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Sample records for cerebral oximetry values

  1. Cerebral oximetry in preterm infants

    DEFF Research Database (Denmark)

    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...

  2. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

    Vretzakis, George; Georgopoulou, Stauroula; Stamoulis, Konstantinos; Stamatiou, Georgia; Tsakiridis, Kosmas; Katsikogianis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Mpakas, Andreas; Beleveslis, Thomas; Koletas, Alexander; Siminelakis, Stavros N.; Zarogoulidis, Konstantinos

    2014-01-01

    Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients. PMID:24672700

  3. 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 units...

  4. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    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 units...

  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. Cerebral Oximetry in Ugandan Children With Severe Anemia: Clinical Categories and Response to Transfusion.

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    Dhabangi, Aggrey; Ainomugisha, Brenda; Cserti-Gazdewich, Christine; Ddungu, Henry; Kyeyune, Dorothy; Musisi, Ezra; Opoka, Robert; Stowell, Christopher P; Dzik, Walter H

    2016-10-01

    Severe anemia, defined as a hemoglobin level of less than 5.0 g/dL, affects millions of children worldwide. The brain has a high basal demand for oxygen and is especially vulnerable to hypoxemia. Previous studies have documented neurocognitive impairment in children with severe anemia. Data on cerebral tissue oxygenation in children with severe anemia and their response to blood transfusion are limited. To measure hemoglobin saturation in cerebral tissue (cerebral tissue oxygen saturation [tSo2]) before, during, and after blood transfusion in a cohort of children presenting to hospital with severe anemia. This was a prospective, observational cohort study conducted from February 2013 through May 2015 and analyzed in July 2015 at a university hospital pediatric acute care facility in Kampala, Uganda, of 128 children, ages 6 to 60 months who were enrolled in a larger clinical trial, with a presenting hemoglobin level of less than 5.0 g/dL and a blood lactate level greater than 5mM. Most children had either malaria or sickle cell disease. Red blood cell (RBC) transfusion given as 10 mL/kg over 120 minutes. Clinical and laboratory characteristics of children with pretransfusion cerebral tSo2 levels less than 65%, 65% to 75%, and greater than 75%. Change in cerebral tSo2 as a result of transfusion. Of 128 children included in the study, oximetry results in 8 cases were excluded owing to motion artifacts; thus, 120 were included in this analysis. Cerebral tSo2 values prior to transfusion ranged from 34% to 87% (median, 72%; interquartile range [IQR], 65%-76%). Eighty-one children (67%) demonstrated an initial cerebral tSo2 level (≤75%) corresponding to an oxygen extraction ratio greater than 0.36. Patients with sickle cell disease (n = 17) and malaria (n = 15) contributed in nearly equal numbers to the subgroup with an initial cerebral tSo2 (children failed to achieve a tSo2 level greater than 75%. Severe anemia in children is frequently associated with low

  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...

  8. Cerebral oximetry and cerebral blood flow monitoring in 2 pediatric survivors with out-of-hospital cardiac arrest.

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    Abramo, Thomas; Aggarwal, Nitin; Kane, Ian; Crossman, Kristen; Meredith, Mark

    2014-04-01

    In pediatric out-of-hospital cardiac arrest (POHCA), cardiovascular monitoring tools have improved resuscitative endeavors and cardiovascular outcomes but with still poor neurologic outcomes. Regarding cardiac arrest in patients with congenital heart disease during surgery, the application of cerebral oximetry with blood volume index (BVI) during the resuscitation has shown significant results and prognostic significance. We present 2 POHCA patients who had cerebral oximetry with BVI monitoring during their arrest and postarrest phase in the emergency department and its potential prognostic aspect.Basic procedures include left and right cerebral oximetry with BVI monitoring at every 5-second interval during cardiac arrest, resuscitation, and postarrest in 2 POHCA patients in the pediatric emergency department.Regional cerebral tissue oxygen saturation (rSo2) with BVI readings in these 2 POHCA survivors demonstrated interesting cerebral physiology, blood flow, and potential prognostic outcome. In 1 patient, the reference range of cerebral rSo2 with positive blood flow during arrest and postarrest phases consistently occurred. This neurologic monitoring had its significance when the resuscitation effectiveness was used and end-tidal CO2 changes were lost. The other patient's cerebral rSo2 with simultaneous BVI readings and trending showed the effectiveness of the emergency medical services (EMS) resuscitation.Cerebral oximetry with cerebral blood flow index monitoring in these POHCA survivors demonstrates compelling periarrest and postarrest cerebral physiology information and prognostication. Cerebral oximetry with cerebral BVI monitoring during these arrest phases has potential as a neurologic monitor for the resuscitative intervention's effectiveness and its possible neurologic prognostic application in the pediatric OCHA patients.

  9. Evaluation of cerebral oximetry during endovascular treatment of carotid-cavernous fistula

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    Dujovny, Manuel; Misra, Mukesh; Alp, M. Serdar; Debrun, Gerard; Charbel, F. T.; Aletich, Victor; Ausman, James I.

    1997-08-01

    Endovascular treatment of carotid cavernous fistula is done routinely in our institution. We have been monitoring these patients with transcranial cerebral oximetry. The transcranial cerebral oximeter is a reliable, low-cost, non-invasive device that provides real-time evaluation of regional brain oxygen saturation during and after endovascular treatment of cerebrovascular diseases. We used the INVOS 3100A (Somanetics, Troy, MI) in our study. We discuss seven patients with carotid-cavernous fistulas treated by endovascular balloon occlusion, each monitored continuously before, during, and after the procedure with transcranial cerebral oximetry. The cerebral oxygen saturation depicted was directly related to the side of the venous drainage of the fistula, with the brain oxygen saturation 15 - 20% higher on the side of the venous drainage. Following endovascular occlusion of the fistula, oxygen saturation gradually became equal on both sides. In our patients treated for carotid-cavernous fistula, we evaluated the sensitivity and usefulness of cerebral oximetry as an important non-invasive monitoring tool for the endovascular treatment of carotid-cavernous fistula.

  10. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

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

    2015-01-01

    in eight European countries. PARTICIPANTS: 166 extremely preterm infants born before 28 weeks of gestation: 86 were randomised to cerebral NIRS monitoring and 80 to blinded NIRS monitoring. The only exclusion criterion was a decision not to provide life support. INTERVENTIONS: Monitoring of cerebral...... 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......-85% for cerebral oxygenation multiplied by the mean absolute deviation, expressed in %hours (burden of hypoxia and hyperoxia). One hour with an oxygenation of 50% gives 5%hours of hypoxia. Secondary outcomes were all cause mortality at term equivalent age and a brain injury score assessed by cerebral...

  11. A comparison of pulse oximetry and cerebral oxygenation in children with severe sleep apnea-hypopnea syndrome: a pilot study.

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    Olmo Arroyo, Jorge; Khirani, Sonia; Amaddeo, Alessandro; Griffon, Lucie; De Sanctis, Livio; Pouard, Philippe; Fauroux, Brigitte

    2017-05-31

    Near infrared spectroscopy (NIRS) has been used to assess the impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) on cerebral oxygenation. However, the relationship between the variations in the cerebral tissue oxygen saturation (ΔTOI) and pulse oximetry (ΔSpO2 ) has not been assessed in children with OSAHS. Consecutive clinically stable children with severe OSAHS [apnea-hypopnea index (AHI) >15 events h(-1) ] diagnosed during a night-time polygraphy with simultaneous recording of cerebral oxygenation with NIRS (NIRO-200NX, Hamamatsu Photonics KK) were included between September 2015 and June 2016. Maximal ΔSpO2 (SpO2 drop from the value preceding desaturation to nadir) and concomitant variations in transcutaneous carbon dioxide (ΔPtcCO2 ), maximal ΔTOI and maximal variations in cerebral oxygenated (O2 Hb) and deoxygenated (HHb) haemoglobin were reported. The relationships between ΔSpO2 , ΔPtcCO2 and ΔTOI, ΔO2 Hb and ΔHHb were investigated. The data from five children (three boys, aged 9.6 ± 6.7 years, AHI 16-91 events h(-1) ) were analysed. Strong correlations were found between ΔSpO2 and ΔTOI (r = 0.887, P < 0.001), but also with ΔO2 Hb and ΔHHb with a particular pattern in the youngest child with a dark skin pigmentation. Mean ΔSpO2 was 20 ± 17% and mean ΔTOI was 8 ± 7%. Maximal ΔSpO2 of approximately 70% were coupled with ΔTOI of no more than 35%. ΔPtcCO2 correlated only weakly with the cerebral oxygenation indexes. This pilot study shows a strong relationship between pulse oximetry and cerebral oxygenation in children with OSAHS, with lower changes in TOI compared to SpO2 . Future studies should address the clinical impact of respiratory events on cerebral oxygenation and its consequences. © 2017 European Sleep Research Society.

  12. Jugular venous oximetry

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    Avanish Bhardwaj

    2015-01-01

    Full Text Available The measurement of saturation of venous blood as it drains out of brain by sampling it from the jugular bulb provides us with an estimate of cerebral oxygenation, cerebral blood flow and cerebral metabolic requirement. Arterio-jugular venous difference of the oxygen content (AVDO 2 and jugular venous oxygen saturation (SjVO 2 values per se helps clinicians in identifying the impairment of cerebral oxygenation due to various factors thereby prompting implementation of corrective measures and the prevention of secondary injury to the brain due to ischaemia. SjVO 2 values are also used for prognostication of patients after traumatic brain injury and in other clinical situations. Sampling and measuring SjVO 2 intermittently or continuously using fibreoptic oximetry requires the tip of the catheter to be placed in the jugular bulb, which is a relatively simple bedside procedure. In the review below we have discussed the relevant anatomy, physiology, techniques, clinical applications and pitfalls of performing jugular venous oximetry as a tool for measurement of cerebral oxygenation.

  13. Impact of Intraoperative Events on Cerebral Tissue Oximetry in Patients Undergoing Cardiopulmonary Bypass

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    Severdija, E.E.; Vranken, N.P.; Teerenstra, S.; Ganushchak, Y.M.; Weerwind, P.W.

    2015-01-01

    Previous studies showed that decreased cerebral saturation during cardiac surgery is related to adverse postoperative outcome. Therefore, we investigated the influence of intraoperative events on cerebral tissue saturation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A t

  14. Higher temporal resolution is necessary for continuous-wave near -infrared spectrophotometric monitors in both cerebral and muscular tissue oximetry

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

    1998-01-01

    Conventional near infrared spectrophotometric monitors have temporal resolution of less than about 1 Hz. However, physiological Hb signals such as pulsation and muscle contraction have higher frequency than 1 Hz. Insufficient sampling rates inevitably lead aliasing of the recorded signals in tissue oximetry for both brain and muscle. Cerebral Hb signals (57 y.o. female artificially ventilated under general anesthesia) and thigh muscle (22 y.o. male with 20 W - 240 W exercise at 1 Hz cycling in semirecumbent ergometer) were measured with NIRS monitor with temporal resolution of 10 Hz (OMRON Co. Ltd., Japan). The detail of physiological fluctuations such as pulsation, ventilation, and muscle pumping was clearly recognized with a 10 Hz sampling. The comparison with recalculated waveforms at slower sampling rate (0.5 Hz, 1 Hz, 2 Hz) revealed that with slower sampling than 1 Hz cerebral respiratory waves were deformed by pulsation, and that magnitudes of muscle pumping could not be properly evaluated in dynamic exercise. In both pulsatile and muscle contractile cycle a phase delay between oxygenated component and deoxygenated one was also detected, which has been overlooked by conventional NIRS monitoring.

  15. Impact of Intraoperative Events on Cerebral Tissue Oximetry in Patients Undergoing Cardiopulmonary Bypass.

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    Ševerdija, Ervin E; Vranken, Nousjka P A; Teerenstra, Steven; Ganushchak, Yuri M; Weerwind, Patrick W

    2015-03-01

    Previous studies showed that decreased cerebral saturation during cardiac surgery is related to adverse postoperative outcome. Therefore, we investigated the influence of intraoperative events on cerebral tissue saturation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A total of 52 adult patients who underwent cardiac surgery using pulsatile CPB were included in this prospective explorative study. Cerebral tissue oxygen saturation (SctO2) was measured in both the left and right cerebral hemisphere. Intraoperative events, involving interventions performed by anesthesiologist, surgeon, and clinical perfusionist, were documented. Simultaneously, in-line hemodynamic parameters (partial oxygen pressure, partial carbon dioxide pressure, hematocrit, arterial blood pressure, and CPB flow rates) were recorded. Cerebral tissue saturation was affected by anesthetic induction (p retractor (p cardiac surgery. Future studies are needed to identify methods of mitigating periods of reduced cerebral saturation.

  16. Oxygen Saturation Reference Value by Percutaneous Pulse Oximetry in Asymptomatic Newborn Babies in Nigeria: A Cross-Sectional Study

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    Obumneme Ezeanosike

    2016-08-01

    Full Text Available About 1/4 of all neonatal deaths in Nigeria are caused by birth asphyxia. Normal values of oxygen saturation vary according to regional altitudes. They are important for the screening of cyanotic congenital heart diseases and during newborn resuscitation. There is a dearth of such information in Nigeria. We determined reference values for oxygen saturation by pulse oximetry (SpO2 in asymptomatic newborns aged ≤7 days in Enugu at an altitude of 180 m. The study was cross-sectional. Neonates weighing ≥1500 g at birth were enrolled consecutively. Pre-and post-ductal oxygen saturation was measured using a Datex-Ohmeda Tuffsat® pulse oximeter with neonatal probes. Five hundred and fourteen babies comprising of 24 (4.4% preterm and 490 (95.3% term neonates were studied. The mean pre-ductal SpO2 of all babies was 96.1% ± 1.4% and higher than mean post-ductal SpO2 of 95.9% ± 1.4% (p = 0.022. The mean pre-ductal SpO2 were 96.1% ± 1.5% and 96.1% ± 1.3%, (p = 1.000 for males and females, respectively. The mean pre-ductal SpO2 values were higher than the mean post-ductal SpO2 for the corresponding post-natal ages.

  17. Pulse oximetry in severe anaemia

    DEFF Research Database (Denmark)

    Ramsing, T; Rosenberg, J

    1992-01-01

    Measurement of arterial oxygen saturation by pulse oximetry was performed in two patients with acute and chronic anaemia (haemoglobin concentrations: 2.9 mmol/l (4.7 g/dl) and 1.9 mmol/l (3.0 g/dl), respectively) using a Radiometer OXI and a Nellcor N-200 pulse oximeter. The two oximeters read...... alternating different values in the two patients. In conclusion, pulse oximeters are able to give a value for oxygen saturation even at extreme anaemia, and when a high value is given, it possibly reflects arterial oxygen saturation. The value of pulse oximetry in severe anaemia is discussed....

  18. 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

  19. 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

  20. Continuous pulse oximetry in acute hemiparetic stroke

    NARCIS (Netherlands)

    Elting, JW; Stewart, R; den Arend, A; De Keyser, J; Sulter, G.

    2000-01-01

    Background and purpose: Hypoxemia can adversely affect ischemic brain tissue in laboratory animals. The aim of this study was to assess the Value of early continuous monitoring with pulse oximetry in detecting arterial oxygen desaturations in patients with acute hemiparetic stroke, and the effects

  1. 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

  2. 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

  3. Pulse oximetry for perioperative monitoring

    DEFF Research Database (Denmark)

    Pedersen, Tom; Møller, Ann Merete; Hovhannisyan, Karen

    2009-01-01

    Pulse oximetry is extensively used in the perioperative period and might improve patient outcomes by enabling an early diagnosis and, consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomized clinical trials of pulse oximetry...

  4. Pulse oximetry for perioperative monitoring

    DEFF Research Database (Denmark)

    Pedersen, Tom; Nicholson, Amanda; Hovhannisyan, Karen

    2014-01-01

    . Results indicated that hypoxaemia was reduced in the pulse oximetry group, both in the operating theatre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the pulse oximetry group was 1.5 to three times less. Postoperative cognitive function was independent...... postoperative complications or even death. Only a few randomized clinical trials of pulse oximetry during anaesthesia and in the recovery room have been performed that describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. OBJECTIVES: To study the use...... checked the reference lists of trials and review articles. The original search was performed in January 2005, and a previous update was performed in May 2009. SELECTION CRITERIA: We included all controlled trials that randomly assigned participants to pulse oximetry or no pulse oximetry during...

  5. Wearable Oximetry for Harsh Environments

    Science.gov (United States)

    2017-04-26

    to this, commercial oximetry sensors (e.g., from Masimo, BSX Insight, Cercacor) are now being marketed for enhancing performance of elite athletes...considerable re-packaging and integration. The green wavelength is well known to provide a strong modulation for measuring HR [8], as evidenced by nearly...every consumer PPG-based HR monitor using green LEDs. However, for oximetry, red and IR wavelengths are the standard choices, in order to

  6. 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......, Reykjavik, Iceland). The device simultaneously acquires images at two wavelengths (570 nm and 600 nm) and specialized software automatically detects retinal blood vessels. In three pigs, invasive pO2-measurements were performed after the initial non-invasive measurements. RESULTS: Comparison of femoral...

  7. Feasibility and accuracy of nasal alar pulse oximetry.

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    Morey, T E; Rice, M J; Vasilopoulos, T; Dennis, D M; Melker, R J

    2014-06-01

    The nasal ala is an attractive site for pulse oximetry because of perfusion by branches of the external and internal carotid arteries. We evaluated the accuracy of a novel pulse oximetry sensor custom designed for the nasal ala. After IRB approval, healthy non-smoking subjects [n=12; aged 28 (23-41) yr; 6M/6F] breathed hypoxic mixtures of fresh gas by a facemask to achieve oxyhaemoglobin saturations of 70-100% measured by traditional co-oximetry from radial artery samples. Concurrent alar and finger pulse oximetry values were measured using probes designed for these sites. Data were analysed using the Bland-Altman method for multiple observations per subject. Bias, precision, and accuracy root mean square error (ARMS) over a range of 70-100% were significantly better for the alar probe compared with a standard finger probe. The mean bias for the alar and finger probes was 0.73% and 1.90% (Palar and finger probes, respectively. The within/between-subject variation for the alar and finger probes were 1.14/1.57% and 1.87/1.47%, respectively. The limits of agreement were 3.96/-2.50% and 5.48/-1.68% for the alar and finger probes, respectively. Nasal alar pulse oximetry is feasible and demonstrates accurate pulse oximetry values over a range of 70-100%. The alar probe demonstrated greater accuracy compared with a conventional finger pulse oximeter. © The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Wearable oximetry for harsh environments

    Science.gov (United States)

    2017-02-23

    a wearable monitor is required. Related to this, commercial oximetry sensors (e.g., from Masimo, BSX Insight, Cercacor) are now being marketed for...Schmid, C. Fulco, S. Muza, “Predictive models of acute mountain sickness after rapid ascent to various altitudes,” Med & Sci in Sports & Exercise, 792

  9. Increased intrathoracic pressure affects cerebral oxygenation following cardiac surgery

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    Pedersen, Lars M; Nielsen, Jonas; Østergaard, Morten

    2012-01-01

    Cerebral oximetry reflects circulatory stability during surgery. We evaluated whether frontal lobe oxygenation is influenced by a transient increase in intrathoracic pressure as induced by a lung recruitment manoeuvre.......Cerebral oximetry reflects circulatory stability during surgery. We evaluated whether frontal lobe oxygenation is influenced by a transient increase in intrathoracic pressure as induced by a lung recruitment manoeuvre....

  10. Review of splanchnic oximetry in clinical medicine

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    Bailey, Sean M.; Mally, Pradeep V.

    2016-09-01

    Global tissue perfusion and oxygenation are important indicators of physiologic function in humans. The monitoring of splanchnic oximetry through the use of near-infrared spectroscopy (NIRS) is an emerging method used to assess tissue oxygenation status. Splanchnic tissue oxygenation (SrS) is thought to be potentially of high value in critically ill patients because gastrointestinal organs can often be the first to suffer ischemic injury. During conditions of hypovolemia, cardiac dysfunction, or decreased oxygen-carrying capacity, blood flow is diverted toward vital organs, such as the brain and the heart at the expense of the splanchnic circulation. While monitoring SrS has great potential benefit, there are limitations to the technology and techniques. SrS has been found to have a relatively high degree of variability that can potentially make it difficult to interpret. In addition, because splanchnic organs only lie near the skin surface in children and infants, and energy from currently available sensors only penetrates a few centimeters deep, it can be difficult to use clinically in a noninvasive manner in adults. Research thus far is showing that splanchnic oximetry holds great promise in the ability to monitor patient oxygenation status and detect disease states in humans, especially in pediatric populations.

  11. 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

    .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 ... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  12. 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)

  13. Cerebral Tissue Oxygenation during Immediate Neonatal Transition and Resuscitation

    Science.gov (United States)

    Pichler, Gerhard; Schmölzer, Georg M.; Urlesberger, Berndt

    2017-01-01

    This article provides a review of cerebral tissue oxygenation during immediate transition after birth in human neonates. Recommended routine monitoring, especially if resuscitation is needed, during this period includes arterial oxygen saturation and heart rate measured by pulse oximetry and electrocardiogram. However, there is increasing interest to monitor in addition with near-infrared spectroscopy (NIRS) the oxygenation of the brain. There is a different pattern of increase between cerebral tissue oxygenation and arterial oxygen saturation during the immediate transition, with cerebral tissue oxygenation reaching a plateau faster than arterial oxygen saturation. Differences can be explained, since cerebral tissue oxygenation is not only affected by arterial oxygen saturation but also by cerebral blood flow, hemoglobin content, and cerebral oxygen consumption. Normal values have already been established for different devices, gestational ages, and modes of delivery in neonates without any medical support. Cerebral hypoxia during immediate transition might cause brain damage. In preterm neonates with cerebral hemorrhage evolving in the first week after birth, the cerebral tissue oxygenation is already lower in the first minutes after birth compared to preterm neonates without cerebral hemorrhage. Using cerebral NIRS in combination with intervention guidelines has been shown to reduce the burden of cerebral hypoxia in preterm neonates. Cerebral tissue oxygenation during immediate transition seems to have an impact on outcome, whereby NIRS monitoring is feasible and has the advantage of continuous, non-invasive recording. The impact of NIRS monitoring and interventions on short- and long-term outcomes still need to be evaluated. PMID:28280719

  14. REFLECTANCE PULSE OXIMETRY IN FETAL LAMBS

    NARCIS (Netherlands)

    DASSEL, AC; GRAAFF, R; AARNOUDSE, JG; ELSTRODT, JM; HEIDA, P; KOELINK, MH; DEMUL, FF; GREVE, J

    1992-01-01

    Transmission pulse oximetry is used for monitoring in many clinical settings. However, for fetal monitoring during labor and in situations with poor peripheral perfusion, transmission pulse oximetry cannot be used. Therefore, we developed a reflectance pulse oximeter, which uses the relative intensi

  15. Nasal pulse oximetry overestimates oxygen saturation

    DEFF Research Database (Denmark)

    Rosenberg, J; Pedersen, M H

    1990-01-01

    Ten surgical patients were monitored with nasal and finger pulse oximetry (Nellcor N-200) for five study periods with alternating mouth and nasal breathing and switching of cables and sensors. Nasal pulse oximetry was found to overestimate arterial oxygen saturation by 4.7 (SD 1.4%) (bias...

  16. 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.)

  17. 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...... occlusion. Mean StO(2) was 70.1% ± 6.7 with INVOS 5100, 69.4% ± 5.0 with NIRO 200 NX, 63.4% ± 4.5 with NIRO 300, and 60.8% ± 3.6 with OxyPrem. The corresponding reproducibility S(w) was 5.4% (CI 4.4-6.9), 4.4% (CI 3.5-5.2), 4.1% (CI 3.3-4.9), and 2.7% (CI 2.2-3.2), respectively. The dynamic ranges ¿StO(2......) were 45.0%, 46.8%, 44.8%, and 27.8%, respectively. In conclusion, the three commercial NIRS instruments showed different absolute values, whereas reproducibility and dynamic range were quite similar....

  18. 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...... occlusion. Mean StO(2) was 70.1% ± 6.7 with INVOS 5100, 69.4% ± 5.0 with NIRO 200 NX, 63.4% ± 4.5 with NIRO 300, and 60.8% ± 3.6 with OxyPrem. The corresponding reproducibility S(w) was 5.4% (CI 4.4-6.9), 4.4% (CI 3.5-5.2), 4.1% (CI 3.3-4.9), and 2.7% (CI 2.2-3.2), respectively. The dynamic ranges ΔStO(2......) were 45.0%, 46.8%, 44.8%, and 27.8%, respectively. In conclusion, the three commercial NIRS instruments showed different absolute values, whereas reproducibility and dynamic range were quite similar....

  19. 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.

  20. [Value of computerized axial tomography in cranio-cerebral injuries].

    Science.gov (United States)

    Vigouroux, R P; Baurand, C; Gomez, A; Legre, J; Regis, H; Debaene, A

    1976-01-01

    Since May 1975 was have been working in the field of C.A.T. and its application to study head injuries. We are presenting differents groups of patients studied by C.A.T. I. -- DATA OF C.A.T. IN THE CASES OF EMERGENCY AND IMMEDIATE POST-OPERATIVE FOLLOW-UP OF HEAD INJURIES A) EMERGENCY STATE As soon as the clinical state of an head injured patient was supposed to need an operation, C.A.T. was realized; so differents abnormal scanners may be observed: 1. epidural hematoma, 2. subdural hematoma, 3. intra-cerebral hematoma, 4. acute subdural hematoma or contusion. We must do some comments: -- The Emi-scanner is pre-eminent in showing the exact topography of the lesion : so, the flap is easier to realise. -- In most cases the Emi-scanner is easier to interpret than angiogram for example contusion and hematoma. We know the goods results in hematomas and the poors results in surgery of contusions. -- But the senior advantage of C.A.T. is to provide all the informations in the totality of skull content. Emi-scanner shows bilateral lesions, ipsilateral lesion. C.A.T. is pre-eminent in showing the presence of this two lesions, more accurately than senior methods of investigations, so C.A.T. permits emergency neurosurgical treatment. B) C.A.T. AND FOLLOW-UP Repeated studies at post-intervals can be accomplished without risk to the patient, thus making follow-up simpler and more effective to the neurosurgical attitude. C) POST-OPERATIVE CONTROL AND C.A.T. Post-operative complications are always hard to diagnosis. C.A.T. is painless, quick and safe, and easier to interpret than an angiogram. II -- SEQUELLAE STADE AND C.A.T. In this field certains advantages of C.A.T. are immediatly apparents. In most cases the C.A.T. is the best screening method. Patients carried out are: -- psychiatric troubles, -- post-traumatic epilepsy. The results are not reliable. There is no anatomical-clinical relation in most cases. Differents pictures are observed: -- asymetrical ventricle enlargment

  1. [Evaluation of cerebral oxygenation in newborns with prematurity apnea: new frequency domain NIR oximeter].

    Science.gov (United States)

    Pratesi, S; Donzelli, G

    2000-01-01

    Near infrared spectroscopy (NIRS) is a non invasive, portable, safe technique for monitoring cerebral oxygenation and haemodynamics. A new frequency-domain tissue oximeter based on a multi-distance measurement protocol is presented. The effects of apneic episodes on cerebral and peripheral arterial oxygen saturation (SatO2) in preterm newborns, as monitored by NIRS and by pulse oximetry, are reported. The study population consist of 5 preterms (26 to 30 weeks of gestational age), in the second week of postnatal age, affected by apnea of prematurity. NIRS and pulse oximetric measurements were made contemporarily for a 40-minutes period for each infant. All monitorized apneic events were associated with bradicardia, and resolved spontaneously or after tactile stimulation. As results: a) there was always cerebral deoxygenation in association with apneic events, b) the mean SatO2 as measured by NIRS was slightly lower than the pulse oximeter readings, c) cerebral SatO2 decreased faster and the absolute value of the cerebral SaO2 decrease was greater than that measured peripherally (mean value of 27 versus 13%), d) increases of cerebral deoxyhemoglobin and total hemoglobin and a decrease of oxyhemoglobin were also observed. These preliminary results show that peripheral oxygen saturation measurements as measured by pulse oximetry could not always reflect brain oxygenation.

  2. Prognostic value of collateral circulation in patients with unilateral middle cerebral artery occlusion

    Institute of Scientific and Technical Information of China (English)

    梅雨晴

    2014-01-01

    Objective To investigate the characteristics of the collateral circulation in patients with acute cerebral infarction after the middle cerbral artery(MCA)occlusion,and to evaluate its prognostic value.Methods Consecutive series of 118 patients with first-ever stroke after MCA occlusions subjects were retrieved from our hospital and Nanjing Stroke Registry Program between April 2010 and

  3. Reference values for anaerobic performance and agility in ambulatory children and adolescents with cerebral palsy

    NARCIS (Netherlands)

    Verschuren, Olaf; Bloemen, Manon; Kruitwagen, Cas; Takken, Tim

    2010-01-01

    Aim The aim of this study was to provide reference values of anaerobic performance and agility in a group of children and adolescents with spastic cerebral palsy (CP). Method A total of 300 children (184 males, 116 females) with spastic CP were recruited from 26 rehabilitation centres in six differe

  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. 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.

  6. The Leicester cerebral haemodynamics database: normative values and the influence of age and sex.

    Science.gov (United States)

    Patel, Nikil; Panerai, Ronney B; Haunton, Victoria; Katsogridakis, Emmanuel; Saeed, Nazia P; Salinet, Angela; Brodie, Fiona; Syed, Nazia; D'Sa, Schnell; Robinson, Thompson G

    2016-09-01

    Normative values of physiological parameters hold significance in modern day clinical decision-making. Lack of such normative values has been a major hurdle in the translation of research into clinical practice. A large database containing uniform recordings was constructed to allow more robust estimates of normative ranges and also assess the influence of age and sex. Doppler recordings were performed on healthy volunteers in the same laboratory, using similar protocols and equipment. Beat-to-beat blood pressure, heart-rate, electrocardiogram, and end-tidal CO2 were measured continuously. Bilateral insonation of the middle cerebral arteries (MCAs) was performed using TCD following a 15 min stabilisation, and a 5 min baseline recording. Good quality Doppler recordings for both MCAs were obtained in 129 participants (57 female) with a median age of 57 years (range 20-82). Age was found to influence baseline haemodynamic and transfer function analysis parameters. Cerebral blood flow velocity and critical closing pressure were the only sex-related differences found, which was significantly higher in females than males. Normative values for cerebral haemodynamic parameters have been defined in a large, healthy population. Such age/sex-defined normal values can be used to reduce the burden of collecting additional control data in future studies, as well as to identify disease-associated changes.

  7. DIAGNOSTIC VALUE OF D-DIMER MEASUREMENT IN PATIENTS SUSPECTED TO HAVE CEREBRAL VENOUS THROMBOSIS

    Directory of Open Access Journals (Sweden)

    M Ghaffarpour

    2008-12-01

    Full Text Available "nAmong the causes of headache, cerebral venous and/or dural sinus thrombosis (CVT is an important challenge because of its variable clinical presentation, having negative brain CT in up to 30% of cases and unavailability of MRI in some situations. On the other hand as D-Dimer (DD test has been reported to be a sensitive test for the exclusion of venous thromboembolism, we sought whether it could be useful in the diagnosis of cerebral venous thrombosis. A prospective study of 104 consecutive patients with headache or unusual ischemic stroke (infarction in brain CT, but not compatible with any brunch of cerebral arteries, suggesting CVT was conducted between 2003 and 2005. D-Dimer test determined for all patients in the emergency ward before MRI or MRV was performed. Titers above 500 ng/ml were regarded as positive test. From a total 104 patients, 21 cases (20.2% were confirmed (by MRI and/or MRV to have CVT, 20/21 (95.7% of whom had positive DD test. In the remainder 83 (without CVT it was only positive in 16.8% (14/83, which was statistically meaningful (P < 0.001. Specificity, sensitivity, negative and positive predictive values of DD test were 83.1, 95.2, 98.6 and 58.8%, respectively, so application of this test would be useful in the diagnosis of CVT and values below 500 ng/ml make acute thrombosis unlikely.

  8. 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.

  9. 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%.

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

    Science.gov (United States)

    Clair, Marie-Philippine; Rambaud, Jérôme; Flahault, Adrien; Guedj, Romain; Guilbert, Julia; Guellec, Isabelle; Durandy, Amélie; Demoulin, Maryne; Jean, Sandrine; Mitanchez, Delphine; Chalard, François; Sileo, Chiara; Carbajal, Ricardo; Renolleau, Sylvain

    2017-01-01

    Objectives 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. Study design This was a prospective study in infants < 3 months of age admitted to a pediatric intensive care unit and requiring ECMO support. Measurements 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. Results 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). Conclusion StcO2 appears to be a strong prognostic factor of survival and of the presence of cerebral lesions in young infants during ECMO. PMID:28278259

  11. Transcranial doppler sonography diagnostic value for the cerebral flow velocity changes in the interictal phase of classic migraine

    Science.gov (United States)

    Sedighi, Behnaz; Ali Ebrahimi, Hossein; Jabbarpour, Shirin; Shafiee, Kaveh

    2011-01-01

    Background: An imbalance of the cerebrovascular response during functional activation of the brain has been postulated as a factor in the pathophysiology of migraine. The purpose of this study was to determine the transcranial doppler sonography (TDS) diagnostic value for the cerebral flow velocity changes in the interictal phase of classic migraine. Methods: This study was carried out on 46 patients (23 cases and 23 controls). We used Doppler instrument via trans-temporal window and detected middle cerebral artery, anterior cerebral artery and posterior cerebral artery by 2 MHz probe. The flow velocity in the posterior cerebral artery before, during and immediately after stimulation was recorded. Stimulation was done using a flickering light in 100 seconds. Results: At the baseline, the middle cerebral artery had more peak systolic velocity in migraineurs than the control group. Although peak systolic velocity changes in the mid-photic period is not statistically significant. On the other hand, post-photic peak systolic velocity increased significantly. The diagnostic accuracy of the peak systolic volume (PSV) changes in the posterior cerebral artery (PCA) for the migraine was 72.3%. Conclusion: This stimulation we found altered cerebral vasomotor reactivity in the interictal phase in migraineurs with visual aura. This seemed to be an unavoidable hindrance for the wider implementation of functional TCD in diagnostic work up of migraine patients. PMID:24024011

  12. Retinal oximetry measures systemic hypoxia in central nervous system vessels in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Eliasdottir, Thorunn Scheving; Bragason, David; Hardarson, Sveinn Hakon; Vacchiano, Charles; Gislason, Thorarinn; Kristjansdottir, Jona Valgerdur; Kristjansdottir, Gudrun; Stefánsson, Einar

    2017-01-01

    Determination of the blood oxyhemoglobin saturation in the retinal vessels of the eye can be achieved through spectrophotometric retinal oximetry which provides access to the state of oxyhemoglobin saturation in the central nervous system circulation. The purpose of this study was to test the capability of the Oxymap T1 oximeter to detect systemic hypoxemia and the effect of supplemental oxygen on retinal vessel oxyhemoglobin saturation. Oxygen saturation of hemoglobin in retinal arterioles and venules was measured in 11 subjects with severe chronic obstructive pulmonary disease (COPD) on long term oxygen therapy. Measurements were made with and without their daily supplemental oxygen. Eleven healthy age and gender matched subjects were measured during ambient air breathing for comparison of oxyhemoglobin saturation in retinal arterioles and venules. Retinal arteriolar oxyhemoglobin saturation in COPD subjects inspiring ambient air was compared with finger pulse oximetry and blood samples from radial artery. COPD subjects had significantly lower oxyhemoglobin saturation during ambient air breathing than healthy controls in both retinal arterioles (87.2%±4.9% vs. 93.4%±4.3%, p = 0.02; n = 11) and venules (45.0%±10.3% vs. 55.2%±5.5%, p = 0.01). Administration of their prescribed supplemental oxygen increased oxyhemoglobin saturation in retinal arterioles (87.2%±4.9% to 89.5%±6.0%, p = 0.02) but not in venules (45.0%±10.3% to 46.7%±12.8%, p = 0.3). Retinal oximetry values were slightly lower than radial artery blood values (mean percentage points difference = -5.0±5.4, 95% CI: -15.68 to 5.67) and finger pulse oximetry values (-3.1±5.5, 95% CI: -14.05 to 7.84). The noninvasive Oxymap T1 retinal oximetry detects hypoxemia in central nervous system vessels in patients with severe COPD compared with healthy controls. The instrument is sensitive to changes in oxygen breathing but displays slightly lower measures than finger pulse oximetry or radial artery

  13. EARLY DETECTION OF CRITICAL CONGENITAL HEART DISEASE IN NEW BORNS USING PULSE OXIMETRY SCREENING

    Directory of Open Access Journals (Sweden)

    ShahForum,Chatterjee Rajib, PatelPrashant C, Kunkulol Rahul R

    2015-01-01

    Full Text Available Background: Congenital heart diseases which are dependent on the ductusarteriosus to maintain adequate oxygenation or systemic blood flow are termed as a critical congenital heart disease (CCHD. Delay in the diagnosis of CCHD is the major cause leading to morbidity and mortality in newborn infants. Clinical evaluation is likely to miss the diagnosis in first few hours of hospital stay after birth due to absence of signs and symptoms of CCHD. In the absence of clinical findings during early neonatal period, the best parameter that can be assessed is the detection of hypoxemia by pulse oximetry screening. Objectives: To record the value of Pulse Oximetry within 24 hours of birth and evaluate Pulse Oximetry as screening tool for early diagnosis of CCHD. &Methods: Longitudinal descriptive study was conducted on total 700 intramural neonates, satisfying the inclusion and exclusion criteria, who were evaluated within 24 hours of birth with currently available pulse oximeter, after the Institutional Ethical Committee approval. The study was conducted over a period of 4 months. Part-A: Neonatal Case Record, Part-B: Pulse Oximetry Screening Record, Part-C: Clinical Examination Record, Part-D: Echocardiography Record. Results and Conclusion: Total 700 neonates were screened by pulse oximeter with consecutive sampling method. 4 (0.57% subjects were detected to have positive screen and the diagnosis was confirmed by echocardiography. Study revealed that Pulse Oximetry Screening can be an important primary screening tool in routine neonatal care for early detection of Critical Congenital Heart Diseases particularly in rural setup

  14. Pulse Oximetry as a Medical Physics Practical on School Trips

    Science.gov (United States)

    Gibson, Adam P.; Chandra, Elizabeth; Chandra, Manik

    2009-01-01

    We have measured blood oxygenation levels in a group of 14 people (8 young people and 6 adults) on a physically demanding expedition to Mt Kenya. Blood oxygenation was measured at 11 different altitudes between 1910 and 4985 m using pulse oximetry. We found that pulse oximetry was suitable for use on a youth expedition and we were able to show…

  15. ROx3: Retinal oximetry utilizing the blue-green oximetry method

    Science.gov (United States)

    Parsons, Jennifer Kathleen Hendryx

    The ROx is a retinal oximeter under development with the purpose of non-invasively and accurately measuring oxygen saturation (SO2) in vivo. It is novel in that it utilizes the blue-green oximetry technique with on-axis illumination. ROx calibration tests were performed by inducing hypoxia in live anesthetized swine and comparing ROx measurements to SO 2 values measured by a CO-Oximeter. Calibration was not achieved to the precision required for clinical use, but limiting factors were identified and improved. The ROx was used in a set of sepsis experiments on live pigs with the intention of tracking retinal SO2 during the development of sepsis. Though conclusions are qualitative due to insufficient calibration of the device, retinal venous SO2 is shown to trend generally with central venous SO2 as sepsis develops. The novel sepsis model developed in these experiments is also described. The method of cecal ligation and perforation with additional soiling of the abdomen consistently produced controllable severe sepsis/septic shock in a matter of hours. In addition, the ROx was used to collect retinal images from a healthy human volunteer. These experiments served as a bench test for several of the additions/modifications made to the ROx. This set of experiments specifically served to illuminate problems with various light paths and image acquisition. The analysis procedure for the ROx is under development, particularly automating the process for consistency, accuracy, and time efficiency. The current stage of automation is explained, including data acquisition processes and the automated vessel fit routine. Suggestions for the next generation of device minimization are also described.

  16. Evaluation of non-reassuring fetal heart rate patterns with fetal pulse oximetry combined with vibratory acoustic stimulation.

    Science.gov (United States)

    Salamalekis, E; Vitoratos, N; Loghis, C; Kassanos, D; Salloum, I; Batalias, L; Creatsas, G

    2003-02-01

    To determine the value of fetal pulse oximetry and vibratory acoustic stimulation in the presence of non-reassuring fetal heart rate patterns during labor. Prospective study in women monitored by cardiotocography and fetal pulse oximetry during labor. During a period of 18 months, 907 consecutive parturients in labor were monitored by cardiotocography. Out of these women, 63 were selected on the basis of a non-reassuring fetal heart rate tracing during the first stage of labor. In these cases, fetal pulse oximetry was applied. Vibratory acoustic stimulation was applied in fetuses without spontaneous reactivity in order to evaluate the fetal status. Our cases were classified into three groups, according to the lower fetal oxygen saturation levels, from the time of oximetry application until delivery. Group A consisted of 29 cases where fetal oxygen saturation levels were > or = 41%, group B (20 cases) with fetal oxygen saturation of 31-40% and group C (14 cases) with levels of fetal oxygen saturation levels. The mean umbilical artery pH levels were 7.29 +/- 0.051 in group A, 7.21 +/- 0.057 in group B and 7.04 +/- 0.05 in group C. Fetal pulse oximetry should be indicated not only in fetuses without any reactivity but also in those with induced reactivity, after the application of vibratory acoustic stimulation.

  17. [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.

  18. 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...... integrated in a flexible array. The flexibility is achieved by combining silicon with Polydimethylsiloxane and polyimide using standard IC manufacturing. This ensures that the electrical interconnects on the sensor can withstand being bent in order for the sensor to confine to the curved surface of the head...

  19. Quantification of Phase Values of Cerebral Microbleeds in Hypertensive Patients Using ESWAN MRI.

    Science.gov (United States)

    Guo, L F; Geng, J; Qiu, M H; Mao, C H; Liu, C; Cui, L

    2013-09-01

    The presence of cerebral microbleeds (CMBs) may have predictive and diagnostic value for cerebrovascular diseases. The purpose of our study was to measure the phase values (PVs) of CMBs by phase maps. We retrospectively analyzed 75 patients with hypertension who had CMBs using enhanced T2*-weighted angiography (ESWAN). The PVs of CMBs were measured and documented. The mean PVs of CMBs were correlated with demographic features and the grade of white matter lesions for seven brain regions. A total of 275 CMBs were found. Their mean PV was - 1.39 ± 0.29 radians. The mean PV of CMBs in seven brain regions was significantly lower than that of red nucleus and substantia nigra of healthy controls (P CMBs in the basal ganglia gray matter was significantly lower than that of the brainstem, subcortical white matter, and cerebellum (P CMBs and the demographic features addressed or the grade of white matter lesions. Measurement of the PV of phase maps using ESWAN sequence provides quantitative information for detection of CMBs. The measurement data reported herein will provide a reference for a longitudinal study of CMBs in the future.

  20. 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)

    G.M. Ecury-Goossen (Ginette); M.M.A. Raets (Marlou); F.A. Camfferman (Fleur); Vos, R.H.J. (Rik H. J.); J.M. van Rosmalen (Joost); I.K.M. Reiss (Irwin); P. Govaert (Paul); J. Dudink (Jeroen)

    2016-01-01

    textabstractBackground: 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

  1. 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

    2016-01-01

    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 arteri

  2. Value of cerebral perfusion and vascular reserve for the treatment of symptomatic intracranial arterial stenosis

    Institute of Scientific and Technical Information of China (English)

    Li'an Huang; Xuewen Song; Anding Xu

    2008-01-01

    BACKGROUND: It is crucial to understand cerebral perfusion and vascular reserve in stegnotic arterial blood-supply regions to treat ischemic cerebrovascular diseases. However, effects on symptomatic intracrani-al arterial stenosis (SICAS) need to be further studied in additional applications. OBJECTIVE: To evaluate and summarize the effects of cerebral perfusion and vascular reserve on the treatment of SICAS. RETRIEVAL STRATEGY: A computer-based online search of English language publications from January 2000 to July 2007 was conducted in PubMed to identify publications that addressed cerebral perfusion and vascular reserve of SICAS. Search key words were "intracranial stenosis, perfusion, brain reserve". Relevant data were also searched with the China Journal Net, using the same key words in Chinese from January 2000 to January 2007. In total, 101 articles were retrieved. Inclusion criteria: ① Articles describing the current status for the diagnosis and treatment of SICAS; ② Articles concerning research developments of cerebral perfusion and vascular reserve of SICAS. Exclusion criteria: duplicated articles. LITERATURE EVALUATION: This study included 21 articles of experimental studies and conference re-ports.DATA SYNTHESIS: When performing interventional surgery in SICAS patients, it is important to under-stand cerebral perfusion and vascular reserve in addition to knowing the clinical symptoms and degrees of arterial stenosis. In recent years, there are a growing number of reports on measurements of vascular reserve through the use of magnetic resonance perfusion imaging (MR-PWI). Investigations demonstrate cerebral perfusion and vascular reserve decrease in many SICAS patients. Many studies show that both improve after surgical intervention. CONCLUSION: Cerebral perfusion could provide direct evidence of whether ischemia has occurred in the brain. Because of lateral circulation and cerebral vascular reserve, intracranial vascular stenosis and/or decreased

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

    Institute of Scientific and Technical Information of China (English)

    Jing Xie

    2016-01-01

    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 non-occlusion 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, Aβ, 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, Aβ, 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, Aβ, 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 disease prognosis.

  4. Absolute cerebral blood flow and blood volume measured by magnetic resonance imaging bolus tracking: comparison with positron emission tomography values

    DEFF Research Database (Denmark)

    Østergaard, Leif; Smith, D F; Vestergaard-Poulsen, Peter;

    1998-01-01

    The authors determined cerebral blood flow (CBF) with magnetic resonance imaging (MRI) of contrast agent bolus passage and compared the results with those obtained by O-15 labeled water (H215O) and positron emission tomography (PET). Six pigs were examined by MRI and PET under normo......- and hypercapnic conditions. After dose normalization and introduction of an empirical constant phi Gd, absolute regional CBF was calculated from MRI. The spatial resolution and the signal-to-noise ratio of CBF measurements by MRI were better than by the H215O-PET protocol. Magnetic resonance imaging cerebral...... blood volume (CBV) estimates obtained using this normalization constant correlated well with values obtained by O-15 labeled carbonmonooxide (C15O) PET. However, PET CBV values were approximately 2.5 times larger than absolute MRI CBV values, supporting the hypothesized sensitivity of MRI to small...

  5. Reliable? The Value of Early Postoperative Magnetic Resonance Imaging after Cerebral Cavernous Malformation Surgery.

    Science.gov (United States)

    Chen, Bixia; Göricke, Sophia; Wrede, Karsten; Jabbarli, Ramazan; Wälchli, Thomas; Jägersberg, Max; Sure, Ulrich; Dammann, Philipp

    2017-07-01

    Cerebral cavernous malformations (CCM) can cause intracerebral hemorrhage. The lesions themselves are frequently associated with perifocal hemosiderin deposits caused by repetitive microhemorrhages. Main indications for a surgical treatment are recurrent symptomatic hemorrhages or cavernoma-related epilepsy. After surgical resection, follow-up magnetic resonance imaging (MRI) is usually performed to confirm 1) the complete resection of the CCM and, especially in cases of cavernoma-related epilepsy, 2) the complete resection of the hemosiderin deposits. This prospective study evaluates the value of early postoperative MRI (within 72 hours) regarding the detection of CCM or hemosiderin remnants compared with a standard 3-6 months postoperative MRI control in 61 CCM cases. Sensitivity of early postoperative MRI for CCM remnant detection was 66.67% (95% confidence interval [CI], 9.43%-99.16%), specificity was 76.74% (95% CI, 61.37%-88.24%), positive predictive value was 16.67% (95% CI, 2.09%-48.41%), and negative predictive value was 97.06% (95% CI, 84.67%-99.93%). Because of the high number of patients who could not be evaluated because of imaging artifacts, sensitivity and specificity analysis was not performed for early postoperative MRI using T2*/susceptibility-weighted imaging to assess hemosiderin remnants. Sensitivity of early postoperative MRI for hemosiderin remnant detection using T2-weighted sequences was 85.71% (95% CI, 63.66%-96.95%), specificity was 66.67% (95% CI, 44.68%-84.37%), positive predictive value was 69.23% (95% CI, 55.45%-80.27%), and negative predictive value was 84.21% (95% CI, 64.31%-94.04%). Our data suggest that early postoperative MRI after CCM surgery is often hampered by imaging artifacts creating false-positive results and therefore ineligible for a resection control. However, reliability of a negative result on early postoperative T2-weighted MRI is relatively high regarding both CCM and hemosiderin remnants. Copyright © 2017

  6. Oximetry in obese children with sleep-disordered breathing

    OpenAIRE

    Evangelisti, Melania; Shafiek, Hanaa; Rabasco, Jole; Forlani, Martina; Montesano, Marilisa; Barreto, Mario; Verhulst, Stijn; Villa, Maria Pia

    2016-01-01

    Abstract: Background: Obesity is an important risk factor for obstructive sleep apnea syndrome (OSAS), and obese children with OSAS have frequently shown oxygen desaturations when compared with normal-weight children. The aim of our study was to investigate the oximetry characteristics in children with obesity and sleep-disordered breathing (SDB). Methods: Children referred for suspected OSAS were enrolled in the study. All children underwent sleep clinical record (SCR), pulse oximetry, and p...

  7. Examiner's finger-mounted fetal tissue oximetry

    Science.gov (United States)

    Kanayama, Naohiro; Niwayama, Masatsugu

    2014-06-01

    The best way to assess fetal condition is to observe the oxygen status of the fetus (as well as to assess the condition of infants, children, and adults). Previously, several fetal oximeters have been developed; however, no instrument has been utilized in clinical practice because of the low-capturing rate of the fetal oxygen saturation. To overcome the problem, we developed a doctor's finger-mounted fetal tissue oximeter, whose sensor volume is one hundredth of the conventional one. Additionally, we prepared transparent gloves. The calculation algorithm of the hemoglobin concentration was derived from the light propagation analysis based on the transport theory. We measured neonatal and fetal oxygen saturation (StO2) with the new tissue oximeter. Neonatal StO was measured at any position of the head regardless of amount of hair. Neonatal StO was found to be around 77%. Fetal StO was detected in every position of the fetal head during labor regardless of the presence of labor pain. Fetal StO without labor pain was around 70% in the first stage of labor and around 60% in the second stage of labor. We concluded that our new concept of fetal tissue oximetry would be useful for detecting fetal StO in any condition of the fetus.

  8. Detection of pulpal blood flow in vivo with pulse oximetry in dogs

    Directory of Open Access Journals (Sweden)

    Jessica eRiehl

    2016-05-01

    Full Text Available Objective: The aim of the present study was to investigate the ability of pulse oximetry to detect blood flow within the canine tooth of dogs. Materials and methods: Dogs aged 18-138 months presenting for oral treatment and meeting the inclusion criteria underwent pulse oximetry evaluation of at least one canine tooth. Oxygen saturation (SpO2 and pulse rate values were acquired from vital canine teeth of 38 clinical patients (representing 40 total teeth with a hand-held pulse oximeter and compared to a control area. SpO2 values from the tooth and control area were recorded every 5 seconds for three 60-second intervals. The sensors were repositioned after each 60-second interval. Results: The vital teeth consistently recorded SpO2 values significantly lower than the control area. The mean vital tooth SpO2 was 85.9% (median = 87%; SD = 8.6 and the mean control area SpO2 was 97.7% (median = 98%; SD = 1.8. An age-related significant difference was noted in vital tooth SpO2 values.Conclusions: In conclusion, the present data supports the possible use of pulse oximetry to detect blood flow in canine teeth. However, there was no significant correlation between SpO2 values in the vital tooth and in the control areas. Additionally, the results were not definitive and validation of the modality with additional studies of non-vital canine teeth is needed before clinical use can be recommended.

  9. Variations in physician interpretation of overnight pulse oximetry monitoring.

    Science.gov (United States)

    Ramsey, Rory; Mehra, Reena; Strohl, Kingman P

    2007-09-01

    Overnight pulse oximetry is commonly used for hypoxemia evaluation in patients with COPD and sleep-disordered breathing. There is little information regarding its impact on physician decision making, and therefore an important measure of its clinical utility is untested and unknown. The aim of this study was to describe physician interpretation, use, and opinions regarding overnight pulse oximetry. Forty-one pulmonary physicians and fellows participated in structured interviews consisting of three oximetry record interpretations, oral responses to a standard question set, and a questionnaire. Qualitative data were analyzed using an open coding process. Quantitative data were assessed for distributions. Four measures were consistently used by the majority of physicians in record interpretation: background information, arterial oxygen saturation measured by pulse oximetry (Spo(2)) waveform and pattern, and time spent with Spo(2) 60% consensus. There was a wide range of opinions on important matters related to this test, including test utility, indications, variables considered most important for interpretation, and criteria for nocturnal oxygen prescription. Forty-one physicians provided 35 different opinions on when nocturnal supplemental oxygen should be initiated. The variation in physician interpretation, use, and opinions regarding overnight pulse oximetry calls into question its clinical utility and underscores a need for standardization of presentation, training, and interpretation.

  10. Advanced Pulse Oximetry System for Remote Monitoring and Management

    Directory of Open Access Journals (Sweden)

    Ju Geon Pak

    2012-01-01

    Full Text Available 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.

  11. Application of ESR spin label oximetry in food science.

    Science.gov (United States)

    Zhou, Yu-Ting; Yin, Jun-Jie; Lo, Y Martin

    2011-12-01

    Lipid oxidation attributed to the presence of oxygen has long been a focal area for food science research due in early years mainly to its broad impact on the quality and shelf stability. The need to effectively strategize interventions to detect and eventually eliminate lipid oxidation in food remains as evidence on nutritional and health implications continue to accumulate. Electron spin resonance (ESR) spin label oximetry has been shown capable of detecting dissolved oxygen concentration in both liquid and gaseous phases based on the collision between oxygen and stable free radicals. This review aimed to summarize not just the principles and rationale of ESR spin label oximetry but also the wide spectrum of ESR spin label oximetry applications to date. The feasibility to identify in very early stage oxygen generation and consumption offers a promising tool for controlling lipid oxidation in food and biological systems.

  12. Digital pressure ulcer after pulse oximetry [Digitales Druckulkus nach Pulsoxymetrie

    Directory of Open Access Journals (Sweden)

    Zeplin, Philip H.

    2013-06-01

    Full Text Available [english] In emergency medical service, in intensive care unit and anaesthesia oxygenation is monitored with pulse oximetry apparatus. Pulse oximetry probe is usually attached to the finger, toe or earlobe. To the best of our knowledge this is the first case report describing the occurrence of a pressure ulcer after finger pulse oximetry measurement.[german] Sowohl in der Notfall- und Intensivmedizin als auch in der Anästhesie wird die Sauerstoffsättigung des Blutes mit Pulsoxymetern ermittelt. Diese Pulsoxymeter werden üblicherweise an den Fingern, den Zehen oder dem Ohrläppchen angebracht. Wir beschreiben einen Fall, bei dem es nach Anlage eines Fingerclip-Pulsoxymeters zur Ausbildung eines operationsbedürftigen Druckulkus kam.

  13. Evidence for Abnormal Fetal Middle Cerebral Artery Values in Addict Women

    Directory of Open Access Journals (Sweden)

    M. Mohammadi Fard

    2008-01-01

    Full Text Available Background/Objective: Addiction is a risk factor for perinatal morbidity and mortality, although the pre-cise mechanism is unknown. They may alter oxygen delivery to the fetus. The middle cerebral artery (MCA pulsatility index (PI is a sensitive parameter for detection of blood flow redistribution or centrali-zation. The aim of this study was to determine whether addiction, without smoking, is associated with changes in the PI of the MCA and the umbilical artery (UA."nPatients and Methods: The PI of the MCA and UA were determined prospectively in 212 consecutive addict and pregnant women with singleton pregnan-cies (study group and in 212 matched pregnant women without addiction (control group. The con-trol group was matched for maternal age, gravidity, parity and gestational age at examination. Patients with fetal structural or chromosomal anomalies, dia-betes mellitus, and smokers were excluded. A PI be-low the 5th percentile for the MCA was considered abnormal. "nResults: The rate of abnormal MCA PI was signifi-cantly higher in the study group than control group: 33.3% vs. 6.3%, respectively, (p < 0.0001. "nConclusions: Our observations provide evidence of cerebral blood flow redistribution in fetuses with ad-dicted mothers.

  14. Sickle Cell Anemia: Reference Values of Cerebral Blood Flow Determined by Continuous Arterial Spin Labeling MRI

    Science.gov (United States)

    Arkuszewski, M.; Krejza, J.; Chen, R.; Melhem, E.R.

    2013-01-01

    Sickle cell anemia (SCA) is a chronic illness associated with progressive deterioration in patients' quality of life. The major complications of SCA are cerebrovascular accidents (CVA) such as asymptomatic cerebral infarct or overt stroke. The risk of CVA may be related to chronic disturbances in cerebral blood flow (CBF), but the thresholds of “normal” steady-state CBF are not well established. The reference tolerance limits of CBF can be useful to estimate the risk of CVA in asymptomatic children with SCA, who are negative for hyperemia or evidence of arterial narrowing. Continuous arterial spin labeling (CASL) MR perfusion allows for non-invasive quantification of global and regional CBF. To establish such reference tolerance limits we performed CASL MR examinations on a 3-Tesla MR scanner in a carefully selected cohort of 42 children with SCA (mean age, 8.1±3.3 years; range limits, 2.3–14.4 years; 24 females), who were not on chronic transfusion therapy, had no history of overt stroke or transient ischemic attack, were free of signs and symptoms of focal vascular territory ischemic brain injury, did not have intracranial arterial narrowing on MR angiography and were at low risk for stroke as determined by transcranial Doppler ultrasonography. PMID:23859242

  15. The value of in-utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral ventriculomegaly

    Energy Technology Data Exchange (ETDEWEB)

    Morris, J.E. [Section of Academic Radiology, Royal Hallamshire Hospital, University of Sheffield (United Kingdom); Rickard, S. [Section of Academic Radiology, Royal Hallamshire Hospital, University of Sheffield (United Kingdom); Paley, M.N.J. [Section of Academic Radiology, Royal Hallamshire Hospital, University of Sheffield (United Kingdom); Griffiths, P.D. [Section of Academic Radiology, Royal Hallamshire Hospital, University of Sheffield (United Kingdom); Rigby, A. [Department of Cardiology, University of Hull, Kingston upon Hull (United Kingdom); Whitby, E.H. [Section of Academic Radiology, Royal Hallamshire Hospital, University of Sheffield (United Kingdom)]. E-mail: e.whitby@sheffield.ac.uk

    2007-02-15

    Aim: To assess whether magnetic resonance imaging (MRI) is a useful adjunct to ultrasound (US) when imaging cases of foetal isolated cerebral ventriculomegaly. To assess whether, in such cases, ventricular morphology is a useful indicator for the underlying pathology, as has recently been suggested. Materials and methods: A retrospective analysis was undertaken of 30 cases of isolated ventriculomegaly diagnosed using US and referred for in utero MRI. The gestational age of each case was noted and the MRI report. Both ventricles were measured and each case was categorized according to severity and morphology. The MRI report was compared to the final diagnosis. Results: Of the 30 cases evaluated 18 had mild ventriculomegaly (<15 mm; gestational age range 20-31 weeks, mean 22.8, median 22) and 12 had severe ventriculomegaly (>15 mm; gestational age range 21-37 weeks, mean 28, median 28.5). Additional abnormalities were found in 50% of cases overall (44% mild, 58% severe) using MRI. Conclusions: Using MRI additional abnormalities were identified in 50% of the foetuses. The morphology of the cases did not suggest underlying pathology in this group. In utero MRI is a useful adjunct to US in cases of foetal cerebral ventriculomegaly referred after initial diagnosis using US.

  16. Sickle cell anemia: reference values of cerebral blood flow determined by continuous arterial spin labeling MRI.

    Science.gov (United States)

    Arkuszewski, M; Krejza, J; Chen, R; Melhem, E R

    2013-04-01

    Sickle cell anemia (SCA) is a chronic illness associated with progressive deterioration in patients' quality of life. The major complications of SCA are cerebrovascular accidents (CVA) such as asymptomatic cerebral infarct or overt stroke. The risk of CVA may be related to chronic disturbances in cerebral blood flow (CBF), but the thresholds of "normal" steady-state CBF are not well established. The reference tolerance limits of CBF can be useful to estimate the risk of CVA in asymptomatic children with SCA, who are negative for hyperemia or evidence of arterial narrowing. Continuous arterial spin labeling (CASL) MR perfusion allows for non-invasive quantification of global and regional CBF. To establish such reference tolerance limits we performed CASL MR examinations on a 3-Tesla MR scanner in a carefully selected cohort of 42 children with SCA (mean age, 8.1±3.3 years; range limits, 2.3-14.4 years; 24 females), who were not on chronic transfusion therapy, had no history of overt stroke or transient ischemic attack, were free of signs and symptoms of focal vascular territory ischemic brain injury, did not have intracranial arterial narrowing on MR angiography and were at low risk for stroke as determined by transcranial Doppler ultrasonography.

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

    NARCIS (Netherlands)

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

    2009-01-01

    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 chi

  18. Pulse oximetry for screening critical congenital heart disease in newborns

    Institute of Scientific and Technical Information of China (English)

    CHEN Cui-ying; WU Shu-yan; YOU Ke-li; CHEN Guan-di; LI Zhi-gang

    2016-01-01

    Background Pulse oximetry screening (POS) has been proposed as an effective,noninvasive,inexpensive tool allowing earlier diagnosis of critical congenital heart disease (CCHD).However,most neonates are discharged from the hospital without this evaluation in China.This study aimed at assessing the feasibility of POS for newborns in detecting CCHD in the department of obstetrics and neonatal intensive care unit (NICU).Methods POS was performed in 355 neonates born in the department of obstetrics or admitted to the NICU between January 2015 and June 2015.These neonates were divided into normal group,mild congenital heart disease group (MCHD) and CCHD group,according to the result of echocardiography or computerized tomography (CT).The gestational age,birth weight and arterial oxygen saturation (SpO2) were compared among the three groups.The SpO2 value and diagnosis time of the CCHD cases were classified and analyzed.Results The premature birth and low birth weight were the high risk factors of mild congenital heart disease.There was no difference (P > 0.05) in SpO2 between the MCHD group and the normal group.Significant difference in the SpO2 appeared between the CCHD group and the normal group (P < 0.05).Combination of POS and clinical examination can reduce the missing diagnosis rate in screening for CCHD.Conclusions POS incurs very low cost and risk of harm and is not required for special gaining,therefore,an effective way to identify CCHD in neonates.

  19. Diagnostic Value of D-Dimer’s Serum Level in Iranian Patients with Cerebral Venous Thrombosis

    Science.gov (United States)

    Hashami, Leila; Rakhshan, Vahid; Karimian, Hoda; Moghaddasi, Mehdi

    2016-01-01

    Cerebral venous thrombosis (CVT) is a long-term debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran) during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001). It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction. PMID:27441064

  20. Diagnostic value of D-dimer’s serum level in Iranian patients with cerebral venous thrombosis

    Directory of Open Access Journals (Sweden)

    Leila Hashami

    2016-06-01

    Full Text Available Cerebral venous thrombosis (CVT is a longterm debilitating vascular brain disease with high morbidity and mortality. It may be associated with rise in D-dimer level. The aim of this study was to examine this potential association and identify the critical D-dimer cut-off level corresponding to increase the risk of CVT. This case-control study was conducted on two groups of patients with and without CVT attending the Rasool Akram Hospital (Iran during 2014 and 2015. D-dimer levels were measured by the rapid sensitive D-dimer assay. Data were analyzed by Spearman’s correlation coefficient test, independent-samples t-test, backward-selection multiple linear regression and multiple binary logistic regression analyses. Sensitivity-specificity tests were used to detect D-dimer cut-off for CVT. Differences between the D-dimer levels of the case and control groups were significant (P<0.001. It showed that each level of increase in the number of symptoms could increase the risk of thrombosis occurrence for about 3.5 times. All symptom types except for headache were associated with D-dimer level, while headache has negative association with D-dimer level. D-dimer cut-off point for CVT diagnosis was estimated at 350 ng/mg. We concluded that D-dimer serum level significantly rises in CVT patients. A rounded cut-off point of 350 ng/mg can be used as a diagnostic criterion for CVT prediction.

  1. 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.

  2. Visualization of oxygen transportation in microcirculation by sidestream dark-field oximetry

    Science.gov (United States)

    Kurata, Tomohiro; Takahashi, Minori; Oda, Shigeto; Kawahira, Hiroshi; Ohnishi, Takashi; Haneishi, Hideaki

    2017-02-01

    The sidestream dark-field (SDF) imaging allows direct visualization of red blood cells in microvessels near tissue surfaces. We have developed an image-based oximetry method using two-band images obtained by SDF imaging (SDF oximetry) and a trial SDF device with light-emitting diodes to obtain band images. In this study, we propose a technique of producing oxygen saturation (SO2) maps from SDF images and perform animal experiments in vivo. To produce SO2 maps, we use spectral analysis using two band images obtained with our SDF device. As an image processing, the combination of both the Hessian-based and pixel value-based techniques as blood vessel extraction from an SDF image is used. From the experiment with the surface of rat small intestines, we can produce SO2 maps and find that the map represents arterioles and venules those were determined based on the blood ow from SDF images. Moreover, we find the variation of SO2 along a blood vessel running direction.

  3. 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.

  4. [Wavelength selection of the oximetry based on test analysis of variance].

    Science.gov (United States)

    Lin, Ling; Li, Wei; Zeng, Rui-Li; Liu, Rui-An; Li, Gang; Wu, Xiao-Rong

    2014-07-01

    In order to improve the precision and reliability of the spectral measurement of blood oxygen saturation, and enhance the validity of the measurement, the method of test analysis of variance was employed. Preferred wavelength combination was selected by the analysis of the distribution of the coefficient of oximetry at different wavelength combinations and rational use of statistical theory. Calculated by different combinations of wavelengths (660 and 940 nm, 660 and 805 nm and 805 and 940 nm) through the clinical data under different oxygen saturation, the single factor test analysis of variance model of the oxygen saturation coefficient was established, the relative preferabe wavelength combination can be selected by comparative analysis of different combinations of wavelengths from the photoelectric volume pulse to provide a reliable intermediate data for further modeling. The experiment results showed that the wavelength combination of 660 and 805 nm responded more significantly to the changes in blood oxygen saturation and the introduced noise and method error were relatively smaller of this combination than other wavelength combination, which could improve the measurement accuracy of oximetry. The study applied the test variance analysis to the selection of wavelength combination in the blood oxygen result measurement, and the result was significant. The study provided a new idea for the blood oxygen measurements and other related spectroscopy quantitative analysis. The method of test analysis of variance can help extract the valid information which represents the measured values from the spectrum.

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

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    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.

  6. LED power reduction trade-offs for ambulatory pulse oximetry.

    Science.gov (United States)

    Peláez, Eduardo Aguilar; Villegas, Esther Rodríguez

    2007-01-01

    The development of ambulatory arterial pulse oximetry is key to longer term monitoring and treatment of cardiovascular and respiratory conditions. The investigation presented in this paper will assist the designer of an ambulatory pulse oximetry monitor in minimizing the overall LED power consumption (P LED,TOT) levels by analyzing the lowest achievable limit as constrained by the optical components, circuitry implementation and final SpO2 reading accuracy required. LED duty cycle (D LED) reduction and light power (P LED,ON) minimization are proposed as methods to reduce P LED,TOT. Bandwidth and signal quality calculations are carried out in order to determine the required P LED,TOT as a function of the different noise sources.

  7. Monitoring cerebral tissue oxygen saturation at frontal and parietal regions during carotid artery stenting.

    Science.gov (United States)

    Meng, Lingzhong; Hall, Melanie; Settecase, Fabio; Higashida, Randall T; Gelb, Adrian W

    2016-04-01

    Cerebral oximetry is normally placed on the upper forehead to monitor the frontal lobe cerebral tissue oxygen saturation (SctO2). We present a case in which the SctO2 was simultaneously monitored at both frontal and parietal regions during internal carotid artery (ICA) stenting. Our case involves a 79-year-old man who presented after a sudden fall and was later diagnosed with a watershed ischemic stroke in the distal fields perfused by the left middle cerebral artery. He had diffuse atherosclerotic occlusive lesions in the carotid and cerebral arterial systems including an 85 % stenotic lesion in the left distal cervical ICA. The brain territory perfused by the left ICA was devoid of collateral flow from anterior and posterior communicating arteries due to an abnormal circle of Willis. During stenting, the SctO2 monitored at both frontal and parietal regions tracked the procedure-induced acute flow change. However, the baseline SctO2 values of frontal and parietal regions differed. The SctO2-MAP correlation was more consistent on the stroked hemisphere than the non-stroked hemisphere. This case showed that SctO2 can be reliably monitored at the parietal region, which is primarily perfused by the ICA. SctO2 of the stroked brain is more pressure dependent than the non-stroked brain.

  8. Knowledge of pulse oximetry among medical and nursing staff

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    Dimitrios Kosmidis

    2007-04-01

    Full Text Available The pulse oximetry is a widely used non invasive method for monitoring the arterial oxygenation. The doctors and the nurses are persons which are in charge for right interpretation of measurements, receiving suitable interventions for the management of patients. Aim: To assess nurses' and doctors' knowledge of pulse oximetry and identify training needs. Material and method: Participants in this study were 376 doctors and nurses from critical and general care settings in seven hospitals in Greece. The data collection was done through a self-administered questionnaire. Frequency of use, critical care experience, and opinions about education needs were included in demographic data. The knowledge test consisted of a 15 item, multiple-choice questionnaire, designed by researchers based on international bibliography. Results: A 70,7% of participants, use pulse oximeter often and 66,3% consider that is very useful in daily clinical practice. 83,7% didn't have some type of past education while more than 81,4% believes that they need further education. The average score for all (on a 15-point scale was 8,5. Ιn particular, the average score for each team had as follows: 10,5±2,7 for the specialized doctors, 9,6±3,1 for residents, 7,8±3,3 for the nurses and 7,4±3,4 for the nurse assistants. Low percentages of right answers were observed mainly in the questions about principles on which the pulse oximetry are based, clinical application and limitations, as well as normal ranges. Conclusion: The comprehension of pulse oximetry is insufficient, mainly in the nursing staff while totally is observed the need for further education.

  9. 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.

  10. Parameters from preoperative overnight oximetry predict postoperative adverse events.

    Science.gov (United States)

    Chung, F; Zhou, L; Liao, P

    2014-10-01

    Continuous home monitoring of oxygen saturation has become a reliable and feasible practice. The objective of this study was to investigate the role of preoperative overnight oximetry in predicting postoperative adverse events. Following research ethics board approval, consented patients underwent a preoperative overnight monitoring of oxygen saturation with a portable oximeter. Parameters from the oximetry data were extracted and their predictive performance for postoperative adverse events was evaluated. A total of 573 patients were studied with age: 60±12 years and 45% male. Oxygen desaturation index (ODI), cumulative time percentage with SpO2 3.0 events/h, >9.2 events/h and > 28.5 events/h; CT90: >0.1%, >1.1% and >7.2%; mean SpO2: rate of postoperative adverse events. For ODI >28.5 vs. ODI ⋝28.5 events/h, the odds ratio adjusted with age, gender, body mass index and American Society of Anesthesiologists physical status was 2.2 (95% CI: 1.3-3.9). Patients with mean preoperative overnight SpO2 28.5 events/h or CT90 >7.2% are at higher risk for postoperative adverse events. Overnight oximetry could be a useful tool to stratify patients for the risk of postoperative adverse events.

  11. Retinal oximeter for the blue-green oximetry technique

    Science.gov (United States)

    Denninghoff, Kurt R.; Sieluzycka, Katarzyna B.; Hendryx, Jennifer K.; Ririe, Tyson J.; Deluca, Lawrence; Chipman, Russell A.

    2011-10-01

    Retinal oximetry offers potential for noninvasive assessment of central venous oxyhemoglobin saturation (SO2) via the retinal vessels but requires a calibrated accuracy of +/-3% saturation in order to be clinically useful. Prior oximeter designs have been hampered by poor saturation calibration accuracy. We demonstrate that the blue-green oximetry (BGO) technique can provide accuracy within +/-3% in swine when multiply scattered light from blood within a retinal vessel is isolated. A noninvasive on-axis scanning retinal oximeter (ROx-3) is constructed that generates a multiwavelength image in the range required for BGO. A field stop in the detection pathway is used in conjunction with an anticonfocal bisecting wire to remove specular vessel reflections and isolate multiply backscattered light from the blood column within a retinal vessel. This design is tested on an enucleated swine eye vessel and a retinal vein in a human volunteer with retinal SO2 measurements of ~1 and ~65%, respectively. These saturations, calculated using the calibration line from earlier work, are internally consistent with a standard error of the mean of +/-2% SO2. The absolute measures are well within the expected saturation range for the site (-1 and 63%). This is the first demonstration of noninvasive on-axis BGO retinal oximetry.

  12. Predicting long-term independency in activities of daily living after middle cerebral artery stroke: does information from MRI have added predictive value compared with clinical information?

    NARCIS (Netherlands)

    Schiemanck, S.K.; Kwakkel, G.; Post, M.W.; Kappelle, L.J.; Prevo, A.J.

    2006-01-01

    BACKGROUND AND PURPOSE: To investigate whether neuroimaging information has added predictive value compared with clinical information for independency in activities of daily living (ADL) 1 year after stroke. METHODS: Seventy-five first-ever middle cerebral artery stroke survivors were evaluated in l

  13. The Value of Tranexamic Acid in Reducing Blood Loss following Hip Reconstruction in Children with Cerebral Palsy

    Science.gov (United States)

    Majid, I.; Alshryda, S.; Somanchi, B.; Morakis, E.; Foster, A.

    2015-01-01

    This is a retrospective study of 51 consecutive hip reconstructions in children with cerebral palsy performed between 2011 and 2013. Tranexamic acid (TXA) was used in 14 hip reconstructions only. Transfusion rate was higher, postoperative Hb was lower, and patients stayed longer in the TXA group. This did not reach a statistical significance (P = 0.75, 0.5, and 0.71, resp.). More than half of the patients who had TXA underwent bilateral hip reconstructions in comparison with 27% only in the non-TXA group. Bilateral hip reconstructions mean more surgery, more blood loss, and more blood transfusion. The patients who had TXA were significantly more disabled as evident by the higher proportions of patient with worse GMFCS levels. Although we have not been able to demonstrate the value of TXA in reducing blood loss and transfusion rate in children with CP who underwent hip reconstruction, it is hoped that an interest in exploring the value of TXA in paediatric orthopaedic surgery is generated. Ideally this should be explored further in an adequately powered, randomised controlled trial where risk of bias is minimized. PMID:26664830

  14. The Value of Tranexamic Acid in Reducing Blood Loss following Hip Reconstruction in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    I. Majid

    2015-01-01

    Full Text Available This is a retrospective study of 51 consecutive hip reconstructions in children with cerebral palsy performed between 2011 and 2013. Tranexamic acid (TXA was used in 14 hip reconstructions only. Transfusion rate was higher, postoperative Hb was lower, and patients stayed longer in the TXA group. This did not reach a statistical significance (P = 0.75, 0.5, and 0.71, resp.. More than half of the patients who had TXA underwent bilateral hip reconstructions in comparison with 27% only in the non-TXA group. Bilateral hip reconstructions mean more surgery, more blood loss, and more blood transfusion. The patients who had TXA were significantly more disabled as evident by the higher proportions of patient with worse GMFCS levels. Although we have not been able to demonstrate the value of TXA in reducing blood loss and transfusion rate in children with CP who underwent hip reconstruction, it is hoped that an interest in exploring the value of TXA in paediatric orthopaedic surgery is generated. Ideally this should be explored further in an adequately powered, randomised controlled trial where risk of bias is minimized.

  15. CT脑灌注成像临床诊断急性脑梗死价值评价与平扫CT值差值的测量价值%Value Evaluation on Clinical Diagnosis of CT Cerebral Perfusion Imaging on Acute Cerebral infarction and Measurement Value of Difference Value of Plain Scan CT Value

    Institute of Scientific and Technical Information of China (English)

    余东

    2015-01-01

    Objective This Paper is to explore the application value of CT perfusion imaging and differential value of measured CT value in the diagnosis of acute cerebral infarction. Methods Thirty six patients with acute cerebral infarction admitted the Radiology Department of the Hospital were selected as research subjects, retrospective analysis and summary were conducted according to clinical data. CT plaint scan and brain CT perfusion imaging were made respectively, The time to peak (TIP), cerebral blood flow (CBF) and cerebral blood volume (CBV) of CT perfusion imaging were evaluated, the difference of CT value on both sides of symmetric positions was measured. In addition, 36 patients with no brain disease and normal nervous function were divided into the control group, and diagnostic value of the difference between CT perfusion imaging and CT measurement value in acute cerebral infarction was analyzed. Results It is visually found that there were 17 patients with suspicious lesions with the sensitivity at 47.2%, and it was found that there were 28 patients with suspicious lesions by measuring CT value difference. It was found that the CTP of 3 patients was normal CT perfusion imaging examination, and such 2 patients were finally diagnosed to suffer from transient ischemic attack, and others were abnomal, rCBF, rCBV and rTTP changed obviously, the comparison in lesion center and perimeter and controlled side satisfied p<0.05, and the differences were statistically significant. Conclusion CT perfusion imaging and the difference value in CT value measurement delivers high application value in the diagnosis of acute cerebral infarction, and it is capable of diagnosing cerebral infarction in early differential diagnosis, the infarct area and ischemic penumbra area may be differentiated via through quantitative analysis, providing important basis for clinical determination on the existence of infarct and development of therapeutic schedule.%目的:探讨CT灌注成像

  16. Early-Phase 11C-PiB PET in Amyloid Angiopathy-Related Symptomatic Cerebral Hemorrhage: Potential Diagnostic Value?

    Science.gov (United States)

    Farid, Karim; Hong, Young T; Aigbirhio, Franklin I; Fryer, Tim D; Menon, David K; Warburton, Elizabeth A; Baron, Jean-Claude

    2015-01-01

    Although late-phase (>35min post-administration) 11C-PiB-PET has good sensitivity in cerebral amyloid angiopathy (CAA), its specificity is poor due to frequently high uptake in healthy aged subjects. By detecting perfusion-like abnormalities, early-phase 11C-PiB-PET might add diagnostic value. Early-frame (1-6min) 11C-PiB-PET was obtained in 11 non-demented patients with probable CAA-related symptomatic lobar intracerebral haemorrhage (70±7yrs), 9 age-matched healthy controls (HCs) and 10 HCs PiB data did not change the sensitivity and specificity of late-phase PiB, but combined early- and late-phase positivity entails a very high suspicion of underlying Aβ-related clinical disorder, i.e., CAA or Alzheimer disease (AD). In order to clarify this ambiguity, we then show that the occipital/posterior cingulate ratio is markedly lower in CAA than in AD (N = 7). These pilot data suggest that early-phase 11C-PiB-PET may not only add to late-phase PiB-PET with respect to the unclear situation of late-phase positivity, but also help differentiate CAA from AD.

  17. 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.

  18. Investigation of optimum wavelengths for oximetry

    Science.gov (United States)

    Huong, Audrey K. C.; Stockford, Ian M.; Crowe, John A.; Morgan, Stephen P.

    2009-07-01

    An evaluation of the optimum choice of wavelengths, when using the 'Modified Lambert-Beer law' to estimate blood oxygen saturation, that minimises the mean error across a range of oxygen saturation values is presented. The stability of this approach and its susceptibility to noise are also considered.

  19. Reflectance pulse oximetry at the forehead of newborns : The influence of varying pressure on the probe

    NARCIS (Netherlands)

    Dassel, ACM; Graaff, R; Zijlstra, WG; Aarnoudse, JG

    1996-01-01

    Objective: Transmission pulse oximetry (TPO) is not a practical method of intrapartum fetal monitoring of arterial oxygen saturation. Reflectance pulse oximetry (RPO) requires a sensor applied to the skin of the fetal head and may be a useful technique. During labor, various degrees of pressure will

  20. Reflectance pulse oximetry at the forehead of newborns : The influence of varying pressure on the probe

    NARCIS (Netherlands)

    Dassel, ACM; Graaff, R; Zijlstra, WG; Aarnoudse, JG

    1996-01-01

    Objective: Transmission pulse oximetry (TPO) is not a practical method of intrapartum fetal monitoring of arterial oxygen saturation. Reflectance pulse oximetry (RPO) requires a sensor applied to the skin of the fetal head and may be a useful technique. During labor, various degrees of pressure will

  1. Application value of CT perfusion imaging with acetazolamide challenge test in the diagnosis of chronic cerebral insufficiency

    Institute of Scientific and Technical Information of China (English)

    高轩

    2014-01-01

    Objective To explore the CT perfusion imaging with acetazolamide(ACZ)challenge test in the diagnosis of chronic cerebral insufficiency.Methods 100 patients undergoing health examination in our hospital from Aug2009 to Feb 2011 were chosen,52 patients diagnosed as chronic cerebral insufficiency were defined as the case group,and the remaining 48 cases of healthy elderly people were defined as the control group.The brain CT

  2. {sup 19}F MRI oximetry: simulation of perfluorocarbon distribution impact

    Energy Technology Data Exchange (ETDEWEB)

    Baete, S H; Vandecasteele, J; De Deene, Y, E-mail: steven.baete@ugent.be [Department of Radiation Oncology and Experimental Cancer Research, Ghent University, De Pintelaan 185, 9000 Gent (Belgium)

    2011-04-21

    In {sup 19}F MRI oximetry, a method used to image tumour hypoxia, perfluorocarbons serve as oxygenation markers. The goal of this study is to evaluate the impact of perfluorocarbon distribution and concentration in {sup 19}F MRI oximetry through a computer simulation. The simulation studies the correspondence between {sup 19}F measured (pO{sup FNMR}{sub 2}) and actual tissue oxygen tension (pO{sub 2}) for several tissue perfluorocarbon distributions. For this, a Krogh tissue model is implemented which incorporates the presence of perfluorocarbons in blood and tissue. That is, in tissue the perfluorocarbons are distributed homogeneously according to Gaussian diffusion profiles, or the perfluorocarbons are concentrated in the capillary wall. Using these distributions, the oxygen tension in the simulation volume is calculated. The simulated mean oxygen tension is then compared with pO{sup FNMR}{sub 2}, the {sup 19}F MRI-based measure of pO{sub 2} and with pO{sup 0}{sub 2}, pO{sub 2} in the absence of perfluorocarbons. The agreement between pO{sup FNMR}{sub 2} and actual pO{sub 2} is influenced by vascular density and perfluorocarbon distribution. The presence of perfluorocarbons generally gives rise to a pO{sub 2} increase in tissue. This effect is enhanced when perfluorocarbons are also present in blood. Only the homogeneous perfluorocarbon distribution in tissue with no perfluorocarbons in blood guarantees small deviations of pO{sup FNMR}{sub 2} from pO{sub 2}. Hence, perfluorocarbon distribution in tissue and blood has a serious impact on the reliability of {sup 19}F MRI-based measures of oxygen tension. In addition, the presence of perfluorocarbons influences the actual oxygen tension. This finding may be of great importance for further development of {sup 19}F MRI oximetry.

  3. 19F MRI oximetry: simulation of perfluorocarbon distribution impact

    Science.gov (United States)

    Baete, S. H.; Vandecasteele, J.; De Deene, Y.

    2011-04-01

    In 19F MRI oximetry, a method used to image tumour hypoxia, perfluorocarbons serve as oxygenation markers. The goal of this study is to evaluate the impact of perfluorocarbon distribution and concentration in 19F MRI oximetry through a computer simulation. The simulation studies the correspondence between 19F measured (pOFNMR2) and actual tissue oxygen tension (pO2) for several tissue perfluorocarbon distributions. For this, a Krogh tissue model is implemented which incorporates the presence of perfluorocarbons in blood and tissue. That is, in tissue the perfluorocarbons are distributed homogeneously according to Gaussian diffusion profiles, or the perfluorocarbons are concentrated in the capillary wall. Using these distributions, the oxygen tension in the simulation volume is calculated. The simulated mean oxygen tension is then compared with pOFNMR2, the 19F MRI-based measure of pO2 and with pO02, pO2 in the absence of perfluorocarbons. The agreement between pOFNMR2 and actual pO2 is influenced by vascular density and perfluorocarbon distribution. The presence of perfluorocarbons generally gives rise to a pO2 increase in tissue. This effect is enhanced when perfluorocarbons are also present in blood. Only the homogeneous perfluorocarbon distribution in tissue with no perfluorocarbons in blood guarantees small deviations of pOFNMR2 from pO2. Hence, perfluorocarbon distribution in tissue and blood has a serious impact on the reliability of 19F MRI-based measures of oxygen tension. In addition, the presence of perfluorocarbons influences the actual oxygen tension. This finding may be of great importance for further development of 19F MRI oximetry.

  4. The Impact of Reduced Pulse Oximetry Use on Alarm Frequency.

    Science.gov (United States)

    Schondelmeyer, Amanda C; Brady, Patrick W; Sucharew, Heidi; Huang, Guixia; Hofacer, Kelsey E; Simmons, Jeffrey M

    2016-04-01

    Concerns about alarm fatigue prompted The Joint Commission to issue a Sentinel Event Alert urging hospitals to minimize alarms. We previously conducted a quality improvement project on a single unit that reduced time on continuous pulse oximetry, a common source of physiologic monitor alarms, for patients with wheezing (ie, asthma and bronchiolitis, wheezing-associated respiratory infections). To study the impact of our improvement work on overall physiologic monitor alarm frequency for these patients. This was a retrospective cohort study at a freestanding children's hospital over an 8-week period. We compared alarm count, including respiratory, cardiac, and pulse oximetry alarms, for patients admitted to the intervention unit with the alarm count for similar patients on a control unit by using the Wilcoxon rank sum test. We used negative binomial regression to evaluate differences in alarm count between the units, adjusting for age, medical comorbidity, and length of stay. There were 101 patients on the intervention unit and 46 patients on the control unit. The percentage of patients with medical comorbidities was significantly higher on the intervention unit (P=.01). Median alarm count per day for patients on the intervention unit was lower; however, this difference was not statistically significant (71 vs 76 alarms per patient-day, P=.29). The multivariable model estimated a nonsignificant 6.4-count decrease in alarms for patients on the intervention unit. Reducing continuous pulse oximetry use alone may not make substantial reductions in overall alarm counts. Even on our intervention unit, alarm burden remained quite high. Copyright © 2016 by the American Academy of Pediatrics.

  5. 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

  6. Adjustable fetal phantom for pulse oximetry

    Science.gov (United States)

    Stubán, Norbert; Niwayama, Masatsugu

    2009-05-01

    As the measuring head of a fetal pulse oximeter must be attached to the head of the fetus inside the mother's uterus during labor, testing, and developing of fetal pulse oximeters in real environment have several difficulties. A fetal phantom could enable evaluation of pulse oximeters in a simulated environment without the restrictions and difficultness of medical experiments in the labor room. Based on anatomic data we developed an adjustable fetal head phantom with three different tissue layers and artificial arteries. The phantom consisted of two arteries with an inner diameter of 0.2 and 0.4 mm. An electronically controlled pump produced pulse waves in the arteries. With the phantom we investigated the sensitivity of a custom-designed wireless pulse oximeter at different pulsation intensity and artery diameters. The results showed that the oximeter was capable of identifying 4% and 2% changes in diameter between the diastolic and systolic point in arteries of over 0.2 and 0.4 mm inner diameter, respectively. As the structure of the phantom is based on reported anatomic values, the results predict that the investigated custom-designed wireless pulse oximeter has sufficient sensitivity to detect the pulse waves and to calculate the R rate on the fetal head.

  7. Assessment of the calibration curve for transmittance pulse-oximetry

    Science.gov (United States)

    Doronin, A.; Fine, I.; Meglinski, I.

    2011-11-01

    Optical/laser modalities provide a broad variety of practical solutions for clinical diagnostics and therapy in a range from imaging of single cells and molecules to non-invasive biopsy of specific biological tissues and organs tomography. Near-infrared transmittance pulse oximetry with laser diodes is the accepted standard in current clinical practice and widely used for noninvasive monitoring of oxygen saturation in arterial blood hemoglobin. Conceptual design of practical pulse oximetry systems requires careful selection of various technical parameters, including intensity, wavelength, beam size and profile of incident laser radiation, size, numerical aperture of the detector, as well as a clear understanding of how the spatial and temporal structural alterations in biological tissues can be linked with and can be distinguished by variations of these parameters. In current letter utilizing state-of-the-art NVIDEA CUDA technology, a new object oriented programming paradigm and on-line solutions we introduce a computational tool applied for human finger transmittance spectra simulation and assessment of calibration curve for near-infrared transmitted pulseoximetry.

  8. 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.).

  9. Diagnosis of PLMD from increased pulse rate variability on overnight oximetry.

    Science.gov (United States)

    Krishnaswamy, Uma M; Higgins, Sean E; Kosky, Christopher A; Delacy, Simone; Williams, Adrian J

    2010-01-01

    This study was undertaken in a group of patients with periodic limb movement disorder (PLMD) to assess whether the presence of increased pulse rate variability (PRV) without desaturation on overnight oximetry was suggestive of the occurrence of periodic limb movements (PLMs). Seventy sleepy patients with a polysomnographic diagnosis of PLMD and 25 controls with obstructive sleep apnea were included in this retrospective study. All patients had undergone initial domiciliary oximetry and subsequent polysomnography (PSG). The oximetry tracings were independently interpreted by five sleep unit personnel for the presence of increased PRV. Further, the association between increased PRV and PLMs was evaluated in the summary graph of the PSG. Fifty seven (81.4%) patients had definite evidence of increased PRV without episodes of desaturation on initial oximetry, which was later confirmed to be due to PLMs on PSG. 13 (18.6%) patients had no PRV on oximetry and PSG but had PLMD. The inter-interpreter concurrence in suspecting a diagnosis of PLMD based on oximetry alone was more than 80% in 64 (91%) patients. The presence of isolated increased PRV on overnight oximetry is a valuable tool in suspecting nonsleep apnea disorders like PLMD.

  10. Reference Values for Aerobic Fitness in Children, Adolescents, and Young Adults Who Have Cerebral Palsy and Are Ambulatory

    NARCIS (Netherlands)

    Verschuren, Olaf; Bloemen, Manon; Kruitwagen, Cas; Takken, Tim

    2010-01-01

    Background. Very few objective data exist regarding aerobic performance in young people with cerebral palsy (CP). The characterization of aerobic fitness could provide baseline and outcome measures for the rehabilitation of young people with CP. Objective. The objective of this study was to provide

  11. MRI对脑静脉畸形的诊断价值%Diagnostic value of MRI in cerebral venous malformation

    Institute of Scientific and Technical Information of China (English)

    牛磊; 朱蒙蒙; 王明皓; 崔文; 刘圆圆; 朱斌

    2011-01-01

    目的:探讨MRI对脑静脉畸形(CVM)的诊断价值.方法:收集本院18例脑静脉畸形病例,均行磁共振T1WI、T2WI、FLAIR、SWI、DWI、MRA及T1 Wl增强扫描的资料.结果:CVM位于幕下5例,幕上13例,18例均呈典型的“海蛇头”征.MRI显示髓静脉呈长T1长T2信号,引流静脉呈短T1稍长T2信号或长T1长T2信号.FLAIR上髓静脉为稍高信号,引流静脉为低信号或稍高信号.SWI及DWI上髓静脉和引流静脉均为低信号.增强呈“海蛇头”样改变,即多条髓静脉呈辐射状汇入粗大的引流静脉.结论:MRI能明确诊断脑静脉畸形.T1WI增强扫描及SWI均较敏感.SWI对CVM的诊断价值明显优于常规MRI序列.%Objective:To investigate the diagnostic value of MRI in cerebral venous malformations (CVM). Methods: 18 patients of CVM were collected, and all of them underwent T1 WI, T2WI. FLAIR. SWI. DWI. MRA. And T,W1 enhancement scans. Results:CVMs were located in infra in five cases, and supra tentorium in thirteen eleven patients. Eighteen presented the typical " caput medusae" appearance. As for MRI plain scans.the medullary veins showed hypointensity in T1 WI and hyperintensity in T2WI, while, the drainage veins featured hyperintensity in T1 WI and hyperintensity in T2 WI. FLAIR sequences manifested less medullary veins with hyperintensity and drainage veins with hypointensity or hyperintensity. Both the medullary and the drainage veins appeared hypointensity in DWI and SWI. After enhancement, numerous radiating medullary veins gathered together into one or two larger drainage veins and flowed into superficial or deeper veins. Demonstrating the so-called "Caput Medusae" appearance. Conclusion: MRI is the first choice for suspected CVM patients thus providing more diagnostic information. T1 WI enhancement and SWI are sensitive to manifesting CVMs. SWI diagnosis of CVM is significantly superior to conventional MRI sequences.

  12. 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.

  13. The Effect of Skin Pigmentation on the Accuracy of Pulse Oximetry in Infants with Hypoxemia.

    Science.gov (United States)

    Foglia, Elizabeth E; Whyte, Robin K; Chaudhary, Aasma; Mott, Antonio; Chen, Jodi; Propert, Kathleen J; Schmidt, Barbara

    2017-03-01

    To compare pulse oximetry measurement bias between infants with hypoxemia with either dark skin or light skin with Masimo Radical 7 and Nellcor Oximax. There was no significant difference in systematic bias based on skin pigment for either oximeter.

  14. The impact of increasing oximetry usage in India: A pilot study

    Directory of Open Access Journals (Sweden)

    Gretl A McHugh

    2011-01-01

    Full Text Available The overall goal of the global oximetry (GO project was to increase patient safety during anaesthesia and surgery in low and middle income countries by decreasing oximetry costs and increasing oximetry utilisation. Results from the overall project have been previously published. This paper reports specifically on pilot work undertaken in four hospitals in one Indian State. The aim of this work was to assess the impact of increasing oximetry provision in terms of benefits to anaesthetists and in the identification of patient problems during anaesthesia, to identify training needs and to explore perceptions regarding barriers to more comprehensive oximetry coverage. Data collection was by interview with hospital staff, use of a log-book to capture data on desaturation episodes and a follow-up questionnaire at 10 months after the introduction of additional oximeters. Increasing oximetry utilisation in the four hospitals was viewed positively by the anaesthetic staff and enabled improvement in monitoring patients. Of the 939 monitored patients studied, 214 patients (23% experienced a total of 397 desaturation episodes. For nearly half of the patients undergoing caesarean section under regional anaesthesia following a desaturation event supplementary oxygen was required. In 53 of the 379 female sterilisations (14% desaturation episodes occurred and in eight patients, there were 17 episodes of desaturation due to obstruction. In the recovery room, 91 of the 939 patients were monitored using the oximeters with 12 patients (13% requiring oxygen. This study has highlighted that pulse oximetry must be used even in patients having surgical procedures or caesarean section under regional or local anaesthesia as these procedures are associated with hypoxic episodes. Anaesthetists must ensure they are complying with the Indian Society of Anaesthesiologists monitoring standards for anaesthesia and ensure patients are monitored by pulse oximetry.

  15. Analyzing Ph value, energy and phospholipid metabolism of various cerebral tumors and normal brain tissue with 31P magnetic resonance spectroscopy

    Institute of Scientific and Technical Information of China (English)

    Wei Tan; Guangyao Wu; Junmo Sun

    2006-01-01

    BACKGROUND: 31P magnetic resonance spectroscopy (31P MRS) can be used to non-injuredly and dynamicly detect various metabolites including phosphorus in organis and reflect changes of phospholipid metabolism and energy metabolism in tissue and pH value in cells.OBJECTIVE: To observe changes of pH value, phospholipid metabolism and energy metabolism of various cerebral tumors and normal brain tissue with 31P MRS.DESIGN: Semi-quantitative contrast observation.PARTICIPANTS: A total of 44 patients with cerebral tumor diagnosed with surgery operation were selected from the Department of Magnetic Resonance, Central South Hospital, Wuhan University from September 2004 to June 2006. All the subjects had complete 31P MRS data before steroid and operation. Among them,16 patients had glioma of grade Ⅱ-Ⅲ, 12 spongioblastoma and 16 meningioma. The mean age was (45±6)years. Another 36 subjects without focus on cerebral MRI were regarded as normal group, including 19 males and 18 females, and the mean age was (41±4) years. Included subjects were consent.METHODS: Eclipse1.5T MRS (Philips Company) was used to collect wave spectrum; jMRUI(1.3) was used to analyze experimental data and calculate pH value in voxel and ratios of phosphocreatine (PCr)/inorganic phosphate (Pi), PCr/phosphodiesterase (PDE) and phosphomonoesterase (PME)/β-adenosine triphosphate (β-ATP) of various metabolites. 31P MRS results were compared with t test between tumor patients and normal subjects.MAIN OUTCOME MEASURES: Changes of phospholipid metabolism (PME/PDE), energy metabolism (PCr/ATP) and pH value of various cerebral tumors and normal brain tissues.RESULTS: A total of 44 cases with cerebral tumor and 36 normal subjects were involved in the final analysis. pH value and semi-quantitative measurements of normal brain tissues and various cerebral tumors: ① pH value at top occipital region and temple occipital region of normal brain tissue was 7.04±0.02;PCt/β-ATP was 1.51 ±0.03; PCt/Pi was 2.85

  16. 颅内动脉瘤介入术前模拟的价值%Value and pitfall of interventional preoperative simulation in cerebral aneurysm

    Institute of Scientific and Technical Information of China (English)

    魏欣; 赵晓伟; 钟立明; 谢晓东; 王朝华; 游箭; 何家全; 胡鸿; 范润金; 胡孔琼

    2011-01-01

    Objective To explore the value and pitfall of virtual three - dimensional individual cerebral aneurysm and instrument models in interventional preoperative simulation.Methods The individual simulation results of 17 patients with interventional preoperative cerebral aneurysms were retrospectively analyzed and compared with the results of actual surgery.To evaluate the value and pitfall in the time - consuming of preoperative simulation and modeling, the simulation results of optimal showing angle of the aneurysm, the simulation pathway of inserting catheter, the simulation results of coil and stent placement accuracy and simulation results in teaching and training were evaluated.Results (1)The practical value of establishing individual cerebral aneurysm model was not ideal because of longer time -consuming.The practical value of preoperative simulation could be accepted because of shorter time -consuming.(2)The simulation results of optimal showing angle of the aneurysm had some practical value because the accuracy was high (14/17).The simulation results of intubation pathway had reference value to guide a reasonable micro - catheter and micro - wire tip moulding.The simulation results of packing coil and releasing stent compared with actual operation results were the same or similar (13/17).(3) Questionnaire survey results showed that the proportion in enhancing comprehension of the operative intent with a high value was 38/41, the proportion of software operation method with a high difficulty in establishing individual cerebral aneurysm model was 22/41.Conclusions In aspects of operational method of preoperative simulation, the accuracy of simulation results, the teaching and staff training have better practicability.In aspects of optimizing the individual modeling method of cerebral aneurysm is worth further study.%目的 探讨个体化颅内动脉瘤及介入器械的虚拟三维模型在神经介入术前模拟中的价值.方法 回顾性分析17例术前模

  17. Correction method for influence of tissue scattering for sidestream dark-field oximetry using multicolor LEDs

    Science.gov (United States)

    Kurata, Tomohiro; Oda, Shigeto; Kawahira, Hiroshi; Haneishi, Hideaki

    2016-10-01

    We have previously proposed an estimation method of intravascular oxygen saturation (SO_2) from the images obtained by sidestream dark-field (SDF) imaging (we call it SDF oximetry) and we investigated its fundamental characteristics by Monte Carlo simulation. In this paper, we propose a correction method for scattering by the tissue and performed experiments with turbid phantoms as well as Monte Carlo simulation experiments to investigate the influence of the tissue scattering in the SDF imaging. In the estimation method, we used modified extinction coefficients of hemoglobin called average extinction coefficients (AECs) to correct the influence from the bandwidth of the illumination sources, the imaging camera characteristics, and the tissue scattering. We estimate the scattering coefficient of the tissue from the maximum slope of pixel value profile along a line perpendicular to the blood vessel running direction in an SDF image and correct AECs using the scattering coefficient. To evaluate the proposed method, we developed a trial SDF probe to obtain three-band images by switching multicolor light-emitting diodes and obtained the image of turbid phantoms comprised of agar powder, fat emulsion, and bovine blood-filled glass tubes. As a result, we found that the increase of scattering by the phantom body brought about the decrease of the AECs. The experimental results showed that the use of suitable values for AECs led to more accurate SO_2 estimation. We also confirmed the validity of the proposed correction method to improve the accuracy of the SO_2 estimation.

  18. Correction method for influence of tissue scattering for sidestream dark-field oximetry using multicolor LEDs

    Science.gov (United States)

    Kurata, Tomohiro; Oda, Shigeto; Kawahira, Hiroshi; Haneishi, Hideaki

    2016-12-01

    We have previously proposed an estimation method of intravascular oxygen saturation (SO_2) from the images obtained by sidestream dark-field (SDF) imaging (we call it SDF oximetry) and we investigated its fundamental characteristics by Monte Carlo simulation. In this paper, we propose a correction method for scattering by the tissue and performed experiments with turbid phantoms as well as Monte Carlo simulation experiments to investigate the influence of the tissue scattering in the SDF imaging. In the estimation method, we used modified extinction coefficients of hemoglobin called average extinction coefficients (AECs) to correct the influence from the bandwidth of the illumination sources, the imaging camera characteristics, and the tissue scattering. We estimate the scattering coefficient of the tissue from the maximum slope of pixel value profile along a line perpendicular to the blood vessel running direction in an SDF image and correct AECs using the scattering coefficient. To evaluate the proposed method, we developed a trial SDF probe to obtain three-band images by switching multicolor light-emitting diodes and obtained the image of turbid phantoms comprised of agar powder, fat emulsion, and bovine blood-filled glass tubes. As a result, we found that the increase of scattering by the phantom body brought about the decrease of the AECs. The experimental results showed that the use of suitable values for AECs led to more accurate SO_2 estimation. We also confirmed the validity of the proposed correction method to improve the accuracy of the SO_2 estimation.

  19. Use of perfusion index from pulse oximetry to determine efficacy of stellate ganglion block

    Directory of Open Access Journals (Sweden)

    Yamazaki H

    2012-03-01

    Full Text Available Hajime Yamazaki, Junichi Nishiyama, Toshiyasu SuzukiDepartment of Anesthesiology, Surgical Science, Tokai University School of Medicine, Kanagawa, JapanBackground: Stellate ganglion block (SGB is a widely used procedure for treatment of pain in the head and upper body, but the clinical signs used to verify the effectiveness of SGB can be ambiguous or variable in some patients. We observed the chronological changes in perfusion index (PI from pulse oximetry to determine if these changes correlated with the clinical signs associated with an effective SGB. We hypothesized that PI could provide an easy method to assess the effectiveness of SGB.Method: We compared the chronologies in PI on the treated and untreated sides of 21 patients in whom treatment by SGB was found to be effective. The SGB was performed by administering 6 mL of 1% mepivacaine. The effectiveness of the SGB was confirmed on the basis of clinical signs. Additionally, in two patients we tested whether increased PI on the treatment side correlated with increased microcirculation as measured by laser-Doppler blood flowmetry.Results: On the side treated by SGB, PI increased 61.4% in the earlobe and 60.5% from baseline values in the upper limbs, at 5 minutes after initiation of the procedure. Differences in PI before and after treatment were significant at both sites. No time-course increases in PI were found on the untreated side at either site. Following SGB, increases in PI correlated with increases in blood flow as measured by laser-Doppler flowmetry.Conclusion: PI increased in the earlobe and upper limbs on the treated side of 21 patients who received an effective SGB but not on the untreated side. The positive correlations between changes in PI and both presence of clinical signs and changes in blood flow in the skin microcirculation indicate a sympatholytic effect, suggesting that the PI could be useful in determination of the efficacy of SGB.Keywords: stellate ganglion block

  20. Dopamine therapy is associated with impaired cerebral autoregulation in preterm infants

    DEFF Research Database (Denmark)

    Eriksen, Vibeke R; Hahn, Gitte H; Greisen, Gorm

    2014-01-01

    cerebral autoregulation (CA). METHODS: Near-infrared spectroscopy was used to measure the cerebral oxygenation index in 60 very preterm infants, and mean arterial blood pressure was monitored towards the end of their first day of life. Measurements were performed continuously for two to three hour periods....... CA was quantified as the cerebral oximetry index (COx). RESULTS: We treated 13 of the 60 infants (22%) with dopamine during the measurements. COx was higher in the dopamine group than the untreated group (0.41 ± 0.25 vs. 0.08 ± 0.25, p pressure tended to be lower in the dopamine group...

  1. Percutaneous nocturnal oximetry in amyotrophic lateral sclerosis: periodic desaturation.

    Science.gov (United States)

    de Carvalho, Mamede; Costa, João; Pinto, Susana; Pinto, Anabela

    2009-06-01

    Percutaneous nocturnal oximetry (PNO) is useful to screen respiratory function in amyotrophic lateral sclerosis (ALS). PNO recordings of some patients disclose a periodical pattern of O(2) desaturation (PP), whose significance is unknown. We aimed to characterize PP pattern, and we used a prospective study enrolling 261 consecutive ALS patients. Clinical, pulmonary and neurophysiological tests performed included: ALS functional rating scale, forced vital capacity (FVC), maximal inspiratory pressure (PImax), mouth occlusion pressure (MOP), phrenic nerve motor response, needle electromyography of the diaphragm, PNO, and sleep study. A total of 837 PNO recordings were analysed (3.2 recordings/patient) and 45 patients showed typical PP (17.2%). Four were excluded, 13 had normal diaphragm (group 1, G1), and in 28 the diaphragm was abnormal (G2). The two groups were comparable, apart from respiratory score, FVC and PImax which were lower in G2. In G1, REM sleep was absent and hypoventilation occurred at slow-wave sleep. Five patients in G1 were very spastic, had low MOP/FVC and a short survival. This study identified a subgroup of ALS patients (G1) with marked signs of upper motor neuron lesion, strong respiratory muscles, PP, low MOP/FVC ratio and poor prognosis. We speculate that they have a central respiratory dysfunction and deserve special care.

  2. Near-infrared spectroscopy extended with indocyanine green dye dilution for cerebral blood flow measurement: Median values in healthy volunteers

    Science.gov (United States)

    Mudra, R.; Muroi, C.; Niederer, P.; Keller, E.

    2008-09-01

    The cerebral blood flow (CBF) is an important vital parameter in neurointensive care. Currently, there is no non-invasive method for its measurement that can easily be applied at the bedside. A new tool to determine CBF is based on near-infrared spectroscopy (NIRS) applied together with indocyanine green (ICG) dye dilution. From a bilateral measurement on selected regions on the head of infrared (IR) absorption at various wavelengths during the dilution maneuver, the vascular perfusion characteristics of the two brain hemispheres can be determined in terms of mean transit time (mtt) of ICG, cerebral blood volume (CBV) and CBF. So far, on nine healthy volunteers, NIRS ICG dye dilution bihemispheric measurements were performed, which yielded to mtt given as median (range) of 9.3 s (5.1-16.3 s), CBV of 3.5 ml/100 g (1.7-4.1 ml/100 g), and CBF of 18.2 ml/(100 g×min) [11.1-48.6 ml/(100 g×min)]. Additionally, the blood flow index (BFI) was calculated with BFI= 13.8 mg/(100 g×s) [6.6-15.2 mg/(100 g×s)]. The Spearman rank correlation coefficient between CBF and BFI was RS = 0.76. However, as the Bland & Altman plot between CBFNIRS and the CBFBFI documents, the limits of agreement are rather wide (21.9±6.7). Under physiological conditions in healthy volunteers, no differences could be detected between the hemispheres.

  3. Neonatal pulse oximetry screening improves detecting of critical congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    MA Xiao-jing; HUANG Guo-ying

    2013-01-01

    Objective Life-threatening critical congenital heart disease (cCHD) is often not detected in the neonatal period.Unrecognized cCHD results in high morbidity and mortality rates.As a non-invasive,convenient,quick and accurate measuring method,pulse oximetry is considered to be a promising strategy to screen for cCHD in neonates.This article is a review on the neonatal pulse oximetry screening for cCHD.Data sources Articles on neonatal pulse oximetry screening for cCHD were accessed from PubMed,using keywords including congenital heart defects,neonatal screening and oximetry.Study selection Original articles and critical reviews selected were relevant to the review's theme.Results The factors in the course of implementation,including threshold for positive pulse-oximetry screening results,the pulse oximeters used,timing of the screening,and the measuring position,influence the accuracy of the screening.It is recommended that the screening is completed on the second day of life,before hospital discharge.Motion-tolerant pulse oximeters,which can also be applied to measure the saturation in low-perfusion conditions,should be used.The probe should be put on both the right hand and on one foot.Thresholds of <95% in either limb or a difference of >3% between the limbs as a positive result may be appropriate.It should be emphasized that pulse-oximetry screening cannot be used as the only way to detect cCHD,clinical examination is also important in this situation.Cost-benefit analysis in the United Kingdom revealed it was plausible to use pulse oximetry as an adjunct to clinical examination.However,it is still controversial as to whether pulse oximetry can be used as a routine screening method for cCHD in neonates.Conclusions Neonatal pulse oximetry screening improves detection of cCHD.Further studies should be carried out before it becomes one of the routine newborn screening programs.

  4. 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.

  5. Evaluating the impact of pulse oximetry on childhood pneumonia mortality in resource-poor settings.

    Science.gov (United States)

    Floyd, Jessica; Wu, Lindsey; Hay Burgess, Deborah; Izadnegahdar, Rasa; Mukanga, David; Ghani, Azra C

    2015-12-01

    It is estimated that pneumonia is responsible for 15% of childhood deaths worldwide. Recent research has shown that hypoxia and malnutrition are strong predictors of mortality in children hospitalized for pneumonia. It is estimated that 15% of children under 5 who are hospitalized for pneumonia have hypoxaemia and that around 1.5 million children with severe pneumonia require oxygen treatment each year. We developed a deterministic compartmental model that links the care pathway to disease progression to assess the impact of introducing pulse oximetry as a prognostic tool to distinguish severe from non-severe pneumonia in under-5 year olds across 15 countries with the highest burden worldwide. We estimate that, assuming access to supplemental oxygen, pulse oximetry has the potential to avert up to 148,000 deaths if implemented across the 15 countries. By contrast, integrated management of childhood illness alone has a relatively small impact on mortality owing to its low sensitivity. Pulse oximetry can significantly increase the incidence of correctly treated severe cases as well as reduce the incidence of incorrect treatment with antibiotics. We also found that the combination of pulse oximetry with integrated management of childhood illness is highly cost-effective, with median estimates ranging from US$2.97 to $52.92 per disability-adjusted life year averted in the 15 countries analysed. This combination of substantial burden reduction and favourable cost-effectiveness makes pulse oximetry a promising candidate for improving the prognosis for children with pneumonia in resource-poor settings.

  6. Preliminary evaluation of a new fibre-optic cerebral oximetry system.

    Science.gov (United States)

    Phillips, J P; Langford, R M; Kyriacou, P A; Jones, D P

    2008-12-01

    A new system for measuring the oxygen saturation of blood within tissue has been developed, for a variety of patient monitoring applications. A particular unmet need is in the central nervous system, and this project aims to devise a means for measuring blood oxygen saturation in the brain tissue of patients recovering from neurosurgery or head injury. Coupling light sources and a photodetector to optical fibres results in a probe small enough to pass through a cranial bolt of the type already in use for intra-cranial pressure monitoring. The development and evaluation of a two-wavelength fibre-optic reflectance photoplethysmography (PPG) system are described. It was found that good quality red and near-infrared PPG signals could be obtained from the finger using a fibre-optic probe. Experiments were conducted to find the inter-fibre spacings that yield signals most suitable for calculating oxygen saturation. Reliable signals could be obtained for inter-fibre spacings between 2 mm and 5 mm, the latter being the size of the maximum aperture in the cranial bolt. A preliminary measurement from human brain tissue is also presented.

  7. Assessment of cerebral visual impairment with the L94 visual perceptual battery: clinical value and correlation with MRI findings.

    Science.gov (United States)

    Ortibus, E; Lagae, L; Casteels, I; Demaerel, P; Stiers, P

    2009-03-01

    In this article we describe visual perceptual abilities of a clinical population, referred for visual problems to our multidisciplinary team and assessed with the five computer tasks from the L94 visual perceptual battery. Clinical and neuroimaging findings were correlated with the findings on this task battery. Seventy children (35 males, 35 females) constituted our cohort. Age ranged from 4 to 20 years (mean 7y [SD 3y]). Forty children were born before 37 weeks gestational age. Thirty-six children had cerebral palsy (CP), of whom 24 had spastic diplegia, five had spastic hemiplegia, and four had spastic quadriplegia. Three children had ataxic CP. Perceptual visual impairment (PVI) was established in comparison to the performance age obtained on non-verbal intelligence subtests, instead of chronological age. Our results suggest that children with a history of preterm birth and a clinical CP picture are most at risk for a specific PVI. Correlations among other clinical variables did not define a clinical subgroup more at risk. Children with periventricular leucomalacia were almost equally represented in both PVI and non-PVI groups. Normal magnetic resonance imaging did not exclude the presence of PVI. In these children, however, we found another impairment profile, more in favour of dorsal stream impairment.

  8. 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

    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...... 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....... 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...

  9. The accuracy of pulse oximetry in emergency department patients with severe sepsis and septic shock: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Lord Jason A

    2010-05-01

    Full Text Available Abstract Background Pulse oximetry is routinely used to continuously and noninvasively monitor arterial oxygen saturation (SaO2 in critically ill patients. Although pulse oximeter oxygen saturation (SpO2 has been studied in several patient populations, including the critically ill, its accuracy has never been studied in emergency department (ED patients with severe sepsis and septic shock. Sepsis results in characteristic microcirculatory derangements that could theoretically affect pulse oximeter accuracy. The purposes of the present study were twofold: 1 to determine the accuracy of pulse oximetry relative to SaO2 obtained from ABG in ED patients with severe sepsis and septic shock, and 2 to assess the impact of specific physiologic factors on this accuracy. Methods This analysis consisted of a retrospective cohort of 88 consecutive ED patients with severe sepsis who had a simultaneous arterial blood gas and an SpO2 value recorded. Adult ICU patients that were admitted from any Calgary Health Region adult ED with a pre-specified, sepsis-related admission diagnosis between October 1, 2005 and September 30, 2006, were identified. Accuracy (SpO2 - SaO2 was analyzed by the method of Bland and Altman. The effects of hypoxemia, acidosis, hyperlactatemia, anemia, and the use of vasoactive drugs on bias were determined. Results The cohort consisted of 88 subjects, with a mean age of 57 years (19 - 89. The mean difference (SpO2 - SaO2 was 2.75% and the standard deviation of the differences was 3.1%. Subgroup analysis demonstrated that hypoxemia (SaO2 2 was in the 90-93% range the SaO2 was Conclusions Pulse oximetry overestimates ABG-determined SaO2 by a mean of 2.75% in emergency department patients with severe sepsis and septic shock. This overestimation is exacerbated by the presence of hypoxemia. When SaO2 needs to be determined with a high degree of accuracy arterial blood gases are recommended.

  10. Normative database of retinal oximetry in Asian Indian eyes.

    Directory of Open Access Journals (Sweden)

    Ashwin Mohan

    Full Text Available To study the oxygen saturation profile in normal Asian Indian eyes.A cross sectional prospective study.Ninety eight consecutive patients presenting to our hospital with best corrected distance visual acuity (BCVA of 20/20 and a normal ophthalmic examination were included in the study. Patients having any ocular or systemic disease were excluded from the study.Oximetry was performed on all subjects with the Oxymap T1 retinal oximeter (Oxymap hf, Reykjavik, Iceland.The images were analysed for oxygen saturation and diameter.The mean age was 33 years (Range: 18-63; SD: 12.4. The average arteriolar saturation was 90.3 ± 6.6% and the venous saturation was 56.9% ± 6.3. The average A-V (arterio-venous difference was 33.2% ± 5.2. There was an increase in arteriolar (R2 = 0.264; p=0.001 and venous saturation (R2 = 0.151; p=0.001 with age. There was no significant change in the arterio-venous saturation difference (AVSD. The inferotemporal quadrant had the lowest saturations. Age correlated positively with ocular perfusion pressure (OPP(R2 = 0.07; p=0.007. OPP correlated positively with global arteriolar saturation (R2=0.057, p=0.018.This study provides the normative database for an Indian population and is comparable to previous studies. Age, vessel diameter and OPP were the significant factors that influenced the saturation. Arteriolar and venous saturations increased with age while the AVSD did not change significantly.

  11. 前列地尔对脑梗塞的治疗价值分析%Analysis of the Value of Alprostadil in the Treatment of Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    张力月

    2015-01-01

    Objective To investigate the value of alprostadil in the treatment of cerebral infarction. Methods 72 patients were randomly assigned into control group and observation group. The control group was Xuesetong treatment, observation group alprostadil treatment. Results The effective rate of the observation group was 86.11%, higher than that of the control group of 63.89%, The neurological function defect score in the observation group was (9.27±1.36), which was lower than that in the control group (15.34± 2.18), and the difference was statistically significant (P<0.05). Conclusion The effect of alprostadil in patients with cerebral infarction was signiifcantly high clinical value.%目的:探讨前列地尔在脑梗塞治疗中的应用价值。方法选取患者72例,按随机数字表法分为对照组与观察组。对照组采用血塞通治疗,观察组采用前列地尔治疗。结果观察组治疗有效率为86.11%,高于对照组的63.89%;观察组治疗后神经功能缺损评分为(9.27±1.36)分,低于对照组的(15.34±2.18)分,对比差异有统计学意义(P<0.05)。结论前列地尔在脑梗塞患者治疗中的效果较好。

  12. Pulse Oximetry in the Physics Lab: A Colorful Alternative to Traditional Optics Curricula

    Science.gov (United States)

    Kutschera, Ellynne; Dunlap, Justin C.; Byrd, Misti; Norlin, Casey; Widenhorn, Ralf

    2013-11-01

    We designed a physics laboratory exercise around pulse oximetry, a noninvasive medical technique used to assess a patient's blood oxygen saturation. An alternative to a traditional optics and light lab, this exercise teaches the principles of light absorption, spectroscopy, and the properties of light, while simultaneously studying a common medical device. Pulse oximeters are ubiquitous in clinical environments; many people who have undergone surgery or visited a hospital environment have experienced the use of this device, making it a good candidate for an investigative lab. The experiment elicits the creative process of device development from students as they conduct measurements using a blood analog that reconstructs the principles of pulse oximetry.

  13. 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....../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...

  14. The head-shaft angle of the hip in early childhood: a comparison of reference values for children with cerebral palsy and normally developing hips.

    Science.gov (United States)

    van der List, J P; Witbreuk, M M; Buizer, A I; van der Sluijs, J A

    2015-09-01

    The recognition of hips at risk of displacement in children with cerebral palsy (CP) is a difficult problem for the orthopaedic surgeon. The Gross Motor Function Classification System (GMFCS) and head-shaft angle (HSA) are prognostic factors for hip displacement. However, reference values for HSA are lacking. This study describes and compares the development of HSA in normal hips and children with CP. We selected 33 children from a retrospective cohort with unilateral developmental dysplasia of the hip (DDH) (five boys, 28 girls) and 50 children (35 boys, 15 girls) with CP with GMFCS levels II to V. HSA of normal developing hips was measured at the contralateral hip of unilateral DDH children (33 hips) and HSA of CP children was measured in both hips (100 hips). Measurements were taken from the radiographs of the children at age two, four and seven years. The normal hip HSA decreased by 2° per year (p GMFCS levels II and III HSA decreased by 0.6° (p = 0.046) and 0.9° (p = 0.049) per year, respectively. The HSA did not alter significantly in GMFCS levels IV and V. Between the ages of two and eight years, the HSA decreases in normal hips and CP children with GMFCS level, II to III but does not change in GMFCS levels IV to V. As HSA has a prognostic value for hip displacement, these reference values may help the orthopaedic surgeon to predict future hip displacement in children with CP.

  15. Malaria cerebral Cerebral malaria

    OpenAIRE

    Carlos Hugo Zapata Zapata; Silvia Blair Trujillo

    2003-01-01

    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 citoqu...

  16. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  17. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  18. Cerebral effects of scalp cooling and extracerebral contribution to calculated blood flow values using the intravenous 133Xe technique

    DEFF Research Database (Denmark)

    Friberg, L; Kastrup, J; Hansen, M

    1986-01-01

    values. With a two-compartmental analysis of the wash-out curves during cooling there was a significant reduction of the CBF indices f1, representing mainly fast blood flow in the grey matter and f2, representing blood flow in the slowly perfused white matter and extracerebral structures. The reduction...

  19. Pulse Oximetry in the Physics Lab: A Colorful Alternative to Traditional Optics Curricula

    Science.gov (United States)

    Kutschera, Ellynne; Dunlap, Justin C.; Byrd, Misti; Norlin, Casey; Widenhorn, Ralf

    2013-01-01

    We designed a physics laboratory exercise around pulse oximetry, a noninvasive medical technique used to assess a patient's blood oxygen saturation. An alternative to a traditional optics and light lab, this exercise teaches the principles of light absorption, spectroscopy, and the properties of light, while simultaneously studying a common…

  20. Feasibility of pulse oximetry in the initial prehospital management of victims of drowning : A preliminary study

    NARCIS (Netherlands)

    Montenij, Leonard J.; de Vries, Wiebe; Schwarte, Lothar; Bierens, Joost J. L. M.

    2011-01-01

    Aim: Immediate delivery of oxygen is the most important treatment for victims of drowning at the rescue site. Monitoring oxygen saturation with pulse oximetry is potentially useful, but its use may be limited by poor peripheral perfusion due to hypothermia. This preliminary study explores the feasib

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

    NARCIS (Netherlands)

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

    1995-01-01

    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

  2. Desaturation Patterns Detected by Oximetry in a Large Population of Athletes

    Science.gov (United States)

    Garrido-Chamorro, Raul P.; Gonzalez-Lorenzo, Marta; Sirvent-Belando, Jose; Blasco-Lafarga, Cristina; Roche, Enrique

    2009-01-01

    Optimal exercise performance in well trained athletes can be affected by arterial oxygen saturation failure. Noninvasive detection of this phenomenon when performing a routine ergometric test can be a valuable tool for subsequent planning of the athlete's training, recovery, and nutrition. Oximetry has been used to this end. The authors studied…

  3. Desaturation Patterns Detected by Oximetry in a Large Population of Athletes

    Science.gov (United States)

    Garrido-Chamorro, Raul P.; Gonzalez-Lorenzo, Marta; Sirvent-Belando, Jose; Blasco-Lafarga, Cristina; Roche, Enrique

    2009-01-01

    Optimal exercise performance in well trained athletes can be affected by arterial oxygen saturation failure. Noninvasive detection of this phenomenon when performing a routine ergometric test can be a valuable tool for subsequent planning of the athlete's training, recovery, and nutrition. Oximetry has been used to this end. The authors studied…

  4. 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...

  5. 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...

  6. Cost analysis of near-infrared spectroscopy tissue oximetry for monitoring autologous free tissue breast reconstruction.

    Science.gov (United States)

    Pelletier, Aaron; Tseng, Charles; Agarwal, Shailesh; Park, Julie; Song, David

    2011-10-01

    Free flap monitoring typically requires specialized nursing that can increase medical costs. This study uses near-infrared spectroscopy (NIRS) tissue oximetry to monitor free tissue breast reconstruction. We hypothesize this practice will reduce medical costs by eliminating the need for specialized nursing. From August 2006 to January 2010, women undergoing unilateral free tissue breast reconstruction were enrolled and admitted postoperatively to either the surgical intensive care unit (ICU) or floor. Each underwent continuous monitoring using NIRS tissue oximetry and intermittent clinical examination with surface Doppler ultrasonography. Patient demographics, comorbidities, perioperative details, and financial data were recorded. There were 50 patients studied, all with abdominal-based flaps (25 per group). There were no statistically significant differences in patient demographics, comorbidities, mean flap weight, ischemia time, or length of stay between the ICU and floor groups. Four flaps had vascular complications, all detected by NIRS tissue oximetry. Comparison of hospital costs showed an average reduction of $1937 per patient when monitored on the surgical floor (P = 0.036). NIRS tissue oximetry is a sensitive and reliable monitoring tool, eliminating the need for specialized nursing care. The effect is decreased cost structure and increased hospital contribution margin for autologous free tissue breast reconstruction.

  7. Hepatopulmonary syndrome in patients with chronic liver disease: role of pulse oximetry

    Directory of Open Access Journals (Sweden)

    Olschewski Manfred

    2006-04-01

    Full Text Available Abstract Background Hepatopulmonary syndrome (HPS is a rare complication of liver diseases of different etiologies and may indicate a poor prognosis. Therefore, a simple non-invasive screening method to detect HPS would be highly desirable. In this study pulse oximetry was evaluated to identify patients with HPS. Methods In 316 consecutive patients with liver cirrhosis (n = 245, chronic hepatitis (n = 69 or non-cirrhotic portal hypertension (n = 2 arterial oxygen saturation (SaO2 was determined using a pulse oximeter. In patients with SaO2 ≤92% in supine position and/or a decrease of ≥4% after change from supine to upright position further diagnostic procedures were performed, including contrast-enhanced echocardiography and perfusion lung scan. Results Seventeen patients (5.4% had a pathological SaO2. Four patients (1.3% had HPS. HPS patients had a significant lower mean SaO2 in supine (89.7%, SD 5.4 vs. 96.0%, SD 2.3; p = 0.003 and upright position (84.3%, SD 5.0 vs. 96.0%, SD 2.4; p = 0.001 and had a lower mean PaO2 (56.2 mm Hg, SD 15.2 vs. 71.2 mm Hg, SD 20.2; p = 0.02 as compared to patients without HPS. The mean ΔSaO2 (difference between supine and upright position was 5.50 (SD 7 in HPS patients compared to non-HPS patients who showed no change (p = 0.001. There was a strong correlation between shunt volume and the SaO2 values (R = -0.94. Conclusion Arterial SaO2 determination in supine and upright position is a useful non-invasive screening test for HPS and correlates well with the intrapulmonary shunt volume.

  8. Visible light optical coherence tomography for microvascular oximetry in ocular circulation (Conference Presentation)

    Science.gov (United States)

    Chen, Siyu; Yi, Ji; Zhang, Hao F.

    2016-03-01

    Visible light optical coherence tomography (vis-OCT) is intrinsically capable of optical determination of blood oxygen saturation (sO2). Thanks to its 3D sectioning ability, confounding factors that plaque multi-wavelength fundus photography can be avoided. We further supplemented it with motion-enhanced angiography (vis-OCTA), which allowed us to resolve retinal micro vessels without losing spectral information. As a result, spectroscopic vis-OCTA can extract microvascular sO2 which are generally inaccessible. Here we extend the theoretical formulation of vis-OCTA oximetry to include optical attenuation, scattering and motion contrast. The model allows robust estimation of sO2, while also promising reduction of illuminating power to 1/3 of current value of ~1 mW. To demonstrate the capability of our approach, we performed oxygen challenge while taking vis-OCTA measurements on rat ocular circulation in vivo. We supplied the experiment animal with the following gas mixture: normal air, 5% CO2 air, pure O2 and 10% O2 air. For each inhalation gas, the OCTA measurements were compared with peripheral capillary sO2 (spO2) provided by a pulse oximeter. The retinal artery sO2 measurements corresponded well with spO2 reading as expected (R2 = 0.87). We found that both retinal and choroidal circulation sO2 moderately increased when we supplied 5% CO2 air. 100% O2 inhalation significantly increased both artery and vein oxygenation. On the contrary, 10% O2 air could deplete the oxygen reservoir in the circulation and lead to low sO2 readings.

  9. 颈动脉狭窄与颅脑ADC值的相关性研究%Study on the correlation between carotid stenosis and cerebral ADC value

    Institute of Scientific and Technical Information of China (English)

    方慧; 周勇; 伍建林

    2012-01-01

    目的 探讨颈动脉狭窄程度与同侧脑区ADC值间的相关性.方法 收集经颈动脉三维对比增强磁共振血管成像证实颈动脉狭窄者116例和正常志愿者21例行T2 FLAIR和DWI检查,测量多脑区ADC值并分析狭窄程度与ADC值的相关性,P<0.05为有统计学意义.结果 颈动脉狭窄程度与侧脑室前部(r=0.260,P=0.000)、后部(r=0.149,P=0.014)、前角(r=0.194,P=0.001)、后角(r=0.188,P=0.002),周围脑实质、颞叶(r=0.186,P=0.002)及尾状核头(r=0.125,P=0.039)等脑区ADC值间相关性有统计学意义.结论 多脑区ADC值升高与颈动脉狭窄有关,以侧脑室前部周围脑实质相关性最高,可视为间接反映低灌注状态的最敏感区域.%Objective To investigate the relations between ADC values of interested cerebral regions and carotid stenosis using diffusion-weighted imaging and MR angiography. Methods 116 cases of carotid stenosis and 21 cases of matched healthy controls were recruited in this study On the basis of three-dimensional contrast enhanced MR angiography (MRA) of carotid artery and were checked with DWI and T2 FLAIR. ADC values of interested regions were measured on DWI (b = 0,1 000 s/mm2) images. The relationship between carotid stenosis and ADC values were analysed, P <0. 05 is of statistical significance. Results The ADC values around anterior ( r =0. 194, P =0. 001) and posterior horn ( r =0.188, P = 0. 002) of lateral ventricle and the ADC values of periventricular anterior ( r =0. 260, P =0. 000) and posterior ( r = 0. 149, P =0.014), the temporal lobe ( r =0. 186, P =0.002) and the caudate nucleus head ( r =0. 125, P =0. 039) were positively linearly correlated with the degree of stenosis with 274 branches of carotid arteries. Conclusion ADC values in the majority of cerebral regions positively correlated with the severeness of carotid stenosis. Especially, ADC values of periventricular anterior was most closely related to the carotid stenosis, which was most

  10. 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 ...

  11. Cerebral malaria Malaria cerebral

    OpenAIRE

    Silvia Blair Trujillo; Carlos Hugo Zapata Zapata

    2003-01-01

    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...

  12. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available 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. 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.

  13. EEG maturation and stability of cerebral oxygen extraction in very low birth weight infants.

    Science.gov (United States)

    El-Dib, M; Govindan, R; Aly, S; Mohamed, M; du Plessis, A; Aly, H

    2016-04-01

    Fractional cerebral tissue oxygen extraction (FTOE) can be continuously monitored by simultaneous near-infrared spectroscopy (NIRS) and pulse oximetry. The objective of this study is to test the hypothesis that in very low birth weight (VLBW) infants, the more mature EEG activity is, the less variable FTOE is. A prospective study was conducted on VLBW infants (transcutaneous carbon dioxide tension. Increased maturation of EEG activity is associated with decreased variability in cerebral oxygen extraction. The implications of increased variability in FTOE on brain injury in premature infants need further exploration.

  14. 表面通透性值对脑内、外肿瘤的鉴别%Differential diagnosis of cerebral inside and outside neoplasm with permeability surface value

    Institute of Scientific and Technical Information of China (English)

    李智勇; 韩晓雨; 刘伟; 纪元; 苗延巍

    2011-01-01

    Objective To study the perfusion imaging technique with multi-slice CT(MSCT)and its clinical application value on differential diagnosis in cerebral inside and outside neoplasm. Methods Thirty-five patienLs with brain neoplasm were enrolled,male 21, female 14, aged 24 - 83 years old, mean age 50.1 years old, and in those patients the perfusion imaging with 16-slice CT was performed. The CT brain plane scanning was performed to determine the central slice of brain neoplasm, and perfusion imaging in central slice of brain neoplasm was scanned with CT cine scanning, the scanning images were analyzed by Perfusion 2 software. Results The values of cerebral blood flow and cerebral hlood volume in cerebral inside and outside neoplasm had partial overlapped. The permeability surface (PS) value in cerebral outside neoplasm exceeded obviously in cerebral inside neoplasm.Conclusion It is demonstrated that PS value in MSCT perfusion imaging is helpful for differential diagnosis of cerebral inside and outside neoplasm.%目的 初步探讨多层螺旋CT(MSCT)灌注成像在脑内、外肿瘤鉴别诊断中的临床应用价值.方法 35例已知有脑部肿瘤患者,其中男性21例,女性14例;年龄24~83岁,平均年龄50.1岁.行16层CT灌注成像扫描,先行脑部CT平扫以确定肿瘤中心层面,然后采用CT电影扫描技术对肿瘤中心层面进行灌注扫描,扫描图像应用Perfusion 2软件进行灌注成像分析.结果 脑血流量(CBF)值、血容量(CBV)值脑内、外肿瘤间有交叉;脑外肿瘤的表面通透性(PS)值均大于脑内肿瘤的PS值.结论 MSCT灌注成像中PS值有助于脑内、外肿瘤的鉴别诊断.

  15. Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters.

    Science.gov (United States)

    Sahadan, Dg Zuraini; Davey, Margot J; Horne, Rosemary S C; Nixon, Gillian M

    2015-12-01

    Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA. One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 % M) had PSG. Fifty-seven of 93 (61 %) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean ± SD 58.5 ± 29.0/h in OSA group vs 48.6 ± 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 ± 25.0 vs 36.2 ± 16.7, p = 0.06) and PRI-15 (24.4 ± 14.5 vs 18.9 ± 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 % for OSA. The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.

  16. The Comparison of Pulse Oximetry and Cardiac Catheterization in Managing the Treatment of Children with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    R Abbasi

    2015-03-01

    Full Text Available Bachground & aim: Pulse oximetry and cardiac catheterization are concerned in the treatment of children with congenital heart disease. Diagnosis of arterial oxygen saturation in patients with congenital heart disease (CHD can be used to assess and manage their effecacy. The purpose of this study was to compare pulse oximetry and cardiac catheterizations in treatment manage of children with congenital heart disease. Methods: In the present cross sectional study, 110 patients with cyanic and non syani heart disease were studied undergoing right and left heart catheterization by pulse oximetry of index finger and simultaneously, oxygen saturation was measured by cardiac catheterization. Data were analyzed with SPSS software by using Pearson correlation and linear regression. Results: A significant correlation was seen between arterial oxygen saturation measured by pulse oximetry and arterial oxygen saturation (p<0.0001 as well as heart rate, electrocardiogram and pulse oximetry (p<0.0001 respectively. Furthermore, the presence of cyanosis (p=0.001, digital clubbing of the fingers ((p=0.001, low oxygen saturation in the superior vena cava and right atrium (p=0.002 can reduce the accuracy of pulse oximetry for detection of arterial oxygen saturation. The mean right atrial pressure can effect on accuracy of pulse oximetry to detect heartbeat (p=0.034. Maximum sensitivity and specificity for detection of pulse oximetry oxygen saturation was 88 % and 88 heart rate per minute. Conclusion: Pulse oximetric is a useful tool for estimating the arterial oxygen saturation and heart rate in children with congenital heart disease (CHD and is a non-invasive method in comparison with cardiac catheterization. Key words: Pulse oximeter, Congenital Heart Disease, Cardiac Catheterization

  17. 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.

  18. The effect of nail polish and acrylic nails on pulse oximetry reading using the Lifebox oximeter in Nigeria.

    Science.gov (United States)

    Desalu, I; Diakparomre, O I; Salami, A O; Abiola, A O

    2013-12-01

    AIMS AND OBJECTIVES - Pulse oximetry is mandatory during anaesthesia, sedation and transfer of critically ill patients. The effect of nail polish and acrylic nails on the accuracy of saturation reading is inconsistent. The Lifebox pulse oximeter is reliable and recommended for low and middle income countries. We investigated its accuracy in the presence of 4 nail colours and acrylic nails SUBJECTS AND METHODS Fifty non-smoking volunteers had their fingers numbered from right to left (little finger of right hand =1 and little finger of left hand =10). Alternate fingers were nails painted with clear, red, brown and black nail polish and the 5th finger had acrylic nail applied. The corresponding finger on the other hand acted as control. The oxygen saturation was determined using the Lifebox pulse oximeter. Results All fingers (100%) with clear nail polish, red nail polish and acrylic nails recorded a saturation value. Each of the mean saturation value for clear nail polish, red nail polish and acrylic nails was not significantly different from the control mean (p= 0.378, 0.427 and 0.921). Only 12% and 64% of nails polished black and brown respectively recorded a saturation value. The mean SpO- for black and brown polish were significantly different from their control mean (ppolish resulted in a significant decrease in SpO with the Lifebox oximeter. Dark coloured nail polish should be removed prior to SpO2 determination to ensure that accurate readings can be obtained.

  19. The follow-up research on the value of the plasma homocystine after methionine loading test on the recurrent ischemic vascular event in cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    刘怀翔

    2014-01-01

    Objective To evaluate the effect of the plasma homocystine(Hcy)after methionine loading test(MLT)on the recurrence of ischemic vascular event,including cerebral infarction,transient ischemic attack(TIA),acute coronary syndrome,other vascular embolism in cerebral infarction patients.Methods The fasting plasma homocystine(FHcy)and homocystine after MLT(PHcy)levels were measured by high-performance liquid chromatog-

  20. 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

  1. An analysis on the theory of pulse oximetry by Monte Carlo simulation

    Science.gov (United States)

    Fan, Shangchun; Cai, Rui; Xing, Weiwei; Liu, Changting; Chen, Guangfei; Wang, Junfeng

    2008-10-01

    The pulse oximetry is a kind of electronic instrument that measures the oxygen saturation of arterial blood and pulse rate by non-invasive techniques. It enables prompt recognition of hypoxemia. In a conventional transmittance type pulse oximeter, the absorption of light by oxygenated and reduced hemoglobin is measured at two wavelength 660nm and 940nm. But the accuracy and measuring range of the pulse oximeter can not meet the requirement of clinical application. There are limitations in the theory of pulse oximetry, which is proved by Monte Carlo method. The mean paths are calculated in the Monte Carlo simulation. The results prove that the mean paths are not the same between the different wavelengths.

  2. Screening of Obstructive Sleep Apnea with Empirical Mode Decomposition of Pulse Oximetry

    CERN Document Server

    Schlotthauer, Gastón; Larrateguy, Luis D; Milone, Diego H

    2014-01-01

    Detection of desaturations on the pulse oximetry signal is of great importance for the diagnosis of sleep apneas. Using the counting of desaturations, an index can be built to help in the diagnosis of severe cases of obstructive sleep apnea-hypopnea syndrome. It is important to have automatic detection methods that allows the screening for this syndrome, reducing the need of the expensive polysomnography based studies. In this paper a novel recognition method based on the empirical mode decomposition of the pulse oximetry signal is proposed. The desaturations produce a very specific wave pattern that is extracted in the modes of the decomposition. Using this information, a detector based on properly selected thresholds and a set of simple rules is built. The oxygen desaturation index constructed from these detections produces a detector for obstructive sleep apnea-hypopnea syndrome with high sensitivity ($0.838$) and specificity ($0.855$) and yields better results than standard desaturation detection approach...

  3. A Novel Photodiode for Reflectance Pulse Oximetry in low-power applications

    DEFF Research Database (Denmark)

    Haahr, Rasmus Grønbek; Duun, Sune; Birkelund, Karen;

    2007-01-01

    The amount of light collected is crucial for low-power applications of pulse oximetry. In this work a novel ring-shaped backside photodiode has been developed for a wearable reflectance pulse oximeter. The photodiode is proven to work with a dual LED with wavelengths of 660 nm and 940 nm. For the......The amount of light collected is crucial for low-power applications of pulse oximetry. In this work a novel ring-shaped backside photodiode has been developed for a wearable reflectance pulse oximeter. The photodiode is proven to work with a dual LED with wavelengths of 660 nm and 940 nm....... For the purpose of continuously monitoring vital signs of a human, a temperature sensor is integrated onto the chip containing the photodiode. This biomedical multisensor chip is made for integration into "the electronic patch", an autonomous monitoring system for humans....

  4. 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.

  5. The use of pulse oximetry as a screening assessment for paediatric neurogenic dysphagia.

    Science.gov (United States)

    Morgan, A T; Omahoney, R; Francis, H

    2008-01-01

    Early screening and intervention for dysphagia is crucial to offset potential outcomes such as compromised nutrition or reduced respiratory function. Current paediatric dysphagia screening tests are subjective with poor sensitivity and specificity. The present study examined whether an objective method, pulse oximetry (measuring oxygen saturation (SpO2) levels), could differentiate between children with and without dysphagia, in relation to (1) Average pre-feeding baseline SpO2 levels; (2) Average feeding SpO2 levels; (3) Average post-feeding SpO2 levels; and (4) The number of events of oxygen desaturation pre-, during and after feeding. Nine participants with chronic neurological disability (CND) (7 F, 2 M) (9; 7-15; 11 years) and nine control participants matched for age (9; 5-16; 0 years) and sex were assessed using a clinical bedside evaluation (CBE) and pulse oximetry. A statistically significant difference was found in SpO2 levels between the two groups (p dysphagia experienced 'events' of SpO2 desaturation during feeding. Pulse oximetry may provide a useful adjunct to the CBE for dysphagia screening, with average SpO2 levels during feeding predicting those with and without dysphagia with moderate levels of sensitivity and specificity. The finding of individual variation in desaturation 'events', however, warrants the provision of further data on large homogenous populations to provide definitive criterion for pathological SpO2 levels associated with dysphagia during oral feeding.

  6. 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.

  7. Transcutaneous oximetry monitoring in patients with type 2 diabetes mellitus and critical limb ischemia

    Directory of Open Access Journals (Sweden)

    O N Bondarenko

    2013-03-01

    Full Text Available Aims. To evaluate transcutaneous oximetry as a method for diagnostics and monitoring in patients with diabetes mellitus (DM and critical limb ischemia (CLI after percutaneous transluminal balloon angioplasty (PTBA.Materials and Methods. We enrolled 126 patients with DM and CLI for participation in this study (148 limbs in total. 22 patients underwent PTBA on both lower limbs, and 104 – on single limb. Transcutaneous oximetry and duplex ultrasonography of lower limb arteries was performed prior to PTBA with subsequent examinations on 5-7th days, 1st, 3rd and 6th month after intervention. Transcu- taneous oxygen tension (TcpO2 was measured by Radiometer (Copenhagen oximeter system. Duplex ultrasonography was performed on Voluson 730® Expert system (GE Medical Systems Kretztechnik GmbH&Co OHG, Austria.Results. Multiple factor analysis suggests that results of TcpO2 monitoring prior to and after PTBA are influenced by presence of ischemic heart disease, severe lower limb infections, serum creatinine, arterial hypertension and lower limb reperfusion edema. We observed a strong correlation of TcpO2 with the degree of anterior tibial artery and dorsal pedis artery occlusion.Conclusion. Transcutaneous oximetry allows evaluation of CLI severity and efficiency of PTBA in the majority oа patients with DM and CLI. Certain comorbidities impose limitations on this technique. Efficiency of endovascular intervention should be evaluated based on complex non-invasive examination, clinical data and signs of CLI.

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

    Science.gov (United States)

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

    2010-07-01

    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.

  9. Cerebral Edema in Chronic Mountain Sickness: a New Finding

    Science.gov (United States)

    Bao, Haihua; Wang, Duoyao; Zhao, Xipeng; Wu, Youshen; Yin, Guixiu; Meng, Li; Wang, Fangfang; Ma, Lan; Hackett, Peter; Ge, Ri-Li

    2017-01-01

    We observed patients with chronic mountain sickness (CMS) in our clinic who developed progressive neurological deterioration (encephalopathy) and we wished to investigate this. We studied nine such CMS patients, and compared them to 21 CMS patients without encephalopathy, and to 15 healthy control subjects without CMS. All 45 subjects lived permanently at 3200–4000 m. Measurements at 2260 m included CMS symptom score, multi-slice CT, perfusion CT, pulse oximetry (SpO2%), and hemoglobin concentration (Hb). One patient had MRI imaging but not CT; 5 had CSF pressure measurements. CMS subjects had lower SpO2, higher Hb, higher brain blood density, lower mean cerebral blood flow (CBF), and significant cerebral circulatory delay compared to controls. The nine CMS subjects with neurological deterioration showed diffuse cerebral edema on imaging and more deranged cerebral hemodynamics. CSF pressure was elevated in those with edema. We conclude that cerebral edema, a previously unrecognized complication, may develop in CMS patients and cause encephalopathy. Contributing factors appear to be exaggerated polycythemia and hypoxemia, and lower and sluggish CBF compared to CMS patients without cerebral edema; but what triggers this complication is unknown. Recognition and treatment of this serious complication will help reduce morbidity and mortality from CMS. PMID:28233815

  10. Monitoring Cerebral Oxygenation in Neonates: An Update

    Science.gov (United States)

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

    2017-01-01

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

  11. 磁共振扩散张量成像在儿童脑性瘫痪诊断中的价值%Diagnostic Value of Diffusion Tensor Imaging in Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    王欣欣; 丁忠祥; 袁建华; 毛德旺; 罗晓明; 李玉梅; 陈方宏

    2011-01-01

    目的 探讨扩散张量成像在儿童脑瘫诊断中的价值.方法 将42例脑瘫患儿及性别、年龄相匹配的42例健康儿童作为研究对象.进行常规脑MR平扫检查后,行脑的DTI检查,得到ADC图、FA图及彩色编码FA图.分别于双侧半卵圆中心、内囊前肢、内囊膝部、内囊后肢、环池水平皮质脊髓束设置感兴趣区( ROI),测定每个ROI的FA、ADC值,并以环池水平的皮质脊髓束及同侧内囊后肢为ROI,分别作出两侧皮质脊髓束图.结果 42例脑瘫患儿中,6例常规颅脑MRI显示正常,36例分别显示为脑室周围白质软化(PVL)、脑萎缩、脑裂畸形等.42例脑瘫患儿ADC图、FA图、彩色编码FA图显示异常.脑瘫组半卵园中心、皮质脊髓束FA降低、ADC值增高,与正常对照相比均有显著性差异(P<0.05).结论 DTI检查对脑瘫患儿的诊断及白质纤维损伤具有重要的价值,尤其是常规颅脑MRI显示为正常的可疑脑瘫患儿,进行DTI检查是必要的.%Objective To explore the diagnostic value of diffusion tensor imaging (DTI) in children with cerebral palsy. Methods Forty - two children with cerebral palsy as diseased group and 42 healthy children as control group were recruited in the study. The age and gender were matched between the two groups. Conventional plain MR scans and DTI sequence of brain were performed in all subjects by Siemens Trio 3. OT MR system. ADC maps, FA maps and color - coded FA maps were obtained. FA and ADC value of regions of interest ( ROI) on cerebral structures were measured, including bilateral centrum semiovale; anterior limb, genu and posterior limb of internal capsule; corticospinal tract at the level of the cisterna ambiens. Corticospinal tract was achieved regarding corticospinal area at the level of cistema ambiens and ipsolateral posterior limb of internal capsule as ROI respectively. Results In all 42 children with cerebral palsy, 6 showed normal on conventional MR imaging, 36 appeared

  12. Multicenter Study Validating Accuracy of a Continuous Respiratory Rate Measurement Derived From Pulse Oximetry: A Comparison With Capnography

    Science.gov (United States)

    Bergese, Sergio D.; Kelley, Scott D.; McIntyre, Robert; Uribe, Alberto A.; Sethi, Rakesh; Watson, James N.; Addison, Paul S.

    2017-01-01

    BACKGROUND: Intermittent measurement of respiratory rate via observation is routine in many patient care settings. This approach has several inherent limitations that diminish the clinical utility of these measurements because it is intermittent, susceptible to human error, and requires clinical resources. As an alternative, a software application that derives continuous respiratory rate measurement from a standard pulse oximeter has been developed. We sought to determine the performance characteristics of this new technology by comparison with clinician-reviewed capnography waveforms in both healthy subjects and hospitalized patients in a low-acuity care setting. METHODS: Two independent observational studies were conducted to validate the performance of the Medtronic NellcorTM Respiration Rate Software application. One study enrolled 26 healthy volunteer subjects in a clinical laboratory, and a second multicenter study enrolled 53 hospitalized patients. During a 30-minute study period taking place while participants were breathing spontaneously, pulse oximeter and nasal/oral capnography waveforms were collected. Pulse oximeter waveforms were processed to determine respiratory rate via the Medtronic Nellcor Respiration Rate Software. Capnography waveforms reviewed by a clinician were used to determine the reference respiratory rate. RESULTS: A total of 23,243 paired observations between the pulse oximeter-derived respiratory rate and the capnography reference method were collected and examined. The mean reference-based respiratory rate was 15.3 ± 4.3 breaths per minute with a range of 4 to 34 breaths per minute. The Pearson correlation coefficient between the Medtronic Nellcor Respiration Rate Software values and the capnography reference respiratory rate is reported as a linear correlation, R, as 0.92 ± 0.02 (P Medtronic Nellcor Respiration Rate Software was 0.18 breaths per minute with a precision (SD) of 1.65 breaths per minute (healthy volunteers: 0.37 ± 0

  13. Next-generation pulse oximetry. Focusing on Masimo's signal extraction technology.

    Science.gov (United States)

    2000-10-01

    Pulse oximeters are used to determine trends in patients' blood oxygen saturation and to warn of dangerous saturation levels. But conventional pulse oximetry has some inherent limitations. For example, it has difficulty monitoring patients who are moving or who have poor perfusion; it is also subject to interference from certain visible and infrared light sources. Over the past several years, a number of companies have developed advanced signal-processing techniques that allow pulse oximeters to overcome many of these limitations. We refer to such new technologies as next-generation pulse oximetry. In this Evaluation, we focus on the first next-generation technology to have reached the market: Masimo Corporation's Signal Extraction Technology (SET). We designed our study of Masimo SET to address the main question that needs to be asked of any next-generation technology: How well does it compare to conventional pulse oximetry? Specifically, how well does it perform when a patient is moving or being moved, when a patient is poorly perfused, or when certain types of light strike the sensor while it is attached to or detached from the patient? We also examined one type of sensor used with this product, comparing it to conventional tape-on sensors for comfort and durability. Several other next-generation pulse-oximeter products have become available since we began this study. We are currently evaluating these products and will publish our findings in the near future. A list of the products, including a brief description of each, is included in this article. Pulse oximeters are used to determine trends in patients' blood oxygen saturation and to warn against dangerous saturation levels. These monitors are often vital in helping to ensure patient safety, especially for critically ill patients, pediatric patients, and neonates. But conventional pulse oximetry has some inherent limitations--most significantly, it has difficulty monitoring patients who are moving or who have

  14. 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.

  15. Cerebral autoregulation in the preterm newborn using near-infrared spectroscopy: a comparison of time-domain and frequency-domain analyses

    Science.gov (United States)

    Eriksen, Vibeke R.; Hahn, Gitte H.; Greisen, Gorm

    2015-03-01

    The aim was to compare two conventional methods used to describe cerebral autoregulation (CA): frequency-domain analysis and time-domain analysis. We measured cerebral oxygenation (as a surrogate for cerebral blood flow) and mean arterial blood pressure (MAP) in 60 preterm infants. In the frequency domain, outcome variables were coherence and gain, whereas the cerebral oximetry index (COx) and the regression coefficient were the outcome variables in the time domain. Correlation between coherence and COx was poor. The disagreement between the two methods was due to the MAP and cerebral oxygenation signals being in counterphase in three cases. High gain and high coherence may arise spuriously when cerebral oxygenation decreases as MAP increases; hence, time-domain analysis appears to be a more robust-and simpler-method to describe CA.

  16. 新生儿颅脑疾病床边超声的诊断价值%Value of bedside high-frequence ultrasound in diagnosis of neonatal cerebral disease

    Institute of Scientific and Technical Information of China (English)

    葛晖; 丁中; 韩旻; 李社会; 刘浩; 李叶刚; 王君琴

    2009-01-01

    目的:探讨床边高频超声在新生儿颅脑疾病中的诊断价值.方法:应用二维超声高频探头,以新生儿前囟为声窗,对78例新生儿进行床边颅脑检查,并与CT诊断结果作对比.结果:通过颅脑超声观察到颅内出血(intracranial hemorrhage,ICH)33例,缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)41例,脑发育异常1例,脑内钙化灶3例.除蛛网膜下腔出血(subaracheoid hemorrhage,SAH)外,超声对新生儿颅脑疾病的检出与CT基本相符.结论:超声对新生儿颅脑疾病有较好的诊断价值,应用超声诊断可以实现对新生儿颅脑疾病的动态观察,且无放射损伤,简便、易行、无创、价廉,可重复床边检查.%Objective:To study the value of bedside high-frequence ultrasound in diagnosis of neonatal cerebral disease.Methods:Seventy eight cases of neonatal cerebral disease were examined bedside by ultrasound high frequency probe,and the result was compared with that by computer tomography(CT).Results:Intracranial hemorrhage was observed in 33 cases,hypoxic-ischemic encephalopathy in 41 cases,encephalodysplasia in 1 case and intracranial calcification in 3 cases by cerebral ultrasound;The result by ultrasonic examination for cerebral disease coincided with that by computer tomography except subarachnoid hemorrhage,and the changes of the cerebral disease could be monitored by ultrasound.Conclusions:Ultrasound is of high value in diagnosis of neonatal cerebral disease and has the advantages of no radiation injury,convenience,easy application and cost efficacy.

  17. Cerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia.

    Science.gov (United States)

    Perez, William; Dukatz, Christopher; El-Dalati, Sami; Duncan, James; Abdel-Rasoul, Mahmoud; Springer, Andrew; Go, Michael R; Dzwonczyk, Roger

    2015-12-01

    Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation (rSO2) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO2 and processed EEG monitor. The response of the monitors during carotid artery clamping and shunting were assessed and compared between monitors and bilaterally within each monitor. Sixty-nine patients were included in the study. At clamping the surgical-side and contralateral-side rSO2 dropped significantly below the baseline incision value (-17.6 and -9.4% respectively). After shunting, the contralateral-side rSO2 returned to baseline while the surgical-side rSO2 remained significantly below baseline (-9.0%) until the shunt was removed following surgery. At clamping the surgical-side and contralateral-side processed EEG also dropped below baseline (-19.9 and -20.6% respectively). However, following shunt activation, the processed EEG returned bilaterally to baseline. During the course of this research, we found the rSO2 monitor to be clinically more robust (4.4% failure rate) than the processed EEG monitor (20.0% failure rate). There was no correlation between the rSO2 or processed EEG changes that occurred immediately after clamping and the degree of surgical side stenosis measured pre-operatively. Both rSO2 and processed EEG respond to clamping and shunting during CEA. Cerebral oximetry discriminates between the surgical and contralateral side during surgery. The rSO2 monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these

  18. Study on application value of DWI and DTI in the early diagnosis of cerebral infarction%DWI及DTI在脑梗死诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    韩晓磊; 杨全新

    2014-01-01

    Objective To explore the application values of magnetic resonance diffusion weighted imaging (DWI)and diffusion tensor imaging (DTI)in the early diagnosis of cerebral infarction.Methods 1 2 1 patients with single side cerebral infarction were di-vided into five groups by disease time,the brain examination was performed by conventional MRI,DWI and DTI in every case.The le-sions were observed and compared in different sequences imaging.Mean diffusivity(MD)and fractional anisotropy(FA)values of cere-bral infarction lesions and the symmetrical positions in normal hemispheres were measured and compared.The correlations between relative MD(rMD)value,relative FA(rFA)value and disease time were analyzed.Results The display rate on DWI in showing ultra-acute and acute cerebral infarction lesions was 100%,which was superior to that on other sequences of conventional MRI obviously (P0.05).MD value was higher at early chronic and late chronic phase(P0.05),but at the later separate phases,FA values reduced successively(P0.05),慢性早期和慢性晚期升高(P0.05),以后各期依次降低(P<0.001)。脑梗死区 rMD值与发病时间呈正相关(rs=0.990,P<0.001);rFA值与发病时间呈负相关(rs=-0.994,P<0.001)。结论 DWI对超早期脑梗死灶的检出敏感,DTI参数检测能更精确地判断脑梗死的临床分期和损伤程度,两者联合可以为临床个体化治疗方案的选择及预后评估提供依据。

  19. Strength Training to Strengthen the Clinical Value of Spastic Cerebral Palsy Analysis%强化肌力训练对痉挛型脑瘫的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    白彦君

    2015-01-01

    目的:探讨强化肌力训练对痉挛型脑瘫患儿的临床价值。方法对我院收治的100例痉挛型脑瘫患儿均展开强化肌力训练,对其治疗效果进行分析。结果治疗后,患儿的肌力和大运动功能测试量表各区评分均高于治疗前(P<0.05)。结论对痉挛型脑瘫患儿实施强化肌力训练,能够有效增强患儿康复效果,且不会给肌张力造成影响,值得推广。%Objective To investigate the enhancement the clinical value of muscle strength training on children with spastic cerebral palsy.Methods In our hospital 100 cases of children with spastic cerebral palsy were launched to strengthen the strength training, to analyze the therapeutic effect.Results After treatment, patients with muscle strength and motor function measure the score were higher than before the treatment (P< 0.05).Conclusion To strengthen the muscle strength training on children with spastic cerebral palsy, can effectively enhance the effect of rehabilitation of children, and not to the muscle tension effect, worthy of promotion.

  20. Using India Ink as a Sensor for Oximetry: Evidence of its Safety as a Medical Device.

    Science.gov (United States)

    Flood, Ann Barry; Wood, Victoria A; Swartz, Harold M

    2017-01-01

    Clinical EPR spectroscopy is emerging as an important modality, with the potential to be used in standard clinical practice to determine the extent of hypoxia in tissues and whether hypoxic tissues respond to breathing enriched oxygen during therapy. Oximetry can provide important information useful for prognosis and to improve patient outcomes. EPR oximetry has many potential advantages over other ways to measure oxygen in tissues, including directly measuring oxygen in tissues and being particularly sensitive to low oxygen, repeatable, and non-invasive after an initial injection of the EPR-sensing material is placed in the tumor. The most immediately available oxygen sensor is India ink, where two classes of carbon (carbon black and charcoal) have been identified as having acceptable paramagnetic properties for oximetry. While India ink has a long history of safe use in tattoos, a systematic research search regarding its safety for marking tissues for medical uses and an examination of the evidence that differentiates between ink based on charcoal or carbon black has not been conducted. Using systematic literature search techniques, we searched the PubMed and Food and Drug Administration databases, finding ~1000 publications reporting on adverse events associated with India/carbon based inks. The detailed review of outcomes was based on studies involving >16 patients, where the ink was identifiable as carbon black or charcoal. Fifty-six studies met these criteria. There were few reports of complications other than transient and usually mild discomfort and bleeding at injection, and there was no difference in charcoal vs. carbon black India ink. India ink was generally well tolerated by patients and physicians reported that it was easy to use in practice and used few resources. The risk is low enough to justify its use as an oxygen sensor in clinical practice.

  1. Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study

    Directory of Open Access Journals (Sweden)

    Goldring James JP

    2010-10-01

    Full Text Available Abstract Background The ability to objectively differentiate exacerbations of chronic obstructive pulmonary disease (COPD from day-to-day symptom variations would be an important development in clinical practice and research. We assessed the ability of domiciliary pulse oximetry to achieve this. Methods 40 patients with moderate-severe COPD collected daily data on changes in symptoms, heart-rate (HR, oxygen saturation (SpO2 and peak-expiratory flow (PEF over a total of 2705 days. 31 patients had data suitable for baseline analysis, and 13 patients experienced an exacerbation. Data were expressed as multiples of the standard deviation (SD observed from each patient when stable. Results In stable COPD, the SD for HR, SpO2 and PEF were approximately 5 min-1, 1% and 10l min-1. There were detectable changes in all three variables just prior to exacerbation onset, greatest 2-3 days following symptom onset. A composite Oximetry Score (mean magnitude of SpO2 fall and HR rise distinguished exacerbation onset from symptom variation (area under receiver-operating characteristic curve, AUC = 0.832, 95%CI 0.735-0.929, p = 0.003. In the presence of symptoms, a change in Score of ≥1 (average of ≥1SD change in both HR and SpO2 was 71% sensitive and 74% specific for exacerbation onset. Conclusion We have defined normal variation of pulse oximetry variables in a small sample of patients with COPD. A composite HR and SpO2 score distinguished exacerbation onset from symptom variation, potentially facilitating prompt therapy and providing validation of such events in clinical trials.

  2. Clinical evaluation of pulse oximetry monitors on critically ill patients.

    Science.gov (United States)

    De Pauw, C; Poelaert, J; Rolly, G; Colardyn, F

    1990-01-01

    Four pulse oximeters and two pulse oximeter-capnographs were evaluated on accuracy of measuring oxygen saturation and heartrate for the former and oxygen saturation, heartrate, respiratory rate and capnography for the latter. In the first part of the study four pulse oximeters (Criticare Systems Model 501 +, Ohmeda Biox 3700 Pulse Oximeter, Nellcor Model N 100 and Datex Satlite) were simultaneously studied on 10 ventilated ICU patients. Fifty simultaneous measurements were done for heartrate and oxygen saturation and compared to arterial saturations and ECG heartrates. Mean differences from pulse oximeter values versus control arterial and ECG values were within two percent for the four instruments. In the second part two oxicaps (Ohmeda 4700 and Nellcor N 1000) were evaluated with the same control parameters. Thirty measurements on 3 patients were done. As in the first part of the study all results were accurate within two percent of control values. From those data we can conclude that all examined monitors were fairly accurate compared to simultaneous arterial blood gas analysis and ECG monitoring. The oxicap monitors have the advantage of giving continuous information on two very important parameters of patient monitoring: CO2 and saturation.

  3. Value of Plasmodium falciparum Histidine-Rich Protein 2 Level and Malaria Retinopathy in Distinguishing Cerebral Malaria From Other Acute Encephalopathies in Kenyan Children

    Science.gov (United States)

    Kariuki, Symon M.; Gitau, Evelyn; Gwer, Samson; Karanja, Henry K.; Chengo, Eddie; Kazungu, Michael; Urban, Britta C.; Newton, Charles R. J. C.

    2014-01-01

    Background. The diagnosis of cerebral malaria is problematic in malaria-endemic areas because encephalopathy in patients with parasitemia may have another cause. Abnormal retinal findings are thought to increase the specificity of the diagnosis, and the level of histidine-rich protein 2 (HRP2) may reflect the parasite biomass. Methods. We examined the retina and measured plasma HRP2 levels in children with acute nontraumatic encephalopathy in Kenya. Logistic regression, with HRP2 level as an independent variable and World Health Organization–defined cerebral malaria and/or retinopathy as the outcome, was used to calculate malaria-attributable fractions (MAFs) and retinopathy-attributable fractions (RAFs). Results. Of 270 children, 140 (52%) had peripheral parasitemia, 80 (30%) had malaria retinopathy, and 164 (61%) had an HRP2 level of >0 U/mL. During 2006–2011, the incidence of HRP2 positivity among admitted children declined by 49 cases per 100 000 per year (a 78% reduction). An HRP2 level of >0 U/mL had a MAF of 93% for cerebral malaria, with a MAF of 97% observed for HRP2 levels of ≥10 U/mL (the level of the best combined sensitivity and specificity). HRP2 levels of >0 U/mL had a RAF of 77% for features of retinopathy combined, with the highest RAFs for macular whitening (99%), peripheral whitening (98%), and hemorrhages (90%). Conclusion. HRP2 has a high attributable fraction for features of malarial retinopathy, supporting its use in the diagnosis of cerebral malaria. HRP2 thresholds improve the specificity of the definition. PMID:24041795

  4. Clinical value of detection on serum monocyte chemotactant protein-1 and vascular endothelial cadherin levels in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Xia Zhou; Cheng Zhang

    2016-01-01

    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.

  5. 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.

  6. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  7. 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

  8. 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

    New measurement principles in pulse oximetry have been introduced to decrease the incidence of false movement alarms. Experimental studies have shown that the new Nellcor Symphony N-3000 may reduce the incidence of false alarms when monitoring during different activities. We compared the Nellcor...... working principles of the two generations of oximeters were reflected in the present results derived from a clinical setting. The Nellcor Symphony N-3000 may offer an advantage compared with the Nellcor N-200, because of the reduced frequency of alarms and total time in alarm when monitoring patients...

  9. Prone position is associated with mild cerebral oxygen desaturation in elderly surgical patients.

    Directory of Open Access Journals (Sweden)

    Stacie Deiner

    Full Text Available PURPOSE: A variety of hemodynamic and respiratory alterations accompany patients in the prone position; however the effect of the prone position on intraoperative cerebral saturation has not been studied. We sought to examine whether the incidence of cerebral oxygen desaturation in elderly patients (≥68 years of age undergoing spine surgery in the prone position was more common than patients undergoing major surgery in the supine position. METHODS: We performed a retrospective cohort study of 205 patients; 63 patients underwent surgery in the prone position and 142 in the supine position. Patients were evaluated for cerebral desaturation with bilateral cerebral oximetry. The primary predictor was position, secondary were: length of the surgery, incidence and duration of cerebral desaturation episodes at several thresholds, average time of Bispectral index below threshold of 45 in minutes, average electroencephalogram suppression ratio >0, amount of blood transfused, and the incidence of hypotension and hypertension. RESULTS: Elderly spine surgery patients in the prone position were more than twice as likely to experience mild cerebral desaturation as patients in the supine position. Patients in the prone position had longer surgeries; however cerebral desaturation in the prone position was significantly more common even when adjusted for surgery time and the occurrence of intraoperative hypotension. CONCLUSION: Cerebral desaturation is related to the prone position in elderly surgery patients. Future studies are necessary to determine whether this translates to a higher incidence of postoperative cognitive dysfunction and delirium.

  10. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

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

  11. Application and value of MRI in the diagnosis of cerebral venous malformation.%脑静脉性血管畸形MRI应用及价值

    Institute of Scientific and Technical Information of China (English)

    王秀兰; 田为中; 李瑗; 陈锦华; 陈小云

    2011-01-01

    Objective To explore the application and evaluation of a variety of imaging sequences of magnetic resonance (MR) imaging in diagnosing cerebral venous malformation (CVM). Methods The distribution of 22 CVM cases and corresponding MR features were retrospectively analyzed. All the patients underwent conventional routine MRI sean and following examinations including 18 cases with extra enhanced TIWI, 8 cases with contrast enhanced magnetic resonance angiography (CE MRA), 3 eases with 3D time of flight magnetic resonance angiography (3D TOFMRA) and 6 cases with susceptibility-weighted imaging (SWI) were processed. Results he conventional routine MRI scans of draining veins were shown as long T1 and long T2 signal intensities except for few short T2 signal intensifies. Most oft. he conventional routine MRI scans of medullary veins were unclear and shown as long T1 and long T2 or iso T2 signal intensities, and after enhancement, several radial medullary veins were dearly shown afflux into bulky drain veins, demonstrating typical “jellyfish head” appearance or “centipede” and “roots shape” changes.The SWI was rather susceptible to CVM with low intensity on draining veins and medullary veins. Conclusion The characteristic representation of CVM can be achieved by combining a variety of imaging methods, which provided significant value in the diagnosis of CVM and assessment of corresponding eomplieatious.%目的 探讨MRI多种成像序列在脑静脉性畸形诊断中的应用及评价.方法 回顾性分析22例CVM分布及MR征象.常规平扫后,其中18例加做增强后TWI扫描,CE-MRA 8例,3D-TOFMRA 3例,SWI 6例.结果 MRI平扫显示引流静脉(或导静脉)通常为长T长T信号影,少数为短T信号;髓静脉为长T、长T或等T信号,大部分显示不佳,增强后可清晰显示多根髓静脉呈放射状汇入粗大的引流静脉,呈典型"水母头"状或"蜈蚣"、"树根状"改变.SWI显示CVM更为敏感,引流静脉和髓

  12. Development of a luminous textile for reflective pulse oximetry measurements

    Science.gov (United States)

    Krehel, Marek; Wolf, Martin; Boesel, Luciano F.; Rossi, René M.; Bona, Gian-Luca; Scherer, Lukas J.

    2014-01-01

    In this paper, a textile-based sensing principle for long term photopletysmography (PPG) monitoring is presented. Optical fibers were embroidered into textiles such that out-coupling and in-coupling of light was possible. The “light-in light-out” properties of the textile enabled the spectroscopic characterization of human tissue. For the optimization of the textile sensor, three different carrier fabrics and different fiber modifications were compared. The sample with best light coupling efficiency was successfully used to measure heart rate and SpO2 values of a subject. The latter was determined by using a modified Beer-Lambert law and measuring the light attenuation at two different wavelengths (632 nm and 894 nm). Moreover, the system was adapted to work in reflection mode which makes the sensor more versatile. The measurements were additionally compared with commercially available system and showed good correlation. PMID:25136484

  13. Development of a luminous textile for reflective pulse oximetry measurements.

    Science.gov (United States)

    Krehel, Marek; Wolf, Martin; Boesel, Luciano F; Rossi, René M; Bona, Gian-Luca; Scherer, Lukas J

    2014-08-01

    In this paper, a textile-based sensing principle for long term photopletysmography (PPG) monitoring is presented. Optical fibers were embroidered into textiles such that out-coupling and in-coupling of light was possible. The "light-in light-out" properties of the textile enabled the spectroscopic characterization of human tissue. For the optimization of the textile sensor, three different carrier fabrics and different fiber modifications were compared. The sample with best light coupling efficiency was successfully used to measure heart rate and SpO2 values of a subject. The latter was determined by using a modified Beer-Lambert law and measuring the light attenuation at two different wavelengths (632 nm and 894 nm). Moreover, the system was adapted to work in reflection mode which makes the sensor more versatile. The measurements were additionally compared with commercially available system and showed good correlation.

  14. 超声诊断在新生儿颅脑疾病中的应用价值%Value of ultrasound in the diagnosis of the neonatal cerebral disease

    Institute of Scientific and Technical Information of China (English)

    田园; 邱敬涛

    2015-01-01

    Objective To explore the value and application method of ultrasonic diagnosis in neonatal cerebral disease. Methods Ultrasound examination was performed through the bregma. The coronal and sagittal brain structure was displayed through continuous check of deflection scanning probe. Results Ultrasonic examination has special diagnostic value in neonatal intracranial hemorrhage. It could make a definite diagnosis caused by hypoxic ischemic brain damage. The advantage of ultra‐sound was more obvious when hemorrhage position closed to midline.Conclusion Ultrasound examination provides good appli‐cation value for diagnosis and follow‐up in neonatal cerebral disease.%目的:探讨超声诊断新生儿颅脑疾病的应用方法及价值。方法通过前囟门检查,偏转探头连续扫查,分别显示脑结构的冠状面、矢状面。结果超声对部分新生儿颅内出血具有特异性的诊断价值,越是靠近脑中线的出血超声优势越明显,对缺氧缺血性脑损伤能作出明确诊断。结论超声检查在新生儿颅脑疾病的诊断及随访中有很好的应用价值。

  15. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Cerebral Palsy KidsHealth > For Teens > Cerebral Palsy Print A A ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  16. Comparable Cerebral Blood Flow in Both Hemispheres During Regional Cerebral Perfusion in Infant Aortic Arch Surgery.

    Science.gov (United States)

    Rüffer, André; Tischer, Philip; Münch, Frank; Purbojo, Ariawan; Toka, Okan; Rascher, Wolfgang; Cesnjevar, Robert Anton; Jüngert, Jörg

    2017-01-01

    Cerebral protection during aortic arch repair can be provided by regional cerebral perfusion (RCP) through the innominate artery. This study addresses the question of an adequate bilateral blood flow in both hemispheres during RCP. Fourteen infants (median age 11 days [range, 3 to 108]; median weight, 3.6 kg [range, 2.8 to 6.0 kg]) undergoing RCP (flow rate 54 to 60 mL · kg(-1) · min(-1)) were prospectively included. Using combined transfontanellar/transtemporal two- and three-dimensional power/color Doppler sonography, cerebral blood flow intensity in the main cerebral vessels was displayed. Mean time average velocities were measured with combined pulse-wave Doppler in the basilar artery, and both sides of the internal carotid, anterior, and medial cerebral arteries. In addition, bifrontal regional cerebral oximetry (rSO2) was assessed. Comparing both hemispheres, measurements were performed at target temperature (28°C) during full-flow total body perfusion (TBP) and RCP. A regular circle of Willis with near-symmetric blood flow intensity to both hemispheres was visualized in all infants during both RCP and TBP. In the left internal carotid artery, blood flow direction was mixed (retrograde, n = 5; antegrade, n = 8) during TBP and retrograde during RCP. Comparison between sides showed comparable cerebral time average velocities and rSO2, except for higher time average velocities in the right internal carotid artery (TBP p = 0.019, RCP p = 0.09). Unilateral comparison between perfusion methods revealed significantly higher rSO2 in the right hemisphere during TBP (82% ± 9%) compared with RCP (74% ± 11%, p = 0.036). Bilateral assessment of cerebral rSO2 and time average velocity in the main great cerebral vessels suggests that RCP is associated with near-symmetric blood flow intensity to both hemispheres. Further neurodevelopmental studies are necessary to verify RCP for neuroprotection during aortic arch repair. Copyright © 2017 The Society of Thoracic

  17. 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.

  18. Hydroxocobalamin and cyanocobalamin interference on co-oximetry based hemoglobin measurements.

    Science.gov (United States)

    Pamidi, Prasad V A; DeAbreu, Marlene; Kim, Donghak; Mansouri, Sohrab

    2009-03-01

    Hydroxocobalamin (OHCbl) and cyanocobalamin (CNCbl) are dark-red colored analogs of vitamin B-12. OHCbl is used as an alternate antidote for cyanide poisoning. Due to the strong red color, if uncorrected, these cobalamins interfere with hemoglobin measurements and can introduce errors in spectrophotometric assay on co-oximeters. The impact of cobalamins on commonly used co-oximetry systems was compared to evaluate the accuracy of hemoglobin measurements and to further assess the ability of the instruments to detect and flag cobalamin interference. Blood samples spiked with varying concentrations of hydroxocobalamin or cyanocobalamin (0-2 g/l), were measured on 3 GEM Premier 4000 s, 3 IL 682 CO-Oximeter, 1 Radiometer ABL 735 and 1 Siemens Rapidpoint 405 analyzer. The effect of OHCbl or CNCbl interference on total hemoglobin and hemoglobin derivatives is evaluated using the measured difference between the control sample and the spiked sample. Spectral measurements, blood measurements and delta spectral data confirmed that hemoglobin measurement accuracy is affected by the presence of OHCbl or CNCbl and that the source of interference is from errors in measurement algorithms, and not due to cobalamin induced hemoglobin changes. Among the 4 co-oximeters tested in this evaluation, GEM Premier 4000 and Rapidpoint 405 analyzer showed minimal impact for hydroxocobalamin concentrations around 0.5 g/l. Cyanocobalamin displayed similar interference effect on co-oximetry measurements as OHCbl. The error detection system in the GEM Premier 4000 appropriately detected and flagged interferences on sample measurements.

  19. TELEMOLD project: oximetry and exercise telemonitoring to improve long-term oxygen therapy.

    Science.gov (United States)

    Faria, Inês; Gaspar, Carina; Zamith, Manuela; Matias, Isabel; das Neves, Rui César; Rodrigues, Fátima; Bárbara, Cristina

    2014-07-01

    Standard assessment of long-term oxygen therapy (LTOT) prescription involves hospital-based clinical tests. However, there is some evidence suggesting that oxygen demand during daily activities may not be correctly estimated by such tests, when compared with continuous ambulatory oximetry. The authors describe the results of a study aiming to evaluate the clinical relevance of a home telemonitoring system in LTOT optimization. Thirty-five chronic respiratory failure patients were monitored in real time with an oximeter sensor and an accelerometer. Signals were sent via Bluetooth(®) (Bluetooth SIG, Kirkland, WA) to a mobile phone and then via 3G or general packet radio service to a server. Continuous and secure access to data was established through an Internet site. Each patient was monitored an average of 7.6 ± 4.5 days (total, 83 ± 67 h). Valid records were on average 65 ± 24%. Records of rest, activity, and sleep time per patient were, on average, 28 ± 21%, 7 ± 6%, and 59 ± 25%, respectively. Significant desaturation during rest, activity, and sleep was found in 2, 26, and 9 patients, respectively. Patients' ratings of the user-friendliness of the equipments, assessed by questionnaire, were fairly good (76% reported it as easy/very easy). Our study suggests that a telemonitoring system combining oximetry and physical activity evaluation might contribute to a more adequate oxygen prescription, mainly during daily activities.

  20. A paramagnetic implant containing lithium naphthalocyanine microcrystals for high-resolution biological oximetry.

    Science.gov (United States)

    Meenakshisundaram, Guruguhan; Pandian, Ramasamy P; Eteshola, Edward; Lee, Stephen C; Kuppusamy, Periannan

    2010-03-01

    Lithium naphthalocyanine (LiNc) is a microcrystalline EPR oximetry probe with high sensitivity to oxygen [R.P. Pandian, M. Dolgos, C. Marginean, P.M. Woodward, P.C. Hammel, P.T. Manoharan, P. Kuppusamy, Molecular packing and magnetic properties of lithium naphthalocyanine crystal: hollow channels enabling permeability and paramagnetic sensitivity to molecular oxygen J. Mater. Chem. 19 (2009) 4138-4147]. However, direct implantation of the crystals in the tissue for in vivo oxygen measurements may be hindered by concerns associated with their direct contact with the tissue/cells and loss of EPR signal due to particle migration in the tissue. In order to address these concerns, we have developed encapsulations (chips) of LiNc microcrystals in polydimethyl siloxane (PDMS), an oxygen-permeable, bioinert polymer. Oximetry evaluation of the fabricated chips revealed that the oxygen sensitivity of the crystals was unaffected by encapsulation in PDMS. Chips were stable against sterilization procedures or treatment with common biological oxidoreductants. In vivo oxygen measurements established the ability of the chips to provide reliable and repeated measurements of tissue oxygenation. This study establishes PDMS-encapsulated LiNc as a potential probe for long-term and repeated measurements of tissue oxygenation. Copyright (c) 2009 Elsevier Inc. All rights reserved.

  1. Combined heart rate variability and pulse oximetry biofeedback for chronic obstructive pulmonary disease: preliminary findings.

    Science.gov (United States)

    Giardino, Nicholas D; Chan, Leighton; Borson, Soo

    2004-06-01

    The purpose of this study was to examine the feasibility of an intervention that included heart rate variability (HRV) biofeedback and walking with pulse oximetry feedback to improve functioning and quality of life for patients with chronic obstructive pulmonary disease (COPD). Twenty patients with COPD participated in 5 weekly sessions of HRV biofeedback and 4 weekly sessions of walking practice with oximetry feedback, with instructions for daily home practice. Primary outcomes measures were the distance walked in 6 min (6MWD) and overall quality of life, as measured by the St. George's Respiratory Questionnaire (SGRQ). Secondary outcomes included measures of self-efficacy, self-reported disability, anxiety, depression, dyspnea before and after the 6MWD, and HRV at the frequency of respiration during spontaneous and paced breathing. After 10 weeks of training, participants showed statistically and clinically significant improvements in 6MWD and quality of life. Significant changes were also seen in self-efficacy, disability, dyspnea before and after the 6MWD, and HRV amplitude during spontaneous breathing. We conclude that our intervention is feasible for patients with COPD and that further research using a randomized controlled design is warranted.

  2. Evaluation of oxygen saturation by pulse-oximetry in mouth breathing patients.

    Science.gov (United States)

    Niaki, Esfandiar Akhavan; Chalipa, Javad; Taghipoor, Elahe

    2010-01-01

    Mouth breathing might not always result in hypoxia, but can contribute to it. The aim of the present study was to determine the effect of mouth breathing on hypoxia. Based on a pilot study, 323 patients with mouth breathing were selected. Assessment of mouth breathing was based on clinical examination and questionnaires filled out by patients and their companions. The patients were also examined for further oral findings that could be attributable to mouth breathing. Oxygen saturation of each case was measured by means of a pulse oximetry device. The level of 95% saturation was set as the limit, under which the patient was considered hypoxemic. Acquired data was analyzed for descriptive data and frequency and also by means of the Chi-square and Spearman's correlation coefficient tests. 34.6% of the cases had normal O2 saturation. 65.4% of cases were hypoxemic (saturation level was below 95% in 42.8% and 95% in 22.6%). Most of the mouth breathing patients were male who were also more hypoxemic. A weak inverse relationship existed between the age of the patients and Oxygen saturation. Deep palatal vaults (29.4%) and gingival hyperplasia (29.2%) were the most frequent intraoral findings. Concerning the effects of hypoxia on body systems, the use of pulse oximetry in suspected mouth breathing patients could be recommended in routine oral and dental examinations.

  3. Evaluation of Oxygen Saturation by Pulse-Oximetry in Mouth Breathing Patients

    Directory of Open Access Journals (Sweden)

    Esfandiar Akhavan Niaki

    2010-02-01

    Full Text Available Mouth breathing might not always result in hypoxia, but can contribute to it. The aim of the present study was to determine the effect of mouth breathing on hypoxia. Based on a pilot study, 323 patients with mouth breathing were selected. Assessment of mouth breathing was based on clinical examination and questionnaires filled out by patients and their companions. The patients were also examined for further oral findings that could be attributable to mouth breathing. Oxygen saturation of each case was measured by means of a pulse oximetry device. The level of 95% saturation was set as the limit, under which the patient was considered hypoxemic. Acquired data was analyzed for descriptive data and frequency and also by means of the Chi-square and Spearman’s correlation coefficient tests.  34.6% of the cases had normal O2 saturation. 65.4% of cases were hypoxemic (saturation level was below 95% in 42.8% and 95% in 22.6%. Most of the mouth breathing patients were male who were also more hypoxemic.  A weak inverse relationship existed between the age of the patients and Oxygen saturation. Deep palatal vaults (29.4% and gingival hyperplasia (29.2% were the most frequent intraoral findings. Concerning the effects of hypoxia on body systems, the use of pulse oximetry in suspected mouth breathing patients could be recommended in routine oral and dental examinations.

  4. 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.

  5. 磁敏感成像序列在脑微出血诊断中的价值%The value of susceptibility weighted imaging in the diagnosis of cerebral micro-bleeding

    Institute of Scientific and Technical Information of China (English)

    王绍娟; 王利伟; 黄海青; 高歌军; 殷信道

    2013-01-01

    To evaluate the detection ability of MR susceptibility weighted imaging (SWI) in the cerebral micro-bleedings (CMB) and recessive cerebral microbleedings (rCMB). Materials and Methods: Magnetic resonance images of 45 cases with cerebral micro-bleeding were retrospectively analyzed. The features including size and location of the cerebral micro-bleedings were observed, and the detection rate of MRI and SWI were compared. These sequences of magnetic resonance imaging (T1WI, T2WI, FLAIR, DWI) and SWI were carried out. SWI was the VEN-BOLDHR gradient echo sequence. Results: Altogether, 197 CMBs were deceted with a total of 162 CMB lesions on MRI, 191 CMB lesions on SWI. The detection rate of SWI is 1.18 times of the routine sequences. There was statistic difference in showing cerebral micro-bleeding among those sequences(χ2=22.90, P<0.01). Conclusion: SWI has a higher value in the detection of CMB and rCMB than the routine sequences, and should be one of the conventional sequences.%目的探讨磁敏感加权成像(SWI)在检出脑微出血灶(CMB)及隐匿性CMB (rCMB)中的价值。方法回顾性分析45例有脑CMB患者的MR影像资料,观察病灶大小、部位等特征,比较常规MR成像序列及SWI序列的检出率。检查序列包括常规MR成像序列(T1WI、T2WI、FLAIR及DWI)及SWI序列。SWI采用Ven-Bold-HR三维梯度回波序列。结果共检出197个CMB,常规MR序列检出162个,SWI检出191个,SWI的CMB检出率是常规序列的1.18倍,两者的差异有统计学意义(χ2=22.90,P<0.01)。SWI序列可以检出常规序列不能检出的隐匿性CMB(rCMB)。结论 SWI在检出CMB及rCMB中优于常规MRI序列,建议作为MRI检查的常规序列之一。

  6. The value of spiral CT in diagnose and curativ e effect of cerebral infarction following surgery for hypertensive cerebral hemorrhage%螺旋CT在高血压脑出血术后继发性脑梗死诊断及疗效观察中的价值

    Institute of Scientific and Technical Information of China (English)

    祝华强; 罗东梅; 邱其良; 刘奕仕; 陈建乐; 周才金

    2015-01-01

    目的:探讨螺旋CT在高血压脑出血术后早期脑缺血/脑梗死诊断及疗效观察中的价值。方法回顾分析我院2008—2014年间收治的25例高血压脑出血术后脑梗死病例影像资料。结果25例脑出血中基底节区15例,皮层区9例,脑室内1例,血肿破入脑室5例。术后出现脑梗死共72处(按脑叶统计),其中额叶12处(17%)、颞叶12处(17%)、顶叶11处(15%)、枕叶21处(29%)、小脑3处(4%)、脑干5处(7%)、基底节区8处(11%)。随诊观察治疗效果,经治疗除了6例病例死亡,其余病例经8~40 d随诊复查,10例脑梗死区密度恢复正常,4例病情好转转院治疗,5例脑梗死区出现脑软化灶。25例患者进行随访,按照目前常用的日常生活能力分级(GOS评分):GOS评分Ⅰ级3例(12%);GOS评分Ⅱ级8例(32%);GOS评分Ⅲ级5(20%),GOS评分Ⅳ级2例(8%),GOS评分Ⅴ级1例(4%);死亡6例(24%)。结论螺旋CT扫描速度快,检查时间短,对早期发现高血压脑出血术后继发脑梗死病变、及时治疗以提高患者的生存率,降低病残率以及估计其预后有重要的意义。%Objective To study the value of spiral CT in diagnose and curative effect of cerebral ischemia/infarction following surgery for hypertensive cerebral hemorrhage (HCH). Methods Retrospective analysis the CT image data 25 cases with cerebral infarction following the surgery for HCH, who were treated in our department from, 2008 to 2014. Results In 25 cases of cerebral infarction following surgery for hypertensive cerebral Hemorrhage. There were 15 cases of basis festival area cerebral hemorrhage, 9 cases of cortical hemorrhage, 1 cases of in-traventricular hemorrhage, 5 cases of hematoma broken into ventricles. Postoperative cerebral infarction were 72 points (according to the statistics), the frontal lobe were 12 points(17%), temporal lobe were 12 points(17%), parietal

  7. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  8. 颅脑超声检查在高危新生儿颅内疾病中的诊断价值%Diagnostic Value of Cerebral Ultrasound in High-risk Neonatal Intracranial Diseases

    Institute of Scientific and Technical Information of China (English)

    阿衣努尔·买买提力; 乔丽潘·玉奴斯

    2016-01-01

    目的:探讨颅脑超声检查在高危新生儿颅内疾病中的诊断价值。方法选择2014年11月~2015年12月我院收治的80例高危新生儿作为研究对象,使用颅脑超声检查患儿脑实质及双侧大脑半球回声结构,对双侧脉络丛的宽度和双侧侧脑室前角的宽度进行测量,再对80例患儿进行头部CT检查。结果80例患儿中有18例为脑室扩张,有20例为脑内出血,有缺血缺氧性脑病25例,有6例为室管膜下囊肿,有11例为脑室周围白质软化,排除网膜下腔出血及小脑内出血、硬脑膜下出血等检查结果以外,超声检查结果和CT检查结果及临床正常基本一致。结论应用颅脑超声检查对于高危新生儿颅内疾病诊断具有极高的价值,而且超声检查操作方便,不会对患儿造成放射性损害,尤其对患儿颅脑中央分辨能力较强。%Objective To study the cerebral ultrasound diagnostic value in high risk of neonatal intracranial diseases.Methods From November 2014 to December 2015, 80 cases of high-risk newborns in our hospital were taken as the research objects, underwent cerebral ultrasound to examine brain parenchyma and bilateral cerebral hemisphere echo structure, measured the width of bilateral choroid plexus and the anterior horn of bilateral ventricle, then conducted in 80 cases of children with head CT examination. ResultsIn 80 cases of newborn, 18 cases of ventricular expansion, 20 cases of cerebral hemorrhage, 25 cases of hypoxic-ischemic encephalopathy, 6 cases of subependymal cysts, 11 cases of eriventricular leukomalacia, exclusion of subarachnoid hemorrhage, cerebellum hemorrhage, subdural hemorrhage and other test results, ultrasound and CT examination results were basically identical.Conclusion Cerebral ultrasound examination for high-risk neonates intracranial disease diagnosis has a very high value, and ultrasound examination is easy to operate, and will not cause radioactive damage

  9. Prognostic value of reduced discrimination and oedema on cerebral computed tomography in a daily clinical cohort of out-of-hospital cardiac arrest patients

    DEFF Research Database (Denmark)

    Langkjær, Sandra; Hassager, Christian; Kjaergaard, Jesper

    2015-01-01

    bleeding' in 4(3%), 'new cerebral infarction' in 10(7%), and 'reduced discrimination between white and grey matter and/or oedema' in 45(30%) patients. 'Reduced discrimination and/or oedema' by late cCT was independently associated with higher 30-day mortality compared to patients with a normal late CT (HR......(adjusted) = 2.6 (95%CI: 1.4-4.8, p = 0.002). CONCLUSION: Our observations suggest that a cCT may be useful as part of the neurological prognostication in patients with OHCA. 'Reduced discrimination between white and grey matter and/or oedema' on cCT was independently associated with a poor prognosis....

  10. 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

    2017-09-25

    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.

  11. 磁共振灌注加权成像在颅脑胶质瘤分级中的价值研究%Value of MR perfusion weighted imaging in differentiating the tumor grade of cerebral gliomas

    Institute of Scientific and Technical Information of China (English)

    李伟; 龙晚生; 罗学毛; 何义改; 兰勇; 蔡小琴

    2011-01-01

    目的 探讨相对脑血容积(rCBV)、相对脑血流量(rCBF)和相对平均通过时间(rMTT)在鉴别颅脑胶质瘤病理分级中的价值.方法 对病理证实为颅脑胶质瘤的患者(Ⅱ级胶质瘤9例,Ⅲ级胶质瘤11例,Ⅳ级胶质瘤14例)行MR灌注加权成像及常规MRI检查.由灌注加权成像数据获取脑血容积(CBV)图、脑血流量(CBF)图和平均通过时间(MTT)图,计算出rCBV、rCBF和rMTT值.结果 Ⅱ级胶质瘤的rCBV、rCBF和rMTT值分别为2.68±1.37、2.52±1.29和1.02±0.30,Ⅲ级胶质瘤的rCBV、rCBF和rMTT值分别为4.99±2.34、4.77±1.97和1.07±0.15,Ⅳ级胶质瘤的rCBV、rCBF和rMTT值分别为6.69±1.88、6.97±1.73和1.08±0.22,各组间rCBV和rCBF值比较差异有统计学意义(P0.05).结论 MR灌注加权成像能有效地在术前评价颅脑胶质瘤的病理级别,rCBV值结合rCBF值可以更好地对颅脑胶质瘤进行病理分级.%Objective To explore the value of relative cerebral blood volume(rCBV), relative cerebral blood flow(rCBF) and relative mean through time(rMTT) in differentiating the tumor grade of cerebral gliomas. Methods This study involved 34 patients (9 cases of grade Ⅱ,11 cases of grade Ⅲ,14 cases of grade Ⅳ) which were identified as gliomas proved by histopathologic. MR perfusion weighted imaging and conventional MR imaging were underwent on them preoperatively. The perfusion weighted imaging datas were deconvoluted to get a color map of CBV, CBF and MTT. The value of rCBV, rCBF and rMTT of each lesion were calculated and correlated with histopathologic grading of gliomas. Results The value of rCBV, rCBF and rMTT of grade Ⅱ,grade Ⅲ,grade Ⅳ gliomas was (2.68±1.37, 4.99±2.34,6.69±1.88), (2.52±1.29,4.77±1.97,6.97±1.73) and (1.02±0.30,1.07±0.15,1.08±0.22), respectively. The value of rCBV and rCBF had statistically difference in each groups (P0.05).Conclusions MR perfusion weighted imaging is useful in the preoperative assessment of the histopathologic grade

  12. Pulse oximetry and supplemental oxygen during gastrointestinal endoscopy: a critical review

    DEFF Research Database (Denmark)

    Holm, C; Rosenberg, J

    1996-01-01

    A high proportion of the mortality and morbidity associated with endoscopic procedures may be of cardiopulmonary origin. For this reason, the appropriate degree of monitoring and prophylactic measures to be used in the sedated patient undergoing endoscopy has become a topic of discussion during...... recent years. The development of myocardial ischaemia during gastrointestinal endoscopy has traditionally been considered to be due to the simultaneous arterial hypoxaemia; however, recent investigations have suggested that tachycardia may be a more important pathogenic factor. No study has ever shown...... that pulse oximetry monitoring or supplemental oxygen will reduce the morbidity or mortality during gastrointestinal endoscopy. The current guidelines for monitoring and oxygen therapy are therefore not supported by scientific data. There is a need for further studies on the pathogenic mechanisms...

  13. Is Pulse Oximetry Useful for Screening Neonates for Critical Congenital Heart Disease at High Altitudes?

    Science.gov (United States)

    Hoffman, Julien I E

    2016-06-01

    Now that pulse oximetry is used widely to screen for critical congenital heart disease, it is time to consider whether this screening method is applicable to those who live at high altitudes. Consideration of basic physical principles and reports from the literature indicate that not only is the 95 % cutoff point for arterial oxygen saturation incorrect at high altitudes, but the lower saturations are accompanied by greater variability and therefore there is the possibility of a greater percentage of false-positive screening tests at high altitudes. Because of ethnic differences in response to high altitudes, normative data will have to be collected separately in different countries and perhaps for different ethnic groups.

  14. Diagnostic accuracy of a mathematical model to predict apnea-hypopnea index using nighttime pulse oximetry

    Science.gov (United States)

    Ebben, Matthew R.; Krieger, Ana C.

    2016-03-01

    The intent of this study is to develop a predictive model to convert an oxygen desaturation index (ODI) to an apnea-hypopnea index (AHI). This model will then be compared to actual AHI to determine its precision. One thousand four hundred and sixty-seven subjects given polysomnograms with concurrent pulse oximetry between April 14, 2010, and February 7, 2012, were divided into model development (n=733) and verification groups (n=734) in order to develop a predictive model of AHI using ODI. Quadratic regression was used for model development. The coefficient of determination (r2) between the actual AHI and the predicted AHI (PredAHI) was 0.80 (r=0.90), which was significant at a papnea.

  15. Pulse oximetry in the newborn: Is the left hand pre- or post-ductal?

    Directory of Open Access Journals (Sweden)

    Bucher Hans

    2010-05-01

    Full Text Available Abstract Background Over the past few years, great efforts have been made to screen duct-dependent congenital heart diseases in the newborn. Arterial pulse oximetry screening (foot and/or right hand has been put forth as the most useful strategy to prevent circulatory collapse. The left hand, however, has always been ignored, as it was unclear if the ductus arteriosus influences left-hand arterial perfusion. The objective of our study was to evaluate the impact of the arterial duct on neonatal pulse oximetry saturation (POS on the left hand. Methods In this observational study, arterial oxygen saturation on both hands and on one foot was measured within the first 4 hours of life. Results Two hundred fifty-one newborns were studied: 53% males and 47% were delivered by caesarean section. The median gestational age was 38 4/7 weeks (90% CI, 32 6/7 - 41 2/7 weeks, the median birth weight was 3140 g (90% CI, 1655 - 4110 g and the median age at recording was 60 minutes (90% CI, 15 - 210 minutes. The mean POS for the overall study population was 95.7% (90% CI, 90 - 100% on the right hand, 95.7% (90% CI, 90 - 100% on the left hand, and 94.9% (90% CI, 86 - 100% on the foot. Four subgroups (preterm infants, babies with respiratory disorders, neonates delivered by caesarean section, and newborns ≤15 minutes of age were formed and analysed separately. None of the subgroups showed a statistically significant difference between the right and left hands. Additionally, multivariate logistic regression did not identify any associated factors influencing the POS on the left hand. Conclusions With the exception of some children with complex or duct dependent congenital heart defects and some children with persistent pulmonary hypertension, POS on both hands can be considered equally pre-ductal.

  16. Pulmonary ultrasound and pulse oximetry versus chest radiography and arterial blood gas analysis for the diagnosis of acute respiratory distress syndrome: a pilot study

    OpenAIRE

    Bass, Cameron M.; Sajed, Dana R.; Adedipe, Adeyinka A.; West, T Eoin

    2015-01-01

    Introduction In low-resource settings it is not always possible to acquire the information required to diagnose acute respiratory distress syndrome (ARDS). Ultrasound and pulse oximetry, however, may be available in these settings. This study was designed to test whether pulmonary ultrasound and pulse oximetry could be used in place of traditional radiographic and oxygenation evaluation for ARDS. Methods This study was a prospective, single-center study in the ICU of Harborview Medical Center...

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

    Science.gov (United States)

    Niknafs, Pedram; Norouzi, Elahe; Bahman Bijari, Bahareh; Baneshi, Mohammad Reza

    2015-05-01

    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 blood gas analysis. However, the validity of pulse oximetry was not good enough to detect acidosis, hypercapnia, and hypoxemia.

  18. Diagnostic Value of Brain Perfusion Imaging with 64 Multi-Detector Spiral CT in Early Cerebral Infarction%64排螺旋 CT 脑灌注成像对早期脑梗死的诊断价值

    Institute of Scientific and Technical Information of China (English)

    奚彬; 盛伟华; 唐建伟; 黄松; 宋黎涛

    2014-01-01

    目的:探讨64排螺旋 CT 脑灌注成像(CT perfusion imaging,CTP)对早期脑梗死的诊断价值。方法:临床拟诊早期脑梗死患者38例,均在症状出现24 h 内行头颅 CT 平扫及 CTP 检查。将脑梗死核心区、缺血半暗带(ischemic penumbra,IP)区与健侧对应区的情况做对比分析。结果:38例患者中,15例头颅 CT 平扫发现可疑脑梗死区,主要位于大脑半球,表现为密度轻度减低、局部脑沟稍变浅等;其余23例患者 CT 平扫未发现异常。38例患者的 CTP 检查均发现灌注异常区,表现为脑梗死区脑血流量(cerebral blood flow,CBF)与脑血容量(cerebral blood volume,CBV)均较健侧对应区明显下降,对比剂平均通过时间(mean transit time,MTT)较健侧对应区缩短,对比剂达峰时间(time to peak,TTP)较健侧对应区明显延长,差异均有统计学意义(P <0.01)。早期脑梗死患者 IP 区与梗死核心区比较,CBF、CBV、MTT 及 TTP 差异均有统计学意义(P <0.01);IP区与健侧对应区比较,CBF、MTT、TTP 差异均有统计学意义(P <0.05、0.01),CBV 差异无统计学意义(P >0.05)。获得随访的18例患者中,经积极溶栓等治疗后梗死区缩小6例,梗死区消失5例,仅表现为梗死区 TTP 和 MTT 延长、CBF 和 CBV 变化不大3例,梗死区无明显变化4例。结论:64排螺旋 CTP 检查可以准确地提示早期脑梗死。%Objective:To explore the diagnostic value of CT perfusion imaging(CTP)with 64 multi-detector spiral CT in early cerebral infarction.Methods:A total of 38 patients with suspected early cerebral infarction underwent plain CT and CTP within 24 h after the onset of related symptoms.The imaging results in infarction core area,ischemic penumbra (IP) and the contralateral normal region were comparatively analyzed.Results:Early cerebral infarction,mainly in cerebral hemispheres, were suspected

  19. 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 ...

  20. CT脑灌注成像在短暂性脑缺血发作的应用价值探讨%To Study the Application Value of CT Cerebral Perfusion Imaging in Transient Ischemic Attack

    Institute of Scientific and Technical Information of China (English)

    杜彦挺; 夏志强; 杜光勇; 张伟; 李涛

    2016-01-01

    目的:探讨CT脑灌注成像(CT perfusion,CTP)在短暂性脑缺血发作(transient ischemic attack,TIA)的应用价值。方法收集我院从2013年4月至2015年4月收治的55例短暂性TIA患者作为研究对象,发病24h内进行CTP和CTA(CT angiography)检查,发病72h内进行头颅MRI(magnetic resonance imaging)和MRA(magnetic resonance angiography)进行检查,比较CTP与其他检查方法的检出结果差异,并对病灶侧与健康侧的脑灌注成像参数如获得达峰时间(time to peak, TTP)、平均通过时间(mean transit time, MTT)、脑血流量(cerebral blood flow, CBF)、脑血容量(cerebral blood volume, CBV)进行比较分析。结果 CTA检出35个病灶,MRI检出44个病灶,CTP检出59个病灶,CTP对病灶的检出率高于CTA和MR检查,具有统计学意义(P<0.05);CTP检出的病灶表现分型中I1期12个,I2期29个,II1期11个, II2期7个,I2期明显多于其他分型,具有统计学意义(P<0.05);CTP病灶侧的TTP值、MTT值(P<0.05);CTP病灶侧的CBV值与健康侧没有明显差异(P>0.05)。结论采用CT脑灌注成像检查短暂性脑缺血发作可以全面的诊断,对治疗短暂性脑缺血发作提供可靠的依据。%Objective To study the application value of CT cerebral perfusion imaging(CTP) in Transient ischemic attack(TIA).Methods Fifty-five cases of transient ischemic attack from April 2013 to April 2015 in our hospital were collected as research subject, all of them were performed CTP, CTA(CT angiography) in 24 hours after onset and MRI(Magnetic Resonance imaging) and MRA(Magnetic Resonance angiography) in 72 hours. The inspection results of CTA and MRI and CTP were compared, and the parameters of CTP like time to peak(TTP), mean transit time(MTT), cerebral blood flow(CBF), cerebral blood volume(CBV) were analyzed and compared between lesion side and healthy side.Results Thirty-five lesions were checked out by CTA inspection, 44 lesions by MRI, and 59

  1. Oxygen and pulse oximetry in childhood pneumonia: a survey of healthcare providers in resource-limited settings.

    Science.gov (United States)

    Ginsburg, Amy Sarah; Van Cleve, William C; Thompson, Mary I W; English, Mike

    2012-10-01

    Globally, pneumonia is the leading cause of death in children provider perceptions and practices regarding their role in childhood pneumonia, we conducted a survey using a convenience sampling strategy targeting clinicians working in resource-limited countries. Most respondents were physicians from public district and provincial hospitals with access to oxygen and pulse oximetry; however, reported therapeutic use for childhood pneumonia was low. Common barriers included insufficient supply, competition for use, lack of policies, guidelines and training and perceived high cost. Despite the frequency of hypoxemia, the inaccuracy of clinical predictors, the poor outcome hypoxemia portends and the effectiveness of pulse oximetry and oxygen in childhood pneumonia, our data indicate that these tools may be underused in resource-limited settings.

  2. 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.

  3. Blood gases and oximetry: calibration-free new dry-chemistry and optical technology for near-patient testing.

    Science.gov (United States)

    Boalth, N; Wandrup, J; Larsson, L; Frischauf, P A; Lundsgaard, F C; Andersen, W L; Jensen, N; Singer, R; Troldborg, C P; Lunding, G

    2001-05-01

    The first calibration-free Near-Patient-Testing instrument (NPT7) for blood gases, pH and oximetry has been developed. With cartridges of 30 single-use cuvettes, the NPT7 needs no preparation prior to sample aspiration, no manual calibration, and no maintenance apart from paper and cartridge changes and regulatory quality control. Each cuvette measures pCO2, pO2, pH, total hemoglobin (ctHb), oxygen saturation (sO2), fractions of carboxyhemoglobin (FCOHb) and methemoglobin (FMetHb) on 95 microl whole blood with a 110-s measuring cycle. The measurement principles are as follows: pCO2-three-wavelength infrared spectroscopy of dissolved CO2; pO2-measurement of O2-induced changes in the decay time of phosphorescence; pH-the absorbance spectra change of an azo-dye color indicator; and oximetry is performed with a 128-wavelength spectrophotometer. We determined the within and between instrument variations with tonometered whole blood on seven prototype instruments, using between one and five control levels per analyte. The 95% analytical performance limits: +/-(/Bias/ +2 xS(T)) in the NPT7 instrument matched the analytical performance criteria for the measured quantities as defined by AACC guidelines. The application of these optical measuring methods for blood gases, pH and oximetry in single-use devices introduces a new concept into point-of-care testing (POCT), where preanalytical activities otherwise associated with instrument preparation are eliminated.

  4. 皮层下动脉硬化性脑病100例临床CT分析%CT and MRI T2WI, and FLAIR and DWI in diagnostic value of cerebral lacunar infarction and its prognosis analysis

    Institute of Scientific and Technical Information of China (English)

    罗青毅; 邹习忠; 冉强; 董志鹏

    2014-01-01

    目的:探讨皮层下动脉硬化性脑病颅脑ct诊断的意义和价值。方法结合我院临床诊断为皮层下动脉硬化性脑病, ct表现为侧脑室周围脑白质脱髓鞘改变的100例病例,按Goto分类法,将侧脑室前角周围脑白质脱髓鞘改变程度不同分为三型的标准,进行临床和影像综合分析。结果按Goto分类法Ⅰ型和Ⅱ型63例,临床表现轻,Ⅲ型37例,症状重,常偏瘫和言语不清,ct表现伴有脑萎缩(96例),腔隙性脑梗死(74例),伴大面积脑梗死(8例)、脑出血(7例)、脑积水和蛛网膜下腔积液(12例)。结论 ct检查对皮层下动脉硬化性脑病的诊断具有重要的价值,对于临床在预防、诊断和治疗皮层下动脉硬化性脑病方面具有重要意义。%Objectiveto explore the value of ct in diagnosis of subcortical arteriosclerotic encephalopathy (sae). Methods100 patients were deifnitely diagnosed as SAE by clinic. CT showed low density of surrounding bilateral ventricle. Demyelinating encephalopathy of frontal horn of bilateral ventricle were divided into three types according to the classiifcation of Goto.Results clinical presentations showed mild in typesⅠ andⅡ in 63 patients, severe symptoms were found in 37 patients, including hemiplegia, and barylalia. ct appeared cerebral atrophy in 96 patients; cerebral lacunar infarction in 74; diffuse cerebral infarction in 8; hemorrhage in 7; and hydrocephalus and hydrops of subarachnoid space in 12.Conclusion ct was very valuable on diagnosis and evaluation of subcortical arteriosclerotic encephalopathy.

  5. 血清降钙素原对急性重度脑卒中患者并感染的预测价值研究%The predictive value of procalcitonin in severe acute cerebral apoplexy complicated infection

    Institute of Scientific and Technical Information of China (English)

    马晓红

    2013-01-01

    Objective To evaluation the predictive value of serum procalcitonin (PCT) in severe acute cerebral apoplexy complicated infection. Methods Severe brain damage due to acute stroke, need access to ICU care of 48 patients, Detect when admitted to ICU, 3rd-, 5th-day PCT, and serum c-reactive protein (CRP) levels and occurrence of infections. Results Compared with non-infected group, Infected patients into icu and 3 days, 5 days serum PCT level significantly higher, The difference has statistics significance (P 0.05). Conclusion PCT determination contributed to early prediction of occurrence of severe infection in patients with acute cerebral apoplexy.%目的评估严重急性脑卒中患者的血清降钙素原(PCT)预测感染的临床价值。方法对急性脑卒中导致的严重脑损伤,需要进入ICU监护的患者48例,检测其入住ICU时第3天、第5天血清PCT和C反应蛋白(CRP)水平及感染发生情况。结果与非感染组相比,感染组患者入ICU时及第3天、第5天时血清PCT水平明显升高,差异有统计学意义(P0.05)。结论PCT测定有助于早期预测严重急性脑卒中患者感染的发生。

  6. 脉搏碳氧-血氧仪监测肝硬化患者血红蛋白浓度的精确性%Measurement of total hemoglobin in cirrhosis patients by pulse CO-Oximetry

    Institute of Scientific and Technical Information of China (English)

    张月宁; 单晶; 范春蕾; 董桂芳; 刘静

    2016-01-01

    Objective To evaluate the application of noninvasive pulse CO-Oximetry in continuous measurement of hemoglobin (Hb) in cirrhosis patients. Methods The level of hemoglobin was continuously measured using pulse CO-Oximetry, while samples of venous blood were collected to undergo routine testing. Results A total of 273 patients were enrolled in the current study. According to laboratory results, the concentration of Hb was between 33.6-129.8 g/L, with a mean value of (75.1 ± 4.9) g/L, in contrast with the readings between 42.3-140.8 g/L provided by pulse CO-Oximetry, with a mean value of (81.4±9.6) g/L (P<0.05). The regression equation of these two methods was y=1.56+0.857x, r=0.816, P=0.000. Bland-Altman analysis showed that the mean value of D-value between those two methods was 12.1g/L (95%CI 16-25 g/L), the mean value of M-value was 78.3 g/L and the ratio of D-value to M-value was 15.5%. Conclusions Masimo Radical-7 pulse CO-Oximetry tends to provide a higher reading than laboratory results. However, its readings show acceptable precision and accuracy and can reflect the trend of changes in hemoglobin level. With respect to its characteristics of non-incision and continuity, this method is worthy of promotion in clinical setting.%目的:评价无创脉搏碳氧-血氧仪连续监测肝硬化患者血红蛋白浓度的精确性。方法住院肝硬化患者用脉搏碳氧-血氧仪连续监测血红蛋白浓度,同时送静脉血至实验室进行血常规检测。结果共检测273例肝硬化患者,实验室测得血红蛋白浓度在33.6~129.8 g/L,均值(75.1±4.9)g/L;仪器检测血红蛋白在42.3~140.8 g/L,均值(81.4±9.6)g/L,P<0.05。两种检测结果的回归方程为y=1.56+0.957x,相关系数r=0.816,P=0.000。Bland-Altman一致性分析,两种检测方法差值的平均值为12.1g/L(95%CI为16~25 g/L),均值的平均值为78.3 g/L,差值占均值比为15.5%。结论Masimo Radical-7脉搏碳氧-血氧仪对于

  7. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

    Abay, T Y; Kyriacou, P A

    2016-04-01

    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.

  9. Monitoring respiration in wheezy preschool children by pulse oximetry plethysmogram analysis.

    Science.gov (United States)

    Wertheim, David; Olden, Cathy; Symes, Liz; Rabe, Heike; Seddon, Paul

    2013-09-01

    The aim of this study was to investigate whether respiratory information can be derived from pulse oximetry plethysmogram (pleth) recordings in acutely wheezy preschool children. A digital pulse oximeter was connected via 'Bluetooth' to a notebook computer in order to acquire pleth data. Low pass filtering and frequency analysis were used to derive respiratory rate from the pleth trace; the ratio of heart rate to respiratory rate (HR/RR) was also calculated. Recordings were obtained during acute wheezy episodes in 18 children of median age 31 months and follow-up recordings from 16 of the children were obtained when they were wheeze-free. For the acutely wheezy children, frequency analysis of the pleth waveform was within 10 breaths/min of clinical assessment in 25 of 29 recordings in 15 children. For the follow-up measurements, frequency analysis of the pleth waveform showed similarly good agreement in recordings on 15 of the 16 children. Respiratory rate was higher (p < 0.001), and HR/RR ratio was lower (p = 0.03) during acute wheeze than at follow-up. This study suggests that respiratory rate can be derived from pleth traces in wheezy preschool children.

  10. 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.

  11. Oximetry Signal Processing Identifies REM Sleep-Related Vulnerability Trait in Asthmatic Children

    Science.gov (United States)

    Perez, Geovanny F.; Gutierrez, Maria J.; Huseni, Shehlanoor; Pancham, Khrisna; Rodriguez-Martinez, Carlos E.; Nino, Cesar L.; Nino, Gustavo

    2013-01-01

    Rationale. The sleep-related factors that modulate the nocturnal worsening of asthma in children are poorly understood. This study addressed the hypothesis that asthmatic children have a REM sleep-related vulnerability trait that is independent of OSA. Methods. We conducted a retrospective cross-sectional analysis of pulse-oximetry signals obtained during REM and NREM sleep in control and asthmatic children (n = 134). Asthma classification was based on preestablished clinical criteria. Multivariate linear regression model was built to control for potential confounders (significance level P ≤ 0.05). Results. Our data demonstrated that (1) baseline nocturnal respiratory parameters were not significantly different in asthmatic versus control children, (2) the maximal % of SaO2 desaturation during REM, but not during NREM, was significantly higher in asthmatic children, and (3) multivariate analysis revealed that the association between asthma and REM-related maximal % SaO2 desaturation was independent of demographic variables. Conclusion. These results demonstrate that children with asthma have a REM-related vulnerability trait that impacts oxygenation independently of OSA. Further research is needed to delineate the REM sleep neurobiological mechanisms that modulate the phenotypical expression of nocturnal asthma in children. PMID:24288619

  12. Oximetry Signal Processing Identifies REM Sleep-Related Vulnerability Trait in Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Geovanny F. Perez

    2013-01-01

    Full Text Available Rationale. The sleep-related factors that modulate the nocturnal worsening of asthma in children are poorly understood. This study addressed the hypothesis that asthmatic children have a REM sleep-related vulnerability trait that is independent of OSA. Methods. We conducted a retrospective cross-sectional analysis of pulse-oximetry signals obtained during REM and NREM sleep in control and asthmatic children (n=134. Asthma classification was based on preestablished clinical criteria. Multivariate linear regression model was built to control for potential confounders (significance level P≤0.05. Results. Our data demonstrated that (1 baseline nocturnal respiratory parameters were not significantly different in asthmatic versus control children, (2 the maximal % of SaO2 desaturation during REM, but not during NREM, was significantly higher in asthmatic children, and (3 multivariate analysis revealed that the association between asthma and REM-related maximal % SaO2 desaturation was independent of demographic variables. Conclusion. These results demonstrate that children with asthma have a REM-related vulnerability trait that impacts oxygenation independently of OSA. Further research is needed to delineate the REM sleep neurobiological mechanisms that modulate the phenotypical expression of nocturnal asthma in children.

  13. Reproducibility of transcutaneous oximetry and laser Doppler flowmetry in facial skin and gingival tissue.

    Science.gov (United States)

    Svalestad, J; Hellem, S; Vaagbø, G; Irgens, A; Thorsen, E

    2010-01-01

    Laser Doppler flowmetry (LDF) and transcutaneous oximetry (TcPO(2)) are non-invasive techniques, widely used in the clinical setting, for assessing microvascular blood flow and tissue oxygen tension, e.g. recording vascular changes after radiotherapy and hyperbaric oxygen therapy. With standardized procedures and improved reproducibility, these methods might also be applicable in longitudinal studies. The aim of this study was to evaluate the reproducibility of facial skin and gingival LDF and facial skin TcPO(2). The subjects comprised ten healthy volunteers, 5 men, aged 31-68 years. Gingival perfusion was recorded with the LDF probe fixed to a custom made, tooth-supported acrylic splint. Skin perfusion was recorded on the cheek. TcPO(2) was recorded on the forehead and cheek and in the second intercostal space. The reproducibility of LDF measurements taken after vasodilation by heat provocation was greater than for basal flow in both facial skin and mandibular gingiva. Pronounced intraday variations were observed. Interweek reproducibility assessed by intraclass correlation coefficient ranged from 0.74 to 0.96 for LDF and from 0.44 to 0.75 for TcPO(2). The results confirm acceptable reproducibility of LDF and TcPO(2) in longitudinal studies in a vascular laboratory where subjects serve as their own controls. The use of thermoprobes is recommended. Repeat measurements should be taken at the same time of day.

  14. 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.

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

    Science.gov (United States)

    Smit, Marrit; Ganzeboom, Angelina; Dawson, Jennifer A; Walther, Frans J; Bustraan, Jacqueline; van Roosmalen, Jos J M; te Pas, Arjan B

    2014-05-01

    to evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. a prospective, observational study of infants born after midwifery supervised (home) births. 27 midwives from seven practices providing primary care in (home) births used PO at birth or the early puerperal period over a ten-month period. Data were obtained on the effect of PO on outcome, interventions and decision-making. Midwives were surveyed about applicability and usefulness of PO. 153 infants born in primary midwifery care. all births were uncomplicated except for one infant receiving supplemental oxygen and another was mask ventilated. In 138/153 (90%) infants PO was successfully used and 88% of midwives found PO easy to use. In 148/153 (97%) infants PO did not influence midwives' clinical judgment and referral policy. In 5/153 (3%) infants, midwives were uncertain of the infant's condition, but PO measurements were reassuring. In case of suboptimal neonatal condition or resuscitation, 100% of midwives declared they would use PO again. it is feasible to use PO in community based midwifery care, but not considered an important contribution to routine evaluation of infants. Midwives would like to have PO available during suboptimal neonatal condition or when resuscitation is required. PO can be applied in community based midwifery care; it does not lead to insecurity or extra referral. Further research on a larger group of infants must show the effect of PO on neonatal outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Cerebral tissue O2 saturation during prolonged robotic surgery in the steep Trendelenburg position: an observational case series in a diverse surgical population.

    Science.gov (United States)

    Lahaye, Laura; Grasso, Mario; Green, Jeffrey; Biddle, C J

    2015-03-01

    Demands associated with the Trendelenburg position (TP) are well known yet there is little attention given to regional cerebral tissue O2 saturation (SctO2) in those undergoing robotic surgery in the TP with CO2 insufflation (C-INSF). This is the first study to report on SctO2 in a wide range of patients undergoing lengthy TP and robotic surgery. We measured SctO2 during robotic surgery in patients in the TP with C-INSF, as well as a control robotic thyroid surgery group who were supine with no C-INSF. We recorded relevant variables and periods of cerebral desaturation (CD). We studied 42 patients in 25°-45° of TP for ≥125 min. Management was at the providers' discretion. The INVOS(®) 5100C Cerebral Oximeter (Covidien, Boulder, CO) recorded SctO2. CD was defined as a >20 % decrease from baseline SctO2 or a value ≤55 % for ≥10 min. Patients were assessed for adverse outcome. The sample consisted of 13 males and 29 females aged 22-73, BMI 22-36 had general (N = 3), urological (N = 14) and gynecological (N = 25) surgery; two patients had CD lasting 150 and 190 min and two had episodic CD lasting 10-35 min. The four were female aged 22-60 in 38°-45° of TP. Eleven cases had multiple episodic CD for ≤15 min, 27 TP cases had no CD. Other observations included a consistent fall in SctO2 with phenylephrine; an increased SctO2 with ephedrine; and FiO2 and EtCO2 being generally strong, direct modifiers of SctO2. High MAP was inconsistently associated with high SctO2. BMI had no observed effect on SctO2. Pulse oximetry was ≥97 % in all cases. We observed no adverse cerebral events on follow-up. Additional clinical studies are warranted.

  17. M RI在诊断退变期脑实质型脑囊虫病同小转移瘤的鉴别价值%Value of convertional MRI in detecting degenerative phase of cerebral cysticerlosis and small metastases

    Institute of Scientific and Technical Information of China (English)

    王立源; 曾睿; 黄红芳; 张雪; 侯仲军

    2014-01-01

    目的:通过常规M RI序列与DWI序列,鉴别退变期脑实质型脑囊虫病与小病灶环形强化转移瘤。方法回顾29例脑囊虫病患者与30例多发小病灶转移瘤患者的M R检查,观察两者的影像学表现及测量ADC值进行统计学处理。结果常规T2 WI退变期脑囊虫病组和小转移瘤组病灶出现低信号环的比例分别为91.9%和9.1%,诊断敏感性为90.7%(78/86)、特异性90.9%(60/66)、准确性90.8%(138/152);DWI退变期脑囊虫病组和转移瘤组病灶出现低信号所占比例分别为95.4%和69.7%,诊断敏感性95.4%(82/86)、特异性30.3%(20/66)、准确性67.1%(102/152)。退变期脑囊虫组病灶ADC值(1.54±0.42)×10-3 s/mm2,脑转移瘤病灶组ADC值(1.12±0.36)×10-3 s/mm2,两者比较具有统计学差异( P <0.01)。结论 T2 WI病灶周围连续的低信号和完整规则的环形强化是退变期脑囊虫病的特殊表现。DWI序列对退变期脑囊虫病和小病灶转移瘤的鉴别具有一定的价值。%Objective To study the difference of degeno-death stage cerebral neurocysticercosis lesions and brain metas-tasis nodules through the conventional MR scan and DWI sequence .Methods MRI data of 29 patients with degeno-death stage cerebral neurocysticercosis and 30 patients with brain metastasis were reviewed .The imaging features were studied and the ADC value of the lesions ,were measured with spss 16 .0 statistical software as data analysis .Results 91 .9% le-sions of degeno-death stage cerebral nerocyticercosis displayed surrounding hypointense signal on T 2 WI ,while ,the brain metastasis nodules was 9 .1% .The diagnostic sensitivety ,specificity and accuracy of T2WI low signal intensity surround-ing were 90 .7% (78/86) ,90 .9% (60/66) and 90 .8% (138/152) respectively .Among those ,95 .4% lesions of degeno-death stage cerebral nerocyticercosis were shown hypointense signal on

  18. Canadian Cardiovascular Society/Canadian Pediatric Cardiology Association Position Statement on Pulse Oximetry Screening in Newborns to Enhance Detection of Critical Congenital Heart Disease.

    Science.gov (United States)

    Wong, Kenny K; Fournier, Anne; Fruitman, Deborah S; Graves, Lisa; Human, Derek G; Narvey, Michael; Russell, Jennifer L

    2017-02-01

    Congenital heart disease is the most common congenital malformation and approximately 3 in 1000 newborns have critical congenital heart disease (CCHD). Timely diagnosis affects morbidity, mortality, and disability, and newborn pulse oximetry screening has been studied to enhance detection of CCHD. In this position statement we present an evaluation of the literature for pulse oximetry screening. Current detection strategies including prenatal ultrasound examination and newborn physical examination are limited by low diagnostic sensitivity. Pulse oximetry screening is safe, noninvasive, easy to perform, and widely available with a high specificity (99.9%) and moderately high sensitivity (76.5%). When an abnormal saturation is obtained, the likelihood of having CCHD is 5.5 times greater than when a normal result is obtained. The use of pulse oximetry combined with current strategies has shown sensitivities of up to 92% for detecting CCHD. False positive results can be minimized by screening after 24 hours, and testing the right hand and either foot might further increase sensitivity. Newborns with abnormal screening results should undergo a comprehensive assessment and echocardiography performed if a cardiac cause cannot be excluded. Screening has been studied to be cost neutral to cost effective. We recommend that pulse oximetry screening should be routinely performed in all healthy newborns to enhance the detection of CCHD in Canada. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  19. Study on the Value of Urine Ferritin Creatinine Ratio Detection in Patients with Acute Cerebral Infarction%急性脑梗死患者尿铁蛋白肌酐比检测价值探讨

    Institute of Scientific and Technical Information of China (English)

    袁静宁

    2015-01-01

    Objective To explore the detection value of urine ferritin/urine creatinine ratio in the diag-nosis of patients with cerebral infarction.Methods A total of 52 patients with cerebral infarction(the obser-vation group) admitted in Kaijiang County People's Hospital from Mar.2012 to Sep.2014 and 60 healthy patients underwent physical examination in the hospital during the same period(the control group) were cho-sen as the research objects,ferritin levels in serum and urine of the two groups were detected by radioimmu-noassay.Results Levels of urine ferritin/urine creatinine and serum ferritin of the observation group were higher than those of the control group,there were statistically significant differences[(15.2 ±2.4) μg/g vs (6.3 ±1.2) μg/g,(96.3 ±11.7) μg/L vs (46.6 ±12.2) μg/L,P<0.01].Results of correlation analy-sis showed that there was significant positive correlation between urine ferritin/urine creatinine and serum ferritin(r=0.882,P <0.05).With the increase of infarction area,level of urine ferritin/urine creatinine increased; with the increase of neural function deficit score,level of urine ferritin/urine creatinine increased. Results of Pearson correlation analysis showed that level of urine ferritin/urine creatinine was positively corre-lated with the infarction area and nerve defect scores(r=0.873,0.675,all P<0.05).Conclusion Early detection of urine ferritin/urine creatinine ratio has a certain value in diagnosing cerebral infarction .%目的 探讨尿铁蛋白/尿肌酐在脑梗死患者病情诊断中的检测价值. 方法 选取2012 年3月至2014年9 月开江县人民医院收治的52例脑梗死患者(观察组)以及同期本院进行体检60 例健康体检者(对照组)为研究对象,采用放射免疫法测定两组血清以及尿液中的铁蛋白水平. 结果观察组尿铁蛋白/尿肌酐及血清铁蛋白均高于对照组[(15.2 ±2.4) μg/g 比 (6.3 ±1.2) μg/g, (96.3 ±11.7) μg/L 比(46.6 ±12.2) μg/L,P<0.01]. 相关性分

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

    Directory of Open Access Journals (Sweden)

    Gitte H Hahn

    Full Text Available BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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

  1. Cerebral blood flow in the neonate.

    Science.gov (United States)

    Vutskits, Laszlo

    2014-01-01

    Ensuring adequate oxygenation of the developing brain is the cornerstone of neonatal critical care. Despite decades of clinical research dedicated to this issue of paramount importance, our knowledge and understanding regarding the physiology and pathophysiology of neonatal cerebral blood flow are still rudimentary. This review primarily focuses on currently available human clinical and experimental data on cerebral blood flow and autoregulation in the preterm and term infant. Limitations of systemic blood pressure values as surrogates for monitoring adequate cerebral oxygen delivery are discussed. Particular emphasis is placed on the high interindividual variability in cerebral blood flow values, vasoreactivity, and autoregulatory thresholds making the applications of normative values highly questionable. Technical and ethical difficulties to conduct such trials leave us with a near complete lack of knowledge on how pharmacological and surgical interventions impact on cerebral autoregulation. The ensemble of these works argues for the necessity of highly individualized care by taking advantage of continuous bedside monitoring of cerebral circulation. They also point to the urgent need for further studies addressing the exciting but difficult issue of cerebral blood flow autoregulation in the neonate.

  2. Cerebral oxygen saturation: graded response to carbon dioxide with isoxia and graded response to oxygen with isocapnia.

    Directory of Open Access Journals (Sweden)

    W Alan C Mutch

    Full Text Available BACKGROUND: Monitoring cerebral saturation is increasingly seen as an aid to management of patients in the operating room and in neurocritical care. How best to manipulate cerebral saturation is not fully known. We examined cerebral saturation with graded changes in carbon dioxide tension while isoxic and with graded changes in oxygen tension while isocapnic. METHODOLOGY/PRINCIPAL FINDINGS: The study was approved by the Research Ethics Board of the University Health Network at the University of Toronto. Thirteen studies were undertaken in healthy adults with cerebral oximetry by near infrared spectroscopy. End-tidal gas concentrations were manipulated using a model-based prospective end-tidal targeting device. End-tidal carbon dioxide was altered ±15 mmHg from baseline in 5 mmHg increments with isoxia (clamped at 110±4 mmHg. End-tidal oxygen was changed to 300, 400, 500, 80, 60 and 50 mmHg under isocapnia (37±2 mmHg. Twelve studies were completed. The end-tidal carbon dioxide versus cerebral saturation fit a linear relationship (R(2 = 0.92±0.06. The end-tidal oxygen versus cerebral saturation followed log-linear behaviour and best fit a hyperbolic relationship (R(2 = 0.85±0.10. Cerebral saturation was maximized in isoxia at end-tidal carbon dioxide of baseline +15 mmHg (77±3 percent. Cerebral saturation was minimal in isocapnia at an end-tidal oxygen tension of 50 mmHg (61±3 percent. The cerebral saturation during normoxic hypocapnia was equivalent to normocapnic hypoxia of 60 mmHg. CONCLUSIONS/SIGNIFICANCE: Hypocapnia reduces cerebral saturation to an extent equivalent to moderate hypoxia.

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

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    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.

  4. 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

  5. Timing of Newborn Pulse Oximetry Screenings for Critical Congenital Heart Defects Before Discharge.

    Science.gov (United States)

    Crouch, Lynn; Speroni, Karen Gabel; Jones, Ruth Ann; MacDougall, Eileen P; Daniel, Marlon G

    2016-01-01

    To determine if there would be positive results from a second pulse oximetry screening (POS) completed for newborns at discharge at 28 to 48 hours of age in addition to the newborn POS completed at 24 to 25 hours of age. Prospective descriptive research study. Rural, mid-Atlantic, 13-bed, level I hospital. Newborns (N = 1,002) at 35 weeks' gestation or older discharged from the newborn nursery. Registered nurses (RNs) performed POS at 24 to 25 hours of age (POS 1) and at discharge but less than 48 hours of age (POS 2). Data related to critical congenital heart defects were collected. There were no positive POS results (O2 saturation ≤ 90%) at POS 1 or POS 2, and no additional diagnostic tests were ordered as a result of POS. Although one full-term newborn had negative results at POS 1 and POS 2, the RN identified a murmur, and a subsequent echocardiogram was used to detect tetralogy of Fallot and pulmonary atresia. The RNs detected concerning conditions in 14 newborns that resulted in 28 additional tests, including echocardiograms (9), chest x-ray imaging (8), laboratory testing (7), electrocardiograms (3), and ultrasound imaging (1). The POS-positive result rate was 0 for newborns at POS 1 and POS 2. Therefore, our study findings supported Maryland's mandate of one POS completed within 24 to 48 hours of birth. Nurses must continue to be vigilant about assessing newborns, including screening for critical congenital heart defects and congenital heart defects. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  6. Green Channel in the Emergency Rescue Hypertension Cerebral Hemorrhage Patients to Explore the Value%急诊绿色通道在抢救高血压脑出血患者中的价值探讨

    Institute of Scientific and Technical Information of China (English)

    曾贵成

    2013-01-01

    Objective to study retrospectively the green channel in the rescue hypertension cerebral hemorrhage patients in clinical application value.Methods a retrospective analysis in our hospital rescue hypertension cerebral hemorrhage patients 126 cases material, according to whether to of prehospital emergency treatment group: of prehospital emergency treatment group 66 examples, not of prehospital emergency treatment group of 60 cases first aid after statistical patients mortality, final y statistical methods to test the dif erences have statistical significance.Results the death of prehospital emergency treatment group 7 cases (10.6%), not of prehospital emergency treatment group of death 23 cases (38.3%), statistical methods to test showed that with statistical dif erence (P<0.05). 1 hours emergency person 2 cases died (5.6%), 1~5 hours the first aid death 10 cases (20%).Conclusion emergency green channel in the rescue hypertension cerebral hemorrhage patients play an important role, is to reduce the mortality of patients with first aid ef ective means.%目的探讨急诊绿色通道在抢救高血压脑出血患者中的临床应用价值。方法回顾性分析在我院抢救高血压脑出血患者126例病例资料,按照是否进行院前急救分组:院前急救组66例,非院前急救组60例,急救后统计患者死亡率情况,再按急救时间分组:1h内急救者36例,1~5h内急救者50例,5h以上者40例,急救后统计患者死亡率,最后统计学方法检验各组间的差异是否具有统计学意义。结果院前急救组死亡7例(10.6%),非院前急救组死亡23例(38.3%),统计学方法检验表明具有统计学差异(P<0.05)。1h内急救者死亡2例(5.6%),1~5h内急救者死亡10例(20%),5h以上者死亡19例(47.5%)。结论急诊绿色通道在抢救高血压脑出血患者中发挥重要作用,是降低患者急救死亡率的有效手段。

  7. MRI在脑性瘫痪患儿临床中的应用价值及意义%Magnetic Resonance Imaging (MRI) in Children with Cerebral Palsy in the Clinical Application Value and Signiifcance

    Institute of Scientific and Technical Information of China (English)

    王佳; 周丽华; 蔡依稀

    2015-01-01

    Objective To study the clinical application of MRI technology for children with cerebral palsy sex value and the significance. Methods From May 2013 to May 2013 hospitalized children with cerebral palsy of 25 cases were studied. Research and analysis all the patient's clinical manifestation and MRI imaging features. Results All children through MRI detection, appears according to the results of 12 cases of children with cerebral white matter lesions; 5 cases underwent subcallosal sacral body appear lesions; 3 cases of children with brain softening oven; 2 cases of children with brain atrophy. Tests showed normal 6 cases, 19 cases displayed as abnormal. All the families of children with the MRI testing showed the index scores before and after the implementation situation. Quality of children's life and mood for before the test score (65.3-5.0) and (68.2-5.4), significantly lower after testing (87.5-5.8) and (89.3-6.1), statistically significant difference (P<0.05). All children with MRI test again after the treatment, the cerebral white matter lesions in 12 cases, 9 cases of basic restoration, 3 cases improved effectively. 2 cases of brain atrophy patients, 1 case of basic recovery, 1 case was improved effectively. Through the associated chi-square test, children with brain lesions ease the situation and the patient's recovery between the significant correlation (P<0.05). Conclusion MRI has important clinical significance in children with cerebral palsy. MRI can be determined for children with lesion location, can in time to make a diagnosis and give treatment on children with diagnosed at an early date. It is of great significance to children's physical and mental development. Worthy of clinical use.%目的:研究MRI技术对于脑瘫性患儿的临床应用价值以及相关意义。方法对我院2013年5月至2014年5月入院治疗脑性瘫痪的患儿25例进行研究。研究分析所有患儿的临床表现以及MRI影像学特征。结果所有患儿经

  8. Comparison of Cerebral Oxygen Saturation and Cerebral Perfusion Computed Tomography in Cerebral Blood Flow in Patients with Brain Injury.

    Science.gov (United States)

    Trofimov, Alexey O; Kalentiev, George; Voennov, Oleg; Grigoryeva, Vera

    2016-01-01

    The purpose of this study was to determine the relationship between cerebral tissue oxygen saturation and cerebral blood volume in patients with traumatic brain injury. Perfusion computed tomography of the brain was performed in 25 patients with traumatic brain injury together with simultaneous SctO2 level measurement using cerebral near-infrared oxymetry. The mean age of the injured persons was 34.5±15.6 years (range 15-65); 14 men, 11 women. The Injury Severity Score (ISS) values were 44.4±9.7 (range 25-81). The Glasgow Coma Score (GCS) mean value before the study was 10.6±2.1 (range 5-13). SctO2 ranged from 51 to 89%, mean 62±8.2%. Cerebral blood volume (CBV) values were 2.1±0.67 ml/100 g (min 1.1; max 4.3 ml/100 g). Cerebral blood flow (CBF) was 31.99±13.6 ml/100 g×min. Mean transit time (MTT) values were 5.7±4.5 s (min 2.8; max 34.3 s). The time to peak (TTP) was 22.2±3.1 s. A statistically significant correlation was found between SctO2 level and cerebral blood volume (CBV) level (R=0.9; pperfusion.

  9. C反应蛋白和纤维蛋白原对脑梗死患者预后判定的比较%Comparison of values of C-reactive protein and fibrinogen in evaluating prognosis of cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    肖伟忠; 姚琳; 孙圣刚

    2005-01-01

    whether CRP has the same value in predicting the prognosis of cerebral infarction.OBJECTIVE: To explore and compare the clinical value of CRP and fibrinogen(FIB) in evaluating the prognosis of cerebral infarction.DESIGN: A case control study based on diagnosis.SETTING and PARTICIPANTS: All the 94 patients with cerebral infarction came from the Neurology Department of Second Affiliated Hospital,Lanzhou Medical College. There were 58 males and 36 females, with an average age of(58 ± 11) years old.INTERVENTIONS: Levels of fasting CRP and FIB in the plasm were measured with immunoturbidity assay. The reagent kits were produced by Fujian Sun Biological Technology Corporation. The scores of neurological deficit of the patients were worked out within 3 days of onset, and disability rate and fatality rate were added up at the third month of the follow-up.MAIN OUTCOME MEASURES: The neurologic deficit score (NDS),disability rate and fatality rate of the patients with cerebral infarction.RESULTS: The patients were divided into different groups according to CRP and FIB levels, which were high CRP group, low CRP group, high FIB group and low FIB group. NDS, disability rate and fatality rate in high CRP group[(18. 12 ±8.96) points, 74% (40/54), and 20% (11/54), respectively]were significantly higher than those in low CRP group[(10. 52±4.42)points, 38% (15/40) and 5% (2/40), respectively] (t = 3.82, X2 = 12.66,4.56, P < 0. 001 ). Similarly, NDS and disability rate in high FIB group[ (17.69 ± 5.12) points and 70% (35/50), respectively] were significantly higher than those in low FIB group[(14.32±4.65) points and45% (20/44), respectively] (t = 2. 19, x2= 7.1, P < 0. 001 ) while the fatality rate of the two groups was not significantly different. CRP level had significant correlations with NDS, disability rate and fatality rate in the patients with cerebral infarction( r = 0. 742, 0. 812 , 0. 681 ) . On the other hand,FIB level had certain relationship with NDS and disability rate

  10. Valor preditivo da ultra-sonografia do cérebro em recém-natos com diagnóstico de meningite bacteriana neonatal: seguimento de 12 anos Predictive value of cerebral ultrasound with respect to clinical outcome in infants diagnoses on neonatal meningitis: a focus 12 years later

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Vieira Monteiro

    2006-06-01

    Full Text Available OBJETIVO: Avaliar o valor preditivo da ultra-sonografia do cérebro, para o dano cerebral, em crianças com diagnóstico de meningite neonatal. MÉTODO: Estudo retrospectivo realizado no Instituto Fernandes Figueira (FIOCRUZ-RJ em 16 crianças que realizaram ultra-sonografia do cérebro por diagnóstico de meningite no período neonatal e tiveram seguimento neurológico até 12 anos. Foram calculados: valores preditivos positivo e negativo, sensibilidade e especificidade. RESULTADOS: 56,25% eram do sexo masculino e 81,25% prematuros. Hidrocefalia foi o achado mais freqüente (56,25%, seguido pelo exame normal (43,75%. Achados de hidrocefalia (9, somente em um havendo evolução favorável e achados normais (7, em 4 (57,14% não havendo déficit neurológico. Achados de ventriculite (4 e abscesso cerebral (2: todos evoluíram com dano cerebral. Diagnóstico de encefalomalácia (2; em 50% havendo desenvolvimento cognitivo satisfatório. Diagnostico de atrofia (2, todos com dano cerebral severo. CONCLUSÃO: Valor preditivo positivo de 88,89%, negativo de 57,14%, sensibilidade de 72,73% e especificidade de 80%.OBJECTIVE: To evaluate the predictive value of cerebral ultrasound in infants diagnoses on meningitis neonatal to the neurological outcome. METHOD: A retrospective study of 16 children admitted at Institute Fernandes Figueira RJ - Brazil, who had neonatal meningitis and were examined by cerebral ultrasound. The neurologic outcome was evaluated until 12 years of age. Positive and negative predictive values, sensitivity and specificity were calculated. RESULTS: 56.25% were male and 81.25% premature. Hydrocephalus was the most frequent finding (56.25% followed by normal exam (43.75%. Findings of hydrocephalus (9 only one had good neurologic outcome; and normal exam (7: only 57.14% without brain damage. Findings of ventriculitis (4 and brain abscesses (2 all had neurologic damage. Diagnosis of encephalomalacia (2: only one had good cognitive

  11. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  12. Employees with Cerebral Palsy

    Science.gov (United States)

    ... problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture (United Cerebral Palsy, 2010). "Cerebral" refers to the ...

  13. Cerebral Palsy (For Kids)

    Science.gov (United States)

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Cerebral Palsy KidsHealth > For Kids > Cerebral Palsy Print A A A What's in this article? ... the first word you spoke? For kids with cerebral palsy, called CP for short, taking a first step ...

  14. Initial clinical experience with near-infrared spectroscopy in assessing cerebral tissue oxygen saturation in cerebral vasospasm before and after intra-arterial verapamil injection.

    Science.gov (United States)

    Meng, Lingzhong; Settecase, Fabio; Xiao, Jifang; Yu, Zhaoxia; Flexman, Alana M; Higashida, Randall T

    2016-04-01

    Cerebral vasospasm is a devastating complication after subarachnoid hemorrhage. The use of cerebral tissue oxygen saturation (SctO2) to non-invasively assess changes in cerebral tissue perfusion induced by intra-arterial (IA) verapamil treatment has not been described to our knowledge. A total of 21 consecutive post-craniotomy patients scheduled for possible IA verapamil treatment of cerebral vasospasm were recruited. The effect of IA verapamil injection on SctO2 being continuously monitored on both the left and right forehead was investigated. Comparisons between changes in SctO2 monitored on the ipsilateral and contralateral forehead in relationship to the side of internal carotid artery (ICA) injection were performed. A total of 47 IA verapamil injections (15 left ICA, 18 right ICA, and 14 vertebral artery injections) during 18 neurointerventional procedures in 13 patients were analyzed. IA verapamil administration led to both increases and decreases in SctO2. Changes in SctO2 ipsilateral to the ICA injection side were more pronounced (p=0.02 and 0.07 for left and right ICA injections, respectively) and favored compared to contralateral SctO2 changes. We were unable to obtain reliable measurements on the side ipsilateral to the craniotomy during four procedures in three patients, presumably secondary to pneumocephalus. The local cerebral vasodilating effect of IA verapamil injection is suggested by the differential changes in SctO2 ipsilateral and contralateral to the ICA injection side. The inconsistent changes in SctO2 and the limitations of applying cerebral oximetry in this patient population needs to be recognized.

  15. 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.

  16. Early CT Performance of Cerebral Infarction and Its Value in Prognosis Evaluation%脑梗死早期CT表现及其在预后评估中的价值

    Institute of Scientific and Technical Information of China (English)

    倪剑刚

    2015-01-01

    目的探讨脑梗死早期的CT表现以及分型情况,评价其在预后评估中的价值。方法本组30病例中,在12h之内进行CT平扫以后,发现有异常情况的共18例,占比60%,显示为阴性的占比40%,共12例。在24h以后进行CT平扫复查后发现30病例均为异常病例,均显示为阳性,确诊为早期脑梗死患者。脑梗死的CT表现分型I型2例,I 型12例,I I型1例,IV型3例,V型3例,V型7例。结果入院时的NIHSS的评分为I型(6.77±3.01)分,I 型(7.98±3.51)分,I I型(8.26±3.52)分,IV型(9.22±3.55)分,V型(10.13±4.61)分,VI型(10.65±4.75)分;发病2个月经过治疗后的的NIHSS的评分为I型(4.02±2.07)分,I 型(4.78±2.53)分,II 型(5.25±2.42)分,IV型(6.32±2.75)分,V型(6.83±2.91)分,VI型(6.95±3.1)分,经过治疗后NIHSS2与NIHSS1比较,<0.05。结论使用CT平扫判断早期脑梗死并且进行CT表现分型后,有针对性的进行治疗,能够有效的提高患者的预后效果。%Objective To discuss the CT manifestation of early cerebral infarction and parting, evaluate its value in prognosis evaluation. Methods 30 cases, within 12 h after CT scan, and found that a total of 18 cases with abnormal situation, accounted for 60%, shows negative accounted for 40%, a total of 12 cases. After 24 h after reviewed CT scan found 30 cases were abnormal cases, al showed positive, early diagnosis of cerebral infarction patients. CT manifestation of cerebral infarction parting type 1 in 2 cases, 12 cases type II and type II in 1 case, type IV (3 cases), V (3 cases), v-shaped 7 cases. Results NIHSS score on admission to hospital for type I (6.77±3.01), type I (7.98±3.51), type II (8.26±3.52), type IV (9.22±3.55 mm), V (10.13±4.61), type VI (10.65±4.75);2 months after treatment, the disease of NIHSS score for type I (4.02±2.07), type I (4.78±2.53), type II (5.25±2.42), type IV (6.32±2.75 mm

  17. 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.)

  18. MRI新技术对星形细胞瘤术前分级的临床价值%The clinical value of new technology of MRI in grading diagnosis of cerebral astrocytoma

    Institute of Scientific and Technical Information of China (English)

    李静; 任转琴; 陈涛; 张雷; 李莉; 苟晓光

    2012-01-01

    Objective To evaluate the value of enhanced gradient echo T2 star weighted angiography (ESWAN) in grading diagnosis of cerebral actrocytoma by analyzing the association between the grade of astrocytoma and its quantities of the micrangium and hemorrhage showed in ESWAN. Methods ESWAN of 30 cases with cerebral astrocytoma surgically and pathologically confirmed were retrospectively analyzed. All patients had been examined with non-enhanced CT, non-enhanced routine MRI, contract enhanced Ti weighted imaging, and ESWAN pre-operation. The quantities of the micrangium and hemorrhage showed in ESWAN were measured by two experienced radiologists blindly. The diagnosis validity and reliability of ESWAN, by judging the present of hemorrhage, in diagnosing the malignant astrocytoma, were calculated contrary to pathology results. Differences of the rateiof blooding and the microvessel count and hemorrhage volume in highly and low malignant astrocytoma groups were also compared using Fisher's exact probability test and independent samples t-test in SPSS 13. 0, abeing 0. 05. Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of hemorrhage showed in ESWAN in diagnosing the malignant astrocytoma were 80% (12/15) , 53.3% (8/15), 66.7% (20/30), 63.2% (12/19), and 72. 7% (8/11) respectively. The rate of bleeding of highly malignant group (93. 3%) was greater than that of low grade group (33. 3%) , which was statistically significant (x2 =13. 41, P <0. 001). The microvessel count and hemorrhage volume of highly malignant group were greater than those of low one. The difference was statistically significant ( t =2. 569 , P <0. 001). Conclusion ESWAN is sensitive to show the micrangium and hemorrhage in a tumor and is useful in grading diagnosis of cerebral astrocytoma, which should be performed before the operation of astrocytoma resection.%目的 分析脑星形细胞瘤磁敏感加权成像(ESWAN)内微血管数量及出血量

  19. 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

  20. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer [Klinikum der Universitaet Muenchen (Germany). Abt. fuer Neuroradiologie

    2011-03-15

    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.)

  1. Cerebral toxoplasmosis in AIDS

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-02-01

    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.

  2. 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

  3. 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.)

  4. 低场强 MRI 弥散加权成像(DWI)对急性脑梗塞的诊断价值%The low field MRI diffusion weighted imaging (DWI) on acuteDiagnostic value of cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    赵丽蓉; 武丽红

    2013-01-01

    目的:探讨低场 MRI 对脑梗塞早期诊断价值。方法分析我院2008年2月至2009年2月,64例弥散加权成像急性脑梗塞表现,总结 DWI 对其诊断价值。结果3~6H 内弥散加权成像(DWI)诊断敏感率可以达到96%。结论低场 DWI 优于 CT 检查,为患者提供早期脑梗塞诊断,可以为临床提供可靠溶栓治疗的依据。%Objective The goal discusses low field MRI to the cerebral infarction early diagnosis value.Method analyzes my courtyard in February, 2008 - February, 2009, 64 example dissemination weighting image formation acute cerebral infarction displays, summarizes DWI to its diagnosis value. Results finally in 3-6H disseminates the weighting image formation (DWI) to diagnose sensitively rate may achieve 96%. Conclusion low field DWI surpasses the CT inspection, provides the early cerebral infarction for the patient to diagnose, may for clinical provide dissolves the hitch treatment reliably the basis.

  5. Value of 15 items of nervimotion exam on early diagnosis of infant cerebral palsy%婴儿脑瘫早期诊断神经运动检查15项

    Institute of Scientific and Technical Information of China (English)

    任世光; 崔红; 李娜; 金春华; 韩慧贤

    2012-01-01

    [目的]探讨婴儿脑瘫早期诊断的神经运动检查方法. [方法]结合多种方法,通过实践总结出早期诊断脑瘫的主要项目. [结果] 自发姿势运动及姿势运动反应7项,足背屈角、内收角、腘窝角、肩外展角、肘伸展角5项,踝阵挛、侧弯反射、膝腱反射3项,共同反映姿势、运动、肌张力、反射异常的神经运动检查15项,在婴儿神经运动检查中对早期认出脑瘫最为重要. [结论]应用神经运动检查15项可以早期认出脑瘫倾向或脑瘫.%[Objective] To investigate the nervimotion exam focus on early diagnosis of infant cerebral palsy. [Method] Absorbing the quintessence from many methods and concluding from practice, the major items were summaried on early diagnosis of infant cerebral palsy. [Results] The 15 items of nervimotion exam were the most important exams for early diagnosis of infant cerebral palsy,which includ:7items of spontaneous posture movement and posture movement responses,dorsiflexion of foot angle,adduction angle,popliteal fossa angle,shoulder abduct angle,elbow extension angle,ankle clonus,lateral curvature reflexion, knee reflexion, examinations of posture, movement, muscular tension, dysreflexia. [Conclusion] The cerebral palsy tendency or cerebral palsy can be early recognized by the 15 items of nervimotion exam.

  6. Hyperdense lesions in CT of cerebral toxoplasmosis. Lesiones hiperdensas en TC en la toxoplamosis cerebral

    Energy Technology Data Exchange (ETDEWEB)

    Quiones 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[sub 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.

  7. Thyroxine Level of Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    Zhang Jie

    2000-01-01

    Objective:To investigate the thyroxine level of Children with cerebral palsy so as to understand thd changes of their nevous endocrine. Methods:Radioimmunoassay was applied to 57 Children with cerebral palsy and 108 normal children.The serum level of tridothyronine(T3), thyroxine(T4)free tridothyronine(FT3),free thyroxin(FT4),and thyroid stimulating hormone(TSH) were measured for those children in the moming and and in condition without any food Rsults: (1)Chiidren with cerebral palsy all showed low T3 values.The difference of T3 value between CP children and norrmal children was significant (P<0.001). (2)Results from groups with difference ages:the CP toddler′s age group also showed low T4 and FT4 values The difference of T4 and FT4 values between the toddler′s age CP childrengroup and the toddler′s age normal children group tegted was significant (CP<0.01 for T4, P <0. 05 for FT4): Conclusion:The tlyroxine level of children with cerebral palsy showed lower values compared to normal children, especisly, the low T3 values were significant.

  8. Influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Hui Lu; Ning-Ning Cui; Bin-Cheng Wang

    2016-01-01

    Objective:To study the influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease. Methods:A total of 58 patients with ischemic cerebrovascular disease in our hospital from April 2015 to January 2016 were selected as the study object, and 58 patients were randomly divided into two groups, 29 patients in control group were treated with routine treatment, 29 patients in observation group were treated with remote ischemic preconditioning on the basic treatment of control group, then the cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment and at first, third and sixth month after the treatment were respectively detected and compared.Results:The cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment all showed no significant differences (allP>0.05), while the cerebral oxygen metabolism and cerebral blood flow indexes of observation group at first, third and sixth month after the treatment were all significantly better than those before the treatment, and the results were all significantly better than those of control group at the same time too (allP>0.05).Conclusions: The influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease are better, and its application value for the patients with ischemic cerebrovascular disease is higher.

  9. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

    ... SSI file Error processing SSI file Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  10. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

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

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...

  11. Reversible cerebral vasoconstriction syndrome

    Directory of Open Access Journals (Sweden)

    Saini Monica

    2009-01-01

    Full Text Available Reversible cerebral vasoconstriction syndromes (RCVS are a group of disorders that have in common an acute presentation with headache, reversible vasoconstriction of cerebral arteries, with or without neurological signs and symptoms. In contrast to primary central nervous system vasculitis, they have a relatively benign course. We describe here a patient who was diagnosed with RCVS.

  12. Pulsioximetría fetal. Nuevo método de control fetal intraparto: Estudio comparativo con técnicas invasivas acerca del bienestar fetal Fetal pulse oximetry. Intrapartum foetal hipoxia evaluation: Comparative study with invasive techniques concerning foetal welfare

    Directory of Open Access Journals (Sweden)

    I. Fernández Andrés

    2004-08-01

    of both groups. Following the perinatal results obtained, the data indicates that there are no significant differences between the two groups in the pH values of the umbilical artery or in the Apgar values at one and five minutes after delivery, for which reason both protocols are equally satisfactory. The correlation of the data obtained by pH-metry with those of pulse oximetry was statistically significant. Conclusions. The combined use of both techniques increases the sensitivity and specificity of the diagnosis of suspected loss of foetal intrapartum welness, without worsening perinatal outcomes, decreasing the Caesarean Intrapartum Rate due to pathological or non-reassuring foetal electronic monitoring. There is a significant statistical correlation between the results from the foetal pulse oximeter and the values obtained from the foetal scalp blood sample and from the umbilical cord at birth.

  13. INFLUENCE OF DIFFERENT NEEDLE-RETAINING DURATION ON CEREBRAL HEMODYNAMICS OF CEREBRAL PARALYSIS CHILDREN

    Institute of Scientific and Technical Information of China (English)

    袁青; 王琴玉; 冯健强; 张壮涛; 陈雪云; 靳瑞

    2004-01-01

    Objective: To investigate the effects of different needle-retaining duration on cerebral hemodynamics in cerebral paralysis (CP) children.Methods: A total of 20 cases of CP children were subjected into this study.Changes of systolic peak value (Vs), blood flow velocity at the end-diastolic phase (Ved), mean velocity (Vm), pulsation index (PI) and resistance index (RI) of the cerebral hemodynamics before and after performing JIN's Three-Needling Therapy with the needles retained for 30 min (group A) and 5 min (group B) were observed by using transcranial Doppler ultrasonography (TCD).Results: After acupuncture, the blood flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was accelerated, and the resistance of blood vessels decreased.The effect of needle-retaining-30 min was better than that of needle-retaining-5 min.Conclusion: In treating cerebral paralysis by using JIN's Three-Needling Therapy, sufficient stimulation provided by needle remaining is an important factor for achieving satisfactory therapeutic effects.

  14. The effects of sevoflurane and propofol anesthesia on cerebral oxygenation in gynecological laparoscopic surgery

    OpenAIRE

    Kim, Sung-Jin; Kwon, Jae Young; Cho, Ah-Reum; Kim, Hae Kyu; Kim, Tae Kyun

    2011-01-01

    Background Both the Trendelenburg position and pneumoperitoneum with carbon dioxide have been reported to increase intracranial pressure (ICP) and to alter cerebral blood flow or cerebral blood volume. Also anesthetic agents have variable effects on cerebral hemodynamics and ICP. The present study was conducted to determine whether regional cerebral oxygen saturation (rSO2) values differ between propofol and sevoflurane anesthesia during laparoscopic surgery in the Trendelenburg position. Met...

  15. Cerebral Salt Wasting Syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Sevdi

    2016-12-01

    Full Text Available A serum sodium (Na value below 135 mEq/L is evaluated as hyponatremia. Hyponatremia is the most common electrolyte abnormality observed in hospitalized patients in particular. Hypovolemic hypoosmolar hyponatremia is the most frequent clinical table. One of the reasons of this is cerebral salt-wasting syndrome (CSWS. CSWS is a rare condition progressing with low plasma osmolality, urine osmolality above 100-150 mOsm/kg and urine- Na concentration above 20 mEq/L. In the blood and urine sample analysis performed upon sudden loss of consciousness on the 15th day of the intensive care unit follow-up of 79-year-old female patients due to falling from stairs, blood biochemistry Na value was 120 mEq/L, plasma osmolality was 250 mOsm/kg, urine Na value was 180 mEq/L, urine osmolality was 1200 mOsm/kg, urine diuresis was >3 mL/kg/hour. The central venous pressure was 2 mmHg. The patient, considered to be diagnosed with CSWS, was treated with 9% NaCl and 3% hypertonic saline solution. Her clinical course was improved on the 18th day. She died on the 81st day secondary to septicemia in the subsequent follow-up. In this article, it was aimed to report a patient with CSWS which progresses with low percentage in intensive care unit patients with head trauma, is frequently confused with inappropriate antidiuretic hormone syndrome and progresses mortally when not diagnosed distinctively well.

  16. Contrast study on CT and BA in cerebral hemorrhage due to hypertension%CONTRAST STUDY ON CT AND BA IN CEREBRAL HEMORRHAGE DUE TO HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    Mingshun Liu; Guoqiu Wang; Po Ma

    2007-01-01

    Objectives:To explore contrast application on CT and BA in cerebral hemorrhage due to hypertension. Methods: CT and BA were examined in 106 patients with cerebral hemorrhage due to hypertension. Results:The different changes of CT and BA were showed in 106 patients with cerebral hemorrhage due to hypertension. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of cerebral hemorrhage due to hypertension. The value of clinical application of BA was important in cerebral hemorrhage due to hypertension.

  17. 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.)

  18. Association factor analysis between osteoporosis with cerebral artery disease

    Science.gov (United States)

    Jin, Eun-Sun; Jeong, Je Hoon; Lee, Bora; Im, Soo Bin

    2017-01-01

    Abstract The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified

  19. Systematic review of the effects of mirror therapy in children with cerebral palsy

    National Research Council Canada - National Science Library

    EOM-JI PARK; SOON-HYUNG BAEK; SOOHEE PARK

    2016-01-01

    [Abstract.] [Purpose] To provide data for systematic intervention plans in occupational therapy practice by objectivity showing the value of mirror therapy interventions in children with cerebral palsy...

  20. 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

  1. Anestesia e paralisia cerebral

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    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 n...

  2. 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.

  3. 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

    Science.gov (United States)

    Venâncio, Carlos; Souza, Almir P.; Ferreira, Luísa Maria; Branco, Paula Sério; de Pinho, Paula Guedes; Amorim, Pedro; Ferreira, David A.

    2014-01-01

    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. PMID:24971192

  4. 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.

  5. Optical oximetry of volume-oscillating vascular compartments: contributions from oscillatory blood flow

    Science.gov (United States)

    Kainerstorfer, Jana M.; Sassaroli, Angelo; Fantini, Sergio

    2016-10-01

    We present a quantitative analysis of dynamic diffuse optical measurements to obtain oxygen saturation of hemoglobin in volume oscillating compartments. We used a phasor representation of oscillatory hemodynamics at the heart rate and respiration frequency to separate the oscillations of tissue concentrations of oxyhemoglobin (O) and deoxyhemoglobin (D) into components due to blood volume (subscript V) and blood flow (subscript F): O=OV+OF, D=DV+DF. This is achieved by setting the phase angle Arg(OF)-Arg(O), which can be estimated by a hemodynamic model that we recently developed. We found this angle to be -72 deg for the cardiac pulsation at 1 Hz, and -7 deg for paced breathing at 0.1 Hz. Setting this angle, we can obtain the oxygen saturation of hemoglobin of the volume-oscillating vascular compartment, SV=|OV|/(|OV|+|DV|). We demonstrate this approach with cerebral near-infrared spectroscopy measurements on healthy volunteers at rest (n=4) and during 0.1 Hz paced breathing (n=3) with a 24-channel system. Rest data at the cardiac frequency were used to calculate the arterial saturation, S(a); over all subjects and channels, we found ==0.96±0.02. In the case of paced breathing, we found =0.66±0.14, which reflects venous-dominated hemodynamics at the respiratory frequency.

  6. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    Energy Technology Data Exchange (ETDEWEB)

    Asari S.; Satch, T.; Sakurai, M.; Yamamoto, Y. (Matsuyama Shimin Hospital, Matsuyama (Japan)); Sadamoto, K.

    1981-06-01

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

  7. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  8. 围生期窒息新生儿脑损伤早期超声的临床诊断价值%Diagnostic value of cerebral ultrasound in early brain damage of asphyxia children in perinatal period

    Institute of Scientific and Technical Information of China (English)

    李静波; 王建荣; 张海峰

    2015-01-01

    目的:对围生期窒息病史的新生儿,72h内行床旁颅脑超声检查,观察脑组织结构及血流动力学改变,探讨此类患儿早期常见脑损伤类型及超声表现。方法方患儿出生后72h内行首次颅脑超声检查,多普勒技术经颞囟检测大脑前动脉、中动脉血流动力学变化,主要参数:收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)。结果生后72h内超声检查,60例患儿中47例表现不同程度的脑损伤,阳性率78.3%。结论围生期窒息患儿易造成缺氧缺血性脑损伤,颅脑超声可早期发现脑组织结构改变及血流动力学变化,72h内检查阳性率高,对NICU中的重症患儿,超声具有床旁检查的优势。%Objective In this work ,the newborn babies with the history of asphyxia in the perinatal period were subjec‐ted to the bedside cerebral ultrasound examination within 72 h .The brain structure and hemodynamic changes were ob‐served so as to early explore the the common type of brain injury and sonographic findings in these children .Methods Children born within 72 h underwent the bedeside cerebral ultrasound examination for the first time .The main parame‐ters ,which reflected the blood flow dynamic changes in anterior cerebral artery and middle cerebral artery ,in terms of the peak systolic blood flow velocity (Vs) ,end‐diastolic velocity (Vd) ,and resistance index (RI) ,were detected with doppler technique via temporal fontanelle .Results By the Ultrasound test within 72 h after birth ,47 out of 60 cases were shown brain injury at different extent .The positive rate was 78 .3% .Conclusion Children with asphyxia in the perinatal period are prone to hypoxic ischemic brain damage .Cerebral ultrasound can early detect the changes of brain tissue structure and hemodynamics .Checking within 72 h ,the positive rate is high .For the severe patients in NICU ,ultrasound has the ad‐vantages for

  9. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

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

  10. Effects of desflurane on cerebral autoregulation.

    Science.gov (United States)

    Bedforth, N M; Girling, K J; Skinner, H J; Mahajan, R P

    2001-08-01

    The aim of this study was to determine the effects of desflurane, at 1 and 1.5 MAC, on cerebral autoregulation. Data were analysed from eight patients undergoing non-neurosurgical procedure. The blood flow velocity in the middle cerebral artery was measured by transcranial Doppler ultrasound and cerebral autoregulation was assessed by the transient hyperaemic response test. Partial pressure of the end-tidal carbon dioxide (PE'(CO(2))) and mean arterial pressure were measured throughout the study. Anaesthesia was induced with propofol and was maintained with desflurane at end-tidal concentrations of 7.4% (1 MAC) or 10.8% (1.5 MAC). The order of administration of the desflurane concentrations was determined randomly and a period of 15 min was allowed for equilibration at each concentration. The transient hyperaemic response tests were performed before induction of anaesthesia and after equilibration with each concentration of desflurane. An infusion of phenylephrine was used to maintain pre-induction mean arterial pressure and ventilation was adjusted to maintain the pre-induction value of PE'(CO(2)) throughout the study. Two indices derived from the transient hyperaemic response test (the transient hyperaemic response ratio and the strength of autoregulation) were used to assess cerebral autoregulation. Desflurane resulted in a marked and significant impairment in cerebral autoregulation; at concentrations of 1.5 MAC, autoregulation was almost abolished.

  11. 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.

  12. Pulse oximetry-derived pleth variability index can predict dexmedetomidine-induced changes in blood pressure in spontaneously breathing patients.

    Science.gov (United States)

    Sato, Makoto; Kunisawa, Takayuki; Kurosawa, Atsushi; Sasakawa, Tomoki

    2016-11-01

    Hypertension or hypotension in patients receiving continuous infusions of dexmedetomidine (DEX) is often due to changes in vascular resistance caused by α2 receptor stimulation. We investigated whether baseline perfusion index (PI) and pleth variability index (PVI), derived from pulse oximetry readings, could predict DEX-induced changes in the hemodynamic status in spontaneously breathing patients. Observational study. Operating room. Patients (American Society of Anesthesiologists performance status 1 or 2) scheduled to undergo lower extremity or abdominal procedures under regional anesthesia were approached. The PI and PVI were set as baseline upon arrival in theater and were then measured at 2.5-minute intervals. Upon attaining stable hemodynamic status under spontaneous breathing, intravenous administration of DEX was initiated at 6 μg kg(-1) h(-1) for 10minutes, followed by continuous infusion at 0.6 μg kg(-1) h(-1). Blood pressure, heart rate, PI, and PVI were measured. Hypertension was defined as an increase in systolic blood pressure (SBP) >15% and hypotension as a decrease in SBP PVI correlated with the degree of change in SBP. The maximum percentage increase as well as the maximum percentage of decrease in SBP from baseline correlated with baseline PI (r=0.418 [P=.005] and r=0.507 [PPVI (r=-0.658 [PPVI PVI >16 identified DEX-induced hypotension (sensitivity 83%, specificity 64%). PVI may predict DEX-induced changes in blood pressure in spontaneously breathing patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. 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...

  14. 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...

  15. 仿真三维虚拟支架技术在脑动脉狭窄介入治疗中的作用%Value of 3D virtual stenting in the interventional therapy of cerebral artery stenosis

    Institute of Scientific and Technical Information of China (English)

    罗杰; 杨振九; 王皓; 廖煜君; 吴剑煌; 张朋

    2015-01-01

    目的:探讨仿真三维虚拟支架技术在脑动脉狭窄介入治疗中的作用。方法选取脑动脉狭窄支架介入治疗患者34例,分为2组。三维数字减影脑血管造影(3D-DSA)组22例,其中男性13例,女性9例;年龄48~74岁,平均年龄62.5岁;通过3D-DSA重建方法,确定脑动脉狭窄的程度和部位,运用虚拟支架血管分析程序,得到脑动脉狭窄的虚拟支架数据参数,并指导血管内治疗。对照组12例,其中男性8例,女性4例;年龄52~76岁,平均年龄64.3岁;采用普通脑血管造影指导血管内治疗。结果与普通DSA相比,3D-DSA重建图像能够多角度清晰地观察和显示脑动脉狭窄的部位、形态、狭窄程度;以虚拟支架技术的数据参数为依据,选择相应型号的支架行介入治疗效果更满意。结论3D-DSA虚拟支架技术对脑动脉狭窄支架成形术有指导价值,便于施术者正确地选择合适的支架。%Objective To investigate the interventional treatment role of three-dimensional (3D) virtual stenting in cerebral artery stenosis. Methods A total of 34 cases of cerebral artery stenosis with interventional treatment were enrolled, which were divided into 2 groups, 3D digital subtraction angiography(3D-DSA) group and control group. In 3D-DSA group, which included 13 males and 9 females, aged 48-74 years old with mean age of 62.5 years old, the location and degree of stenosis were determined by 3D-DSA reconstruction. Virtual stent analysis technology was applied to obtain data parameters of virtual cerebral stent and guide the endovascular therapy. In control group, which included 8 males and 4 females, aged 52-76 years old with mean age of 64.3 years old, the common cerebrovascular angiography was used to guide endovascular treatment. Results Compared with control group, the site, shape and degree of stenosis in 3D-DSA group were clearly demonstrated in 3D reconstruction images

  16. 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

  17. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  18. [Intraoperative monitoring of cerebral blood-flow and condition of cerebral at open and endovascular interventions in carotid system].

    Science.gov (United States)

    Kuntsevich, G I; Tanashian, M M; Skrylev, S I; Krotenkova, M V; Shchipakin, V L; Koshcheev, A Iu; Lagoda, O V; Gemdzhian, E G; Medvedev, R B; Kulikova, S N

    2011-01-01

    The aim of our research is to study hemodynamic and embolic situation during the carotid endarterectomy (CEA), carotid angioplastic and stenting (CAS), and to reveal the prognostic significance of the data provided by intraoperative monitoring of the brain blood flow in exposing acute ischemic lesions in brain. Intraoperative monitoring of blood flow in artery ophthalmic vas carried out with 60% of patients, in the middle cerebral artery-with 40% during the main stages of CEA, and with 64 patients in the middle cerebral artery during CAS. The comparison of the data of intraoperative monitoring of blood flow in middle cerebral artery with the result of brain diffusion-weighted magnetic resonance imaging (DW-MRI) 24 hours after the operation shows, that solid microembolic signals and vasospasm are prognostic signals (sensibility and specifics make up 95%) in the development of acute ischemic cerebral lesions. The monitoring of blood flow in artery ophthalmic is of the greatest diagnostic value in estimation of the hemodynamic situation, but it is of the lowest practical value in detecting microembolic signals. According to the data of the intraoperative blood flow monitoring in middle cerebral artery in group CEA the development of acute ischemic cerebral lesions were predicted with 11,1% of patients and the cause of postoperative stroke, developed by 2,9% of the patients, was specified. According to the result of DW-MRI, acute ischemic cerebral lesions were diagnosed with 21% of patients, that is, 18% of ischemic cerebral lesions were asymptomatic. In group CAS ischemic cerebral lesions were prognosed with 30% of patients, actually they were later detected with 40,6% of cases by means of DW-MRI. According to the data of intraoperative of blood flow monitoring the cause of the development of postoperative stroke was specified in 6,2% of cause; in 34,4% of cause the acute ischemic cerebral lesions were asymptomatic.

  19. Comparison of SpO2 values from different fingers of the hands.

    Science.gov (United States)

    Basaranoglu, Gokcen; Bakan, Mefkur; Umutoglu, Tarik; Zengin, Seniyye Ulgen; Idin, Kadir; Salihoglu, Ziya

    2015-01-01

    Pulse oximetry is a frequently used tool in anesthesia practice. Gives valuable information about arterial oxygen content, tissue perfusion and heart beat rate. In this study we aimed to provide the comparison of peripheral capillary hemoglobin oxygen saturation (SpO2) values among every finger of the two hands. Thirty-seven healthy volunteers from operative room stuffs between the ages of 18-30 years were enrolled in the study. They were monitored after 5 min of rest. After their non invasive blood pressure, heart rate, fasting time and body temperature were measured, SpO2 values were obtained from every finger and each of two hands fingers with the same pulse oximetry. All the SpO2 values were obtained after at least 1 min of measurement period. A total of 370 SpO2 measurements from 37 volunteers were obtained. The highest average SpO2 value was measured from right middle finger (98.2 % ± 1.2) and it was statistically significant when compared with right little finger and left middle finger. The second highest average SpO2 value was measured from right thumb and it was statistically significant only when compared with left middle finger (the finger with the lowest average SpO2 value) (p < 0.05). SpO2 measurement from the fingers of the both hands with the pulse oximetry, the right middle finger and right thumb have statistically significant higher value when compared with left middle finger in right-hand dominant volunteers. We assume that right middle finger and right thumb have the most accurate value that reflects the arterial oxygen saturation.

  20. Cerebral phaeohyphomycosis by Exophiala dermatitidis

    Directory of Open Access Journals (Sweden)

    S Sood

    2014-01-01

    Full Text Available Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  1. Cerebral phaeohyphomycosis by Exophiala dermatitidis.

    Science.gov (United States)

    Sood, S; Vaid, V K; Sharma, M; Bhartiya, H

    2014-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  2. [Outcome measures in perinatal medicine--pO2 and SO2. With remarks on pulse oximetry].

    Science.gov (United States)

    Roemer, V M

    2005-10-01

    Due to the outstanding pioneer work of Ronald E. Myers (Bethesda, Maryland) using term rhesus monkey fetuses we know for sure that hypoxia is the leading cause for brain damage and death when exposure occurs perinatally. He defined threshold values for oxygen content and time variables leading to death or cerebral injury. Years later pulsoximetry was developed for measuring fetal oxygen saturation (%) continuously. In this context the obstetrician wants to know: 1) what is the diagnostic potential of pO(2) (mmHg), SO(2) (%) and oxygen content (vol%) in umbilical blood? and 2) using these data could we ascertain fetal pulsoximetry which in addition uses the factor time. In a sample of 7814 term fetuses, delivered in cephalic presentation by the vaginal route, actual blood gases and the variables of the fetal acid-base balance were determined in umbilical blood using equipments (BMS up to ABL 3) from RADIOMETER, Copenhagen. Measurements were done immediately post-partum by trained medical personal. Fetal oxygen saturation (%) for HbF was computed using the algorithm of Ruiz et al. Oxygen content (vol%) was determined according to Severinghaus using Hb values (g%) in each case. The median pO(2) in blood of the umbilical artery (UA) was 17.9 (mean: 18.8 +/- 8.3) mm Hg and in the umbilical vein (UV) 28.5 (mean: 29.3 +/- 9.2) mmHg, respectively. The median oxygen saturation (%) amounted to 24.8 (UA) and 60.9 (UV) using pO(2), pH and pCO(2) for computation in each case. The oxygen variable pO(2) showed no clinically important correlation neither with actual pH (r = 0.032, P = 0.005) nor with base excess (r = 0.047, P values of 6.9 are associated with 10 % oxygen saturation only in UA. P (50) values change dramatically with lowering pH values, i. e., acidosis. Oxygen content (vol %) offers no diagnostic advantages over oxygen saturation. Separation of the whole sample (N = 7814) according to the boundary of 30 % saturation in UA/UV blood leads necessarily to a big

  3. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  4. 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.

  5. Utility of overnight pulse oximetry and heart rate variability analysis to screen for sleep-disordered breathing in chronic heart failure.

    Science.gov (United States)

    Ward, Neil R; Cowie, Martin R; Rosen, Stuart D; Roldao, Vitor; De Villa, Manuel; McDonagh, Theresa A; Simonds, Anita; Morrell, Mary J

    2012-11-01

    Sleep-disordered breathing (SDB) is under diagnosed in chronic heart failure (CHF). Screening with simple monitors may increase detection of SDB in a cardiology setting. This study aimed to evaluate the accuracy of heart rate variability analysis and overnight pulse oximetry for diagnosis of SDB in patients with CHF. 180 patients with CHF underwent simultaneous polysomnography, ambulatory electrocardiography and wrist-worn overnight pulse oximetry. SDB was defined as an apnoea-hypopnoea index ≥15/h. To identify SDB from the screening tests, the per cent very low frequency increment (%VLFI) component of heart rate variability was measured with a pre-specified cutoff ≥2.23%, and the 3% oxygen desaturation index was measured with a pre-specified cutoff >7.5 desaturations/h. 173 patients with CHF had adequate sleep study data; SDB occurred in 77 (45%) patients. Heart rate variability was measurable in 78 (45%) patients with area under the %VLFI receiver operating characteristic curve of 0.50. At the ≥2.23% cutoff, %VLFI sensitivity was 58% and specificity was 48%. The 3% oxygen desaturation index was measurable in 171 (99%) patients with area under the curve of 0.92. At the pre-specified cutoff of >7.5 desaturations/h, the 3% oxygen desaturation index had a sensitivity of 97%, specificity of 32%, negative likelihood ratio of 0.08 and positive likelihood ratio of 1.42. Diagnostic accuracy was increased using a cutoff of 12.5 desaturations/h, with sensitivity of 93% and specificity of 73%. The high sensitivity and low negative likelihood ratio of the 3% oxygen desaturation index indicates that pulse oximetry would be of use as a simple screening test to rule out SDB in patients with CHF in a cardiology setting. The %VLFI component of heart rate variability is not suitable for detection of SDB in CHF.

  6. A review of signal processing used in the implementation of the pulse oximetry photoplethysmographic fluid responsiveness parameter.

    Science.gov (United States)

    Addison, Paul S

    2014-12-01

    ΔPOP is a physiological parameter derived from the respiration-induced change in the pulse oximetry plethysmographic (POP) waveform or "pleth." It has been proposed as a proxy for pulse pressure variation used in the determination of the response to intravascular volume expansion in hypovolemic patients. Many studies have now reported on the parameter, and many research groups have constructed algorithms for its computation from the first principles where the implementation details have been described. This review focuses on the signal processing aspects of ΔPOP, as reported in the literature, and aims to provide a comprehensive summary of the wide-ranging algorithmic strategies that have been attempted in its computation. A search was conducted for articles concerning the use of ΔPOP as a fluid responsiveness parameter. In particular, articles concerning the correlation between ΔPOP and pulse pressure variation were targeted. Comments and replies to comments by the authors in which signal processing aspects were discussed were also included in the review. The parameter is first defined, and a history of the early work surrounding pleth-based fluid responsiveness parameters is presented. This is followed by an overview of the signal processing methods used in the reported studies, including details of exclusion criteria, manual filtering (preprocessing), gain change issues, acquisition details, selection of registration periods, averaging methods, physiological influences on the pleth, and comments by the investigators themselves. It is concluded that to develop a robust, fully automated ΔPOP algorithm for use in the clinical environment, more rigorous signal processing is required. Specifically, signals should be evaluated over significant periods of time, with emphasis on the quality and temporal relevance of the information.

  7. Respiratory rate and pulse oximetry derived information as predictors of hospital admission in young children in Bangladesh: a prospective observational study

    Science.gov (United States)

    Garde, Ainara; Zhou, Guohai; Raihana, Shahreen; Dunsmuir, Dustin; Karlen, Walter; Dekhordi, Parastoo; Huda, Tanvir; Arifeen, Shams El; Larson, Charles; Kissoon, Niranjan; Dumont, Guy A; Ansermino, J Mark

    2016-01-01

    Objective Hypoxaemia is a strong predictor of mortality in children. Early detection of deteriorating condition is vital to timely intervention. We hypothesise that measures of pulse oximetry dynamics may identify children requiring hospitalisation. Our aim was to develop a predictive tool using only objective data derived from pulse oximetry and observed respiratory rate to identify children at increased risk of hospital admission. Setting Tertiary-level hospital emergency department in Bangladesh. Participants Children under 5 years (n=3374) presenting at the facility (October 2012–April 2013) without documented chronic diseases were recruited. 1-minute segments of pulse oximetry (photoplethysmogram (PPG), blood oxygen saturation (SpO2) and heart rate (HR)) and respiratory rate were collected with a mobile app. Primary outcome The need for hospitalisation based on expert physician review and follow-up. Methods Pulse rate variability (PRV) using pulse peak intervals of the PPG signal and features extracted from the SpO2 signal, all derived from pulse oximetry recordings, were studied. A univariate age-adjusted logistic regression was applied to evaluate differences between admitted and non-admitted children. A multivariate logistic regression model was developed using a stepwise selection of predictors and was internally validated using bootstrapping. Results Children admitted to hospital showed significantly (p<0.01) decreased PRV and higher SpO2 variability compared to non-admitted children. The strongest predictors of hospitalisation were reduced PRV-power in the low frequency band (OR associated with a 0.01 unit increase, 0.93; 95% CI 0.89 to 0.98), greater time spent below an SpO2 of 98% and 94% (OR associated with 10 s increase, 1.4; 95% CI 1.3 to 1.4 and 1.5; 95% CI 1.4 to 1.6, respectively), high respiratory rate, high HR, low SpO2, young age and male sex. These variables provided a bootstrap-corrected AUC of the receiver operating characteristic

  8. Evaluation of cerebral hemodynamics with perfusion CT

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yuzo; Furuichi, Masahiro; Nokura, Hiroaki [Inuyama Central Hospital, Aichi (Japan); Sakai, Noboru [Gifu Univ. (Japan). School of Medicine

    2002-07-01

    We report on the evaluation of cerebral ischemic lesions with perfusion CT. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of 52 patients mostly with ischemic cerebrovascular disease were analysed using the box-modulation transfer function method with 30 ml of contrast medium intravenously injected at 5 ml/sec. CBF, CBV and MTT of the middle cerebral artery (MCA) territory were 43.5{+-}4.6 ml/100 g/min, 1.9{+-}0.2 ml/100 g and 2.9{+-}0.6 seconds at the unaffected side, and 37.7{+-}7.3 ml/100 g /min, 2.1{+-}0.3 ml/100 g, 3.7{+-}0.9 seconds at the lesion side with stenosis or occlusion in the main MCA trunks or internal carotid artery, respectively. A statistically significant difference was shown in CBF and MTT values. Furthermore, there was a close correlation in CBF values of MCA territories between Xe-CT and perfusion CT (r=0.645, n=76, p<0.0001). MTT showed a positive correlation with CBV in those subjects when MTT was below 4.1 seconds (r=0.526, p<0.0001, n=83). MTT also showed a negative correlation with CBF in those patients when MTT indicated more than 4.1 seconds (r=0.818, p<0.001, n=21). These results suggest that the progression of cerebral ischemia may be classified in 4 stages using perfusion CT. The stages are as follows: stage 0; normal CBF without prolonged MTT and increased CBV, stage 1; relatively increased CBV, stage 2; significantly prolonged MTT, and stage 3; significantly deceased CBF with prolonged MTT. (author)

  9. 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

  10. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the ischemic focus...

  11. 16层螺旋CT平扫和增强扫描对急性脑出血临床结局预测价值的比较%Comparision of predictive value of 16 slice spiral CT plain scan and en-hanced scan for clinical outcome of acute cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈弼政; 吴欣洪

    2015-01-01

    Objective To compare predictive value of 16 slice spiral CT plain scan and enhanced scan for clinical out-come of acute cerebral hemorrhage. Methods 200 patients with acute cerebral hemorrhage treated in our hospital from January 2010 to January 2014 were selected as research objects,and they were divided into the two groups,and there were 100 cases in each group.Observation group was conducted with CT enhanced scan,while control group was given CT plain scan.Imaging characteristics of two groups was observed,and diagnosed value between two groups was com-pared. Results The sensitivity of was 47.62%,the specificity was 84.81%,the negative predictive value was 85.90%,the positive predictive value was 45.45% in control group while the sensitivity was 66.67%,the specificity was 92.41%,the negative predictive value was 91.25%,the positive predictive value was 70.0% in observation group,and sensitivity and specificity in observation group was obviously higher than that of control group,and there was a statistical difference (P<0.05). Conclusion Predictive value of clinical outcome of acute cerebral hemorrhage of 16 slice spiral CT enhanced scan is higher than that of CT plain scan.%目的:比较16层螺旋CT平扫和增强扫描对急性脑出血临床结局的预测价值。方法选取本院2010年1月~2014年1月收治的急性脑出血患者200例为研究对象,根据影像学诊断方法不同分为两组,每组100例。观察组进行CT增强扫描,对照组行常规CT平扫,观察两组的影像学特征,比较两组的诊断价值。结果对照组预测脑出血增长的灵敏度为47.62%,特异度为84.81%,阴性预测值为85.90%,阳性预测值为45.45%,观察组的灵敏度为66.67%,特异度为92.41%,阴性预测值为91.25%,阳性预测值为70.0%,观察组的灵敏度、特异度均明显高于对照组,差异有统计学意义(P<0.05)。结论16层螺旋CT增强扫描对急性脑出血临床结局的预测价值高于常规平扫。

  12. Cerebral Venous Thrombosis.

    Science.gov (United States)

    Sassi, Samia Ben; Touati, Nahla; Baccouche, Hela; Drissi, Cyrine; Romdhane, Neila Ben; Hentati, Fayçal

    2016-01-01

    Data regarding cerebral venous thrombosis in North Africa are scarce. This study aims to identify the clinical features, risk factors, outcome, and prognosis of cerebral venous thrombosis in Tunisia. Data of 160 patients with radiologically confirmed cerebral venous thrombosis, hospitalized in Mongi Ben Hmida National Institute of Neurology (Tunis, Tunisia), were retrospectively collected and analyzed. The mean age was 37.3 years with a female predominance (83.1%). The mode of onset was subacute in most cases (56.2%). Headache was the most common symptom (71.3%), and focal neurologic symptoms were the main clinical presentation (41.8%). The most common sites of thrombosis were the superior sagittal sinus (65%) and the lateral sinus (60.6%). More than 1 sinus was involved in 114 (71.2%) patients. Parenchymal lesions observed in 85 (53.1%) patients did not correlate with cerebral venous thrombosis extent. Major risk factors were obstetric causes (pregnancy and puerperium) found in 46 (38.6% of women aged <50 years) patients, followed by anemia (28.1%) and congenital or acquired thrombophilia (16.2%). Mortality rate was of 6.6%. Good outcome at 6 months (modified Rankin Scale ≤2) was observed in 105 (87.5%)of 120 patients available for follow-up. Predictors of poor outcome were altered consciousness and elevated plasma C-reactive protein levels. Clinical and radiologic presentation of cerebral venous thrombosis in Tunisia was quite similar to other parts of the world with, however, a particularly high frequency of obstetric causes. Plasma C-reactive protein level should be considered as a prognostic factor in CVT.

  13. Iodoamphetamine as a new tracer for local cerebral blood flow in the rat

    DEFF Research Database (Denmark)

    Rapin, J R; Le Poncin-Lafitte, M; Duterte, D

    1984-01-01

    practically no differences. Autoradiographic quantification of the local cerebral blood flow, calculated according to the microsphere model, produced identical results for both molecules. However, compared with the values reported for other tracers, our values constituted an underestimation of white matter...

  14. The value of transcranial doppler on therapeutic effects of intravenous thrombolysis for patients with acute cerebral infarction%经颅多普勒在急性脑梗死静脉溶栓治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    邓宇平; 罗伟良

    2010-01-01

    Objective To explore the role of transcranial doppler(TCD) on therapeutic effects of intravenous thrombolysis for patients with acute cerebral infarction by using transcranial doppler to make dynamic detection pre and pro-intravenous thrombolysis. Methods 60 patients with the final diagnosis of acute cerebral infarction were selected according to the inclusion criteria and exclusion criteria standard promissory. Recombinant tissue type plasminogen activator as the intravenous thrombolysis agent was used 4.5h later onset of the disease in all these cases, and TCD monitoring was preformed to understand the sitiations of the target blood vessels pre and pro-thrombloysis treatment on the 6,12 hours and 24 hours,the 2st day and the 7th day,all the data offered by which was used to adjust the treatment protocois of antiplatelet and anticoagulant therapy after 24 hours. All patients were followed up for 3 months,among whom prognostic evaluation, situations of revascularization was carried out as well as the complications of secondary intracranial hemorrhages and reocclusion basing on the neurologic impairment Score and the Thrombolysis in Brain lschemia(TIBI) respectively. Results No patient was dead after following-up for 3 months and 17 cases with basi- healing(28.3%) ,20 cases with excellence(33.3%), 16 cases got better(26.7%) ,3 cases with inefficiency (5.0%), and 4 cases became deterioration (6.7%). According to the Thrombolysis in Brain lschemia( TIBI), 22 cases got 4-5 level( 36.7 %), 31 cases with 2-3 level ( 51.7% ), and 7 cases got 0-1 level ( 11.6 % ). Among all these cases ,4 cases were found with secondary intracranial hemorrhages (6. 7% ) and 5 cases with reocclusion ( 8.3% ) Conclusion Dynamic detection with transcranial doppler pre and pro-intravenous thrombolysis could improve the therapeutic effect on patients with acute cerebral infarction, and reduce its complication, which is important for the clinical wrok and deserving consulting.%目的 利用经

  15. The value of the combination of specific sequences of magnetic resonance imaging in the diagnosis of primary cerebral lymphoma%MRI多检查序列联合应用对原发性脑淋巴瘤诊断的价值探讨

    Institute of Scientific and Technical Information of China (English)

    朱秀芳; 李蕾; 苗重昌; 李佳

    2016-01-01

    Objective To explore the value of the combination of specific sequences of magnetic resonance imaging ( MRI)in the diagnosis of primary cerebral lymphoma .Methods The clinical and MRI imaging data of 18 patients with primary cerebral lymphoma were respectively studied . The sequences included T 1 WI, T2 WI, enhanced-T1 WI, DWI, MRS, SWI, DTI, ADC and MRV.To find the different value of them , characteristic signals of cerebral lesions were analyzed and compared among the se-quences.Results The lesions were found soliary in 12 cases and multiple in 6 cases.29 lesions were found altogether , in which 25 lesions were supratentorial ,and 4 lesions were infratentorial .The lesions presened slightly low or equal signal in T 1 WI, and slightly high or equal signal in T 2 WI.All of the lesions were enhanced significantly ,in which 3lesions existed central necrosis , and the the rest of the lesions showed homogeneous enhanced .The lesions showed high or slightly high signal in DWI , and oppo-site sign in ADC .MRS showed that Cho was increased , Cr and NAA were slightly decreased .SWI showed no vessel in the le-sions, while the vessels around the lesions were pushed displacement .FA of the lesions in DTI were decreased ,and the fiber bundie in DTT were disrupted .In essence, tumors had the FA value reduction , DTT in tumors had significantly reduced area fiber bundle .Co nclusion The combination of specific sequences of MRI can do a pretty good job in the diagnosis of primary cerebral lymphoma.%目的 探讨MRI多序列联合应用对原发性脑淋巴瘤的诊断价值. 方法 回顾性分析18例原发性脑淋巴瘤患者的临床及MRI资料. 18例患者均行MRI检查,序列包括:T 1WI、 T2 WI、增强T1 WI、DWI、MRS、SWI、DTI. 分析并比较不同序列中病灶的表现及信号特征,探讨其在脑淋巴瘤诊断中的作用. 结果 单发12例,多发6例. 共检出病灶29个,其中幕上25个,幕下4个. T1 WI呈稍低或等信号,T2 WI

  16. Parálisis cerebral Cerebral palsy

    OpenAIRE

    Jorge Malagon Valdez

    2007-01-01

    El término parálisis cerebral (PC) engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia me...

  17. 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

    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 ... 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

  18. Respiratory variations in the photoplethysmographic waveform amplitude depend on type of pulse oximetry device.

    Science.gov (United States)

    Høiseth, Lars Øivind; Hoff, Ingrid Elise; Hagen, Ove Andreas; Kirkebøen, Knut Arvid; Landsverk, Svein Aslak

    2016-06-01

    Respiratory variations in the photoplethysmographic waveform amplitude predict fluid responsiveness under certain conditions. Processing of the photoplethysmographic signal may vary between different devices, and may affect respiratory amplitude variations calculated by the standard formula. The aim of the present analysis was to explore agreement between respiratory amplitude variations calculated using photoplethysmographic waveforms available from two different pulse oximeters. Analysis of registrations before and after fluid loads performed before and after open-heart surgery (aortic valve replacement and/or coronary artery bypass grafting) with patients on controlled mechanical ventilation. Photoplethysmographic (Nellcor and Masimo pulse oximeters) and arterial pressure waveforms were recorded. Amplitude variations induced by ventilation were calculated and averaged over ten respiratory cycles. Agreements for absolute values are presented in scatterplots (with least median square regression through the origin, LMSO) and Bland-Altman plots. Agreement for trending presented in a four-quadrant plot. Agreement between respiratory photoplethysmographic amplitude variations from the two pulse oximeters was poor with LMSO ΔPOPNellc = 1.5 × ΔPOPMas and bias ± limits of agreement 7.4 ± 23 %. Concordance rate with a fluid load was 91 %. Agreement between respiratory variations in the photoplethysmographic waveform amplitude calculated from the available signals output by two different pulse oximeters was poor, both evaluated by LMSO and Bland-Altman plot. Respiratory amplitude variations from the available signals output by these two pulse oximeters are not interchangeable.

  19. Pulmonary ultrasound and pulse oximetry versus chest radiography and arterial blood gas analysis for the diagnosis of acute respiratory distress syndrome: a pilot study.

    Science.gov (United States)

    Bass, Cameron M; Sajed, Dana R; Adedipe, Adeyinka A; West, T Eoin

    2015-07-21

    In low-resource settings it is not always possible to acquire the information required to diagnose acute respiratory distress syndrome (ARDS). Ultrasound and pulse oximetry, however, may be available in these settings. This study was designed to test whether pulmonary ultrasound and pulse oximetry could be used in place of traditional radiographic and oxygenation evaluation for ARDS. This study was a prospective, single-center study in the ICU of Harborview Medical Center, a referral hospital in Seattle, Washington, USA. Bedside pulmonary ultrasound was performed on ICU patients receiving invasive mechanical ventilation. Pulse oximetric oxygen saturation (SpO2), partial pressure of oxygen (PaO2), fraction of inspired oxygen (FiO2), provider diagnoses, and chest radiograph closest to time of ultrasound were recorded or interpreted. One hundred and twenty three ultrasound assessments were performed on 77 consecutively enrolled patients with respiratory failure. Oxygenation and radiographic criteria for ARDS were met in 35 assessments. Where SpO2 ≤ 97%, the Spearman rank correlation coefficient between SpO2/FiO2 and PaO2/FiO2 was 0.83, p arterial blood gas testing and chest radiography are not readily available.

  20. Parálisis cerebral Cerebral palsy

    Directory of Open Access Journals (Sweden)

    Jorge Malagon Valdez

    2007-01-01

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

  1. 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

  2. Correlation of Venous Blood Gas and Pulse Oximetry With Arterial Blood Gas in the Undifferentiated Critically Ill Patient.

    Science.gov (United States)

    Zeserson, Eli; Goodgame, Ben; Hess, J Daniel; Schultz, Kristine; Hoon, Cynthia; Lamb, Keith; Maheshwari, Vinay; Johnson, Steven; Papas, Mia; Reed, James; Breyer, Michael

    2016-06-09

    Blood gas analysis is often used to assess acid-base, ventilation, and oxygenation status in critically ill patients. Although arterial blood gas (ABG) analysis remains the gold standard, venous blood gas (VBG) analysis has been shown to correlate with ABG analysis and has been proposed as a safer less invasive alternative to ABG analysis. The purpose of this study was to evaluate the correlation of VBG analysis plus pulse oximetry (SpO2) with ABG analysis. We performed a prospective cohort study of patients in the emergency department (ED) and intensive care unit (ICU) at a single academic tertiary referral center. Patients were eligible for enrollment if the treating physician ordered an ABG. Statistical analysis of VBG, SpO2, and ABG data was done using paired t test, Pearson χ(2), and Pearson correlation. There were 156 patients enrolled, and 129 patients completed the study. Of the patients completing the study, 53 (41.1%) were in the ED, 41 (31.8%) were in the medical ICU, and 35 (27.1%) were in the surgical ICU. The mean difference for pH between VBG and ABG was 0.03 (95% confidence interval: 0.03-0.04) with a Pearson correlation of 0.94. The mean difference for pCO2 between VBG and ABG was 4.8 mm Hg (95% confidence interval: 3.7-6.0 mm Hg) with a Pearson correlation of 0.93. The SpO2 correlated well with PaO2 (the partial pressure of oxygen in arterial blood) as predicted by the standard oxygen-hemoglobin dissociation curve. In this population of undifferentiated critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis. The combination of VBG analysis plus SpO2 provided accurate information on acid-base, ventilation, and oxygenation status for undifferentiated critically ill patients in the ED and ICU. © The Author(s) 2016.

  3. Application value of MR diffusion tensor imaging in the diagnosis of spastic cerebral palsy%MR扩散张量成像在痉挛型脑瘫诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    蒋昊翔; 宋旸; 齐乃新; 白芝兰; 张增俊; 李敏; 张晓娜

    2014-01-01

    目的 探讨MR扩散张量成像(diffusion tensor imaging,DTI)及纤维束示踪成像(fiber tractography,FT)在痉挛型脑瘫(cerebral palsy,CP)诊断中的应用价值.方法 21例痉挛型CP合并脑室周围白质软化症(periventricular leucomalacia,PVL)患儿与26例同龄正常儿童行颅脑常规MRI及DTI检查,测量脑桥及内囊后肢水平面皮质脊髓束、内囊前肢、丘脑后辐射、胼胝体膝部和胼胝体压部的各向异性分数(fractional anisotropy,FA)及平均扩散(mean diffusivity,MD)值,并对白质纤维束进行FT三维重建.以独立样本均数t检验进行组间比较,以Spearman相关分析DTI与CP粗大运动功能的相关性.结果 与对照组相比,病例组患儿白质纤维束FA值显著降低(P<0.01);丘脑后辐射、胼胝体压部及胼胝体膝部MD值显著增高(P<0.01,P<0.01,P<0.05);FT显示病变区白质纤维束明显稀疏.此外,病例组患儿粗大运动功能分级系统(gross motor function classification sys-tem,GMFCS)与FA值呈负相关(P<0.05),而与MD值呈正相关(P<0.05).GMFCS与内囊后肢水平面皮质脊髓束FA值相关程度最高(r=-0.80,P<0.01).结论 DTI可被用于评估脑白质纤维束损伤情况,皮质脊髓束FA值可作为痉挛型CP患儿早期监测及病情评估的敏感指标.

  4. 多层螺旋CT血管成像在脑动静脉畸形诊断及治疗中的价值%Value of multi-slice spiral CT angiography in diagnosis and treatment of cerebral arteriovenous malformations

    Institute of Scientific and Technical Information of China (English)

    余海浪; 庹秀均; 李战辉; 张应和

    2013-01-01

    目的 探讨脑动静脉畸形(CAVM)在多层螺旋CT血管造影(MSCTA)中的表现及MSCTA的临床价值.方法 收集36例行MSCTA检查的CAVM患者的资料,采用容积再现重组(VR)血管生长技术(AV)进行血管重建,分析供血动脉、引流静脉的表现.结果 36例CAVM患者中,病变累及枕叶10例,颞叶9例,额叶2例,顶叶3例,枕叶、小脑半球7例,颞、枕叶3例,额、顶叶2例,均清楚显示畸形血管团、供血动脉及引流静脉;4例合并血管畸形内动脉瘤,2例合并血管畸形外动脉瘤,3例蛛网膜下腔出血,6例脑出血.结论 MSCTA能清楚显示CAVM的畸形血管团、供血动脉、引流静脉及合并的动脉瘤.%Objective To evaluate the manifestation of cerebral arteriovenous malformations (CAVM) on multi-slice spiral CT (MSCT) angiography and the clinical value of this examinaion.Methods The data on 36 patients with CAVM undergoing MSCT angiography were collected.Vascular reconstruction were performed by volume rendering and AV.The manifestations of feeding arteries and draining veins were then analyzed.Results Among these 36 patients with cerebral arteriovenous malformations,ten patients had the lesion in occipital lobe,nine in temporal lobe,two in frontal lobe,three in parietal lobe,seven in occipital lobe and cerebellar hemisphere,three in occipital and temporal lobe,and two in frontal and parietal lobe,with a clear display of masses of deformed vessels,feeding arteries and draining veins; 4 patients were complicated by intra-aneurysm of CAVM,2 were complicated by extra-aneurysm of CAVM,3 concurred with subarachnoid hemorrhage,and 6 concurred with cerebral hemorrhage.Conclusions Multi-slice spiral angiography can clearly detect masses of deformed vessels,feeding arteries,draining veins,and coexisting aneurysms.

  5. Cerebral blood flow and metabolism during sleep.

    Science.gov (United States)

    Madsen, P L; 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 levels of sleep into consideration, show that light sleep (stage II) is characterized by global levels of CBF and CMR only slightly reduced by 3-10% below the level associated with wakefulness, whereas CBF and CMR during deep sleep (stage III-IV) is dramatically reduced by 25-44%. Furthermore, recent data indicate that global levels of CBF and CMR are about the same during REM sleep as in wakefulness. On the regional level, deep sleep seems to be associated with a uniform decrease in regional CBF and CMR. Investigations concerning regional CBF and CMR during REM sleep are few but data from recent investigations seem to identify site-specific changes in regional CBF and CMR during REM sleep. CBF and CMR are reflections of cerebral synaptic activity and the magnitude of reduction in these variables associated with deep sleep indicates that overall cerebral synaptic activity is reduced to approximately one-half the level associated with wakefulness, while cerebral synaptic activity levels during REM sleep are similar to wakefulness. However, even though the new understanding of CBF and CMR during sleep provides significant and important information of the brain's mode of working during sleep, it does not at its current state identify the physiological processes involved in sleep or the physiological role of sleep.

  6. Advanced cerebral monitoring in neurocritical care

    Directory of Open Access Journals (Sweden)

    Barazangi Nobl

    2008-01-01

    Full Text Available New cerebral monitoring techniques allow direct measurement of brain oxygenation and metabolism. Investigation using these new tools has provided additional insight into the understanding of the pathophysiology of acute brain injury and suggested new ways to guide management of secondary brain injury. Studies of focal brain tissue oxygen monitoring have suggested ischemic thresholds in focal regions of brain injury and demonstrated the interrelationship between brain tissue oxygen tension (P bt O 2 and other cerebral physiologic and metabolic parameters. Jugular venous oxygen saturation (SjVO 2 monitoring may evaluate global brain oxygen delivery and consumption, providing thresholds for detecting brain hypoperfusion and hyperperfusion. Furthermore, critically low values of P bt O 2 and SjVO 2 have also been predictive of mortality and worsened functional outcome, especially after head trauma. Cerebral microdialysis measures the concentrations of extracellular metabolites which may be relevant to cerebral metabolism or ischemia in focal areas of injury. Cerebral blood flow may be measured in the neurointensive care unit using continuous methods such as thermal diffusion and laser Doppler flowmetry. Initial studies have also attempted to correlate findings from advanced neuromonitoring with neuroimaging using dynamic perfusion computed tomography, positron emission tomography, and Xenon computed tomography. Additionally, new methods of data acquisition, storage, and analysis are being developed to address the increasing burden of patient data from neuromonitoring. Advanced informatics techniques such as hierarchical data clustering, generalized linear models, and heat map dendrograms are now being applied to multivariable patient data in order to better develop physiologic patient profiles to improve diagnosis and treatment.

  7. Value of Diagnosis the Dysplasis of Fetal Cerebral Sulcus and Gyrus Abnormality by Two-dimensional Combined with Three-dimensional Ultrasonography%二维联合三维超声诊断胎儿脑沟脑回发育异常的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    陈晓康; 吕国荣; 凌乐文

    2014-01-01

    Objective To evaluate the value of two-dimensional combined with three-dimensional ultrasound (2D&3D-US) on diagnosing the dysplasia of the fetal cerebral sulcus and gyrus . Methods 2D-US was performed to record the growth of cerebral sulcus and gyrus of 66 fetuses ,who were suspicious central nervous system dysplastic . Then 3D-US were performed for volume scan in three orthogonal planes mode display and storage ,offline diagnostics ,and comparing the diagnosis and follow-up results . Results Compared to the follow-up or autopsy ,36 fetuses proved to be 2cerebral sulcus and gyrus dysplasia or combine with it . Of them ,10 fetuses were agyric ,26 fetuses were hypoplasia ,and the rest 30 fetuses were normal . The diagnose accordance rate of 2D&3D and 2D-US were 92 .42% (61/66)and 75 .76%(50/66) ,respectively . There was statistically significant difference between them (χ2 =6 .68 ,P<0 .01) . Conclusions 2D&3D-US could promote the accurate diagnosis in dysplasia of fetal cerebral sulcus and gyrus ,w hich has an important clinical value .%目的:探讨二维联合三维超声诊断胎儿脑沟脑回发育异常的应用价值。方法对疑有中枢神经系统畸形的66胎胎儿,行二维超声检测记录脑沟脑回发育情况,后行三维超声容积扫描,以三正交多平面模式显示并储存,下线诊断,并将诊断结果与随访结果进行比较。结果经随访或尸检证实36胎胎儿存在或合并有脑沟回发育异常(10胎脑沟回未发育,26胎脑沟回发育迟缓);30胎正常。二维联合三维超声诊断符合率为92.42%(61/66),单纯二维超声诊断符合率为75.76%(50/66),两者有显著差异(χ2=6.68,P<0.01)。结论二维联合三维超声可提高胎儿脑沟脑回发育异常诊断的准确性,具有重要的临床应用价值。

  8. 脑静脉窦血栓形成患者磁共振成像与磁共振静脉血管成像联合诊断的价值%The value of magnetic resonance imaging combined with magnetic resonance venography in diagnosis of cere-bral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    徐炳福

    2015-01-01

    Objective To investigate the value of the magnetic resonance imaging (MRI) combined with magnetic reso‐nance venography (MRV) in the diagnosis of cerebral venous sinus thrombosis. Methods Patients who were collected from A‐pril 2009 to May 2013 in our hospital were analyzed retrospectively. All of the patients were scanned by MR ,12 of which went on DSA (digital subtraction angiography) ,6 of which were scanned by MRV and 22 of which were received enhanced scan. Re‐sults 6 patients with the thrombosis of single transverse sinus ,and 8 patients with superior sagittal sinus ,transverse sinus and sigmoid sinus involvement was observed;while single sigmoid sinus involvement in 16 and both superior sagittal sinus and transverse sinus in 10 patients.Abnormal venous enhancement was found on contrast enhanced MRI in 22 patients ,but venous sinus thrombosis did not be enhanced. The results of MRV in 6 patients and DSA in 12 patients showed that the cerebral ve‐nous sinus was not obvious ,narrow and irregular. Conclusion The value of the magnetic resonance imaging (MRI) combined with magnetic resonance venography (MRV) in the diagnosis of cerebral venous sinus thrombosis is effective ,should be widely applied to clinical practice.%目的:探讨脑静脉窦血栓(cerebral venous sinus thrombosis ,CVST )形成患者磁共振成像与磁共振静脉血管成像联合诊断的价值。方法选取脑静脉窦血栓患者40例进行分析。诊断过程中,全体患者均接受磁共振(magnetic resonance venography ,MR)平扫,数字减影血管造影(digital subtraction angiography ,DSA)检查12例,MRV检测6例,增强扫描22例。结果单一横窦受累6例,上矢状窦、乙状窦及横窦受累8例,单一乙状窦受累16例,横窦和上矢状窦联合受累10例。所有患者磁共振成像(magnetic resonance venography ,MRI)及磁共振静脉成像(magnetic resonance venography ,MRV)均表现出信号改变。22例

  9. 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...... is the value of value for morality and ethics?To make things a bit more precise, we can make use of the common distinction between ethics and morality, i.e. that morality is the immediate, collective and unconscious employment of morals, whereas ethics is the systematic, individual and conscious reflections...

  10. 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.

  11. 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.

  12. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  13. Adding value(s)

    DEFF Research Database (Denmark)

    Carré, David

    2015-01-01

    , 1992). In response, behavioral economics (Camerer, 1999) has shown that agents have values other than optimization underpinning their decisions. Therefore, concerns arose regarding which values are guiding the agent but not about how such values became relevant for the agent. In this presentation, I......Most economic inquires revolve around agents making decisions. Getting the ‘best value’, it is assumed, drives such decisions: gaining most while risking least. This assumption has been debunked by showing that people does not always choose neither maximum benefit nor less risk (Kahneman & Tversky...... will explore the consequences of shifting to the latter perspective, i.e. looking for the generative framework of values. Here I argue that economic behavior should also be seen as a sense-making process, guided by values that are chosen/rejected along with fellow human beings, in specific socio...

  14. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  15. Cerebral salt wasting syndrome

    Directory of Open Access Journals (Sweden)

    Harshal Dholke

    2016-01-01

    Full Text Available Traumatic brain injury (TBI is on the rise, especially in today′s fast-paced world. TBI requires not only neurosurgical expertise but also neurointensivist involvement for a better outcome. Disturbances of sodium balance are common in patients with brain injury, as the central nervous system plays a major role in sodium regulation. Hyponatraemia, defined as serum sodium <135 meq/L is commonly seen and is especially deleterious as it can contribute to cerebral oedema in these patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH, is the most well-known cause of hyponatraemia in this subset of patients. Cerebral Salt Wasting Syndrome (CSWS, leading to renal sodium loss is an important cause of hyponatraemia in patients with TBI. Although incompletely studied, decreased renal sympathetic responses and cerebral natriuretic factors play a role in the pathogenesis of CSWS. Maintaining a positive sodium balance and adequate hydration can help in the treatment. It is important to differentiate between SIADH and CSWS when trying to ascertain a case for patients with acute brain injury, as the treatment of the two are diametrically opposite.

  16. Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients.

    Science.gov (United States)

    Nikolić, Igor; Majerić-Kogler, Visnja; Plavec, Davor; Maloca, Ivana; Slobodnjak, Zoran

    2008-02-01

    To test the predictive value of stairs climbing test for the development of postoperative complications in lung cancer patients with forced expiratory volume in one second (FEV1)stairs climbing with pulse oximetry before the operation with the number of steps climbed and the time to complete the test recorded. Oxygen saturation and pulse rate were measured every 20 steps. Data on postoperative complications including oxygen use, prolonged mechanical ventilation, and early postoperative mortality were collected. Eighty-seven of 101 patients (86%) had at least one postoperative complication. The type of surgery was significantly associated with postoperative complications (25.5% patients with lobectomy had no early postoperative complications), while age, gender, smoking status, postoperative oxygenation, and artificial ventilation were not. There were more postoperative complications in more extensive and serious types of surgery (Pstairs climbing test produced a significant decrease in oxygen saturation (-1%) and increase in pulse rate (by 10/min) for every 20 steps climbed. The stairs climbing test was predictive for postoperative complications only in lobectomy group, with the best predictive parameter being the quotient of oxygen saturation after 40 steps and test duration (positive likelihood ratio [LR], 2.4; 95% confidence interval [CI], 1.71-3.38; negative LR, 0.53; 95% CI, 0.38-0.76). In patients with other types of surgery the only significant predictive parameter for incident severe postoperative complications was the number of days on artificial ventilation (P=0.006). Stairs climbing test should be done in routine clinical practice as a standard test for risk assessment and prediction of the development of postoperative complications in lung cancer patients selected for elective surgery (lobectomy). Comparative to spirometry, it detects serious disorders in oxygen transport that are a baseline for a later development of cardiopulmonary postoperative

  17. 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.)

  18. 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...... levels of sleep into consideration, show that light sleep (stage II) is characterized by global levels of CBF and CMR only slightly reduced by 3-10% below the level associated with wakefulness, whereas CBF and CMR during deep sleep (stage III-IV) is dramatically reduced by 25-44%. Furthermore, recent...

  19. Subject variables and cerebral organization for language.

    Science.gov (United States)

    Searleman, A

    1980-08-01

    The present study investigated the usefulness of a variety of subject variables that have been proposed as having predictive value for determining cerebral organization for language. To accomplish this, a total of 373 subjects (117 left-handers and 256 right-handers) were given 240 trials of a consonant-vowel dichotic listening task to assess direction and degree of language lateralization. Each subject was also classified on the basis of eight subject variables (handedness, strength of handedness, familial sinistrality, writing hand posture, sex, sighting dominance, preferred footedness, and overall laterality). The results of the study indicated that left hemisphere language processing is very pervasive and that most of the subject variables examined were not very useful predictors of language lateralization. In addition, surprisingly, footedness and not handedness was the single best predictor of cerebral organization for language.

  20. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

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

    2013-01-01

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

  1. Determining cerebral death with radiologic diagnostic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, R.M.

    1980-05-01

    Cerebral death determination has become a very important medicolegal question. The imaging modalities of computed tomographic scanning, nuclear medicine, and cerebral angiography are enabling the physician to better evaluate those conditions that may mimic cerebral death.

  2. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

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

    2016-03-01

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

  3. 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

  4. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

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

    2014-01-01

    the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced......This review summarizes evidence in humans for an association between hyperventilation (HV)-induced hypocapnia and a reduction in cerebral perfusion leading to syncope defined as transient loss of consciousness (TLOC). The cerebral vasculature is sensitive to changes in both the arterial carbon...

  5. Human cerebral autoregulation before, during and after spaceflight.

    Science.gov (United States)

    Iwasaki, Ken-ichi; Levine, Benjamin D; Zhang, Rong; Zuckerman, Julie H; Pawelczyk, James A; Diedrich, André; Ertl, Andrew C; Cox, James F; Cooke, William H; Giller, Cole A; Ray, Chester A; Lane, Lynda D; Buckey, Jay C; Baisch, Friedhelm J; Eckberg, Dwain L; Robertson, David; Biaggioni, Italo; Blomqvist, C Gunnar

    2007-03-15

    Exposure to microgravity alters the distribution of body fluids and the degree of distension of cranial blood vessels, and these changes in turn may provoke structural remodelling and altered cerebral autoregulation. Impaired cerebral autoregulation has been documented following weightlessness simulated by head-down bed rest in humans, and is proposed as a mechanism responsible for postspaceflight orthostatic intolerance. In this study, we tested the hypothesis that spaceflight impairs cerebral autoregulation. We studied six astronauts approximately 72 and 23 days before, after 1 and 2 weeks in space (n = 4), on landing day, and 1 day after the 16 day Neurolab space shuttle mission. Beat-by-beat changes of photoplethysmographic mean arterial pressure and transcranial Doppler middle cerebral artery blood flow velocity were measured during 5 min of spontaneous breathing, 30 mmHg lower body suction to simulate standing in space, and 10 min of 60 deg passive upright tilt on Earth. Dynamic cerebral autoregulation was quantified by analysis of the transfer function between spontaneous changes of mean arterial pressure and cerebral artery blood flow velocity, in the very low- (0.02-0.07 Hz), low- (0.07-0.20 Hz) and high-frequency (0.20-0.35 Hz) ranges. Resting middle cerebral artery blood flow velocity did not change significantly from preflight values during or after spaceflight. Reductions of cerebral blood flow velocity during lower body suction were significant before spaceflight (P e.m.) cerebral blood flow velocity after 10 min upright tilt were smaller after than before spaceflight (absolute, -4 +/- 3 cm s(-1) after versus -14 +/- 3 cm s(-1) before, P = 0.001; and percentage, -8.0 +/- 4.8% after versus -24.8 +/- 4.4% before, P < 0.05), consistent with improved rather than impaired cerebral blood flow regulation. Low-frequency gain decreased significantly (P < 0.05) by 26, 23 and 27% after 1 and 2 weeks in space and on landing day, respectively, compared with

  6. The cerebral perivascular cells.

    Science.gov (United States)

    Angelov, D N; Walther, M; Streppel, M; Guntinas-Lichius, O; Neiss, W F

    1998-01-01

    This monograph reviews the literature and presents experimental data on the intracerebral presentation of antigen(s) to the immune system as a consequence of neuronal cell death. "Which cells are the antigen presenting cells (APC) of the brain?" is the main question of this book. The immune surveillance of the CNS occurs through specialized resident cells, which present (auto)antigen(s) to the immune system and thus initiate an (auto)immune response. There are four established prerequisites necessary to identify resident APC of the brain. First, the APC must be capable to phagocytose dead neurons. Second, in order to be recognized by T lymphocytes, these neuronophages must express Major Histocompatibility Complex (MHC) cells II glycoproteins on their surface. Third, in order to present (auto)antigen, the MHC class II-positive neuronophages must also be able to contact T lymphocytes. Fourth, in order to exert a stimulatory effect on T lymphocytes, the APC should be able to produce the cytokine interleukin-1 beta (IL-128 Mb). Three main tools were used to identify and characterize the APC of the brain. First, a lesion model was employed that yields a slowly progressing neuronal cell loss without disruption of the blood-brain barrier. This model consisted of resection of 10 mm of the facial nerve, which caused a slowly occurring neuronal death so that one year after resection the amount of facial neurons was about 44% of the control value. Second, neuronophages were labeled in vivo in situ via phagocytosis of the permanent fluorescent marker Fluoro-Gold (FG) from decaying pre-loaded facial motoneurons. Third, the FG-labeled neuronophages were immunocytochemically characterized with the new method "immunoquenching of fluorescence". Sections of the brainstem containing FG-labeled, i.e. fluorescent, neuronophages were incubated with a variety of primary antibodies, followed by avidin-HRP and DAB-nickel as a dark brown reaction product for bright-field microscopy. In the

  7. Aquaporin-4 gene silencing protects injured neurons after early cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Zhan-ping He; Hong Lu

    2015-01-01

    Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cel-lular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffu-sion-weighted imaging (DWI). We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and siRNA-aquaporin-4 was immediately injectedvia the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefifcient value on T2-weighted imaging (T2WI) and DWI gradually increased within 0.5–6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2WI and DWI reduced, relative apparent diffusion coefifcient value was increased, and cellular edema was ob-viously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefifcient value was similar between treatment and model groups, but angioedema was still obvious in the treat-ment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefifcient value and the area of high signal intensity on T2WI and DWI can relfect therapeutic effects of aquaporin-4 gene silencing on cellular edema.

  8. Predicting hemorrhagic transformation by microvascular permeability using perfusion CT acute cerebral infarction in elderly patients

    Institute of Scientific and Technical Information of China (English)

    田超

    2014-01-01

    Objective To study the possibility of microvascular permeability(PS)value derived from perfusion CT(PCT)in predicting hemorrhagic transformation(HT)in acute cerebral infarction in elderly patients.Methods 52consecutive patients with middle cerebral artery acute ischemic stroke who received thrombolytic therapy were divided into HT group and control group,and patients in

  9. Peripheral tissue oximetry

    DEFF Research Database (Denmark)

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

    2014-01-01

    , 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...

  10. Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    XU Fang-hong; CHEN Wei-jian; YANG Yun-jun; DUAN Yu-xia; FU Feng-li

    2008-01-01

    Objective: To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction. Methods: MSCTA was performed on 10 patients who were initiailly diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (Rcbf), regional cerebral blood volume (Rcbv), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained. Results: Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from steno sis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA. Conclusion: The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral

  11. The appraisal value of transcranial doppler and flash visual evoked potential on minimally invasive surgery for cerebral hemorrhage%经颅多普勒与闪光视觉诱发电位对脑出血微创术疗效的评估价值

    Institute of Scientific and Technical Information of China (English)

    郝丽娜; 冉晨光; 王利春; 赵荣忠

    2015-01-01

    Objective To investigate the appralsal value of the transcranial doppler (TCD) and flash visual evoked potential (FVEP) on minimally invasive surgery for cerebral hemorrhage. Methods 60 patients with hypertensive massive cerebral hemorrhage in basal ganglia and who were treated in the department of cerebral surgery of our hospital from January 2013 to December 2013 were selected as the investigation objects of this time, and all the patients were admitted within 24h after the onset of the disease. In addition, the patients were divided into the group received minimally invasive operation and the group received medical conservative treatment according to the difference of treatment methods, and all the patients of the both groups were received examinations of TCD and FVEP on the first day and the seventh day of the disease course, and hemodynamic parameters, the latency of each wave, and the results of NIHSS score and GCS score obtalned in the process of diagnosis were compared, and the intracranial pressures were predicted by the two kinds of noninvasive methods, TCD and FVEP, at the same time. Results compared with the conservative group, TCD parameters, the latencies of each wave of FVEP, NIHSS scores, GCS scores and predicted intracranial pressures on the first day in the patients of minimally invasive group did not change significantly;and cerebral blood flow velocities on the seventh day in the patients of minimally invasive group were accelerated significantly, the pulsatility indexes were decreased, all the latencies of each wave of FVEP were shortened significantly and the predicted intracranial pressures were decreased significantly. When compared with the first day, cerebral blood flow velocities on the seventh day in the patients of minimally invasive group were accelerated significantly, the pulsatility indexes were decreased, and the latencies of N2 and P3 waves of FVEP were shortened significantly, but the NIHSS and GCS scores did not change

  12. A PC-Based Pulse Oximetry Monitor for Four Patients%微机化多床位脉搏血氧饱和度监测仪

    Institute of Scientific and Technical Information of China (English)

    刘国忠; 李萍

    2001-01-01

    微机多床位脉搏血氧饱和度监测仪具有系统结构简单、灵活、存储容量大、功能强、性能价格比高等特点,且易实现多机通讯。介绍了监测仪的硬件系统组成原理及软件模块功能。%Pulse oximeters are used in many departments of a hospital. The pc-based pulse oximetry monitor for many patients has the features of simplicity, flexbility, large memory,powerful function, high ratio of performance to price, and it is easy to communicate with mul-timonitors. The principles of hardware system and the function of software block of the monitor are introduced too in this paper.

  13. Oligodendrogenesis after Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ruilan eZhang

    2013-10-01

    Full Text Available AbstractNeural stem cells in the subventricular zone (SVZ of the lateral ventricle of adult rodent brain generate oligodendrocyte progenitor cells (OPCs that disperse throughout the corpus callosum and striatum where some of OPCs differentiate into mature oligodendrocytes. Studies in animal models of stroke demonstrate that cerebral ischemia induces oligodendrogenesis during brain repair processes. This article will review evidence of stroke-induced proliferation and differentiation of OPCs that are either resident in white matter or are derived from SVZ neural progenitor cells and of therapies that amplify endogenous oligodendrogenesis in ischemic brain.

  14. Resting cerebral blood flow

    Science.gov (United States)

    Ances, B M.; Sisti, D; Vaida, F; Liang, C L.; Leontiev, O; Perthen, J E.; Buxton, R B.; Benson, D; Smith, D M.; Little, S J.; Richman, D D.; Moore, D J.; Ellis, R J.

    2009-01-01

    Objective: HIV enters the brain soon after infection causing neuronal damage and microglial/astrocyte dysfunction leading to neuropsychological impairment. We examined the impact of HIV on resting cerebral blood flow (rCBF) within the lenticular nuclei (LN) and visual cortex (VC). Methods: This cross-sectional study used arterial spin labeling MRI (ASL-MRI) to measure rCBF within 33 HIV+ and 26 HIV− subjects. Nonparametric Wilcoxon rank sum test assessed rCBF differences due to HIV serostatus. Classification and regression tree (CART) analysis determined optimal rCBF cutoffs for differentiating HIV serostatus. The effects of neuropsychological impairment and infection duration on rCBF were evaluated. Results: rCBF within the LN and VC were significantly reduced for HIV+ compared to HIV− subjects. A 2-tiered CART approach using either LN rCBF ≤50.09 mL/100 mL/min or LN rCBF >50.09 mL/100 mL/min but VC rCBF ≤37.05 mL/100 mL/min yielded an 88% (29/33) sensitivity and an 88% (23/26) specificity for differentiating by HIV serostatus. HIV+ subjects, including neuropsychologically unimpaired, had reduced rCBF within the LN (p = 0.02) and VC (p = 0.001) compared to HIV− controls. A temporal progression of brain involvement occurred with LN rCBF significantly reduced for both acute/early (<1 year of seroconversion) and chronic HIV-infected subjects, whereas rCBF in the VC was diminished for only chronic HIV-infected subjects. Conclusion: Resting cerebral blood flow (rCBF) using arterial spin labeling MRI has the potential to be a noninvasive neuroimaging biomarker for assessing HIV in the brain. rCBF reductions that occur soon after seroconversion possibly reflect neuronal or vascular injury among HIV+ individuals not yet expressing neuropsychological impairment. GLOSSARY AEH = acute/early HIV infection; ANOVA = analysis of variance; ASL-MRI = arterial spin labeling MRI; CART = classification and regression tree; CBF = cerebral blood flow; CH = chronic HIV

  15. Evaluation of entropy and bispectral index values for monitoring depth of sevoflurane anesthesia in children with cerebral palsy%熵指数和脑电双频指数用于脑瘫患儿七氟醚麻醉时镇静深度监测的评价

    Institute of Scientific and Technical Information of China (English)

    周丽萍; 贾乃光; 张亚军

    2012-01-01

    目的:通过熵指数和脑电双频指数(BIS)在脑瘫患儿七氟醚麻醉时与镇静深度的相关性和预测作用,评价熵指数和BIS用于脑瘫患儿镇静程度监测的准确性.方法:选择ASA Ⅰ或Ⅱ级、5~15岁择期在全身麻醉下行选择性周围神经缩窄术的脑瘫患儿25例.经面罩吸入5%七氟醚和N2O/O2:70%/30%.记录清醒时改良警觉/镇静评分(mOAAS)各阶段的反应熵(RE)、状态熵(SE) 、BIS、无创血压(NIBP)、平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2).RE、SE、BIS与mOAAS评分的关系采用Spearman's等级相关进行分析.计算RE、SE、BIS、MAP、HR、SPO2对镇静深度的预测概率.结果:脑瘫患儿RE、SE 、BIS与mOAAS评分密切相关,明显优于MAP、HR、SPO2.RE、SE、BIS对镇静深度的预测概率(Pk)值明显高于MAP、HR、SPO2(P<0.01).结论:RE、SE、BIS均可以在脑瘫患儿七氟醚-笑气麻醉中反应镇静深度.%Objective:To evaluate the accuracy of entropy and bispectral index (BIS)for monitoring depth of sevoflurane anesthesia in children with cerebral palsy .Methods:Twenty-five ASA I or II children aged 5-15 years undergoing elective surgery of peripheral neurotomy were enrolled in this study.Anesthesia were induced with 5% sevoflurane and 70% nitrous oxide in oxygen,Rresponse entropy(RE),state entropy(SE),BIS,non-invasive blood pressure (NIBP) t mean artery pressure (MAP), heart rate(HR)and pulse oxygen saturation (SPO2) values in awake and each stage of mOAAS (modified Observer's Assessment of Alertness/Sedation score)were recorded during the induction of anesthesia.The correlation between the different electroencephalographic indices (SE,RE and BIS) and mOAA/S were calculated by nonparainetric Spearman's rank-correlation analysis and analyzed with prediction probability (Pk).Results:RE,SE and BIS were significantly better correlated with mOAA/S score than MAP,HR and SPO2 in children with cerebral palsy,The Pk values of RE,SE and

  16. [Acute tetraparesis of cerebral origin].

    Science.gov (United States)

    Feuillet, L; Milandre, L; Kaphan, E; Ali Cherif, A

    2005-09-01

    Thrombolytic treatment in the early stage of ischemic cerebral attacks requires rapid confirmation of the diagnosis and topographic localization. Unusual clinical features can lead to misdiagnosis with the risk of delaying optimal therapeutic management. We report the cases of two patients who experienced acute tetraparesis without any associated encephalic sign, consistent with the diagnosis of spinal cord injury. Cervical magnetic resonance imaging (MRI) was normal. Conversely, cerebral MRI displayed in both cases bilateral hemispheric infarction. Two ischemic lesions were revealed in the territory of both anterior cerebral arteries in the first patient, while the second patient had a bilateral infarction in the posterior arms of both internal capsules. In case of tetraparesis, emergency spinal cord MRI should be performed to rule out neurosurgical etiologies and ischemia. If negative, cerebral MRI should be performed at the same time to look for early cerebral infarction in both hemispheres and determine the indication for thrombolysis.

  17. Uncommon Causes of Cerebral Microbleeds.

    Science.gov (United States)

    Noorbakhsh-Sabet, Nariman; Pulakanti, Varun Chandi; Zand, Ramin

    2017-10-01

    Cerebral microbleeds (CMBs) are small and round perivascular hemosiderin depositions detectable by gradient echo sequences or susceptibility-weighted imaging. Cerebral microbleeds are common among patients with hypertension, cerebral ischemia, or cerebral amyloid angiopathy. In this article, we describe uncommon causes of CMBs. We searched Pubmed with the keyword CMBs for relevant studies and looked for different uncommon causes of CMBs. CMBs have several uncommon etiologies including posterior reversible encephalopathy syndrome, infective endocarditis, brain radiation therapy, cocaine abuse, thrombotic thrombocytopenic purpura, traumatic brain injury, intravascular lymphomatosis or proliferating angio-endotheliomatosis, moyamoya disease, sickle cell anemia/β-thalassemia, cerebral autosomal dominant arteriopathy subcortical infarcts, and leukoencephalopathy (CADASIL), genetic syndromes, or obstructive sleep apnea. Understanding the uncommon causes of CMBs is not only helpful in diagnosis and prognosis of some of these rare diseases, but can also help in better understanding different pathophysiology involved in the development of CMBs. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Cerebral sinus venous thrombosis

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  19. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

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

  20. 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.

  1. 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.

  2. Cerebrovascular hemodynamics in patients with cerebral arteriosclerosis

    Institute of Scientific and Technical Information of China (English)

    Jianbo Yang; Changcong Cui; Chengbin Wu

    2011-01-01

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

  3. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag L. STOSHLJEVIKJ

    2008-12-01

    Full Text Available Pupils with cerebral palsy attend elementary education accordind to a regular and special teaching plan and program. Regular school curriculum was reformed in 1992, while special plan and program has not been changed and adapted according to pupil’s needs and capacities. Music is one of the best means of expressing oneself and plays a very important role in the development of every child, the child with cerebral palsy in particular.In order to test the possibility of pupils with cerebral palsy, with and without mental retardation, to apprehend the actual program content, we have conducted research on musical achievement of children with cerebral palsy. During 2007 a research was carried out, on the sample of 27 pupils with cerebral palsy and mild mental retardation who attended classes in the school “Miodrag Matikj”, and a sample of16 students with cerebral palsy without mental retardation who attended the school “Dr. Dragan Hercog” in Belgrade.Results of the research, as well as analysis of music curriculum content, indicated that the capacities of students with cerebral palsy to carry out the curriculum tasks require special approach and methodology. Therefore, we introduced some proposals to overcome the difficulties in fulfilling music curriculum demands of those pupils. We made special emphasis on the use of computer based Assistive technology which facilitates the whole process to a large extent.

  4. Association factor analysis between osteoporosis with cerebral artery disease: The STROBE study.

    Science.gov (United States)

    Jin, Eun-Sun; Jeong, Je Hoon; Lee, Bora; Im, Soo Bin

    2017-03-01

    The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified cerebral artery

  5. Application value of DTI tracing the optic tract and optic radiation for the selection of postoperative radiotherapy plan of cerebral gliomas%DTI技术示踪视束、视辐射在指导脑胶质瘤术后放疗方案选择中的应用价值

    Institute of Scientific and Technical Information of China (English)

    赵超云; 夏新舍; 王明磊; 刘子姗; 高文奇; 马辉; 王晓东; 夏鹤春

    2015-01-01

    Objective:To analyze whether the optic tract and the optic radiation showed by diffusion tensor imaging (DTI) can be used to evaluate the value in the guidance of selecting postoperative radiotherapy plan of cerebral gliomas.Materials and Methods: Thirty patients with conifrmed cerebral gliomas underwent conventional and contrast-enhanced MRI and DTI before postoperative radiotherapy. In order to delineate the radiotherapy target volume, organs at risk, optic tract and optic radiation, tractography data sets was fused with correlation MR and CT anatomy image by importing it to radiotherapy planning system. The radiotherapy plans developed with intensity modulated radiation therapy (IMRT) and three- dimensional conformal radiotherapy (3D-CRT) techniques were compared.Results:Both the IMRT and the 3D-CRT plans were ensured the therapeutic dose to the target volume and conventional organs at risk had been protected. The doses patients suffered by using the IMRT plan were lower than that of the 3D-CRT plan both in affected,unaffected side optic tract and optic radiation (P<0.05).Conclusion:DTI can display the location, shape of the optic tract and optic radiation, and the relationship with postoperative radiotherapy target volume of cerebral gliomas, and formulate protective treatment plan to reduce the radiation dose suffered by the optic tract and optic radiation, thereby reducing the visual dysfunction risk after radiotherapy.%目的:通过扩散张量成像(diffusion tensor imaging,DTI)示踪视束、视辐射,探讨其在指导脑胶质瘤术后放疗方案中的应用价值。材料与方法选取30例脑胶质瘤患者,术后拟行放疗前行常规MRI平扫、增强及DTI扫描。获取视束、视辐射的影像学信息与3D T1解剖图像融合,将融合后的3D T1图像导入放疗计划系统并与定位CT匹配,以此勾画放疗靶区、常规危及器官及视束、视辐射。利用调强放疗(intensity modulated radiation therapy,IMRT)

  6. The Value of Comprehensive Nursing Care in the Prevention of Falls in El-derly Patients with Cerebral Infarction%综合护理对老年脑梗死患者跌倒事件的预防价值

    Institute of Scientific and Technical Information of China (English)

    袁平

    2015-01-01

    目的:研究老年脑梗死跌倒患者步态、平衡感调查及综合护理对跌倒事件的预防价值。方法选取该院2014年4月—2015年5月收治的82例脑梗死老年患者,通过问卷调查、交谈和临床观察了解该82例患者的行走平衡能力。抽签随机分为对照组和观察组各41例,对照组给予病情监护等常规护理,观察组在常规护理基础上给予预防跌倒的综合护理,观察两组护理后的跌倒情况。结果调查显示该82例患者存在行走困难、步态失衡率74.39%较未出现步态失衡率25.61%明显较高,差异有统计学意义(P<0.05);护理后观察组跌倒发生率2.44%较对照组14.63%显著较低,差异有统计学意义(P<0.05)。结论行走困难、步态失衡在脑梗死老年患者中较为常见,跌倒的综合预防护理能有效减少跌倒的发生风险。%Objective To study the fall in the senile cerebral infarction patients with gait and balance investigation and comprehensive preventive value of nursing to stumble. Methods Select our hospital in April 2014 - May 2015 treated 82 cases of cerebral infarction of elderly patients, through questionnaire, conversation, and clinical observation to understand the 82 patients of walking balance. Draw 41 cases were randomly divided into control group and observation group, control group given condition monitoring and other routine care, observation group on the basis of conventional nursing care to pre-vent falls comprehensive care, observation nursing after the fall of the two groups. Results According to the survey the 82 cases of patients with walking difficulties, gait imbalance rate 74.39% is not present gait imbalance rate 25.61% signifi-cantly higher, with statistical significance (P<0.05);Fall in the observation group after nursing incidence was significantly lower than the control group 14.63% 2.44%, with statistical significance (P< 0.05). Conclusion Difficulty walking, gait im-balances is

  7. Nutritional Assessment of the Young Child with Cerebral Palsy.

    Science.gov (United States)

    Fee, Maureen A.; And Others

    1988-01-01

    Children with cerebral palsy sometimes display nutritional inadequacy, as evaluated through anthropometric measurements and laboratory values. Causes of poor nutritional status include inadequate calories offered or adequate calories offered but not consumed. Inadequate caloric retention may be due to vomiting, rumination, or gastroesophageal…

  8. The relationship between cerebral blood flow and volume in humans

    DEFF Research Database (Denmark)

    Rostrup, Egill; Knudsen, Gitte M; Law, Ian;

    2005-01-01

    The purpose of this study was to establish the relationship between regional CBF and CBV at normal, resting cerebral metabolic rates. Eleven healthy volunteers were investigated with PET during baseline conditions, and during hyper- and hypocapnia. Values for rCBF and rCBV were obtained using (15...

  9. Cerebral blood flow response to propranolol in streptozotocin diabetic rats

    DEFF Research Database (Denmark)

    Lass, Preben; Knudsen, G M

    1990-01-01

    The influence of propranolol on cerebral blood flow (CBF) was tested in streptozotocin diabetic rats and in control animals. Resting CBF values were 40% lower in the diabetic rats compared with controls. Intravenous injection of propranolol (2 mg kg-1) decreased CBF significantly in the control...

  10. Delayed coma in head injury : Consider cerebral fat embolism

    NARCIS (Netherlands)

    Metting, Zwany; Rodriger, Lars A.; Regtien, Joost G.; van der Naalt, Joukje

    Objective: To describe a case of a young man with delayed coma after mild head injury, suggestive of cerebral fat embolism (CFE). To underline the value of MR imaging in the differential diagnosis of secondary deterioration in mild head injury. Case report: A 21-year-old man admitted with mild head

  11. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cerebral palsy (CP is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cerebral palsy in the study group. MATERIA LS AND METHODS: Retrospective study was done to assess possible associated antenatal risk factors for cerebral palsy. Mothers of 100 cerebral palsy children were selected who are treated in Rani Chandramani Devi Hospital, a Government hospital in Visakhapa tn am, Andhra Pradesh State, India , from 2012 to 2014 and 100 controls, mothers of normal children were studied. Detailed antenatal history was obtained from the mothers of the children in both affected and control group. RESULTS: From the data, we conclude that the association of maternal anaemia with cerebral palsy is 7.3 times higher; association of maternal hypertension with cerebral palsy is 6.6 time higher, association with Pre - eclampsia is 6 times higher; association with Eclampsia is 8.6 times higher ; with antepartum haemorrhage, the association is 8.6 times higher and association of multiple pregnancy with cerebral palsy is 4.8 times higher than with controls. CONCLUSION: From this study of the role of antenatal risk factors, in the occurrence of cer ebral palsy in children it is concluded that the most common risk factor associated with cerebral palsy is the maternal anaemia and the other important risk factors associated being hypertension, pre eclampsia, eclampsia, antepartum haemorrhage and multipl e births.

  12. Values of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient in the Cerebral Infarction Model of Monkey and Their Change Rules%弥散加权成像及表面弥散系数在猴脑梗死模型中的应用及变化规律

    Institute of Scientific and Technical Information of China (English)

    徐军红; 周智鹏; 邓燕贤; 邱维加; 廖国宇

    2013-01-01

    Objective To discuss the values of diffusion-weighted imaging ( DWI) and apparent diffusion co-efficient ( ADC) in the cerebral infarction model of monkey ,and to analyze their change rules .Methods A total of 8 healthy adult monkeys ( Macaca mulatta ) were used as the experimental animals .The model was established by injec-ting autoblood clots into middle cerebral artery through the inserted micro-catheter to occlude the artery .MRI was per-formed in the first hour,second hour,24th hour,7th day,14th day,21th day and 28th day after embolization,and the values of ADC were measured .Results MRI performed in the first hour showed the high signals on DWI in 6 mon-keys,and showed the high signals on DWI in the second hour in 8 monkeys.And no abnormal findings were observed on T1WI and T2WI.DWI showed the significantly higher signals and T 2WI showed the high signals in the 24th hour. DWI showed the high signals on the 7th day and the slightly higher signals on the 14th day,but it showed the equal or low signals on the 21th day and the low signals on the 28th day.T2WI showed the high signals in all time .ADC values decreased within 24 hours,which increased to be almost normal on the 7th day and gradually increased to be higher than the normal on the 14th day,21th day and 28th day.Conclusion DWI shows the cerebral infarction earlier com-pared with routine T2WI.In the acute cerebral infarction stage ,DWI shows the high signals while ADC decreases .In the subacute and chronic stages ,ADC gradually increases while DWI signals gradually decreases ,but both are not syn-chronous.%目的:探讨脑梗死后弥散加权成像( DWI )及表面弥散系数( ADC )在猴脑梗死模型中的应用价值及变化规律。方法选择8只广西猕猴为实验动物,经股动脉穿刺插管至颈总动脉,引入微导管超选至大脑中动脉后注入适量自体血栓,分别于栓塞后1、2、24 h及7、14、21、28 d行磁共振检查

  13. 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.

    2016-10-01

    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-acetoxymethoxycarbonyl-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.

  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. Changes of Cerebral

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To explore the strengthening of acupuncture analgesic mechanism on the level of β-endorphin and proopimelanocortin mRNA expression in the arcuate nucleus of hypothalamus in rats following electroacupuncture(EA) combined with melatonin (MEL). Methods: Integrated optical density (IOD) was measured by ABC immuno-histochemical and in situ hybridization technique with computerized image processing. The rat's brain was coronally sectioned after combination of EA and MEL. Results: IOD of β-endorphin-like immunopositive substance in rat's brain was lowered significantly, which was measured after MEL (60 mg/kg) was injected intraperitoneally and followed by EA 30 min later for 30 min, and the IOD of cerebral POMC mRNA positive substance increased significantly 10 hrs later. Conclusion:The mechanism of MEL in enhancing EA analgesic effect might be related with the release and synthesis of β-endorphin

  16. Cerebral Arterial Fenestrations

    Science.gov (United States)

    Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V

    2014-01-01

    Summary Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms “fenestration” or “fenestrated” with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

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

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    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 n...

  18. Neuromodulation of cerebral blood flow

    NARCIS (Netherlands)

    ter Laan, Mark

    2014-01-01

    Dit proefschrift behandelt de modulatie van de cerebrale doorbloeding (cerebral blood flow, CBF) door cervicale elektrische stimulatie en de aanname dat het sympathisch zenuwstelsel hierin een specifieke rol speelt. Enkele resultaten met cervicale ruggenmergsstimulatie (spinal cord stimulation, SCS)

  19. 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)

  20. Learn More About Cerebral Palsy

    Centers for Disease Control (CDC) Podcasts

    2008-03-30

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

  1. Parálisis cerebral :

    OpenAIRE

    Giral Lamenca, Mónica

    2015-01-01

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

  2. 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.).

  3. Cerebral oedema in episodic ataxia.

    Science.gov (United States)

    Crevits, L; Cambron, M; Anseeuw, S

    2009-03-01

    We report a patient with episodic ataxia (presumably of type 2) who developed cerebral oedema secondary to a common infection (presumably viral). Cerebral oedema may be a part of the clinical spectrum of familial episodic ataxia and argues for an overlap with hemiplegic migraine. It is suggested to consider a diagnosis of episodic ataxia or familial hemiplegic migraine in catastrophic reactions to apparent trivial trauma or infection.

  4. Sustainability and long-term effectiveness of the WHO surgical safety checklist combined with pulse oximetry in a resource-limited setting: two-year update from Moldova.

    Science.gov (United States)

    Kim, Rebecca Y; Kwakye, Gifty; Kwok, Alvin C; Baltaga, Ruslan; Ciobanu, Gheorghe; Merry, Alan F; Funk, Luke M; Lipsitz, Stuart R; Gawande, Atul A; Berry, William R; Haynes, Alex B

    2015-05-01

    Little is known about the sustainability and long-term effect of surgical safety checklists when implemented in resource-limited settings. A previous study demonstrated the marked, short-term effect of a structured hospital-wide implementation of a surgical safety checklist in Moldova, a lower-middle-income country, as have studies in other low-resource settings. To assess the long-term reduction in perioperative harm following the introduction of a checklist-based surgical quality improvement program in a resource-limited setting and to understand the long-term effects of such programs. Twenty months after the initial implementation of a surgical safety checklist and the provision of pulse oximetry at a referral hospital in Moldova, a lower-middle-income, resource-limited country in Eastern Europe, we conducted a prospective study of perioperative care and outcomes of 637 consecutive patients undergoing noncardiac surgery (the long-term follow-up group), and we compared the findings with those from 2106 patients who underwent surgery shortly after implementation (the short-term follow-up group). Preintervention data were collected from March to July 2010. Data collection during the short-term follow-up period was performed from October 2010 to January 2011, beginning 1 month after the implementation of the launch period. Data collection during the long-term follow-up period took place from May 25 to July 6, 2012, beginning 20 months after the initial intervention. The primary end points of interest were surgical morbidity (ie, the complication rate), adherence to safety process measures, and frequency of hypoxemia. Between the short- and long-term follow-up groups, the complication rate decreased 30.7% (P = .03). Surgical site infections decreased 40.4% (P = .05). The mean (SD) rate of completion of the checklist items increased from 88% (14%) in the short-term follow-up group to 92% (11%) in the long-term follow-up group (P rate of hypoxemic events

  5. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

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

    2014-12-01

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

  6. 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 (pDragon's blood dropping pills had protective effects on focal cerebral ischemia rats.

  7. 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.

  8. 奇异值分解法用于MR灌注成像脑血流量估计的仿真研究%A Simulation Study on Singular Value Decomposition to Estimate the Cerebral Blood Flow in MR Perfusion Imaging

    Institute of Scientific and Technical Information of China (English)

    马栋敏; 李颖; 彭川; 郭延庆; 郭磊; 何任杰; 饶利芸

    2011-01-01

    MR脑灌注成像是MR方法中提供代谢能力度量的唯一途径,对于疾病诊断和治疗效果评估有重要意义.MR灌注成像灌注参数的确定本质上是一个逆问题的求解过程,对一种求逆估计方法一奇异值分解法的逆问题性质进行了研究.在对奇异值分解法进行理论推导后,设计仿真方案,分别针对不同的信噪比进行仿真实验,并对动脉输入函数的延迟与失真进行分析.结果表明,在信噪比分别为150和10时,奇异值分解法都可以有效地估计脑血流量.该方法对动脉输入函数的失真不敏感,但是发生动脉输入函数延迟时,高脑血流量会被低估20% ~ 30%.针对这一情况,对动脉输入函数的延迟效应进行了修正,修正后低估程度减小到±5%,得以明显改善.仿真结果表明,奇异值分解法是一种有效的估计MR灌注成像脑血流量的方法.%MR perfusion imaging provides the unique approach to measure the metabolic capacity of brain, which is important in diagnosing the disease as well as assessing the treatment. The retrieve of perfusion parameters from MR perfusion imaging of brain is typically a process of inverse problem. In this paper, singular value decomposition ( SVD ) is advocated as a solver for the inverse problem, and the SVD technique for estimating the cerebral blood flow ( CBF) is elaborated in short. Simulation schemes are designed towards revealing the properties of the inverse problem, namely the effects of signal-noise ratio, arterial input function (AIF) delay and distortion. Our simulation experiments show that the SVD technique is able to precisely reproduce flows when SNR equals to 150 or 10 respectively. The solution of SVD technique is found to be stable in the presence of the AIF distortion. However, the SVD technique is sensitive to the effect of AIF delay, where the high CBFs are underestimated about 20% ~ 30% . Hence therefore a delay correction method is developed and the

  9. Predictive value of crawling ability for prognostication of the functional amelioration of children with cerebral palsy after selective posterior rehizotomy%脑性瘫痪患儿术前爬行能力与选择性脊神经后根切断术后下肢功能改善的相关分析

    Institute of Scientific and Technical Information of China (English)

    易斌; 徐林; 洪毅; 俞兴; 王兵

    2001-01-01

    目的分析术前爬行能力与术后下肢功能特别是独立行走能力的关联。方法以量化功能的方式评估选择性脊神经后根切断术后下肢功能。将爬行功能分为A~D4个等级,同时将下肢功能分别量化,观察各级患儿手术前、后的功能变化,并统计分析术前、后的功能差异。结果术后肌张力明显降低,下肢各项功能显著改善;术前爬行能力良好的患儿术后下肢各项功能与独立行走与爬行能力差的患者有显著性差异。结论术前爬行能力对判断手术预后具有参考价值。%Objective To evaluate the value of crawling ability as predictor of walking postoperatively.Methods To observe the function of lower limbs with quantitative functional measurement,and analyze the relation between walk ability after SPR and preoperative crawling stage. Results Muscle tone was significantly decreased,and the development of function of lower limbs was obviously.The achievement was continuously in 1 year and 2 year follow up group.The ability of crawling was closely related with walk ability after SPR. Conclusion SPR decreases spasticity and increases lower estremity range of motion in children with cerebral palsy and appears to be associated with functional improvements.The ability of crawling is a predictive reference of ability to walk after selective posterior rhizotomy.

  10. T2’-Imaging to Assess Cerebral Oxygen Extraction Fraction in Carotid Occlusive Disease: Influence of Cerebral Autoregulation and Cerebral Blood Volume

    Science.gov (United States)

    Deichmann, Ralf; Pfeilschifter, Waltraud; Hattingen, Elke; Singer, Oliver C.; Wagner, Marlies

    2016-01-01

    Purpose Quantitative T2'-mapping detects regional changes of the relation of oxygenated and deoxygenated hemoglobin (Hb) by using their different magnetic properties in gradient echo imaging and might therefore be a surrogate marker of increased oxygen extraction fraction (OEF) in cerebral hypoperfusion. Since elevations of cerebral blood volume (CBV) with consecutive accumulation of Hb might also increase the fraction of deoxygenated Hb and, through this, decrease the T2’-values in these patients we evaluated the relationship between T2’-values and CBV in patients with unilateral high-grade large-artery stenosis. Materials and Methods Data from 16 patients (13 male, 3 female; mean age 53 years) with unilateral symptomatic or asymptomatic high-grade internal carotid artery (ICA) or middle cerebral artery (MCA) stenosis/occlusion were analyzed. MRI included perfusion-weighted imaging and high-resolution T2’-mapping. Representative relative (r)CBV-values were analyzed in areas of decreased T2’ with different degrees of perfusion delay and compared to corresponding contralateral areas. Results No significant elevations in cerebral rCBV were detected within areas with significantly decreased T2’-values. In contrast, rCBV was significantly decreased (pperfusion delay and decreased T2’. Furthermore, no significant correlation between T2’- and rCBV-values was found. Conclusions rCBV is not significantly increased in areas of decreased T2’ and in areas of restricted perfusion in patients with unilateral high-grade stenosis. Therefore, T2’ should only be influenced by changes of oxygen metabolism, regarding our patient collective especially by an increase of the OEF. T2’-mapping is suitable to detect altered oxygen consumption in chronic cerebrovascular disease. PMID:27560515

  11. Cerebral edema associated with acute hepatic failure.

    Directory of Open Access Journals (Sweden)

    Fujiwara,Masachika

    1985-02-01

    Full Text Available 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 frequently in patients later found to have cerebral edema. Moreover, the length of time from deep coma to death was much shorter in the brain edema cases with cerebral herniation than without herniation.

  12. 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

    2017-06-20

    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.

  13. 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.

  14. 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.

  15. Cerebral palsy update.

    Science.gov (United States)

    Krägeloh-Mann, Ingeborg; Cans, Christine

    2009-08-01

    A common language on CP has been developed for the European registers by the SCPE (Surveillance of Cerebral Palsy in Europe) working group and the common database allows prevalence analyses on a larger basis. CP prevalence increases with lower birthweight and higher immaturity. Increase of survival after preterm birth has first also increased CP rates. But already in the 80s this trend was reversed for LBW infants, and in the 90 s also for VLBW or very immature infants. The outcome with respect to CP in the group of extremely LBW or immature infants remains a matter of specific concern, as prevalence seems to be rather stable on a high level. CP is caused in more than 80% by brain lesions or maldevelopments which can be attributed to different timing periods of the developing brain. Extent and topography determine the clinical subtype of CP and are related also to the presence and severity of associated disabilities. CP, thus, offers a model to study plasticity of the developing brain. Reorganisation following unilateral lesions is mainly interhemispheric and homotopic. In the motor system, it involves the recruitment of ipsilateral tracts; functionality seems to be limited and decreases already towards the end of gestation. There is no clear evidence for substantial reorganisation in the sensory system. The best compensatory potential is described concerning language function following left hemispheric lesions. Language function reorganized to the right hemisphere eventually seems not to be impaired, this occurs, however, on the expense of primary right hemispheric functions.

  16. Predictive value of magnetic resonance diffusion tensor imaging in motor function of patients with tumors in the motor areas of cerebral cortex after surgery on the hemiplegic limbs%DTI对脑皮质运动区肿瘤患者偏瘫肢体术后运动功能的预测价值

    Institute of Scientific and Technical Information of China (English)

    赵琳; 王守森; 黄银兴; 周晓平

    2012-01-01

    Objective To discuss the predictive value of magnetic resonance diffusion tensor imaging (MR-DTI) in motor function of patients with tumors in the motor areas of cerebral cortex after surgery on the hemiplegic limbs. Methods Twenty patients with tumors in the motor areas of cerebral cortex,admitted to our hospital from March 2009 to January 2011,were recruited in our study; all these patients underwent MR-DTI and motor function of the hemiplegic limbs was evaluated with Brunnstrom scale before and after the surgery.According to the results of DTI test,the injured corticospinal tract (CST) was divided into 4 grades:type Ⅰ (CST integrity),type Ⅱ (CST integrity with mild compression),type Ⅲ (CST partial disruption) and type Ⅳ (CST mostly/completely disruption).The correlations between the CST damaged level and motor function of the hemiplegic limbs before and after surgery were analyzed. Results FA values ofipsilateral brain parenchyma (0.387±0.012) were statistically lower than those of the contralateral normal brain tissue (0.498±0.015,P<0.05).No significant differences on CST damaged level and motor function of the hemiplegic limbs were noted between before and after surgery (P>0.05).CST damaged level and motor function of the hemiplegic limbs had a negative correlation (P<0.05).Motor function of the hemiplegic limbs and CST damaged level before the surgery and 6 months after the surgery had a significantly negative correlation (before the surgery:r=-0.901,P=0.000; after the surgery:r=-0.912,P=0.000). Conclusion DTI can display damaged level of the tumors in the motor area of cerebral cortex and reflect the motor function of the hemiplegic limbs after the surgery.%目的 探讨磁共振(MRI)弥散张量成像(DTI)对脑皮质运动区肿瘤患者偏瘫肢体术后运动功能的评估价值. 方法 南京军区福州总医院神经外科自2009年3月至2011年1月共收治脑皮质运动区肿瘤患者20例,手术前后均行DTI检查并应

  17. The Value of ultrasonography in pregnancy a severe thalassemia fetal middle cerebral artery in prenatal diagnosis%怀孕中期应用彩超检测120例 a 型重度地中海贫血胎儿大脑中动脉的临床研究

    Institute of Scientific and Technical Information of China (English)

    叶菀华; 徐婉芳; 林洋洋

    2015-01-01

    Objective To analyze and study the value of the mid-pregnancy ultrasound detected a line of severe thalassemia fetal middle cerebral artery in prenatal diagnosis.Methods Since January 2012 to September 2014 in our hospital as a result of both spouses thalassemia line villus sampling or amniocentesis diagnostic examination of 240 cases of pregnant women,fetuses of pregnant women test group were confirmed by villus sampling inspection or amniocentesis is a confirmed diagnosis of thalassemia,a control group of pregnant women do not carry a fetus thalassemia gene,the fetus is normal.Research object villus sampling or amniocentesis to check whether they carry a diagnosis of fetal thalassemia gene;at the same time ultrasonography to measure the fetal middle cerebral artery peak systolic velocity.Results The experimental group,a moderate to severe thalassemia 59 cases (49.17%),10 cases of thalassemia a moderate groups (8.33%),a mild thalassemia 51 cases (42.50%);120 cases in the control group (100.00%)no a thalassemia. A test group with moderate to severe thalassemia MCA -PSV was significantly higher,with statistical significance as well as with other types of control group,the difference between the experimental group,(P <0.05).Conclusion In mid-pregnancy ultrasound examina-tion performed fetal middle cerebral artery,the diagnosis of a severe thalassemia has a high diagnostic value,and the detection method is fast,safe,reliable,economical and practical.%目的:分析并研究怀孕中期行彩超检测 a 型重度地中海贫血胎儿大脑中动脉在产前诊断中的价值。方法:选取夫妻双方为 a 型地中海贫血行绒毛采样检查或羊膜腔穿刺术诊断的孕妇240例,每组120例。试验组孕妇的胎儿均经绒毛采样检查或羊膜腔穿刺术诊断确诊为 a 型地中海贫血;对照组孕妇的胎儿不携带 a 型地中海贫血基因,胎儿正常。对研究对象进行绒毛采样检查或羊膜腔穿

  18. 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.

  19. Value of interictal/ictal single photon emission computed tomography regional cerebral blood flow imaging in localization of epileptic foci%发作间期/发作期SPECT rCBF显像在癫痫灶定位诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    杨雅娜; 罗焱; 胡云; 苏红媛; 杨辉; 张青

    2012-01-01

    Objective To study the value of interictal/ictal single photon emission computed tomography (SPECT) regional cerebral blood flow (rCBF) imaging in localization of epileptic foci. Methods Interictal/ictal SPECT, EEG, VEEG, CT or MRI, and ECoG of 115 epilepsy patients, who underwent operation in Department of Neurosurgery, Xinqiao Hospital, Third Military Medical University, were retrospectively analyzed and compared. Results The positive detection rate of interictal/ictal SPECT for epilepsy was higher than that of EEG, VEEG, CT and MRI (90.4% va 37.4% , 82.6% , 48. 8% and 54.2% , P <0.05). The localization rate of interictal/ictal SPECT for epileptic foci was higher than that of ECoG (91. 3% vs 71. 2% , P<0.05). Conclusion The interictal/ictal SPECT is highly consistent with ECoG in localization of epileptic foci, thus playing an important role in preoperative localization of epilepsy.%目的 探讨发作间期/发作期SPECT局部脑血流灌注显像(regional cerebral blood flow,rCBF)在癫痫术前定位诊断中的价值.方法 回顾性分析第三军医大学新桥医院神经外科行外科手术治疗的115例癫痫患者,术前分别行发作间期/发作期SPECT显像、常规脑电图(electroencephalogram,EEG)、视频脑电图(vedio-EEC,VEEG)、CT或MRI检查,术中行皮层脑电图(electrocorticogram,ECoG)监测,与发作间期/发作期SPECT、EEG、VEEG、CT和MRI检查结果进行比较分析.结果 发作间期/发作期SPECT检出癫痫的阳性率为90.4%,高于EEG的37.4% (P <0.05)、VEEG的82.6%(P>0.05)、CT的48.8% (P <0.05)和MRI的54.2% (P <0.05).与术中ECoG结果比较,发作间期/发作期SPECT对癫痫灶定侧率为91.3%,定位率为71.2%.结论 术前发作间期/发作期SPECT显像与ECoG在癫痫灶定位诊断上具有较高的一致性,在术前综合定位诊断中具有重要意义.

  20. Transcutaneous oximetry but not arterial toe blood pressure or ankle-brachial index is related to macular thickness in patients with chronic diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Per Katzman

    2013-04-01

    Full Text Available Objectives: Diabetes related vascular complications of the lower extremity could be classified as micro- and macrovascular. Ankle-brachial index (ABI and toe blood pressure (TBP measurements evaluate macro-circulation, whereas transcutaneous oximetry (TcPO2 is considered to be a composite measure of vascular function, thereby also reflecting microcirculation. Microvascular disease in the eye involves abnormal capillary permeability and possibly thereby increased macular thickness. The aim of the present clinical study was to evaluate if microvascular disease in the eye was related to measures of foot ischemia in patients with diabetes mellitus. Methods: Twenty consecutive patients with diabetes and chronic full-thickness foot ulcers were included. Peripheral ischemia was diagnosed using TcPO2, TBP and ABI. Macular thickness was measured with optical coherence tomography technique. Results: Based on TcPO2, TBP and ABI measurements 14, 13 and 13 patients, respectively, were classified as ischemic. Patients with ischemic TcPO2 levels at the dorsum of the foot had significantly higher macular thicknesses. This was not the case in patients with ischemic TBP or ABI levels. Conclusion: TcPO2, unlike TBP and ABI, seems to be a clinically relevant measure of peripheral microvascular disease in patients with diabetes mellitus and may, if low, indicate an increased risk of macular edema. [J Exp Integr Med 2013; 3(2.000: 81-85

  1. Arterial input function of an optical tracer for dynamic contrast enhanced imaging can be determined from pulse oximetry oxygen saturation measurements

    Science.gov (United States)

    Elliott, Jonathan T.; Wright, Eric A.; Tichauer, Kenneth M.; Diop, Mamadou; Morrison, Laura B.; Pogue, Brian W.; Lee, Ting-Yim; St. Lawrence, Keith

    2012-12-01

    In many cases, kinetic modeling requires that the arterial input function (AIF)—the time-dependent arterial concentration of a tracer—be characterized. A straightforward method to measure the AIF of red and near-infrared optical dyes (e.g., indocyanine green) using a pulse oximeter is presented. The method is motivated by the ubiquity of pulse oximeters used in both preclinical and clinical applications, as well as the gap in currently available technologies to measure AIFs in small animals. The method is based on quantifying the interference that is observed in the derived arterial oxygen saturation (SaO2) following a bolus injection of a light-absorbing dye. In other words, the change in SaO2 can be converted into dye concentration knowing the chromophore-specific extinction coefficients, the true arterial oxygen saturation, and total hemoglobin concentration. A simple error analysis was performed to highlight potential limitations of the approach, and a validation of the method was conducted in rabbits by comparing the pulse oximetry method with the AIF acquired using a pulse dye densitometer. Considering that determining the AIF is required for performing quantitative tracer kinetics, this method provides a flexible tool for measuring the arterial dye concentration that could be used in a variety of applications.

  2. Neurophysiologic findings in children with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Ruchi Kothari

    2010-01-01

    Full Text Available Context : Cerebral palsy (CP is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture caused by chronic brain injuries. It is the most common cause of physical disability in childhood; spastic cerebral palsy being the most prevalent of its various forms. There is scanty information about the neurophysiologic investigations in children diagnosed as having spastic CP. Aims : The aim of the study was to investigate the relationship between abnormal VEP and BAEP findings with different clinical parameters in children with spastic cerebral palsy. Materials and Methods : Fifteen children with spastic CP in the age range 4 months to 10 years participated in this study. Evaluation of VEPs, brainstem evoked potentials (BAEPs were performed in all study patients as well as 35 healthy children as controls. The study was conducted after obtaining ethics committee approval and informed consent of parents. Statistical Analysis Used : Significance of difference in the mean values of different parameters in different groups was assessed by Student′s "t" test and the P value <0.05 was considered to be significant. All the values were expressed as mean ± 1 Std. Deviation. Results : A significant difference was found in the VEP latencies and amplitude between the subjects with CP and controls. Striking BAEP abnormalities in CP patients include prolongation of absolute latency of wave V, interpeak latencies of III-V and lowered I-V ratio. Abnormal VEPs and BAEPs in children with bilateral spastic cerebral palsy demonstrated a correlation with the presence of moderate to severe developmental delay. Conclusions : The differences in VEPs and BAEPs were determined between CP children and healthy children. The abnormalities found are probably linked to the neurological deficits present in cases of cerebral palsy.

  3. Middle cerebral artery blood velocity during rowing

    DEFF Research Database (Denmark)

    Secher, Niels Henry; Pott, F; Knudsen, L.;

    1997-01-01

    original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler......original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler...

  4. 11 Things to Know about Cerebral Palsy

    Science.gov (United States)

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

  5. 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....

  6. 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.

  7. Cerebral venous thrombosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  8. Neuronal autophagy in cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Feng Xu; Jin-Hua Gu; Zheng-Hong Qin

    2012-01-01

    Autophagy has evolved as a conserved process for the bulk degradation and recycling of cytosolic components,such as long-lived proteins and organelles.In neurons,autophagy is important for homeostasis and protein quality control and is maintained at relatively low levels under normal conditions,while it is upregulated in response to pathophysiological conditions,such as cerebral ischemic injury.However,the role of autophagy is more complex.It depends on age or brain maturity,region,severity of insult,and the stage of ischemia.Whether autophagy plays a beneficial or a detrimental role in cerebral ischemia depends on various pathological conditions.In this review,we elucidate the role of neuronal autophagy in cerebral ischemia.

  9. Assessment of maternal cerebral blood flow in patients with preeclampsia

    Directory of Open Access Journals (Sweden)

    Mandić Vesna

    2005-01-01

    Full Text Available Introduction Systemic vasoconstrktion 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 beginning of eclamptic attack and 3 the application of anticonvidsive therapy. Material and methods 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 p < 0.05. Results Significantly increased Pi, Ri and all velocities were established in the group of patients with severe preeclampsia compared with the other two groups. In the group with severe preeclamsia we registrated significantly increased values of all velocities (patients with signs of threatening eclampsia. After MgSO4 treatment in patients with severe preeclampsia significantly decreased values of Pi, Ri, S/D ratio and all velocities were registered. Discussion In the studied group of patients with severe preclampsia we found increased velocity values, Pi and Ri, especially in

  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. 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…

  12. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-08-01

    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.

  13. 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…

  14. 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.

  15. 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....... The population analyzed was retrieved from the Danish Cerebral Palsy Register, which covers the eastern part of the country and has registered about half of the Danish population of individuals with CP since 1950. For this study we analyzed 2367 individuals with CP, who were born in 1930 to 2000 and were alive...

  16. Value of serum phosphopyruvate hydratase protein for the diagnosis of cerebral injuries in patients with brain malignant tumor%血清磷酸丙酮酸水合酶检测在颅内恶性肿瘤患者放射性脑损伤诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    杜丽莉; 韩存芝; 荆结线; 赵先文; 田保国

    2012-01-01

    Objective To study the value of serum phosphopyruvate hydratase PH protein for the diagnosis of cerebral injuries in patients with brain malignant tumor.Methods Serum PH protein levels were detected by enzyme-linked immunosorbent assay in 56 patients with brain malignant tumor. Compare the differences among the status of cerebral injuries.And compare the differences among the patients with general with different radiotherapy methods 32 cases,three dimensional conformal radiothrapy 24 cases,and different peritumoral brain edema levels (cmild 18 cases, moderate ao cases severe 30 cases). Results Before radiotherapy the levels of serum PH protein in patients and the health control were (4.12±0.56),(4.66±0.62)μg/L,no significant differece(P>0.05).And there was also no significant difference between the before and after radiotherapy for the cerebroma,the levels were(7.84±0.72) μg/L,(t=3.89,P=0.001 ).The PH levels of general radiation therapy and three dimensional comformal radiotherapy were (13.59±0.92),(6.14±0.52)μg/L.There was cignificant difference(P=0.002) After radiotherapy,The levels of serum PH protein of the different dropsical degree,mild,moderate and severe were(4.47:±0.55),(6.17±0.62),(15.21±0.86) μg/L, respectively,showing significant difference (F=15.61,P=0.0001). The therapies influenced the serum PH levels (P<0.05)Conclusion High levels of serum PH protein are associated with severe cerebral injuries in brain malignant tumor.So high serum PH level may serve as an progressive predictor of the injury.%目的 研究血清磷酸丙酮酸水合酶(PH)在颅内恶性肿瘤患者放射性脑损伤早期诊断中的作用.方法 采用酶联免疫吸附试验检测56例颅内恶性肿瘤患者(脑转移瘤26例,脑肿瘤30例)在接受放射性治疗前、后的血清PH水平,比较其差异.同时比较颅内恶性肿瘤患者不同放疗方案(普通放疗组32例,三维适形放疗组24例)、瘤周水肿程度(轻度18例,中度20例,重度18

  17. A study on the values of color doppler ultrasonography in testing middle cerebral artery of fetuses from pregnant patients with pre-eclampsia%彩色多普勒超声检测子痫前期患者胎儿大脑中动脉的价值

    Institute of Scientific and Technical Information of China (English)

    和家旭

    2014-01-01

    Objective To study the principle of hemodynamic changes of middle cerebral artery(MCA) of fetuses of 32-34 weeks from pregnant patients with pre-eclampsia, and to explore its value in predicting small for gestational age fetuses. Methods Healthy fetuses of 32-34 weeks and fetuses from pregnant patients with pregnancy-induced hypertension were tested via color Doppler ultrasonography to test the pulse index(PI), resistance index(RI) and S/D ratio of MCA, and calculate the average values of MCA-PI, MCA-RI and MCA-S/D ratio; the weights of fetuses were calculated by measuring BPD,FL,HC,AC values, and related analysis was carried out. Results The values of MCA-PI, MCA-RI and MCA-S/D ratio in the group of mild pre-eclampsia(P 0.05). Conclusion The MCA of fetuses from pregnant women with pre-eclampsia shows significant hemodynamic changes, which is worthy of predicting small for gestational age fetuses.%目的:研究妊娠期子痫前期患者32~34周胎儿大脑中动脉(MCA)的血流动力学变化规律,探讨其在预测小于孕龄儿的价值。方法对孕32~34周正常胎儿和妊娠期高血压疾病胎儿应用彩色多普勒超声检测大脑中动脉的搏动指数(PI)、阻力指数(RI)、收缩期/舒张期比值(S/D),计算MCA-PI、MCA-RI、MCA-S/D的比值,均取平均值;通过测量BPD、FL、AC、HC等计算胎儿体重,进行相关分析。结果MCA-PI与MCA-RI、MCA-S/D值在轻度子痫前期(P<0.05)、重度子痫前期(P<0.01)与正常组比较差异有显著性。在轻度子痫前期组与正常组比较差异无显著性(P>0.05)。结论孕妇子痫前期胎儿MCA的血流动力学指标有明显变化,对预测小于孕龄儿具有一定实用价值。

  18. Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals.

    Science.gov (United States)

    Gregg, Nicholas M; Kim, Albert E; Gurol, M Edip; Lopez, Oscar L; Aizenstein, Howard J; Price, Julie C; Mathis, Chester A; James, Jeffrey A; Snitz, Beth E; Cohen, Ann D; Kamboh, M Ilyas; Minhas, Davneet; Weissfeld, Lisa A; Tamburo, Erica L; Klunk, William E

    2015-09-01

    Cerebral microbleeds (CMBs) are collections of blood breakdown products that are a common incidental finding in magnetic resonance imaging of elderly individuals. Cerebral microbleeds are associated with cognitive deficits, but the mechanism is unclear. Studies show that individuals with CMBs related to symptomatic cerebral amyloid angiopathy have abnormal vascular reactivity and cerebral blood flow (CBF), but, to our knowledge, abnormalities in cerebral blood flow have not been reported for healthy individuals with incidental CMBs. To evaluate the association of incidental CMBs with resting-state CBF, cerebral metabolism, cerebrovascular disease, β-amyloid (Aβ), and cognition. A cross-sectional study of 55 cognitively normal individuals with a mean (SD) age of 86.8 (2.7) years was conducted from May 1, 2010, to May 1, 2013, in an academic medical center in Pittsburgh; data analysis was performed between June 10, 2013, and April 9, 2015. 3-Tesla magnetic resonance imaging was performed with susceptibility-weighted imaging or gradient-recalled echo to assess CMBs, arterial spin labeling for CBF, and T1- and T2-weighted imaging for atrophy, white matter hyperintensities, and infarcts. Positron emission tomography was conducted with fluorodeoxyglucose to measure cerebral metabolism and Pittsburgh compound B for fibrillar Aβ. Neuropsychological evaluation, including the Clinical Dementia Rating scale, was performed. Magnetic resonance images were rated for the presence and location of CMBs. Lobar CMBs were subclassified as cortical or subcortical. Measurements of CBF, metabolism, and Aβ were compared with the presence and number of CMBs with voxelwise and region-of-interest analyses. The presence of cortical CMBs was associated with significantly reduced CBF in multiple regions on voxelwise and region-of-interest analyses (percentage difference in global CBF, -25.3%; P = .0003), with the largest reductions in the parietal cortex (-37.6%; P CMBs showed a

  19. 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.

  20. 脑瘫儿童选择性脊神经后根切断术术前爬行能力与术后下肢功能改善的关联分析%Predictive value of crawling ability for prognostication of the functional amelioration of children with cerebral palsy after selective posterior rhizotomy

    Institute of Scientific and Technical Information of China (English)

    易斌; 徐林; 洪毅; 俞兴; 王兵; 郑大滨

    2001-01-01

    Objective: To investigate functional changes of lower extremities after selective posterior rhizotomy, and to evaluate the value of crawling ability as a predictor of walking postoperatively. Method: To observe the function of lower limbs with quantitative functional measurement, and analyze the relation between walk ability after SPR and preoperative crawling stage. Result: (1)Muscle tone was significantly decreased, and the development of function of lower limbs was obvious. (2) The achievement was progressing in 1-year and 2-year follow-up groups. ( 3 ) The ability of crawling was closely related with walk ability after SPR. Conclusion:SPR decreases spasticity and increases lower extremity range of motion in children with cerebral palsy and appears to be associated with functional improvements. The ability of crawling is a predictive reference of ability to walk after selective posterior rhizotomy.%目的:分析术前爬行能力与术后下肢功能,特别是独立行走能力的关系。方法:以量化功能的方式评估选择性脊神经后根切断术(SPR)后下肢功能,将爬行功能分为A-D 4个等级,同时将下肢功能分别量化,观察各级患儿手术前、后的功能变化,并统计分析手术前、后功能差异。结果:脑瘫患者SPR术后肌张力明显降低,下肢各项功能显著改善;术前爬行能力良好的患儿术后下肢各项功能及独立行走与爬行能力差的患者有显著性差异。结论:术前评估爬行能力对判断手术预后具有参考价值。

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

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Kreiner, Svend

    2002-01-01

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

  2. Changes and clinical value of heart-type fatty acid binding protein in patients with acute hypertensive cerebral hemorrhage%急性高血压脑出血患者血清h-FABP水平变化及其临床应用价值

    Institute of Scientific and Technical Information of China (English)

    杨文东

    2012-01-01

    目的 通过观察急性高血压脑出血患者血清心脏型脂肪酸结合蛋白(h-FABP)水平变化,探讨其临床检测价值.方法 血清h-FABP采用双抗体夹心酶联免疫一步法定量检测;cTnI采用固相酶联免疫吸附实验(ELISA);CK-MB采用免疫抑制法测定HT5"H〗结果 急性高血压脑出血患者组血清h-FABP水平显著高于对照组(P<0.01),大量出血者及意识不清者血清h-FABP水平分别显著高于小量出血者及意识清醒者(P<0.01);血清h-FABP阳性率显著高于血清cTnI、CK-MB及心电图的阳性率(P<0.01);死亡率为25.5%(28/110),血清h-FABP、cTnI、CK-MB及心电图异常组的死亡率显著高于正常组(P<0.01);血清h-FABP预测发生死亡具有高的敏感性和阴性预测值,特异性和准确度较低,但心电图具有较高的特异性(64.5%)和准确度(69.1%).结论 血清h-FABP定量测定可作为判断急性高血压脑出血病情轻重及评价发生意外的1项客观指标,联合心电图监测临床价值更高.%Objective To understand the clinical value of heart-type fatty acid binding protein (h-FABP) in patients with acute hypertensive cerebral hemorrhage(AHCE) through the variation analysis of its serum level. Methods Serum level of h-FABP was determined by enzyme-linked immunosorbent one-step quantitative detection, cardiac troponin I(cTnl) was detected by solid-phase enzyme-linked immunosorbent assay (ELISA) and isoenzyme MB of creatine kinase(CK-MB) was assayed by immunosuppression assay. Results The h-FABP level in(AHCE) group was significantly higher than healthy control group(P<0. 01) and that in AHCE patients with massive haemorrhage and unconsciousness was significantly higher than in patients with small heamorrhage and consciousness. The positive rate of h-FABP was significantly higher than cTnI,CK-MB and electrocardiogram(P<0. 01). The mortality rate in patients, with abnormality of serum level of h-FABP,cTnl and CK-MB and ECG, was higher than patients

  3. 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.

  4. 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.

  5. 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)

  6. Sirt1 in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Kevin B Koronowski

    2015-01-01

    Full Text Available Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD +-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer′s Disease, Parkinson′s Disease, and Huntington′s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance.

  7. Pathogenesis of cerebral amyloid angiopathy.

    NARCIS (Netherlands)

    Rensink, A.A.M.; Waal, R.M.W. de; Kremer, H.P.H.; Verbeek, M.M.

    2003-01-01

    Cerebral amyloid angiopathy (CAA) is the result of the deposition of an amyloidogenic protein in cortical and leptomeningeal vessels. The most common type of CAA is caused by amyloid beta-protein (Abeta), which is particularly associated with Alzheimer's disease (AD). Excessive Abeta-CAA formation c

  8. Sirt1 in cerebral ischemia

    Science.gov (United States)

    Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2015-01-01

    Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD+)-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer’s Disease, Parkinson’s Disease, and Huntington’s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance. PMID:26819971

  9. Embodying Investigations of Cerebral Palsy

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke

    The main question of Kristian Martiny’s dissertation is: how do we help persons living with the brain damage, cerebral palsy (CP)? This question is as complex and difficult to answer as any healthcare question. Martiny argues that we need to ‘open up’ how we do ( cognitive ) science in order...

  10. Cerebral blood-flow tomography

    DEFF Research Database (Denmark)

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

    1983-01-01

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

  11. Graft selection in cerebral revascularization.

    Science.gov (United States)

    Baaj, Ali A; Agazzi, Siviero; van Loveren, Harry

    2009-05-01

    Cerebral revascularization constitutes an important treatment modality in the management of complex aneurysms, carotid occlusion, tumor, and moyamoya disease. Graft selection is a critical step in the planning of revascularization surgery, and depends on an understanding of graft and regional hemodynamics, accessibility, and patency rates. The goal of this review is to highlight some of these properties.

  12. Cerebral edema in drug addicts

    Directory of Open Access Journals (Sweden)

    Daruši Dragana J.

    2014-01-01

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

  13. [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.

  14. 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...... haemodynamics' includes cerebral blood flow (CBF), cerebral blood flow velocity, and cerebral blood volume (CBV). Therapy aimed at changing vascular anatomy is not available. Therefore, prevention of disturbances in CBF and CBV is pivotal. However, continuous monitoring of CBF and CBV is still unavailable...... for clinical use. Tissue oxygenation may be used as a surrogate for CBF, although precision is still questionable. General knowledge of the regulation of CBF and CBV is important. Although this knowledge is still incomplete, especially regarding autoregulation and the exact role of CBV, it is still useful...

  15. [Mesoglycan in acute focal cerebral ischemia].

    Science.gov (United States)

    Cazzato, G; Zorzon, M; Masé, G; Antonutti, L; Iona, L G

    1989-01-01

    An open, randomized, controlled study including 57 patients with acute cerebral infarct was performed. All the patients, followed and controlled by the same examiner, received, in the first ten days, 24 mg/die i.v. of dexamethasone. 28 patients were also treated with mesoglycan (150 mg/die i.m. for five days and 144 mg/die per os for a further twenty-five days). The differences between the basal and final scores in the mesoglycan group and in the controls were not statistically significant as analysed by the Mann-Whitney U test. The mesoglycan influenced only slightly the laboratory values (PT, PTT, alkaline phosphatase, GOT, GPT, cholesterol and triglycerides, fibrinogen, blood glucose, azotemia and creatinine) performed before the beginning of the treatment, as their changes after thirty days of therapy were in the normal range. The mesoglycan was very well tolerated and no side-effects were observed during the treatment.

  16. Perioperative cerebral ischaemia in cardiac surgery and BIS.

    Science.gov (United States)

    Villacorta, J; Kerbaul, F; Collart, F; Guidon, C; Bonnet, M; Guillen, J C; Gouin, F

    2005-08-01

    A 46-year-old woman was monitored by bispectral index monitoring (BIS) during redo aortic and mitral valve replacement. On release of the aortic cross clamp there was a sudden, severe, unexplained, and sustained fall in the BIS value. Postoperatively, a CT scan was consistent with multiple ischaemic lesions. The lesions were presumed to be due to air embolism. This case suggests that a sudden unexplained and persistent fall in BIS may indicate cerebral ischaemia.

  17. 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

  18. Values Research

    Science.gov (United States)

    2009-10-01

    horizontal vs. vertical. • According to the theory of Planned Behavior ( Ajzen , 1988, 2002) attitude, subjective norms and perceived 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...attitudes with social structure. 4 Defining Human Values • According to Parsons (Parsons & Shils, 1951), values instigate behavior . • In line

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

    Science.gov (United States)

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

    2016-09-01

    Blood-brain barrier permeability is not routinely evaluated in the clinical setting. Global cerebral edema occurs after SAH and is associated with BBB disruption. Detection of global cerebral edema using current imaging techniques is challenging. Our purpose was to apply blood-brain barrier permeability imaging in patients with global cerebral edema by using extended CT perfusion. Patients with SAH underwent CTP in the early phase after aneurysmal rupture (days 0-3) and were classified as having global cerebral edema or nonglobal cerebral edema using established noncontrast CT criteria. CTP data were postprocessed into blood-brain barrier permeability quantitative maps of PS (permeability surface-area product), K(trans) (volume transfer constant from blood plasma to extravascular extracellular space), Kep (washout rate constant of the contrast agent from extravascular extracellular space to intravascular space), VE (extravascular extracellular space volume per unit of tissue volume), VP (plasmatic volume per unit of tissue volume), and F (plasma flow) by using Olea Sphere software. Mean values were compared using t tests. Twenty-two patients were included in the analysis. Kep (1.32 versus 1.52, P brain barrier permeability in patients with SAH with and without global cerebral edema. Kep is an important indicator of altered blood-brain barrier permeability in patients with decreased blood flow, as Kep is flow-independent. Further study of blood-brain barrier permeability is needed to improve diagnosis and monitoring of global cerebral edema. © 2016 by American Journal of Neuroradiology.

  20. Digital subtraction angiography in cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sin Young; Kim, Ji Hun; Suh, Hong Kil; Kim, Hyo Heon; Kwack, Eun Young; Lee, Il Seong [College of Medicine Hallym University, Seoul (Korea, Republic of)

    1995-01-15

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.

  1. Four-wavelength near-infrared peripheral oximetry in cardiac surgery patients: a comparison between EQUANOX and O3.

    Science.gov (United States)

    Ferraris, Arnaud; Jacquet-Lagrèze, Matthias; Fellahi, Jean-Luc

    2017-05-02

    Near-infrared spectroscopy (NIRS) is a continuous and noninvasive technology that measures regional tissue oxygen saturation (rSO2). A new 4-wavelength generation of NIRS monitors is now available. We aimed to compare peripheral somatic rSO2 values given by the 4-wavelength EQUANOX™ 7600 device (Nonin Medical Inc., Plymouth, Mn) and O3™ device (Masimo Corporation, Irvine, CA). Twenty adult patients scheduled for conventional elective cardiac surgery with cardiopulmonary bypass over a 4-month period were included after local Ethics Committee approval. For each patient, 2 NIRS sensors (EQUANOX and O3) were placed over the medial part of the forearm. Thirteen couples of measurements were performed at predefined intraoperative time points. We compared 260 couples of absolute intraoperative rSO2 values. No significant difference was found between both monitors: EQUANOX median rSO2 60% (95% CI 57-62) versus O3 median rSO2 62% (95% CI 61-64), P = 0.103. Bias was 4.0% and limits of agreement were ±26.3%. Significant correlations were evidenced between EQUANOX and O3 rSO2 absolute values: rho = 0.758 (95% CI 0.701-0.806), P < 0.0001, and rSO2 percent maximum difference versus baseline: rho = 0.582 (95% CI 0.188-0.815), P = 0.007. While absolute values of rSO2 given by both devices were equivalent and well correlated, the clinical agreement is probably not acceptable, meaning that EQUANOX and O3 are not interchangeable in routine practice.

  2. Pulse Oximetry for the Detection of Obstructive Sleep Apnea Syndrome: Can the Memory Capacity of Oxygen Saturation Influence Their Diagnostic Accuracy?

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro

    2011-01-01

    Full Text Available Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS. Methods. All participants (135 performed the oximetry (three oximeters WristOx 3100 and polysomnography (PSG simultaneously in the sleep laboratory. Both recordings were interpreted blindly. Each oximeter was set to one of three different recording settings (memory capabilities 0.25, 0.5, and 1 Hz. The software (nVision 5.1 calculated the adjusted O2 desaturation index-mean number of O2 desaturation per hour of analyzed recording ≥2, 3, and 4% (ADI2, 3, and 4. The ADI2, 3, and 4 cutoff points that better discriminated between subjects with or without OSAS arose from the receiver-operator characteristics (ROCs curve analysis. OSAS was defined as a respiratory disturbance index (RDI ≥ 5. Results. 101 patients were included (77 men, mean age 52, median RDI 22.6, median BMI 27.4 kg/m2. The area under the ROCs curves (AUC-ROCs of ADI2, 3, and 4 with different data storage rates were similar (AUC-ROCs with data storage rates of 0.25/0.5/1 Hz: ADI2: 0.958/0.948/0.965, ADI3: 0.961/0.95/0.966, and ADI4: 0.957/0.949/0.963, P NS. Conclusions. The ability of WristOx 3100 to detect patients with OSAS was not affected by the data storage rate of the oxygen saturation signal. Both memory capacity of 0.25, 0.5, or 1 Hz showed a similar performance for the diagnosis of OSAS.

  3. [Study of regional cerebral glucose metabolism, in man, while awake or asleep, by positron emission tomography].

    Science.gov (United States)

    Franck, G; Salmon, E; Poirrier, R; Sadzot, B; Franco, G

    1987-03-01

    Measurements of regional cerebral glucose uptake by the 18F-fluorodeoxyglucose technique (18FDG) and positron emission tomography (PET) along with polygraph recordings were made serially during relaxed wakefulness and different stages of nocturnal sleep in two right-handed normal volunteers. During stage III-IV sleep, values declined diffusely in both hemispheric regions (-31%), thalamus (-33%), cerebellum (-33%) and brain stem (-25%). During paradoxical sleep regional values increased diffusely compared with slow wave sleep. Compared to wakefulness, regional metabolic values seemed to increase but the results were more variable from one volunteer to the other. These preliminary data indicate important regional alterations in cerebral metabolism between sleep states.

  4. 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.

  5. PET/CT in Combination with High b Value Water Molecules Diffusion Imaging in the Diagnosis of Cerebral and Cervical Tumor%PET/CT联合高b值水分子弥散成像在头颈部肿瘤诊断应用

    Institute of Scientific and Technical Information of China (English)

    王珍; 王琪; 邵文静; 徐凯

    2015-01-01

    Objective Cerebral and cervical anatomy structure is complex, rich blood supply and various organs, single mode imaging techniques met challenges in clinical diagnosis and differential diagnosis. This research adopts the18F FDG PET/CT in combination with MRI high b values DWI imaging of head and neck cancer clinical diagnosis can efficiency were studied.Methods A total of 27cases of clinical diagnosis with head and neck cancer patients accepted18F FDG PET/CT in combination with MRI (high b DWI) imaging scan. PET/CT scan first, and then to MR conventional sequence and multi b scan. Respectively in the workstation calculation of18F FDG PET/CT lesions standard perturbation values (standardized uptake value, SUV) with single index (0,1000s/mm2) and multiple index model (small b 0-200,middle b 300-1500 and high b, 1700-4500 s/mm2) a water molecule diffusion imaging apparent diffusion coefficient (ADC).Results18F FDG PET/CT and routine MRI scanning sequences were found in patients with head and neck lesions. Visual detection head and neck when b is greater than 3000 s/mm2 benign lesions DWI lesions on signal can have disappeared, and malignant lesions are present high signal. SUV maximum and average have significant statistical difference between benign and malignant lesions(P<0.03), and the number of b scan only high b values exist significant difference(P<0.02). No significant correlations were found between SUV and b value of ADC values(P<0.47).Conclusion The high value of DWI imaging technology can b can help of18F FDG PET/CT intake in the identification of benign and malignant lesions.%目的:头颈部解剖结构复杂、血供丰富、各类器官密集,单模式影像技术在临床诊断、鉴别诊断上有一定挑战。本研究采用18F FDG PET/CT联合MRI高b值DWI成像技术对头颈部肿瘤临床诊断效能进行研究。方法对27例临床诊断头颈肿瘤患者进行18F FDG PET/CT联合MRI高b值DWI成像。先进行PET/CT扫描,然后进

  6. Cerebral aterial spasm. I. Adrenergic mechanism in experimental cerebral vasospasm.

    Directory of Open Access Journals (Sweden)

    Morooka,Hiroshi

    1978-04-01

    Full Text Available This study demonstrates that an adrenergic mechanism plays an important role in producing the delayed cerebral vasospasm which follows subarachnoid hemorrhage. Results were as follows: 1. Experimental subarachnoid hemorrhage (SAH was produced by injection of fresh arterial blood into the cisterna magna in cats. The cerebral vasospasm was shown angiographically to be biphasic in nature: immediate constriction lasting 1 h and marked prolonged spasm occurring between the 3rd and 5th day after SAH. The amount of noradrenaline (NA and dopamine-beta-hydroxylase (DBH activity decreased over a period of 24 h both within the wall of the basilar artery and in the locus ceruleus and then gradually increased, reaching a maximum on the 3rd day after SAH. 2. Topical application of spasmogenic substances (NA and blood produced a marked constriction of the hypersensitive basilar artery on the 3rd day after SAH. 3. 6-Hydroxydopamine (6-OHDA injection into the cisterna magna produced prolonged vasocilatation. The dilated vessel responded with mild transient constriction after the topical application of NA or fresh blood. DBH activity and NA concentration in the vessels, locus ceruleus and medial hypothalamus decreased markedly on the 3rd day after the cisternal injection of 6-OHDA. 4. Various spasmogenic substances (i.e. serotonin, NA, prostaglandins and methemoglobin were measured in a mixture of equal volume of CSF and blood in cats. ONly the serotonin in the mixed fluid produced vasoconstriction. Spasmogenic substances decreased markedly in the mixed fluid incubated for 3 days at 37 degrees C, and none of these substances apart from methemoglobin was present in a concentration sufficient to produce constriction of vessels. 5. These results suggest that early spasm is induced by serotonin around the arteries of the cranial base, and delayed spasm might be caused by hyperreaction of cerebral vessels to spasmogenic substances such as methemoglobin, during the

  7. 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.)

  8. Cerebral calcifications and schizophreniform disorder

    Directory of Open Access Journals (Sweden)

    Leonardo Fernandez Meyer

    2013-01-01

    Full Text Available OBJECTIVES: Discuss pathophysiological aspects of cerebral calcifications (CC and highlight its importance related to the occurrence of neuropsychiatric syndromes. METHOD: Single case report. RESULT: Man 52 years old, 20 years after going through a total thyroidectomy, starts showing behavioral disturbance (psychotic syndrome. He was diagnosed as schizophrenic (paranoid subtype and submitted to outpatient psychiatric treatment. During a psychiatric admission to evaluate his progressive cognitive and motor deterioration, we identified a dementia syndrome and extensive cerebral calcifications, derived from iatrogenic hypoparathyroidism. CONCLUSION: The calcium and phosphorus disturbances, including hypoparathyroidism, are common causes of CC. Its symptoms can imitate psychiatric disorders and produce serious and permanent cognitive sequelae. The exclusion of organicity is mandatory in any psychiatric investigative diagnosis in order to avoid unfavorable outcomes, such as in the present case report.

  9. Chinese semantic processing cerebral areas

    Institute of Scientific and Technical Information of China (English)

    SHAN Baoci; ZHANG Wutian; MA Lin; LI Dejun; CAO Bingli; TANG Yiyuan; WU Yigen; TANG Xiaowei

    2003-01-01

    This study has identified the active cerebral areas of normal Chinese that are associated with Chinese semantic processing using functional brain imaging. According to the traditional cognitive theory, semantic processing is not particularly associated with or affected by input modality. The functional brain imaging experiments were conducted to identify the common active areas of two modalities when subjects perform Chinese semantic tasks through reading and listening respectively. The result has shown that the common active areas include left inferior frontal gyrus (BA 44/45), left posterior inferior temporal gyrus (BA37); the joint area of inferior parietal lobules (BA40) and superior temporal gyrus, the ventral occipital areas and cerebella of both hemispheres. It gives important clue to further discerning the roles of different cerebral areas in Chinese semantic processing.

  10. 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.

  11. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    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 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  12. [Should cerebral autoregulation be reassessed?

    DEFF Research Database (Denmark)

    Secher, Niels H.

    2009-01-01

    Maintained cardiac output (CO) and cerebral oxygenation (ScO2) are of importance for a reduction in perioperative complications. Normovolaemia is defined as a central blood volume that does not limit CO for the supine patient and is maintained by individualized goal directed fluid therapy. Thereb......, ScO2 is maintained even when the mean arterial pressure is pressure and it is recommended that ScO2 be monitored Udgivelsesdato: 2009/8/10...

  13. 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....

  14. 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.

  15. Cerebral ischaemia: A neuroradiological study

    Energy Technology Data Exchange (ETDEWEB)

    Bories, J.

    1985-01-01

    After a brief clinical and pathophysiological approach, the papers presented in this book are devoted to CT and angiography. Concerning CT, a particular study has been made of cerebral arterial territories on cuts parallel to the orbito-meatal line: these are very important in making the differential diagnosis from some tumors. Also concerning CT, a paper has been devoted to cerebral ''lacunae.'' The term ''lacuna'' as far as CT imaging is concerned, should be reserved only for those hypodense areas corresponding to small cavities containing fluid, which are sequelae of infarcts in the territory of penetrating arteries. Before this sequellar state come all the evolutive states of a small deep infarct. The angiographic study specifies the indications of angiography in the study of cerebral ischemia, and the techniques to be used. It shows the main etiologic aspects. Because of the important place of vascular surgery today, it seemed necessary to show also the main post operative angiographic aspects. After CT and angiography, some pages are reserved to more modern techniques. Finally, some pages are devoted to certain particular associations and etiologies: childhood, cardiopathies, migraine, oral contraception and end with venous infarction.

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

    OpenAIRE

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

    2004-01-01

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

  17. [Histostructural changes of rat cerebral cortex during hemorrhagic stroke modeling].

    Science.gov (United States)

    Savos'ko, S I; Chaĭkovs'kyĭ, Iu B; Pogoriela, N Kh; Makarenko, O M

    2012-01-01

    Pathological changes during modeling of primary and secondary acute hemorrhagic stroke were studied in rats. We revealed differences in the activity of pharmacological action of medications under condition of acute stroke. The action of medications increased viability of neurons in both hemispheres of rat cerebrum at a right-side primary and secondary hemorrhagic stroke. Following secondary stroke, the amount of degenerative neurons amounted 25.5 +/- 0.8 cells/mm2, following the action ofcerebrolysin this value was 17.6 +/- 1.7 cells/ mm2 and after the action of cortexine and cerebral this value amounted 18.0 +/- 0.9 cells/mm2 and 10.7 +/- 0.4 cells/ mm2, respectively. In control animals the number of degenerative neurons did not exceed 2% and averaged 1.5 +/- 0.1 cells/mm2. Analysis of the morphological and statistical data showed that the most effective remedies under the primary and secondary hemorrhagic insult are cortexine and cerebral. Cerebral was found to be more effective.

  18. 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).

  19. 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.

  20. Interferência da coloração de esmaltes de unha e do tempo na oximetria de pulso em voluntários sadios Interference of nail polish colors and time on pulse oximetry in healthy volunteers

    Directory of Open Access Journals (Sweden)

    Mara Harumi Miyake

    2003-12-01

    Full Text Available INTRODUÇÃO: A oximetria de pulso é um método não invasivo de mensuração da saturação periférica da oxiemoglobina (SpO2. É freqüentemente utilizado em unidades de emergência, de terapia intensiva e em centro cirúrgico. A leitura da oximetria de pulso tem acurácia limitada na presença de metaemoglobina, carboxiemoglobina, anemia, vasoconstrição periférica, esmalte de unha, luz fluorescente e movimentação. OBJETIVO: Avaliar a interferência da coloração de esmalte de unha e do tempo sobre a SpO2 em indivíduos sadios. MÉTODO: Participaram do estudo 61 voluntárias sadias, com idades entre 18 e 32 anos. Foi avaliada SpO2 nas seguintes colorações de esmaltes: base (dedo mínimo, rosa claro (dedo anular, rosa claro com cintilante (dedo médio e vermelha (polegar. O indicador não recebeu esmalte. Foi analisado o tempo para cada coloração de esmalte, a cada minuto até completar cinco minutos. RESULTADOS: Quando comparadas as medidas da SpO2 com o controle, as colorações base (p = 0,56, rosa claro (p = 0,56 e rosa claro com cintilante (p = 0,37 não apresentaram diferença estatisticamente significante. A SpO2 apresentou variação significante na cor vermelha (p BACKGROUND: Pulse oximetry is a noninvasive method to measure the saturation of peripheral oxyhaemoglobin (SpO2. It's usually used in emergency, intensive care and operating room units. Pulse oximeter readings have limited accuracy in the presence of methemoglobin, carboxyhemoglobin, anaemia, peripheral vasoconstriction, nail polish, fluorescent light, and motion. OBJECTIVES: To evaluate the interferences of the color of nail polishes and time on SpO2 in healthy individuals. METHODS: Sixty-one healthy female volunteers, ages ranging from 18 to 32 years. The nail polish colors used to evaluate SpO2 were: base coat on the little finger, light pink on the ring finger, sparkling light pink on the medium finger and red on the thumb. The index finger was used as control

  1. Quantitative Cerebral Blood Flow Measurements Using MRI

    OpenAIRE

    Muir, Eric R; Watts, Lora Talley; Tiwari, Yash Vardhan; Bresnen, Andrew; Timothy Q Duong

    2014-01-01

    Magnetic resonance imaging utilized as a quantitative and noninvasive method to image cerebral blood flow. The two most common techniques used to detect cerebral blood flow are dynamic susceptibility contrast (DSC) perfusion MRI and arterial spin labeling perfusion MRI. Herein we describe the use of these two techniques to measure cerebral blood flow in rodents, including methods, analysis, and important considerations when utilizing these techniques.

  2. Cerebral embolic stroke after disappearing takotsubo cardiomyopathy.

    Science.gov (United States)

    Matsuzono, Kosuke; Ikeda, Yoshio; Deguchi, Shoko; Yamashita, Toru; Kurata, Tomoko; Deguchi, Kentaro; Abe, Koji

    2013-11-01

    Takotsubo cardiomyopathy can induce cerebral embolic stroke because of intracardiac thrombosis, but the timing of cardiogenic embolism relating to takotsubo cardiomyopathy has not been well described. We evaluated a 71-year-old woman with takotsubo cardiomyopathy, who developed cardiogenic cerebral embolism after recovery of cardiac wall motion. Nevertheless, we treated her with anticoagulation therapy. The present clinical observation suggests that attention should be paid to the timing when takotsubo cardiomyopathy resolves against risk of cardiogenic cerebral embolism.

  3. Cerebral Vasospasm Pharmacological Treatment: An Update

    OpenAIRE

    Ioannis Siasios; Kapsalaki, Eftychia Z; Fountas, Kostas N

    2013-01-01

    Aneurysmal subarachnoid hemorrhage- (aSAH-) associated vasospasm constitutes a clinicopathological entity, in which reversible vasculopathy, impaired autoregulatory function, and hypovolemia take place, and lead to the reduction of cerebral perfusion and finally ischemia. Cerebral vasospasm begins most often on the third day after the ictal event and reaches the maximum on the 5th–7th postictal days. Several therapeutic modalities have been employed for preventing or reversing cerebral vasosp...

  4. 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...... 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....

  5. The value of value congruence.

    Science.gov (United States)

    Edwards, Jeffrey R; Cable, Daniel M

    2009-05-01

    Research on value congruence has attempted to explain why value congruence leads to positive outcomes, but few of these explanations have been tested empirically. In this article, the authors develop and test a theoretical model that integrates 4 key explanations of value congruence effects, which are framed in terms of communication, predictability, interpersonal attraction, and trust. These constructs are used to explain the process by which value congruence relates to job satisfaction, organizational identification, and intent to stay in the organization, after taking psychological need fulfillment into account. Data from a heterogeneous sample of employees from 4 organizations indicate that the relationships that link individual and organizational values to outcomes are explained primarily by the trust that employees place in the organization and its members, followed by communication, and, to a lesser extent, interpersonal attraction. Polynomial regression analyses reveal that the relationships emanating from individual and organizational values often deviated from the idealized value congruence relationship that underlies previous theory and research. The authors' results also show that individual and organizational values exhibited small but significant relationships with job satisfaction and organizational identification that bypassed the mediators in their model, indicating that additional explanations of value congruence effects should be pursued in future research. (c) 2009 APA, all rights reserved.

  6. Application of dual energy cerebral arteries computed tomographic angiography in diagnosis of cerebral aneurysm%双能量脑动脉CT血管造影在脑动脉瘤诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    孙莉; 张岩睿; 刘艳; 李江红

    2014-01-01

    Objective To study the value of dual energy cerebral arteries computed tomographic angiography (CTA) in diagnosis of cerebral aneurysm.Methods As a gold standard of digital subtraction angiography (DSA) findings,the dual energy cerebral arteries CTA imaging features of 30 cases confirmed by DSA for cerebral aneurysm were retrospectively analyzed.The diagnosis accuracy of cerebral aneurysm between dual energy cerebral arteries and DSA was compared.Results Dual energy cerebral arteries CTA could display the direct signs of cerebral aneurysms,it played better in the signs of aneurysm of the siphon segment of internal carotid artery than that by conventional cerebral arteries CTA.The measurement of the size and neck by dual energy cerebral arteries CTA had good agreement to DSA,there was no statistical difference (P > 0.05).The radiation dose of dual energy cerebral arteries CTA was 19.1-25.4(21.7 ± 0.5)mSv.Conclusion The dual energy cerebral arteries CTA can show the size and neck of cerebral aneurysm clearly,has high value in clinical application of the diagnosis of cerebral aneurysm.%目的 探讨双能量脑动脉CT血管造影(CTA)在脑动脉瘤诊断中的价值.方法 以数字减影血管造影(DSA)结果为金标准,回顾性分析30例经DSA证实为脑动脉瘤患者的双能量脑动脉CTA影像学特点,比较双能量脑动脉CTA和DSA检查对脑动脉瘤诊断准确性.结果 双能量脑动脉CTA能较好地显示脑动脉瘤的直接征象,对颈内动脉虹吸段的动脉瘤征象显示优于常规脑动脉CTA扫描.对瘤体及瘤颈的测量与DSA有较高的一致性,两种方法比较差异无统计学意义(P>0.05).双能量脑动脉CTA辐射剂量为19.1~25.4(21.7±0.5) mSv.结论 双能量脑动脉CTA能够清晰显示脑动脉瘤的瘤体大小及瘤颈,对脑动脉瘤的诊断有较高的临床应用价值.

  7. MRI of cerebral ischaemia in rats with occlusion of the middle cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Thuomas, K.AA. [Dept. of Diagnostic Radiology, University Hospital, Uppsala (Sweden); Kotwica, Z. [Dept. of Neurosurgery, University Hospital, Uppsala (Sweden); Bergstroem, K. [Dept. of Diagnostic Radiology, University Hospital, Uppsala (Sweden); Bolander, H. [Dept. of Neurosurgery, University Hospital, Uppsala (Sweden); Hillered, L. [Dept. of Neurosurgery, University Hospital, Uppsala (Sweden)]|[Dept. of Clinical Chemistry, University Hospital, Uppsala (Sweden); Olsson, Y. [Dept. of Neuropathology, University Hospital, Uppsala (Sweden); Ponten, U. [Dept. of Neurosurgery, University Hospital, Uppsala (Sweden); Persson, L. [Dept. of Neurosurgery, University Hospital, Uppsala (Sweden)

    1991-11-01

    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.)

  8. P2X7 receptors in cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Hui-Yu Bai; Ai-Ping Li

    2013-01-01

    Cerebral ischemia is one of the most common diseases resulting in death and disability in aged people.It leads immediately to rapid energy failure,ATP depletion,and ionic imbalance,which increase extracellular ATP levels and accordingly activate P2X7 receptors.These receptors are ATP-gated cation channels and widely distributed in nerve cells,especially in the immunocompetent cells of the brain.Currently,interest in the roles of P2X7 receptors in ischemic brain injury is growing.In this review,we discuss recent research progress on the actions of P2X7 receptors,their possible mechanisms in cerebral ischemia,and the potential therapeutic value of P2X7 receptor antagonists which may provide a new target both for clinical and for research purposes.

  9. Cerebral blood flow and oxygen metabolism in the Rett syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yoshikawa, Hideto; Fueki, Noboru; Suzuki, Hisaharu; Sakuragawa, Norio; Iio, Masaaki (National Central Hospital for Mental, Nervous and Muscular Disorders, Tokyo (Japan))

    1992-05-01

    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{sub 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{sub 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).

  10. 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:…

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Sepsis may be associated with disturbances in cerebral oxygen transport and cerebral haemodynamic function, thus rendering the brain particularly susceptible to hypoxia. The purpose of this study was to assess the impact of isocapnic hypoxia and hyperoxia on dynamic cerebral autoregulation...... in a human-experimental model of the systemic inflammatory response during the early stages of sepsis....

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

    Directory of Open Access Journals (Sweden)

    Masamichi Aikawa

    1992-01-01

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

  13. Cerebral hemodynamics in aging : the interplay between blood pressure, cerebral perfusion, and dementia

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2008-01-01

    Advances in measurement techniques have made it possible to study dynamic changes in brain blood flow. Transcranial Doppler ultrasonography measures changes in cerebral blood flow-velocity in the larger cerebral arteries (e.g. the middle cerebral artery). Near infrared spectroscopy records changes i

  14. Value Representations

    DEFF Research Database (Denmark)

    Rasmussen, Majken Kirkegaard; Petersen, Marianne Graves

    2011-01-01

    Stereotypic presumptions about gender affect the design process, both in relation to how users are understood and how products are designed. As a way to decrease the influence of stereotypic presumptions in design process, we propose not to disregard the aspect of gender in the design process......, as the perspective brings valuable insights on different approaches to technology, but instead to view gender through a value lens. Contributing to this perspective, we have developed Value Representations as a design-oriented instrument for staging a reflective dialogue with users. Value Representations...

  15. 基于扩散理论的脉搏血氧测量系统%A Pulse Oximetry System Based on Diffusion Theory

    Institute of Scientific and Technical Information of China (English)

    高峰; 陈玮婷; 周晓青; 刘明; 张书颖; 赵会娟

    2013-01-01

    为了对低血氧饱和度进行准确测量,采用光子扩散方程模型替代传统的朗伯-比尔定律模型来推导血氧饱和度与特征值R之间的关系,并得到相应的定标曲线,从而克服了朗伯-比尔定律模型所固有的忽略散射效应这一问题及其所导致的较低的测量精度;在此基础上搭建了以数字信号处理器为核心处理设备的脉博血氧测量系统,并进行了手指阻断定性实验和低血氧饱和度水平下的仿体定量实验.实验结果表明,基于光子扩散方程模型的测量系统能够有效地反映出组织体血氧饱和度值的变化趋势;在低血氧饱和度情况下,采用扩散方程模型求得的结果较传统的朗伯-比尔定律模型获得的结果准确性提高了20%以上.该方法有望应用于低血氧饱和度的准确测量.%In order to overcome the inherent drawbacks of Lambert-Beer's Law, which ignores the scattering effect and thus leads to a poor measurement precision, especially for low oxygen saturation, a study on the accurate measurement of low oxygen saturation was conducted in this paper. The photon diffusion theory was employed to achieve the calibration curve between oxygen saturation and the eigenvalue R rather than Lambert-Beer's Law. A pulse oximetry system using digital signal processer as core device was set up based on the above theory. A finger blocking-up qualitative experiment and a series of quantitative phantom experiments were performed under low oxygen saturation. The results demonstrate that the measurement system based on photon diffusion theory can effectively provide the variation trends of oxygen saturation in tissue, and that there is an improvement of 20% in accuracy compared with Lambert-Beer's Law theory when low oxygen saturation is measured. The approach proposed in this paper offers a promising tool for the accurate measurement of low oxygen saturation.

  16. Effects of midazolam on cerebral blood flow in human volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Forster, A.; Juge, O.; Morel, D.

    1982-06-01

    The effects of intravenously administered midazolam on cerebral blood flow were evaluated in eight healthy volunteers using the /sup 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.

  17. Transcranial regional cerebral oxygen desaturation predicts delayed cerebral ischaemia and poor outcomes after subarachnoid haemorrhage: a correlational study.

    Science.gov (United States)

    Yousef, Khalil M; Balzer, Jeffrey R; Crago, Elizabeth A; Poloyac, Samuel M; Sherwood, Paula R

    2014-12-01

    To examine the relationship between regional cerebral oxygen saturation (rSO2), delayed cerebral ischaemia (DCI), and outcomes after aneurysmal subarachnoid haemorrhage (aSAH). Subjects (n = 163) with aSAH, age 21-75 years, and Fisher grade >1 were included in the study. Continuous rSO2 monitoring was performed for 5-10 days after injury using near-infrared spectroscopy with sensors over the frontal/temporal cortex. rSO250 (OR 3.25, 95%CI 1.58-6.69), positive predictive value (PPV) = 70%. Subjects with rSO2 50 (OR 2.7, 95%CI 1.1-7.2), PPV = 70%. These results suggest that NIRS has the potential for detecting DCI after aSAH. This potential needs to be further explored in a larger prospective study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. 结合需要层次理论的护理干预在高血压脑出血患者中的应用价值%Value of nursing intervention based on Maslow's Hierarchy of Needs in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    崔翱; 林容旭; 张宝月; 罗针

    2016-01-01

    Objective To analyze the value of nursing intervention based on Maslow's Hierarchy of Needs in pa-tients with hypertensive cerebral hemorrhage. Methods A total of 118 patients of hypertensive cerebral hemorrhage treat-ed in West China Hospital, Sichuan University from December 2011 to December 2014 were chosen as study subjects, which were divided into observation group and control group according to random number table, each with 59 patients. Af-ter admission, the patients in the control group received routine nursing care, while those in the observation group received nursing intervention based on Maslow's Hierarchy of Needs. The recovery-related indicators, nerve function and activities of daily living, mental status and quality of life were compared between the two groups. Results (1) The score of basic nursing care quality in the observation group was (96.17 ± 3.28), significantly higher than (78.55 ± 5.82) in the control group. The time for consciousness recovery, limb function recovery, hospital stay in the observation group were shorter than those in the control group [(5.62 ± 0.92) d vs (9.81 ± 2.16) d, (8.72 ± 2.83) d vs (14.68 ± 3.07) d, (13.27 ± 3.78) d vs (25.16 ± 5.73) d], with statistically significant difference (P<0.05). (2) After nursing treatment, the National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI) score in the observation group were higher than those in the con-trol group [(59.72 ± 7.11) vs (42.38 ± 5.67), (63.29 ± 7.93) vs (41.26 ± 5.45)], with statistically significant difference (P<0.05). (3) After nursing treatment, the Self-Rating Anxiety Scale (SAS) score, Hamilton Depression Scale (HAMD) score in the observation group were significantly lower than those in the control group [(17.39 ± 3.11) vs (28.54 ± 4.57), (19.53 ± 3.26) vs (31.42 ± 4.78)], and the Short Form 36 health survey questionnaire (SF-36) score in the observation group was significantly higher than that in the control group [(83.11

  19. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    Science.gov (United States)

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

  20. Effect of labetalol on cerebral blood flow and middle cerebral arterial flow velocity in healthy volunteers

    DEFF Research Database (Denmark)

    Schroeder, T; Schierbeck, Jens; Howardy, P;

    1991-01-01

    in normotensive subjects. Neither does it affect CO2 reactivity. The uniform results obtained with the two methods suggest TCD as a usable alternative to conventional CBF technique in the assessment of cerebral vasoactivity of various drugs in subjects with a normal cerebral circulation.......The effect of labetalol, a combined alpha- and beta-adrenoceptor antagonist, on the cerebral circulation was investigated in 7 normotensive subjects. Cerebral blood flow (CBF) was measured with the intravenous 133Xe method and mean flow velocity (Vmean) in the middle cerebral artery was determined...

  1. Novel optoacoustic system for noninvasive continuous monitoring of cerebral venous blood oxygenation

    Science.gov (United States)

    Petrov, Yuriy; Petrov, Irene Y.; Prough, Donald S.; Esenaliev, Rinat O.

    2012-02-01

    Traumatic brain injury (TBI) and spinal cord injury are a major cause of death for individuals under 50 years of age. In the USA alone, 150,000 patients per year suffer moderate or severe TBI. Moreover, TBI is a major cause of combatrelated death. Monitoring of cerebral venous blood oxygenation is critically important for management of TBI patients because cerebral venous blood oxygenation below 50% results in death or severe neurologic complications. At present, there is no technique for noninvasive, accurate monitoring of this clinically important variable. We proposed to use optoacoustic technique for noninvasive monitoring of cerebral venous blood oxygenation by probing cerebral veins such as the superior sagittal sinus (SSS) and validated it in animal studies. In this work, we developed a novel, medical grade optoacoustic system for continuous, real-time cerebral venous blood oxygenation monitoring and tested it in human subjects at normal conditions and during hyperventilation to simulate changes that may occur in patients with TBI. We designed and built a highly-sensitive optoacoustic probe for SSS signal detection. Continuous measurements were performed in the near infrared spectral range and the SSS oxygenation absolute values were automatically calculated in real time using a special algorithm developed by our group. Continuous measurements performed at normal conditions and during hyperventilation demonstrated that hyperventilation resulted in approximately 12% decrease of cerebral venous blood oxygenation.

  2. 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)

  3. Validation of hyperintense middle cerebral artery sign in acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Gang Guo; Yonggui Yang; Weiqun Yang

    2012-01-01

    We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on magnetic resonance angiography and digital subtraction angiography. No patients in the non-hemorrhagic group had hyperintense middle cerebral artery sign on MRI. The sensitivity, specificity, and positive predictive values of the hyperintense middle cerebral artery sign on MRI T1-weighted image for subsequent hemorrhagic transformation were 54.5%, 100%, and 100% respectively. Hyperdense middle cerebral artery sign on non-contrast CT was observed in nine patients, five of who developed hemorrhagic transformation. These data suggest that hyperintense middle cerebral artery sign on MRI T1-weighted image is a highly specific and moderately sensitive indicator of subsequent hemorrhagic transformation in patients after acute ischemic stroke, and its specificity is superior to CT.

  4. Altered structure of small cerebral arteries in patients with essential hypertension.

    Science.gov (United States)

    Rizzoni, Damiano; De Ciuceis, Carolina; Porteri, Enzo; Paiardi, Silvia; Boari, Gianluca E M; Mortini, Pietro; Cornali, Claudio; Cenzato, Marco; Rodella, Luigi F; Borsani, Elisa; Rizzardi, Nicola; Platto, Caterina; Rezzani, Rita; Rosei, Enrico Agabiti

    2009-04-01

    Structural alterations in the microcirculation may be considered an important mechanism of organ damage. An increased media-to-lumen ratio of subcutaneous small resistance arteries has been demonstrated to predict the development of cardiocerebrovascular events in hypertensive patients. Alterations in the structure of small cerebral arteries have been demonstrated in animal models of experimental or genetic hypertension. However, no evaluation with reliable techniques has ever been performed in humans. Twenty-eight participants were included in the present study: they were 13 hypertensive patients and 15 normotensive individuals. All participants underwent a neurosurgical intervention for benign or malign tumors. A small portion of morphologically normal cerebral tissue was excised from surgical samples and examined. Cerebral small resistance arteries (relaxed diameter around 200 mum) were dissected and mounted on an isometric and isobaric myograph, and the tunica media to internal lumen ratio was measured. In addition, cerebral cortical microvessel density (MVD) was also evaluated. The tissue was sectioned and stained for CD31, and MVD was measured with an automated image analyzer (percentage of area stained). Blood pressure values were evaluated, before surgical intervention, by standard sphygmomanometry. M/L was significantly greater and MVD significantly lower in hypertensive patients than that in normotensive individuals. No difference between groups in collagen content or mechanical properties of cerebral small arteries was observed. Our results indicate that structural alterations of small cerebral vessels are present in hypertensive patients compared with normotensive individuals, similar to those previously observed in subcutaneous small arteries.

  5. 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

  6. Clinical diagnostic value of plasma homocysteine in the prognosis of patients with acute cerebral infarction%血浆同型半胱胺酸水平检测对急性脑梗死患者预后的临床诊断价值

    Institute of Scientific and Technical Information of China (English)

    宋丽艳; 唐甲凡; 周亦; 翟万庆

    2014-01-01

    Objective To explore the clinical diagnostic value of plasma homocysteine (Hcy)in the prognosis of patients with acute cerebral infarction (ACI).Methods According to Hcy median value on admission,78 ACI patients with hyperhomocysteinemia were divided into high-Hcy group and low-Hcy group,and meanwhile 34 ACI patients with normal Hcy level were de-signed as control group.All patients were given the secondary prevention for cerebrovascular dis-ease.On the basis of conventional therapy,high-Hcy group and low-Hcy group were treated with vitamin B12.BI and NIHSS scores were respectively evaluated,and Hcy level was detected in 3 groups on first day of admission and 21st day of treatment,and the clinical efficiency was compared between high-Hcy group and low-Hcy group.Results Hcy levels in high-Hcy group and low-Hcy group decreased significantly on 21st day of treatment.Hcy levels in high-Hcy grouy and low-Hcy group were significantly higher than control group on first day of admission and 21st day of treat-ment,and the increasing range in high-Hcy group was even larger.NIHSS scores decreased,while BI scores increased significantly in 3 groups on 21st day of treatment.NIHSS scores in high-Hcy group and low-Hcy group were significantly higher than control group on first day of admission and 21st day of treatment,while BI scores were lower,and the increasing and decreasing ranges in high-Hcy group were even larger.The overall response rate of low-Hcy group was superior to high-Hcy group.Conclusion Detecting Hcy level can predict the prognosis of patients with ACI,and reduc-ing Hcy level can improve the neural functional defects and life capability of patients.%目的:探讨血浆同型半胱胺酸(Hcy)水平检测对急性脑梗死患者预后的临床诊断价值。方法根据入院时 Hcy水平的中位数值,将78例急性脑梗死伴高同型半胱氨酸血症患者分为高 Hcy 组与低 Hcy 组,同时选取同期35例急性脑梗死伴Hcy 水平正常者

  7. The Value of Value Sets

    DEFF Research Database (Denmark)

    Sløk-Madsen, Stefan Kirkegaard; Christensen, Jesper

    The world over classrooms in business schools are being taught that corporate values can impact performance. The argument is typically that culture matter more than strategy plans and culture can be influenced and indeed changed by a shared corporate value set. While the claim seems intuitively a...... a unique contribution to the effects of investment in shared company values, and to whether agent rationality can be fundamentally changed by committed organizational efforts.......The world over classrooms in business schools are being taught that corporate values can impact performance. The argument is typically that culture matter more than strategy plans and culture can be influenced and indeed changed by a shared corporate value set. While the claim seems intuitively...... and anecdotally true surprisingly little hard evidence has been produced either for or against. This study attempts to rectify this. The study claims that for corporate values to matter they must at least align, and potentially alter, employee decision-making hence their concept of optimality and rational...

  8. Normative Values of Retinal Oxygen Saturation in Rhesus Monkeys: The Beijing Intracranial and Intraocular Pressure (iCOP Study.

    Directory of Open Access Journals (Sweden)

    Jing Li

    Full Text Available To study the normal values of the retinal oxygen saturation in Rhesus monkeys and to evaluated repeatability and reproducibility of retinal oxygen saturation measurements.Eighteen adult Rhesus macaque monkeys were included in this experimental study. An Oxymap T1 retinal oximeter (Oxymap, Reykjavik, Iceland was used to perform oximetry on all subjects. Global arterial (SaO2 and venous oxygen saturation (SvO2, arteriovenous difference in SO2 were measured. In the first examination, each eye was imaged three times. At the following two examinations, each eye was imaged once. All examinations were finished in one month. P values were calculated to evaluate the difference between the measurements during three visits by performing an ANOVA. Intra-visit and inter-visit intraclass correlation coefficient (ICC was determined.At baseline, the average SaO2 and SvO2 were 89.48 ± 2.64% and 54.85 ± 2.18%, respectively. The global A-V difference was 34.63 ± 1.91%. The difference between the three visits was not significant (p>0.05. The highest A-V difference in SO2 and lowest saturations were found in the inferotemporal quadrant. Intra-session and inter-visit repeatability were both high. For all oxygen saturation parameters, the ICC values of the intra-session repeatability ranged between 0.92 and 0.96. As found previously, a relatively high ICC value for inter-visit repeatability also was found for all oxygen saturation measurements, ranging between 0.86 and 0.94, with the lowest values in the infero-nasal quadrant.Our study is the first to describe retinal SO2 in healthy Rhesus monkeys. In normal monkey eyes, the reproducibility and repeatability of retinal oximetry oxygen saturation measurements were high in the retinal arterioles and venules. Our results support that Oxymap T1 retinal oximetry is a suitable and reliable technique in monkey studies.

  9. Reconstruction of cerebral hemodynamics with dynamic contrast-enhanced time-resolved near-infrared measurements before and during ischemia

    Science.gov (United States)

    Elliott, Jonathan T.; Diop, Mamadou; Morrison, Laura B.; Lee, Ting-Yim; St. Lawrence, Keith

    2013-03-01

    We present a dynamic contrast-enhanced near-infrared (DCE-NIR) technique that is capable of non-invasive quantification of cerebral hemodynamics in adults. The challenge of removing extracerebral contamination is overcome through the use of multi-distance time-resolved DCE-NIR combined with the kinetic deconvolution optical reconstruction (KDOR) analytical method. As proof-of-principle, cerebral blood flow, cerebral blood volume and mean transit time recovered with DCE-NIR are compared with CT perfusion values in an adult pig during normocapnia, hypocapnia, and ischemia. Measurements of blood flow acquired with DCE-NIR were compared against concomitant measurements using CT Perfusion.

  10. 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.

  11. [Dehydroepiandrosterone and the cerebral functions].

    Science.gov (United States)

    Goncharov, N P; Katsiia, G V; Nizhnik, A N

    2006-01-01

    Of all steroidal hormones, dehydroepiandrosterone (DHEA) and its sulphate form, DHEAS, are synthesized by the adrenal glands in the biggest quantities. In this review the authors consider the ways of the synthesis of the neurosteroids, possible mechanisms of the regulation of these processes, and their dynamics under stressful conditions. The paper presents analysis of experimental and clinical data on the role of DHEAS in the manifestation of different cerebral functions. The authors pay special attention to the results of substitutive therapy with DHEA(S) in patients with such CNS functional disorders, as Alzheimer's disease, depression, age-relative memory and sleep disturbances, etc.

  12. Rhinomaxillary mucormycosis with cerebral extension

    Directory of Open Access Journals (Sweden)

    Goel Shikha

    2009-01-01

    Full Text Available Mucormycosis is a rare opportunistic infection caused by fungus belonging to the order Mucorales. A case of a controlled diabetic male with rhino maxillary mucormycosis, with cerebral extension, is described. The patient presented with hemifacial swelling, a nasal twang in his voice, fever, ocular signs, gross tissue destruction, and was sluggish. Early recognition of mucormycosis is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease.

  13. Cerebral salt wasting syndrome: review.

    Science.gov (United States)

    Cerdà-Esteve, M; Cuadrado-Godia, E; Chillaron, J J; Pont-Sunyer, C; Cucurella, G; Fernández, M; Goday, A; Cano-Pérez, J F; Rodríguez-Campello, A; Roquer, J

    2008-06-01

    Hyponatremia is the most frequent electrolyte disorder in critically neurological patients. Cerebral salt wasting syndrome (CSW) is defined as a renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume. The pathogenesis of this disorder is still not completely understood. Sympathetic responses as well as some natriuretic factors play a role in this syndrome. Distinction between SIADH and CSW might be difficult. The essential point is the volemic state. It is necessary to rule out other intermediate causes. Treatment requires volume replacement and maintenance of a positive salt balance. Mineral corticoids may be useful in complicated cases.

  14. Nonsulfated cholecystokinins in cerebral neurons

    DEFF Research Database (Denmark)

    Agersnap, Mikkel; Zhang, Ming-Dong; Harkany, Tibor

    2016-01-01

    Cholecystokinin (CCK) is a widely expressed neuropeptide system originally discovered in the gut. Both cerebral and peripheral neurons as well as endocrine I-cells in the small intestine process proCCK to tyrosyl-O-sulfated and α-carboxyamidated peptides. Recently, we reported that gut endocrine I...... for nonsulfated CCK-8 with an antibody recognizing both sulfated and nonsulfated CCK. However, nonsulfated CCK immunoreactivity was stronger than that of sulfated CCK in cell bodies and weaker in nerve terminals. We conclude that only a small fraction of neuronal CCK is nonsulfated. The intracellular distribution...... of nonsulfated CCK in neurons suggests that they contribute only modestly to the CCK transmitter activity....

  15. 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 vari