanied by an increase in electroencephalogram total power. No differences between groups were found. However, one hour after the end of the volume replacement, the cardiac output (P=0.03 and the cerebral oxygenation (P=0.008 decreased in the GLR and were significantly lower than in GHES (P=0.02. Volume replacement with HES 130/0.4 was capable of maintaining the cardiac output and cerebral oxygenation during a longer period than LR and caused a decrease in the propofol plasma concentrations.

  5. The clinical study of cerebral blood flow imaging in patients with early syphilis

    International Nuclear Information System (INIS)

    Liu Zengli; Shi Xin; Wu Jinchang; Tang Jun; Zhong Jijun

    2003-01-01

    Objective: To study the clinical value of cerebral blood flow imaging for evaluation of patients with early syphilis. Methods: Fifty-three patients with early syphilis underwent cerebral blood flow imaging using 99 Tc m -ethylenecysteinate dimer(ECD). Regional cerebral blood flow (rCBF) changes were analyzed. Results: The acquired images of 53 patients were graded as 5 types. The rCBF was significantly depressed in 48 of 53 patients mainly in the areas dominated by anterior cerebral artery and middle cerebral artery. Conclusion: Treponema pallidum (TP) could start invading central nervous system at the early stage of infection

  6. 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

  7. 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

  8. 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.

  9. 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)

  10. Gammagraphy of cerebral perfusion

    International Nuclear Information System (INIS)

    Vazquez, Silvia

    2003-01-01

    Important aspects of the gammagraphy of cerebral perfusion and the diverse clinical applications in the neurological diseases are comment in this article. We focus in the usefulness of the photon emission cerebral tomography (SPECT) and its capacity to cross the hemato encephalic barrier through the use of radiopharmacons like 99 mTc-H M-PAO and 99mTc-EDC, thus managing to offer functional data on the captantes neurons of the radiopharmacon. The clinical applications of SPECT are studied; cerebrovascular disease, transient ischemic attacks, dementias, Alzheimer disease, as well as other neurological diseases are referred. (The author)

  11. 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...

  12. Quantitation of regional cerebral blood flow corrected for partial volume effect using O-15 water and PET: II. Normal values and gray matter blood flow response to visual activation

    DEFF Research Database (Denmark)

    Law, I; Iida, H; Holm, S

    2000-01-01

    One of the most limiting factors for the accurate quantification of physiologic parameters with positron emission tomography (PET) is the partial volume effect (PVE). To assess the magnitude of this contribution to the measurement of regional cerebral blood flow (rCBF), the authors have formulated...... or 3D). Furthermore, the authors wanted to measure the activation response in the occipital gray matter compartment, and in doing so test the stability of the PTF, during perturbations of rCBF induced by visual stimulation. Eight dynamic PET scans were acquired per subject (n = 8), each for a duration...... of 6 minutes after IV bolus injection of H2(15)O. Four of these scans were performed using 2D and four using 3D acquisition. Visual stimulation was presented in four scans, and four scans were during rest. Model C was found optimal based on Akaike's Information Criteria (AIC) and had the smallest...

  13. 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.)

  14. Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

    Directory of Open Access Journals (Sweden)

    Jun Xu

    Full Text Available Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR, the better the appearance of pulse oximetry plethysmographic waveform (POP. We investigated whether the area under the curve (AUC and/or the amplitude (Amp of POP could be used to monitor the quality of CPR.Prospective, randomized controlled study.Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.Healthy 3-month-old male domestic swine.34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm and a "high quality" group (with a depth of 5cm. All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP, partial pressure of end-tidal carbon dioxide (PETCO2] as well as AUC and Amp of POP were all collected and analyzed.There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05. AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01. There was no statistical difference between the heart rate calculated according to the POP (FCPR and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

  15. Cerebral malaria: susceptibility weighted MRI

    Directory of Open Access Journals (Sweden)

    Vinit Baliyan

    2015-03-01

    Full Text Available Cerebral malaria is one of the fatal complications of Plasmodium falciparum infection. Pathogenesis involves cerebral microangiopathy related to microvascular plugging by infected red blood cells. Conventional imaging with MRI and CT do not reveal anything specific in case of cerebral malaria. Susceptibility weighted imaging, a recent advance in the MRI, is very sensitive to microbleeds related to microangiopathy. Histopathological studies in cerebral malaria have revealed microbleeds in brain parenchyma secondary to microangiopathy. Susceptibility weighted imaging, being exquisitely sensitive to microbleeds may provide additional information and improve the diagnostic accuracy of MRI in cerebral malaria.

  16. High Altitude Cerebral Edema

    Science.gov (United States)

    1986-03-01

    described neuropathological findings of cerebral edema and wi4espread petechial hemorrhages in two HAPE fatalities and later reported (52...lethargy, thirst, indigestion, hysterical outburst o: other behavior disturbances, decreased concentration, fever , couhh and peripheral edema (52...autopsy results from the two fatalities in their series. In both cases multiple, widespread petechial hemorrhages were noted throughout the brain. One

  17. Cerebral autoregulation after subarachnoid hemorrhage: comparison of three methods

    OpenAIRE

    Budohoski, Karol P; Czosnyka, Marek; Smielewski, Peter; Varsos, Georgios V; Kasprowicz, Magdalena; Brady, Ken M; Pickard, John D; Kirkpatrick, Peter J

    2012-01-01

    In patients after subarachnoid hemorrhage (SAH) failure of cerebral autoregulation is associated with delayed cerebral ischemia (DCI). Various methods of assessing autoregulation are available, but their predictive values remain unknown. We characterize the relationship between different indices of autoregulation. Patients with SAH within 5 days were included in a prospective study. The relationship between three indices of autoregulation was analyzed: two indices calculated using spontaneous...

  18. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... 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...... cardiac output brain perfusion becomes jeopardized. Whether, in patients with cardiovascular disease and/or defect, cerebral blood flow cerebral control HV-induced hypocapnia elicits cerebral hypoperfusion, leading to TLOC, remains to be established....

  19. 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.)

  20. Human cerebral asymmetries evaluated by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Chang Chui, H; Damasio, A R [Iowa Univ., Iowa City (USA)

    1980-10-01

    The handedness of seventy-five persons without evidence of neurological disease, was assessed with a standardised test. An analysis of the CT scans of the same persons was performed to determine (1) presence and lateralisation of frontal and occipital 'petalia', (2) width of frontal and occipital lobes of each hemisphere, (3) direction of straight sinus deviation. Results suggest that handedness and cerebral asymmetries are independent variables. There were no significant differences between right-handers and non-right handers. Also there was no significant differences between strongly left-handed and ambidextrous individuals, nor were there differences between right-handers with or without family history of left-handedness. Irrespective of handedness, left occipital 'petalia' was more common than right (p<0.01), right frontal petalia was more common than left (p<0.01), and straight sinus deviation was more commonly toward the right. The study does not support the concept that cerebral 'symmetry' or 'reverse asymmetry' are associated with left-handedness or ambidexterity. The noted asymmetries are more likely to be direct correlates of cerebral language dominance, than of handedness. Outside forces acting on the bone may also contribute to the asymmetries. CT scan may be of value as a direct predictor of cerebral dominance.

  1. Human cerebral asymmetries evaluated by computed tomography

    International Nuclear Information System (INIS)

    Chang Chui, H.; Damasio, A.R.

    1980-01-01

    The handedness of seventy-five persons without evidence of neurological disease, was assessed with a standardised test. An analysis of the CT scans of the same persons was performed to determine (1) presence and lateralisation of frontal and occipital 'petalia', (2) width of frontal and occipital lobes of each hemisphere, (3) direction of straight sinus deviation. Results suggest that handedness and cerebral asymmetries are independent variables. There were no significant differences between right-handers and non-right handers. Also there was no significant differences between strongly left-handed and ambidextrous individuals, nor were there differences between right-handers with or without family history of left-handedness. Irrespective of handedness, left occipital 'petalia' was more common than right (p<0.01), right frontal petalia was more common than left (p<0.01), and straight sinus deviation was more commonly toward the right. The study does not support the concept that cerebral 'symmetry' or 'reverse asymmetry' are associated with left-handedness or ambidexterity. The noted asymmetries are more likely to be direct correlates of cerebral language dominance, than of handedness. Outside forces acting on the bone may also contribute to the asymmetries. CT scan may be of value as a direct predictor of cerebral dominance. (author)

  2. Effects of smoking on regional cerebral blood flow in cerebral vascular disease patients and normal subjects

    International Nuclear Information System (INIS)

    Kubota, Kazuo; Yamaguchi, Tatsuo; Fujiwara, Takehiko; Matsuzawa, Taiju

    1987-01-01

    The chronic effect of smoking on the regional cerebral blood flow (r-CBF) was studied by 133-Xenon inhalation method and described with the Initial Slope Index (ISI). Fifty-two patients as the control group who had no abnormality neurologically or with CT scan, 32 patients with old cerebral infarction and 20 patients with old cerebral hemorrhage were introduced to the present study, and these patients were divided into smokers and non-smokers in each group. Those whose smoking index of 200 or more [(number of cigarettes/day) x (years of smoking history) ≥ 200] were designated as smokers. ISI values were decreased significantly in smokers than non-smokers in all groups. Mean ISI value of unaffected hemisphere in smokers decreased by 16 % in the infarction group and 22 % in the hemorrhage group comparing to the non-smokers', respectively. In the control group, mean ISI value of right hemisphere decreased by 15 % and left 14 % in smokers compared to the non-smokers. The r-CBF values in 44 of the 47 smokers were found to be lower than the expected age matched values in non-smokers. Serum high density lipoprotein cholesterol value in smokers was significantly lower than that in non-smokers. We demonstrated preliminarily that the smoking chronically reduced the r-CBF. Advanced atherosclerosis associated with the smoker was suggested to affect the CBF. (author)

  3. Cerebral localization in antiquity.

    Science.gov (United States)

    Rose, F Clifford

    2009-07-01

    Fragments of neurology can be found in the oldest medical writings in antiquity. Recognizable cerebral localization is seen in Egyptian medical papyri. Most notably, the Edwin Smith papyrus describes hemiplegia after a head injury. Similar echoes can be seen in Homer, the Bible, and the pre-Hippocratic writer Alcmaeon of Croton. While Biblical writers thought that the heart was the seat of the soul, Hippocratic writers located it in the head. Alexandrian anatomists described the nerves, and Galen developed the ventricular theory of cognition whereby mental functions are classified and localized in one of the cerebral ventricles. Medieval scholars, including the early Church Fathers, modified Galenic ventricular theory so as to make it a dynamic model of cognition. Physicians in antiquity subdivided the brain into separate areas and attributed to them different functions, a phenomenon that connects them with modern neurologists.

  4. Cerebral venous thrombosis

    International Nuclear Information System (INIS)

    Soralova, T.; Sevcikova, H.; Petersky, D.

    2014-01-01

    We decided to process this theme due to its nonspecific clinical features as they often cause diagnostic problems not only to clinicians but also to diagnostic. It is important to think of this disease mainly in young women who administer hormonal contraception. Imaging methods play the crucial role in diagnostic of cerebral venous sinus thrombosis. The gold standard is a native CT of brain which shows the venous sinus thrombosis as a hyperdense lesion in the locus of the sinus (dense triangle sign), CT venography shows the sinus thrombosis as a defect in a contrast filling of the venous sinus (empty delta sign). Other investigative methods are magnetic resonance imaging or MRA. In short we also mention quite a rare but more serious thrombosis of profound cerebral veins v. cerebri magna-Galeni, vv. cerebri internae). The importance of early diagnostic and non specificity of symptoms is presented in 3 clinical cases that are the part of this work. (author)

  5. 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.

  6. Cerebral ketone body metabolism.

    Science.gov (United States)

    Morris, A A M

    2005-01-01

    Ketone bodies (KBs) are an important source of energy for the brain. During the neonatal period, they are also precursors for the synthesis of lipids (especially cholesterol) and amino acids. The rate of cerebral KB metabolism depends primarily on the concentration in blood; high concentrations occur during fasting and on a high-fat diet. Cerebral KB metabolism is also regulated by the permeability of the blood-brain barrier (BBB), which depends on the abundance of monocarboxylic acid transporters (MCT1). The BBB's permeability to KBs increases with fasting in humans. In rats, permeability increases during the suckling period, but human neonates have not been studied. Monocarboxylic acid transporters are also present in the plasma membranes of neurons and glia but their role in regulating KB metabolism is uncertain. Finally, the rate of cerebral KB metabolism depends on the activities of the relevant enzymes in brain. The activities vary with age in rats, but reliable results are not available for humans. Cerebral KB metabolism in humans differs from that in the rat in several respects. During fasting, for example, KBs supply more of the brain's energy in humans than in the rat. Conversely, KBs are probably used more extensively in the brain of suckling rats than in human neonates. These differences complicate the interpretation of rodent studies. Most patients with inborn errors of ketogenesis develop normally, suggesting that the only essential role for KBs is as an alternative fuel during illness or prolonged fasting. On the other hand, in HMG-CoA lyase deficiency, imaging generally shows asymptomatic white-matter abnormalities. The ability of KBs to act as an alternative fuel explains the effectiveness of the ketogenic diet in GLUT1 deficiency, but its effectiveness in epilepsy remains unexplained.

  7. 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

  8. Magnetic Resonance Features of Cerebral Malaria

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, P.; Sharma, R.; Kumar, S.; Kumar, U. (Dept. of Radiodiagnosis and Dept. of Medicine, All India Institute of Medical Sciences, New Delhi (India))

    2008-06-15

    Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm2, and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients

  9. Magnetic Resonance Features of Cerebral Malaria

    International Nuclear Information System (INIS)

    Yadav, P.; Sharma, R.; Kumar, S.; Kumar, U.

    2008-01-01

    Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm 2 , and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients

  10. Neonatal cerebral infarction

    International Nuclear Information System (INIS)

    Fujimoto, Shinji; Togari, Hajime; Sobajima, Hisanori; Suzuki, Shigesumi; Wada, Yoshiro; Yokochi, Kenji; Nishimura, Yutaka; Inukai, Kazuhisa; Futamura, Masahide.

    1992-01-01

    In a retrospective multi-center study, we investigated eighteen infants with unilateral cerebral infarctions confirmed by computed tomography (CT) scans. The initial symptoms were observed in all the patients between 0 and 3 days of age. Convulsions or apneic attacks were the initial symptoms in all but one. Only 4 patients had complicated obstetric histories and none showed polycythemia or electrolyte abnormalities. All of the initial CT scans revealed unilaterally localized hypodense areas. In 10, the initial CT scans were performed within 24 hours after the clinical onset. In 16, the lesions were within the territory of the middle cerebral artery, 9 of which also involved the cortico-spinal tract (CST). In the remaining 2 patients, the lesions were located whithin the territory of the posterior cerebral artery. None of the 9 patients without CST involvement developed hemiplegia, whereas 5 (56%) of the 9 with CST involvement had hemiplegia, which is a fairly low incidence compared with that in adult cases. This difference was thought to be related to neonatal brain plasticity. (author)

  11. 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.)

  12. Molecular pathophysiology of cerebral edema

    Science.gov (United States)

    Gerzanich, Volodymyr; Simard, J Marc

    2015-01-01

    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. PMID:26661240

  13. Measuring arterial oxygenation in a high altitude field environment: comparing portable pulse oximetry with blood gas analysis.

    Science.gov (United States)

    Ross, Elliot M; Matteucci, Michael J; Shepherd, Matthew; Barker, Matthew; Orr, Lance

    2013-06-01

    High altitude environments present unique medical treatment challenges. Medical providers often use small portable pulse oximetry devices to help guide their clinical decision making. A significant body of high altitude research is based on the use of these devices to monitor hypoxia, yet there is a paucity of evidence that these devices are accurate in these environments. We studied whether these devices perform accurately and reliably under true mountain conditions. Healthy unacclimatized active-duty military volunteers participating in mountain warfare training at 2100 m (6900 feet) above sea level were evaluated with several different pulse oximetry devices while in a cold weather, high altitude field environment and then had arterial blood gases (ABG) drawn using an i-STAT for comparison. The pulse oximeter readings were compared with the gold standard ABG readings. A total of 49 individuals completed the study. There was no statistically significant difference between any of the devices and the gold standard of ABG. The best performing device was the PalmSAT (PS) 8000SM finger probe with a mean difference of 2.17% and SD of 2.56 (95% CI, 1.42% to 2.92%). In decreasing order of performance were the PS 8000AA finger probe (mean ± SD, 2.54% ± 2.68%; 95% CI, 1.76% to 3.32%), the PS 8000Q ear probe (2.47% ± 4.36%; 95% CI, 1.21% to 3.75%), the Nonin Onyx 9500 (3.29% ± 3.12%; 95% CI, 2.39% to 4.20%), and finally the PS 8000R forehead reflectance sensor (5.15% ± 2.97%; 95% CI, 4.28% to 6.01%). Based on the results of this study, results of the newer portable pulse oximeters appear to be closely correlated to that of the ABG measurements when tested in true mountain conditions. Copyright © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  14. Cerebral blood flow and oxygen metabolism after subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Ito, Hidemichi; Sakurai, Takashi; Hayashi, Tatsuo; Hashimoto, Takuo

    2004-01-01

    The mechanism of reduction of cerebral circulation in the early phase of aneurysmal subarachnoid hemorrhage (SAH) has not yet been clarified. Previous studies have variously indicated that cerebral blood flow (CBF) reduction may be due to cerebral vasospasm, an elevation in intracranial pressure (ICP), constriction of intraparenchymal arterioles, or metabolic reduction. The aim of this study is to investigate the relationship between cerebral circulation and oxygen metabolism. In 36 patients with aneurysmal SAH, the values of mean cerebral blood flow (mCBF), cerebral metabolic rate of oxygen (GMRO 2 ) and oxygen extraction fraction (OEF) were measured by using single photon emission computed tomography (SPECT) with arterial blood drawing and oxygen saturation of internal jugular bulb blood (SjO 2 ) in the acute stage (1-3 days after onset) and the spasm stage (7-10 days after onset). The patients in our study were selected by using the following criteria: no history of cerebrovascular or cardiopulmonary diseases; under the age of 70; the ruptured aneurysm was treated by clipping or coil embolization within 72 hours after onset; no symptoms of cerebral vasospasm; no signs of cerebral ischemic change on CT scans. These patients were divided into 2 groups according to the World Federation of Neurological Surgeons (WFNS) grading classification; the mild group (Grades I and II) consisted of 27 cases and the severe group (Grade IV) consisted of 9 cases. We studied differences in mCBF CMRO 2 , and OEF between the mild group and severe group. In the mild group, mCBF, CMRO 2 , and OEF were significantly higher than in the severe group during both the acute and the spasm stage. Also mCBF showed a direct correlation with CMRO 2 . All the patients were kept under the following conditions: the bed was positioned so that the upper body was raised at an angle at 30 deg; blood pressure was maintained at 130-150 mmHg and PaCO 2 of arterial blood was maintained at 35-40 mmHg; ICP

  15. 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.

  16. Cerebral Amyloid Angiopathy

    Directory of Open Access Journals (Sweden)

    Mahmut Edip Gürol

    2009-03-01

    Full Text Available Cerebral amyloid angiopathy (CAA is characterized by the accumulation of amyloid beta-peptides (Ab in the walls of leptomeningeal arteries, arterioles, and veins. Despite the fact that these pathological changes were first described in 1909, major advancement in our understanding of the clinicoradiological manifestations, neurobiology, and course of CAA has occurred only during the last 30 years. No significant associations have been shown between CAA and other systemic/visceral amyloidoses or vascular risk factors, including hypertension. CAA is well known as the most common cause of spontaneous and anticoagulant-related lobar parenchymal ICH in the elderly. It also causes lobar cerebral microbleeds (CMBs, small dot-like dark susceptibility artifacts visible with gradient recalled echo (GRE-magnetic resonance imaging (MRI. CMBs are important markers of disease severity and predictors of CAA progression. Amyloid angiopathy is also a common cause of ischemic microvascular white matter disease (WMD and deep cerebral infarctions. Such WMD is defined as subcortical and periventricular white matter changes without obvious infarction, as well as a dark appearance on computerized tomography (CT and a bright appearance on fluid attenuated inversion recovery (FLAIR-MRI. CAA-related vascular dysfunction, with its hemorrhagic and ischemic complications, is a recognized contributor to vascular cognitive impairment in the elderly, an independent effect that is synergistically increased by Alzheimer pathologies, such as plaques and tangles. A set of clinicoradiological criteria was established for the accurate diagnosis of CAA. According to the Boston Criteria, patients aged 55 years and older with multiple hemorrhages (on CT or GRE-MRI restricted to the lobar, cortical, or corticosubcortical regions (cerebellar hemorrhage allowed are diagnosed as probable CAA when no other etiology is found; a single hemorrhage in the same region is classified as possible

  17. Comparison between fluorimetry and oximetry techniques to measure photosynthesis in the diatom Skeletonema costatum cultivated under simulated seasonal conditions.

    Science.gov (United States)

    Lefebvre, Sébastien; Mouget, Jean-Luc; Loret, Pascale; Rosa, Philippe; Tremblin, Gérard

    2007-02-01

    This study reports comparison of two techniques measuring photosynthesis in the ubiquitous diatom Skeletonema costatum, i.e., the classical oximetry and the recent modulated fluorimetry. Microalgae in semi-continuous cultures were exposed to five different environmental conditions simulating a seasonal effect with co-varying temperature, photoperiod and incident light. Photosynthesis was assessed by gross rate of oxygen evolution (P(B)) and the electron transport rate (ETR) measurements. The two techniques were linearly related within seasonal treatments along the course of the P/E curves. The light saturation intensity parameters (Ek and Ek(ETR)), and the maximum electron transport rate increased significantly with the progression of the season while the maximum light utilization efficiency for ETR (alpha(ETR)) was constant. By contrast, the maximum gross oxygen photosynthetic capacity (Pmax(B)) and the maximum light utilization efficiency for P(B) (alpha(B)) increased from December to May treatment but decreased from May to July treatment. Both techniques showed clear photoacclimation in microalgae with the progression of the season, as illustrated by changes in photosynthetic parameters. The relationship between the two techniques changed when high temperature, photoperiod and incident light were combined, possibly due to an overestimation of the PAR--averaged chlorophyll-specific absorption cross-section. Despite this change, our results illustrate the strong suitability of in vivo chlorophyll fluorimetry to estimate primary production in the field.

  18. Oximetry: a reflective tool for the detection of physiological expression of emotions in a science education classroom

    Science.gov (United States)

    Calderón, Olga

    2016-09-01

    The pulse oximeter is a device that measures the oxygen concentration (or oxygen saturation—SpO2); heart rate, and heartbeat of a person at any given time. This instrument is commonly used in medical and aerospace fields to monitor physiological outputs of a patient according to health conditions or physiological yields of a flying pilot according to changes in altitude and oxygen availability in the atmosphere. Nonetheless, the uses for pulse oximetry may expand to other fields where there is human interaction and where physiological outputs reflect fluctuations mediated by arising emotions. A classroom, for instance is filled with a plethora of emotions, but very often participants in this space are unaware of others' or their own sentiments as these arise as a result of interactions and responses to class discussions. In this paper I describe part of a larger study-taking place at Brooklyn College of the City University of New York. The focus is on the exploration of emotions and mindfulness in the science classroom. The oximeter is used in this study as a reflexive tool to detect emotions emerging among participants of a graduate History and Philosophy of Science Education course offered in the spring of 2012. Important physiological information of class participants provided by the oximeter is used to analyze the role of emotions in the classroom as sensitive and controversial topics in science education are discussed every week.

  19. Interfaces para control cerebral

    OpenAIRE

    Spinelli, Enrique Mario

    2000-01-01

    La función de una interfaz para control cerebral basada en señales de electroencefalograma (EEG), en forma general denominada BCI (Brain control Interface), es establecer un enlace directo entre el cerebro y una máquina, sin utilizar acciones motoras directas. Una BCI permite realizar operaciones simples a partir de la interpretación de las señales de EEG. Su desarrollo está principalmente orientado hacia la ayuda a personas con discapacidades motoras severas, que poseen deterioros en el sist...

  20. Techniques in cerebral protection.

    Science.gov (United States)

    Fanelli, Fabrizio; Bezzi, Mario; Boatta, Emanuele; Passariello, Roberto

    2006-10-01

    Carotid angioplasty and stenting is a valid alternative option to conventional carotid endarterectomy in the treatment of carotid artery stenosis. During the stenting process, however, distal embolization can occur with neurological consequences. To avoid this, cerebral protection devices have been introduced. Three principal types of protection system have been developed: distal balloon occlusion, distal filters and proximal protection with or without reversal of flow. As protection devices became the focus of interest by manufactures and physicians, several trials are going on worldwide to analyze the characteristics of each of them and to evaluate their efficacy to reduce the rate of distal embolization.

  1. Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Fris-Hansen, B

    1978-01-01

    In the course of our studies on cerebral blood flow in newborn infants, we have observed a striking depressing effect of sodium bicarbonate infusion on cerebral blood flow which in some cases may severely aggravate cerebral ischemia. We measured cerebral blood flow before and after the treatment...... with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior...... to the bicarbonate infusion. In one case an extreme reduction occurred: cerebral blood flow was reduced to 3 ml/100 g/min, well below the level compatible with tissue survival. The results are discussed with regard to the optimal treatment of the acidotic newborn....

  2. 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.

  3. Prognosis after cerebral ischaemia of arterial origin: clinical characteristics and genetic information

    NARCIS (Netherlands)

    Achterberg, S.

    2013-01-01

    Background. Patients who have suffered from cerebral ischemia have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that cerebral ischemia has a heritable component, addition of genetic information might

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. Cerebral Gluconeogenesis and Diseases

    Science.gov (United States)

    Yip, James; Geng, Xiaokun; Shen, Jiamei; Ding, Yuchuan

    2017-01-01

    The gluconeogenesis pathway, which has been known to normally present in the liver, kidney, intestine, or muscle, has four irreversible steps catalyzed by the enzymes: pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose 1,6-bisphosphatase, and glucose 6-phosphatase. Studies have also demonstrated evidence that gluconeogenesis exists in brain astrocytes but no convincing data have yet been found in neurons. Astrocytes exhibit significant 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 activity, a key mechanism for regulating glycolysis and gluconeogenesis. Astrocytes are unique in that they use glycolysis to produce lactate, which is then shuttled into neurons and used as gluconeogenic precursors for reduction. This gluconeogenesis pathway found in astrocytes is becoming more recognized as an important alternative glucose source for neurons, specifically in ischemic stroke and brain tumor. Further studies are needed to discover how the gluconeogenesis pathway is controlled in the brain, which may lead to the development of therapeutic targets to control energy levels and cellular survival in ischemic stroke patients, or inhibit gluconeogenesis in brain tumors to promote malignant cell death and tumor regression. While there are extensive studies on the mechanisms of cerebral glycolysis in ischemic stroke and brain tumors, studies on cerebral gluconeogenesis are limited. Here, we review studies done to date regarding gluconeogenesis to evaluate whether this metabolic pathway is beneficial or detrimental to the brain under these pathological conditions. PMID:28101056

  9. Cerebral Gluconeogenesis and Diseases.

    Science.gov (United States)

    Yip, James; Geng, Xiaokun; Shen, Jiamei; Ding, Yuchuan

    2016-01-01

    The gluconeogenesis pathway, which has been known to normally present in the liver, kidney, intestine, or muscle, has four irreversible steps catalyzed by the enzymes: pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose 1,6-bisphosphatase, and glucose 6-phosphatase. Studies have also demonstrated evidence that gluconeogenesis exists in brain astrocytes but no convincing data have yet been found in neurons. Astrocytes exhibit significant 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 activity, a key mechanism for regulating glycolysis and gluconeogenesis. Astrocytes are unique in that they use glycolysis to produce lactate, which is then shuttled into neurons and used as gluconeogenic precursors for reduction. This gluconeogenesis pathway found in astrocytes is becoming more recognized as an important alternative glucose source for neurons, specifically in ischemic stroke and brain tumor. Further studies are needed to discover how the gluconeogenesis pathway is controlled in the brain, which may lead to the development of therapeutic targets to control energy levels and cellular survival in ischemic stroke patients, or inhibit gluconeogenesis in brain tumors to promote malignant cell death and tumor regression. While there are extensive studies on the mechanisms of cerebral glycolysis in ischemic stroke and brain tumors, studies on cerebral gluconeogenesis are limited. Here, we review studies done to date regarding gluconeogenesis to evaluate whether this metabolic pathway is beneficial or detrimental to the brain under these pathological conditions.

  10. Significance of non-specific complaints in asymptomatic cerebral infarction. Approach based on the cerebral circulation

    Energy Technology Data Exchange (ETDEWEB)

    Sakayori, Osamu; Kitamura, Shin; Nagazumi, Atsushi; Terashi, Akirou [Nippon Medical School, Tokyo (Japan)

    1997-10-01

    Seventy-three cases with asymptomatic cerebral infarction detected by MR scanning and 80 cases of past stroke patients were evaluated. The regional cerebral blood flow (CBF) using the SPECT, idoine-123-IMP autoradiography (ARG) method was measured. Twenty-two patients with non-specific complaints (dizziness, numbness of the extremities, headache, etc.) without cerebrovascular risk factors were also examined as controls. Fifty-two percent of the asymptomatic infarction cases had non-specific complaints. The regional CBF in all cerebral non-specific complaints showed significantly lower values as compared to the controls. There was no difference in CBF values between the asymptomatic infarction cases with non-specific complaints and the past stroke patients. Among the asymptomatic infarction patients, cases with both non-specific complaints and hypertension displayed significantly lower CBF values, especially in the frontal and temporal cortical regions, than did cases without non-specific complaints or hypertension. These findings suggest that the patient`s complaints should be taken into consideration when determining the clinical treatment of asymptomatic infarction. (author)

  11. T2 Relaxometry MRI Predicts Cerebral Palsy in Preterm Infants.

    Science.gov (United States)

    Chen, L-W; Wang, S-T; Huang, C-C; Tu, Y-F; Tsai, Y-S

    2018-01-18

    T2-relaxometry brain MR imaging enables objective measurement of brain maturation based on the water-macromolecule ratio in white matter, but the outcome correlation is not established in preterm infants. Our study aimed to predict neurodevelopment with T2-relaxation values of brain MR imaging among preterm infants. From January 1, 2012, to May 31, 2015, preterm infants who underwent both T2-relaxometry brain MR imaging and neurodevelopmental follow-up were retrospectively reviewed. T2-relaxation values were measured over the periventricular white matter, including sections through the frontal horns, midbody of the lateral ventricles, and centrum semiovale. Periventricular T2 relaxometry in relation to corrected age was analyzed with restricted cubic spline regression. Prediction of cerebral palsy was examined with the receiver operating characteristic curve. Thirty-eight preterm infants were enrolled for analysis. Twenty patients (52.6%) had neurodevelopmental abnormalities, including 8 (21%) with developmental delay without cerebral palsy and 12 (31.6%) with cerebral palsy. The periventricular T2-relaxation values in relation to age were curvilinear in preterm infants with normal development, linear in those with developmental delay without cerebral palsy, and flat in those with cerebral palsy. When MR imaging was performed at >1 month corrected age, cerebral palsy could be predicted with T2 relaxometry of the periventricular white matter on sections through the midbody of the lateral ventricles (area under the receiver operating characteristic curve = 0.738; cutoff value of >217.4 with 63.6% sensitivity and 100.0% specificity). T2-relaxometry brain MR imaging could provide prognostic prediction of neurodevelopmental outcomes in premature infants. Age-dependent and area-selective interpretation in preterm brains should be emphasized. © 2018 by American Journal of Neuroradiology.

  12. Cerebral Fat Embolism: Diffusion-weighted Magnetic Resonance Imaging Findings

    International Nuclear Information System (INIS)

    Ryu, C.W.

    2005-01-01

    PURPOSE: To demonstrate the diffusion-weighted (DWI) magnetic resonance imaging (MRI) findings, and the follow-up MRI findings, of cerebral fat embolism in the acute stage. MATERIAL AND METHODS: The initial DWI and clinical findings of six patients with cerebral fat embolism were retrospectively evaluated. The finding of DWI with a b-value of 1000 s/mm 2 (b=1000) was compared with that of DWI with a b-value of 0 s/mm 2 (b=0). In three patients who underwent follow-up MRI, the interval change of the lesion on T2-weighted images was investigated. RESULTS: The characteristic DWI finding of cerebral fat embolism in the acute stage was multiple, hyperintense, dot-like lesions disseminated in the brain. These lesions were distributed dominantly in the bilateral border-zone areas. Some lesions had an ancillary location including the cortex, deep white matter, basal ganglia, and cerebellum. The lesions were more intense and numerous in DWI (b=1000) than in DWI (b=0). The findings on the follow-up T2-weighted images were multiple confluent hyperintense lesions in the white matter with progression since the initial MRI. CONCLUSION: DWI could be a sensitive tool for detecting cerebral fat embolism in the acute phase. It is recommended that DWI be included in the initial evaluation of cerebral fat embolism with MRI

  13. 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

  14. Multiple cerebral hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Banzo, J.; Pina, J.I.; Abos, M.D.; Rios, G.; Garcia, D.; Marin, F.; Diaz, F.J.

    1984-12-01

    A 39-year-old woman was admitted to hospital with headaches, vomiting, psychic impairment and diplopia. Three hydatid cysts of the lung had been previously removed. An avascular mass in the left hemisphere with left-to-right displacement of the anterior cerebral arteries was noted during a brain angioscintigraphy. A cerebralthrombosis (CT) brain scan showed two cystic lesions situated in the left-frontal and occipital regions. A CT abdominal scan showed multiple cysts in the liver, spleen and both kidneys. At operation, two brain cysts were totally extirpated without rupture. The definite pathological diagnosis was secondry hydatid cysts. The headaches, vomiting and diplopia were persistent in the post-operative period. Seven days after the operation, a CT brain scan showed an infratenrorial cyst. The patient rejected any surgical intervention.

  15. Dynamic changes in oxygenation of intracranial tumor and contralateral brain during tumor growth and carbogen breathing: A multisite EPR oximetry with implantable resonators

    Science.gov (United States)

    Hou, Huagang; Dong, Ruhong; Li, Hongbin; Williams, Benjamin; Lariviere, Jean P.; Hekmatyar, S.K.; Kauppinen, Risto A.; Khan, Nadeem; Swartz, Harold

    2013-01-01

    Introduction Several techniques currently exist for measuring tissue oxygen; however technical difficulties have limited their usefulness and general application. We report a recently developed electron paramagnetic resonance (EPR) oximetry approach with multiple probe implantable resonators (IRs) that allow repeated measurements of oxygen in tissue at depths of greater than 10 mm. Methods The EPR signal to noise (S/N) ratio of two probe IRs was compared with that of LiPc deposits. The feasibility of intracranial tissue pO2 measurements by EPR oximetry using IRs was tested in normal rats and rats bearing intracerebral F98 tumors. The dynamic changes in the tissue pO2 were assessed during repeated hyperoxia with carbogen breathing. Results A 6–10 times increase in the S/N ratio was observed with IRs as compared to LiPc deposits. The mean brain pO2 of normal rats was stable and increased significantly during carbogen inhalation in experiments repeated for 3 months. The pO2 of F98 glioma declined gradually, while the pO2 of contralateral brain essentially remained the same. Although a significant increase in the glioma pO2 was observed during carbogen inhalation, this effect declined in experiments repeated over days. Conclusion EPR oximetry with IRs provides a significant increase in S/N ratio. The ability to repeatedly assess orthotopic glioma pO2 is likely to play a vital role in understanding the dynamics of tissue pO2 during tumor growth and therapies designed to modulate tumor hypoxia. This information could then be used to optimize chemoradiation by scheduling treatments at times of increased glioma oxygenation. PMID:22033225

  16. Evaluating cost and resource use associated with pulse oximetry screening for critical congenital heart disease: Empiric estimates and sources of variation.

    Science.gov (United States)

    Reeder, Matthew R; Kim, Jaewhan; Nance, Amy; Krikov, Sergey; Feldkamp, Marcia L; Randall, Harper; Botto, Lorenzo D

    2015-11-01

    Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is being implemented in the United States and internationally; however, few data are available on the associated in-hospital costs and use of resources. Time and motion study in well-baby nurseries at two large urban hospitals in Utah using different approaches to pulse oximetry screening. Two observers recorded the time for each screening step together with provider and equipment characteristics. Structured questionnaire provided additional information on labor and equipment costs. Fifty-three CCHD screens were observed. At site A (n = 22), screening was mostly done by medical assistants (95%) using disposable probes (100%); at site B (n = 31), screening was mostly performed by certified nursing assistants (90%) using reusable probes (90%). Considering only first screens (n = 53), the median screen time was 8.6 min (range: 3.2-23.2), with no significant difference between sites. The overall cost ($ in 2014) of screening per baby was $24.52 at site A and $2.60 at site B. Nearly all the variation in cost (90%) was due to the cost of disposable probes; labor costs were similar between sites. CCHD screening by means of pulse oximetry is reasonably fast for most babies, leading to relative small labor costs with little variation by provider type. The main driver of costs is equipment: in a high throughput setting, reusable probes are currently associated with considerable cost saving compared with disposable probes. As programs expand to universal screening, improved and cheaper technologies could lead to considerable economies of scale. © 2015 Wiley Periodicals, Inc.

  17. Pulse oximetry recorded from the Phone Oximeter for detection of obstructive sleep apnea events with and without oxygen desaturation in children.

    Science.gov (United States)

    Garde, Ainara; Dehkordi, Parastoo; Wensley, David; Ansermino, J Mark; Dumont, Guy A

    2015-01-01

    Obstructive sleep apnea (OSA) disrupts normal ventilation during sleep and can lead to serious health problems in children if left untreated. Polysomnography, the gold standard for OSA diagnosis, is resource intensive and requires a specialized laboratory. Thus, we proposed to use the Phone Oximeter™, a portable device integrating pulse oximetry with a smartphone, to detect OSA events. As a proportion of OSA events occur without oxygen desaturation (defined as SpO2 decreases ≥ 3%), we suggest combining SpO2 and pulse rate variability (PRV) analysis to identify all OSA events and provide a more detailed sleep analysis. We recruited 160 children and recorded pulse oximetry consisting of SpO2 and plethysmography (PPG) using the Phone Oximeter™, alongside standard polysomnography. A sleep technician visually scored all OSA events with and without oxygen desaturation from polysomnography. We divided pulse oximetry signals into 1-min signal segments and extracted several features from SpO2 and PPG analysis in the time and frequency domain. Segments with OSA, especially the ones with oxygen desaturation, presented greater SpO2 variability and modulation reflected in the spectral domain than segments without OSA. Segments with OSA also showed higher heart rate and sympathetic activity through the PRV analysis relative to segments without OSA. PRV analysis was more sensitive than SpO2 analysis for identification of OSA events without oxygen desaturation. Combining SpO2 and PRV analysis enhanced OSA event detection through a multiple logistic regression model. The area under the ROC curve increased from 81% to 87%. Thus, the Phone Oximeter™ might be useful to monitor sleep and identify OSA events with and without oxygen desaturation at home.

  18. 3-lead electrocardiogram is more reliable than pulse oximetry to detect bradycardia during stabilisation at birth of very preterm infants.

    Science.gov (United States)

    Iglesias, Beatriz; Rodrí Guez, Marí A José; Aleo, Esther; Criado, Enrique; Martí Nez-Orgado, Jose; Arruza, Luis

    2018-05-01

    Current neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR <100 beats per minute (bpm)) during preterm stabilisation in the DR. Video recordings of resuscitations of infants <32 weeks of gestation were reviewed. HR readings in a situation of bradycardia (<100 bpm) at any moment during stabilisation were registered with both devices every 5 s from birth. A total of 29 episodes of bradycardia registered by the ECG in 39 video recordings were included in the analysis (n=29). PO did not detect the start of these events in 20 cases (69%). PO detected the start and the end of bradycardia later than the ECG (median (IQR): 5 s (0-10) and 5 s (0-7.5), respectively). A decline in PO accuracy was observed as bradycardia progressed so that by the end of the episode PO offered significantly lower HR readings than ECG. PO detects the start and recovery of bradycardia events slower and less accurately than ECG during stabilisation at birth of very preterm infants. ECG use in this scenario may contribute to an earlier initiation of resuscitation manoeuvres and to avoid unnecessary prolongation of resuscitation efforts after recovery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Cerebrospinal fluid ionic regulation, cerebral blood flow, and glucose use during chronic metabolic alkalosis

    International Nuclear Information System (INIS)

    Schroeck, H.K.; Kuschinsky, W.

    1989-01-01

    Chronic metabolic alkalosis was induced in rats by combining a low K+ diet with a 0.2 M NaHCO3 solution as drinking fluid for either 15 or 27 days. Local cerebral blood flow and local cerebral glucose utilization were measured in 31 different structures of the brain in conscious animals by means of the iodo-[14C]antipyrine and 2-[14C]deoxy-D-glucose method. The treatment induced moderate [15 days, base excess (BE) 16 mM] to severe (27 days, BE 25 mM) hypochloremic metabolic alkalosis and K+ depletion. During moderate metabolic alkalosis no change in cerebral glucose utilization and blood flow was detectable in most brain structures when compared with controls. Cerebrospinal fluid (CSF) K+ and H+ concentrations were significantly decreased. During severe hypochloremic alkalosis, cerebral blood flow was decreased by 19% and cerebral glucose utilization by 24% when compared with the control values. The decrease in cerebral blood flow during severe metabolic alkalosis is attributed mainly to the decreased cerebral metabolism and to a lesser extent to a further decrease of the CSF H+ concentration. CSF K+ concentration was not further decreased. The results show an unaltered cerebral blood flow and glucose utilization together with a decrease in CSF H+ and K+ concentrations at moderate metabolic alkalosis and a decrease in cerebral blood flow and glucose utilization together with a further decreased CSF H+ concentration at severe metabolic alkalosis

  20. Limitations of middle cerebral artery peak systolic velocity in the ...

    African Journals Online (AJOL)

    We present a case of a mother with severe pre-eclampsia at 32 weeks' gestation and non-immune fetal hydrops without obvious cause. Since the. MCA peak systolic velocity (PSV) was ... Limitations of middle cerebral artery peak systolic velocity .... [7] found MCA PSV of value in 9 women with chronic abruption, but in 5.

  1. surgery of the hand in infants with cerebral palsy* 655

    African Journals Online (AJOL)

    1971-06-19

    Jun 19, 1971 ... cerebral palsy is by re-education-physical, occupational, speech and drug therapy."· Orthopaedic surgery is usually considered as an adjunct to therapy'" and is indicated only for its value ... than long-continued postural training and stretching.",13 ... In each child in this series, the hand on the affected side.

  2. Radiotracer transit measurements as an index of regional cerebral blood flow. Pt. 1. Methodological and clinical results in chronic alcoholics cortical blood flow

    International Nuclear Information System (INIS)

    Dobrzanski, T.

    1975-01-01

    The numerical mean values of the cerebral radiorheographic index in healthy control subjects and in patients with cerebrovascular disease were not significantly different from the values of regional cerebral blood flow reported, respectively, by other authors using a modification of the Xe-133 method. In the group of chronic alcoholics there was a significant correlation between the duration of alcoholism and certain numerical values of the cerebral radiorheographic index. (author)

  3. Cerebral Laterality and Verbal Processes

    Science.gov (United States)

    Sherman, Jay L.; And Others

    1976-01-01

    Research suggests that we process information by way of two distinct and functionally separate coding systems. Their location, somewhat dependent on cerebral laterality, varies in right- and left-handed persons. Tests this dual coding model. (Editor/RK)

  4. 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

  5. Cerebral infarcts resulting from trauma

    International Nuclear Information System (INIS)

    Busch, G.

    1985-01-01

    Vascular occlusions due to cerebral trauma have always been regarded as great rarities. However, we have found hypo-dense foci of vascular distribution in 3.5% of 3500 CT examinations for trauma during the late phase. Lesions in the vascular territory of the posterior cerebral artery are usually the result of supratentorial pressure rise from epidural and subdural haematomas, leading to compression of the vessels against the edge of the tentorium. Typical infacts in the territory of the medial and anterior cerebral arteries were found only rarely by CT after cerebral trauma. Infarcts at the watersheds between the three vascular territories were found with surprising frequency and small infarcts were found in the basal ganglia. It is assumed that these were due to ischaemic or hypoxic events due to cardiac or pulmonary complications during the initial phase. (orig.) [de

  6. 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 ...

  7. MRI of cerebral alveolar echinococcosis

    International Nuclear Information System (INIS)

    Tunaci, M.; Tunaci, A.; Engin, G.; Oezkorkmaz, B.; Ahishali, B.; Rozanes, I.

    1999-01-01

    Cerebral alveolar echinococcosis is rare. We report a case with multiple intracranial masses which show cauliflower-like contrast enhancement pattern on MRI. The lesions originated from hepatic involvement with invasion of the inferior vena cava. (orig.)

  8. 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.

  9. False positive rate of carbon monoxide saturation by pulse oximetry of emergency department patients.

    Science.gov (United States)

    Weaver, Lindell K; Churchill, Susan K; Deru, Kayla; Cooney, Darryl

    2013-02-01

    Symptoms of carbon monoxide (CO) poisoning are non-specific. Diagnosis requires suspicion of exposure, confirmed by measuring ambient CO levels or carboxyhemoglobin (COHb). An FDA-approved pulse oximeter (Rad-57) can measure CO saturation (S(pCO)). The device accuracy has implications for clinical decision-making. From April 1 to August 15, 2008, study personnel measured S(pCO) and documented demographic factors at time of clinical blood draw, in a convenience sample of 1,363 subjects presenting to the emergency department at Intermountain Medical Center, Murray, Utah. The technician then assayed COHb. COHb and S(pCO) values were compared by subject; false positive or negative values were defined as S(pCO) at least 3 percentage points greater or less than COHb level, reported by the manufacturer to be ± 1 SD in performance. In 1,363 subjects, 613 (45%) were male, 1,141 (84%) were light-skinned, 14 in shock, 4 with CO poisoning, and 122 (9%) met the criteria for a false positive value (range 3-19 percentage points), while 247 (18%) met the criteria for a false negative value (-13 to -3 percentage points). Risks for a false positive S(pCO) reading included being female and having a lower perfusion index. Methemoglobin, body temperature, and blood pressure also appear to influence the S(pCO) accuracy. There was variability among monitors, possibly related to technician technique, as rotation of monitors among technicians was not enforced. While the Rad-57 pulse oximeter functioned within the manufacturer's specifications, clinicians using the Rad-57 should expect some S(pCO) readings to be significantly higher or lower than COHb measurements, and should not use S(pCO) to direct triage or patient management. An elevated S(pCO) could broaden the diagnosis of CO poisoning in patients with non-specific symptoms. However, a negative S(pCO) level in patients suspected of having CO poisoning should never rule out CO poisoning, and should always be confirmed by COHb. © 2013

  10. Long-term follow-up of cerebral blood flow in patients with ruptured cerebral aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Yamakami, Iwao; Tanno, Hirokazu; Isobe, Katsumi [Kimitsu Central Hospital, Kisarazu, Chiba (Japan); Yamaura, Akira

    1992-03-01

    The xenon-133 inhalation technique was used to make three measurements of regional cerebral blood flow (CBF) in 34 patients with ruptured cerebral aneurysm: in the acute period (<14 days) after subarachnoid hemorrhage, in the subacute period (15-30 days), and in the chronic period (12-24 months). The hemispheric mean value of initial slope index was used as the mean CBF. The clinical outcomes were classified into good recovery (GR)(24 cases), moderate disability (MD)(5), and severe disability (SD)(5) on the Glasgow Outcome Scale. In all periods, the mean CBF significantly correlated with the outcome. GR patients had the highest mean CBF, MD patients the intermediate mean CBF, and SD patients the lower mean CBF. GR patients had a near-normal mean CBF by the chronic period, while SD patients showed no significant CBF recovery throughout the course. (author).

  11. Parálisis cerebral :

    OpenAIRE

    Cabrero Izquierdo, María del Carmen

    2012-01-01

    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).

  12. 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.)

  13. 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.).

  14. Critical Congenital Heart Disease Screening by Pulse Oximetry in a Neonatal Intensive Care Unit

    Science.gov (United States)

    Manja, Veena; Mathew, Bobby; Carrion, Vivien; Lakshminrusimha, Satyan

    2014-01-01

    Critical congenital heart disease (CCHD) screening is effective in asymptomatic late preterm and term newborn infants with a low false positive rate (0.035%). Objective (1) To compare 2817 NICU discharges before and after implementation of CCHD screening; and (2) to evaluate CCHD screening at < 35 weeks gestation. Methods collection of results of CCHD screening including preductal and postductal SpO2 values. Results During the pre-CCHD screen period, 1247 infants were discharged from the NICU and one case of CCHD was missed. After 3/1/12, 1508 CCHD screens were performed among 1570 discharges and no CCHDs were missed. The preductal and postductal SpO2 values were 98.8±1.4% and 99±1.3% respectively in preterm and 98.9±1.3% and 98.9±1.4% in term infants. Ten infants had false positive screens (10/1508=0.66%). Conclusions Performing universal screening in the NICU is feasible but is associated with a higher false positive rate compared to asymptomatic newborn infants. PMID:25058746

  15. Valuing Essays: Essaying Values

    Science.gov (United States)

    Badley, Graham

    2010-01-01

    The essay regularly comes under attack. It is criticised for being rigidly linear rather than flexible and reflective. I first challenge this view by examining reasons why the essay should be valued as an important genre. Secondly, I propose that in using the essay form students and academics necessarily exemplify their own critical values. Essays…

  16. Comparison of the psychometric properties of two balance scales in children with cerebral palsy

    OpenAIRE

    Jeon, Yong-Jin; Kim, Gyoung-Mo

    2016-01-01

    [Purpose] The purpose of this study was to compare the item difficulty degree between the Pediatric Balance Scale and Fullerton Advanced Balance scale for children with cerebral palsy. [Subjects and Methods] Forty children with cerebral palsy (male=17, female=23) voluntarily participated in the study. Item difficulty was expressed in the Rasch analysis using a logit value, with a higher value indicative of increasing item difficulty. [Results] Among the 24 items of the combined Pediatric Bala...

  17. Significance of preoperative cerebral blood flow measurements in endovascular occlusion of the internal carotid and middle cerebral arteries

    International Nuclear Information System (INIS)

    Laurent, A.; Weitzner, I.; Luft, A.; Merland, J.J.

    1988-01-01

    Cerebral blood flow (CBF) measurements during 12 endovascular balloon occlusions (ten internal carotid and two middle cerebral arteries) with good clinical and angiographic tolerance were done with repeated boluses of Xe-133 injected directly into the ipsi- and contralateral carotid systems, during the occlusion and repeated measurements with detectors on both sides (before occlusion and 5-30 minutes after occlusion). In two cases of unchanged and four of increased CBF, one reversible deficit was probably due to an embolus. In six cases of decreased CBF, two deficits occurred, characterized by a greater than 25% decrease. It seems to represent a good predictive value for intolerance to occlusion

  18. Utility of cerebral circulation evaluation in acute traumatic brain injuries

    International Nuclear Information System (INIS)

    Honda, Mitsuru; Sakata, Yoshihito; Haga, Daisuke; Nomoto, Jun; Noguchi, Yoshitaka; Seiki, Yoshikatsu; Machida, Keiichi; Sase, Shigeru

    2007-01-01

    Severe traumatic brain injury (TBI) is well-known to cause dynamic changes in cerebral blood flow (CBF). Specifically, TBI has been reported to cause decreases in cerebral blood flow (CBF). In this study, we measured CBF, mean transit time (MTT) and cerebral blood volume (CBV) after TBI. Our purpose was investigate the possibility of assessing TBI outcome and severity with these physiological parameters, and the clinical utility of cerebral circulation evaluation for brain-oriented intensive care. In 37 patients with TBI, xenon-enhanced CT (Xe-CT) and perfusion CT were performed on days 1-3 post-event (phase II). We measured CBF using Xe-CT and MTT by Perfusion CT and calculated CBV using an AZ-7000W98 computer system. Relative intra cranicol pressure (ICP) and CBF showed significant negative correlations. Relative ICP and MTT showed significant positive correlations. Outcomes, correlated with valuse of CBF and MIT. Significant differences in CBF and MTT were found between favorable outcome group (good recovery (GR) and moderate disability (MD)) and poor outcome group (severe disability (SD), vegetative state (VS), and dead (D)). We could estimate the outcome of patients after TBI by analyzing values of CBF and MTT with a probability of 74%. We evaluated cerebral circulation status in patients with TBI by CBF and MTT. These tests can help to optimize management and improve outcome in patients with severe TBI. (author)

  19. Accuracy of carboxyhemoglobin detection by pulse CO-oximetry during hypoxemia.

    Science.gov (United States)

    Feiner, John R; Rollins, Mark D; Sall, Jeffrey W; Eilers, Helge; Au, Paul; Bickler, Philip E

    2013-10-01

    Carbon monoxide poisoning is a significant problem in most countries, and a reliable method of quick diagnosis would greatly improve patient care. Until the recent introduction of a multiwavelength "pulse CO-oximeter" (Masimo Rainbow SET(®) Radical-7), obtaining carboxyhemoglobin (COHb) levels in blood required blood sampling and laboratory analysis. In this study, we sought to determine whether hypoxemia, which can accompany carbon monoxide poisoning, interferes with the accurate detection of COHb. Twelve healthy, nonsmoking, adult volunteers were fitted with 2 standard pulse-oximeter finger probes and 2 Rainbow probes for COHb detection. A radial arterial catheter was placed for blood sampling during 3 interventions: (1) increasing hypoxemia in incremental steps with arterial oxygen saturations (SaO2) of 100% to 80%; (2) normoxia with incremental increases in %COHb to 12%; and (3) elevated COHb combined with hypoxemia with SaO2 of 100% to 80%. Pulse-oximeter (SpCO) readings were compared with simultaneous arterial blood values at the various increments of hypoxemia and carboxyhemoglobinemia (≈25 samples per subject). Pulse CO-oximeter performance was analyzed by calculating the mean bias (SpCO - %COHb), standard deviation of the bias (precision), and the root-mean-square error (A(rms)). The Radical-7 accurately detected hypoxemia with both normal and elevated levels of COHb (bias mean ± SD: 0.44% ± 1.69% at %COHb <4%, and -0.29% ± 1.64% at %COHb ≥4%, P < 0.0001, and A(rms) 1.74% vs 1.67%). COHb was accurately detected during normoxia and moderate hypoxia (bias mean ± SD: -0.98 ± 2.6 at SaO2 ≥95%, and -0.7 ± 4.0 at SaO2 <95%, P = 0.60, and A(rms) 2.8% vs 4.0%), but when SaO2 decreased below approximately 85%, the pulse CO-oximeter always gave low signal quality errors and did not report SpCO values. In healthy volunteers, the Radical-7 pulse CO-oximeter accurately detects hypoxemia with both low and elevated COHb levels, and accurately detects COHb

  20. 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.

  1. Pseudotumoral delayed cerebral radionecrosis

    International Nuclear Information System (INIS)

    Ciaudo-Lacroix, C.; Lapresle, J.

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. γEG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed [fr

  2. Pseudotumoral delayed cerebral radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Ciaudo-Lacroix, C; Lapresle, J [Centre Hospitalier de Bicetre, 94 - Le Kremlin-Bicetre (France)

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. ..gamma..EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

  3. Continuous pulse oximetry in the general surgical ward: Nellcor N-200 versus Nellcor N-3000

    DEFF Research Database (Denmark)

    Christensen, M; Lie, C; Rosenberg, J

    1999-01-01

    of drop-outs (loss of signal) was 13 (range 1-46) with the N-200 compared with nine (2-41) with the N-3000 (p = 0.06). The N-200 registered saturation values of 85% or below for 23% of the observation time compared with 6% of the observation time with the N-3000 pulse oximeter (p ... Symphony N-3000 with the Nellcor N-200 pulse oximeter, when monitoring patients in the general surgical ward. Twenty-two patients were monitored during unrestricted ward activities for a total of 275 h with a N-3000 and a N-200 pulse oximeter simultaneously. Data were analysed for lack of concordance...... between the two pulse oximeters with respect to frequency of registered hypoxaemic episodes and thus the amount of time spent in the alarm state. The median number of desaturation episodes with the N-200 was 18 (range 0-511) compared with four (range 0-476) with the N-3000 (p

  4. New screening system for unruptured cerebral aneurysms

    International Nuclear Information System (INIS)

    Samejima, Hirotsugu; Ushikubo, Yukio; Mizokami, Toru

    1990-01-01

    We have designed a screening system to diagnose unruptured aneurysms, including the use of digital subtraction angiography (DSA). We surveyed 115 patients who had undergone clipping procedures after subarachnoid hemorrhage (SAH) and questioned them with regard to the subjective symptoms. Sixty-eight of 92 patients who returned the questionnaire reported, prior to rupture, headache,eye pain, and neck pain most frequently, and also impairment of extraocular movements, ptosis, visual field defects, and motor and sensory disturbances. Nineteen (47.5%) of 40 patients who had complete pain relief after surgery complained of headache from 1 week to 1 month before SAH. In addition, nine patients (22.5%) complained of headache for several years, and were also pain-free after surgery. For the indication of DSA, we employed an expert system based on fuzzy set theory. Seven groups of parameters are: Group 1, a basic questionnaire concerning age, sex, and past and family histories; Group 2, 15 warning signs selected on the basis of retrospective study; and Groups 3-7, detailed questions concerning each sign. Scoring weights assigned to each condition based on the results of the retrospective study, and threshold values were determined by several neurosurgeons. The certainty factors for intermediate hypotheses were calculated from these weights and threshold values and summed up, from which the conclusion was obtained. Twelve new cases of unruptured cerebral aneurysm were diagnosed using this screening system. This system may improve the ability to diagnose cerebral aneurysms before rupture. (author)

  5. Dragon's blood dropping pills have protective effects on focal cerebral ischemia rats model.

    Science.gov (United States)

    Xin, Nian; Yang, Fang-Ju; Li, Yan; Li, Yu-Juan; Dai, Rong-Ji; Meng, Wei-Wei; Chen, Yan; Deng, Yu-Lin

    2013-12-15

    Dragon's blood is a bright red resin obtained from Dracaena cochinchinensis (Lour.) S.C.Chen (Yunnan, China). As a traditional Chinese medicinal herb, it has great traditional medicinal value and is used for wound healing and to stop bleeding. Its main biological activity comes from phenolic compounds. In this study, phenolic compounds were made into dropping pills and their protective effects were examined by establishing focal cerebral ischemia rats model used method of Middle Cerebral Artery Occlusion (MCAO), and by investigating indexes of neurological scores, infarct volume, cerebral index, cerebral water content and oxidation stress. Compared to model group, high, middle and low groups of Dragon's blood dropping pills could improve the neurological function significantly (ppills had protective effects on focal cerebral ischemia rats. Copyright © 2013 Elsevier GmbH. All rights reserved.

  6. Contribution of positron emission tomography to physiopathological study of cerebral ischemia in man

    Energy Technology Data Exchange (ETDEWEB)

    Baron, J C; Bousser, M G; Comar, D; Rougemont, D; Lebrun-Grandie, P [Commissariat a l' Energie Atomique, Centre Hospitalier Frederic Joliot, 91 - Orsay (France); Castaigne, P [Hopital de la Salpetriere, 75 - Paris (France)

    1983-12-29

    The development of positron emission tomography now allows the local study of cerebral blood flow, oxygen consumption and glucose utilization in ischemic stroke patients. In recent cerebral infarction, a disruption of the normal couple between flow and metabolism is almost constantly observed: in the first few days cerebral blood flow is either inadequate (persistant ischemia) or over-abundant (''luxury perfusion''), whereas a late ''luxury perfusion'' is almost constant within the necrotic area between the 10th and the 40th day. Threshold values for cerebral blood flow and oxygen consumption that are ultimately associated with necrosis or tissue integrity have been determined. A metabolic depression without C.T. Scan counterpart has been observed in various brain structures remote from the infarcted area per se. Lastly, the hemodynamic and metabolic effects of superficial-temporal-middle-cerebral-artery anastomosis have been studied.

  7. Inter-eye comparison of retinal oximetry and vessel caliber between eyes with asymmetrical glaucoma severity in different glaucoma subtypes

    Directory of Open Access Journals (Sweden)

    Cheng CS

    2016-07-01

    differences in oximetric parameters or vessel calibers between the worse and the better eyes in POAG and NTG groups. Conclusion: Eyes with PACG showed increased arteriolar oxygen saturation and increased AV difference. This was not observed in POAG and NTG eyes. Arteriolar diameter in PACG and venular diameter in all three glaucoma groups were reduced. The difference observed in PACG eyes may be due to an increased metabolic demand in the disease process compared to open-angle glaucoma. Keywords: glaucoma, oximetry, retinal vessels, imaging

  8. Teeth grinding, oral motor performance and maximal bite force in cerebral palsy children.

    Science.gov (United States)

    Botti Rodrigues Santos, Maria Teresa; Duarte Ferreira, Maria Cristina; de Oliveira Guaré, Renata; Guimarães, Antonio Sergio; Lira Ortega, Adriana

    2015-01-01

    Identify whether the degree of oral motor performance is related to the presence of teeth grinding and maximal bite force values in children with spastic cerebral palsy. Ninety-five spastic cerebral palsy children with and without teeth grinding, according to caregivers' reports, were submitted to a comprehensive oral motor performance evaluation during the feeding process using the Oral Motor Assessment Scale. Maximal bite force was measured using an electronic gnathodynamometer. The teeth grinding group (n = 42) was younger, used anticonvulsant drugs, and was more frequently classified within the subfunctional oral motor performance category. Teeth grinding subfunctional spastic cerebral palsy children presented lower values of maximal bite force. The functional groups showing the presence or absence of teeth grinding presented higher values of maximal bite force compared with the subfunctional groups. In spastic cerebral palsy children, teeth grinding is associated with the worse oral motor performance. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  9. Capnography is superior to pulse oximetry for the detection of respiratory depression during colonoscopy La capnografía es superior a la pulsioximetría en la detección de depresión respiratoria durante las colonoscopias

    Directory of Open Access Journals (Sweden)

    G. Cacho

    2010-02-01

    Full Text Available Background: pulse oximetry is a widely accepted procedure for ventilatory monitoring during gastrointestinal endoscopy, but this method provides an indirect measurement of the respiratory function. In addition, detection of abnormal ventilatory activity can be delayed, especially if supplemental oxygen is provided. Capnography offers continuous real-time measurement of expiratory carbon dioxide. Objective: we aimed at prospectively examining the advantages of capnography over the standard pulse oximetry monitoring during sedated colonoscopies. Patients and methods:fifty patients undergoing colonoscopy were simultaneously monitored with pulse oximetry and capnography by using two different devices in each patient. Several sedation regimens were administered. Episodes of apnea or hypoventilation detected by capnography were compared with the occurrence of hypoxemia. Results: twenty-nine episodes of disordered respiration occurred in 16 patients (mean duration 54.4 seconds. Only 38% of apnea or hypoventilation episodes were detected by pulse oximetry. A mean delay of 38.6 seconds was observed in the events detected by pulse oximetry (two episodes of disturbed ventilation were simultaneously detected by capnography and pulse oximetry. Conclusions: apnea or hypoventilation commonly occurs during colonoscopy with sedation. Capnography is more reliable than pulse oximetry in early detection of respiratory depression in this setting.

  10. Performance of Aspergillus PCR in cerebrospinal fluid for the diagnosis of cerebral aspergillosis.

    Science.gov (United States)

    Imbert, S; Brossas, J-Y; Palous, M; Joly, I; Meyer, I; Fekkar, A

    2017-11-01

    Cerebral aspergillosis is a rare but often fatal form of invasive aspergillosis that remains difficult to diagnose. The literature has shown the value of Aspergillus PCR in blood-derived samples for the diagnosis of invasive aspergillosis but provides far less information for cerebrospinal fluid (CSF) in cerebral aspergillosis. Here, we evaluated the usefulness of an Aspergillus PCR assay performed on CSF for the diagnosis of cerebral aspergillosis. This retrospective study involved 72 patients with suspected cerebral aspergillosis for a total of 88 CSF samples in whom CSF Aspergillus PCR was performed. Seventeen patients had proven/probable invasive aspergillosis according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria, including 12 cases of proven/probable cerebral aspergillosis. Aspergillus PCR in CSF was positive in nine of the twelve patients with cerebral aspergillosis, i.e. 75% sensitivity. In contrast, CSF culture was positive for Aspergillus in only two patients. In the non-cerebral aspergillosis group (60 patients), PCR was positive in one patient, i.e. 98.3% specificity. In this particular population of high-risk patients with suspicion of cerebral aspergillosis, the disease incidence was 16.7%. Therefore, the positive and negative predictive values of PCR were 90% and 95.2%, respectively. The results of this study indicate that Aspergillus PCR in CSF is an interesting tool that may eliminate the need for cerebral biopsy in patients with suspected cerebral aspergillosis. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  11. Hydrostatic determinants of cerebral perfusion

    International Nuclear Information System (INIS)

    Wagner, E.M.; Traystman, R.J.

    1986-01-01

    We examined the cerebral blood flow response to alterations in perfusion pressure mediated through decreases in mean arterial pressure, increases in cerebrospinal fluid (CSF) pressure, and increases in jugular venous (JV) pressure in 42 pentobarbital anesthetized dogs. Each of these three pressures was independently controlled. Cerebral perfusion pressure was defined as mean arterial pressure minus JV or CSF pressure, depending on which was greater. Mean hemispheric blood flow was measured with the radiolabeled microsphere technique. Despite 30-mm Hg reductions in mean arterial pressure or increases in CSF or JV pressure, CBF did not change as long as the perfusion pressure remained greater than approximately 60 mm Hg. However, whenever perfusion pressure was reduced to an average of 48 mm Hg, cerebral blood flow decreased 27% to 33%. These results demonstrate the capacity of the cerebral vascular bed to respond similarly to changes in the perfusion pressure gradient obtained by decreasing mean arterial pressure, increasing JV pressure or increasing CSF pressure, and thereby support the above definition of cerebral perfusion pressure

  12. 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

  13. Tomographic analysis of CBF in cerebral infarction

    International Nuclear Information System (INIS)

    Segawa, Hiromu; Kimura, Kazumoto; Ueda, Yuichi; Nagai, Masakatsu; Yoshimasu, Norio.

    1983-01-01

    Cerebral perfusion was examined in various types of occlusive disease by computed tomographic CBF method. The method utilized has several advantages over conventional studies using isotope, providing high resolution images in a direct relation to CT anatomy. Ten representative cases were presented from 25 consective cases of occlusive disease studied by this method. The method included inhalation of 40 to 60% xenon with serial CT scanning for 25 min. K (build-up rate), lambda (partition coefficient) and CBF values were calculated from ΔHU for each pixel and ΔXe in expired air, based on Fick's principle, and displayed on CRT as K-, lambda- and CBF-map separately. CBF for gray matter of normal control was 82 +- 11 ml/100 gm/min and that for white matter was 24 +- 5 ml/100 gm/min. The ischemic threshold for gray matter appeared to be approximately 20 ml/100 gm/min, as blood flow in focus of complete infarction was below this level. Blood flow between 20 - 30 ml/ 100 gm/min caused some change on CT, such as localized atrophy, cortical thinning, loss of distinction between gray and white matter and decreased or increased density, which were considered to be compatible with pathological changes of laminar necrosis or gliosis with neuronal loss. In a case with occlusion of middle cerebral artery with subsequent recanalization, causing hemorrhagic infarct, hyperemia was observed in the infarcted cortex that was enhanced by iodine. Periventricular lucency observed in two cases, where blood flow was decreased below threshold, could be classified as ''watershed infarction'' mainly involving white matter. In moyamoya disease, blood flow in the anterior circulation was decreased near ischemic level, whereas that in basal ganglia and territory of posterior cerebral artery was fairly preserved, which was compatible with general angiographic finding of this disease. (author)

  14. Regional quantitative noninvasive assessment of cerebral perfusion and function with N-Isopropyl-[123I]p-iodoamphetamine

    International Nuclear Information System (INIS)

    von Schulthess, G.K.; Ketz, E.; Schubiger, P.A.; Bekier, A.

    1985-01-01

    Although several reports on the clinical usefulness of N-isopropyl-[ 123 I]p-iodoamphetamine (IMP) in the diagnosis of cerebral disease have appeared in the literature, quantitative, noninvasive measurements of regional cerebral blood flow with this method pose difficulties because cerebral IMP uptake not only depends on cerebral perfusion but also on cerebral function. Rather than trying to develop a method to measure cerebral perfusion with IMP, the authors have chosen to test a method to quantitatively evaluate planar and emission computed tomographic (ECT) studies by comparing the data obtained in patients with established pathology with the data obtained in a group of normal individuals. Using this method, absolute cerebral IMP uptake (counts/pixel/mCi/min) and planar anterior right-left ratios were obtained. Also measured were right-left ratios obtained from 12 paired regions in three ECT slices. The evaluation of the patients cerebral IMP uptake asymmetries relative to the normal standard values is a useful adjunct to qualitative image analysis in assessing the presence ans severity of disease, as qualitative analysis is prone to false-positive and negative results. Cerebral IMP uptake as measured in cts/pixel/mCi/min is abnormal only in severe cerebral disease and therefore generally a less helpful parameter

  15. 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 ...

  16. Dynamic Cerebral Autoregulation after Cardiopulmonary Bypass

    DEFF Research Database (Denmark)

    Christiansen, Claus Behrend; Berg, Ronan M G; Plovsing, Ronni R

    2016-01-01

    Background Cerebral hemodynamic disturbances in the peri- or postoperative period may contribute to postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). We therefore examined dynamic cerebral autoregulation (d...

  17. 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.

  18. Natriuretic peptides and cerebral hemodynamics

    DEFF Research Database (Denmark)

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

    2014-01-01

    Natriuretic peptides have emerged as important diagnostic and prognostic tools for cardiovascular disease. Plasma measurement of the bioactive peptides as well as precursor-derived fragments is a sensitive tool in assessing heart failure. In heart failure, the peptides are used as treatment...... 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...

  19. Measurement of regional cerebral blood flow by positron emission tomography

    International Nuclear Information System (INIS)

    Herscovitch, P.; Powers, W.J.

    1987-01-01

    The principal advantage of positron emission tomography over other methods for measuring cerebral blood flow stems from the accurate, quantitative three-dimensional measurements of regional brain radioactivity that are possible with this technique. As a result, accurate quantitative measurements of regional cerebral blood flow can be obtained for both superficial and deep cerebral structures. The value of PET for investigating central nervous system physiology and pathology extends far beyond this, however. Through the use of different radiotracers and appropriate mathematical models, PET can be applied to the measurement of a wide variety of physiologic variables. Measurements of rCBF tell only part of the story. Experience with PET and with a variety of other techniques has taught us that rCBF is at times a poor indicator of the metabolic, functional, and biochemical status of cerebral tissue. It is only by understanding the interaction of all of these factors that our understanding of neurologic disease can advance. It is in the investigation of these complex relationships that the real value of PET resides

  20. Is there any influence of breastfeeding on the cerebral blood flow? A review of 256 healthy newborns

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Vieira Monteiro

    2012-10-01

    Full Text Available OBJECTIVE: To investigate whether breastfeeding influence the cerebral blood-flow velocity. MATERIALS AND METHODS: The present study included 256 healthy term neonates, all of them with appropriate weight for gestational age, 50.8% being female. Pulsatility index, resistance index and mean velocity were measured during breastfeeding or resting in the anterior cerebral artery, in the left middle cerebral artery, and in the right middle cerebral artery of the neonates between their first 10 and 48 hours of life. The data were analyzed by means of a paired t-test, Brieger's f-test for analysis of variance and linear regression, with p < 0.01 being accepted as statistically significant. RESULTS: Mean resistance index decreased as the mean velocity increased significantly during breastfeeding. Pulsatility index values decreased as much as the resistance index, but in the right middle cerebral artery it was not statistically significant. CONCLUSION: Breastfeeding influences the cerebral blood flow velocities.

  1. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, José A; Märzendorfer, Olivia; Brada, Muriel; Saporito, Andrea; Borgeat, Alain; Bühler, Philipp

    2016-12-01

    Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. University hospital operating room. Forty patients with American Society of Anesthesiologists classes I-II physical status scheduled for elective shoulder surgery. Cerebral saturation and blood flow of the middle cerebral artery were measured prior to anesthesia and continued after beach chair positioning until discharge to the postanesthesia care unit. The anesthesiologist was blinded for these values. Controlled hypotension with systolic blood pressure≤100mm Hg was maintained during surgery. Neurobehavioral tests and values of regional cerebral saturation, bispectral index, the mean maximal blood flow of the middle cerebral artery, and invasive blood pressure were measured prior to regional anesthesia, and measurements were repeated after placement of the patient on the beach chair position and every 20 minutes thereafter until discharge to postanesthesia care unit. The neurobehavioral tests were repeated the day after surgery. The incidence of cerebral desaturation events was 5%. All patients had a significant blood pressure drop 5 minutes after beach chair positioning, measured at the heart as well as the acoustic meatus levels, when compared with baseline values (Psurgery (Pshoulder surgery had no major impact on cerebral blood flow and cerebral oxygenation. However, some impact on neurobehavioral outcome 24 hours after surgery was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Regional cerebral blood flow measurement with intravenous [15O]water bolus and [18F]fluoromethane inhalation

    International Nuclear Information System (INIS)

    Herholz, K.; Pietrzyk, U.; Wienhard, K.; Hebold, I.; Pawlik, G.; Wagner, R.; Holthoff, V.; Klinkhammer, P.; Heiss, W.D.

    1989-01-01

    In 20 patients with ischemic cerebrovascular disease, classic migraine, or angiomas, we compared paired dynamic positron emission tomographic measurements of regional cerebral blood flow using both [ 15 O]water and [ 18 F]fluoromethane as tracers. Cerebral blood flow was also determined according to the autoradiographic technique with a bolus injection of [ 15 O]water. There were reasonable overall correlations between dynamic [ 15 O]water and [ 18 F]fluoromethane values for cerebral blood flow (r = 0.82) and between dynamic and autoradiographic [ 15 O]water values for cerebral blood flow (r = 0.83). We found a close correspondence between abnormal pathologic findings and visually evaluated cerebral blood flow tomograms obtained with the two tracers. On average, dynamic [ 15 O]water cerebral blood flow was 6% lower than that measured with [ 18 F]fluoromethane. There also was a general trend toward a greater underestimation with [ 15 O]water in high-flow areas, particularly in hyperemic areas, probably due to incomplete first-pass extraction of [ 15 O]water. Underestimation was not detected in low-flow areas or in the cerebellum. Absolute cerebral blood flow values were less closely correlated between tracers and techniques than cerebral blood flow patterns. The variability of the relation between absolute flow values was probably caused by confounding effects of the variation in the circulatory delay time. The autoradiographic technique was most sensitive to this type error

  3. Cerebral edema associated with acute hepatic failure.

    OpenAIRE

    Fujiwara, Masachika; Watanabe, Akiharu; Yamauchi, Yasuhiko; Hashimoto, Makoto; Nakatsukasa, Harushige; Kobayashi, Michio; Higashi, Toshihiro; Nagashima, Hideo

    1985-01-01

    The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64%) of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more fre...

  4. Quantification of cerebral blood flow via Duplex sonography

    International Nuclear Information System (INIS)

    Vogl, G.; Pohl, P.; Willeit, J.; Aichner, F.

    1987-01-01

    An attempt was made to measure quantitatively the total cerebral blood flow by means of Duplex sonography. In a group of healthy young subjects a median value for total cerebral blood flow was obtained amounting to 469 ml/min ± 30%, repeat measurements yielded a maximum deviation of ± 11%. In three patients the values obtained after severe apoplectic insult due to occlusion of the internal carotid artery were definitely below the value of the group of healthy subjects, whereas the value for the total blood flow was in the upper range of normal values in a patient with occlusion of the a. cerebri media. Comparative measurements of the regional cerebral blood flow with xenon 13 yielded in those patients with occlusion of the internal carotid artery a markedly reduced mean flow and in the patient with occlusion of the a. cerebri media a less markedly reduced mean flow. Regionally reduced perfusion was seen in all the four patients in the range of the clinically and computer tomographically well-known ischaemia zone. Thanks to the simplicity of this sonographic examination method it could be a useful decision parameter in determining the indication for a reconstruction of the carotid artery, especially in asymptotic patients. (orig.) [de

  5. 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

  6. 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.

  7. 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 ...

  8. 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

  9. 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…

  10. 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...

  11. Fenestration of the anterior cerebral artery

    International Nuclear Information System (INIS)

    Ito, J.; Washiyama, K.; Hong Kim, C.; Ibuchi, Y.

    1981-01-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed. (orig.)

  12. The Value of Value

    DEFF Research Database (Denmark)

    Sørensen, Asger

    parts of business ethics given prominence to especially one term, namely `value'. The question that interests me is the following: What does the articulation of ethics and morality in terms of values mean for ethics and morality as such. Or, to put the question in a more fashionably way: What......As a social scientist of ethics and morality, Luhmann has noticed the ethical wave that has recently swept across the western world, and states that this particular kind of wave seems to have a wavelength of about one hundred years (cf. Luhmann 1989: 9 ff.). Even though the frequency...... and the regularity of such a phenomenon is both hard to verify and, if true, difficult to explain, it seems fair to say that since the Enlightenment, an approaching fin-de-siecle has brought an increased interest in matters concerning morality and ethics.1 The present peak has in public-political discourse and some...

  13. [Neuronavigator-assisted microsurgical resection of glioma located in cerebral functional areas].

    Science.gov (United States)

    Su, Guohui; Liu, Zhixiong; Huo, Lei; Li, Chuntao; Zhang, Mingyu

    2017-05-28

    To evaluate value of neuronavigator-assisted microsurgery of glioma located in cerebral functional areas.
 Methods: Patients with glioma located in cerebral functional areas were underwent operation in Xiangya Hospital. Of 64 patients, 34 patients were performed neuronavigator-assisted microsurgery, and 30 were underwent routine surgical operation.
 Results: The neuronavigator-assisted microsurgery group showed high complete resection rate with low neurological deficit and cerebral edema compared with the routine surgical group (PNeuronavigator-assisted microsurgery is effective and characterized by accurate location, personalized operative incision design, and higher rate of tumor resection.

  14. 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)

  15. The evaluation of diffusion weighted imaging in acute cerebral infarction with permanent type MR scanner

    International Nuclear Information System (INIS)

    Peng Sen; Ye Wenwei; Luo Zhongrao; Yang Zenian; Zhang Zhongwei; Li Ziping

    2006-01-01

    Objective: To evaluate the value of diffusion weighted imaging (DWI) in acute cerebral infarction using permanent type MR scanner. Methods: DWI and conventional MRI sequences were done in 77 patients suspected with cerebral infarction. The sensitivity of DWI and conventional MRI was comparatively evaluated on lesion signal intensity and size. The characteristics and orderliness of lesions were studied. Results: (1) DWI has higher sensitivity than conventional MRI. (2) The higher b value was applied in the imaging, the higher signal intensity of acute cerebral infarction was revealed. The lesions were easier to identify on DWI images than on conventional MRI. Conclusion: DWI of permanent type MR imager is a feasible imaging modality, which is valuable in early diagnosis and management of acute cerebral infarction. (authors)

  16. Oculoauriculovertebral spectrum and cerebral anomalies

    NARCIS (Netherlands)

    Schrander-Stumpel, C. T.; de Die-Smulders, C. E.; Hennekam, R. C.; Fryns, J. P.; Bouckaert, P. X.; Brouwer, O. F.; da Costa, J. J.; Lommen, E. J.; Maaswinkel-Mooy, P. D.

    1992-01-01

    We report on three Dutch children with a clinical diagnosis of oculoauriculovertebral spectrum (OAVS) and hydrocephalus. The clinical features are compared to 15 published cases of OAVS and hydrocephalus. Several other cerebral abnormalities were present in the whole group. About half of the cases

  17. CT of cerebral hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Rudwan, M.A.; Khaffaji, S.

    1988-12-01

    Six cases of cerebral hydatid disease (CHD) were seen in Kuwait over a period of 8 years. The typical CT appearance of a large well-defined spherical nonenhanced unilocular cyst was seen in four cases. Two unusual but characteristic types of calcification were seen, one in each of the remaining two cases.

  18. CT of cerebral hydatid disease

    International Nuclear Information System (INIS)

    Rudwan, M.A.; Khaffaji, S.

    1988-01-01

    Six cases of cerebral hydatid disease (CHD) were seen in Kuwait over a period of 8 years. The typical CT appearance of a large well-defined spherical nonenhanced unilocular cyst was seen in four cases. Two unusual but characteristic types of calcification were seen, one in each of the remaining two cases. (orig.)

  19. MR imaging of cerebral palsy

    International Nuclear Information System (INIS)

    Saginoya, Toshiyuki; Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide

    1996-01-01

    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)

  20. 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)

  1. Cerebral gigantism with West syndrome.

    Science.gov (United States)

    Ray, Munni; Malhi, P; Bhalla, A K; Singhi, P D

    2003-07-01

    A case of cerebral gigantism (Sotos syndrome) with West syndrome in a one-year-old male child is reported. The case had a large stature, typical facies and neurodevelopmental delay along with infantile spasms, which were refractory to treatment with valproate and clonazepam.

  2. 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)

  3. 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.

  4. Computerized tomography of cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, K; Mihara, T; Kobayashi, E; Yamamoto, K; Kusumoto, K [Kagoshima Univ. (Japan). Faculty of Medicine

    1978-12-01

    In 120 cases of patients with cerebral infarction, the affected areas in the CT images were analyzed with special reference to the site, the size, and the extension. Moreover, on 39 scans of 34 cases examined with 8 weeks after the onset of strokes, the CT images were analyzed from the viewpoint of the presence of a mass effect, edema, contrast enhancement, and the accompanying hemorrhage. From these investigations, the authors have obtained the following results; 1) The greatest incidence of infarcts was in the area supplied by the middle cerebral artery (57% of the cases), and, among those, the area of the lenticulostriate arteries showed the highest incidence (53%). Even in the posterior fossa, infarcts were found in 6% of the cases. These findings are coincident with those in autopsied cases. 2) Putaminal infarcts and infarctions occurring in the area supplied by the calcarine artery seemed to be uniformity of the arcuate pattern. 3) Most of the infarcts in the perfusion area of the anterior cerebral artery and the basal ganglia were found to be small and multifocal; they were thought to correspond with water-shed and/or lacunar infarcts. 4) In approximately 25% of the cases examined within 8 weeks after the onset of strokes, the CT images revealed mass effects which had never been observed after more than 3 weeks. In conclusion, the presence of a mass effect, accompanying hemorrhage, and contrast enhancement detected by CT should lead us to reconsider the conventional management of cerebral infarction.

  5. Cerebral imaging and dementia

    International Nuclear Information System (INIS)

    Rascol, A.; Celsis, P.; Berry, I.

    1989-01-01

    Modern imaging techniques undoubtedly are of value when applied to the study of dementia. This value, however, varies with the technique utilized, and one must distinguish between acquired and potential knowledge. Morphological imaging with computerized tomography or magnetic resonance detects or confirms certain causes of dementia (tumours, lacunae, hydrocephalus with normal CSF pressure), but it is still not sensitive and specific enough to be very useful in primary dementias. Functional imaging (essentially with emission tomography) has already provided interesting data in the study of degenerative dementia (correlations with neuropsychology, subtyping), but what is most promising is its possibilities in the physiopathological approach of the disease [fr

  6. Cerebral imaging and dementia

    Energy Technology Data Exchange (ETDEWEB)

    Rascol, A.; Celsis, P.; Berry, I.

    1989-02-01

    Modern imaging techniques undoubtedly are of value when applied to the study of dementia. This value, however, varies with the technique utilized, and one must distinguish between acquired and potential knowledge. Morphological imaging with computerized tomography or magnetic resonance detects or confirms certain causes of dementia (tumours, lacunae, hydrocephalus with normal CSF pressure), but it is still not sensitive and specific enough to be very useful in primary dementias. Functional imaging (essentially with emission tomography) has already provided interesting data in the study of degenerative dementia (correlations with neuropsychology, subtyping), but what is most promising is its possibilities in the physiopathological approach of the disease.

  7. 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

  8. MR angiography of cerebral aneurysms

    International Nuclear Information System (INIS)

    Miki, Hitoshi; Tanada, Shuji; Sakaki, Saburo; Hamamoto, Ken; Sadamoto, Kazuhiko.

    1992-01-01

    Time-of-flight (TOF) MR angiography (MRA) and phase-contrast (PC) MRA are examined clinically for evaluating cerebral aneurysms. In the morphological diagnosis of cerebral aneurysms, three-dimensional (3D) MRA is superior to two-dimensional (2D) MRA because 3D MRA has a higher S/N ratio and a higher spatial resolution. However, it is difficult to decide which, 3D TOF MRA or 3D PC MRA, is superior, for both methods have many scan parameters. In our study, 3D PC MRA was performed using two methods; one had the same acquisition time as 3D TOF MRA, while the other had the same spatial resolution as 3D TOF MRA. The detectability of aneurysms by each MRA method was evaluated in comparison with 3D TOF MRA. In fifteen patients (6 males and 9 females), a total of 16 cerebral aneurysms (3 ruptured and 13 unruptured) were studied. The lesion sizes ranged from 2.5 to 18 mm. All the 16 lesions were examined by means of 3D TOF MRA, 3D PC MRA, and conventional angiography. MR imaging was performed with a 1.5 tesla MRI system (Signa). All of the 16 cerebral aneurysms were detected by 3D TOF MRA, while only 11 of them were detected by 3D PC MRA. When 3D PC MRA was performed with the same acquisition time as 3D TOF MRA, 3D PC MRA was superior in showing one of the 7 aneurysms. When 3D PC MRA was performed with same spatial resolution as 3D TOF MRA, 3D PC MRA was superior in showing two of the 10 aneurysms. 3D TOF MRA was superior to 3D PC MRA in the detection of cerebral aneurysms because of the long acquisition times and the different flow velocity, which induced different signal intensities between the aneurysms and parent arteries in 3D PC MRA. 3D PC MRA was superior to 3D TOF MRA in patients with large thrombotic aneurysms of the internal carotid artery. We consider that 3D TOF MRA should be the first choice for screening and following-up cerebral aneurysms. 3D PC MRA should then be performed for large cerebral aneurysms in addition to 3D TOF MRA. (author)

  9. Clinical significance of the corpus callosum in cerebral palsy

    International Nuclear Information System (INIS)

    Lee, Eun Ja; Kim, Ji Chang; Kim, Jong Chul; And Others

    2000-01-01

    To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury

  10. Clinical significance of the corpus callosum in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Kim, Ji Chang [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Jong Chul [School of Medicine, Chungnam National University, Taejon (Korea, Republic of); And Others

    2000-10-01

    To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury.

  11. Regional effects of craniotomy on cerebral circulation and metabolism

    International Nuclear Information System (INIS)

    Abumiya, Takeo; Sayama, Ichiro; Asakura, Ken; Hadeishi, Hiromu; Mizuno, Makoto; Suzuki, Akifumi; Yasui, Nobuyuki; Shishido, Fumio; Uemura, Kazuo

    1990-01-01

    Regional effects of craniotomy on cerebral circulation and metabolism, such as regional cerebral blood flow (rCBF), regional cerebral oxygen consumption (rCMRO 2 ), regional oxygen extraction fraction (rOEF), and regional cerebral blood volume (rCBV) were examined by a PET (positron emission tomography) study concerning surgery that was performed on un-ruptured aneurysm patients. Eight patients with intracranial un-ruptured aneurysms were studied pre- and post-operatively by the 15 O labelled-gas steady-state method, using HEADTOME-III. All patients underwent aneurysmal surgery performed by the transsylvian approach. There was a significant increase in the mean OEF values taken from the whole-brains of 8 patients, but there was not a significant change in CBF, CMRO 2 or CBV. The increase in OEF was caused by decrease of O 2 content, which was caused by post-operative decrease in the Hb value. So, this OEF increase was not the direct effect of craniotomy. In 2 patients, the rCBF and rCMRO 2 , in the fronto-temporal region (where craniotomy was performed) increased post-operatively. This regional effect suggests transient reactive hyperemia following compressive ischemia during the operative procedure, and metabolic demands for recovery of brain function. In 2 other patients, who had relatively low rCBFs during the pre-operative study, rCBF and rCMRO 2 in the bi-frontal region had decreased more at the post-operative study. This change appears to have been caused by removal of cerebrospinal fluid and depression of the frontal lobe. From this study, it becomes evident that the regional effect of craniotomy on cerebral circulation and metabolism is not so great, when adequate microsurgical techniques are used. (author)

  12. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zhaosheng, Luan; Pengyong,; Xiqin, Sun; Wei, Wang; Huisheng, Liu; Wen, Zhou [88 Hospital PLA, Taian, SD (China). Dept. of Nuclear Medicine

    1992-11-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed.

  13. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Pengyong; Sun Xiqin; Wang Wei; Liu Huisheng; Zhou Wen

    1992-01-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed

  14. 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

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório neste tipo de paciente. CONTEÚDO: O artigo aborda aspectos da paralisia cerebral como etiologia, classificação, fatores de risco, fisiopatologia, quadro clínico, diagnóstico, terapêuticas utilizadas bem como avaliação pré-operatória, medicação pré-anestésica, manuseio intra e pós-operatório, analgesia pós-operatória e dor crônica. CONCLUSÕES: O anestesiologista desempenha um papel importante na diminuição da morbidade e mortalidade anestésico-cirúrgica em pacientes portadores de paralisia cerebral. O conhecimento da fisiopatologia dos diferentes tipos de paralisia cerebral bem como das doenças associadas e suas terapêuticas é imprescindível, pois permite ao anestesiologista antecipar e prevenir complicações intra e pós-operatórias neste tipo de paciente.JUSTIFICATIVA Y OBJETIVOS: La parálisis cerebral (PC es una enfermedad no progresiva consecuente de una lesión en el sistema nervioso central, llevando a un comprometimiento motor del paciente. El portador de PC, frecuentemente es sometido a procedimientos quirúrgicos debido a enfermedades usuales y situaciones particulares consecuentes de la parálisis cerebral. El objetivo de este artículo, fue revisar aspectos de la parálisis cerebral de interés para el anestesista, permitiendo un adecuado manoseo pre, intra y posoperatorio en este tipo de paciente. CONTENIDO: El artículo aborda aspectos de la parálisis cerebral como etiología, clasificación, factores de

  15. Assessment of the Changes in 9L and C6 Glioma pO2 by EPR Oximetry as a Prognostic Indicator of Differential Response to Radiotherapy

    Science.gov (United States)

    Hou, Huagang; Mupparaju, Sriram P.; Lariviere, Jean P.; Hodge, Sassan; Gui, Jiang; Swartz, Harold M.; Khan, Nadeem

    2013-01-01

    Tumor hypoxia impedes the outcome of radiotherapy. As the extent of hypoxia in solid tumors varies during the course of radiotherapy, methods that can provide repeated assessment of tumor pO2 such as EPR oximetry may enhance the efficacy of radiotherapy by scheduling irradiations when the tumors are oxygenated. The repeated measurements of tumor pO2 may also identify responders, and thereby facilitate the design of better treatment plans for nonresponding tumors. We have investigated the temporal changes in the ectopic 9L and C6 glioma pO2 irradiated with single radiation doses less than 10 Gy by EPR oximetry. The 9L and C6 tumors were hypoxic with pO2 of approximately 5–9 mmHg. The pO2 of C6 tumors increased significantly with irradiation of 4.8–9.3 Gy. However, no change in the 9L tumor pO2 was observed. The irradiation of the oxygenated C6 tumors with a second dose of 4.8 Gy resulted in a significant delay in growth compared to hypoxic and 2 Gy × 5 treatment groups. The C6 tumors with an increase in pO2 of greater than 50% from the baseline of irradiation with 4.8 Gy (responders) had a significant tumor growth delay compared to nonresponders. These results indicate that the ectopic 9L and C6 tumors responded differently to radiotherapy. We propose that the repeated measurement of the oxygen levels in the tumors during radiotherapy can be used to identify responders and to design tumor oxygen guided treatment plans to improve the outcome. PMID:23391148

  16. Assessment of the changes in 9L and C6 glioma pO2 by EPR oximetry as a prognostic indicator of differential response to radiotherapy.

    Science.gov (United States)

    Hou, Huagang; Mupparaju, Sriram P; Lariviere, Jean P; Hodge, Sassan; Gui, Jiang; Swartz, Harold M; Khan, Nadeem

    2013-03-01

    Tumor hypoxia impedes the outcome of radiotherapy. As the extent of hypoxia in solid tumors varies during the course of radiotherapy, methods that can provide repeated assessment of tumor pO2 such as EPR oximetry may enhance the efficacy of radiotherapy by scheduling irradiations when the tumors are oxygenated. The repeated measurements of tumor pO2 may also identify responders, and thereby facilitate the design of better treatment plans for nonresponding tumors. We have investigated the temporal changes in the ectopic 9L and C6 glioma pO2 irradiated with single radiation doses less than 10 Gy by EPR oximetry. The 9L and C6 tumors were hypoxic with pO2 of approximately 5-9 mmHg. The pO2 of C6 tumors increased significantly with irradiation of 4.8-9.3 Gy. However, no change in the 9L tumor pO2 was observed. The irradiation of the oxygenated C6 tumors with a second dose of 4.8 Gy resulted in a significant delay in growth compared to hypoxic and 2 Gy × 5 treatment groups. The C6 tumors with an increase in pO2 of greater than 50% from the baseline of irradiation with 4.8 Gy (responders) had a significant tumor growth delay compared to nonresponders. These results indicate that the ectopic 9L and C6 tumors responded differently to radiotherapy. We propose that the repeated measurement of the oxygen levels in the tumors during radiotherapy can be used to identify responders and to design tumor oxygen guided treatment plans to improve the outcome.

  17. [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.

  18. Regional cerebral blood flow measurement using a scintillation camera

    International Nuclear Information System (INIS)

    Heiss, W.D.

    1979-01-01

    A scintillation camera connected to auxillary equipment with off-line data processing or connected to an on-line dedicated computer system permits measurement of hemispheric and regional cerebral blood flow. Reliable flow values are obtained from regions limited in size by spatial resolution and the count rates achieved. Flow measurements obtained with the camera are able to resolve inhomogeneities of cerebral circulation in normal subjects. In a variety of clinical conditions, the localization, severity and extent of flow alterations are shown. Results of flow measurements in individual cases elucidate the pathogenesis of neurologic deficits, quantify the damage to the brain, indicate therapeutic measures of potential value and permit an estimation of the further clinical course. With restricted spatial resolution, flow measurements after intravenous 133 Xe injection are also feasible

  19. Quantitative measurement of the cerebral blood flow

    International Nuclear Information System (INIS)

    Houdart, R.; Mamo, H.; Meric, P.; Seylaz, J.

    1976-01-01

    The value of the cerebral blood flow measurement (CBF) is outlined, its limits are defined and some future prospects discussed. The xenon 133 brain clearance study is at present the most accurate quantitative method to evaluate the CBF in different regions of the brain simultaneously. The method and the progress it has led to in the physiological, physiopathological and therapeutic fields are described. The major disadvantage of the method is shown to be the need to puncture the internal carotid for each measurement. Prospects are discussed concerning methods derived from the same general principle but using a simpler, non-traumatic way to introduce the radio-tracer, either by breathing into the lungs or intraveinously [fr

  20. Regional cerebral blood flow in SPECT pattern in Parkinson's disease

    International Nuclear Information System (INIS)

    Lenart-Jankowska, D.; Junik, R.; Sowinski, J.; Gembicki, M.; Wender, M.

    1997-01-01

    The purpose of our work was to compare the regional cerebral blood flow (rCBF) in SPECT examination in Parkinson's disease with (17 cases) and without (7 cases) dementia and in various clinical stages of the disease. The patients underwent SPECT examination 5-40 min after intravenous application of HMPAO (Ceretec, Amersham) with 740 Mbq (20 mCi) pertechnate 99m Tc. SPECT was performed with a Siemens Diacam single-head rotating gamma camera coupled to a high resolution collimator and Icon computer system provided by the manufacturer. The results were defined in relative values of ROI in relation to cerebellum. Patients with Parkinson's disease showed hypoperfusion in cerebral lobes and in deep cerebral structures including the basal ganglia. Regional perfusion deficit in SPECT was seen with and without associated dementia and already in early stage of the disease. Parkinson's disease is provoked by the lesions of dopaminergic neurons of the central nervous system leading to domination of extrapyramidal symptoms. There are many indications that also the neurotransmitters associated with cognitive functions as acetylcholine demonstrate some abnormalities. However, only in some cases of Parkinson's disease dementia is the dominating symptom. Our results of regional cerebral blood flow testify that in Parkinson's disease the dysfunction of the central nervous system is more diffuse than has previously been suggested. (author)

  1. Diagnosing cerebral visual impairment in children with good visual acuity.

    Science.gov (United States)

    van Genderen, Maria; Dekker, Marjoke; Pilon, Florine; Bals, Irmgard

    2012-06-01

    To identify elements that could facilitate the diagnosis of cerebral visual impairment (CVI) in children with good visual acuity in the general ophthalmic clinic. We retrospectively investigated the clinical characteristics of 30 children with good visual acuity and CVI and compared them with those of 23 children who were referred with a suspicion of CVI, but proved to have a different diagnosis. Clinical characteristics included medical history, MRI findings, visual acuity, crowding ratio (CR), visual field assessment, and the results of ophthalmologic and orthoptic examination. We also evaluated the additional value of a short CVI questionnaire. Eighty-three percent of the children with an abnormal medical history (mainly prematurity and perinatal hypoxia) had CVI, in contrast with none of the children with a normal medical history. Cerebral palsy, visual field defects, and partial optic atrophy only occurred in the CVI group. 41% of the children with CVI had a CR ≥2.0, which may be related to dorsal stream dysfunction. All children with CVI, but also 91% of the children without CVI gave ≥3 affirmative answers on the CVI questionnaire. An abnormal pre- or perinatal medical history is the most important risk factor for CVI in children, and therefore in deciding which children should be referred for further multidisciplinary assessment. Additional symptoms of cerebral damage, i.e., cerebral palsy, visual field defects, partial optic atrophy, and a CR ≥2 may support the diagnosis. CVI questionnaires should not be used for screening purposes as they yield too many false positives.

  2. Impact of short-term treatment with telmisartan on cerebral arterial remodeling in SHR.

    Directory of Open Access Journals (Sweden)

    Sébastien Foulquier

    Full Text Available Chronic hypertension decreases internal diameter of cerebral arteries and arterioles. We recently showed that short-term treatment with the angiotensin II receptor blocker telmisartan restored baseline internal diameter of small cerebral arterioles in spontaneously hypertensive rats (SHR, via reversal of structural remodeling and inhibition of the angiotensin II vasoconstrictor response. As larger arteries also participate in the regulation of cerebral circulation, we evaluated whether similar short-term treatment affects middle cerebral arteries of SHR.Baseline internal diameters of pressurised middle cerebral arteries from SHR and their respective controls, Wistar Kyoto rats (WKY and responses to angiotensin II were studied in a small vessel arteriograph. Pressure myogenic curves and passive internal diameters were measured following EDTA deactivation, and elastic modulus from stress-strain relationships.Active baseline internal diameter was 23% lower in SHR compared to WKY, passive internal diameter (EDTA 28% lower and elastic modulus unchanged. Pressure myogenic curves were shifted to higher pressure values in SHR. Telmisartan lowered blood pressure but had no effect on baseline internal diameter nor on structural remodeling (passive internal diameter and elastic modulus remained unchanged compared to SHR. Telmisartan shifted the pressure myogenic curve to lower pressure values than SHR.In the middle cerebral arteries of SHR, short-term treatment with telmisartan had no effect on structural remodeling and did not restore baseline internal diameter, but allowed myogenic tone to adapt towards lower pressure values.

  3. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    Science.gov (United States)

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

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  4. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

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

    2014-01-01

    .19 p = standard deviation during steady-state repeated measurements was 4.8% ± 0.86 for INVOS and 2.8% ± 0.5 for FORE-SIGHT. CONCLUSION......, the mean cStO2 value increased from 53.4% (CI 36.8-69.9%) to 86.0% (CI 80.2-91.7%) for INVOS and from 61.6% (CI 55.4-67.8%) to 82.2% (CI 77.7-86.7%) for FORE-SIGHT. The Bland-Altman plot revealed decreasing difference (INVOS minus FORE-SIGHT) (D) in absolute values (A) with increasing cStO2 (D = 0.5A - 38...

  5. Effect of pregnancy on regional cerebral blood flow

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Ikeda, Tomoaki; Mori, Norimasa

    1993-01-01

    Regional cerebral blood flow (r-CBF) of 10 pregnant women were quantified by 133 Xe SPECT study with inhalation method before and after artificial abortion. During pregnancy, value of r-CBF in each region except occipital lobe was significantly higher than that of the post abortion. Arterial blood gas was analyzed after SPECT procedure. P co2 concentration increased significantly after artificial abortion. Although its mechanism is unknown, our preliminary work demonstrates that r-CBF increased by pregnancy. (author)

  6. Transcranial Doppler ultrasound and cerebral angiography - alternative or complementary

    International Nuclear Information System (INIS)

    Bockenheimer, S.; Lorey, N.

    1985-01-01

    Transcranial Doppler ultrasound is a noninvasive method of recording the flow velocity of larger intracranial vessels. The impact on diagnosis of cerebravascular occlusive disease is not yet evaluated. We present 15 patients, age range 39-73 years, who suffered from completed stroke. The findings of transcranial Doppler ultrasound and of cerebral angiography are presented. The value of both methods in treatment strategy is discussed. (orig.) [de

  7. Genetic modification of cerebral arterial wall: implications for prevention and treatment of cerebral vasospasm.

    Science.gov (United States)

    Vijay, Anantha; Santhanam, R; Katusic, Zvonimir S

    2006-10-01

    Genetic modification of cerebral vessels represents a promising and novel approach for prevention and/or treatment of various cerebral vascular disorders, including cerebral vasospasm. In this review, we focus on the current understanding of the use of gene transfer to the cerebral arteries for prevention and/or treatment of cerebral vasospasm following subarachnoid hemorrhage (SAH). We also discuss the recent developments in vascular therapeutics, involving the autologous use of progenitor cells for repair of damaged vessels, as well as a cell-based gene delivery approach for the prevention and treatment of cerebral vasospasm.

  8. Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Shin; Ujike, Takashi; Kuroki, Soemu; Sakamoto, Shizuki; Soeda, Toshiyuki; Terashi, Akiro; Iio, Masaaki

    1988-10-01

    The purpose of this study was to determine functional changes in the cerebral cortex and basal ganglia in Parkinson's disease (PD). Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO/sub 2/) were determined using 0-15 positron emission tomography in 10 PD patients and five age-matched healthy volunteers. There was a tendency among PD patients towards a decreased CBF and CMRO/sub 2/ in the cerebral cortex and basal ganglia. These values were significantly lower in the frontal cortex in the PD group than the control group. There was no difference in OEF between the groups. A more decreased cerebral oxygen metabolism was observed in patients staged as severer on the scale of Hoehn and Yahr. There was no correlation between cerebral oxygen metabolism and tremor, rigidity, or bradykinesis. A decreased cerebral oxygen metabolism was associated with mental disorders, such as depression, hallucination, and dementia. These results may provide an important clue for the understanding of mesocortical dopaminergic pathway and the relationship between PD and dementia. (N.K.).

  9. Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Kitamura, Shin; Ujike, Takashi; Kuroki, Soemu; Sakamoto, Shizuki; Soeda, Toshiyuki; Terashi, Akiro; Iio, Masaaki.

    1988-01-01

    The purpose of this study was to determine functional changes in the cerebral cortex and basal ganglia in Parkinson's disease (PD). Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO 2 ) were determined using 0-15 positron emission tomography in 10 PD patients and five age-matched healthy volunteers. There was a tendency among PD patients towards a decreased CBF and CMRO 2 in the cerebral cortex and basal ganglia. These values were significantly lower in the frontal cortex in the PD group than the control group. There was no difference in OEF between the groups. A more decreased cerebral oxygen metabolism was observed in patients staged as severer on the scale of Hoehn and Yahr. There was no correlation between cerebral oxygen metabolism and tremor, rigidity, or bradykinesis. A decreased cerebral oxygen metabolism was associated with mental disorders, such as depression, hallucination, and dementia. These results may provide an important clue for the understanding of mesocortical dopaminergic pathway and the relationship between PD and dementia. (N.K.)

  10. Cerebral Taurine Levels are Associated with Brain Edema and Delayed Cerebral Infarction in Patients with Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Kofler, Mario; Schiefecker, Alois; Ferger, Boris; Beer, Ronny; Sohm, Florian; Broessner, Gregor; Hackl, Werner; Rhomberg, Paul; Lackner, Peter; Pfausler, Bettina; Thomé, Claudius; Schmutzhard, Erich; Helbok, Raimund

    2015-12-01

    Cerebral edema and delayed cerebral infarction (DCI) are common complications after aneurysmal subarachnoid hemorrhage (aSAH) and associated with poor functional outcome. Experimental data suggest that the amino acid taurine is released into the brain extracellular space secondary to cytotoxic edema and brain tissue hypoxia, and therefore may serve as a biomarker for secondary brain injury after aSAH. On the other hand, neuroprotective mechanisms of taurine treatment have been described in the experimental setting. We analyzed cerebral taurine levels using high-performance liquid chromatography in the brain extracellular fluid of 25 consecutive aSAH patients with multimodal neuromonitoring including cerebral microdialysis (CMD). Patient characteristics and clinical course were prospectively recorded. Associations with CMD-taurine levels were analyzed using generalized estimating equations with an autoregressive process to handle repeated observations within subjects. CMD-taurine levels were highest in the first days after aSAH (11.2 ± 3.2 µM/l) and significantly decreased over time (p taurine levels compared to those without (Wald = 7.3, df = 1, p taurine supplementation and brain extracellular taurine (p = 0.6). Moreover, a significant correlation with brain extracellular glutamate (r = 0.82, p taurine levels were found in patients with brain edema or DCI after aneurysmal subarachnoid hemorrhage. Its value as a potential biomarker deserves further investigation.

  11. In vivo EPR oximetry using an isotopically-substituted nitroxide: Potential for quantitative measurement of tissue oxygen

    Science.gov (United States)

    Weaver, John; Burks, Scott R.; Liu, Ke Jian; Kao, Joseph P.Y.; Rosen, Gerald M.

    2017-01-01

    Variations in brain oxygen (O2) concentration can have profound effects on brain physiology. Thus, the ability to quantitate local O2 concentrations noninvasively in vivo could significantly enhance understanding of several brain pathologies. However, quantitative O2 mapping in the brain has proven difficult. The electron paramagnetic resonance (EPR) spectra of nitroxides are sensitive to molecular O2 and can be used to estimate O2 concentrations in aqueous media. We recently synthesized labile-ester-containing nitroxides, such as 3-acetoxymethoxycarbonyl-2,2,5,5-tetramethyl-1-pyrrolidinyloxyl (nitroxide 4), which accumulate in cerebral tissue after in situ hydrolysis, and thus enable spatial mapping of O2 concentrations in the mouse brain by EPR imaging. In an effort to improve O2 quantitation, we prepared 3-acetoxymethox ycarbonyl-2,2,5,5-tetra(2H3)methyl-1-(3,4,4-2H3,1-15N)pyrrolidinyloxyl (nitroxide 2), which proved to be a more sensitive probe than its normo-isotopic version for quantifying O2 in aqueous solutions of various O2 concentrations. We now demonstrate that this isotopically substituted nitroxide is ~2-fold more sensitive in vivo than the normo-isotopic nitroxide 4. Moreover, in vitro and in vivo EPR spectral-spatial imaging results with nitroxide 2 demonstrate significant improvement in resolution, reconstruction and spectral response to local O2 concentrations in cerebral tissue. Thus, isotopic-substituted nitroxides, such as 2, are excellent sensors for in vivo O2 quantitation in tissues, such as the brain. PMID:27567323

  12. 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)

  13. Animal models of cerebral ischemia

    Science.gov (United States)

    Khodanovich, M. Yu.; Kisel, A. A.

    2015-11-01

    Cerebral ischemia remains one of the most frequent causes of death and disability worldwide. Animal models are necessary to understand complex molecular mechanisms of brain damage as well as for the development of new therapies for stroke. This review considers a certain range of animal models of cerebral ischemia, including several types of focal and global ischemia. Since animal models vary in specificity for the human disease which they reproduce, the complexity of surgery, infarct size, reliability of reproduction for statistical analysis, and adequate models need to be chosen according to the aim of a study. The reproduction of a particular animal model needs to be evaluated using appropriate tools, including the behavioral assessment of injury and non-invasive and post-mortem control of brain damage. These problems also have been summarized in the review.

  14. MR of experimental cerebral ischemia

    International Nuclear Information System (INIS)

    DeLaPaz, R.; Steinberg, G.; Rocklage, S.; Glover, G.H.

    1990-01-01

    This paper reports on MR imaging of cerebral ischemia and treatment with N-methyl-D-aspartate (NMDA) antagonists in an animal model. Forty-four New Zealand white rabbits underwent 1-hour transorbital ICA-MCA-ACA occlusion and pretreatment or immediate posttreatment with systemic dextromethorphan (DM, n = 14), dextrorphan (DX, n = 14), or normal saline (NS, n = 16). Serial MR studies (1.5 T) were performed 1--6 hours after occlusion with T1- and T2-weighted spinecho, IVIM (b = 1,352), gradient recalled acquisition in a steady-state, and chemical shift sequences (for magnetic susceptibility, T2* and T2') and DyDTPA-BMA intravenous contrast material (Salutar). Spatial correlation between MR findings, histologic findings (ischemic neuronal damage), and regional cerebral blood flow (microspheres) was done

  15. Primary cerebral lymphoma: radiological findings

    International Nuclear Information System (INIS)

    Ruiz, J.C.; Grandse, D.; Equidazu, J.; Elizagaray, E.; Grande, J.; Carrandi, J.

    1990-01-01

    We present four cases of primary cerebral lymphoma in non-immunodepressed adult patients. All cases were dsemonstrated with pathological study. CAT study showed solitary or multiple isodense lesions, which incorporated avidly and homoneneously the contrast. Arteriography performed in three patients and magnetic resonance, performed in one did not help for diagnosis. We also review the radiological findings obtained with different imaging methods, and suggest the criteria which could be useful for early diagnosis (Author)

  16. 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....

  17. Significance of postoperative crossed cerebellar hypoperfusion in patients with cerebral hyperperfusion following carotid endarterectomy: SPECT study

    Energy Technology Data Exchange (ETDEWEB)

    Ogasawara, Kuniaki; Kobayashi, Masakazu; Suga, Yasunori; Chida, Kohei; Saito, Hideo; Komoribayashi, Nobukazu; Otawara, Yasunari; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan)

    2008-01-15

    Cerebral hyperperfusion after carotid endarterectomy (CEA) results in cerebral hyperperfusion syndrome and cognitive impairment. The goal of the present study was to clarify the clinical significance of postoperative crossed cerebellar hypoperfusion (CCH) in patients with cerebral hyperperfusion after CEA by assessing brain perfusion with single-photon emission computed tomography (SPECT). Brain perfusion was quantitatively measured using SPECT and the [{sup 123}I]N-isopropyl-p-iodoamphetamine-autoradiography method before and immediately after CEA and on the third postoperative day in 80 patients with ipsilateral internal carotid artery stenosis ({>=}70%). Postoperative CCH was determined by differences between asymmetry of perfusion in bilateral cerebellar hemispheres before and after CEA. Neuropsychological testing was also performed preoperatively and at the first postoperative month. Eleven patients developed cerebral hyperperfusion (cerebral blood flow increase of {>=}100% compared with preoperative values) on SPECT imaging performed immediately after CEA. In seven of these patients, CCH was observed on the third postoperative day. All three patients with hyperperfusion syndrome exhibited cerebral hyperperfusion and CCH on the third postoperative day and developed postoperative cognitive impairment. Of the eight patients with asymptomatic hyperperfusion, four exhibited CCH despite resolution of cerebral hyperperfusion on the third postoperative day, and three of these patients experienced postoperative cognitive impairment. In contrast, four patients without postoperative CCH did not experience postoperative cognitive impairment. The presence of postoperative CCH with concomitant cerebral hyperperfusion reflects the development of hyperperfusion syndrome. Further, the presence of postoperative CCH in patients with cerebral hyperperfusion following CEA suggests development of postoperative cognitive impairment, even when asymptomatic. (orig.)

  18. Significance of postoperative crossed cerebellar hypoperfusion in patients with cerebral hyperperfusion following carotid endarterectomy: SPECT study

    International Nuclear Information System (INIS)

    Ogasawara, Kuniaki; Kobayashi, Masakazu; Suga, Yasunori; Chida, Kohei; Saito, Hideo; Komoribayashi, Nobukazu; Otawara, Yasunari; Ogawa, Akira

    2008-01-01

    Cerebral hyperperfusion after carotid endarterectomy (CEA) results in cerebral hyperperfusion syndrome and cognitive impairment. The goal of the present study was to clarify the clinical significance of postoperative crossed cerebellar hypoperfusion (CCH) in patients with cerebral hyperperfusion after CEA by assessing brain perfusion with single-photon emission computed tomography (SPECT). Brain perfusion was quantitatively measured using SPECT and the [ 123 I]N-isopropyl-p-iodoamphetamine-autoradiography method before and immediately after CEA and on the third postoperative day in 80 patients with ipsilateral internal carotid artery stenosis (≥70%). Postoperative CCH was determined by differences between asymmetry of perfusion in bilateral cerebellar hemispheres before and after CEA. Neuropsychological testing was also performed preoperatively and at the first postoperative month. Eleven patients developed cerebral hyperperfusion (cerebral blood flow increase of ≥100% compared with preoperative values) on SPECT imaging performed immediately after CEA. In seven of these patients, CCH was observed on the third postoperative day. All three patients with hyperperfusion syndrome exhibited cerebral hyperperfusion and CCH on the third postoperative day and developed postoperative cognitive impairment. Of the eight patients with asymptomatic hyperperfusion, four exhibited CCH despite resolution of cerebral hyperperfusion on the third postoperative day, and three of these patients experienced postoperative cognitive impairment. In contrast, four patients without postoperative CCH did not experience postoperative cognitive impairment. The presence of postoperative CCH with concomitant cerebral hyperperfusion reflects the development of hyperperfusion syndrome. Further, the presence of postoperative CCH in patients with cerebral hyperperfusion following CEA suggests development of postoperative cognitive impairment, even when asymptomatic. (orig.)

  19. MR findings of cerebral palsy

    International Nuclear Information System (INIS)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki

    1994-01-01

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage

  20. MR findings of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1994-11-15

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.

  1. 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

  2. [Assessment of maternal cerebral blood flow in patients with preeclampsia].

    Science.gov (United States)

    Mandić, Vesna; Miković, Zeljko; Dukić, Milan; Vasiljević, Mladenko; Filimonović, Dejan; Bogavac, Mirjana

    2005-01-01

    Systemic vasoconstriction in preeclamptic patients increases vascular resistance, and is manifested by increased arterial blood flow velocity. The aim of the study is to evaluate if there is a change of Doppler indices in maternal medial cerbral artery (MCA) in severe preeclampsia due to: 1) severity of clinical symptoms, 2) the begining of eclamptic attack and 3) the application of anticonvulsive therapy. A prospective clinical study included 92 pregnant women, gestational age 28-36 weeks. They were divided into three groups: normotensive (n=30), mild preeclampsia (n=33), and severe preeclampsia (n=29). We investigated maternal cerebral circulation by assessing the MCA. We registrated: pulsatility index (Pi), resistance index (Ri), systolic/diastolic ratio (S/D), and the maximum systolic, end diastolic and medium velocity. Patients with severe preeclampsia were divided into two subgroups. subgroup 1 included patients without symptoms of threatening eclampsia (n=18; 62.06%); while subgroup 2 included those with symptoms of preeclampsia (n=11; 37.94%). All patients with severe preeclampsia were treated with magnesium sulfate (MgSO4), and cerebral blood flow was measured before and after the treatment. Statistical analysis was done by oneway ANOVA, Student t-test and t-paired sample test. The difference was considered to be significant if ppreclampsia we found increased velocity values, Pi and Ri, especially in patients with signs of threatened eclampsia, suggesting that blood vessels changes are most prominent in severe preeclampsia. Cerebral blood flow meassurements can be used as a clinical test for the prediction of eclampsia. Magnesium-sulfate (MgSO4) has a signifficant role in prophylaxis and treatment of eclampsia, and, therefore, positive influence on reduction of cerebral ishemic lesions can be expected. We can conclude that changes of the cerebral blood flow can be evaluated by evaluating blood flow velocities in the medial cerebral artery. Velocities tend

  3. Saturação de oxigênio fetal medida pela oximetria de pulso durante o trabalho de parto: relações com o ph da artéria umbilical Fetal oxygen saturation measured by pulse oximetry during labor: relation to umbilical artery pH

    Directory of Open Access Journals (Sweden)

    Edson Nunes de Morais

    1999-04-01

    Full Text Available Objetivos: estudar os níveis de saturação de oxigênio fetal (SpO2 durante o trabalho de parto pela técnica da oximetria de pulso e sua relação com o pH da artéria umbilical (AU. Pacientes e Métodos: a SpO2 fetal foi medida durante o parto por meio da técnica da oximetria de pulso em 50 casos. Comparou-se a média dos valores de SpO2 entre os dois períodos do trabalho de parto, sendo o primeiro subdividido em fases, segundo a dilatação cervical ( ou = 7,20 e ou = 30,0%. Resultados: as médias da SpO2 fetal no primeiro período do parto foram de 53,0 ± 7,3% e 44,2 ± 6,8%, e no segundo 46,8 ± 7,7% e 38,4 ± 7,1% (pH da AU > ou = 7,20 e ou = 7,20 foram de 55,1 ± 5,1% (Purpose: to study fetal oxygen saturation (SpO2 levels during labor by continuous pulse oximetry tecnique, and its relation to umbilical artery (UA pH. Patients and Methods: fetal SpO2 levels were measured during labor by the pulse oximetry technique in 50 subjects. Average values of SpO2 were compared between the first and second stage of labor, with the first stage further subdivided into phases, according to cervical dilatation of ( or = 7.20 and or = 30.0% was considered normal. Results: fetal SpO2 averages during the first stage were 53.0 ± 7.3% and 44.2 ± 6.8% (UA pH > or = 7.20 and or = 7.20 were 55.1 ± 5.1% (<=4 cm, 52.3 ± 4.6% (5-7 cm and 51.5 ± 7.2% (8-9 cm; for UA pH <7.20, the fetal SpO2 averages were 46.3 ± 5.1% (<=4 cm, 43.6 ± 6.7% (5-7 cm and 42.8 ± 5.8% (8-9 cm. Considering the UA pH, these differences were statistically significant (p<0.01. Conclusion: a significant decrease of oxygen saturation values was observed during labor when fetal pulse oximetry was used.

  4. Positron emission tomographic measurement of acute hemodynamic changes in primate middle cerebral artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Tenjin, Hiroshi; Ueda, Satoshi; Mizukawa, Norihiko [Kyoto Prefectural Univ. of Medicine (Japan); and others

    1992-10-01

    Specific hemodynamic changes in acute ischemia were investigated using a middle cerebral artery occlusion primate model and positron emission tomography. The cerebral blood flow (CBF), cerebral blood volume, oxygen extraction fraction (OEF), and cerebral metabolic rate for oxygen were measured 1, 3, and 9 hours after occlusion. OEF showed an increase in ischemic areas, and especially where CBF was below 18 ml/100 gm/min 1 hour after occlusion the OEF increased significantly (0.69[+-]0.20, p<0.05). Nine hours after occlusion, the OEF values were lower compared to those 1 and 3 hours after occlusion. Areas where CBF ranged from 18 to 31 ml/100 gm/min showed an increase in OEF at all times (p<0.05). Clearly, OEF changes remarkably in the acute stage. (author).

  5. Differentiation of normal pressure hydrocephalus and cerebral atrophy by computed tomography and spinal infusion test

    Energy Technology Data Exchange (ETDEWEB)

    Tans, J T.J. [Nijverheidsorganisatie TNO, The Hague (Netherlands). Dept. of Neurology and Research Unit TNO for Clinical Neurophysiology

    1979-01-01

    The diagnostic value of computed tomography (CT) and spinal infusion test (SIT) was investigated in 27 patients with normal pressure hydrocephalus (NPH) and 35 patients with cerebral atrophy. The most consistent CT finding of NPH was dilatation of the temporal horns, that of cerebral atrophy widening of the convexity sulci. However, 43% of patients with cerebral atrophy demonstrated no cortical atrophy. The SIT showed an excellent relation with isotope cisternography and continuous intracranial pressure recording. NPH and cerebral atrophy were correctly differentiated in 71% by CT and SIT. A normal SIT and a CT scan without the typical features of NPH exclude impairment of cerebrospinal fluid absorption. An abnormal SIT and a CT scan showing ventricular enlargement without dilatation of convexity sulci, require isotope cisternography and possibly intracranial pressure recording to determine the degree of the absorption deficit.

  6. Normal pressure hydrocephalus. Influences on cerebral hemodynamic and cerebrospinal fluid pressure--chemical autoregulation

    International Nuclear Information System (INIS)

    Meyer, J.S.; Tachibana, H.; Hardenberg, J.P.; Dowell, R.E. Jr.; Kitagawa, Y.; Mortel, K.F.

    1984-01-01

    Blood flow in the cerebral gray matter was measured in normal pressure hydrocephalus and Alzheimer disease by 133Xe inhalation. Flow values in the frontal and temporal gray matter increased after lowering cerebrospinal fluid (CSF) pressure by lumbar puncture in normal pressure hydrocephalus (p less than 0.05) and also after shunting. One case with cerebral complications did not improve clinically. In Alzheimer disease the reverse (decreases in flow in the gray matter) occurred after removal of CSF. Normal pressure hydrocephalus was associated with impaired cerebral vasomotor responsiveness during 100% oxygen and 5% carbon dioxide inhalation. This complication was restored toward normal after CSF removal and/or shunting. Cerebral blood flow measurements appear to be useful for confirming the diagnosis of normal pressure hydrocephalus and predicting the clinical benefit from shunting

  7. 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

  8. Factors which affect cerebral uptake and retention of 13NH3

    International Nuclear Information System (INIS)

    Phelps, M.E.; Raichle, M.E.; Hoffman, E.J.; Raybaud, C.

    1977-01-01

    The single pass extraction of ammonia (E) by cerebral capillaries was studied in vivo in Rhesus monkeys with 13 N. The value of E for 13 N-ammonia was found to be less than 100%, inversely related to cerebral blood flow and to be limited by the permeability of the blood brain barrier for ammonia. A vaue of the permeability surface area product was determined to be 0.0040 x 10 -4 cm 3 /sec/gm. The single pass extraction fraction, E, for 13 N-ammonia was found to be independent of arterial blood pH (in the range of 7.2 to 7.6) and of arterial blood ammonia concentration (in the range of 80-1400 μgms/100 cc). An insulin induced hypoglycemic reduction in the cerebral metabolic rate for glucose and oxygen of 54% produced a reduction in E of about 24%. When a condition of elevated arterial blood ammonia was added to hypoglycemia, the value of E and cerebral metabolic rate for oxygen remained low while the cerebral metabolic rate for glucose increased by a factor of 2.5 indicating the presence of a detoxification shunt for ammonia. Positron tomographic images of the equilibrium cross section distribution of 13 N-ammonia appeared to reflect regional differences in capillary density of the cerebral tissue

  9. Does helmet CPAP reduce cerebral blood flow and volume by comparison with Infant Flow driver CPAP in preterm neonates?

    Science.gov (United States)

    Zaramella, Patrizia; Freato, Federica; Grazzina, Nicoletta; Saraceni, Elisabetta; Vianello, Andrea; Chiandetti, Lino

    2006-10-01

    We compared neonatal helmet continuous positive airway pressure (CPAP) and the conventional nasal Infant Flow driver (IFD) CPAP in the noninvasive assessment of absolute cerebral blood flow (CBF) and relative cerebral blood volume changes (DeltaCBV) by near-infrared spectroscopy. A randomized crossover study in a tertiary referral NICU. Assessment of CBF and DeltaCBV in 17 very low birth weight infants with respiratory distress (median age 5 days) treated with two CPAP devices at a continuous distending pressure of 4 mbar. Neonates were studied for two consecutive 60-min periods with helmet CPAP and with IFD CPAP. Basal chromophore traces enabled DeltaCBV changes to be calculated. CBF was calculated in milliliters per 100 grams per minute from the saturation rise integral and rate of rise O(2)Hb-HHb. Median (range) CBF with helmet CPAP was 27.37 (9.47-48.20) vs. IFD CBF 34.74 (13.59-60.10)(p=0.049) and DeltaCBV 0.15 (0.09-0.28) with IFD and 0.13 (0.07-0.27) with helmet CPAP (NS). Using helmet and IFD CPAP, the neonates showed no difference in mean physiological parameters (transcutaneous carbon dioxide and oxygen tension, pulse oximetry saturation, heart rate, breathing rate, mean arterial blood pressure, desaturation rate, axillary temperature). Assessing CBF and DeltaCBV measured by near-infrared spectroscopy with two CPAP devices revealed no differences in relative blood volume, but CBF was lower with helmet CPAP. Greater active vasoconstriction and/or passive capillary and/or venous vessel compression seem the most likely reason, due to a positive pressure around the head, neck, and shoulders by comparison with the airway pressure.

  10. Cerebral energy metabolism during induced mitochondrial dysfunction

    DEFF Research Database (Denmark)

    Nielsen, T H; Bindslev, TT; Pedersen, S M

    2013-01-01

    In patients with traumatic brain injury as well as stroke, impaired cerebral oxidative energy metabolism may be an important factor contributing to the ultimate degree of tissue damage. We hypothesize that mitochondrial dysfunction can be diagnosed bedside by comparing the simultaneous changes...... in brain tissue oxygen tension (PbtO(2)) and cerebral cytoplasmatic redox state. The study describes cerebral energy metabolism during mitochondrial dysfunction induced by sevoflurane in piglets....

  11. Cerebral blood flow response to functional activation

    DEFF Research Database (Denmark)

    Paulson, Olaf B; Hasselbalch, Steen G; Rostrup, Egill

    2010-01-01

    Cerebral blood flow (CBF) and cerebral metabolic rate are normally coupled, that is an increase in metabolic demand will lead to an increase in flow. However, during functional activation, CBF and glucose metabolism remain coupled as they increase in proportion, whereas oxygen metabolism only inc...... the cerebral tissue's increased demand for glucose supply during neural activation with recent evidence supporting a key function for astrocytes in rCBF regulation....

  12. Noninvasive quantification of left-to-right shunt by phase contrast magnetic resonance imaging in secundum atrial septal defect: the effects of breath holding and comparison with invasive oximetry.

    Science.gov (United States)

    Yamasaki, Yuzo; Kawanami, Satoshi; Kamitani, Takeshi; Sagiyama, Koji; Sakamoto, Ichiro; Hiasa, Ken-Ichi; Yabuuchi, Hidetake; Nagao, Michinobu; Honda, Hiroshi

    2018-01-16

    To investigate the effect of breath-holding on left-to-right shunts in patients with a secundum atrial septal defect (ASD). Thirty-five consecutive patients with secundum ASDs underwent right heart catheterization and invasive oximetry. Phase-contrast magnetic resonance imaging (MRI) was performed for the main pulmonary artery and ascending aorta. All measurements were obtained during free breathing (FB) (quiet breathing; no breath-hold), expiratory breath-hold (EBH), and inspiratory breath-hold (IBH). Pulmonary circulation flow (Qp) and systemic circulation flow (Qs) were calculated by multiplying the heart rate by the stroke volume. Measurements during FB, EBH, and IBH were compared, and the differences compared to invasive oximetry were evaluated. There were significant differences among the measurements during FB, EBH, and IBH for Qp (FB, 7.70 ± 2.68; EBH, 7.18 ± 2.34; IBH, 6.88 ± 2.51 l/min); however, no significant difference was found for Qs (FB, 3.44 ± 0.74; EBH, 3.40 ± 0.83; IBH, 3.40 ± 0.86 l/min). There were significant differences among the measurements during FB, EBH, and IBH for Qp/Qs (FB, 2.38 ± 1.12; EBH, 2.24 ± 0.95; IBH, 2.14 ± 0.97). Qp/Qs during FB and EBH correlated better with Qp/Qs measured by invasive oximetry than did IBH. The limit of agreement was smaller for EBH than for FB and IBH. In patients with secundum ASDs, Qp/Qs significantly decreased with breath-holding. The accuracy of the Qp/Qs measurement by MRI compared with invasive oximetry during EBH was higher than during FB and IBH.

  13. Cerebral angiography in patients with complicated migraine

    Energy Technology Data Exchange (ETDEWEB)

    Zeiler, K.; Wessely, P.; Holzner, F.

    1985-08-01

    38 patients (mean age: 29 years) were investigated by means of complete 4-vessel angiography: all of them were suffering from complicated migraine without detectable vascular malformation. Stenoses of the great craniocervical vessels were found in 11 patients (28.9%), but there was not a single case of vascular occlusion. A correlation between the localization of the stenosis, the localization of the headache and the presumed region of the transient cerebral function disturbance was found only in a few patients. Concerning the morphological changes of the small intracranial arterial branches, there was hardly an difference between clinically affected and non-affected territories of the middle cerebral artery. The angiograms of the 38 cases of complicated migraine were compared with the angiograms of 40 patients suffering from strokes in the young and those of 49 patients with transient ischaemic attacks. There were remarkably fewer stenoses or occlusions in the great craniocervical arteries of patients suffering from complicated migraine (28.9%) than in the vessels of cases of stroke in the young (52.5%). However, the incidence was comparable with the results in patients with transient ischaemic attacks (34.7%). The degree of morphological changes in the small intracranial arterial branches is likely to depend primarily on the patient's age and less on the diagnosis. The results suggest that in almost 30% of patients with complicated migraine - even at juvenile age-stenoses of the great craniocervical vessels might be found. However, considering the fact that most of the stenoses are without haemodynamic significance and their localization is not in agreement with the clinical data, the pathogenetic value of these vessel wall changes is highly questionable. (Author).

  14. 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.

  15. 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:…

  16. 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...

  17. CT findings of cerebral fat embolism

    International Nuclear Information System (INIS)

    Mashiyama, Shoji; Kawakami, Kiyoshi; Ohtsuki, Taisuke; Ishibashi, Takao.

    1986-01-01

    A case of cerebral fat embolism following multiple bone fractures is presented. A 27-year-old patient was admitted to our clinic 50 minutes after a traffic accident. He was somnolent on admission, but his consciousness level was gradually raised and respiratory symptoms (dyspnea, bloody sputum) appeared with petechiae of his conjunctiva and chest. We diagnosed cerebral fat embolism. On CT scan we found multiple high-density areas, which gradually turned into multiple low-density areas. Subsequent cerebral atrophy and subdural effusion developed one month after the injury. This patient showed a typical clinical course and CT findings of cerebral fat embolism. (author)

  18. Genetics Home Reference: cerebral cavernous malformation

    Science.gov (United States)

    ... Additional NIH Resources (1 link) National Institute of Neurological Disorders and Stroke Educational Resources (7 links) Boston Children's Hospital: Cavernous Malformations Disease InfoSearch: Cerebral Cavernous Malformation ...

  19. 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

  20. Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position.

    Science.gov (United States)

    Buget, Mehmet Ilke; Atalar, Ata Can; Edipoglu, Ipek Saadet; Sungur, Zerrin; Sivrikoz, Nukhet; Karadeniz, Meltem; Saka, Esra; Kucukay, Suleyman; Senturk, Mert N

    2016-01-01

    The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients' internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4)min. There was a significant decrease between T0 and T1 in heart rate (80.5±11.6 vs. 75.9±14.4beats/min), MAP (105.8±21.9 vs. 78.9±18.4mmHg) and PSI (88.5±8.3 vs. 30.3±9.7) (all pstate index values (T1-T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20min. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. [Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position].

    Science.gov (United States)

    Buget, Mehmet Ilke; Atalar, Ata Can; Edipoglu, Ipek Saadet; Sungur, Zerrin; Sivrikoz, Nukhet; Karadeniz, Meltem; Saka, Esra; Kucukay, Suleyman; Senturk, Mert N

    2016-01-01

    The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients' internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4)min. There was a significant decrease between T0 and T1 in heart rate (80.5±11.6 vs. 75.9±14.4beats/min), MAP (105.8±21.9 vs. 78.9±18.4mmHg) and PSI (88.5±8.3 vs. 30.3±9.7) (all pstate index values (T1-T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20min. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. The effects of age on the spontaneous low-frequency oscillations in cerebral and systemic cardiovascular dynamics

    International Nuclear Information System (INIS)

    Peng, Tingying; Rowley, Alex B; Payne, Stephen J; Ainslie, Philip N; Murrell, Carissa; Thomas, Kate; Cotter, James D; Williams, Michael J A; George, Keith; Shave, Rob

    2008-01-01

    Although the effects of ageing on cardiovascular control and particularly the response to orthostatic stress have been the subject of many studies, the interaction between the cardiovascular and cerebral regulation mechanisms is still not fully understood. Wavelet cross-correlation is used here to assess the coupling and synchronization between low-frequency oscillations (LFOs) observed in cerebral hemodynamics, as measured using cerebral blood flow velocity (CBFV) and cerebral oxygenation (O 2 Hb), and systemic cardiovascular dynamics, as measured using heart rate (HR) and arterial blood pressure (ABP), in both old and young healthy subjects undergoing head-up tilt table testing. Statistically significant increases in correlation values are found in the interaction of cerebral and cardiovascular LFOs for young subjects (P 2 Hb and ABP–O 2 Hb), but not in old subjects under orthostatic stress. The coupling between the cerebrovascular and wider cardiovascular systems in response to orthostatic stress thus appears to be impaired with ageing

  3. Speech Respiratory Measures in Spastic Cerebral Palsied and Normal Children

    Directory of Open Access Journals (Sweden)

    Hashem Shemshadi

    2007-10-01

    Full Text Available Objective: Research is designed to determine speech respiratory measures in spastic cerebral palsied children versus normal ones, to be used as an applicable tool in speech therapy plans.  Materials & Methods: Via a comparative cross-sectional study (case–control, and through a directive goal oriented sampling in case and convenience approach for controls twenty spastic cerebral palsied and twenty control ones with age (5-12 years old and sex (F=20, M=20 were matched and identified. All possible inclusion and exclusion criteria were considered by thorough past medical, clinical and para clinical such as chest X-ray and Complete Blood Counts reviews to rule out any possible pulmonary and/or systemic disorders. Their speech respiratory indices were determined by Respirometer (ST 1-dysphonia, made and normalized by Glasgow University. Obtained data were analyzed by independent T test. Results: There were significant differences between cases and control groups for "mean tidal volume", "phonatory volume" and "vital capacity" at a=0/05 values and these values in patients were less (34% than normal children (P<0/001. Conclusion: Measures obtained are highly crucial for speech therapist in any speech therapy primary rehabilitative plans for spactic cerebral palsied children.

  4. Kinetics of 137cesium in cerebral structures and blood

    International Nuclear Information System (INIS)

    Ribas, B.; Gonzalez, M.D.; Rio, J. del; Reus, M.I.S.; Gonzalez-Baron, M.

    1987-01-01

    The old clinical use of cesium in epilepsy expresses a relation of this metal with the central nervous system. Two groups of male Wistar rats of 200 g were administered single doses of 50μCi intravenously for blood kinetics and 2μCi 137 CsCl in each lateral ventricle of the brain for the kinetics in the cerebral structures, respectively. In both cases under ether anesthesia. Blood samples of IV gouts were weighed, and cerebral structure hypothalamus, hypocampus, striatum, cortex, cerebellum, mesencephalon and medulla oblongata dissected, cleaned, washed, dried, weighed, and in both cases cpm of the samples evaluated submitting it to the gamma radiations detector. In both experimental values of the 137 CsCl kinetics are expressed and applying the retroprojection method; parameters and constants are obtained. tsub(1/2) alpha = 0.0358 h and tsub(1/2) beta = 6.7159 h. In tables the equations of the alpha and beta phases are expressed. In blood after the rapid diminution of the radioactivity in the first 5 min the equilibrium phase is reached in 30 min afterwards, and the values remain almost the same 4 h after the injection and cesium is slowly eliminated by the rat. Cerebral structures after its intracerebroventricular application show that cesium has a great uptake velocity, it is rapidly incorporated by hypothalamus and after by cortex, hypocampus, striatum, mesencephalon and medulla oblongata, the two last showing the slower incorporation. After 24 h the cesium radioactivity declines slowly and progressively. (author)

  5. MRI of cerebral ischaemia in rats with occlusion of the middle cerebral artery

    International Nuclear Information System (INIS)

    Thuomas, K.AA.; Kotwica, Z.; Bergstroem, K.; Bolander, H.; Hillered, L.; Olsson, Y.; Ponten, U.; Persson, L.

    1991-01-01

    The development of ischaemic brain oedema caused by middle cerebral artery (MCA) occlusion was studied by serial magnetic resonance imaging (MRI) in rats. Multiple spin echo sequences were used with TR = 1500 ms and TE = 30-240 ms (8 echos). Substraction images were obtained by subtracting the last three echos from the first echo. Fourteen rats were studied 3, 6, and 12 h and 1, 1.5, 3, 4, 6, and 8 days after MCA occlusion, and 2 of them also 3 and 6 weeks later. Two T2 components could be separated, a fast one representing bound water and a slow one representing free bulk water. MR showed T2 prolongation even on the first examination, and the highest values were observed 24 h after occlusion. The subsequent examinations showed a slow reduction in oedema. MR studies 3 and 6 weeks after occlusion revealed an area of very long T2, which correlated well with infarction shown by histology. The substraction images demonstrated both the infarct location and the oedematous changes in the surrounding uninfarcted tissue. MRI imaging employing T2 components and subtraction images appears to be a valuable method for observing the time course of the development and resolution of oedema in cerebral infarction. (orig.)

  6. Cerebral blood flow and oxygen metabolism in the Rett syndrome

    International Nuclear Information System (INIS)

    Yoshikawa, Hideto; Fueki, Noboru; Suzuki, Hisaharu; Sakuragawa, Norio; Iio, Masaaki

    1992-01-01

    Positron emission tomography (PET) was performed on six patients with the Rett syndrome and the results were compared with the concurrent clinical status of the patients. The cerebral metabolic rate of oxygen (CMRO 2 ) was low in five patients, and oxygen extraction fraction (OEF) was low in four patients; both had a tendency to decline with advancing age. Although the cause is unknown, it is suggested that impaired oxidative metabolism exists in the Rett syndrome. An analysis of the distribution among brain regions showed that the ratios of values for the frontal cortex to those for the temporal cortex for both the cerebral blood flow (CBF) and CMRO 2 were lower than those for the controls, which may indicate the loss of of hyperfrontality in the Rett syndrome. Distribution of brain metabolism may be immature in the Rett syndrome. (author)

  7. Study on SPECT image for children with cerebral infarction

    International Nuclear Information System (INIS)

    Xie Wenhuang; Xie Zhichun; Chen Yucai; Lin Haoxue; Zheng Aidong; Xie Hui

    1998-01-01

    To explore the diagnostic value of SPECT image for children with cerebral infarction (CCI), comparative research was made on 26 cases undergoing regional cerebral perfusion (rCP) image between SPECT imaging and CT scanning. The results showed that the rCP in the infarct and its distant area was decreased. The positive rate of SPECT and CT were 92.3% (24/26) and 84.5% (22/26) respectively. The difference was not significant (P = 0.67, P>0.05). But, the positive rate of SPECT image 2 days after onset in 9 CCI was 100% (9/9), significantly higher than 55.6% (5/9) in CT scanning (P = 0.04, P<0.05). These findings suggested that the SPECT imaging is a sensitive method for the early diagnosis of CCI, and also helpful for observation of the therapeutic effect and evaluation of the prognosis

  8. Sequential changes of sodium magnetic resonance images after cerebral hemorrhage

    International Nuclear Information System (INIS)

    Shimizu, T.; Naritomi, H.; Kuriyama, Y.; Sawada, T.

    1992-01-01

    Four patients with cerebral hemorrhage were examined serially from the acute to chronic phase by 1 H magnetic resonance imaging (MRI), 23 Na MRI and computed tomography (CT). At 1-2 days after bleeding, the 23 Na image revealed no visible signal change in the area of hemorrhage, although CT and 1 H images clearly demonstrated the existence of a hematoma in the thalamus or putamen. At 4-7 days after the hemorrhage, the 23 Na images began to exhibit a small increase in signal intensity at the hematoma site, while at 2-3 weeks, a marked increase in 23 Na signal intensity was observed. These findings suggest that the hematoma consisted mainly of a corpuscular component, with a low Na + concentration, with little serum component. 23 Na MRI appears to provide important information for understanding the evoluation of cerebral hemorrhage and for estimating the viability of cells, although its value for diagnosis may not be great. (orig./GDG)

  9. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  10. Cerebral blood flow and metabolism in multi-infarct dementia

    International Nuclear Information System (INIS)

    Ujike, Takashi; Terashi, Akiro; Soeda, Toshiyuki; Kitamura, Shin; Kato, Toshiaki; Iio, Masaaki.

    1985-01-01

    Cerebral blood flow and oxygen metabolism were studied in three aged normal volunteers and 10 patients with multi-infarct dementia (MID) by Positron Emission Tomography using O-15. The diagnosis of MID was done according to the Loeb's modified ischemic score and X-ray CT findings. The MID patients, whose X-ray CT showed localized low density areas in the subcortical white matter and basal ganglia and thalamus, were studied. No occulusion was observed at anterior cerebral artery and/or middle cerebral artery on cerebral angiography. All cases of MID were mild dementias. Regional CBF, rOEF and rCMRO 2 were measured by the steady state technique described by Terry Jones et al. The values of rCBF in MID patients were significantly low compared with those of aged normal subjects in frontal, temporal, occipital, parietal cortices and thalamus. The values of CMRO 2 in MID were significantly low in frontal, temporal, occipital cortices and thalamus compared with normal subjects'. The OEF was 0.46 in aged normal subjects, and 0.52 in MID patients. The MID patients in the early stage of dementia showed the increased oxygen extraction fraction, and this fact suggests that ischemia is a significant pathogenic mechanism in the production and progression of multi-infarct dementia. The decrease of CBF and CMRO 2 in MID compared from normal subjects' were most remarkable in frontal cortex. The impairment of mental functions in MID should be caused by the decreased neuronal activities in frontal association cortex. (author)

  11. Effects of midazolam on cerebral blood flow in human volunteers

    International Nuclear Information System (INIS)

    Forster, A.; Juge, O.; Morel, D.

    1982-01-01

    The effects of intravenously administered midazolam on cerebral blood flow were evaluated in eight healthy volunteers using the 133 Xe inhalation technique. Six minutes after an intravenous dose of 0.15 mg/kg midazolam, the cerebral blood flow decreased significantly (P less than 0.001) from a value of 40.6 +/- 3.3 to a value of 27.0 +/- 5.0 ml . 100 g-1 . min-1. Cerebrovascular resistance (CVR) increased from 2.8 +/- 0.2 to 3.9 to 0.6 mmHg/(ml . 100 g-1 . min-1)(P less than 0.001). Mean arterial blood pressure decreased significantly (P less than 0.05) from 117 +/- 8 to 109 +/- 9 mmHg and arterial carbon dioxide tension increased from 33.9 +/- 2.3 to 38.6 +/- 3.2 mmHg (P less than 0.05). Arterial oxygen tension remained stable throughout the study, 484 +/- 95 mmHg before the administration of midazolam and 453 +/- 76 mmHg after. All the subjects slept after the injection of the drug and had anterograde amnesia of 24.5 +/- 5 min. The decrease in mean arterial blood pressure was probably not important since it remained in the physiologic range for cerebral blood flow autoregulation. The increase in arterial carbon dioxide tension observed after the midazolam injection may have partially counteracted the effect of this new benzodiazepine on cerebral blood flow. Our data suggest that midazolam might be a safe agent to use for the induction of anethesia in neurosurgical patients with intracranial hypertension

  12. A Promising Approach to Integrally Evaluate the Disease Outcome of Cerebral Ischemic Rats Based on Multiple-Biomarker Crosstalk

    Directory of Open Access Journals (Sweden)

    Guimei Ran

    2017-01-01

    Full Text Available Purpose. The study was designed to evaluate the disease outcome based on multiple biomarkers related to cerebral ischemia. Methods. Rats were randomly divided into sham, permanent middle cerebral artery occlusion, and edaravone-treated groups. Cerebral ischemia was induced by permanent middle cerebral artery occlusion surgery in rats. To form a simplified crosstalk network, the related multiple biomarkers were chosen as S100β, HIF-1α, IL-1β, PGI2, TXA2, and GSH-Px. The levels or activities of these biomarkers in plasma were detected before and after ischemia. Concurrently, neurological deficit scores and cerebral infarct volumes were assessed. Based on a mathematic model, network balance maps and three integral disruption parameters (k, φ, and u of the simplified crosstalk network were achieved. Results. The levels or activities of the related biomarkers and neurological deficit scores were significantly impacted by cerebral ischemia. The balance maps intuitively displayed the network disruption, and the integral disruption parameters quantitatively depicted the disruption state of the simplified network after cerebral ischemia. The integral disruption parameter u values correlated significantly with neurological deficit scores and infarct volumes. Conclusion. Our results indicate that the approach based on crosstalk network may provide a new promising way to integrally evaluate the outcome of cerebral ischemia.

  13. Regional cerebral blood flow in schizophrenia

    International Nuclear Information System (INIS)

    Kanoh, Masayuki

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured at rest using the 133 Xe inhalation technique in 40 DSM-III-diagnosed schizophrenics (22 males, 18 females: mean age 35.0 years, range 20-49 years) and 31 age-and sex-matched normal controls (16 males, 15 females: mean age 34.3 years, range 21-49 years). The absolute value (AV) and the percent value (PV) of the rCBF in schizophrenics were compared with those in controls. Correlations between rCBF and the Brief Psychiatric Rating Scale (BPRS) scores or the performance of Wisconsin Card Sorting Test (WCST) were examined in schizophrenics. Schizophrenics showed significantly lower AVs in all brain regions examined and a significantly lower PV in the left superior frontal region than controls. The hyperfrontal rCBF distribution which was found in both hemispheres in controls, was absent in the left hemisphere in schizophrenics. In schizophrenics, superior frontal blood flows were significantly negatively correlated with the negative symptom scores of the BPRS but not with the total scores and the positive symptom scores of the BPRS. In schizophrenics, inferior frontal blood flows were significantly correlated with the number of sorting categories achieved. These results indicate that rCBF in schizophrenia is reduced in the whole brain and especially in the left superior frontal region. These findings suggest a frontal lobe dysfunction in schizophrenia. (author)

  14. 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.

  15. Let us save the brain with cerebral oximeter: Two case reports

    Directory of Open Access Journals (Sweden)

    İlknur Suidiye Şeker

    2017-01-01

    Full Text Available In the neonates, tracheal atresia and tracheoesophageal fistula (TEF surgery may result in hemodynamic instabilization, leading to cerebral perfusion insufficiency due to the retraction of the pulmonary vessels and truncus brachiocephalicus. We represented one male and one female neonates which were performed thoracoscopic primary repair of TEF through right thoracotomy at the 3th and 4th postpartum day. Anesthesia was induced using sodium thiopental (5 mg/kg, fentanyl 4 mcg, and rocuronium (0.5 mg/kg given through intravenous route. Sevoflurane 2% and 50% O2in air were used for the maintenance therapy. During the right lung compression to expose posterior esophagus, no value was observed on the pulse oximeter (PO probe placed on the right hand, and radial artery was not palpated. At the same time, oxygen saturation was observed as 96%–97% on the left foot probe. As the right cerebral oximeter values (rSO2 were rapidly decreased to 31%, the lung compression was ceased. Right pulse oximeter and right rSO2measurements return to the baseline levels. For the second case - different from the first case -both left and right rSO2was rapidly decreased to 40% levels and return to the baseline levels after was removed the retractors. Right PO and right and left cerebral rSO2values returned to baseline immediately when the retractor compression was ended During the operations involving the great vessels in neonates, cerebral perfusion could be preserved using cerebral oximeter. Cerebral oximeter is more efficient than pulse oximeter for detecting cerebral tissue oxygenation and could be helpful to minimize neuronal damage in the neonates.

  16. Dominant inheritance of cerebral gigantism.

    Science.gov (United States)

    Zonana, J; Sotos, J F; Romshe, C A; Fisher, D A; Elders, M J; Rimoin, D L

    1977-08-01

    Cerebral gigantism is a syndrome consisting of characteristic dysmorphic features, accelerated growth in early childhood, and variable degrees of mental retardation. Its etiology and pathogenesis have not been defined. Three families are presented with multiple affected members. The vertical transmission of the trait and equal expression in both sexes in these families indicates a genetic etiology with a dominant pattern of inheritance, probably autosomal. As in previously reported cases, extensive endocrine evaluation failed to define the pathogenesis of the accelerated growth present in this disorder.

  17. Models of Cerebral System Mechanics.

    Science.gov (United States)

    1986-07-20

    elements CBV and C,, are added between the brain tissue and the venous compartments, and between the cerebro - spinal fluid and the venous sinus...impact and whiplash in primates . J. Biomech., 4, 13-21. RYDER, H. W., ESPEY, F. F., KIMBELL, F. D., PENKA, E. J., ROSENAUER, A., PODOLSKY, B. and EVANS...Hirsch, A.E. (1971) Tolerances for cerebral concussion from head impact and whiplash in primates . J. Biomech. 4:13-21. Pamidi, M.R. and Advani, S.H. (1978

  18. Hyperthyroidism and cerebral venous thrombosis.

    Science.gov (United States)

    Mouton, S; Nighoghossian, N; Berruyer, M; Derex, L; Philippeau, F; Cakmak, S; Honnorat, J; Hermier, M; Trouillas, P

    2005-01-01

    The demonstration of an underlying prothrombotic condition in cerebral venous thrombosis (CVT) may have important practical consequences in terms of prevention. Thyrotoxicosis through a hypercoagulable state may be a predisposing factor for CVT. The authors present the cases of 4 patients who developed CVT and hyperthyroidism. At the acute stage, hyperthyroidism was associated with an increase in factor VIII (FVIII). At follow-up, FVIII level remained increased in 2 patients. Hyperthyroidism may have an impact on FVIII level. Accordingly in patients with hyperthyroidism and neurological symptoms, the diagnosis of CVT should be considered and an exhaustive coagulation screening may be appropriate. (c) 2005 S. Karger AG, Basel.

  19. 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

  20. Measurements of regional cerebral blood flow (rCBF) using dynamic single-photon emission computed tomography (DSPECT): Definition of a generally acceptable normal range and follow-up checks after extracranial bypass surgery

    International Nuclear Information System (INIS)

    Kreisig, T.

    1986-01-01

    The usefulness of dynamic single-photon emission computed tomography was evaluated in 50 volunteers with unobtrusive cerebral findings, who were to provide the relevant standard values. It was found that the values measured were easily reproducible. Measurements in patients showing cerebrovascular disease that were carried out before and after extracranial bypass surgery did mostly not suggest any perceivable improvement of cerebral blood flow. In isolated cases the cerebral reserve was influenced favourably, as judged from measurements after administration of acetazolamide. (MBC) [de

  1. Middle cerebral artery blood velocity during running

    NARCIS (Netherlands)

    Lyngeraa, T. S.; Pedersen, L. M.; Mantoni, T.; Belhage, B.; Rasmussen, L. S.; van Lieshout, J. J.; Pott, F. C.

    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)

  2. 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…

  3. OCULAR FINDINGS IN CHILDREN WITH CEREBRAL PALSY ...

    African Journals Online (AJOL)

    Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria. We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of ...

  4. 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...

  5. Cerebral emboli and depressive symptoms in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; Hardicre, J.; Byrne, J.; McCollum, C.N.; Burns, A.

    2006-01-01

    BACKGROUND: The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia. AIMS: To evaluate the association between spontaneous cerebral emboli

  6. 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

  7. 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.)

  8. Benzodiazepine receptor imaging with iomazenil SPECT in aphasic patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Koshi, Yasuhiko; Kitamura, Shin; Ohyama, Masashi [Nippon Medical School, Tokyo (Japan)] (and others)

    1999-08-01

    To investigate the relationship between prognosis of aphasia and neuronal damage in the cerebral cortex, we evaluated the distribution of central-type benzodiazepine receptor (BZR) binding in post-stroke aphasics with [{sup 123}I]iomazenil and SPECT. We performed iomazenil SPECT in six aphasic patients (aged from 45 to 75 years; all right-handed) with unilateral left cerebral infarction. Three patients showed signs of Broca's aphasia and the other three Wernicke's aphasia. Cerebral blood flow (CBF) imaging was performed with [{sup 123}I]iodoamphetamine (IMP). The regions of interest (ROIs) on both images were set in the cerebral cortex, cerebellar cortex and language relevant area in both hemispheres. Three patients were classified in the mild prognosis group and the other three in the moderate prognosis group. The left language-relevant area was more closely concerned with the difference in aphasic symptoms than the right one in both BZR and CBF distribution, but the ipsilateral to the contralateral ratio (I/C ratio) in the language-relevant areas in the BZR distribution was significantly lower in the moderate prognosis group than in the mild prognosis group, although no difference was seen for these values between the two groups in the CBF distribution. These results suggest that BZR imaging, which makes possible an increase in neuronal cell viability in the cerebral cortex, is useful not only for clarifying the aphasic symptoms but also for evaluating the prognosis of aphasia in patients with cerebral infarction. (author)

  9. Benzodiazepine receptor imaging with iomazenil SPECT in aphasic patients with cerebral infarction

    International Nuclear Information System (INIS)

    Koshi, Yasuhiko; Kitamura, Shin; Ohyama, Masashi

    1999-01-01

    To investigate the relationship between prognosis of aphasia and neuronal damage in the cerebral cortex, we evaluated the distribution of central-type benzodiazepine receptor (BZR) binding in post-stroke aphasics with [ 123 I]iomazenil and SPECT. We performed iomazenil SPECT in six aphasic patients (aged from 45 to 75 years; all right-handed) with unilateral left cerebral infarction. Three patients showed signs of Broca's aphasia and the other three Wernicke's aphasia. Cerebral blood flow (CBF) imaging was performed with [ 123 I]iodoamphetamine (IMP). The regions of interest (ROIs) on both images were set in the cerebral cortex, cerebellar cortex and language relevant area in both hemispheres. Three patients were classified in the mild prognosis group and the other three in the moderate prognosis group. The left language-relevant area was more closely concerned with the difference in aphasic symptoms than the right one in both BZR and CBF distribution, but the ipsilateral to the contralateral ratio (I/C ratio) in the language-relevant areas in the BZR distribution was significantly lower in the moderate prognosis group than in the mild prognosis group, although no difference was seen for these values between the two groups in the CBF distribution. These results suggest that BZR imaging, which makes possible an increase in neuronal cell viability in the cerebral cortex, is useful not only for clarifying the aphasic symptoms but also for evaluating the prognosis of aphasia in patients with cerebral infarction. (author)

  10. Cerebral protection devices for use during carotid artery angioplasty with stenting: a health technology assessment.

    Science.gov (United States)

    Menon, Devidas; Stafinski, Tania

    2006-01-01

    This study sought to examine the safety, efficacy, and economic implications of the use of cerebral protection devices during carotid artery angioplasty and stenting (CAS) in high-risk patients with severe carotid artery disease (CAD). A comprehensive search for peer- and non-peer-reviewed studies that compared carotid endarterectomy (CEA) or CAS without cerebral protection to CAS with cerebral protection and appeared in the English language literature between January 1990 and January 2005 was completed. Information from studies identified was extracted using a common data abstraction form and then critically appraised against published quality assessment criteria. Of the eight studies found, six provided information on technical or procedural success rates, with values ranging from 95.6 percent to 100 percent. Three of the four studies comparing groups of patients who received CAS with cerebral protection with those who received only CAS reported a non-statistically significantly higher 30-day incidence of death and stroke (major or minor) in the latter group. None of the three studies comparing CAS with cerebral protection to CEA demonstrated a statistically significant difference in the 30-day incidence of death, major stroke, or myocardial infarction between treatment groups. No economic analyses were found. In high-risk patients with severe CAD, the evidence suggests that CAS with cerebral protection may offer a safe and efficacious alternative to CEA, reducing the risk of embolic peri-procedural complications associated with CAS to acceptable levels.

  11. Preliminary studies of regional cerebral blood flow changes in patients with leukoaraiosis

    International Nuclear Information System (INIS)

    Li Yaming; Ren Yan; He Qiu

    1997-01-01

    PURPOSE: To investigate changes of regional cerebral blood flow (rCBF) in leukoaraiosis (LA) lesion and cortical regions and analyse the relation between rCBF changes and dementia. METHODS: Regional cerebral blood flow perfusion imaging with SPECT was performed in 49 patients with subcortical multiple cerebral infarction, including 24 cases company LA [LA(+)], 25 cases not company LA[LA(-)] and 10 normal subjects. The relative analysis was made between rCBF changes and cognitive scores. RESULTS: Compared the LA(+) with control, the rCBFs in frontal, parietal, temporal cortexes and LA lesion significantly decreased (P<0.05). The rCBF of frontal, parietal cortexes and LA lesions was also significantly decreased (P<0.05) compared with LA(-) groups. The cognitive scores were significantly related with rCBF changes in frontal cortex and LA lesion (r = 0.765, P<0.01 and r = 0.439, P<0.05). CONCLUSION: In patients with subcortical multiple cerebral infarction company LA lesion, there were extensive ischemic hypoperfusion changes in the cortical regions and LA lesion, which may response to decreased cerebral function and had certain relationship with dementia. The examination with SPECT cerebral blood flow perfusion imaging had unique advantage and value

  12. 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.

  13. CT findings in patients with cerebral palsy

    International Nuclear Information System (INIS)

    Konno, Kimiichi

    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. (Ueda, J.)

  14. Statistical parametric mapping of Tc-99m HMPAO SPECT cerebral perfusion in the normal elderly

    International Nuclear Information System (INIS)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A.

    1998-01-01

    Full text: The clinical value of Tc-99m HMPAO SPECT cerebral blood flow studies in cognitive and neuropsychiatric disorders has been well described. Currently, interpretation of these studies relies on qualitative or semi- quantitative techniques. The aim of our study is to generate statistical measures of regional cerebral perfusion in the normal elderly using statistical parametric mapping (Friston et al, Wellcome Department of Cognitive Neurology, London, UK) in order to facilitate the objective analysis of cerebral blood flow studies in patient groups. A cohort of 20 healthy, elderly volunteers, aged 68 to 81 years, was prospectively selected on the basis of normal physical examination and neuropsychological testing. Subjects with risk factors, or a history of cognitive impairment were excluded from our study group. All volunteers underwent SPECT cerebral blood flow imaging, 30 minutes following the administration of 370 MBq Tc-99m HMPAO, on a Trionix Triad XLT triple-headed scanner (Trionix Research Laboratory Twinsburg, OH) using high resolution, fan-beam collimators resulting in a system resolution of 10 mm full width at half-maximum (FWHM). The SPECT cerebral blood flow studies were analysed using statistical parametric mapping (SPM) software specifically developed for the routine statistical analysis of functional neuroimaging data. The SPECT images were coregistered with each individual's T1-weighted MR volume brain scan and spatially normalized to standardised Talairach space. Using SPM, these data were analyzed for differences in interhemispheric regional cerebral blood flow. Significant asymmetry of cerebral perfusion was detected in the pre-central gyrus at the 95th percentile. In conclusion, the interpretation of cerebral blood flow studies in the elderly should take into account the statistically significant asymmetry in interhemispheric pre-central cortical blood flow. In the future, clinical studies will be compared to statistical data sets in age

  15. In vivo assessment of the human cerebral microcirculation and its glycocalyx: A technical report.

    Science.gov (United States)

    Haeren, R H L; Rijkers, K; Schijns, O E M G; Dings, J; Hoogland, G; van Zandvoort, M A M J; Vink, H; van Overbeeke, J J

    2018-06-01

    The cerebral microcirculation and its glycocalyx, a matrix coating the luminal endothelium, are key regulators of capillary permeability and cerebral blood flow. Microvascular abnormalities are described in several neurological disorders. However, assessment of the cerebral microcirculation and glycocalyx has mainly been performed ex vivo. Here, the technical feasibility of in vivo assessment of the human cerebral microcirculation and its glycocalyx using sidestream dark field (SDF) imaging is discussed. Intraoperative assessment requires the application of a sterile drape covering the camera (slipcover). First, sublingual measurements with and without slipcover were performed in a healthy control to assess the impact of this slipcover. Subsequently, using SDF imaging, the sublingual (reference), cortical, and hippocampal microcirculation and glycocalyx were evaluated in patients who underwent resective brain surgery as treatment for drug-resistant temporal lobe epilepsy. Finally, vessel density, and the perfused boundary region (PBR), a validated gauge of glycocalyx health, were calculated using GlycoCheck © software. The addition of a slipcover affects vessel density and PBR values in a control subject. The cerebral measurements in five patients were more difficult to obtain than the sublingual ones. This was probably at least partly due to the introduction of a sterile slipcover. Results on vessel density and PBR showed similar patterns at all three measurement sites. This is the first report on in vivo assessment of the human cerebrovascular glycocalyx. Assessment of the glycocalyx is an additional application of in vivo imaging of the cerebral microcirculation using SDF technique. This method enables functional analysis of the microcirculation and glycocalyx, however the addition of a sterile slipcover affects the measurements. SDF imaging is a safe, quick, and straightforward technique to evaluate the functional cerebral microcirculation and glycocalyx

  16. Statistical parametric mapping of Tc-99m HMPAO SPECT cerebral perfusion in the normal elderly

    Energy Technology Data Exchange (ETDEWEB)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A. [Austin and Repatriation Medical Centre, Heidelberg, VIC (Australia). Departments of Nuclear Medicine and Centre for PET Neurology and Clinical Neuropsychology

    1998-06-01

    Full text: The clinical value of Tc-99m HMPAO SPECT cerebral blood flow studies in cognitive and neuropsychiatric disorders has been well described. Currently, interpretation of these studies relies on qualitative or semi- quantitative techniques. The aim of our study is to generate statistical measures of regional cerebral perfusion in the normal elderly using statistical parametric mapping (Friston et al, Wellcome Department of Cognitive Neurology, London, UK) in order to facilitate the objective analysis of cerebral blood flow studies in patient groups. A cohort of 20 healthy, elderly volunteers, aged 68 to 81 years, was prospectively selected on the basis of normal physical examination and neuropsychological testing. Subjects with risk factors, or a history of cognitive impairment were excluded from our study group. All volunteers underwent SPECT cerebral blood flow imaging, 30 minutes following the administration of 370 MBq Tc-99m HMPAO, on a Trionix Triad XLT triple-headed scanner (Trionix Research Laboratory Twinsburg, OH) using high resolution, fan-beam collimators resulting in a system resolution of 10 mm full width at half-maximum (FWHM). The SPECT cerebral blood flow studies were analysed using statistical parametric mapping (SPM) software specifically developed for the routine statistical analysis of functional neuroimaging data. The SPECT images were coregistered with each individual`s T1-weighted MR volume brain scan and spatially normalized to standardised Talairach space. Using SPM, these data were analyzed for differences in interhemispheric regional cerebral blood flow. Significant asymmetry of cerebral perfusion was detected in the pre-central gyrus at the 95th percentile. In conclusion, the interpretation of cerebral blood flow studies in the elderly should take into account the statistically significant asymmetry in interhemispheric pre-central cortical blood flow. In the future, clinical studies will be compared to statistical data sets in age

  17. Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Croughwell, N.; Lyth, M.; Quill, T.J.; Newman, M.; Greeley, W.J.; Smith, L.R.; Reves, J.G.

    1990-01-01

    We tested the hypothesis that insulin-dependent diabetic patients with coronary artery bypass graft surgery experience altered coupling of cerebral blood flow and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age-matched controls), cerebral blood flow was measured using 133Xe clearance during nonpulsatile, alpha-stat blood gas managed cardiopulmonary bypass at the conditions of hypothermia and normothermia. In diabetic patients, the cerebral blood flow at 26.6 +/- 2.42 degrees C was 25.3 +/- 14.34 ml/100 g/min and at 36.9 +/- 0.58 degrees C it was 27.3 +/- 7.40 ml/100 g/min (p = NS). The control patients increased cerebral blood flow from 20.7 +/- 6.78 ml/100 g/min at 28.4 +/- 2.81 degrees C to 37.6 +/- 8.81 ml/100 g/min at 36.5 +/- 0.45 degrees C (p less than or equal to 0.005). The oxygen consumption was calculated from jugular bulb effluent and increased from hypothermic values of 0.52 +/- 0.20 ml/100 g/min in diabetics to 1.26 +/- 0.28 ml/100 g/min (p = 0.001) at normothermia and rose from 0.60 +/- 0.27 to 1.49 +/- 0.35 ml/100 g/min (p = 0.0005) in the controls. Thus, despite temperature-mediated changes in oxygen consumption, diabetic patients did not increase cerebral blood flow as metabolism increased. Arteriovenous oxygen saturation gradients and oxygen extraction across the brain were calculated from arterial and jugular bulb blood samples. The increase in arteriovenous oxygen difference between temperature conditions in diabetic patients and controls was significantly different (p = 0.01). These data reveal that diabetic patients lose cerebral autoregulation during cardiopulmonary bypass and compensate for an imbalance in adequate oxygen delivery by increasing oxygen extraction

  18. Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Chih-Cheng; Chen, David Yen-Ting; Tseng, Ying-Chi; Lee, Kun-Yu; Chiang, Chen-Hua; Chen, Chi-Jen [Taipei Medical University, Department of Radiology, Shuang-Ho Hospital, New Taipei City (China); Taipei Medical University, School of Medicine, College of Medicine, Taipei (China); Yan, Feng-Xian [Taipei Medical University, Department of Radiology, Shuang-Ho Hospital, New Taipei City (China)

    2017-08-15

    No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P <.05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P <.001), overall nonstenting vascular (P <.001), and ipsilateral PCA (P <.05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. FVHs could be a critical predictor of a significant increase in CBF after IAS. (orig.)

  19. Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting

    International Nuclear Information System (INIS)

    Wan, Chih-Cheng; Chen, David Yen-Ting; Tseng, Ying-Chi; Lee, Kun-Yu; Chiang, Chen-Hua; Chen, Chi-Jen; Yan, Feng-Xian

    2017-01-01

    No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P <.05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P <.001), overall nonstenting vascular (P <.001), and ipsilateral PCA (P <.05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. FVHs could be a critical predictor of a significant increase in CBF after IAS. (orig.)

  20. Neonatal screening for life-threatening conditions persistent – pulmonary hypertension in newborns and critical congenital heart disease – by the method of pulse oximetry

    Directory of Open Access Journals (Sweden)

    D. I. Sadykova

    2017-01-01

    Full Text Available Research objective: to assess the diagnostic significance of the pulse oximetry performed by the newborn for the 3rd hour of life to identify critical conditions and to justify the expediency of further introduction of this technology in the work of obstetric institutions.Results. In 5 maternity hospitals of the Republic of Tatarstan, from April 2016 to February 2017, 8358 88.4% of newborns were pulsometrically screened. Positive results were obtained in 95 (1.14% patients. Because of screening, 13 newborns were diagnosed with congenital heart defects, not diagnosed in utero, in the first hours of life, five of them were critical. All newborns with critical congenital heart defects were successfully operated. Besides, 20 patients had persistent pulmonary hypertension, 30 had intrauterine pneumonia.Conclusions. The measurement of saturation at the 3rd hour of life of a newborn allows avoiding life-threatening complications in children with critical congenital heart defects and persistent pulmonary hypertension and in a stable state to transfer them to a further treatment stage.

  1. Measurement of differences in pO2 in response to perfluorocarbon/carbogen in FSa and NFSa murine fibrosarcomas with low-frequency electron paramagnetic resonance oximetry.

    Science.gov (United States)

    Halpern, H J; Yu, C; Peric, M; Barth, E D; Karczmar, G S; River, J N; Grdina, D J; Teicher, B A

    1996-05-01

    We have used very low-frequency electron paramagnetic resonance (EPR) oximetry to measure the change in oxygen concentration (delta pO2) due to change in breathing atmosphere in FSa and NFSa fibrosarcomas implanted in the legs of C3H mice infused with perfluoro-octylbromine (PFOB). Measurements in each tumor were made before and after the administration of the high-density (47% v/v) perfluorocarbon PFOB, perflubron (Alliance Pharmaceutical Corporation, San Diego, CA). Measurements in each tumor were also made, after the administration of the PFOB, both before (PFOB/air) and after the administration of carbogen (95% O2 + 5% CO2, PFOB/carbogen). Large changes (delta p02) relative to PFOB/air oxygenation were seen with the administration of PFOB/carbogen. No significant difference in oxygen concentration was seen between air-breathing mice with and without PFOB. The mean delta pO2 for FSa tumors was 13 +/- 6 torr, while the mean for NFSa fibrosarcomas was 28 +/- 7 torr. There were such large intertumor differences that the trend toward a smaller change in the more hypoxic FSa tumors was not significant (P = 0.13). This paper describes a novel method of measuring differences in oxygenation in tumor tissues. The results of such measurements indicate large differences in pO2 response to different breathing atmospheres in PFOB-infused tumors of similar histology. The intertumor delta pO2 differences may correlate with differences in radiation response.

  2. Detection of Hb Rothschild HBB: c.[112T>A or 112T>C], Through High Index of Suspicion on Abnormal Pulse Oximetry.

    Science.gov (United States)

    Alli, Nazeer A; Wessels, Piet; Rampersad, Narisha; Clark, Barnaby E; Thein, Swee Lay

    2017-03-01

    We describe a case with a low oxygen affinity hemoglobin (Hb) variant who presented with cyanosis in the absence of cardiopulmonary disease. The patient, a 27-year-old pregnant female (P1G2), complained of a productive cough and bluish discoloration of the lips that started 3 days prior to seeking attention. She had no previous episodes and has generally been in good health. A positive family history of cyanosis was obtained in one sibling. Systematic examination, notably the cardiorespiratory system, revealed no abnormalities. The arterial Hb oxygen saturation (SpO 2 ) on pulse oximetry was 81.0% and Hb separation studies revealed an Hb variant identified as Hb Rothschild [β37(C3)Trp→Arg] (HBB: c.[112 T>A or 112 T>C]) by gene sequencing. The amino acid substitution (Trp→Arg) is an important contact point at the α1β2 interface and favors a T-quaternary state of the Hb tetramer. This leads to a low oxygen affinity state, which results in premature release of oxygen and drop in oxygen saturation. In the absence of cardiopulmonary disease, a decreased oxygen saturation reading, with or without cyanosis, should arouse suspicion for a possible dysHb.

  3. Characteristics of non-cerebral coenurosis in tropical goats.

    Science.gov (United States)

    Christodoulopoulos, G; Kassab, A; Theodoropoulos, G

    2015-07-30

    The epidemiological, clinical, and biochemical profile of non-cerebral coenurosis in goats and the morphological characteristics of the responsible metacestodes (cysts) were examined in a cross-sectional survey of slaughtered goats in abattoirs of the United Arab Emirates (U.A.E.) originating from Abu Dhabi and various tropical countries. The age, country of origin, and location of each cyst in the body of goats were recorded. Blood samples collected from infected and matching healthy goats were subjected to biochemical analysis. Data on the morphological characteristics of the cysts as well as the clusters, scoleces, and rostellar hooks in one cyst from each affected carcass were collected. The data collected were subjected to statistical analysis. A total of 2,284 slaughtered goats were examined and 40 goats were diagnosed as infected with non-cerebral coenurus cysts. The prevalence of non-cerebral coenurosis was 1.75% and the degree of parasite aggregation (k) was 0.003, which is indicative of overdispersion (kgoats were palpation of large single cysts in thigh muscles and higher serum aspartate aminotransferase (AST) value. A total of 76 non-cerebral coenurus cysts from 14 different body locations were collected. No cysts were found in the brain or spinal cord. Cysts located in psoas muscles had on average significantly bigger volumes and higher numbers of scoleces and clusters compared to cysts located in other body parts (P-value=0.000). Significant differences in the morphometric measurements of the rostellar hooks were observed between cysts found in goats from different countries of origin (P-value5; R-Sq=89.4%; P-value=0.000) and between number of clusters and number of scoleces (b=25.13>1; R-Sq=79.8%; P-value=0.000) indicative of following a positive allometric growth as well as between number of clusters and volume of cysts (b=0.25<0.5; R-Sq=69.4%; P-value=0.000) indicative of following a negative allometric growth. The biological significance of the

  4. 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)

  5. 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....... social care costs and productivity costs associated with CP point to a potential gain from labour market interventions that benefit individuals with CP.......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...

  6. 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)

  7. Cerebral cortex modulation of pain

    Institute of Scientific and Technical Information of China (English)

    Yu-feng XIE; Fu-quan HUO; Jing-shi TANG

    2009-01-01

    Pain is a complex experience encompassing sensory-discriminative, affective-motivational and cognitiv e-emotional com-ponents mediated by different mechanisms. Contrary to the traditional view that the cerebral cortex is not involved in pain perception, an extensive cortical network associated with pain processing has been revealed using multiple methods over the past decades. This network consistently includes, at least, the anterior cingulate cortex, the agranular insular cortex, the primary (SⅠ) and secondary somatosensory (SⅡ) cortices, the ventrolateral orbital cortex and the motor cortex. These corti-cal structures constitute the medial and lateral pain systems, the nucleus submedius-ventrolateral orbital cortex-periaque-ductal gray system and motor cortex system, respectively. Multiple neurotransmitters, including opioid, glutamate, GABA and dopamine, are involved in the modulation of pain by these cortical structures. In addition, glial cells may also be in-volved in cortical modulation of pain and serve as one target for pain management research. This review discusses recent studies of pain modulation by these cerebral cortical structures in animals and human.

  8. 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.

  9. Photoplethysmographic signals and blood oxygen saturation values during artificial hypothermia in healthy volunteers

    International Nuclear Information System (INIS)

    Shafique, M; Kyriacou, P A

    2012-01-01

    Pulse oximetry utilizes the technique of photoplethysmography to estimate arterial oxygen saturation (SpO 2 ) values. During hypothermia, the amplitude of the photoplethysmograph (PPG) is compromised which can lead to inaccurate estimation of SpO 2 . A new mutlimode PPG/pulse oximeter sensor was developed to investigate the behaviour of PPGs during conditions of induced hypothermia (hand immersed in an ice bath). PPG measurements from 20 volunteers were conducted and SpO 2 values were estimated at all stages of the experiment. Good quality PPG signals were observed from the majority of the volunteers at almost all hand temperatures. At low temperature ranges, from 13 to 21 °C, the failure rate to estimate SpO 2 values from the multimode transreflectance PPG sensor was 2.4% as compared to the commercial pulse oximeter with a failure rate of 70%. (paper)

  10. Effect of age on cerebral blood flow during hypothermic cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Brusino, F.G.; Reves, J.G.; Smith, L.R.; Prough, D.S.; Stump, D.A.; McIntyre, R.W.

    1989-01-01

    Cerebral blood flow was measured in 20 patients by xenon 133 clearance methodology during nonpulsatile hypothermic cardiopulmonary bypass to determine the effect of age on regional cerebral blood flow during these conditions. Measurements of cerebral blood flow at varying perfusion pressures were made in patients arbitrarily divided into two age groups at nearly identical nasopharyngeal temperature, hematocrit value, and carbon dioxide tension and with equal cardiopulmonary bypass flows of 1.6 L/min/m2. The range of mean arterial pressure was 30 to 110 mm Hg for group I (less than or equal to 50 years of age) and 20 to 90 mm Hg for group II (greater than or equal to 65 years of age). There was no significant difference (p = 0.32) between the mean arterial pressure in group I (54 +/- 28 mm Hg) and that in group II (43 +/- 21 mm Hg). The range of cerebral blood flow was 14.8 to 29.2 ml/100 gm/min for group I and 13.8 to 37.5 ml/100 gm/min for group II. There was no significant difference (p = 0.37) between the mean cerebral blood flow in group I (21.5 +/- 4.6 ml/100 gm/min) and group II (24.3 +/- 8.1 ml/100 gm/min). There was a poor correlation between mean arterial pressure and cerebral blood flow in both groups: group I, r = 0.16 (p = 0.67); group II, r = 0.5 (p = 0.12). In 12 patients, a second cerebral blood flow measurements was taken to determine the effect of mean arterial pressure on cerebral blood flow in the individual patient. Changes in mean arterial pressure did not correlate with changes in cerebral blood flow (p less than 0.90). We conclude that age does not alter cerebral blood flow and that cerebral blood flow autoregulation is preserved in elderly patients during nonpulsatile hypothermic cardiopulmonary bypass

  11. Dynamic cerebral autoregulation changes during sub-maximal handgrip maneuver.

    Directory of Open Access Journals (Sweden)

    Ricardo C Nogueira

    Full Text Available PURPOSE: We investigated the effect of handgrip (HG maneuver on time-varying estimates of dynamic cerebral autoregulation (CA using the autoregressive moving average technique. METHODS: Twelve healthy subjects were recruited to perform HG maneuver during 3 minutes with 30% of maximum contraction force. Cerebral blood flow velocity, end-tidal CO₂ pressure (PETCO₂, and noninvasive arterial blood pressure (ABP were continuously recorded during baseline, HG and recovery. Critical closing pressure (CrCP, resistance area-product (RAP, and time-varying autoregulation index (ARI were obtained. RESULTS: PETCO₂ did not show significant changes during HG maneuver. Whilst ABP increased continuously during the maneuver, to 27% above its baseline value, CBFV raised to a plateau approximately 15% above baseline. This was sustained by a parallel increase in RAP, suggestive of myogenic vasoconstriction, and a reduction in CrCP that could be associated with metabolic vasodilation. The time-varying ARI index dropped at the beginning and end of the maneuver (p<0.005, which could be related to corresponding alert reactions or to different time constants of the myogenic, metabolic and/or neurogenic mechanisms. CONCLUSION: Changes in dynamic CA during HG suggest a complex interplay of regulatory mechanisms during static exercise that should be considered when assessing the determinants of cerebral blood flow and metabolism.

  12. Dynamic Cerebral Autoregulation Changes during Sub-Maximal Handgrip Maneuver

    Science.gov (United States)

    Nogueira, Ricardo C.; Bor-Seng-Shu, Edson; Santos, Marcelo R.; Negrão, Carlos E.; Teixeira, Manoel J.; Panerai, Ronney B.

    2013-01-01

    Purpose We investigated the effect of handgrip (HG) maneuver on time-varying estimates of dynamic cerebral autoregulation (CA) using the autoregressive moving average technique. Methods Twelve healthy subjects were recruited to perform HG maneuver during 3 minutes with 30% of maximum contraction force. Cerebral blood flow velocity, end-tidal CO2 pressure (PETCO2), and noninvasive arterial blood pressure (ABP) were continuously recorded during baseline, HG and recovery. Critical closing pressure (CrCP), resistance area-product (RAP), and time-varying autoregulation index (ARI) were obtained. Results PETCO2 did not show significant changes during HG maneuver. Whilst ABP increased continuously during the maneuver, to 27% above its baseline value, CBFV raised to a plateau approximately 15% above baseline. This was sustained by a parallel increase in RAP, suggestive of myogenic vasoconstriction, and a reduction in CrCP that could be associated with metabolic vasodilation. The time-varying ARI index dropped at the beginning and end of the maneuver (p<0.005), which could be related to corresponding alert reactions or to different time constants of the myogenic, metabolic and/or neurogenic mechanisms. Conclusion Changes in dynamic CA during HG suggest a complex interplay of regulatory mechanisms during static exercise that should be considered when assessing the determinants of cerebral blood flow and metabolism. PMID:23967113

  13. IGF-1 deficiency impairs cerebral myogenic autoregulation in hypertensive mice.

    Science.gov (United States)

    Toth, Peter; Tucsek, Zsuzsanna; Tarantini, Stefano; Sosnowska, Danuta; Gautam, Tripti; Mitschelen, Matthew; Koller, Akos; Sonntag, William E; Csiszar, Anna; Ungvari, Zoltan

    2014-12-01

    Aging impairs autoregulatory protection in the brain, exacerbating hypertension-induced cerebromicrovascular injury, neuroinflammation, and development of vascular cognitive impairment. Despite the importance of the age-related decline in circulating insulin-like growth factor-1 (IGF-1) levels in cerebrovascular aging, the effects of IGF-1 deficiency on functional adaptation of cerebral arteries to high blood pressure remain elusive. To determine whether IGF-1 deficiency impairs autoregulatory protection, hypertension was induced in control and IGF-1-deficient mice (Igf1(f/f)+TBG-iCre-AAV8) by chronic infusion of angiotensin-II. In hypertensive control mice, cerebral blood flow (CBF) autoregulation was extended to higher pressure values and the pressure-induced tone of middle cerebral arteries (MCAs) was increased. In hypertensive IGF-1-deficient mice, autoregulation was markedly disrupted, and MCAs did not show adaptive increases in myogenic tone. In control mice, the mechanism of adaptation to hypertension involved upregulation of TRPC channels in MCAs and this mechanism was impaired in hypertensive IGF-1-deficient mice. Likely downstream consequences of cerebrovascular autoregulatory dysfunction in hypertensive IGF-1-deficient mice included exacerbated disruption of the blood-brain barrier and neuroinflammation (microglia activation and upregulation of proinflammatory cytokines and chemokines), which were associated with impaired hippocampal cognitive function. Collectively, IGF-1 deficiency impairs autoregulatory protection in the brain of hypertensive mice, potentially exacerbating cerebromicrovascular injury and neuroinflammation mimicking the aging phenotype.

  14. Nuclide imaging and computed tomography in cerebral vascular disease

    International Nuclear Information System (INIS)

    Chiu, L.C.; Christie, J.H.; Schapiro, R.L.

    1977-01-01

    This report presents our experience with computed tomographic and radionuclide scans in 224 patients with ischemic or hemorrhagic infarcts or intracerebral hematomas secondary to cerebral occlusive vascular diseases. The results vary according to the site of vascular occlusion. The radionuclide angiograms and static scintigrams show four distinct patterns in cases of occlusion of the middle cerebral artery. Computed tomographic scans exhibit less variation in appearance and have a higher sensitivity in cases of recent ischemic infarction. The ''tentorial confluence sign'' is an important finding on static scintigrams in patients with occipital infarction; if this sign is not present, this diagnosis should be suspect. Earlier reports have established the value of computed tomography and radionuclide scans in the evaluation of cerebral infarction. In individual cases, however, each of these modalities may render nondiagnostic or false negative findings; combining both types of examinations and comparing results yield a greater likelihood of an accurate diagnosis of cerebrovascular disease. Computed tomography is clearly more valuable than radionuclide scans in the diagnosis and follow-up of hemorrhagic infarcts or parenchymal hematomas

  15. Augmented hypoxic cerebral vasodilation in men during 5 days at 3,810 m altitude

    DEFF Research Database (Denmark)

    Jensen, J B; Sperling, B; Severinghaus, J W

    1996-01-01

    , at the lower PCO2 due to the logarithmic relationship of PCO2 to CSF pH. This change was not significant after correction to log PCO2. We conclude that the cerebral vascular response to acute isocapnic hypoxia may increase during acclimatization at high altitude. The mechanism is unknown but is presumably......The fractional increase in cerebral blood flow (CBF) velocity (VCBF) from the control value with 5-min steps of isocapnic hypoxia and hyperoxic hypercapnia was measured by transcranial Doppler in six sea-level native men before and during a 5-day sojourn at 3,810 m altitude to determine whether...... cerebral vasoreactivity to low arterial O2 saturation (SaO2) gradually increased [as does the hypoxic ventilatory response (HVR)] or diminished (adapted, in concert with known slow fall of CBF) at altitude. A control resting PCO2 value was chosen each day during preliminary hyperoxia to set ventilation...

  16. Values Research

    Science.gov (United States)

    2009-10-01

    that individualistic employees in individualistic organizations and collectivistic employees in collectivistic organizations show greater job...with Parsons’ causal assumption, in the nineties values were recognized on top of the cultural control –values control norms which in turn control...determines intention which may end in behavior. 7 Defining Human Values Cross- cultural theories on values emerged in the 80s developed by three main

  17. Noncontrast computed tomographic Hounsfield unit evaluation of cerebral venous thrombosis: a quantitative evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Besachio, David A. [University of Utah, Department of Radiology, Salt Lake City (United States); United States Navy, Bethesda, MD (United States); Quigley, Edward P.; Shah, Lubdha M.; Salzman, Karen L. [University of Utah, Department of Radiology, Salt Lake City (United States)

    2013-08-15

    Our objective is to determine the utility of noncontrast Hounsfield unit values, Hounsfield unit values corrected for the patient's hematocrit, and venoarterial Hounsfield unit difference measurements in the identification of intracranial venous thrombosis on noncontrast head computed tomography. We retrospectively reviewed noncontrast head computed tomography exams performed in both normal patients and those with cerebral venous thrombosis, acquiring Hounsfield unit values in normal and thrombosed cerebral venous structures. Also, we acquired Hounsfield unit values in the internal carotid artery for comparison to thrombosed and nonthrombosed venous structures and compared the venous Hounsfield unit values to the patient's hematocrit. A significant difference is identified between Hounsfield unit values in thrombosed and nonthrombosed venous structures. Applying Hounsfield unit threshold values of greater than 65, a Hounsfield unit to hematocrit ratio of greater than 1.7, and venoarterial difference values greater than 15 alone and in combination, the majority of cases of venous thrombosis are identifiable on noncontrast head computed tomography. Absolute Hounsfield unit values, Hounsfield unit to hematocrit ratios, and venoarterial Hounsfield unit value differences are a useful adjunct in noncontrast head computed tomographic evaluation of cerebral venous thrombosis. (orig.)

  18. Noncontrast computed tomographic Hounsfield unit evaluation of cerebral venous thrombosis: a quantitative evaluation

    International Nuclear Information System (INIS)

    Besachio, David A.; Quigley, Edward P.; Shah, Lubdha M.; Salzman, Karen L.

    2013-01-01

    Our objective is to determine the utility of noncontrast Hounsfield unit values, Hounsfield unit values corrected for the patient's hematocrit, and venoarterial Hounsfield unit difference measurements in the identification of intracranial venous thrombosis on noncontrast head computed tomography. We retrospectively reviewed noncontrast head computed tomography exams performed in both normal patients and those with cerebral venous thrombosis, acquiring Hounsfield unit values in normal and thrombosed cerebral venous structures. Also, we acquired Hounsfield unit values in the internal carotid artery for comparison to thrombosed and nonthrombosed venous structures and compared the venous Hounsfield unit values to the patient's hematocrit. A significant difference is identified between Hounsfield unit values in thrombosed and nonthrombosed venous structures. Applying Hounsfield unit threshold values of greater than 65, a Hounsfield unit to hematocrit ratio of greater than 1.7, and venoarterial difference values greater than 15 alone and in combination, the majority of cases of venous thrombosis are identifiable on noncontrast head computed tomography. Absolute Hounsfield unit values, Hounsfield unit to hematocrit ratios, and venoarterial Hounsfield unit value differences are a useful adjunct in noncontrast head computed tomographic evaluation of cerebral venous thrombosis. (orig.)

  19. Magnetic resonance imaging in acute stage of cerebral ischemia

    International Nuclear Information System (INIS)

    Yamagata, Sen; Kikuchi, Haruhiko; Ihara, Ikuo

    1986-01-01

    The value of the nuclear magnetic resonance image (MRI) was investigated in the acute stage of experimental cerebral ischemia. The MRI system employed was designed for clinical use, and the superconducting magnet was operated at a field strength of 1.5 tesla. Ischemic insult was made by transorbital occlusion of the middle cerebral artery (MCA) permanently in 4 cats and temporarily in 2 cats. After MCA occlusion the regional cerebral blood flow (rCBF) was measured on the affected cortex, and 5 cats with rCBF below 10 ml/100 g/min and one with rCBF over 15 ml/100 g/min were studied. In the permanent occlusion group, MRI was performed every 2 hours from 4 to 12 hours after MCA occlusion and another MRI was carried out 20 min after gadolinium-diethylenetriamine-pentaacetic acid (Gd-DTPA) intravenous administration. The earliest changes were found 6 to 8 hours after MCA occlusion on the spin echo image (repetition time = 1.4 sec, echo time = 70 msec) in 3 cats with severe ischemia. It was postulated that the ischemic lesion could be depicted less than 6 hours on more T 2 -weighted images. The increased intensity area was markedly enhanced with Gd-DTPA 12 hours after occlusion. In the recirculation group, the increased intensity area was observed on enhanced MRI in a cat with recirculation as early as one hour after MCA occlusion, although it was not found on the plain MRI. In the other cat with recirculation after 2 hours' occlusion, definite lesion was found in all parameter images without enhancement. The results suggest that changes in cerebral ischemia can be obtained on the MRI earlier than X-ray computed tomography, and that it may be possible to determine the severity of the ischemic brain injury by the MRI findings. (author)

  20. [Maturation of cerebral somatosensory evoked potentials].

    Science.gov (United States)

    Cadilhac, J; Zhu, Y; Georgesco, M; Echenne, B; Rodiere, M

    1985-07-01

    Cerebral somatosensory evoked potentials (SEPs) were elicited by stimulation of the median nerve and/or posterior tibial nerve in 117 children of 1 day to 16 years old. A major negative wave (N) was consistently recorded from the parietal region of the scalp when the arm was stimulated. The peak latency, the onset latency, the rising time and the duration of H wave are closely correlated with age and body length. The latencies are shortest in the subjects of 1-3 years old. SEPs to lower extremity stimulation were inconstant in the infants before the age of one. The major positive wave (P) has a variable topographic distribution along the middle line, over the scalp. The latencies are also very variable in the different subjects of the same age as well as in the same subject with different locations of active electrode. Among the parameters studied as for N wave, only the rising time of P wave is significantly correlated with age. The latencies of P wave have the shortest value in the subjects of 1-3 years old. The comparison of SEPs to upper and to lower limb stimulations shows that there is no relationship between them in respect to their morphology and amplitude. The minimum value of the latencies of N and P waves was observed at the same age but the difference between the peak latencies of P and N waves in the same subject increases considerably after 2 years of age and reaches the adult value after 5 years of age. These resultats indicate that the maturation of the peripheral somatosensory pathways proceeds at a higher rate than that of the central somatosensory pathways, that the maturation of the somatosensory pathways of the upper limb precedes that of the lower limb, and that the rising time of N or P waves is a good index of cortical maturation. The clinical utility of these SEPs in pediatrics is discussed.