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Sample records for invasive hemodynamic assessment

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

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    Andersen, Mads Jønsson; Borlaug, Barry A

    2014-01-01

    Recent hemodynamic studies have advanced our understanding of heart failure with preserved ejection fraction (HFpEF). Despite improved pathophysiologic insight, clinical trials have failed to identify an effective treatment for HFpEF. Invasive hemodynamic assessment can diagnose or exclude HFp...... of pathophysiological differences and inform the design and entry criteria for future trials....

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

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    Desanka Dragosavac

    1999-08-01

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

  3. Non-invasive prediction of hemodynamically significant coronary artery stenoses by contrast density difference in coronary CT angiography

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    Hell, Michaela M., E-mail: michaela.hell@uk-erlangen.de [Department of Cardiology, University of Erlangen (Germany); Dey, Damini [Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Taper Building, Room A238, 8700 Beverly Boulevard, Los Angeles, CA 90048 (United States); Marwan, Mohamed; Achenbach, Stephan; Schmid, Jasmin; Schuhbaeck, Annika [Department of Cardiology, University of Erlangen (Germany)

    2015-08-15

    Highlights: • Overestimation of coronary lesions by coronary computed tomography angiography and subsequent unnecessary invasive coronary angiography and revascularization is a concern. • Differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve, were assessed. • At a threshold of ≥24%, contrast density difference predicted hemodynamically significant lesions with a specificity of 75%, sensitivity of 33%, PPV of 35% and NPV of 73%. • The determination of contrast density difference required less time than transluminal attenuation gradient measurement. - Abstract: Objectives: Coronary computed tomography angiography (CTA) allows the detection of obstructive coronary artery disease. However, its ability to predict the hemodynamic significance of stenoses is limited. We assessed differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve (FFR). Methods: Lesion characteristics of 59 consecutive patients (72 lesions) in whom invasive FFR was performed in at least one coronary artery with moderate to high-grade stenoses in coronary CTA were evaluated by two experienced readers. Coronary CTA data sets were acquired on a second-generation dual-source CT scanner using retrospectively ECG-gated spiral acquisition or prospectively ECG-triggered axial acquisition mode. Plaque volume and composition (non-calcified, calcified), remodeling index as well as contrast density difference (defined as the percentage decline in luminal CT attenuation/cross-sectional area over the lesion) were assessed using a semi-automatic software tool (Autoplaq). Additionally, the transluminal attenuation gradient (defined as the linear regression coefficient between intraluminal CT attenuation and length from the ostium) was determined

  4. Non-invasive measurements of tissue hemodynamics with hybrid diffuse optical methods

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    Durduran, Turgut

    Diffuse optical techniques were used to measure hemodynamics of tissues non-invasively. Spectroscopy and tomography of the brain, muscle and implanted tumors were carried out in animal models and humans. Two qualitatively different methods, diffuse optical tomography and diffuse correlation tomography, were hybridized permitting simultaneous measurement of total hemoglobin concentration, blood oxygen saturation and blood flow. This combination of information was processed further to derive estimates of oxygen metabolism (e.g. CMRO 2) in tissue. The diffuse correlation measurements of blood flow were demonstrated in human tissues, for the first time, demonstrating continous, non-invasive imaging of oxygen metabolism in large tissue volumes several centimeters below the tissue surface. The bulk of these investigations focussed on cerebral hemodynamics. Extensive validation of this methodology was carried out in in vivo rat brain models. Three dimensional images of deep tissue hemodynamics in middle cerebral artery occlusion and cortical spreading depression (CSD) were obtained. CSD hemodynamics were found to depend strongly on partial pressure of carbon dioxide. The technique was then adapted for measurement of human brain. All optical spectroscopic measurements of CMRO2 during functional activation were obtained through intact human skull non-invasively. Finally, a high spatio-temporal resolution measurement of cerebral blood flow due to somatosensory cortex activation following electrical forepaw stimulation in rats was carried out with laser speckle flowmetry. New analysis methods were introduced for laser speckle flowmetry. In other organs, deep tissue hemodynamics were measured on human calf muscle during exercise and cuff-ischemia and were shown to have some clinical utility for peripheral vascular disease. In mice tumor models, the measured hemodynamics were shown to be predictive of photodynamic therapy efficacy, again suggesting promise of clinical utility

  5. Noninvasive Hemodynamic Assessment as Part of Preoperative Examination of Patients with Colorectal Cancer

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    M. I. Aleksandrov

    2014-01-01

    Full Text Available Objective: to determine the capacities of a noninvasive hemodynamic study in patients with colorectal cancer within a preoperative anesthesiological examination. Subjects and methods. The hemodynamic status was preoperatively analyzed in 97 patients (46 men and 51 women with colorectal cancer. Their mean age was 67.59±9.48 years. The POSSUM intraoperative risk scores were 20.20+3.2. Central hemodynamics was preoperatively assessed in all the patients, by applying a «Computerized Diamant System for Monitoring the Cardiorespiratory System and Tissue Hydration» (Saint-Petersburg, Russia — Registration Certificate ФСР No 2008/03201 dated 22 August, 2008.Results. The non-invasive hemodynamic study can supplement a preoperative examination in patients with colorectal cancer. The patients with colorectal cancer were diagnosed as having hypodynamic and eudynamic circulation in 43.3 and 56.7% of the cases, respectively. The age of the patients was not established to have a significant impact on their hemodynamic status, which confirms that it is expedient to make perioperative multifactorial risk assessment.

  6. Principios de la evaluación hemodinámica no invasiva con cardiografía de impedancia Principles of non-invasive hemodynamic assessment with impedance cardiography

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    Juan E Ochoa M

    2009-06-01

    this technique are included its easy implementation and accessibility, as well as the possibility of its measurement by practically any member of the health team. Impedance cardiography accuracy has been validated in several clinical scenarios such as arterial hypertension, heart failure, pulmonary hypertension, optimization of cardiac resynchronization therapy, and in critically ill patients, situations where it provides information about the hemodynamic state without the risks and costs of other invasive or minimally invasive techniques. It is also an easy to use, cost-effective method for the diagnosis and follow-up of the response to therapeutic interventions in multiple clinical scenarios. Thus, this technology represents a change in the paradigms of hemodynamic monitoring.

  7. A novel non invasive measurement of hemodynamic parameters: Comparison of single-chamber ventricular and dual-chamber pacemaker

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    Ingrid M. Pardede

    2008-03-01

    Full Text Available We carried out a cross sectional study to analyze hemodynamic parameters of single-chamber ventricular pacemaker compared with dual-chamber pacemaker by using thoracic electrical bioimpedance monitoring method (Physio Flow™ - a novel simple non-invasive measurement. A total of 48 consecutive outpatients comprised of 27 single chamber pacemaker and 21 dual chamber were analyzed. We measured cardiac parameters: heart rate, stroke volume index, cardiac output index, estimated ejection fraction, end diastolic volume, early diastolic function ratio, thoracic fluid index, and systemic parameters: left cardiac work index and systemic vascular resistance index. Baseline characteristic and pacemaker indication were similar in both groups. Cardiac parameters assessment revealed no significant difference between single-chamber pacemaker and dual-chamber pacemaker in heart rate, stroke volume index, cardiac index, estimated ejection fraction, end-diastolic volume, thoracic fluid index. There was significantly higher early diastolic function ratio in single-chamber pacemaker compared to dual-chamber pacemaker: 92% (10.2-187.7% vs. 100.6% (48.7-403.2%; p=0.006. Systemic parameters assessment revealed significantly higher left cardiac work index in single-chamber group than dual-chamber group 4.9 kg.m/m² (2.8-7.6 kg.m/m² vs. 4.3 kg.m/m² (2.9-7.2 kg.m/m²; p=0.004. There was no significant difference on systemic vascular resistance in single-chamber compared to dual-chamber pacemaker. Single-chamber ventricular pacemaker provides similar stroke volume, cardiac output and left cardiac work, compared to dual-chamber pacemaker. A non-invasive hemodynamic measurement using thoracic electrical bioimpedance is feasible for permanent pacemaker outpatients. (Med J Indones 2008; 17: 25-32Keywords: Permanent pacemaker, single chamber, dual chamber, thoracic electrical bioimpedance, hemodynamic parameter

  8. Central hemodynamics in risk assessment strategies: additive value over and above brachial blood pressure.

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    Yannoutsos, Alexandra; Rinaldi, Elisa R; Zhang, Yi; Protogerou, Athanassios D; Safar, Michel E; Blacher, Jacques

    2015-01-01

    Although the clinical relevance of brachial blood pressure (BP) measurement for cardiovascular (CV) risk stratification is nowadays widely accepted, this approach can nevertheless present several limitations. Pulse pressure (PP) amplification accounts for the notable increase in PP from central to peripheral arterial sites. Target organs are more greatly exposed to central hemodynamic changes than peripheral organs. The pathophysiological significance of local BP pulsatility, which has a role in the pathogenesis of target organ damage in both the macro- and the microcirculation, may therefore not be accurately captured by brachial BP as traditionally evaluated with cuff measurements. The predictive value of central systolic BP and PP over brachial BP for major clinical outcomes has been demonstrated in the general population, in elderly adults and in patients at high CV risk, irrespective of the invasive or non-invasive methods used to assess central BP. Aortic stiffness, timing and intensity of wave reflections, and cardiac performance appear as major factors influencing central PP. Great emphasis has been placed on the role of aortic stiffness, disturbed arterial wave reflections and their intercorrelation in the pathophysiological mechanisms of CV diseases as well as on their capacity to predict target organ damage and clinical events. Comorbidities and age-related changes, together with gender-related specificities of arterial and cardiac parameters, are known to affect the predictive ability of central hemodynamics on individual CV risk.

  9. Art care: A multi-modality coronary 3D reconstruction and hemodynamic status assessment software.

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    Siogkas, Panagiotis K; Stefanou, Kostas A; Athanasiou, Lambros S; Papafaklis, Michail I; Michalis, Lampros K; Fotiadis, Dimitrios I

    2018-01-01

    Due to the incremental increase of clinical interest in the development of software that allows the 3-dimensional (3D) reconstruction and the functional assessment of the coronary vasculature, several software packages have been developed and are available today. Taking this into consideration, we have developed an innovative suite of software modules that perform 3D reconstruction of coronary arterial segments using different coronary imaging modalities such as IntraVascular UltraSound (IVUS) and invasive coronary angiography images (ICA), Optical Coherence Tomography (OCT) and ICA images, or plain ICA images and can safely and accurately assess the hemodynamic status of the artery of interest. The user can perform automated or manual segmentation of the IVUS or OCT images, visualize in 3D the reconstructed vessel and export it to formats, which are compatible with other Computer Aided Design (CAD) software systems. We employ finite elements to provide the capability to assess the hemodynamic functionality of the reconstructed vessels by calculating the virtual functional assessment index (vFAI), an index that corresponds and has been shown to correlate well to the actual fractional flow reserve (FFR) value. All the modules of the proposed system have been thoroughly validated. In brief, the 3D-QCA module, compared to a successful commercial software of the same genre, presented very good correlation using several validation metrics, with a Pearson's correlation coefficient (R) for the calculated volumes, vFAI, length and minimum lumen diameter of 0.99, 0.99, 0.99 and 0.88, respectively. Moreover, the automatic lumen detection modules for IVUS and OCT presented very high accuracy compared to the annotations by medical experts with the Pearson's correlation coefficient reaching the values of 0.94 and 0.99, respectively. In this study, we have presented a user-friendly software for the 3D reconstruction of coronary arterial segments and the accurate hemodynamic

  10. Plethyzmography in assessment of hemodynamic results of pacemaker functions programming

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    Wojciechowski, Dariusz; Sionek, Piotr; Peczalski, Kazimierz; Janusek, Dariusz

    2011-01-01

    The paper presents potential role of plethyzmography in optimization of heart hemodynamic function during pacemaker programming. The assessment of optimal stroke volume in patients, with implanted dual chamber pacemaker (DDD), by plethyzmography was a goal of the study. The data were collected during pacing rhythm. 20 patients (8 female and 12 male, average 77.4+/-4.6 years) with dual chamber pacemaker (DDD) and with pacing rhythm during routine pacemaker control and study tests were incorporated in the study group. Hemodynamic parameters were assessed during modification of atrio-ventricular delay (AVD) for pacing rhythm of 70 bpm and 90 bpm. The time of atrioventricular was programmed with 20 ms steps within range 100-200 ms and data were recorded with two minutes delay between two consecutive measurements. Stroke volume (SV) and cardiac output (CO) were calculated from plethyzmographic signal by using Beatscope software (TNO Holand). Highest SV calculated for given pacing rhythm was named optimal stroke volume (OSV) and consequently highest cardiac output was named maximal cardiac output (MCO). The time of atrio-ventricular delay for OSV was named optimal atrioventricular delay (OAVD). The results have showed: mean values of OAVD for 70 bpm - 152+/-33 ms and for 90 bpm -149+/-35 ms, shortening of the mean OAVD time caused by increase of pacing rate from 70 bpm to 90 bpm what resulted in statistically significant decrease of OSV with not statistically significant increase of MCO. The analysis of consecutive patients revealed three types of response to increase of pacing rhythm: 1. typical-shortening of OAVD, 2. neutral-no change of OAVD and 3.atypical-lengthening of OAVD.

  11. Noninvasive hemodynamic assessment, treatment outcome prediction and follow-up of aortic coarctation from MR imaging.

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    Ralovich, Kristóf; Itu, Lucian; Vitanovski, Dime; Sharma, Puneet; Ionasec, Razvan; Mihalef, Viorel; Krawtschuk, Waldemar; Zheng, Yefeng; Everett, Allen; Pongiglione, Giacomo; Leonardi, Benedetta; Ringel, Richard; Navab, Nassir; Heimann, Tobias; Comaniciu, Dorin

    2015-05-01

    Coarctation of the aorta (CoA) is a congenital heart disease characterized by an abnormal narrowing of the proximal descending aorta. Severity of this pathology is quantified by the blood pressure drop (△P) across the stenotic coarctation lesion. In order to evaluate the physiological significance of the preoperative coarctation and to assess the postoperative results, the hemodynamic analysis is routinely performed by measuring the △P across the coarctation site via invasive cardiac catheterization. The focus of this work is to present an alternative, noninvasive measurement of blood pressure drop △P through the introduction of a fast, image-based workflow for personalized computational modeling of the CoA hemodynamics. The authors propose an end-to-end system comprised of shape and computational models, their personalization setup using MR imaging, and a fast, noninvasive method based on computational fluid dynamics (CFD) to estimate the pre- and postoperative hemodynamics for coarctation patients. A virtual treatment method is investigated to assess the predictive power of our approach. Automatic thoracic aorta segmentation was applied on a population of 212 3D MR volumes, with mean symmetric point-to-mesh error of 3.00 ± 1.58 mm and average computation time of 8 s. Through quantitative evaluation of 6 CoA patients, good agreement between computed blood pressure drop and catheter measurements is shown: average differences are 2.38 ± 0.82 mm Hg (pre-), 1.10 ± 0.63 mm Hg (postoperative), and 4.99 ± 3.00 mm Hg (virtual stenting), respectively. The complete workflow is realized in a fast, mostly-automated system that is integrable in the clinical setting. To the best of our knowledge, this is the first time that three different settings (preoperative--severity assessment, poststenting--follow-up, and virtual stenting--treatment outcome prediction) of CoA are investigated on multiple subjects. We believe that in future-given wider clinical validation

  12. Prognostic Effect and Longitudinal Hemodynamic Assessment of Borderline Pulmonary Hypertension.

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    Assad, Tufik R; Maron, Bradley A; Robbins, Ivan M; Xu, Meng; Huang, Shi; Harrell, Frank E; Farber-Eger, Eric H; Wells, Quinn S; Choudhary, Gaurav; Hemnes, Anna R; Brittain, Evan L

    2017-12-01

    Pulmonary hypertension (PH) is diagnosed by a mean pulmonary arterial pressure (mPAP) value of at least 25 mm Hg during right heart catheterization (RHC). While several studies have demonstrated increased mortality in patients with mPAP less than that threshold, little is known about the natural history of borderline PH. To test the hypothesis that patients with borderline PH have decreased survival compared with patients with lower mPAP and frequently develop overt PH and to identify clinical correlates of borderline PH. Retrospective cohort study from 1998 to 2014 at Vanderbilt University Medical Center, comprising all patients undergoing routine RHC for clinical indication. We extracted demographics, clinical data, invasive hemodynamics, echocardiography, and vital status for all patients. Patients with mPAP values of 18 mm Hg or less, 19 to 24 mm Hg, and at least 25 mm Hg were classified as reference, borderline PH, and PH, respectively. Mean pulmonary arterial pressure. Our primary outcome was all-cause mortality after adjusting for clinically relevant covariates in a Cox proportional hazards model. Our secondary outcome was the diagnosis of overt PH in patients initially diagnosed with borderline PH. Both outcomes were determined prior to data analysis. We identified 4343 patients (mean [SD] age, 59 [15] years, 51% women, and 86% white) among whom the prevalence of PH and borderline PH was 62% and 18%, respectively. Advanced age, features of the metabolic syndrome, and chronic heart and lung disease were independently associated with a higher likelihood of borderline PH compared with reference patients in a logistic regression model. After adjusting for 34 covariates in a Cox proportional hazards model, borderline PH was associated with increased mortality compared with reference patients (hazard ratio, 1.31; 95% CI, 1.04-1.65; P = .001). The hazard of death increased incrementally with higher mPAP, without an observed threshold. In the 70 patients with

  13. Assessment of Blood Hemodynamics by USPIO-Induced R1 Changes in MRI of Murine Colon Carcinoma

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    van Laarhoven, H. W. M.; Philippens, M.; Peeters, W. J. M.; Rijken, P.; van der Kogel, A.; Punt, C. J. A.; Heerschap, A.

    2010-01-01

    The objective of this study is to assess whether ultrasmall superparamagnetic iron oxide (USPIO)-induced changes of the water proton longitudinal relaxation rate (R1) provide a means to assess blood hemodynamics of tumors. Two types of murine colon tumors (C26a and C38) were investigated prior to and following administration of USPIO blood-pool contrast agent with fast R1 measurements. In a subpopulation of mice, R1 was measured following administration of hydralazine, a well-known blood hemodynamic modifier. USPIO-induced R1 increase in C38 tumors (ΔR1 = 0.072 ± 0.0081 s−1) was significantly larger than in C26a tumors (ΔR1 = 0.032 ± 0.0018 s−1, N = 9, t test, P < 0.001). This was in agreement with the immunohistochemical data that showed higher values of relative vascular area (RVA) in C38 tumors than in C26a tumors (RVA = 0.059 ± 0.015 vs. 0.020 ± 0.011; P < 0.05). Following administration of hydralazine, a decrease in R1 value was observed. This was consistent with the vasoconstriction induced by the steal effect mechanism. In conclusion, R1 changes induced by USPIO are sensitive to tumor vascular morphology and to blood hemodynamics. Thus, R1 measurements following USPIO administration can give novel insight into the effects of blood hemodynamic modifiers, non-invasively and with a high temporal resolution. PMID:20502507

  14. Appreciating the Strengths and Weaknesses of Transthoracic Echocardiography in Hemodynamic Assessments

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    Stephen J. Huang

    2012-01-01

    Full Text Available Transthoracic echocardiography (TTE is becoming the choice of hemodynamic assessment tool in many intensive care units. With an ever increasing number of training programs available worldwide, learning the skills to perform TTE is no longer a limiting factor. Instead, the future emphasis will be shifted to teach the users how to recognize measurement errors and artefacts (internal validity, to realize the limitations of TTE in various applications, and finally how to apply the information to the patient in question (external validity. This paper aims to achieve these objectives in a common area of TTE application—hemodynamic assessments. We explore the strengths and weaknesses of TTE in such assessments in this paper. Various methods of hemodynamic assessments, such as cardiac output measurements, estimation of preload, and assessment of fluid responsiveness, will be discussed.

  15. A New Framework for the Assessment of Cerebral Hemodynamics Regulation in Neonates Using NIRS

    NARCIS (Netherlands)

    Caicedo, Alexander; Alderliesten, Thomas; Naulaers, Gunnar; Lemmers, Petra; van Bel, Frank; Van Huffel, Sabine

    2016-01-01

    We present a new framework for the assessment of cerebral hemodynamics regulation (CHR) in neonates using near-infrared spectroscopy (NIRS). In premature infants, NIRS measurements have been used as surrogate variables for cerebral blood flow (CBF) in the assessment of cerebral autoregulation (CA).

  16. Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team: a pilot study.

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    David J Zorko

    Full Text Available PURPOSE: To determine the feasibility of using the Ultrasound Cardiac Output Monitor (USCOM as an adjunct during hemodynamic assessments by a pediatric medical emergency team (PMET. METHODS: Pediatric in-patients at McMaster Children's Hospital aged under 18 years requiring urgent PMET consultation, were eligible. Patients with known cardiac outflow valve defects, Pediatric Critical Care Unit in-patients, and those in cardiorespiratory arrest, were excluded. The primary outcome was feasibility, and the ease of USCOM transport and application as assessed by a self-administered user questionnaire. Secondary outcomes included the quality of USCOM measurements, and agreement in clinical versus USCOM-derived assessments. RESULTS: Forty-one patients from 85 eligible PMET consultations were enrolled between March and August 2011. A total of 55 USCOM assessments were performed on 36 of 41 (87.8% participants. USCOM could not be completed in 5 (12.2% participants due to patient agitation (n = 4 and emergent care (n = 1. USCOM was reported as easy to transport and apply by 97.4% and 94.7% of respondents respectively, not obstructive to patient care by 94.7%, and yielded timely measurements by 84.2% respondents. USCOM tracings were of good quality in 41 (75.9% assessments. Agreement between clinical and USCOM-derived hemodynamic assessments by two independent raters was poor (Rater 1: κ = 0.094; Rater 2: κ = 0.146. CONCLUSION: USCOM can be applied by a PMET during urgent hemodynamic assessments in children. While USCOM has been validated in stable children, its role in guiding hemodynamic resuscitation and informing therapeutic goals in a hemodynamically unstable pediatric population requires further investigation.

  17. Gutron treatment of patients suffering from essential orthostatic hypotony. Part One--Hemodynamic non-invasive investigation.

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    Axenti, I; Petelenz, T; Sosnoski, M; Slomińska-Petelenz, T

    1993-06-01

    Essential orthostatic hypotony (EOH) seems to present a rarely occurring and not well recognized syndrome. Group of 20 patients (pts) with EOH were treated with midodrine (Gutron, Gu) 5 mg i.v. Non-invasive hemodynamic variables, such as systolic time intervals and their derivates, based on polycardiographic recordings, were analysed. Heart rate and blood pressure measurements during orthostatic test were measured before and after Gu administration. The results of the orthostatic trial were compared to the control group of 20 volunteers. In healthy subjects, up-right position resulted in heart rate (HR) acceleration, diastolic blood pressure (DBP), total peripheral resistance (TPR), double and triple product (DP, TP), contraction coefficient (PEP/LVET) and dicrotic coefficient ('d') elevation, prejection period (PEP), electromechanical delay (QS1) and isovolumic contraction time (ICT) prolongation and lastly stroke volume (SV), cardiac output (CO) and middle rate of left ventricle ejection time (MRLVET) reduction. Patients with EOH showed a reduction of the degree of tilt-induced changes of the parameters. DBP fell down. After Gu these unfavourable changes were corrected to the values nearer the control group levels in three compensatory mechanisms. After Gu application in EOH-pts were seen: 1) favourable translocation of the resting (supine) values, but with the same reactivity to tilt, as before Gu (HR, TPR); 2) positive influences on orthostatic reaction, but inversely without any changes of resting values (PEPI, ICT, PEP/LVET, DP, DBP) and finally 3) favourable translocation of resting values together with inversed orthostatic reaction (SBP, QS2,TP). We stated clinical valuable efficacy of Gu. Gu influenced mainly the initial state of circulatory hemodynamics in resting and also in a lower degree in orthostatic reaction.

  18. The effects of the semirecumbent position on hemodynamic status in patients on invasive mechanical ventilation: prospective randomized multivariable analysis.

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    Göcze, Ivan; Strenge, Felix; Zeman, Florian; Creutzenberg, Marcus; Graf, Bernhard M; Schlitt, Hans J; Bein, Thomas

    2013-04-26

    Adopting the 45° semirecumbent position in mechanically ventilated critically ill patients is recommended, as it has been shown to reduce the incidence of ventilator-associated pneumonia. Although the benefits to the respiratory system are clear, it is not known whether elevating the head of the bed results in hemodynamic instability. We examined the effect of head of bed elevation (HBE) on hemodynamic status and investigated the factors that influence mean arterial pressure (MAP) and central venous oxygen saturation (ScvO2) when patients were positioned at 0°, 30°, and 45°. Two hundred hemodynamically stable adults on invasive mechanical ventilation admitted to a multidisciplinary surgical intensive care unit were recruited. Patients' characteristics included catecholamine and sedative doses, the original angle of head of bed elevation (HBE), the level of positive end expiratory pressure (PEEP), duration and mode of mechanical ventilation. A sequence of HBE positions (0°, 30°, and 45°) was adopted in random order, and MAP and ScvO2 were measured at each position. Patients acted as their own controls. The influence of degree of HBE and of the covariables on MAP and ScvO2 was analyzed by using liner mixed models. Additionally, uni- and multivariable logistic regression models were used to indentify risk factors for hypotension during HBE, defined as MAP mechanical ventilation, the norepinephrine dose, and HBE had statistically significant influences. Pressure-controlled ventilation was the most influential risk factor for hypotension when HBE was 45° (odds ratio (OR) 2.33, 95% confidence interval (CI), 1.23 to 4.76, P = 0.017). HBE to the 45° position is associated with significant decreases in MAP and ScvO2 in mechanically ventilated patients. Pressure-controlled ventilation, higher simplified acute physiology (SAPS II) score, sedation, high catecholamine, and PEEP requirements were identified as independent risk factors for hypotension after backrest

  19. Comparison of different invasive hemodynamic methods for AV delay optimization in patients with cardiac resynchronization therapy: Implications for clinical trial design and clinical practice☆☆☆

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    Whinnett, Zachary I.; Francis, Darrel P.; Denis, Arnaud; Willson, Keith; Pascale, Patrizio; van Geldorp, Irene; De Guillebon, Maxime; Ploux, Sylvain; Ellenbogen, Kenneth; Haïssaguerre, Michel; Ritter, Philippe; Bordachar, Pierre

    2013-01-01

    Background Reproducibility and hemodynamic efficacy of optimization of AV delay (AVD) of cardiac resynchronization therapy (CRT) using invasive LV dp/dtmax are unknown. Method and results 25 patients underwent AV delay (AVD) optimisation twice, using continuous left ventricular (LV) dp/dtmax, systolic blood pressure (SBP) and pulse pressure (PP). We compared 4 protocols for comparing dp/dtmax between AV delays:Immediate absolute: mean of 10 s recording of dp/dtmax acquired immediately after programming the tested AVD,Delayed absolute: mean of 10 s recording acquired 30 s after programming AVD,Single relative: relative difference between reference AVD and the tested AVD,Multiple relative: averaged difference, from multiple alternations between reference and tested AVD. We assessed for dp/dtmax, LVSBP and LVPP, test–retest reproducibility of the optimum. Optimization using immediate absolute dp/dtmax had poor reproducibility (SDD of replicate optima = 41 ms; R2 = 0.45) as did delayed absolute (SDD 39 ms; R2 = 0.50). Multiple relative had better reproducibility: SDD 23 ms, R2 = 0.76, and (p AV delay was LVSBP 2% and LVdp/dtmax 5%, while CRT with pre-determined optimal AVD gave 6% and 9% respectively. Conclusions Because of inevitable background fluctuations, optimization by absolute dp/dtmax has poor same-day reproducibility, unsuitable for clinical or research purposes. Reproducibility is improved by comparing to a reference AVD and making multiple consecutive measurements. More than 6 measurements would be required for even more precise optimization — and might be advisable for future study designs. With optimal AVD, instead of nominal, the hemodynamic increment of CRT is approximately doubled. PMID:23481908

  20. Invasive Hemodynamic Monitoring in Small Animals/ Monitoramento Hemodinâmico Invasivo em Pequenos Animais

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    Paulo Sérgio Patto dos Santos

    2002-05-01

    Full Text Available The aim of this paper was to revise the several homodynamic variables that can be monitored by invasive techniques, direct or indirectly, such as arterial pressure, central venous pressure, cardiac output, systemic vascular resistance, among others. Such techniques offer more accuracy and reliability, and also allow a continuous monitoring, being of great importance and utility in the treatment of the critically ill patient. As they are invasive techniques, they aren’t free of risks and the professional must decide for their utilization analysing the advantages and disadvantages.Com este artigo objetivou-se revisar os diversos parâmetros hemodinâmicos que podem ser monitorados de maneira invasiva, direta ou indiretamente, como a pressão arterial, pressão venosa central, débito cardíaco, resistência vascular periférica, entre outros. Tais técnicas oferecem uma maior confiabilidade e precisão, além de permitirem um monitoramento contínuo, sendo de grande importância e utilidade no tratamento de pacientes em estado crítico. Por serem técnicas invasivas, não são isentas de risco, cabendo ao profissional, face as vantagens e desvantagens inerentes a cada uma, bem como ao estado clínico do paciente, optar ou não pela sua utilização.

  1. Assessing biofuel crop invasiveness: a case study.

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    Christopher Evan Buddenhagen

    Full Text Available BACKGROUND: There is widespread interest in biofuel crops as a solution to the world's energy needs, particularly in light of concerns over greenhouse-gas emissions. Despite reservations about their adverse environmental impacts, no attempt has been made to quantify actual, relative or potential invasiveness of terrestrial biofuel crops at an appropriate regional or international scale, and their planting continues to be largely unregulated. METHODOLOGY/PRINCIPAL FINDINGS: Using a widely accepted weed risk assessment system, we analyzed a comprehensive list of regionally suitable biofuel crops to show that seventy percent have a high risk of becoming invasive versus one-quarter of non-biofuel plant species and are two to four times more likely to establish wild populations locally or be invasive in Hawaii or in other locations with a similar climate. CONCLUSIONS/SIGNIFICANCE: Because of climatic and ecological similarities, predictions of biofuel crop invasiveness in Hawaii are applicable to other vulnerable island and subtropical ecosystems worldwide. We demonstrate the utility of an accessible and scientifically proven risk assessment protocol that allows users to predict if introduced species will become invasive in their region of interest. Other evidence supports the contention that propagule pressure created by extensive plantings will exacerbate invasions, a scenario expected with large-scale biofuel crop cultivation. Proactive measures, such as risk assessments, should be employed to predict invasion risks, which could then be mitigated via implementation of appropriate planting policies and adoption of the "polluter-pays" principle.

  2. Assessment of pedophilia using hemodynamic brain response to sexual stimuli

    DEFF Research Database (Denmark)

    Ponseti, Jorge; Granert, Oliver; Jansen, Olav

    2012-01-01

    Accurately assessing sexual preference is important in the treatment of child sex offenders. Phallometry is the standard method to identify sexual preference; however, this measure has been criticized for its intrusiveness and limited reliability....

  3. Echocardiography and ultrasound dopplerography assessment of central and peripheral hemodynamics in children with septic shock

    Directory of Open Access Journals (Sweden)

    V.V. Yevtushenko

    2017-08-01

    higher heart rate, lower systolic velocity (V max values in the truncus coeliacus and femoral artery, diastolic velocity (V min, and peripheral resistance index in the renal artery at the initial examination. Conclusions. Comprehensive study of central and regional hemodynamics parameters in children through echocardiography and Doppler ultrasound allows non-invasive diagnostic of early violations associated with septic shock and control of the effectiveness of therapeutic measures.

  4. Radius of proximal isovelocity surface area in the assessment of rheumatic mitral stenosis: Connecting flow to anatomy and hemodynamics.

    Science.gov (United States)

    Omar, Alaa Mabrouk Salem; Abdel-Rahman, Mohamed Ahmed; Raslan, Hala; Rifaie, Osama

    2015-10-01

    Echocardiographic assessment of left atrial pressure (LAP) in mitral stenosis (MS) is controversial. We sought to examine the role of the radius of the proximal isovelocity surface area (PISA-r) in the assessment of the hemodynamic status of MS after fixing the aliasing velocity (Val). We studied 42 candidates of balloon mitral valvuloplasty (BMV), for whom pre-BMV echocardiography was done and LAP invasively measured before dilatation. PISA-r was calculated after fixing aliasing velocity to 33 cm/s. In addition, the ratio IVRT/Te'-E was also measured, where IVRT was isovolumic relaxation time, and Te'-E was the time difference between the onset of mitral flow E-wave and mitral annular early diastolic velocity. IVRT/Te'-E and PISA-r showed a strong correlation with LAP (r = -0.715 and -0.637, all p < 0.001) and with right-sided pressures. In addition, PISA-r correlated with mitral valve area by planimetry method (MVA) and with left ventricular outflow tract stroke volume (r = 0.66 and 0.71, all p < 0.001). Receiver operator characteristic curve (ROC-curve) showed that PISA-r was not inferior to IVRT/Te'-E in differentiating LAP ⩾25 from <25 mmHg. Provided that Val is set to a constant of 33 cm/s, PISA-r can assess the hemodynamic status of MS, and seems a simple alternative to the tedious IVRT/Te'-E for estimation of LAP.

  5. Hydraulic and hemodynamic performance of a minimally invasive intra-arterial right ventricular assist device.

    Science.gov (United States)

    Hsu, Po-Lin; Graefe, Roland; Boehning, Fiete; Wu, Chen; Parker, Jack; Autschbach, Rüdiger; Schmitz-Rode, Thomas; Steinseifer, Ulrich

    2014-09-01

    Right ventricular assistance is still in the early phase of development compared to left ventricular assist device (LVAD) technology. In order to provide flexible pulmonary support and potentially reduce the known complications, we propose a minimally invasive right ventricular assist device (MIRVAD), located in the pulmonary artery (PA) and operating in series with the right ventricle (RV). The MIRVAD is an intra-arterial rotary blood pump containing a single axial impeller, which is not enclosed by a rigid housing but stent-fixed within the vessel. The impeller geometry has been designed with the assistance of analytical methods and computational fluid dynamics (CFD). The hydraulic performance of the impeller was evaluated experimentally with a customized test setup using blood synthetic medium (HES). The blade-tip clearance (BTC) was varied between 0.25-4.25 mm to evaluate the effect of different PA sizes on impeller performance. Furthermore, the Langrangian particle-tracking method was used to estimate the level of hemolysis and generate numerical blood damage indexes.The impeller design generated 25.6 mmHg for flow rates of 5 lpm at a speed of 6,000 rpm at the baseline condition, capable of providing sufficient support for the RV. The BTC presented a significant effect on the static pressure generation and the efficiency, but the operational range is suitable for most vessel sizes. The numerical results demonstrated a low risk of blood damage at the design point (mean Lagrangian damage index 2.6*10(-7)). The preliminary results have encouraged further impeller optimization and development of the MIRVAD.

  6. Radionuclide assessment of peripheral hemodynamics: a new technique for measurement of forearm blood volume and flow

    Energy Technology Data Exchange (ETDEWEB)

    Todo, Y.; Tanimoto, M.; Yamamoto, T.; Iwasaki, T.

    1986-02-01

    A new peripheral hemodynamic measurement system using /sup 99m/Tc-labeled red blood cells has been developed. This method was carried out on 22 normal subjects, 29 with coronary artery disease, and two with dilated cardiomyopathy. Peripheral hemodynamic indices obtained from this method included forearm blood volume (FBV), venous capacity (FVC), venous capacity index (VCI), blood flow (FBF), and vascular resistance (FVR), and were compared with the central hemodynamic parameters of left ventricular filling pressure (LVFP), cardiac output (CO), and total systemic vascular resistance (TSVR) obtained with an invasive technique. The normal values were FBV 8.54 +/- 2.04 ml/100 ml; FVC 4.54 +/- 1.23 ml/100 ml; VCI 65.5 +/- 3.8%; FBF 4.26 +/- 0.56 ml/100 ml/min; and FVR 20.9 +/- 4.4 mmHg/ml/100 ml/min. These values were in good agreement with the values reported using conventional plethysmography. The 16 patients with congestive heart failure (NYHA Class II or III) showed significantly lower FBV, FVC, and FBF values and significantly higher VCI and FVR values than the healthy subjects. Capacitance vessel parameters (FBV, FVC, and VCI) and LVFP, FBF and CO, and FVR and TSVR each showed significant correlation; reproducibility was also good. The advantages of this method are (a) the detector does not come in contact with the region being measured; (b) it is possible to ascertain the absolute quantity of blood in the tissue; (c) extravasation of the plasma component can be ignored; and (d) data processing is simple.

  7. Assessment of pedophilia using hemodynamic brain response to sexual stimuli.

    Science.gov (United States)

    Ponseti, Jorge; Granert, Oliver; Jansen, Olav; Wolff, Stephan; Beier, Klaus; Neutze, Janina; Deuschl, Günther; Mehdorn, Hubertus; Siebner, Hartwig; Bosinski, Hartmut

    2012-02-01

    Accurately assessing sexual preference is important in the treatment of child sex offenders. Phallometry is the standard method to identify sexual preference; however, this measure has been criticized for its intrusiveness and limited reliability. To evaluate whether spatial response pattern to sexual stimuli as revealed by a change in the blood oxygen level-dependent signal facilitates the identification of pedophiles. During functional magnetic resonance imaging, pedophilic and nonpedophilic participants were briefly exposed to same- and opposite-sex images of nude children and adults. We calculated differences in blood oxygen level-dependent signals to child and adult sexual stimuli for each participant. The corresponding contrast images were entered into a group analysis to calculate whole-brain difference maps between groups. We calculated an expression value that corresponded to the group result for each participant. These expression values were submitted to 2 different classification algorithms: Fisher linear discriminant analysis and κ -nearest neighbor analysis. This classification procedure was cross-validated using the leave-one-out method. Section of Sexual Medicine, Medical School, Christian Albrechts University of Kiel, Kiel, Germany. We recruited 24 participants with pedophilia who were sexually attracted to either prepubescent girls (n = 11) or prepubescent boys (n = 13) and 32 healthy male controls who were sexually attracted to either adult women (n = 18) or adult men (n = 14). Sensitivity and specificity scores of the 2 classification algorithms. The highest classification accuracy was achieved by Fisher linear discriminant analysis, which showed a mean accuracy of 95% (100% specificity, 88% sensitivity). Functional brain response patterns to sexual stimuli contain sufficient information to identify pedophiles with high accuracy. The automatic classification of these patterns is a promising objective tool to clinically diagnose

  8. Relationship of the duke jeopardy score combined with minimal lumen diameter as assessed by computed tomography angiography to the hemodynamic relevance of coronary artery stenosis.

    Science.gov (United States)

    Yu, Mengmeng; Zhao, Yonghong; Li, Wenbin; Lu, Zhigang; Wei, Meng; Zhou, Wenxiao; Zhang, Jiayin

    2018-03-02

    To study the diagnostic performance of the ratio between the Duke jeopardy score (DJS) and the minimal lumen diameter (MLD) (DJS/MLD CT ratio) as assessed by coronary computed tomographic angiography (CTA) for differentiating functionally significant from non-significant coronary artery stenoses, with reference to invasive fractional flow reserve (FFR). Patients who underwent both coronary CTA and FFR measurement during invasive coronary angiography (ICA) within 2 weeks were retrospectively included in the study. Invasive FFR measurement was performed in patients with intermediate to severe coronary stenoseis. DJS/MLD CT ratio and anatomical parameters were recorded. Lesions with FFR ≤0.80 were considered to be functionally significant. One hundred and sixty-one patients with 175 lesions were included into the analysis. Diameter stenosis in CT, area stenosis, plaque burden, lesion length (LL), ICA-based stenosis degree, DJS, LL/MLD 4 ratio, DJS/MLA ratio as well as DJS/MLD ratio were all significantly different between hemodynamically significant and non-significant lesions (pvalue for DJS/MLD CT ratio to be 1.96 (area under curve = 0.863, 95 % confidence interval = 0.803-0.910), yielding a high diagnostic accuracy (86.9%, 152/175). In coronary artery stenoses detected by coronary CTA, the DJS/MLD ratio is able to predict hemodynamic relevance. Copyright © 2018 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  9. Avaliação hemodinâmica em paciente criticamente enfermo Hemodynamic assessment in the critically ill patient

    Directory of Open Access Journals (Sweden)

    Paulo Novis Rocha

    2010-06-01

    Full Text Available Uma fração crescente das atividades clínicas dos nefrologistas é exercida nas unidades de terapia intensiva (UTIs. Ao avaliar pacientes com insuficiência renal aguda no contexto de choque circulatório, que também apresentam anasarca e/ou trocas gasosas ruins, o nefrologista precisa decidir entre duas condutas antagônicas: 1 remover volume através de diálise ou diureticoterapia para melhorar o quadro edematoso; 2 administrar volume para melhorar a hemodinâmica. Para minimizar a chance de decisões incorretas, é imperativo que o nefrologista conheça as ferramentas disponíveis para avaliação hemodinâmica invasiva e de estimativa de adequação da volemia no paciente com doença crítica. Neste artigo, fazemos uma breve revisão da fisiologia da regulação do volume do líquido extracelular e, em seguida, abordamos o diagnóstico de volemia, com base em critérios clínicos e hemodinâmicos.A growing fraction of the clinical duties of Nephrologists is undertaken inside intensive care units. While assessing patients with acute renal failure in the context of circulatory collapse, which are also edematous and/or with impaired gas exchanges, the Nephrologist must decide between two opposing therapies: 1 remove volume with the aid of dialysis or diuretics to improve the edematous state; 2 volume expand to improve hemodynamics. To minimize the odds of making incorrect choices, the Nephrologist must be familiar with the tools available for determining the adequacy of volume status and for invasive hemodynamic monitoring in the critically ill patient. In this manuscript, we will briefly review the physiology of extra cellular fluid volume regulation and then tackle the issue of volume status assessment, based on clinical and hemodynamic criteria.

  10. Determination of Hemodynamic Changes on Heart Rate for Assessment of Orthostatic Intolerance in Older People

    Energy Technology Data Exchange (ETDEWEB)

    Hortelano Rubio, M.; Reilly, R.B.; Cervigón Abad, R.

    2016-07-01

    Introduction.- The aim of our study was to assess the hemodynamic changes that occur in symptomatic Orthostatic Intolerance (OI) patients, at the starting of exercise and recovery stages during six minutes walking distance test. Materials.- We analysed 65 older subjects, of whom 42 were women. The participants were carried out the Active Stand Protocol. The records were divided into: Phase 1 (pre-exercise), Phase 2 (starting of exercise), Phase 3 (active), Phase 4 (recovery) and Phase 5 (prost-exercise). Methods.- The averages and differences of heart rate (HR) between Phase 1, Phase 3 and Phase 5 were calculated. In the same way, duration before stabilization from passive to active stages (Phase 2) and from active to passive stages (Phase 4) were calculated. The máximum and mínimum values achieved in these time series and the difference between these values were also calculated. Results.- Results showed that the symptomatic OI patients employed more time to reach the active phase tan the asymptomatic OI participants. Moreover, the symptomatic OI participants showed higher mínimum heart rate values at the starting of exercise and recovery stages. However, the asymptomatic OI group illustrated a higher difference between the máximum and mínimum heart rate values in these stages with a significance p=0.003 and p=0.007, respectivecly. Conclusion.- This study provides important information on hemodynamic parameters and can be helpful for description of the hemodynamic changes that occur during OI. (Author)

  11. Magnetic Particle Imaging for High Temporal Resolution Assessment of Aneurysm Hemodynamics.

    Directory of Open Access Journals (Sweden)

    Jan Sedlacik

    Full Text Available The purpose of this work was to demonstrate the capability of magnetic particle imaging (MPI to assess the hemodynamics in a realistic 3D aneurysm model obtained by additive manufacturing. MPI was compared with magnetic resonance imaging (MRI and dynamic digital subtraction angiography (DSA.The aneurysm model was of saccular morphology (7 mm dome height, 5 mm cross-section, 3-4 mm neck, 3.5 mm parent artery diameter and connected to a peristaltic pump delivering a physiological flow (250 mL/min and pulsation rate (70/min. High-resolution (4 h long 4D phase contrast flow quantification (4D pc-fq MRI was used to directly assess the hemodynamics of the model. Dynamic MPI, MRI, and DSA were performed with contrast agent injections (3 mL volume in 3 s through a proximally placed catheter.4D pc-fq measurements showed distinct pulsatile flow velocities (20-80 cm/s as well as lower flow velocities and a vortex inside the aneurysm. All three dynamic methods (MPI, MRI, and DSA also showed a clear pulsation pattern as well as delayed contrast agent dynamics within the aneurysm, which is most likely caused by the vortex within the aneurysm. Due to the high temporal resolution of MPI and DSA, it was possible to track the contrast agent bolus through the model and to estimate the average flow velocity (about 60 cm/s, which is in accordance with the 4D pc-fq measurements.The ionizing radiation free, 4D high resolution MPI method is a very promising tool for imaging and characterization of hemodynamics in human. It carries the possibility of overcoming certain disadvantages of other modalities like considerably lower temporal resolution of dynamic MRI and limited 2D characteristics of DSA. Furthermore, additive manufacturing is the key for translating powerful pre-clinical techniques into the clinic.

  12. Computational and experimental assessment of influences of hemodynamic shear stress on carotid plaque.

    Science.gov (United States)

    Zhou, Hui; Meng, Long; Zhou, Wei; Xin, Lin; Xia, Xiangxiang; Li, Shuai; Zheng, Hairong; Niu, Lili

    2017-07-29

    Studies have identified hemodynamic shear stress as an important determinant of endothelial function and atherosclerosis. In this study, we assess the influences of hemodynamic shear stress on carotid plaques. Carotid stenosis phantoms with three severity (30, 50, 70%) were made from 10% polyvinyl alcohol (PVA) cryogel. The phantoms were placed in a pulsatile flow loop with the same systolic/diastolic phase (35/65) and inlet flow rate (16 L/h). Ultrasonic particle imaging velocimetry (Echo PIV) and computational fluid dynamics (CFD) were used to calculate the velocity profile and shear stress distribution in the carotid stenosis phantoms. Inlet/outlet boundary conditions used in CFD were extracted from Echo PIV experiments to make sure that the results were comparable. Echo PIV and CFD results showed that velocity was largest in 70% than those in 30 and 50% at peak systole. Echo PIV results indicated that shear stress was larger in the upper wall and the surface of plaque than in the center of vessel. CFD results demonstrated that wall shear stress in the upstream was larger than in downstream of plaque. There was no significant difference in average velocity obtained by CFD and Echo PIV in 30% (p = 0.25). Velocities measured by CFD in 50% (93.01 cm/s) and in 70% (115.07 cm/s) were larger than those by Echo PIV in 50% (60.26 ± 5.36 cm/s) and in 70% (89.11 ± 7.21 cm/s). The results suggested that Echo PIV and CFD could obtain hemodynamic shear stress on carotid plaques. Higher WSS occurred in narrower arteries, and the shoulder of plaque bore higher WSS than in bottom part.

  13. Time-Frequency Characterization of Cerebral Hemodynamics of Migraine Sufferers as Assessed by NIRS Signals

    Directory of Open Access Journals (Sweden)

    Filippo Molinari

    2010-01-01

    Full Text Available Near-infrared spectroscopy (NIRS is a noninvasive system for the real-time monitoring of the concentration of oxygenated (O2Hb and reduced (HHb hemoglobin in the brain cortex. O2Hb and HHb concentrations vary in response to cerebral autoregulation. Sixty-eight women (14 migraineurs without aura, 49 migraineurs with aura, and 5 controls performed breath-holding and hyperventilation during NIRS recordings. Signals were processed using the Choi-Williams time-frequency transform in order to measure the power variation of the very-low frequencies (VLF: 20–40 mHz and of the low frequencies (LF: 40–140 mHz. Results showed that migraineurs without aura present different LF and VLF power levels than controls and migraineurs with aura. The accurate power measurement of the time-frequency analysis allowed for the discrimination of the subjects' hemodynamic patterns. The time-frequency analysis of NIRS signals can be used in clinical practice to assess cerebral hemodynamics.

  14. Time-Frequency Characterization of Cerebral Hemodynamics of Migraine Sufferers as Assessed by NIRS Signals

    Directory of Open Access Journals (Sweden)

    Liboni William

    2010-01-01

    Full Text Available Abstract Near-infrared spectroscopy (NIRS is a noninvasive system for the real-time monitoring of the concentration of oxygenated ( and reduced (HHb hemoglobin in the brain cortex. and HHb concentrations vary in response to cerebral autoregulation. Sixty-eight women (14 migraineurs without aura, 49 migraineurs with aura, and 5 controls performed breath-holding and hyperventilation during NIRS recordings. Signals were processed using the Choi-Williams time-frequency transform in order to measure the power variation of the very-low frequencies (VLF: 20–40 mHz and of the low frequencies (LF: 40–140 mHz. Results showed that migraineurs without aura present different LF and VLF power levels than controls and migraineurs with aura. The accurate power measurement of the time-frequency analysis allowed for the discrimination of the subjects' hemodynamic patterns. The time-frequency analysis of NIRS signals can be used in clinical practice to assess cerebral hemodynamics.

  15. Transcranial Doppler ultrasound assessment of intracranial hemodynamics in patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Dikanovic, M.; Balen, I.; Jandric, M.; Hozo, I.; Kokic, S.; Titlic, M.; Kadojic, D.

    2005-01-01

    Diabetics have a 3-fold risk for cardiovascular diseases compared with non-diabetics. This study was designed to evaluate cerebral hemodynamic changes related to type 2 diabetes mellitus (DM) with transcranial Doppler ultrasonography (TCD). TCD is a highly sensitive and specific method of quick bedside assessment of cerebrovascular circular circulation hemodynamics. In a prospective study, we compared a group of 100 patients with the diagnosis of type 2 diabetes mellitus (aged 48 to 67 years) and an age-and sex-matched control group of 100 healthy subjects without diabetes mellitus. We measured flow velocities (Vm) and the Gosling pulsatility index (PI) of the middle cerebral artery (MCA).The rate of TCD abnormalities was significantly higher in diabetic patients than in healthy control subjects (55% vs. 11%, P - 5 years, respectively. This study suggests that TCD is a useful marker for the detection of diabetic cerebrovascular changes. The duration and type of diabetes were found to have an impact on the development of pathologic cerebrovascular changes. (author)

  16. Nurses' attitudinal and normative beliefs concerning hemodynamic assessment by pulmonary artery catheterization.

    Science.gov (United States)

    Pinto, Cristiano José Mendes; Colombo, Roberta Cunha Rodrigues; Gallani, Maria Cecília Bueno Jayme

    2006-01-01

    The objective of this study was to identify, by using the Theory of Reasoned Action/Theory of Planned Behavior, the attitude and normative beliefs that influence the behavioral intention of the nurse to perform a hemodynamic assessment using the pulmonary artery catheterization. Data were collected through semi-structured interviews involving 23 nurses from three hospitals in the city of Campinas, São Paulo. The data were analyzed according to a qualitative methodology. Among the Attitude Beliefs, affective beliefs and those related to the advantages and disadvantages of performing the behavior stand out. Among the Normative Beliefs social referents were identified for the behavior, as well as the behavior-stimulating factors and the factors that discourage the performance of the behavior.

  17. Assessing the feasibility of the Healthy Life in Suriname Study: using advanced hemodynamics to evaluate cardiovascular risk

    NARCIS (Netherlands)

    Aartman, Jet Q.; Diemer, Frederieke S.; Karamat, Fares A.; Bohte, Evelien; Baldew, Sergio M.; Jarbandhan, Ameerani V.; van Montfrans, Gert A.; Oehlers, Glenn P.; Brewster, Lizzy M.

    2017-01-01

    Objectives. To determine the feasibility of assessing population cardiovascular risk with advanced hemodynamics in the Healthy Life in Suriname (HELISUR) study. Methods. This was a preliminary study conducted in May - June 2012 using the Technical-Economic-Legal-Operational-Scheduling (TELOS) method

  18. Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment

    DEFF Research Database (Denmark)

    Laugesen, Esben; Knudsen, Søren Tang; Hansen, Klavs Würgler

    2016-01-01

    Aortic systolic blood pressure (BP) represents the hemodynamic cardiac and cerebral burden more directly than office systolic BP. Whether invasively measured aortic systolic BP confers additional prognostic value beyond office BP remains debated. In this study, office systolic BP and invasively m...

  19. Computational medical imaging and hemodynamics framework for functional analysis and assessment of cardiovascular structures.

    Science.gov (United States)

    Wong, Kelvin K L; Wang, Defeng; Ko, Jacky K L; Mazumdar, Jagannath; Le, Thu-Thao; Ghista, Dhanjoo

    2017-03-21

    Cardiac dysfunction constitutes common cardiovascular health issues in the society, and has been an investigation topic of strong focus by researchers in the medical imaging community. Diagnostic modalities based on echocardiography, magnetic resonance imaging, chest radiography and computed tomography are common techniques that provide cardiovascular structural information to diagnose heart defects. However, functional information of cardiovascular flow, which can in fact be used to support the diagnosis of many cardiovascular diseases with a myriad of hemodynamics performance indicators, remains unexplored to its full potential. Some of these indicators constitute important cardiac functional parameters affecting the cardiovascular abnormalities. With the advancement of computer technology that facilitates high speed computational fluid dynamics, the realization of a support diagnostic platform of hemodynamics quantification and analysis can be achieved. This article reviews the state-of-the-art medical imaging and high fidelity multi-physics computational analyses that together enable reconstruction of cardiovascular structures and hemodynamic flow patterns within them, such as of the left ventricle (LV) and carotid bifurcations. The combined medical imaging and hemodynamic analysis enables us to study the mechanisms of cardiovascular disease-causing dysfunctions, such as how (1) cardiomyopathy causes left ventricular remodeling and loss of contractility leading to heart failure, and (2) modeling of LV construction and simulation of intra-LV hemodynamics can enable us to determine the optimum procedure of surgical ventriculation to restore its contractility and health This combined medical imaging and hemodynamics framework can potentially extend medical knowledge of cardiovascular defects and associated hemodynamic behavior and their surgical restoration, by means of an integrated medical image diagnostics and hemodynamic performance analysis framework.

  20. Echocardiographic assessment of right heart function in heart transplant recipients and the relation to exercise hemodynamics.

    Science.gov (United States)

    Clemmensen, Tor Skibsted; Eiskjaer, Hans; Løgstrup, Brian Bridal; Andersen, Mads Jønsson; Mellemkjaer, Søren; Poulsen, Steen Hvitfeldt

    2016-08-01

    This study aimed to characterize right heart function in heart transplantation (HTx) patients using advanced echocardiographic assessment and simultaneous right heart catheterization (RHC). Comprehensive two-dimensional (2D) and three-dimensional (3D) echocardiographic assessment of right heart function was performed in 105 subjects (64 stable HTx patients and 41 healthy controls). RHC was performed at rest and during semi-supine maximal exercise test. Compared with controls, in conclusion, HTx patients had impaired right ventricle (RV) systolic function in terms of decreased RV-free wall (FW) global longitudinal strain (GLS) (-20 ± 5% vs. -28 ± 5%, P exercise capacity (r = 0.58, P routine right heart function evaluation after HTx. Invasively assessed RV systolic reserve was strongly associated with exercise capacity. © 2016 Steunstichting ESOT.

  1. Complex assessment of regional hemodynamics with tetrapolar rheography and laser Doppler fluometry in patients with low back pain syndrome

    Directory of Open Access Journals (Sweden)

    D. A. Shemetov

    2003-01-01

    Full Text Available Objective. To assess hemodynamic disturbances in pts with low back pain syndrome (LBPS. Material and methods. 57 pts with LBPS were examined (12 female and 45 male aged 18 to 53 years (mean age 36,7 years. Spine osteochondritis was diagnosed in most of them. 34 had subacute and 23 - chronic LBPS course. In 32 pts peripheral hemodinamic indices were examined with tetrapolar rheo- vasography by “ARM-RhEO" apparatus. In 25 pts total local blood flow was assessed in pain points with laser-Doppler fluometry (LDF-2 apparatus. 35 healthy individuals of comparable age and sex were included in control group. Results. 77% of pts showed small vessels tone decrease most prominent in pts with subacute LBPS course. Arterial wall elasticity diminution was revealed in 63% of cases, significant reduction of blood filling level - in 82%, venous flow-out obstacle - in 87%. There was a connection between degree of local blood flow increase in back pain points and (PI score: 0,19 V in pts with PI>60 u and 0,13 V in pts with PK40 u (in control group - 0,08 V, p<0,05 what shows perifocal edema in most painful points. Conclusion. Revealed regional hemodynamic and microcirculation disturbances can objectively confirm participation of hemodynamic disturbances in pain syndrome genesis and serve as a basis for perfection of LBPS treatment methods.

  2. Endothelin-1 Predicts Hemodynamically Assessed Pulmonary Arterial Hypertension in HIV Infection.

    Directory of Open Access Journals (Sweden)

    Rushi V Parikh

    Full Text Available HIV infection is an independent risk factor for PAH, but the underlying pathogenesis remains unclear. ET-1 is a robust vasoconstrictor and key mediator of pulmonary vascular homeostasis. Higher levels of ET-1 predict disease severity and mortality in other forms of PAH, and endothelin receptor antagonists are central to treatment, including in HIV-associated PAH. The direct relationship between ET-1 and PAH in HIV-infected individuals is not well described.We measured ET-1 and estimated pulmonary artery systolic pressure (PASP with transthoracic echocardiography (TTE in 106 HIV-infected individuals. Participants with a PASP ≥ 30 mmHg (n = 65 underwent right heart catheterization (RHC to definitively diagnose PAH. We conducted multivariable analysis to identify factors associated with PAH.Among 106 HIV-infected participants, 80% were male, the median age was 52 years and 77% were on antiretroviral therapy. ET-1 was significantly associated with higher values of PASP [14% per 0.1 pg/mL increase in ET-1, p = 0.05] and PASP ≥ 30 mmHg [PR (prevalence ratio = 1.24, p = 0.012] on TTE after multivariable adjustment for PAH risk factors. Similarly, among the 65 individuals who underwent RHC, ET-1 was significantly associated with higher values of mean pulmonary artery pressure and PAH (34%, p = 0.003 and PR = 2.43, p = 0.032, respectively in the multivariable analyses.Higher levels of ET-1 are independently associated with HIV-associated PAH as hemodynamically assessed by RHC. Our findings suggest that excessive ET-1 production in the setting of HIV infection impairs pulmonary endothelial function and contributes to the development of PAH.

  3. Effect of exercise and pump speed modulation on invasive hemodynamics in patients with centrifugal continuous-flow left ventricular assist devices.

    Science.gov (United States)

    Muthiah, Kavitha; Robson, Desiree; Prichard, Roslyn; Walker, Robyn; Gupta, Sunil; Keogh, Anne M; Macdonald, Peter S; Woodard, John; Kotlyar, Eugene; Dhital, Kumud; Granger, Emily; Jansz, Paul; Spratt, Phillip; Hayward, Christopher S

    2015-04-01

    Continuous-flow left ventricular assist devices (CF-LVADs) improve functional capacity in patients with end-stage heart failure. Pump output can be increased by increased pump speed as well as changes in loading conditions. The effect of exercise on invasive hemodynamics was studied in two study protocols. The first examined exercise at fixed pump speed (n = 8) and the second with progressive pump speed increase (n = 11). Patients underwent simultaneous right-heart catheterization, mixed venous saturation, echocardiography and mean arterial pressure monitoring. Before exercise, a ramp speed study was performed in all patients. Patients then undertook symptom-limited supine bicycle exercise. Upward titration of pump speed at rest (by 11.6 ± 8.6% from baseline) increased pump flow from 5.3 ± 1.0 to 6.3 ± 1.0 liters/min (18.9% increase, p pump flow to a similar extent as pump speed change alone (to 6.2 ± 1.0 liters/min, p pump speed increase with exercise enhanced the pump flow increase (to 7.0 ± 1.4 liters/min, p Pump flow increases with up-titration of pump speed and with exercise. Although increased pump speed decreases filling pressures at rest, the benefit is not seen with exercise despite concurrent up-titration of pump speed. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  4. The assessment of invasive alien plant species removal programs ...

    African Journals Online (AJOL)

    Yusuf Adam

    Abstract. The occupation of natural environments by invasive alien plant species (IAPs) are a growing threat to ecosystems. This has resulted in the creation of government-based initiatives to mitigate invasion, however, there has been little progress towards assessing these initiatives. Remote sensing is a commonly used ...

  5. The assessment of invasive alien plant species removal programs ...

    African Journals Online (AJOL)

    The occupation of natural environments by invasive alien plant species (IAPs) are a growing threat to ecosystems. This has resulted in the creation of government-based initiatives to mitigate invasion, however, there has been little progress towards assessing these initiatives. Remote sensing is a commonly used tool in the ...

  6. Monitoring hemodynamics and oxygenation of the kidney in rats by a combined near-infrared spectroscopy and invasive probe approach

    Science.gov (United States)

    Grosenick, Dirk; Cantow, Kathleen; Arakelyan, Karen; Wabnitz, Heidrun; Flemming, Bert; Skalweit, Angela; Ladwig, Mechthild; Macdonald, Rainer; Niendorf, Thoralf; Seeliger, Erdmann

    2015-07-01

    We have developed a hybrid approach to investigate the dynamics of perfusion and oxygenation in the kidney of rats under pathophysiologically relevant conditions. Our approach combines near-infrared spectroscopy to quantify hemoglobin concentration and oxygen saturation in the renal cortex, and an invasive probe method for measuring total renal blood flow by an ultrasonic probe, perfusion by laser-Doppler fluxmetry, and tissue oxygen tension via fluorescence quenching. Hemoglobin concentration and oxygen saturation were determined from experimental data by a Monte Carlo model. The hybrid approach was applied to investigate and compare temporal changes during several types of interventions such as arterial and venous occlusions, as well as hyperoxia, hypoxia and hypercapnia induced by different mixtures of the inspired gas. The approach was also applied to study the effects of the x-ray contrast medium iodixanol on the kidney.

  7. Assessment of cortical hemodynamics by multichannel near-infrared spectroscopy in steno-occlusive disease of the middle cerebral artery.

    Science.gov (United States)

    Oldag, Andreas; Goertler, Michael; Bertz, Anne-Katrin; Schreiber, Stefanie; Stoppel, Christian; Heinze, Hans-Jochen; Kopitzki, Klaus

    2012-11-01

    In a pilot study we evaluated near-infrared spectroscopy as to its potential benefit in monitoring patients with steno-occlusive disease of a major cerebral artery for alterations in cortical hemodynamics. Cortical maps of time-to-peak (TTP) in 10 patients unilaterally affected by severe stenosis or occlusion of the middle cerebral artery were acquired by multichannel near-infrared spectroscopy after bolus application of indocyanine green. Hemodynamic manifestations were assessed by comparison between affected and unaffected hemisphere and evaluated for common constituents by principal component analysis. In one patient, TTP values were compared with those obtained by dynamic susceptibility contrast imaging. TTP was increased on the affected hemisphere in 9 patients. Mean difference in TTP between hemispheres was 0.44 second (P<0.05) as compared with a mean lateral difference of 0.12 second found in a control group of 10 individuals. In group analysis a significant rise in TTP was found in the distribution of the affected middle cerebral artery, whereas principal component analysis suggests augmentation of hemodynamic effects toward the border zones as a dominant pattern. A linear correlation of 0.61 between TTP values determined by dynamic susceptibility contrast MRI and near-infrared spectroscopy was found to be statistically significant (P<0.001). Multichannel near-infrared spectroscopy might facilitate detection of disease-related hemodynamic changes as yet only accessible by tomographic imaging modalities. Being indicative for hypoperfusion and collateral flow increased values of TTP, as found to a varying extent in the present patient group, might be of clinical relevance.

  8. Hemodynamic Change in Pulmonary Vein Stenosis after Radiofrequency Ablation: Assessment with Magnetic Resonance Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Doyoung; Jung, Jung Im; Oh, Yong Seog; Youn, Ho Joong [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-11-15

    We present a case of pulmonary vein (PV) stenosis after radio-frequency (RF) ablation, in which a hemodynamic change in the pulmonary artery was similar to that of congenital PV atresia on time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA). A 48-year-old man underwent RF ablation due to atrial fibrillation. The patient subsequently complained of hemoptysis, dyspnea on exertion, and right chest pain. Right PV stenosis after catheter ablation was diagnosed through chest computed tomography and lung perfusion scan. Pulmonary TR-MRA revealed the pulmonary artery via systemic arterial collaterals and draining systemic collateral veins. On a velocity-encoded cine image, the flow direction of the right pulmonary artery was reversed in the diastolic phase and the left pulmonary artery demonstrated continuous forward flow throughout the cardiac cycle. These hemodynamic changes were similar to those seen in congenital unilateral PV atresia.

  9. Non-invasive assessment of gastric activity

    International Nuclear Information System (INIS)

    Smallwood, R.H.; Brown, B.H.

    1983-01-01

    There have been many suggestions for the routine clinical use of the electro-enterogram, but with the exception of the reported usage in the USSR no significant penetration into medical practice has been reported elsewhere. Amongst the many suggestions have been the possible application of electrical stimulation via surface electrodes to overcome post-operative inhibition of intestinal electrical activity, which can be recorded via surface electrodes. Gastric emptying studies have shown that duodenal ulceration is associated with changes in the rate and pattern of emptying of solid meals. Identifiable patterns in the electro-gastrogram following a metal might have diagnostic application. There is some evidence of correlations of electrical activity and pathology in the large intestine. In the colon diverticular disease has been shown to change the frequency content of the slow wave electrical activity and there is some evidence that this might be recorded from surface electrodes. A major obstacle to progress remains the inability to relate non-invasive recordings to intestinal motility. The best hope may be the use of direct and yet non-invasive methods of obtaining motility and in this context real-time ultrasound imaging is probably the most promising technique. The electro-gastrogram has certainly been shown to allow recording of gastric slow wave activity and there is a reasonable hope that further methods of analysis will allow inferential information on motility to be obtained. The following section makes brief mention of these techniques

  10. Importance of Collateralization in Patients With Large Artery Intracranial Occlusive Disease: Long-Term Longitudinal Assessment of Cerebral Hemodynamic Function

    Directory of Open Access Journals (Sweden)

    Larissa McKetton

    2018-04-01

    Full Text Available Patients with large artery intracranial occlusive disease (LAICOD are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR using blood oxygen level-dependent (BOLD MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients. Here, we report a case of long-term follow-up in a 28-year-old Caucasian female presented to the neurology clinic with a history of TIAs and LAICOD of the right middle cerebral artery (MCA. Initial structural MRI showed a right MCA stenosis and a small right coronal radiate lacunar infarct. Her CVR study showed a large area of impaired CVR with a paradoxical decrease in BOLD signal with hypercapnia involving the right MCA territory indicating intracerebral steal. The patient was managed medically with anticoagulant and antiplatelet therapy and was followed-up for over 9 years with both structural and functional imaging. Cortical thickness (CT measures were longitudinally assessed from a region of interest that was applied to subsequent time points in the cortical region exhibiting steal physiology and in the same region of the contralateral healthy hemisphere. In the long-term follow-up, the patient exhibited improvement in her CVR as demonstrated by the development of collaterals with negligible changes to CT. Management of patients with LAICOD remains challenging since no revascularization strategies have shown efficacy except in patients with moyamoya disease. Management is well

  11. Non invasive assessment of liver fibrosis in chronic hemodialysis ...

    African Journals Online (AJOL)

    The liver biopsy has long been the "gold standard" for assessing liver fibrosis in patients with hepatitis C. It's an invasive procedure which is associated with an elevated bleeding, especially in chronic hemodialysis patients. Main goal is to assess liver fibrosis in chronic hemodialysis with HCV by Fibroscan and by biological ...

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

    Science.gov (United States)

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

    2016-12-01

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

  13. Characteristics of cerebral hemodynamics assessed by CT perfusion in moyamoya disease.

    Science.gov (United States)

    Sasagawa, Ayaka; Mikami, Takeshi; Hirano, Toru; Akiyama, Yukinori; Mikuni, Nobuhiro

    2018-01-01

    Due to the recent development of multidetector row computed tomography (CT), hemodynamic parameters can now be conveniently obtained with CT perfusion. The purpose of this study is to characterize the hemodynamic parameters of CT perfusion in moyamoya disease, and to discuss the differences in collateral circulation between moyamoya disease and atherosclerotic disease. A total of 16 hemispheric sides of 15 patients with moyamoya disease and 10 hemispheric sides of 9 patients with atherosclerotic disease who underwent bypass surgery were included. CT perfusion was performed with 123 I-IMP SPECT. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) values obtained by CT perfusion using standard singular value decomposition as the deconvolution algorithm in moyamoya disease were calculated. Preoperative values of these parameters were compared with those of atherosclerotic disease. Then, the postoperative changes of these parameters were analyzed. In the impaired side, CBF as measured by CT perfusion was correlated with that measured by 123 I-IMP SPECT. In moyamoya disease, CBV as measured by CT perfusion was significantly increased compared to in atherosclerotic disease, yet CBF was significantly decreased in atherosclerotic disease. Postoperatively, the asymmetry ratios of MTT were significantly improved, especially in atherosclerotic disease compared with moyamoya disease. On CT perfusion, the parameters included transit time and arrival time. CBV increase in moyamoya disease and postoperative improvement of MTT, especially in atherosclerotic disease, were unique characteristics in each. This might be due to the difference of collateral circulation and compensatory mechanisms between moyamoya disease and atherosclerotic disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. How Do I Integrate Hemodynamic Variables When Managing Septic Shock?

    Directory of Open Access Journals (Sweden)

    Olfa Hamzaoui

    2016-11-01

    Full Text Available Hemodynamic management of sepsis-induced circulatory failure is complex since this pathological state includes multiple cardiovascular derangements that can vary from patient to patient according to the degree of hypovolemia, of vascular tone depression, of myocardial depression and of microvascular dysfunction. The treatment of the sepsis-induced circulatory failure is thus not univocal and should be adapted on an individual basis. As physical examination is insufficient to obtain a comprehensive picture of the hemodynamic status, numerous hemodynamic variables more or less invasively collected, have been proposed to well assess the severity of each component of the circulatory failure and to monitor the response to therapy. In this article, we first describe the hemodynamic variables, which are the most relevant to be used, emphasizing on their physiological meaning, their validation and their limitations in patients with septic shock. We then proposed a general approach for managing patients with septic shock by describing the logical steps that need to be followed in order to select and deliver the most appropriate therapies. This therapeutic approach is essentially based on knowledge of physiology, of pathophysiology of sepsis, and of published data from clinical studies that addressed the issue of hemodynamic management of septic shock.

  15. School based assessment module for invasion games category in ...

    African Journals Online (AJOL)

    School based assessment module for invasion games category in physical education. N Salimin, M.I. Shahril, J Jani, A Rahmat, G Elumalai, L Saad, M.R. Abdullah, S.M. Mat-Rasid, N.A. Kosni, A.B.H.M. Maliki ...

  16. [Information content of the rheoencephalogram and rheoencephaloplethysmogram for assessing cerebral hemodynamics].

    Science.gov (United States)

    Eremeev, V S; Semeniutin, V B; Tashaev, Sh S; Teplov, S I

    1978-08-01

    In acute experiments in cats, separate measurement of impedance of extra and intracranial tissues and skull bones was carried out by passing 30-150 kHz electrical current. Extra and intracranaial tissue impedances are approximately equal and one order less than that of skull bones which excludes electrical current penetration into the cranial cavity directly through the bone. The changes on electroplethysmograms recorded with extra and intracranial electrodes during simultaneous clipping of both common carotids or external and internal jugular veins were compared. In part of experiments jugular veins were clipped before and after switching off extracranial blood flow. Intracranial impedance changes thus achieved are several times greater than extracranial ones and are not registered in extracranial bitemporal electrode location. The only way to register them without intracranial electrode insertion is by use of ocular-occipital lead. Yet in this case the intracranial component makes only about 30% of the registered signal. This value increases significantly with artifical stabilization of extracranial hemodynamics.

  17. An approach to quantitative assessment of hemodynamic differences between unruptured and ruptured ophthalmic artery aneurysms.

    Science.gov (United States)

    Yu, Hongyu; Li, Haiyun; Liu, Jian; Yang, Xinjian

    2016-10-01

    Hemodynamic parameters are important in the pathogenesis, evolution and rupture of intracranial aneurysm. Energy loss (EL) has been applied for the rupture risk prediction of artery aneurysms recently. We proposed a new EL and further investigate its effects on the rupture of aneurysms. Sixty-four patient-specific ophthalmic aneurysm datasets were divided into ruptured and unruptured groups based on their clinical history. Based on patient-specific 3D-DSA data, realistic models were retrospectively reconstructed and then analyzed by using computational fluid dynamic method. The flow field feature EL in ruptured cases was significantly higher than that in unruptured cases. The average wall shear stress (WSS) and the maximum WSS in ruptured cases were higher than those in unruptured cases. Modified pressure loss coefficient (PLCM) in ruptured cases was slight higher than that in unruptured cases but the difference has no statistical significance. Multivariate logistic regression analysis demonstrated flow field feature EL (p < 0.05) and the maximum WSS (p < 0.05) were the only independently significant variables to predict rupture of ophthalmic aneurysm. There were no differences in PLCM, the maximum oscillatory shear index (OSI), the average OSI and AR between the two groups. Flow field feature EL may be a reliable factor to predict the rupture risk of aneurysms.

  18. Preliminary methods for wearable neuro-vascular assessment with non-invasive, active sensing.

    Science.gov (United States)

    Carek, Andrew M; Töreyin, Hakan; Hersek, Sinan; Inan, Omer T

    2015-01-01

    In this study, a non-invasive and active sensing scheme that is ultimately aimed to be integrated in a wearable system for neuro-vascular health assessment is presented with preliminary results. With this system, vascular tone is modulated by local heating and cooling of the palm, and the resulting changes in local hemodynamics are monitored via impedance plethysmography (IPG) and photoplethysmography (PPG) sensors interfaced with custom analog electronics. Proof-of-concept measurements were conducted on three subjects using hot packs/ice bags to modulate the palmar skin temperature. From ensemble averaged and smoothed versions of pulsatile IPG and PPG signals, the effects of local changes in skin temperature on a series of parameters associated with neuro-vascular mechanisms (heart rate, blood volume, blood flow rate, blood volume pulse inflection point area ratio, and local pulse transit time) have been observed. The promising experimental results suggest that, with different active temperature modulation schemes (consisting of heating/cooling cycles covering different temperature ranges at different rates), it would be possible to enhance the depth and specificity of the information associated with neuro-vascular health by using biosensors that can fit inside a wearable device (such as a sleeve). This study sets the foundation for future studies on designing and testing such a wearable neuro-vascular health assessment system employing active sensing.

  19. Effects of fat accumulation in the liver on hemodynamic variables assessed by Doppler ultrasonography.

    Science.gov (United States)

    Topal, Naile Bolca; Orcan, Serap; Sığırlı, Deniz; Orcan, Gökhan; Eritmen, Ülkü

    2015-01-01

    To investigate the effect of various degrees of fatty liver infiltration on hepatic hemodynamics using Doppler ultrasonography. We included 40 patients with hepatic steatosis and 20 healthy volunteers. Hepatic steatosis was quantified by a chemical shift MRI. Hepatic artery peak systolic and end-diastolic velocity, resistance index (RI) and pulsatility index (PI), hepatic vein RI and PI, portal vein RI, PI, congestion index, and peak maximum velocity were evaluated by Doppler ultrasonography. The hepatic vein waveforms were classified as triphasic, biphasic, or monophasic. Kruskal-Wallis test was performed for comparing more than two groups. If significant differences were found, Mann-Whitney U test with Bonferroni correction was performed for pair-wise comparisons. Pearson &gch;(2) and Fisher's exact tests were used to compare categorical variables. According to MRI, 15 patients had mild, 14 patients had moderate, and 11 patients had severe fatty infiltration. Portal vein peak maximum velocity was median: 19.8 (range 12-33.3), 21.1 (8-41.8), 16.6 (10.6-24.9), and 29.2 (14.1-40.4) cm/s. Congestion index was 0.05 (0.02-0.16), 0.07 (0.01-0.17), 0.11 (0.06-0.24), and 0.05 (0.02-0.16). Hepatic artery RI was 0.75 (0.56-1.00), 0.66 (0.52-0.87), 0.83 (0.38-1.00), and 0.76 (0.48-2.76), and PI was 1.83 (0.90-3.13), 1.38 (1.04-2.63), 1.97 (0.86-2.90), and 1.82 (0.70-2.90) (p = .046 and p = .036) in the mild, moderate, severe steatosis, and control groups, respectively. The rate of triphasic hepatic vein waveforms was higher in controls than in patients with severe steatosis. Portal vein flow velocity decreases in severe hepatic steatosis when compared with controls. © 2014 Wiley Periodicals, Inc.

  20. A review of hemodynamic monitoring techniques, methods and devices for the emergency physician.

    Science.gov (United States)

    Laher, Abdullah E; Watermeyer, Matthew J; Buchanan, Sean K; Dippenaar, Nicole; Simo, Nelly Clotilde Tchouambou; Motara, Feroza; Moolla, Muhammed

    2017-09-01

    The emergency department (ED) is frequently the doorway to the intensive care unit (ICU) for a significant number of critically ill patients presenting to the hospital. Hemodynamic monitoring (HDM) which is a key component in the effective management of the critically ill patient presenting to the ED, is primarily concerned with assessing the performance of the cardiovascular system and determining the correct therapeutic intervention to optimise end-organ oxygen delivery. The spectrum of hemodynamic monitoring ranges from simple clinical assessment and routine bedside monitoring to point of care ultrasonography and various invasive monitoring devices. The clinician must be aware of the range of available techniques, methods, interventions and technological advances as well as possess a sound approach to basic hemodynamic monitoring prior to selecting the optimal modality. This article comprises an in depth discussion of an approach to hemodynamic monitoring techniques and principles as well as methods of predicting fluid responsiveness as it applies to the ED clinician. We review the role, applicability and validity of various methods and techniques that include; clinical assessment, passive leg raising, blood pressure, finger based monitoring devices, the mini-fluid challenge, the end-expiratory occlusion test, central venous pressure monitoring, the pulmonary artery catheter, ultrasonography, bioreactance and other modern invasive hemodynamic monitoring devices. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Influences of prolonged apnea and oxygen inhalation on pulmonary hemodynamics during breath holding: Quantitative assessment by velocity-encoded MR imaging with SENSE technique

    Energy Technology Data Exchange (ETDEWEB)

    Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan)], E-mail: aznogami@med.kobe-u.ac.jp; Ohno, Yoshiharu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Higashino, Takanori [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Department of Radiology, Tenri Hospital, Tenri, Nara (Japan); Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Yoshikawa, Takeshi [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Department of Radiology, Konan Hospital, Kobe, Hyogo (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Kawamitsu, Hideaki [Division of Radiology, Kobe University Hospital, Kobe, Hyogo (Japan); Fujii, Masahiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Radiology, Kobe University Hospital, Kobe, Hyogo (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan)

    2007-12-15

    Purpose: The purpose of our study was to assess the influence of prolonged apnea and administration of oxygen on pulmonary hemodynamics during breath holding (BH) by using velocity-encoded MR imaging combined with the SENSE technique (velocity MRI). Materials and methods: Ten healthy male volunteers underwent velocity MRI during BH with and without O{sub 2} inhalation. All velocity MRI data sets were obtained continuously with the 2D cine phase-contrast method during a single BH period. The data were then divided into three BH time phases as follows: first, second and third. To evaluate the influence of prolonged apnea on hemodynamics, stroke volume (SV) and maximal change in flow rate during ejection (MCFR) of second and third phases were statistically compared with those of first phase by using the ANOVA followed by Turkey's HSD multiple comparison test. To assess the influence of O{sub 2} on hemodynamics, SV and MCFR with or without O{sub 2} were compared by the paired t-test. To assess the measuring agreement of hemodynamic indices during prolonged breath holding, Bland-Altman's analysis was performed. Results: Prolonged apnea had no significant influence on SV and MCFR regardless of administration of O{sub 2} (p > 0.05). Mean MCFR for all phases was significantly lower with administration of O{sub 2} than without (p < 0.05). The limits of agreement for MCFR with O{sub 2} were smaller than without. Conclusion: O{sub 2} inhalation modulated maximal change in flow rate during ejection, and did not influence stroke volume during breath holding. Influence of O{sub 2} inhalation should be considered for MR measurements of pulmonary hemodynamics during breath holding.

  2. Influences of prolonged apnea and oxygen inhalation on pulmonary hemodynamics during breath holding: Quantitative assessment by velocity-encoded MR imaging with SENSE technique

    International Nuclear Information System (INIS)

    Nogami, Munenobu; Ohno, Yoshiharu; Higashino, Takanori; Takenaka, Daisuke; Yoshikawa, Takeshi; Koyama, Hisanobu; Kawamitsu, Hideaki; Fujii, Masahiko; Sugimura, Kazuro

    2007-01-01

    Purpose: The purpose of our study was to assess the influence of prolonged apnea and administration of oxygen on pulmonary hemodynamics during breath holding (BH) by using velocity-encoded MR imaging combined with the SENSE technique (velocity MRI). Materials and methods: Ten healthy male volunteers underwent velocity MRI during BH with and without O 2 inhalation. All velocity MRI data sets were obtained continuously with the 2D cine phase-contrast method during a single BH period. The data were then divided into three BH time phases as follows: first, second and third. To evaluate the influence of prolonged apnea on hemodynamics, stroke volume (SV) and maximal change in flow rate during ejection (MCFR) of second and third phases were statistically compared with those of first phase by using the ANOVA followed by Turkey's HSD multiple comparison test. To assess the influence of O 2 on hemodynamics, SV and MCFR with or without O 2 were compared by the paired t-test. To assess the measuring agreement of hemodynamic indices during prolonged breath holding, Bland-Altman's analysis was performed. Results: Prolonged apnea had no significant influence on SV and MCFR regardless of administration of O 2 (p > 0.05). Mean MCFR for all phases was significantly lower with administration of O 2 than without (p 2 were smaller than without. Conclusion: O 2 inhalation modulated maximal change in flow rate during ejection, and did not influence stroke volume during breath holding. Influence of O 2 inhalation should be considered for MR measurements of pulmonary hemodynamics during breath holding

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

    Directory of Open Access Journals (Sweden)

    Jing Xie

    2016-08-01

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

  4. Assessing meteorological key factors influencing crop invasion by pollen beetle (

    Directory of Open Access Journals (Sweden)

    Jürgen Junk

    2016-09-01

    Full Text Available The pollen beetle, Meligethes aeneus F. (Coleoptera: Nitidulidae, is a severe pest of winter oilseed rape. A phenological model to forecast the first spring invasion of crops in Luxembourg by M. aeneus was developed in order to provide a tool for improving pest management and for assessing the potential effects of climate change on this pest. The model was derived using long-term, multi-site observational datasets of pollen beetle migration and meteorological data, as the timing of crop invasion is determined mainly by meteorological variables. Daily values of mean air and soil temperature, accumulated sunshine duration and precipitation were used to create a threshold-based model to forecast crop invasion. Minimising of the root mean squared error (RMSE of predicted versus observed migration dates was used as the quality criterion for selecting the optimum combination of threshold values for meteorological variables. We identified mean air temperature 8.0 °C, mean soil temperature 4.6 °C, and sunshine duration of 3.4 h as the best threshold values, with a cut-off of 1 mm precipitation and with no need for persistence of those conditions for more than one day (RMSE=9.3days$RMSE=9.3\\,\\text{days}$. Only in six out of 30 cases, differences between observed and predicted immigration dates were >5$>5$ days. In the future, crop invasion by pollen beetles will probably be strongly affected by changes in air temperature and precipitation related to climate change. We used a multi-model ensemble of 15 regional climate models driven by the A1B emission scenario to assess meteorological changes in two 30‑year future periods, near future (2021–2050 and far future (2069–2098 in comparison with the reference period (1971–2000. Air temperature and precipitation were predicted to increase in the first three months of each year, both in the near future and the far future. The pollen beetle migration model indicated that this change would

  5. Multidetector CT of Locally Invasive Advanced Gastric Cancer: Value of Oblique Coronal Reconstructed Images for the Assessment of Local Invasion

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Hee; Kim, Ah Yong; Kim, Hye Jin; Yook, Jeong Hwan; Yu, Eun Sil; Jang, Yoon Jin; Park, Seong Ho; Shin, Yong Moon; Ha, Hyun Kwon [Asan Medical Center, Seoul (Korea, Republic of)

    2010-01-15

    To evaluate the diagnostic value of oblique coronal reconstructed CT images to determine the local invasion of advanced gastric cancer (AGC). Thirty-four consecutive patients, who were suspected to have locally invasive advanced gastric cancer (more than T3 stage) on a preoperative MDCT scan and underwent a diagnostic or curative laparotomy, were enrolled in this study. Two reviewers performed an independent blind review of three series of MDCT images in random order; axial (AXI), conventional coronal (CCI), and oblique coronal (OCI) (parallel to long axis of gastric body and pancreas) images. In assessing the local invasion, the reader's confidence for the local invasion of AGC was graded using a five point scale (1 = definitely negative, 5 = definitely positive: T4). With surgical findings and histopathological proofs as reference standards, the diagnostic performance of the three different plans of CT images was employed for the verification of local invasion of AGC on a preoperative CT scan using the receiver operating characteristic (ROC) method. Agreements between the two reviewers were analyzed using weighted kappa statistics. Results: In 19 out of 34 patients, local invasion was confirmed surgically or histopathologically (13 pancreas invasion, 6 liver invasion, 4 major vascular invasion, 3 colon and mesocolon invasion, and 2 spleen invasion). The diagnostic performance of OCI was superior to AXI or CCI in the local invasion of AGC. The differences in the area under the curve of AXI (0.770 {+-} 0.087, 0.700 {+-} 0.094), CCI (0.884 {+-} 0.058, 0.958 {+-} 0.038), and OCI (0.954 {+-} 0.050, 0.956 {+-} 0.049), were statistically significant for both reviewers. Inter-observer agreement was excellent for OCI ({kappa}= .973), which was greater than CCI (({kappa}= .839), and AXI (({kappa}= .763). On a CT scan, OCI might be a useful imaging technique in evaluating locally invasive advanced gastric cancer.

  6. Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases.

    Science.gov (United States)

    Alempijevic, Tamara; Zec, Simon; Nikolic, Vladimir; Veljkovic, Aleksandar; Stojanovic, Zoran; Matovic, Vera; Milosavljevic, Tomica

    2017-01-31

    Accurate clinical assessment of liver fibrosis is essential and the aim of our study was to compare and combine hemodynamic Doppler ultrasonography, liver stiffness by transient elastography, and non-invasive serum biomarkers with the degree of fibrosis confirmed by liver biopsy, and thereby to determine the value of combining non-invasive method in the prediction significant liver fibrosis. We included 102 patients with chronic liver disease of various etiology. Each patient was evaluated using Doppler ultrasonography measurements of the velocity and flow pattern at portal trunk, hepatic and splenic artery, serum fibrosis biomarkers, and transient elastography. These parameters were then input into a multilayer perceptron artificial neural network with two hidden layers, and used to create models for predicting significant fibrosis. According to METAVIR score, clinically significant fibrosis (≥F2) was detected in 57.8% of patients. A model based only on Doppler parameters (hepatic artery diameter, hepatic artery systolic and diastolic velocity, splenic artery systolic velocity and splenic artery Resistance Index), predicted significant liver fibrosis with a sensitivity and specificity of75.0% and 60.0%. The addition of unrelated non-invasive tests improved the diagnostic accuracy of Doppler examination. The best model for prediction of significant fibrosis was obtained by combining Doppler parameters, non-invasive markers (APRI, ASPRI, and FIB-4) and transient elastography, with a sensitivity and specificity of 88.9% and 100%. Doppler parameters alone predict the presence of ≥F2 fibrosis with fair accuracy. Better prediction rates are achieved by combining Doppler variables with non-invasive markers and liver stiffness by transient elastography.

  7. CFD: computational fluid dynamics or confounding factor dissemination? The role of hemodynamics in intracranial aneurysm rupture risk assessment.

    Science.gov (United States)

    Xiang, J; Tutino, V M; Snyder, K V; Meng, H

    2014-10-01

    Image-based computational fluid dynamics holds a prominent position in the evaluation of intracranial aneurysms, especially as a promising tool to stratify rupture risk. Current computational fluid dynamics findings correlating both high and low wall shear stress with intracranial aneurysm growth and rupture puzzle researchers and clinicians alike. These conflicting findings may stem from inconsistent parameter definitions, small datasets, and intrinsic complexities in intracranial aneurysm growth and rupture. In Part 1 of this 2-part review, we proposed a unifying hypothesis: both high and low wall shear stress drive intracranial aneurysm growth and rupture through mural cell-mediated and inflammatory cell-mediated destructive remodeling pathways, respectively. In the present report, Part 2, we delineate different wall shear stress parameter definitions and survey recent computational fluid dynamics studies, in light of this mechanistic heterogeneity. In the future, we expect that larger datasets, better analyses, and increased understanding of hemodynamic-biologic mechanisms will lead to more accurate predictive models for intracranial aneurysm risk assessment from computational fluid dynamics. © 2014 by American Journal of Neuroradiology.

  8. Definition of hemodynamic stability in blunt trauma patients: a systematic review and assessment amongst Dutch trauma team members.

    Science.gov (United States)

    Loggers, S A I; Koedam, T W A; Giannakopoulos, G F; Vandewalle, E; Erwteman, M; Zuidema, W P

    2017-12-01

    Trauma is a great contributor to mortality worldwide. One of the challenges in trauma care is early identification and management of bleeding. The circulatory status of blunt trauma patients in the emergency room is evaluated using hemodynamic (HD) parameters. However, there is no consensus on which parameters to use. In this study, we evaluate the used terms and definitions in the literature for HD stability and compare those to the opinion of Dutch trauma team members. A systematic review was performed to collect the definitions used for HD stability. Studies describing the assessment and/or treatment of blunt trauma patients in the emergency room were included. In addition, an online survey was conducted amongst Dutch trauma team members. Out of a total of 222, 67 articles were found to be eligible for inclusion. HD stability was defined in 70% of these articles. The most used parameters were systolic blood pressure and heart rate. Besides the variety of parameters, a broad range of corresponding cut-off points is noted. Despite some common ground, high inter- and intra-variability is seen for the physicians that are part of the Dutch trauma teams. All authors acknowledge HD stability as the most important factor in the assessment and management of blunt trauma patients. There is, however, no consensus in the literature as well as none-to-fair consensus amongst Dutch trauma team members in the definition of HD stability. A trauma team ready to co-operate with consensus-based opinions together with a valid scoring system is in our opinion the best method to assess and treat seriously injured trauma patients.

  9. Preliminary Marine Safety Risk Assessment, Brandon Road Lock and Dam Invasive Species Control Measures

    Science.gov (United States)

    2016-12-01

    Invasive Species Control Measures Distribution Statement A: Approved for public release; distribution is unlimited. December 2016 Report No...CG-D-03-17 Preliminary Marine Safety Risk Assessment, BRLD Invasive Species Control Measures ii UNCLAS//Public | CG-926 RDC | M. Lewandowski...CT 06320 Preliminary Marine Safety Risk Assessment, BRLD Invasive Species Control Measures iii UNCLAS//Public | CG-926 RDC | M

  10. Hemodynamic monitoring during CPR.

    Science.gov (United States)

    Ornato, J P

    1993-02-01

    Real-time hemodynamic monitoring provides useful information that can be used to assess and optimize mechanical and pharmacological interventions during CPR. The standard algorithms should always be the initial approach to resuscitation, because they offer a rapid, logical, coordinated series of treatments with proven success. Pressure and flow measurements during conventional, closed-chest CPR in humans indicate that the technique typically produces a hemodynamic state resembling profound cardiogenic shock, with a low systemic arterial pressure, markedly reduced cardiac output, and high intravascular filling pressures. End-tidal carbon dioxide monitoring provides useful, noninvasive information during clinical resuscitation. A low end-tidal carbon dioxide value during resuscitation should alert the rescuers that something is wrong with ventilation, perfusion, and/or carbon dioxide production and should prompt a search for correctable causes. If one or more hemodynamic parameters are being monitored at the time the patient develops cardiac arrest (eg, an intensive care unit patient who has an arterial line and a pulmonary artery catheter in place), it is appropriate for the resuscitation team to pay attention to the data that are generated during the resuscitation, particularly if the initial algorithm approach is not successful. For patients who are not being monitored at the time of their arrest, end-tidal carbon dioxide measurements provide noninvasive, semiquantitative information that can help the team detect and troubleshoot problems during resuscitation. Further research and better, more affordable technologies are needed to provide in- and out-of-hospital resuscitation teams feedback on the hemodynamic effectiveness of their resuscitative efforts.

  11. A Novel Index Using Ankle Hemodynamic Parameters to Assess the Severity of Peripheral Arterial Disease: A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Jun Tanno

    Full Text Available In peripheral arterial disease (PAD of the lower extremities, the presence of flow-limiting stenoses can be objectively detected by the ankle-brachial index (ABI. However, the severity of ischemic symptoms is not necessarily associated with the ABI value. Atherosclerotic plaque in lower extremity PAD induces ankle arterial stiffness and reduces ankle vascular resistance, which may decrease ankle blood flow and cause ischemic symptoms. We hypothesized that the ankle hemodynamic index (AHI, defined as the ratio of ankle arterial stiffness to ankle vascular resistance, could be used to assess the blood supply deficiency in a diseased lower limb in patients with PAD. The 85 consecutive patients with PAD who were retrospectively analyzed in this study had Rutherford grade 1 to grade 6 ischemia diagnosed as PAD and significant stenotic lesions (>50% diameter stenosis of the lower extremity on contrast angiography. The AHI was calculated as the product of the ankle pulse pressure and the ratio of heart rate to ankle mean arterial pressure (ankle pulse pressure × heart rate/ankle mean arterial pressure. The Rutherford grade was significantly correlated with the AHI (r = 0.50, P < 0.001, but not with the ABI (r = 0.07, P = 0.52. Multiple ordinal regression analysis showed that anemia (odds ratio 0.66, P = 0.002 and AHI (odds ratio 1.04, P = 0.02 were independently associated with Rutherford grade. Our study shows that AHI, a novel parameter based on the ABI measurement, is well correlated with ischemic symptoms, and may be a useful means to assess the arterial blood supply of the lower extremities of patients with PAD.

  12. Assessing the Hemodynamic Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Traumatic Cardiac Arrest When Closed Chest Compressions are Augmented by Directing the Area of Maximal Compression Over the Left Ventricle in a Swine Model (sus scrofa)

    Science.gov (United States)

    2016-09-15

    Assessing the hemodynamic effects of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in traumatic cardiac arrest when closed...Principal Investigator (PI): Name Rank Date of IACUC Training Branch of Service / Corps Staff Resident Fellow Civilian Department / Office

  13. Assessment of sexual orientation using the hemodynamic brain response to visual sexual stimuli

    DEFF Research Database (Denmark)

    Ponseti, Jorge; Granert, Oliver; Jansen, Olav

    2009-01-01

    INTRODUCTION: The assessment of sexual orientation is of importance to the diagnosis and treatment of sex offenders and paraphilic disorders. Phallometry is considered gold standard in objectifying sexual orientation, yet this measurement has been criticized because of its intrusiveness and limited...... response patterns of the brain to sexual stimuli contained sufficient information to predict individual sexual orientation with high accuracy. These results suggest that fMRI-based classification methods hold promise for the diagnosis of paraphilic disorders (e.g., pedophilia)....... reliability. AIM: To evaluate whether the spatial response pattern to sexual stimuli as revealed by a change in blood oxygen level-dependent (BOLD) signal can be used for individual classification of sexual orientation. METHODS: We used a preexisting functional MRI (fMRI) data set that had been acquired...

  14. Assessment of baseline hemodynamic parameters within infarct progression areas in acute stroke patients using perfusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ritzenthaler, Thomas; Cho, Tae-Hee; Derex, Laurent; Nighoghossian, Norbert [Hospices Civils de Lyon, Cerebrovascular Unit, Hopital Neurologique Pierre Wertheimer, Bron (France); Claude Bernard Lyon 1 University, Creatis-LRMN, UMR 5520-Inserm 630, Lyon (France); Wiart, Marlene; Berthezene, Yves [Claude Bernard Lyon 1 University, Creatis-LRMN, UMR 5520-Inserm 630, Lyon (France); Berthiller, Julien [Hospices Civils de Lyon, Pole Information Medicale Evaluation Recherche, Lyon (France); Universite Lyon 1, Lyon (France); Oestergaard, Leif [University of Aarhus, Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus (Denmark); Hermier, Marc [Hospices Civils de Lyon, Neuroradiology Department, Hopital Neurologique Pierre Wertheimer, Lyon (France)

    2011-08-15

    The value of perfusion MRI for identifying the tissue at risk has been questioned. Our objective was to assess baseline perfusion-weighted imaging parameters within infarct progression areas. Patients with anterior circulation stroke without early reperfusion were included from a prospective MRI database. Sequential MRI examinations were performed on admission, 2-3 h (H2), 2-3 days (D2), and between 15 and 30 days after the initial MRI. Maps of baseline time-to-peak (TTP), mean transit time (MTT), cerebral blood volume (CBV), and cerebral blood flow (CBF) were calculated. Lesion extension areas were defined as pixels showing de novo lesions between each MRI and were generated by subtracting successive lesion masks: V{sub 0}, baseline diffusion-weighted imaging (DWI) lesion; V{sub 1}, lesion extension between baseline and H2 DWI; V{sub 2}, lesion extension from H2 to D2 DWI; and V{sub 3}, lesion extension from D2 DWI to final FLAIR. Repeated measures analysis was used to compare hemodynamic parameters within the baseline diffusion lesion and subsequent lesion extension areas. Thirty-two patients were included. Baseline perfusion parameters were significantly more impaired within the acute DWI lesion compared to lesion extension areas (TTP, p<0.0001; MTT, p<0.0001; CBF p<0.0001; CBV, p<0.0001). A significant decrease in MTT (p = 0.01) and TTP (p = 0.01) was found within successive lesion growth areas. A decreasing gradient of severity for TTP and MTT was observed within successive infarct growth areas. (orig.)

  15. Estimation of indocyanine green concentration in blood from fluorescence emission: application to hemodynamic assessment during hemodialysis

    Science.gov (United States)

    Maarek, Jean-Michel I.; Holschneider, Daniel P.

    2009-09-01

    There is considerable interest in assessing cardiovascular function noninvasively in patients receiving hemodialysis. A possible approach is to measure the blood concentration of bolus-injected indocyanine green dye and to apply the dye-dilution method for estimating cardiac output and blood volume. Blood ICG concentration can be derived from a measurement of the ICG fluorescence through the dialysis tubing if a simple and unique calibration relationship can be established between transmural fluorescence intensity and blood ICG concentration. We investigated this relationship using Monte Carlo simulations of light transport in blood with varying hematocrit and ICG concentrations and performed empiric measurements of optical absorption and ICG fluorescence emission to confirm our findings. The ICG fluorescence intensity measured at the blood surface, as well as the light intensity remitted by the blood, varied as hematocrit changes modified the absorption and scattering characteristics of the blood. Calibration relationships were developed between fluorescence intensity and ICG concentration that accounted for hematocrit changes. Combining the backreflected fluorescence and the reflected light measured near the point of illumination provided optimal signal intensity, linearity, and robustness to hematocrit changes. These results provide a basis for developing a noninvasive approach to derive optically circulating blood ICG concentration in hemodialysis circuits.

  16. Assessment of left ventricular hemodynamics by Gd-DTPA enhanced high speed cine MRI

    International Nuclear Information System (INIS)

    Matsumura, Kentaro; Nakase, Emiko; Kawai, Ichiro

    1992-01-01

    To assess the validity of Gd-DTPA enhanced high speed cine MRI in left ventricular (LV) volumes and ejection fraction (EF), high speed cine MRI was compared with intra-venous digital subtraction left ventriculography (IV-DSA) in 14 patients. All patients underwent conventional cine MRI and Gd-DTPA enhanced high speed MRI, simultaneously. The pulse sequences of high speed MRI were TR 8 ms (TR 6 ms plus rewind pulse 2 ms), TE 3.2 ms, matrix 128, phase encode 8 or 6 and NEX 1. Comparison with LV-volume showed a high correlation (y = 0.854x + 1,699, r = 0.985) between high speed cine MRI and VI-DSA. To make left ventricular volume curve by area-length method in cine MRI, manual tracing of LV-cavity was more difficult in conventional cine MRI-method than enhanced high speed cine MRI-method. In conclusion, first pass-Gd-DTPA enhanced high speed cine MRI, using the horizontal long axis approach and the multiphase study, is a highly, accurate reproducible method of evaluating LV-volumetry. (author)

  17. Sex differences in prefrontal hemodynamic response to mental arithmetic as assessed by near-infrared spectroscopy.

    Science.gov (United States)

    Yang, Hongyu; Wang, Ying; Zhou, Zhenyu; Gong, Hui; Luo, Qingming; Wang, Yiwen; Lu, Zuhong

    2009-12-01

    Sex differences in cognitive tasks have been widely investigated. With brain-imaging techniques, the functions of the brain during the performance of tasks can be examined. Mental arithmetic and near-infrared spectroscopy (NIRS) were used to assess sex differences in prefrontal area activation in a functional brain study. Healthy college students were recruited to perform 2 mental arithmetic tasks. In the first (easy) task, students had to subtract a 1-digit number from a 3-digit number. In the second (difficult) task, they had to subtract a 2-digit number from a 3-digit number. Changes in the concentration of oxygenated hemoglobin (oxy-Hgb) in the prefrontal area during the tasks were measured with NIRS. Thirty students (15 men, 15 women; mean [SD] age: 24.9 [2.2] and 24.3 [2.6] years, respectively) were recruited from Southeast University, Nanjing, China, to participate in the study. The concentration of oxy-Hgb increased during both mental arithmetic tasks (difficult task vs easy task, mean [SD] % arbitrary units: 4.36 [4.38] vs 2.26 [2.82]; F(1,28) = 222.80; P mental arithmetic were associated with the intensity of the task. Compared with men, women had greater efficiency in task performance (ie, less activation or oxygen consumption for equal performance). Copyright 2009 Excerpta Medica Inc. All rights reserved.

  18. [Assessment of central hemodynamic properties of the arterial wall in women with previous preeclampsia].

    Science.gov (United States)

    Polónia, Jorge; Olival, Catarina; Ribeiro, Sílvia; Silva, José A; Barbosa, Loide

    2014-06-01

    We investigated viscoelastic properties of the arterial wall in women with previous preeclampsia (PE) compared to those with normal pregnancy (NP). In a cross-sectional study 45 women with previous PE and 55 with NP were included, matched for age (PE 38±6 vs. NP 38±5 years, NS) and body mass index: (PE 25±4 vs. NP 26±4 kg/m(2), NS) studied, respectively, 76±34 and 86±48 months after delivery. We assessed arterial distensibility - pulse wave velocity (PWV, Complior) and reflected waves (augmentation pressure [AP], mmHg) and augmentation index (AIx) - in the central pressure wave and blood pressure (BP) on 24-h ambulatory BP monitoring (ABPM). PE showed higher (pvs. NP 121±19, and central SBP: PE 122±18 vs. NP 110±19 mmHg, with less amplification of central-peripheral pressure: PE 10±4 vs. NP 12±5, p=0.041, and higher (pvs. NP 8±2, and AIx: PE 26±5 vs. NP 20±5 mmHg, but PE and NP did not differ in pulse wave velocity. On ABPM, PE (n=39) vs. NP (n=33) had higher nighttime SBP: PE 121±10 vs. NP 108±10 mmHg and lower percentage nocturnal SBP fall: PE 11±6 vs. NP 18±11%, both pNP. Women with previous PE have a greater risk of hypertension, higher nighttime BP values, blunted nocturnal BP fall and changes in central pressure suggestive of increased reflected waves and peripheral vascular resistance. These factors may contribute to their higher cardiovascular risk after pregnancy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  19. Assessment of sexual orientation using the hemodynamic brain response to visual sexual stimuli.

    Science.gov (United States)

    Ponseti, Jorge; Granert, Oliver; Jansen, Olav; Wolff, Stephan; Mehdorn, Hubertus; Bosinski, Hartmut; Siebner, Hartwig

    2009-06-01

    The assessment of sexual orientation is of importance to the diagnosis and treatment of sex offenders and paraphilic disorders. Phallometry is considered gold standard in objectifying sexual orientation, yet this measurement has been criticized because of its intrusiveness and limited reliability. To evaluate whether the spatial response pattern to sexual stimuli as revealed by a change in blood oxygen level-dependent (BOLD) signal can be used for individual classification of sexual orientation. We used a preexisting functional MRI (fMRI) data set that had been acquired in a nonclinical sample of 12 heterosexual men and 14 homosexual men. During fMRI, participants were briefly exposed to pictures of same-sex and opposite-sex genitals. Data analysis involved four steps: (i) differences in the BOLD response to female and male sexual stimuli were calculated for each subject; (ii) these contrast images were entered into a group analysis to calculate whole-brain difference maps between homosexual and heterosexual participants; (iii) a single expression value was computed for each subject expressing its correspondence to the group result; and (iv) based on these expression values, Fisher's linear discriminant analysis and the kappa-nearest neighbor classification method were used to predict the sexual orientation of each subject. Sensitivity and specificity of the two classification methods in predicting individual sexual orientation. Both classification methods performed well in predicting individual sexual orientation with a mean accuracy of >85% (Fisher's linear discriminant analysis: 92% sensitivity, 85% specificity; kappa-nearest neighbor classification: 88% sensitivity, 92% specificity). Despite the small sample size, the functional response patterns of the brain to sexual stimuli contained sufficient information to predict individual sexual orientation with high accuracy. These results suggest that fMRI-based classification methods hold promise for the diagnosis

  20. CT assessment of mediastinal invasion of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Herman, S.J.; Weisbrod, G.L.; Winton, T.; Towers, M.; Mentzer, S.

    1991-01-01

    Bronchogenic carcinoma is considered unresectable if the primary tumor involves certain mediastinal structures. The purpose of this paper is to determine the ability of CT to assess this involvement. The authors retrospectively reviewed the chest radiographs and CT scans of 75 patients with primary bronchogenic carcinoma who subsequently underwent mediastinoscopy and/or thoracotomy. From these 75 patients, 44 in whom the tumor mass was in contract with the mediastinum on chest radiograph were selected. The degree of contact of the tumor with each of 14 mediastinal structures was then assessed with Ct. Invasion was stated to be present when there was contact, with loss of the fat plane, with more than 90 degrees of the circumference of the structure; 90 or less was called uninvolved. Final assessment of each structure was determined at surgery, with pathologic proof, and was graded as follows: not assessed, not involved, involved but still resectable, or unresectable. One hundred seventy-three structures were assessed in these 44 patients, and 10 were found to be involved by tumor

  1. Geospatial assessment of invasive plants on reclaimed mines in Alabama

    Science.gov (United States)

    D. Lemke; C.J. Schweitzer; W. Tadesse; Y. Wang; J.A. Brown

    2013-01-01

    Throughout the world, the invasion of nonnative plants is an increasing threat to native biodiversity and ecosystem sustainability. Invasion is especially prevalent in areas affected by land transformation and disturbance. Surface mines are a major land transformation, and thus may promote the establishment and persistence of invasive plant communities. Using the Shale...

  2. New approach to intracardiac hemodynamic measurements in small animals

    DEFF Research Database (Denmark)

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

    2012-01-01

    Invasive measurements of intracardiac hemodynamics in animal models have allowed important advances in the understanding of cardiac disease. Currently they are performed either through a carotid arteriotomy or via a thoracotomy and apical insertion. Both of these techniques have disadvantages...... and are not conducive to repeated measurements. Therefore, the purpose of this study was to develop a new technique for measuring intracardiac hemodynamics....

  3. Effective radiation doses associated with non-invasive versus invasive assessment of coronary anatomy and physiology.

    Science.gov (United States)

    Toth, G G; Ntalianis, A; Ntarladimas, Y; de Booij, M; De Winter, O; Barbato, E; Pilet, B; Van Mieghem, C; Wijns, W; De Bruyne, B

    2015-06-01

    To compare the effective radiation dose (ERD) needed to obtain information on coronary anatomy and physiology by a non-invasive versus an invasive diagnostic strategy. Knowledge of anatomy and physiology is needed for management of patients with coronary artery disease (CAD). There is, however, a growing concern about detrimental long-term effects of radiation associated with diagnostic procedures. In a total of 671 patients with suspected CAD, we compared the ERD needed to obtain anatomical and physiological information through a non-invasive strategy or an invasive strategy. The non-invasive strategy consisted of coronary computed tomography angiography (CCTA) and single photon emission computed tomography (SPECT). The invasive strategy included coronary angiography (CA) and fractional flow reserve (FFR) measurement. In 464 patients, the data were acquired in Period 2009 and in 207 the data were acquired in Period 2011 (after each period, the CCTA- and the CA-equipment had been upgraded). For the Period 2009 total ERD of the non-invasive approach was significantly larger compared to the invasive approach (28.45 ± 5.37 mSv versus 15.79 ± 7.95 mSv, respectively; P < 0.0001). For Period 2011, despite the significant decrease in ERD for both groups (P<0.0001 for both), the ERD remained higher for the non-invasive approach compared to the invasive approach (16.67 ± 10.45 mSv vs. 10.36 ± 5.87 mSv, respectively; P < 0.0001). Simulation of various diagnostic scenarios showed cumulative radiation dose is the lowest when a first positive test is followed by an invasive strategy. To obtain anatomic and physiologic information in patients with suspected CAD, the combination of CA and FFR is associated with lower ERD than the combination of CCTA and SPECT. © 2014 Wiley Periodicals, Inc.

  4. Assessment of splanchnic hemodynamics in patients with cirrhosis after separating operations in comparison with non-operated patients with compensated and decompensated clinical course

    Directory of Open Access Journals (Sweden)

    Алий Саитович Тугушев

    2015-09-01

    Full Text Available Separating operations are recommended for treatment and prophylaxis of bleeding from varicose veins of gullet as a result of portocaval (azygoportal shunting at cirrhosis and directed to its elimination using azygoportal separation. At the same time the frequency of relapse of bleeding after operations remains rather high. And the formation of new varicose nodi as a result of disorder of hepatic and splanchnic hemodynamics that inevitably appears at different dates after operation is considered as the main cause of it. At the same time an assessment of hemodynamic changes after azygoportal separation is interpreted in different ways by different authors.Aim of research. To assess an influence of separating surgical interventions on the character of changes of splanchnic hemodynamics in patients with cirrhosis in comparison with non-operated patients with compensated and decompensated clinical course.Material and methods. There were examined 190 patients with cirrhosis: in 133 took place gastrointestinal bleeding from varicose veins of gullet, in 57 – diuretic resistant ascites. 16 patients underwent separating operations. 20 patients underwent endoscopic sclerotherapy of gullet veins. 84 patients died during observation (7 after surgical treatment. Duration of observation was from 2-3 weeks to 2,5-3 years. All patients underwent the repeated ultrasound of abdominal cavity. There were assessed diameter of hepatic and splenic vessels; quantitative and qualitative characteristics of blood flow in hepatic and splenic arteries, portal and splenic veins.Results of research. At assessment of splanchnic hemodynamics the changes of portal blood flow in first months after operation characterized with moderate dilation of portal vein and decrease of linear speed in it. At the same time the volumetric blood flow did not essentially change. It was noticed the decrease of volumetric blood flow in splenic vein at the expense of constriction of its lumen and

  5. Preoperative assessment of microvascular invasion in hepatocellular carcinoma

    Science.gov (United States)

    Chakraborty, Jayasree; Zheng, Jian; Gönen, Mithat; Jarnagin, William R.; DeMatteo, Ronald P.; Do, Richard K. G.; Simpson, Amber L.

    2017-03-01

    Hepatocellular carcinoma (HCC) is the most common liver cancer and the third leading cause of cancer-related death worldwide.1 Resection or liver transplantation may be curative in patients with early-stage HCC but early recurrence is common.2, 3 Microvascular invasion (MVI) is one of the most important predictors of early recurrence.3 The identification of MVI prior to surgery would optimally select patients for potentially curative resection or liver transplant. However, MVI can only be diagnosed by microscopic assessment of the resected tumor. The aim of the present study is to apply CT-based texture analysis to identify pre-operative imaging predictors of MVI in patients with HCC. Texture features are derived from CT and analyzed individually as well as in combination, to evaluate their ability to predict MVI. A two-stage classification is employed: HCC tumors are automatically categorized into uniform or heterogenous groups followed by classification into the presence or absence of MVI. We achieve an area under the receiver operating characteristic curve (AUC) of 0.76 and accuracy of 76.7% for uniform lesions and AUC of 0.79 and accuracy of 74.06% for heterogeneous tumors. These results suggest that MVI can be accurately and objectively predicted from preoperative CT scans.

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

    Directory of Open Access Journals (Sweden)

    Luís E. Rohde

    2002-03-01

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

  7. Occupational exposure in hemodynamic

    International Nuclear Information System (INIS)

    Silva, Amanda J.; Fernandes, Ivani M.; Silva, Paula P. Nou; Sordi, Gian Maria A.A.; Carneiro, Janete C.G.G.

    2011-01-01

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

  8. Hemodynamic Intervention of Cerebral Aneurysms

    Science.gov (United States)

    Meng, Hui

    2005-11-01

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

  9. Clinical impact of left ventricular eccentricity index using cardiac MRI in assessment of right ventricular hemodynamics and myocardial fibrosis in congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Yamasaki, Yuzo; Kamitani, Takeshi; Yamanouchi, Torahiko; Honda, Hiroshi [Kyushu University, Departments of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Nagao, Michinobu; Kawanami, Satoshi [Kyushu University, Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Yamamura, Kenichiro [Kyushu University, Pediatrics, Graduate School of Medical Sciences, Fukuoka (Japan); Sakamoto, Ichiro [Kyushu University, Cardiovascular Medicine, Graduate School of Medical Sciences, Fukuoka (Japan); Yabuuchi, Hidetake [Kyushu University, Health SciencesGraduate School of Medical Sciences, Fukuoka (Japan)

    2016-10-15

    To investigate the utility of eccentricity index (EI) using cardiac cine MRI for the assessment of right ventricular (RV) hemodynamics in congenital heart disease (CHD). Fifty-five patients with CHD (32 women; mean age, 40.7 ± 20.9 years) underwent both cardiac MRI and right heart catheterization. EI was defined as the ratio of the distance between the anterior-posterior wall and the septal-lateral wall measured in the short-axis of mid-ventricular cine MRI. Correlations between EIs and RV hemodynamic parameters were analyzed. EIs were compared between patients with and without late gadolinium enhancement (LGE). A strong correlation between mean pulmonary artery pressure (PAP) and systolic EI (r = 0.81, p < 0.0001) and a moderate negative correlation between diastolic EI and RV ejection fraction (EF) (r = -0.62, p < 0.0001) were observed. Receiver operating characteristic analysis revealed optimal EI thresholds for detecting patients with mean PAP ≥40 mmHg with C-statistics of 0.90 and patients with RVEF <40 % with C-statistics of 0.78. Systolic EIs were significantly greater for patients with LGE (1.45 ± 0.05) than for those without LGE (1.15 ± 0.07; p < 0.001). EI offers a simple, comprehensive index that can predict pulmonary hypertension and RV dysfunction in CHD. (orig.)

  10. Assessing the effects of climate change on aquatic invasive species.

    Science.gov (United States)

    Rahel, Frank J; Olden, Julian D

    2008-06-01

    Different components of global environmental change are typically studied and managed independently, although there is a growing recognition that multiple drivers often interact in complex and nonadditive ways. We present a conceptual framework and empirical review of the interactive effects of climate change and invasive species in freshwater ecosystems. Climate change is expected to result in warmer water temperatures, shorter duration of ice cover, altered streamflow patterns, increased salinization, and increased demand for water storage and conveyance structures. These changes will alter the pathways by which non-native species enter aquatic systems by expanding fish-culture facilities and water gardens to new areas and by facilitating the spread of species during floods. Climate change will influence the likelihood of new species becoming established by eliminating cold temperatures or winter hypoxia that currently prevent survival and by increasing the construction of reservoirs that serve as hotspots for invasive species. Climate change will modify the ecological impacts of invasive species by enhancing their competitive and predatory effects on native species and by increasing the virulence of some diseases. As a result of climate change, new prevention and control strategies such as barrier construction or removal efforts may be needed to control invasive species that currently have only moderate effects or that are limited by seasonally unfavorable conditions. Although most researchers focus on how climate change will increase the number and severity of invasions, some invasive coldwater species may be unable to persist under the new climate conditions. Our findings highlight the complex interactions between climate change and invasive species that will influence how aquatic ecosystems and their biota will respond to novel environmental conditions.

  11. Layer-specific deformation analysis in severe aortic valve stenosis, primary mitral valve regurgitation, and healthy individuals validated against invasive hemodynamic measurements of heart function

    DEFF Research Database (Denmark)

    Bakkestrøm, Rine; Christensen, Nicolaj L; Wolsk, Emil

    2018-01-01

    , strain values in each myocardial layer (endocardial/global longitudinal strain (GLS)/epicardial) were higher (25.0% ± 3.4%/21.6% ± 2.9%/18.8% ± 2.6%) compared to healthy individuals (22.6% ± 3.2%/19.6% ± 2.9%/17.1% ± 2.6%) and AS (20.5% ± 2.8%/17.7% ± 2.5%/14.0% ± 5.6%), P groups exhibited......) but not with LV stroke work or contractility. CONCLUSION: Layer-specific myocardial strain (LSS) patterns differed in patients with severe AS, significant MR, and healthy individuals with highest values in MR. Strain irrespective of layer assessed was associated with LV wall stress but seemed less related......AIM: Speckle tracking echocardiography is considered valuable in assessing left ventricular (LV) function. The method has been refined to assess deformation in different myocardial layers, but the effect of volume vs pressure overload on this pattern is unknown. The aim was to test whether layer...

  12. Assessing stakeholder perspectives on invasive plants to inform risk analysis

    Science.gov (United States)

    Conservation and land management decisions are often based primarily on natural science, but could be more successful if human influences were effectively integrated into decision-making. This is especially true for efforts to manage invasive plants, whose arrival is usually the product of delibera...

  13. Sonographic assessment of vessel invasion by cervical masses in dogs

    Directory of Open Access Journals (Sweden)

    C.F. Carvalho

    2012-10-01

    Full Text Available Tumor invasion of the vessels displays both therapeutic and prognostic implications and represents a challenge for head and neck surgeons. Although previous research has shown that ultrasound can detect such invasions, accurate sonographic parameters to do so have not yet been established. We sought to determine sonographic criteria which are able to characterize these invasions. A high-resolution transducer was used to perform ultrasound examinations of 15 patients selected from a group with inconclusive radiography and computed tomography diagnosis. We found that encasement of the vessel, tumor immobility or fixation in the vessel wall, and narrowing and/or deformity of the lumen were the best criteria. Indeed, when loss of hyperechoic interface of the vessel wall was used as a single criterion it generated false positive results. This study shows that a combination of parameters can be used to provide the best sensitivity and specificity values to produce conclusive diagnosis of vessel invasion by tumors in the cervical region.

  14. Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans.

    Science.gov (United States)

    Trenado, Carlos; Elben, Saskia; Petri, David; Hirschmann, Jan; Groiss, Stefan J; Vesper, Jan; Schnitzler, Alfons; Wojtecki, Lars

    2016-05-19

    In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging (fMRI) for extracting crucial information about the mechanism of the human brain, such methods remain insufficient to provide information about physiological processes reflecting cognitive and emotional functions at the subcortical level. In this respect, modern invasive clinical approaches in humans, such as deep brain stimulation (DBS), offer a tremendous possibility to record subcortical brain activity, namely local field potentials (LFPs) representing coherent activity of neural assemblies from localized basal ganglia or thalamic regions. Notwithstanding the fact that invasive approaches in humans are applied only after medical indication and thus recorded data correspond to altered brain circuits, valuable insight can be gained regarding the presence of intact brain functions in relation to brain oscillatory activity and the pathophysiology of disorders in response to experimental cognitive paradigms. In this direction, a growing number of DBS studies in patients with Parkinson's disease (PD) target not only motor functions but also higher level processes such as emotions, decision-making, attention, memory and sensory perception. Recent clinical trials also emphasize the role of DBS as an alternative treatment in neuropsychiatric disorders ranging from obsessive compulsive disorder (OCD) to chronic disorders of consciousness (DOC). Consequently, we focus on the use of combined invasive (LFP) and non-invasive (EEG) human brain recordings in assessing the role of cortical-subcortical structures in cognitive and emotional processing trough experimental paradigms (e.g. speech stimuli with emotional connotation or paradigms of cognitive control such as the Flanker task), for patients undergoing DBS treatment.

  15. Assessment of splanchnic hemodynamics in patients with cirrhosis after splenectomy in comparison with non-operated patients at the decompensated stage

    Directory of Open Access Journals (Sweden)

    Алий Саитович Тугушев

    2015-10-01

    Full Text Available Splenectomy in patients with cirrhosis presupposes an increase of blood inflow into portal system to decrease the portal pressure. At the same time there are different opinions about splenectomy. So it is actual to study the character of changes of blood flow in vessels of abdominal cavity in pre- and postsurgical periods and assessment of an influence of these changes on the clinical course of cirrhosis.Aim of research: To assess an influence of splenectomy on the character of changes of splanchnic hemodynamics in patients with cirrhosis comparing to non-operated patients with compensated and decompensated clinical course.Materials and methods: There were examined 190 patients with cirrhosis: gastrointestinal bleeding from oesophagus varicose veins took place in 133 patients, diuretic resistant ascites – in 57 ones. 19 patients underwent splenectomy: 7 – in association with sewing of the left gastric vein and artery, 6 – with “skeletonization” of the lesser curvature of stomach with Nessen’s operation, 2 – with Patsiora’s operation, 2 – with application of selective porto-caval shunt between the low mesenteric vein and the left vein of an ovary. 84 patients died during observation. The duration of observation was from 0.5 to 3.5 years. All patients underwent fibrogastroscopy every 3–4 month. Hemodynamics was assessed on the base of repeated ultrasound of abdominal cavity. There were assessed diameter of hepatic and splenic vessels; qualitative and quantitative characteristics of blood flow in hepatic and splenic arteries, portal and splenic veins.Results of research: Changes of hemodynamics in patients after splenectomy as opposed to non-operative patients are characterized with the decrease of diameter of portal vein at almost stable speed of the linear blood flow in it. The result is some decrease of the volume of portal blood and index of portal blood congestion that indirectly indicates the decrease of portal pressure

  16. Individual classification of ADHD children by right prefrontal hemodynamic responses during a go/no-go task as assessed by fNIRS

    Directory of Open Access Journals (Sweden)

    Yukifumi Monden

    2015-01-01

    Full Text Available While a growing body of neurocognitive research has explored the neural substrates associated with attention deficit hyperactive disorder (ADHD, an objective biomarker for diagnosis has not been established. The advent of functional near-infrared spectroscopy (fNIRS, which is a noninvasive and unrestrictive method of functional neuroimaging, raised the possibility of introducing functional neuroimaging diagnosis in young ADHD children. Previously, our fNIRS-based measurements successfully visualized the hypoactivation pattern in the right prefrontal cortex during a go/no-go task in ADHD children compared with typically developing control children at a group level. The current study aimed to explore a method of individual differentiation between ADHD and typically developing control children using multichannel fNIRS, emphasizing how spatial distribution and amplitude of hemodynamic response are associated with inhibition-related right prefrontal dysfunction. Thirty ADHD and thirty typically developing control children underwent a go/no-go task, and their cortical hemodynamics were assessed using fNIRS. We explored specific regions of interest (ROIs and cut-off amplitudes for cortical activation to distinguish ADHD children from control children. The ROI located on the border of inferior and middle frontal gyri yielded the most accurate discrimination. Furthermore, we adapted well-formed formulae for the constituent channels of the optimized ROI, leading to improved classification accuracy with an area under the curve value of 85% and with 90% sensitivity. Thus, the right prefrontal hypoactivation assessed by fNIRS would serve as a potentially effective biomarker for classifying ADHD children at the individual level.

  17. Assessment of patient’s anxiety and expectation associated with hemodynamic changes during surgical procedure under local anesthesia

    Directory of Open Access Journals (Sweden)

    Marcos Vinícius Mendes DANTAS

    Full Text Available Abstract Introduction The dental patient’s anxiety and expectation may significantly alter their vital signs. The use of local anesthetics associated with a vasoconstrictor may also alter the vital signs of these patients, promoting hemodynamic changes that may result in emergency situations. Objective To evaluate the influence of anxiety of patients submitted to third molar extraction and the use of different anesthetic substances with adrenaline on their vital signs (oxygen saturation, heart rate, and systolic and diastolic blood pressure in different moments. Material and method Forty patients answered the questionnaire of the Dental Anxiety Scale (Corah’s Scale and fear (KleinKnecht’s Scale and were submitted to third molar extraction in two surgical times for the use of articaine or mepivacaine, both associated with adrenaline. The results were analyzed by ANOVA followed by Tukey post hoc test, Student's t test, and Pearson's correlation coefficients (α=0.05. Result There was no significant differences in saturation or heart rate. The blood pressure showed significant variations during time for both anesthetics, however mepivacaine resulted in a longer postoperative time to restore blood pressure. Patients with high or moderate anxiety and high fear index were those who had positive correlations with the highest blood pressure values. Conclusion Anxiety and fear positively influence the increase in blood pressure. Mepivacaine promoted a greater resistance to the return of normal vital signs, especially blood pressure levels.

  18. Ecological Risk Assessment with MCDM of Some Invasive Alien Plants in China

    Science.gov (United States)

    Xie, Guowen; Chen, Weiguang; Lin, Meizhen; Zheng, Yanling; Guo, Peiguo; Zheng, Yisheng

    Alien plant invasion is an urgent global issue that threatens the sustainable development of the ecosystem health. The study of its ecological risk assessment (ERA) could help us to prevent and reduce the invasion risk more effectively. Based on the theory of ERA and methods of the analytic hierarchy process (AHP) of multi-criteria decision-making (MCDM), and through the analyses of the characteristics and processes of alien plant invasion, this paper discusses the methodologies of ERA of alien plant invasion. The assessment procedure consisted of risk source analysis, receptor analysis, exposure and hazard assessment, integral assessment, and countermeasure of risk management. The indicator system of risk source assessment as well as the indices and formulas applied to measure the ecological loss and risk were established, and the method for comprehensively assessing the ecological risk of alien plant invasion was worked out. The result of ecological risk analysis to 9 representative invasive alien plants in China shows that the ecological risk of Erigeron annuus, Ageratum conyzoides, Alternanthera philoxeroides and Mikania midrantha is high (grade1-2), that of Oxalis corymbosa and Wedelia chinensis comes next (grade3), while Mirabilis jalapa, Pilea microphylla and Calendula officinalis of the last (grade 4). Risk strategies are put forward on this basis.

  19. An assessment of the effectiveness of a large, national-scale invasive alien plant control strategy in South Africa

    CSIR Research Space (South Africa)

    Van Wilgen, BW

    2012-04-01

    Full Text Available extent of invasive species control operations, assessments of the effectiveness of biological control, and smaller-scale studies. The 19 most important invasive taxa, mainly trees, in terrestrial biomes were identified. The effectiveness of control...

  20. Prospective observational study on assessing the hemodynamic relevance of patent ductus arteriosus with frequency domain near-infrared spectroscopy.

    Science.gov (United States)

    Schwarz, Christoph E; Preusche, Antonio; Wolf, Martin; Poets, Christian F; Franz, Axel R

    2018-02-16

    What constitutes a hemodynamically relevant patent ductus arteriosus (hrPDA) in preterm infants is unclear. Different clinical and echocardiographic parameters are used, but a gold standard definition is lacking. Our objective was to evaluate associations between regional cerebral tissue oxygen saturation (rcStO 2 ), fraction of tissue oxygen extraction (rcFtO 2 E) measured by frequency domain near-infrared spectroscopy (fd-NIRS) and their correlation to echocardiographic, Doppler-ultrasound, and clinical parameters in preterm infants with and without a hrPDA. In this prospective observational study, 22 infants standard deviation (normalised to a median Hb of 13.8 mg/dl) was 57 ±5% for rcStO 2 and 0.39 ±0.05 for rcFtO 2 E. Comparing no-hrPDA with hrPDA infants, there were no significant differences in mean rcStO 2 (58 ±5% vs. 54 ±5%; p = .102), but in mean rcFtO 2 E (0.38 ±0.05 vs. 0.43 ±0.05; p = .038). Echocardiographic parameter and Doppler indices did not correlate with cerebral oxygenation. Oxygen transport capacity of the blood may confound NIRS data interpretation. Cerebral oxygenation determined by fd-NIRS provided additional information for PDA treatment decisions not offered by routine investigations. Whether indicating PDA therapy based on echocardiography complemented by data on cerebral oxygenation results in better outcomes should be investigated in future studies.

  1. Carcinoma of the cervix. Value of dynamic magnetic resonance imaging in assessing early stromal invasion

    International Nuclear Information System (INIS)

    Kojima, Yumi; Aoki, Yoichi; Kase, Hiroaki; Kodama, Shoji; Tanaka, Kenichi

    1998-01-01

    The purpose of this study was to assess the accuracy of contrast-enhanced magnetic resonance imaging (dynamic MR imaging) in the evaluation of preinvasive and early invasive cancer of the cervix. Twenty-nine women with untreated squamous cell carcinoma of the cervix with either no stromal invasion or early stromal invasion underwent pretreatment MR imaging and dynamic MR imaging within 4 weeks of surgical evaluation. The images were evaluated for tumor detection and compared with results of histologic examination of the surgical specimens. The lesions in 17 cases with histologically proven stromal invasion of 4 mm or greater were detected with dynamic MR imaging, whereas lesions in only 8 of these cases were detected with T2 imaging. In 9 cases with stromal invasion between 4.0 mm and 5.0 mm, lesions were represented as early phase focal enhancement on dynamic MR images, but not detected on T2-weighted images. In the 12 cases with less than 4 mm stromal invasion, no lesions were visualized on either T2-weighted images or dynamic MR images, except in 1 case of glandular involvement without stromal invasion that appeared as enhancement on early-phase dynamic MR imaging. Dynamic MR imaging detected more lesions of early stromal invasion in pretreatment imaging for cervical cancer than nonenhanced MR imaging. (author)

  2. Evolving strategies for liver fibrosis staging: Non-invasive assessment.

    Science.gov (United States)

    Stasi, Cristina; Milani, Stefano

    2017-01-14

    Transient elastography and the acoustic radiation force impulse techniques may play a pivotal role in the study of liver fibrosis. Some studies have shown that elastography can detect both the progression and regression of fibrosis. Similarly, research results have been analysed and direct and indirect serum markers of hepatic fibrosis have shown high diagnostic accuracy for advanced fibrosis/cirrhosis. The prognosis of different stages of cirrhosis is well established and various staging systems have been proposed, largely based on clinical data. However, it is still unknown if either non-invasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. In fact, not enough studies have shown both the fibrosis regression in different cirrhosis stages and the point beyond which the prognosis does not change - even in the event of fibrosis regression. Therefore, future studies are needed to validate non-invasive methods in predicting the different phases of liver cirrhosis.

  3. Viability assessment of invasive microplankton in ship’s treated ballast water

    DEFF Research Database (Denmark)

    Lundgreen, Kim; Holbech, Henrik; Pedersen, Knud Ladegaard

    The spreading of aquatic invasive species in ship’s ballast water has huge environmental and health-related consequences and is causing socio-economic losses around the world in the order of US$100 billion per year. Regulations now require all large ships to have an approved ballast water treatment...... system (BWTS) on-board for cleaning of the ballast water to avoid further spreading of invasive species. To ensure BWTS compliance with discharge standards water samples need to be verified for the number of viable organisms in different size classes. The current standard method for assessing organism...... of more efficient BWMS to avoid any further spreading of invasive species....

  4. Efficacy of superficial temporal artery-middle cerebral artery bypass in cerebrovascular steno-occlusive diseases: Hemodynamics assessed by perfusion computed tomography.

    Science.gov (United States)

    Kwon, Woo-Keun; Kwon, Taek-Hyun; Park, Dong-Hyuk; Kim, Joo-Han; Ha, Sung-Kon

    2017-01-01

    Our purpose of this study was to assess the cerebral hemodynamic improvement with perfusion computed tomography (CT), before and after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in patients with cerebrovascular steno-occlusive diseases including both moyamoya disease and nonmoyamoya steno-occlusions. Twenty-four STA-MCA bypasses were performed to 22 patients with symptomatic cerebrovascular steno-occlusive diseases, including both moyamoya disease and nonmoyamoya steno-occlusive diseases. Brain perfusion CT images were obtained before and after the bypass surgery. The relative parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) derived from the perfusion CT were collected and analyzed to assess the efficacy of STA-MCA bypass. The CBF increased, and MTT decreased after the bypass surgery in both moyamoya group and nonmoyamoya group. The increase of CBF in nonmoyamoya group and the decrease of MTT delay in moyamoya group, overall group were statistically significant ( P cerebrovascular steno-occlusive diseases, such as moyamoya disease and internal carotid artery/MCA steno-occlusion. And perfusion CT can be used as an effective quantitative modality to assess the cerebral perfusion before and after the STA-MCA bypass surgery.

  5. Complex Coronary Hemodynamics - Simple Analog Modelling as an Educational Tool.

    Science.gov (United States)

    Parikh, Gaurav R; Peter, Elvis; Kakouros, Nikolaos

    2017-01-01

    Invasive coronary angiography remains the cornerstone for evaluation of coronary stenoses despite there being a poor correlation between luminal loss assessment by coronary luminography and myocardial ischemia. This is especially true for coronary lesions deemed moderate by visual assessment. Coronary pressure-derived fractional flow reserve (FFR) has emerged as the gold standard for the evaluation of hemodynamic significance of coronary artery stenosis, which is cost effective and leads to improved patient outcomes. There are, however, several limitations to the use of FFR including the evaluation of serial stenoses. In this article, we discuss the electronic-hydraulic analogy and the utility of simple electrical modelling to mimic the coronary circulation and coronary stenoses. We exemplify the effect of tandem coronary lesions on the FFR by modelling of a patient with sequential disease segments and complex anatomy. We believe that such computational modelling can serve as a powerful educational tool to help clinicians better understand the complexity of coronary hemodynamics and improve patient care.

  6. Non-invasive assessment of skeletal muscle activity

    Science.gov (United States)

    Merletti, Roberto; Orizio, Claudio; di Prampero, Pietro E.; Tesch, Per

    2005-10-01

    After the first 3 years (2002-2005), the MAP project has made available: - systems fo electrodes, signal conditioning and digital processing for multichannel simultaneously-detected EMG and MMG as well as for simultaneous electrical stimulation and EMG detection with artifact cancellation. - innovative non-invasive techniques for the extraction of individual motor unit action potentials (MUAPS) and individual motor and MMG contributions from the surface EMG interference signal and the MMG signal. - processing techniques for extractions of indicators of progressive fatigue from the electrically-elicited (M-wave) EMG signal. - techniques for the analysis of dynamic multichannel EMG during cyclic or explosive exercise (in collaboration with project EXER/MAP-MED-027).

  7. Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate

    OpenAIRE

    Chai, Shauna-Lee; Zhang, Jian; Nixon, Amy; Nielsen, Scott

    2016-01-01

    Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expec...

  8. Pre- and postoperative assessment of hemodynamics in patients with chronic thromboembolic pulmonary hypertension by MR techniques; Erfassung haemodynamischer Parameter bei Patienten mit chronischer thromboembolischer pulmonaler Hypertonie mittels MRT vor und nach Thrombendarteriektomie

    Energy Technology Data Exchange (ETDEWEB)

    Ley, S.; Kauczor, H.U. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Deutsches Krebsforschungszentrum, Heidelberg (Germany). Inst. fuer Radiologie und Pathophysiologie; Kramm, T.; Mayer, E. [Mainz Univ. (Germany). Klinik fuer Herz- Thorax- und Gefaesschirurgie; Heussel, C.P.; Thelen, M.; Kreitner, K.F. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie

    2003-12-01

    Purpose: To evaluate the potential of MRI to grade cardiac impairment and pulmonary hypertension in patients with chronic thromboembolic pulmonary hypertension (CTEPH) in comparison with invasive pressure measurements before and after surgery. Material and Methods: We examined 35 patients with CTEPH before and after pulmonary thromboendarterectomy (PTE). For assessment of hemodynamics, velocity-encoded segmented GE-sequences (pulmonary arteries and ascending aorta) and segmented cine GE-sequences along the short axis of the heart were performed. The analysis comprised calculation of ejection fractions, peak velocities, mean pulmonary arterial flow and vessel diameter. 10 volunteers served as controls. Flow measurements were compared to invasively measured mean pulmonary arterial pressure (MPAP) and vascular resistance (PVR). Results: Compared to volunteers, CTEPH-patients showed significantly reduced right ventricular ejection fractions (p<0.001), pulmonary peak velocity (p<0.001) and significantly increased diameters of the pulmonary arteries (p<0.001). The flow measurements in the aorta (2713 ml/min) and the pulmonary arteries (2088 ml/min) revealed a large bronchopulmonary shunt. After PTE, there was a significant reduction in vessel diameter (p<0.001). This was associated with a significant increase in pulmonary peak velocities (p<0.001). The increase in pulmonary peak velocities correlated with the decrease of PVR (r=0.5) and MPAP (r=0.6). The ejection fraction of the right ventricle correlated with PVR (r=0.6) and MPAP (r=0.7). The postoperative decrease in MPAP correlated with the increase in right ventricular ejection fraction (r=0.8). After PTE there was no bronchopulmonary shunt volume. All patients had an inverse motion of the interventricular septum. It returned to normal in 68% of patients after surgery. Conclusion: Breath-hold MR-technique enable non-invasive assessment of pulmonary hemodynmics in patients with CTEPH. For postoperative follow

  9. Rapid response for invasive waterweeds at the arctic invasion front: Assessment of collateral impacts from herbicide treatments

    Science.gov (United States)

    Sethi, Suresh; Carey, Michael P.; Morton, John M.; Guerron-Orejuela, Edgar; Decino, Robert; Willette, Mark; Boersma, James; Jablonski, Jillian; Anderson, Cheryl

    2017-01-01

    The remoteness of subarctic and arctic ecosystems no longer protects against invasive species introductions. Rather, the mix of urban hubs surrounded by undeveloped expanses creates a ratchet process whereby anthropogenic activity is sufficient to introduce and spread invaders, but for which the costs of monitoring and managing remote ecosystems is prohibitive. Elodea spp. is the first aquatic invasive plant to become established in Alaska and has potential for widespread deleterious ecological and economic impacts. A rapid eradication response with herbicides has been identified as a priority invasion control strategy. We conducted a multi-lake monitoring effort to assess collateral impacts from herbicide treatment for Elodea in high latitude systems. Variability in data was driven by seasonal dynamics and natural lake-to-lake differences typical of high latitude waterbodies, indicating lack of evidence for systematic impacts to water quality or plankton communities associated with herbicide treatment of Elodea. Impacts on native macrophytes were benign with the exception of some evidence for earlier onset of leaf senescence for lily pads(Nuphar spp.) in treated lakes. We observed a substantial increase in detected native flora richness after Elodea was eradicated from the most heavily infested lake, indicating potential for retention of native macrophyte communities if infestations are addressed quickly. While avoiding introductions through prevention may be the most desirable outcome, these applications indicated low risks of non-target impacts associated with herbicide treatment as a rapid response option for Elodea in high latitude systems.

  10. Hemodynamic Support in Sepsis

    Directory of Open Access Journals (Sweden)

    Fatih Yildiz

    2014-04-01

    Full Text Available Sepsis is called systemic inflammatory response syndrome due to infection. When added to organs failure and perfusion abnormality is defined in severe sepsis, Hypotension that do not respond to fluid therapy is as defined septic shock. Fluid resuscitation is a most important parts of the treatment in patients with septic shock. Ongoing hypotension that despite of the adequate fluid therapy, vasopressor support initiation is required. Sepsis and septic shock, hemodynamic support is often understood as the hemodynamic support. The different approaches to the development of methods to track and objective comes up. Patients with severe sepsis and septic shock should be follow in the intensive care unit and rapid fluid replacement and effectual hemodynamic support should be provided.

  11. Assessment of effects of differences in trunk posture during Fowler’s position on hemodynamics and cardiovascular regulation in older and younger subjects

    Directory of Open Access Journals (Sweden)

    Kubota S

    2017-03-01

    Full Text Available Satoshi Kubota,1 Yutaka Endo,1 Mitsue Kubota,1 Tomohiko Shigemasa2 1School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan; 2Department of Cardiology, International University of Health and Welfare Atami Hospital, Atami, Shizuoka, Japan Background: Downward shifts in blood volume with changing position generally cause tachycardic responses. Age-related decreases in vagal nerve activity could contribute to orthostatic hypotension in older individuals. Fowler’s position is a reclined position with the back between 30° and 60°, used to facilitate breathing, eating, and other routine daily activities in frail and elderly patients. Objective: This study examined whether stroke volume (SV was higher and heart rate (HR lower in Fowler’s position with an upright upper trunk than in Fowler’s position with the whole trunk upright in both older and younger subjects, based on the assumption that lower HR would result from reduced sympathetic activation in older individuals. Methods: We assessed hemodynamics and HR variability from electrocardiography, noninvasive arterial pressure and impedance cardiography in 11 younger male subjects (age range, 20–22 years and 11 older male subjects (age range, 64–79 years, using three positions: supine, or Fowler’s positions with either 30° of lower trunk inclination and 60° of upper trunk inclination (UT60 or 60° of whole trunk inclination (WT60. Comparisons were then made between age groups and between positions. Results: Reductions in SV and tachycardic response were smaller with UT60 than with WT60, in both younger and older subjects. In addition, reduced tachycardic response with upright upper trunk appeared attributable to decreased vagal withdrawal in younger subjects and to reduced sympathetic activation in older subjects. Conclusion: Our findings indicate that an upright upper trunk during Fowler’s position allowed

  12. Hemodynamic Profiling in Complicated Pregnancies

    NARCIS (Netherlands)

    J.M.J. Cornette (Jérôme)

    2016-01-01

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

  13. Differential hemodynamic effects of exercise and volume expansion in people with and without heart failure

    DEFF Research Database (Denmark)

    Andersen, Mads Jønsson; Olson, Thomas P; Melenovsky, Vojtech

    2015-01-01

    BACKGROUND:Invasive hemodynamic exercise testing is commonly used in the evaluation of patients with suspected heart failure with preserved ejection fraction (HFpEF) or pulmonary hypertension. Saline loading has been suggested as an alternative provocative maneuver, but the hemodynamic changes...

  14. Utilization of a pressure sensor guidewire to measure bileaflet mechanical valve gradients: hemodynamic and echocardiographic sequelae.

    Science.gov (United States)

    Doorey, Andrew J; Gakhal, Mandip; Pasquale, Michael J

    2006-04-01

    Suspected prosthetic valve dysfunction is a difficult clinical problem, because of the high risk of repeat valvular surgery. Echocardiographic measurements of prosthetic valvular dysfunction can be misleading, especially with bileaflet valves. Direct measurement of trans-valvular gradients is problematic because of potentially serious catheter entrapment issues. We report a case in which a high-fidelity pressure sensor angioplasty guidewire was used to cross prosthetic mitral and aortic valves in a patient, with hemodynamic and echocardiographic assessment. This technique was safe and effective, refuting the inaccurate non-invasive tests that over-estimated the aortic valvular gradient.

  15. Risk assessment, eradication, and biological control: global efforts to limit Australian acacia invasions

    Science.gov (United States)

    Wilson, John R.U.; Gairifo, Carla; Gibson, Michelle R.; Arianoutsou, Margarita; Bakar, Baki B.; Baret, Stephane; Celesti-Grapow, Laura; DiTomaso, Joseph M.; Dufour-Dror, Jean-Marc; Kueffer, Christoph; Kull, Christian A.; Hoffman, John H.; Impson, Fiona A.C.; Loope, Lloyd L.; Marchante, Elizabete; Harchante, Helia; Moore, Joslin L.; Murphy, Daniel J.; Tassin, Jacques; Witt, Arne; Zenni, Rafael D.; Richardson, David M.

    2011-01-01

    Aim Many Australian Acacia species have been planted around the world, some are highly valued, some are invasive, and some are both highly valued and invasive. We review global efforts to minimize the risk and limit the impact of invasions in this widely used plant group. Location Global. Methods Using information from literature sources, knowledge and experience of the authors, and the responses from a questionnaire sent to experts around the world, we reviewed: (1) a generalized life cycle of Australian acacias and how to control each life stage, (2) different management approaches and (3) what is required to help limit or prevent invasions. Results Relatively few Australian acacias have been introduced in large numbers, but all species with a long and extensive history of planting have become invasive somewhere. Australian acacias, as a group, have a high risk of becoming invasive and causing significant impacts as determined by existing assessment schemes. Moreover, in most situations, long-lived seed banks mean it is very difficult to control established infestations. Control has focused almost exclusively on widespread invaders, and eradication has rarely been attempted. Classical biological control is being used in South Africa with increasing success. Main conclusions A greater emphasis on pro-active rather than reactive management is required given the difficulties managing established invasions of Australian acacias. Adverse effects of proposed new introductions can be minimized by conducting detailed risk assessments in advance, planning for on-going monitoring and management, and ensuring resources are in place for long-term mitigation. Benign alternatives (e.g. sterile hybrids) could be developed to replace existing utilized taxa. Eradication should be set as a management goal more often to reduce the invasion debt. Introducing classical biological control agents that have a successful track-record in South Africa to other regions and identifying new

  16. Assessment of hemodynamic changes in the systemic and pulmonary arterial circulation in patients with cystic fibrosis using phase-contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ley, Sebastian; Eichinger, Monika [DKFZ, Department of Radiology (E010), Heidelberg (Germany); Johannes Gutenberg University, Department of Radiology, University Hospital Mainz, Mainz (Germany); Puderbach, Michael; Fink, Christian; Plathow, Christian; Kauczor, Hans-Ulrich [DKFZ, Department of Radiology (E010), Heidelberg (Germany); Teiner, Susanne [University of Heidelberg, Department of Pediatric Radiology, Heidelberg (Germany); Wiebel, Matthias [Thoraxklinik am Universitaetsklinikum, Department of Pulmonology, Heidelberg (Germany); Mueller, Frank-Michael [University of Heidelberg, Department of Pediatric Pulmonology, Heidelberg (Germany)

    2005-08-01

    Cystic fibrosis (CF) leads to disabling lung disease and pulmonary hypertension (PH). The goal of this study was to assess the hemodynamics in the systemic and pulmonary arterial circulation of patients with CF using MRI. Ten patients with CF and 15 healthy volunteers were examined (1.5-T MRI). Phase-contrast flow measurements were assessed in the ascending aorta, pulmonary trunc, and the left and right pulmonary arteries (PA), resulting in the following parameters: peak velocity (PV) (centimeters per second) velocity rise gradient (VRG), time to PV (milliseconds), and the average area (centimeters squared). The blood flow ratio between the right and left lungs and the bronchosystemic shunt were calculated. For the ascending aorta and pulmonary trunc no parameter was significantly different between both populations. In the right PA a significantly lower PV (p=0.001) and VRG (p=0.02) was found. In the left PA there was a significantly (p=0.007) lower PV but no significant (p=0.07) difference between the VRG. The areas of the right (p=0.08) and left (p=0.5) PA were not significantly enlarged. For the volunteers a linear increase of PV in both PA was found with age, while it decreased in patients with CF. The blood flow distribution (right/left lung) showed no significant (p=0.7) difference between the groups. There was a significantly (p<0.001) higher bronchosystemic shunt volume in patients with CF (1.3 l/min) than in volunteers (0.1 l/min). Magnetic resonance based flow measurements in the right and left PA showed first indications for early development of PH. The significant increase in bronchosystemic shunt volume might be indicative fo the extent of parenchymal changes. (orig.)

  17. Ultraweak photon emission as a non-invasive health assessment: A systematic review

    NARCIS (Netherlands)

    Ives, J.A.; Wijk, E.P.A. van; Bat, N.; Crawford, C.; Walter, A.; Jonas, W.B.; Wijk, R. van; Greef, J. van der

    2014-01-01

    We conducted a systematic review (SR) of the peer reviewed scientific literature on ultraweak photon emissions (UPE) from humans. The question was: Can ultraweak photon emissions from humans be used as a non-invasive health assessment? A systematic search was conducted across eight relevant

  18. Weed risk assessments are an effective component of invasion risk management

    Czech Academy of Sciences Publication Activity Database

    Gordon, D. R.; Flory, S. L.; Lieurance, D.; Hulme, P. E.; Buddenhagen, C.; Caton, B.; Champion, P. D.; Culley, T. M.; Daehler, C. C.; Essl, F.; Hill, J. E.; Keller, R. P.; Kohl, L.; Koop, A. L.; Kumschick, S.; Lodge, D. M.; Mack, R. N.; Meyerson, L. A.; Pallipparambil, G. R.; Panetta, F. D.; Porter, R.; Pyšek, Petr; Quinn, L. D.; Richardson, D. M.; Simberloff, D.; Vila, M.

    2016-01-01

    Roč. 9, č. 1 (2016), s. 81-83 ISSN 1939-7291 Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : weed risk assessment * interspecific variation * invasions Subject RIV: EH - Ecology, Behaviour Impact factor: 0.952, year: 2016

  19. Cardiac abnormalities assessed by non-invasive techniques in patients with newly diagnosed idiopathic inflammatory myopathies

    DEFF Research Database (Denmark)

    Diederichsen, Louise Pyndt; Simonsen, Jane Angel; Diederichsen, Axel Cosmus Pyndt

    2015-01-01

    inflammatory myopathies (IIM) by means of non-invasive techniques. METHODS: Fourteen patients with IIM (8 polymyositis, 4 dermatomyositis, 2 cancer-associated dermatomyositis) and 14 gender- and age- matched healthy control subjects were investigated. Participant assessments included a cardiac questionnaire...

  20. Invasion of the turtles? : exotic turtles in the Netherland: a risk assessment

    NARCIS (Netherlands)

    Bugter, R.J.F.; Ottburg, F.G.W.A.; Roessink, I.; Jansman, H.A.H.; Grift, van der E.A.; Griffioen, A.J.

    2011-01-01

    The authors of this report assessed the risk of exotic turtles becoming invasive in the Netherlands. Main components of the risk are the large scale of introduction of discarded pets to Dutch nature and possible suitability of species to survive and reproduce successfully under present or future

  1. Cerebral hemodynamics: concepts of clinical importance

    Directory of Open Access Journals (Sweden)

    Edson Bor-Seng-Shu

    2012-05-01

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

  2. Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

    Directory of Open Access Journals (Sweden)

    Ulrike Löbel

    Full Text Available Conventional magnetic resonance imaging (MRI of patients with hemolytic uremic syndrome (HUS and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF and aimed to identify a plausible cause.Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved magnetic resonance angiography (4D MRA assessed cerebral hemodynamics by global time-to-peak (TTP, as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2.SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4. Hemoglobin at the time of MRI (n = 35 was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4; hematocrit (n = 33 was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2. Creatinine was abnormally high in 30 of 36 patients (83% (range, 0.8 to 9.7; mean, 3.7 ± 2.2. SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015, hematocrit (r = 0.65, P < 0.001, and TTP (r = 0.35, P = 0.036. No correlation of SWI with blood pressure, heart rate, end-tidal CO2, creatinine, and urea level was observed. Findings suggest that the loss of venous contrast is related to an increase in CBF secondary to severe anemia related to HUS. SWI contrast of patients with pathological conventional MRI findings was significantly lower compared to patients with normal MRI (mean SWI score, 1

  3. A comparison of pelvic retroperitoneal pneumography and computed tomography in the assessment of extramural invasion of rectal carcinoma

    International Nuclear Information System (INIS)

    Kaibara, Nobuaki; Kimura, Osamu; Nishidoi, Hideaki; Ikeguchi, Masahide; Sugezawa, Akira; Sumi, Kenichi; Ohta, Michio; Koga, Shigemasa

    1988-01-01

    Pelvic retroperitoneal pneumography (PRP) and pelvic computed tomography (CT) were performed on 33 patients with rectal carcinoma in order to compare the usefulness of the two diagnostic procedures in the preoperative assessment of local malignant extramural invasion. Six PRP-negative patients in whom no free air was visualized in the retroperitoneal space surrounding the mass, were all assessed as having extramural invasion by CT scan and all had histologic evidence of invasion. Of 27 PRP-positive patients in whom free air was seen surrounding the mass, 18 were diagnosed as having extramural invasion on CT, 15 of whom had histologic proof of invasion. In the remaining 9 PRP-positive patients, there was no evidence of extramural invasion on the CT scans, but 5 patients showed evidence of invasion histologically. PRP, when positive, had an unacceptably high rate of being false positive and was therefore unreliable in assessing extramural invasion, whereas CT was able to detect, to some extent, extramural invasion which PRP failed to demonstrate. Based on these findings, we conclude that CT is more useful than PRP in the preoperative assessment of extramural invasion of rectal carcinoma, but is of limited diagnostic value when negative. (author)

  4. Impact of Diversity of Morphological Characteristics and Reynolds number on Local Hemodynamics in Basilar Aneurysms

    DEFF Research Database (Denmark)

    Rafat, Marjan; Dabagh, Mahsa; Heller, Martin

    2018-01-01

    management. Existing aneurysm hemodynamics studies generally evaluate limited geometries or Reynolds numbers (Re), which are difficult to apply to a wide range of patient-specific cases. We focused on the association between hemodynamic characteristics and morphology. We assessed several two-dimensional (2D...... in the hemodynamic and WSS profiles. Our systematic mapping and non-dimensional analysis qualitatively identify hemodynamic conditions that may predispose aneurysms to rupture. This article is protected by copyright. All rights reserved....

  5. Allelopathic assessment of selected invasive species of pakistan

    International Nuclear Information System (INIS)

    Akhtar, S.

    2014-01-01

    Invader species are a great threat to local flora. Eight invader species of Pakistan were screened for their allelopathic activity through sandwich method. Toxic (inhibitory) and non-toxic (stimulatory) effects were assessed by recording their effect on germination and growth of lettuce. Radicle and plumule growth of lettuce were recorded at 5, 10 and 50 mg leaves concentrations of each species. Among all species the growth activity was found to be concentration dependent. Except Eutcalyptus glabra all species resulted in inhibitory effects at 5, 10 and 50 mg leaves concentrations. Xanthium strumarium and Cannabis sativa showed strong inhibitory effects on radicle and plumule growth of lettuce. Maximum inhibition was recorded at highest concentration; even growth of lettuce was stopped with 50 mg leaves concentration of C. sativa. (author)

  6. Environmental risk assessment for invasive alien species : A case study of apple snails affecting ecosystem services in Europe

    NARCIS (Netherlands)

    Gilioli, Gianni; Schrader, Gritta; Carlsson, Nils; van Donk, Ellen; van Leeuwen, Casper H.A.; Martín, Pablo R.; Pasquali, Sara; Vilà, Montserrat; Vos, Sybren

    2017-01-01

    The assessment of the risk posed by invasive alien species (IAS) to the environment is a component of increasing importance for Pest Risk Analysis. Standardized and comprehensive procedures to assess their impacts on ecosystem services have been developed only recently. The invasive apple snails

  7. Environmental risk assessment for invasive alien species: A case study of apple snails affecting ecosystem services in Europe

    NARCIS (Netherlands)

    Gilioli, Gianni; Schrader, Gritta; Carlsson, Nils; van Donk, Ellen; van Leeuwen, Casper H.A.; Martín, Pablo R.; Pasquali, Sara; Vilà, Montserrat; Vos, Sybren

    Abstract The assessment of the risk posed by invasive alien species (IAS) to the environment is a component of increasing importance for Pest Risk Analysis. Standardized and comprehensive procedures to assess their impacts on ecosystem services have been developed only recently. The invasive apple

  8. Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

    Science.gov (United States)

    Löbel, Ulrike; Forkert, Nils Daniel; Schmitt, Peter; Dohrmann, Thorsten; Schroeder, Maria; Magnus, Tim; Kluge, Stefan; Weiler-Normann, Christina; Bi, Xiaoming; Fiehler, Jens; Sedlacik, Jan

    2016-01-01

    Conventional magnetic resonance imaging (MRI) of patients with hemolytic uremic syndrome (HUS) and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI) revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF) and aimed to identify a plausible cause. Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years) were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved) magnetic resonance angiography (4D MRA) assessed cerebral hemodynamics by global time-to-peak (TTP), as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2. SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4). Hemoglobin at the time of MRI (n = 35) was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4); hematocrit (n = 33) was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2). Creatinine was abnormally high in 30 of 36 patients (83%) (range, 0.8 to 9.7; mean, 3.7 ± 2.2). SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015), hematocrit (r = 0.65, P effect of blood transfusions in patients with HUS and neurological symptoms.

  9. THE PARAMETERS OF THE OXYGEN STATUS IN THE ASSESSMENT OF PROGNOSIS OF A HEMODYNAMICALLY SIGNIFICANT PATENT DUCTUS ARTERIOSUS PRETERM NEONATAL INFANTS

    Directory of Open Access Journals (Sweden)

    M. V. Perestoronina

    2015-01-01

    Full Text Available Objective: to estimate the significance of capillary blood oxygen parameters for the prognosis of longstanding hemodynamically significant patent ductus arteriosus (HSPDA in extremely low birthweight (ELBW neonates. Subjects and methods. On day 8 of their life, two groups of ELBW newborn infants with and without HSPDA were examined for capillary blood рН, рkО2, %SO2с, O2ct, АkDO2, and RIk, as well as mechanical ventilation (MV parameters (Pip, MAP, and FiO2. Comparison of two independent samples used nonparametric statistical tests: MannWhitney test, Wald Wolfowitz test, and Kolmogorov-Smirnov test. A logistic regression analysis was used to assess the relationship between the examined parameters and the presence or absence of HSPDA. ROC curves were constructed, by choosing the cut-off point, to estimate the predictive power of the model developed using logistic regression. Results. The developed model has high sensitivity and high specificity (84,6 and 97% respectively. The logistic regression equation takes the form: -0.479•О2сt+0.708•Pip-6.823. Conclusion. Capillary blood oxygen parameters proved suitable for predicting the duration of HSPDA functioning. The resultant good predictive power of the model developed for day 8 of life points to the fact that this period is critical from the viewpoint of resolution of respiratory distress syndrome or development of bronchopulmonary dysplasia, which is crucially significant for MV duration and further prediction. HSPDA is one of the most important factors contributing to the development of bronchopulmonary dysplasia in ELBW neonatal infants.

  10. Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate.

    Directory of Open Access Journals (Sweden)

    Shauna-Lee Chai

    Full Text Available Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta's biodiversity are giant knotweed (Fallopia sachalinensis, tamarisk (Tamarix chinensis, and alkali swainsonpea (Sphaerophysa salsula. We characterise giant knotweed as 'extremely invasive', with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is 'extremely invasive' with a 64% increase in suitable habitat, and alkali swainsonpea is 'highly invasive' with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change.

  11. Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate.

    Science.gov (United States)

    Chai, Shauna-Lee; Zhang, Jian; Nixon, Amy; Nielsen, Scott

    2016-01-01

    Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta's biodiversity are giant knotweed (Fallopia sachalinensis), tamarisk (Tamarix chinensis), and alkali swainsonpea (Sphaerophysa salsula). We characterise giant knotweed as 'extremely invasive', with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is 'extremely invasive' with a 64% increase in suitable habitat, and alkali swainsonpea is 'highly invasive' with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change.

  12. 4D flow MRI assessment of extracranial-intracranial bypass: qualitative and quantitative evaluation of the hemodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Sekine, Tetsuro [University Hospital Zurich/University of Zurich, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Nippon Medical School, Department of Radiology, Tokyo (Japan); Takagi, Ryo; Amano, Yasuo; Orita, Erika; Matsumura, Yoshio; Kumita, Shin-ichiro [Nippon Medical School, Department of Radiology, Tokyo (Japan); Murai, Yasuo [Nippon Medical School, Department of Neurological Surgery, Tokyo (Japan)

    2016-03-15

    Our aim was to assess the feasibility of using time-resolved 3D phase-contrast (4D flow) MRI to characterize extracranial-intracranial (EC-IC) bypass. We enrolled 32 patients who underwent EC-IC bypass (15 men, 17 women; mean age 66.4 years). In all, 16 underwent radial artery graft (RAG) bypass and 16 underwent superficial temporal artery (STA) bypass. 4D flow MRI, time-of-flight (TOF) magnetic resonance angiography (MRA), and computed tomography angiography (CTA) were performed. Bypass patency, flow direction, and blood flow volume (BFV) of each artery were determined by 4D flow MRI. Arterial diameters were measured by TOF-MRA and CTA. We compared RAG and STA bypasses by evaluating the flow direction and BFV of each artery. We evaluated the correlation between arterial diameters (measured by CTA or MRA) and the BFV and the detectability of flow direction (measured by 4D flow MRI) of each artery. 4D flow MRI confirmed the patency of each bypass artery. Flow direction of the M1 segment of the middle cerebral artery and BFV in the bypass artery differed between RAG and STA groups (p < 0.01). BFV in the bypass slightly correlated with the diameters on CTA (p < 0.05, R{sup 2} = 0.287). Of the 29 arteries in the circle of Willis, nine were not depicted on 4D flow MRI. Cutoff values for arterial diameters on CTA and TOF-MRA for detecting the artery on 4D flow MRI were 2.4 and 1.8 mm, respectively. 4D flow MRI provided unique information for characterizing EC-IC bypasses, although this detectability is limited when addressing small arteries with slow flow. (orig.)

  13. Hemodynamic and Behavioral Differences after Administration of Meloxicam, Buprenorphine, or Tramadol as Analgesics for Telemeter Implantation in Mice

    Science.gov (United States)

    Rätsep, Matthew T; Barrette, Valerie F; Winterborn, Andrew; Adams, Michael A; Croy, B Anne

    2013-01-01

    Cannulation of the common carotid artery for chronic, continuous radiotelemetric recording of aortic hemodynamic properties in mice is a highly invasive recovery surgery. Radiotelemetric recording, by its continuous nature, gives the most accurate measurements of hemodynamic variables in experimental animals, and is widely used in the study of cardiovascular diseases including hypertension. The American Heart Association has recommended data acquisition by radiotelemetric recording but did not provide guidelines regarding postoperative analgesic support. We assessed hemodynamic parameters, locomotor activity, food intake, and weight loss in radiotransmitter-implanted CD1 female mice receiving analgesic support during the first 48 h after surgery. The efficacy of analgesic support from the NSAID meloxicam was compared with that of the widely used opioid agonist buprenorphine and the related compound, tramadol. Meloxicam-treated mice recovered lost body weight more rapidly than did tramadol- or buprenorphine-treated mice. Furthermore, meloxicam-treated mice maintained circadian rhythm after surgery and had tighter regulation of mean arterial pressure than did tramadol- or buprenorphine-treated mice. Meloxicam was also superior with regard to food intake, locomotor activity, and limiting variance in hemodynamic parameters. This study indicates that when compared with buprenorphine and tramadol, meloxicam should be the postoperative analgesic of choice for radiotelemeter implantation in mice. PMID:24041211

  14. Advanced Hemodynamic Management in Patients with Septic Shock.

    Science.gov (United States)

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

    2016-01-01

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

  15. Evaluación hemodinámica no invasiva con cardiografía de impedancia: aplicaciones en falla cardíaca y en hipertensión arterial Non-invasive hemodynamic evaluation with impedance cardiography: applications in heart failure and hypertension

    Directory of Open Access Journals (Sweden)

    Jon Kepa Balparda

    2012-04-01

    Full Text Available La cardiografía de impendancia (CGI representa un método no invasivo para la evaluación del estado hemodinámico latido a latido. Aunque se introdujo por primera vez hace más de 40 años, la CGI ha mostrado un resurgimiento en la última década, a partir de una serie de estudios clínicos que han demostrado su precisión en la estimación del volumen latido, tanto contra el "gold-standard" invasivo (termodilución, como contra los métodos de referencia no invasivos (ecocardiografía. Diversos estudios demuestran la utilidad de esta técnica en el manejo del paciente con falla cardíaca y en el enfoque diagnóstico y terapéutico de la hipertensión arterial, por lo cual constituyen actualmente dos de las aplicaciones clínicas más importantes de la CGI. En falla cardiaca, los cambios en el volumen de líquido del tórax y del gasto cardíaco evaluados por CGI, han demostrado ser predictores de descompensación aguda, incluso semanas antes del inicio de la sintomatología respiratoria; además, permiten identificar el origen cardiogénico o respiratorio de la disnea cuando el examen físico y los demás paraclínicos no son concluyentes. En los pacientes con hipertensión arterial no controlada o resistente, la CGI permite realizar una mejor caracterización del fenotipo hipertensivo y elegir la estrategia farmacológica más específica para intervenir la alteración hemodinámica predominante (resistencia vascular vs. gasto cardiaco elevado. En este artículo se realiza una revisión de los principios biofísicos de la CGI y su utilidad en la evaluación no invasiva del estado hemodinámico, así como una evaluación crítica de la literatura que da soporte a su aplicación clínica en el tratamiento de la falla cardíaca y la hipertensión arterial.Impedance cardiography (ICG represents a non-invasive method for hemodynamic assessment in a beat-to-beat basis. Since its introduction more than forty years ago, a renewed interest in the

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

    Science.gov (United States)

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

    2014-03-01

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

  17. Dynamic Measurement of Hemodynamic Parameters and Cardiac Preload in Adults with Dengue: A Prospective Observational Study.

    Directory of Open Access Journals (Sweden)

    Vipa Thanachartwet

    Full Text Available Few previous studies have monitored hemodynamic parameters to determine the physiological process of dengue or examined inferior vena cava (IVC parameters to assess cardiac preload during the clinical phase of dengue. From January 2013 to July 2015, we prospectively studied 162 hospitalized adults with confirmed dengue viral infection using non-invasive cardiac output monitoring and bedside ultrasonography to determine changes in hemodynamic and IVC parameters and identify the types of circulatory shock that occur in patients with dengue. Of 162 patients with dengue, 17 (10.5% experienced dengue shock and 145 (89.5% did not. In patients with shock, the mean arterial pressure was significantly lower on day 6 after fever onset (P = 0.045 and the pulse pressure was significantly lower between days 4 and 7 (P50% between days 4 and 5 (P<0.05. Hypovolemic shock was observed in 9 (52.9% patients and cardiogenic shock in 8 (47.1%, with a median (interquartile range time to shock onset of 6.0 (5.0-6.5 days after fever onset, which was the median day of defervescence. Intravascular hypovolemia occurred before defervescence, whereas myocardial dysfunction occurred on the day of defervescence until 2 weeks after fever onset. Hypovolemic shock and cardiogenic shock each occurred in approximately half of the patients with dengue shock. Therefore, dynamic measures to estimate changes in hemodynamic parameters and preload should be monitored to ensure adequate fluid therapy among patients with dengue, particularly patients with dengue shock.

  18. Hemodynamic Based Coronary Artery Aneurysm Thrombosis Risk Stratification in Kawasaki Disease Patients

    Science.gov (United States)

    Grande Gutierrez, Noelia; Mathew, M.; McCrindle, B.; Kahn, A.; Burns, J.; Marsden, A.

    2017-11-01

    Coronary artery aneurysms (CAA) as a result of Kawasaki Disease (KD) put patients at risk for thrombosis and myocardial infarction. Current AHA guidelines recommend CAA diameter >8 mm or Z-score >10 as the criterion for initiating systemic anticoagulation. Our hypothesis is that hemodynamic data derived from computational blood flow simulations is a better predictor of thrombosis than aneurysm diameter alone. Patient-specific coronary models were constructed from CMRI for a cohort of 10 KD patients (5 confirmed thrombosis cases) and simulations with fluid structure interaction were performed using the stabilized finite element Navier-Stokes solver available in SimVascular. We used a closed-loop lumped parameter network (LPN) to model the heart and vascular boundary conditions coupled numerically to the flow solver. An automated parameter estimation method was used to match LPN values to clinical data for each patient. Hemodynamic data analysis resulted in low correlation between Wall Shear Stress (WSS)/ Particle Residence Time (PRT) and CAA diameter but demonstrates the positive correlation between hemodynamics and adverse patient outcomes. Our results suggest that quantifying WSS and PRT should enable identification of regions at higher risk of thrombosis. We propose a quantitative method to non-invasively assess the abnormal flow in CAA following KD that could potentially improve clinical decision-making regarding anticoagulation therapy.

  19. Cardiac abnormalities assessed by non-invasive techniques in patients with newly diagnosed idiopathic inflammatory myopathies

    DEFF Research Database (Denmark)

    Diederichsen, Louise Pyndt; Simonsen, Jane Angel; Diederichsen, Axel Cosmus Pyndt

    2015-01-01

    inflammatory myopathies (IIM) by means of non-invasive techniques. METHODS: Fourteen patients with IIM (8 polymyositis, 4 dermatomyositis, 2 cancer-associated dermatomyositis) and 14 gender- and age- matched healthy control subjects were investigated. Participant assessments included a cardiac questionnaire......OBJECTIVES: Knowledge of cardiac involvement in idiopathic inflammatory myopathies (IIM) is limited, especially in the early stage of disease. The objective of the present study was to perform a controlled evaluation of cardiac abnormalities in newly diagnosed, untreated patients with idiopathic...

  20. Natriuretic peptides and cerebral hemodynamics

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  1. A rapid assessment survey of invasive species of macrobenthic invertebrates in Korean waters

    Science.gov (United States)

    Park, Chul; Kim, Sung-Tae; Hong, Jae-Sang; Choi, Keun-Hyung

    2017-09-01

    Introduced species are a growing and imminent threat to living marine resources in parts of the world's oceans. The present study is a rapid assessment survey of invasive macrobenthic invertebrate species in Korean ports. We surveyed over 40 ports around Korea during the period of May 2010 March 2013. Among the sampling sites were concrete walls, docks and associated floats, bumpers, tires, and ropes which might harbor non-native species. We found 15 invasive species as follows: one Sponge, two Bryozoans, three Mollusks, one Polychaete, four Cirripedes, and four Ascidians. Three morphologically similar species, namely X. atrata, M. galloprovincialis, and X. securis were further examined for distinctions in their morphology. Although they could be reasonably distinguished based on shell shapes, significant overlap was noted so that additional analysis may be required to correctly distinguish them. Although many of the introduced species have already spread to all three coastal areas, newly arrived invasive species showed a relatively restricted range, with a serpulid polychaete Ficopomatus enigmaticus and a mytilid bivalve Xenostrobus securis found only at a few sites on the East Coast. An exception is for Balanus perforatus, which has rapidly colonized the East coast of Korea following its introduction into the region. Successful management of invasive macrobenthic invertebrates should be established in order to contain the spread of these newly arrived species.

  2. Hemodynamic assessment in patients with one-and-a-half ventricle repair revealed by four-dimensional flow magnetic resonance imaging.

    Science.gov (United States)

    Uribe, Sergio; Bächler, Pablo; Valverde, Israel; Crelier, Gérard R; Beerbaum, Philipp; Tejos, Cristian; Irarrazaval, Pablo

    2013-02-01

    We report hemodynamic findings in two patients with pulmonary atresia and intact ventricular septum (PAIVS) after "one-and-a-half ventricle repair" and placement of a bidirectional Glenn shunt using four-dimensional (4D) flow magnetic resonance imaging. Quantification of flow and analysis of flow patterns revealed the hemodynamic "battle" between the right ventricle (RV) and the Glenn shunt. Moreover, with a novel approach we calculated during Glenn anastomosis the flow distribution from the superior vena cava (SVC) to the pulmonary arteries. Our results showed a highly asymmetric flow distribution, with most of the flow from the SVC toward the RV and not to the lungs. The evidence provided by 4D flow demonstrates poor efficiency of this system and suggests that both patients might benefit from adding an artificial pulmonary valve to avoid right heart failure.

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

    Science.gov (United States)

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

    2015-10-01

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

  4. Non-invasive assessment of pulsatile intracranial pressure with phase-contrast magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Geir Ringstad

    Full Text Available Invasive monitoring of pulsatile intracranial pressure can accurately predict shunt response in patients with idiopathic normal pressure hydrocephalus, but may potentially cause complications such as bleeding and infection. We tested how a proposed surrogate parameter for pulsatile intracranial pressure, the phase-contrast magnetic resonance imaging derived pulse pressure gradient, compared with its invasive counterpart. In 22 patients with suspected idiopathic normal pressure hydrocephalus, preceding invasive intracranial pressure monitoring, and any surgical shunt procedure, we calculated the pulse pressure gradient from phase-contrast magnetic resonance imaging derived cerebrospinal fluid flow velocities obtained at the upper cervical spinal canal using a simplified Navier-Stokes equation. Repeated measurements of the pulse pressure gradient were also undertaken in four healthy controls. Of 17 shunted patients, 16 responded, indicating high proportion of "true" normal pressure hydrocephalus in the patient cohort. However, there was no correlation between the magnetic resonance imaging derived pulse pressure gradient and pulsatile intracranial pressure (R = -.18, P = .43. Pulse pressure gradients were also similar in patients and healthy controls (P = .26, and did not differ between individuals with pulsatile intracranial pressure above or below established thresholds for shunt treatment (P = .97. Assessment of pulse pressure gradient at level C2 was therefore not found feasible to replace invasive monitoring of pulsatile intracranial pressure in selection of patients with idiopathic normal pressure hydrocephalus for surgical shunting. Unlike invasive, overnight monitoring, the pulse pressure gradient from magnetic resonance imaging comprises short-term pressure fluctuations only. Moreover, complexity of cervical cerebrospinal fluid flow and -pulsatility at the upper cervical spinal canal may render the pulse pressure gradient a poor surrogate

  5. Quantitative assessment of hemodynamic and structural characteristics of in vivo brain tissue using total diffuse reflectance spectrum measured in a non-contact fashion.

    Science.gov (United States)

    Song, Yinchen; Garcia, Sarahy; Frometa, Yisel; Ramella-Roman, Jessica C; Soltani, Mohammad; Almadi, Mohamed; Riera, Jorge J; Lin, Wei-Chiang

    2017-01-01

    Here we present a new methodology that investigates the intrinsic structural and hemodynamic characteristics of in vivo brain tissue, in a non-contact fashion, and can be easily incorporated in an intra-operative environment. Within this methodology, relative total diffuse reflectance spectra (R TD (λ)) were acquired from targets using a hybrid spectroscopy imaging system. A spectral interpretation algorithm was subsequently applied to R TD (λ) to retrieve optical properties related to the compositional and structural characteristics of each target. Estimation errors of the proposed methodology were computationally evaluated using a Monte Carlo simulation model for photon migration under various conditions. It was discovered that this new methodology could handle moderate noise and achieve very high accuracy, but only if the refractive index of the target is known. The accuracy of the technique was also validated using a series of tissue phantom studies, and consistent and accurate estimates of μ s '(λ)/μ a (λ) were obtained from all the phantoms tested. Finally, a small-scale animal study was conducted to demonstrate the clinical utility of the reported method, wherein a forepaw stimulation model was utilized to induce transient hemodynamic responses in somatosensory cortices. With this approach, significant stimulation-related changes (p < 0.001) in cortical hemodynamic and structural characteristics were successfully measured.

  6. The development of a plant risk evaluation (PRE tool for assessing the invasive potential of ornamental plants.

    Directory of Open Access Journals (Sweden)

    Christiana Conser

    Full Text Available Weed Risk Assessment (WRA methods for evaluating invasiveness in plants have evolved rapidly in the last two decades. Many WRA tools exist, but none were specifically designed to screen ornamental plants prior to being released into the environment. To be accepted as a tool to evaluate ornamental plants for the nursery industry, it is critical that a WRA tool accurately predicts non-invasiveness without falsely categorizing them as invasive. We developed a new Plant Risk Evaluation (PRE tool for ornamental plants. The 19 questions in the final PRE tool were narrowed down from 56 original questions from existing WRA tools. We evaluated the 56 WRA questions by screening 21 known invasive and 14 known non-invasive ornamental plants. After statistically comparing the predictability of each question and the frequency the question could be answered for both invasive and non-invasive species, we eliminated questions that provided no predictive power, were irrelevant in our current model, or could not be answered reliably at a high enough percentage. We also combined many similar questions. The final 19 remaining PRE questions were further tested for accuracy using 56 additional known invasive plants and 36 known non-invasive ornamental species. The resulting evaluation demonstrated that when "needs further evaluation" classifications were not included, the accuracy of the model was 100% for both predicting invasiveness and non-invasiveness. When "needs further evaluation" classifications were included as either false positive or false negative, the model was still 93% accurate in predicting invasiveness and 97% accurate in predicting non-invasiveness, with an overall accuracy of 95%. We conclude that the PRE tool should not only provide growers with a method to accurately screen their current stock and potential new introductions, but also increase the probability of the tool being accepted for use by the industry as the basis for a nursery

  7. The development of a plant risk evaluation (PRE) tool for assessing the invasive potential of ornamental plants.

    Science.gov (United States)

    Conser, Christiana; Seebacher, Lizbeth; Fujino, David W; Reichard, Sarah; DiTomaso, Joseph M

    2015-01-01

    Weed Risk Assessment (WRA) methods for evaluating invasiveness in plants have evolved rapidly in the last two decades. Many WRA tools exist, but none were specifically designed to screen ornamental plants prior to being released into the environment. To be accepted as a tool to evaluate ornamental plants for the nursery industry, it is critical that a WRA tool accurately predicts non-invasiveness without falsely categorizing them as invasive. We developed a new Plant Risk Evaluation (PRE) tool for ornamental plants. The 19 questions in the final PRE tool were narrowed down from 56 original questions from existing WRA tools. We evaluated the 56 WRA questions by screening 21 known invasive and 14 known non-invasive ornamental plants. After statistically comparing the predictability of each question and the frequency the question could be answered for both invasive and non-invasive species, we eliminated questions that provided no predictive power, were irrelevant in our current model, or could not be answered reliably at a high enough percentage. We also combined many similar questions. The final 19 remaining PRE questions were further tested for accuracy using 56 additional known invasive plants and 36 known non-invasive ornamental species. The resulting evaluation demonstrated that when "needs further evaluation" classifications were not included, the accuracy of the model was 100% for both predicting invasiveness and non-invasiveness. When "needs further evaluation" classifications were included as either false positive or false negative, the model was still 93% accurate in predicting invasiveness and 97% accurate in predicting non-invasiveness, with an overall accuracy of 95%. We conclude that the PRE tool should not only provide growers with a method to accurately screen their current stock and potential new introductions, but also increase the probability of the tool being accepted for use by the industry as the basis for a nursery certification program.

  8. A Framework for Spatial Risk Assessments: Potential Impacts of Nonindigenous Invasive Species on Native Species

    Directory of Open Access Journals (Sweden)

    Craig R. Allen

    2006-06-01

    Full Text Available Many populations of wild animals and plants are declining and face increasing threats from habitat fragmentation and loss as well as exposure to stressors ranging from toxicants to diseases to invasive nonindigenous species. We describe and demonstrate a spatially explicit ecological risk assessment that allows for the incorporation of a broad array of information that may influence the distribution of an invasive species, toxicants, or other stressors, and the incorporation of landscape variables that may influence the spread of a species or substances. The first step in our analyses is to develop species models and quantify spatial overlap between stressor and target organisms. Risk is assessed as the product of spatial overlap and a hazard index based on target species vulnerabilities to the stressor of interest. We illustrate our methods with an example in which the stressor is the ecologically destructive nonindigenous ant, Solenopsis invicta, and the targets are two declining vertebrate species in the state of South Carolina, USA. A risk approach that focuses on landscapes and that is explicitly spatial is of particular relevance as remaining undeveloped lands become increasingly uncommon and isolated and more important in the management and recovery of species and ecological systems. Effective ecosystem management includes the control of multiple stressors, including invasive species with large impacts, understanding where those impacts may be the most severe, and implementing management strategies to reduce impacts.

  9. In vivo assessment of rodent Plasmodium parasitemia and merozoite invasion by flow cytometry.

    Science.gov (United States)

    Lelliott, Patrick M; McMorran, Brendan J; Foote, Simon J; Burgio, Gaetan

    2015-04-05

    During blood stage infection, malaria parasites invade, mature, and replicate within red blood cells (RBCs). This results in a regular growth cycle and an exponential increase in the proportion of malaria infected RBCs, known as parasitemia. We describe a flow cytometry based protocol which utilizes a combination of the DNA dye Hoechst, and the mitochondrial membrane potential dye, JC-1, to identify RBCs which contain parasites and therefore the parasitemia, of in vivo blood samples from Plasmodium chabaudi adami DS infected mice. Using this approach, in combination with fluorescently conjugated antibodies, parasitized RBCs can be distinguished from leukocytes, RBC progenitors, and RBCs containing Howell-Jolly bodies (HJ-RBCs), with a limit of detection of 0.007% parasitemia. Additionally, we outline a method for the comparative assessment of merozoite invasion into two different RBC populations. In this assay RBCs, labeled with two distinct compounds identifiable by flow cytometry, are transfused into infected mice. The relative rate of invasion into the two populations can then be assessed by flow cytometry based on the proportion of parasitized RBCs in each population over time. This combined approach allows the accurate measurement of both parasitemia and merozoite invasion in an in vivo model of malaria infection.

  10. Assessing the geographic origin of the invasive grey squirrel using DNA sequencing: Implications for management strategies

    Directory of Open Access Journals (Sweden)

    Claire D. Stevenson-Holt

    2015-01-01

    Full Text Available The invasive grey squirrel Sciurus carolinensis has become a major pest species causing negative effects to forestry and biodiversity. This study aims to assess the origin of grey squirrel within Cumbria using phylogeographic analysis to aid in management and control. The work reported analysed mitochondrial DNA sequences in the D-Loop gene of 73 grey squirrel individuals from multiple locations in the UK. The results indicate that individuals in north Cumbria are derived from individuals from Scotland and North East England. Other individuals in north Cumbria share a unique haplotype with south Cumbria and Lancashire suggesting a southerly origin and movement around or over the Cumbrian Mountain range which is thought of as a barrier to movements. The assessment of invasive species geographical origin and the identification of potential wildlife transit corridors through natural barriers are becoming more important as species shift range in response to environmental and ecological changes. With the grey squirrel population expansion also occurring in Italy, the European red squirrel may become threatened across its entire range. It is crucial to understand the population origins of the invasive grey squirrel and landscape usage to successfully manage the incursion routes and control the population.

  11. Assessment of Nonnative Invasive Plants in the DOE Oak Ridge National Environmental Research Park

    Energy Technology Data Exchange (ETDEWEB)

    Drake, S.J.

    2002-11-05

    The Department of Energy (DOE) National Environmental Research Park at Oak Ridge, Tennessee, is composed of second-growth forest stands characteristic of much of the eastern deciduous forest of the Ridge and Valley Province of Tennessee. Human use of natural ecosystems in this region has facilitated the establishment of at least 167 nonnative, invasive plant species on the Research Park. Our objective was to assess the distribution, abundance, impact, and potential for control of the 18 most abundant invasive species on the Research Park. In 2000, field surveys were conducted of 16 management areas on the Research Park (14 Natural Areas, 1 Reference Area, and Walker Branch Watershed) and the Research Park as a whole to acquire qualitative and quantitative data on the distribution and abundance of these taxa. Data from the surveys were used to rank the relative importance of these species using the ''Alien Plant Ranking System, Version 5.1'' developed by the U.S. Geological Survey. Microstegium (Microstegium vimineum) was ranked highest, or most problematic, for the entire Research Park because of its potential impact on natural systems, its tendency to become a management problem, and how difficult it is to control. Microstegium was present in 12 of the 16 individual sites surveyed; when present, it consistently ranked as the most problematic invasive species, particularly in terms of its potential impact on natural systems. Japanese honeysuckle (Lonicera japonica) and Chinese privet (Ligustrum sinense) were the second- and third-most problematic plant species on the Research Park; these two species were present in 12 and 9 of the 16 sites surveyed, respectively, and often ranked second- or third-most problematic. Other nonnative, invasive species, in decreasing rank order, included kudzu (Pueraria montma), multiflora rose (Rosa multiflora), Chinese lespedeza (Lespedeza cuneara), and other species representing a variety of life forms and growth

  12. Invasive cervical carcinoma (stage IB-IIB): assessment with MR imaging

    International Nuclear Information System (INIS)

    Sironi, S.; Del Maschio, A.; Belloni, C.; Taccagni, L.

    1990-01-01

    In patients with cervical carcinoma the selection of the optimal therapy depends on the precise preoperative assessment of the extent of disease. Currently, decisions regarding the management of these patients are made on the basis of clinical (FIGO) staging that has 50% mean error rate. To investigate the value of MR imaging in staging patients with invasive cervical cancer, we performed 25 MR examinations on 23 patients with histologic diagnosis of cervical cancer. All patients were clinically considered as having stage IB or IIB disease and underwent radical hysterectomy, providing specimens for pathologic correlation. The overall accuracy of MR imaging in staging cervical carcinoma (stage IB-IIB) was 78.1%. MR imaging seems to be the most reliable preoperative modality for staging invasive cervical cancer

  13. Integration of non-invasive functional assessments with anatomical risk stratification in complex coronary artery disease: the non-invasive functional SYNTAX score.

    Science.gov (United States)

    Collet, Carlos; Onuma, Yoshinobu; Miyazaki, Yosuke; Morel, Marie-Angèle; Serruys, Patrick W

    2017-04-01

    Since the early days of coronary angiography, the extension and severity of coronary artery disease (CAD) have been used for risk stratification. The SYNTAX score objectively characterizes CAD in patients with multivessel disease. Furthermore, recalculating the SYNTAX score by the incorporation of the functional component coronary stenosis (i.e., FFR) increases the discrimination for the risk of adverse events. The calculation of the SYNTAX score derived from non-invasive modalities such as coronary computed tomography angiography (CTA) has emerged as a mean to obtain the SYNTAX score before invasive cardiac catheterization. Likewise, the computation of the non-invasive fractional flow reserve CT (FFR CT ) allows for the calculation of the non-invasive functional SYNTAX score. Ultimately, the combination of anatomical and functional evaluations with clinical factors further refines the identification of patients at risk and provides a recommendation for the Heart Team regarding the treatment strategy (i.e., PCI or CABG) based on the predicted 4-year mortality. The purpose of this review is to describe the integration of a novel non-invasive functional coronary assessment with the angiographic risk score in patients with multivessel CAD.

  14. Cone-beam CT in the assessment of mandibular invasion by oral squamous cell carcinoma: results of the preliminary study.

    NARCIS (Netherlands)

    Hendrikx, A.W.; Maal, T.J.J.; Dieleman, F.J.; Cann, E.M. van; Merkx, M.A.W.

    2010-01-01

    This preliminary retrospective study evaluates the diagnostic value of cone-beam computed tomography (CBCT), as a potential standard preoperative procedure, in assessing mandibular invasion by oral squamous cell carcinoma (OSCC) compared with conventional preoperative panoramic radiography (PR),

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

    Science.gov (United States)

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

    2012-02-01

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

  16. Acute and short-term hemodynamic, echocardiographic, and clinical effects of enalapril maleate in dogs with naturally acquired heart failure: results of the Invasive Multicenter PROspective Veterinary Evaluation of Enalapril study. The IMPROVE Study Group.

    Science.gov (United States)

    1995-01-01

    The efficacy of enalapril maleate in dogs with naturally acquired class III or class IV heart failure was evaluated in a multicenter study. Fifty-eight dogs with dilated cardiomyopathy (35 dogs), mitral regurgitation (22 dogs), or aortic regurgitation (1 dog) receiving conventional therapy for heart failure (furosemide with or without digoxin) were included in a randomized double-blind study. Thirty-one dogs received enalapril tablets PO at approximately 0.5 mg/kg body weight bid, and 27 dogs received placebo tablets PO bid. Physical, electrocardiographic, hemodynamic, echocardiographic, radiographic, and clinical examinations were performed on each dog before treatment and at the end of the approximately 21-day study. After treatment on day 0, the enalapril-treated dogs had significantly (P < .05) lower heart rate, mean systemic arterial blood pressure, and mean pulmonary arterial blood pressure than the placebo-treated dogs. Pulmonary capillary wedge pressure was marginally decreased (P = .0567) in the enalapril-treated dogs. When compared with those in the placebo-treated dogs, scores for pulmonary edema were significantly (P < .05) decreased on day 2 in the enalapril-treated dogs. At the end of the study, enalapril-treated dogs had significantly (P < .05) greater decreases in class of heart failure, pulmonary edema score, and mobility score relative to baseline, and had significantly (P < .05) better overall evaluation scores when compared with the placebo-treated dogs. This study shows the beneficial hemodynamic and clinical effects of adding enalapril to conventional therapy for dogs with heart failure.

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

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2005-01-01

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

  18. Non-invasive assessment of low- and intermediate-risk patients with chest pain.

    Science.gov (United States)

    Balfour, Pelbreton C; Gonzalez, Jorge A; Kramer, Christopher M

    2017-04-01

    Coronary artery disease (CAD) remains a significant global public health burden despite advancements in prevention and therapeutic strategies. Common non-invasive imaging modalities, anatomic and functional, are available for the assessment of patients with stable chest pain. Exercise electrocardiography is a long-standing method for evaluation for CAD and remains the initial test for the majority of patients who can exercise adequately with a baseline interpretable electrocardiogram. The addition of cardiac imaging to exercise testing provides incremental benefit for accurate diagnosis for CAD and is particularly useful in patients who are unable to exercise adequately and/or have uninterpretable electrocardiograms. Radionuclide myocardial perfusion imaging and echocardiography with exercise or pharmacological stress provide high sensitivity and specificity in the detection and further risk stratification of patients with CAD. Recently, coronary computed tomography angiography has demonstrated its growing role to rule out significant CAD given its high negative predictive value. Although less available, stress cardiac magnetic resonance provides a comprehensive assessment of cardiac structure and function and provides a high diagnostic accuracy in the detection of CAD. The utilization of non-invasive testing is complex due to various advantages and limitations, particularly in the assessment of low- and intermediate-risk patients with chest pain, where no single study is suitable for all patients. This review will describe currently available non-invasive modalities, along with current evidence-based guidelines and appropriate use criteria in the assessment of low- and intermediate-risk patients with suspected, stable CAD. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Coupling ecological and social network models to assess "transmission" and "contagion" of an aquatic invasive species.

    Science.gov (United States)

    Haak, Danielle M; Fath, Brian D; Forbes, Valery E; Martin, Dustin R; Pope, Kevin L

    2017-04-01

    Network analysis is used to address diverse ecological, social, economic, and epidemiological questions, but few efforts have been made to combine these field-specific analyses into interdisciplinary approaches that effectively address how complex systems are interdependent and connected to one another. Identifying and understanding these cross-boundary connections improves natural resource management and promotes proactive, rather than reactive, decisions. This research had two main objectives; first, adapt the framework and approach of infectious disease network modeling so that it may be applied to the socio-ecological problem of spreading aquatic invasive species, and second, use this new coupled model to simulate the spread of the invasive Chinese mystery snail (Bellamya chinensis) in a reservoir network in Southeastern Nebraska, USA. The coupled model integrates an existing social network model of how anglers move on the landscape with new reservoir-specific ecological network models. This approach allowed us to identify 1) how angler movement among reservoirs aids in the spread of B. chinensis, 2) how B. chinensis alters energy flows within individual-reservoir food webs, and 3) a new method for assessing the spread of any number of non-native or invasive species within complex, social-ecological systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

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

    1977-01-01

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

  1. Milestone assessment of minimally invasive surgery in Pediatric Urology fellowship programs.

    Science.gov (United States)

    Smith, P H; Carpenter, M; Herbst, K W; Kim, C

    2017-02-01

    Minimally invasive surgery has become an important aspect of Pediatric Urology fellowship training. In 2014, the Accreditation Council for Graduate Medical Education published the Pediatric Urology Milestone Project as a metric of fellow proficiency in multiple facets of training, including laparoscopic/robotic procedures. The present study assessed trends in minimally invasive surgery training and utilization of the Milestones among recent Pediatric Urology fellows. Using an electronic survey instrument, Pediatric Urology fellowship program directors and fellows who completed their clinical year in 2015 were surveyed. Participants were queried regarding familiarity with the Milestone Project, utilization of the Milestones, robotic/laparoscopic case volume and training experience, and perceived competency with robotic/laparoscopic surgery at the start and end of the fellowship clinical year according to Milestone criteria. Responses were accepted between August and November 2015. Surveys were distributed via e-mail to 35 fellows and 30 program directors. Sixteen fellows (46%) and 14 (47%) program directors responded. All fellows reported some robotic experience prior to fellowship, and 69% performed >50 robotic/laparoscopic surgeries during residency. Fellow robotic/laparoscopic case volume varied: three had 1-10 cases (19%), four had 11-20 cases (25%), and nine had >20 cases (56%). Supplementary or robotic training modalities included simulation (9), animal models (6), surgical videos (7), and courses (2). Comparison of beginning and end of fellowship robotic/laparoscopic Milestone assessment (Summary Fig.) revealed scores of assessments and 10 (75%) of program director assessments. End of training Milestone scores >4 were seen in 12 (75%) of fellow self-assessment and eight (57%) of program director assessments. An improvement in robotic/laparoscopic Milestone scores by both fellow self-assessment and program director assessment was observed during the course of

  2. Non invasive assessment of renal artery using dual MRA techniques compared with invasive renal angiography in cases of renovascular hypertension

    Directory of Open Access Journals (Sweden)

    Y. Ragab

    2011-03-01

    Conclusion: The combined approach of non-invasive CE MRA and PC MRA techniques achieves a very high specificity, PPV and NPV for the detection of renal arterial pathomorphologic features as compared to standard renal angiography. Adding PC MRA to CE MRA helps to differentiate between mild and moderate stenoses as well as moderate and sever arterial stenotic lesions. So, CE MRA is a morphological test while PC MRA helps in grading the arterial stenoses.

  3. Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance

    Energy Technology Data Exchange (ETDEWEB)

    Gutiérrez-Barrios, Alejandro, E-mail: aleklos@hotmail.com [Cardiology Department, Jerez Hospital, Jerez (Spain); Camacho-Jurado, Francisco [Cardiology Department, Punta Europa Hospital, Algeciras (Spain); Díaz-Retamino, Enrique; Gamaza-Chulián, Sergio; Agarrado-Luna, Antonio; Oneto-Otero, Jesús; Del Rio-Lechuga, Ana; Benezet-Mazuecos, Javier [Cardiology Department, Jerez Hospital, Jerez (Spain)

    2015-10-15

    Summary: We present a review of microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and an interesting case of a symptomatic familial HCM patient with inducible ischemia by single photon emission computed tomography. Coronary angiography revealed normal epicardial arteries. Pressure wire measurements of fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microvascular resistance (IMR) demonstrated a significant microcirculatory dysfunction. This is the first such case that documents this abnormality invasively using the IMR. The measurement of IMR, a novel marker of microcirculatory dysfunction, provides novel insights into the pathophysiology of this condition. - Highlights: • Microvascular dysfunction is a common feature in hypertrophic cardiomyopathy (HCM) and represents a strong predictor of unfavorable outcome and cardiovascular mortality. • The index of microvascular resistance (IMR) is a new method for invasively assessing the state of the coronary microcirculation using a single pressure-temperature sensor-tipped coronary wire. • However assessment of IMR in HCM has not been previously reported. We report a case in which microvascular dysfunction is assessed by IMR. This index may be useful in future researches of HCM.

  4. Echocardiographic Evaluation of Hemodynamics in Neonates and Children

    Directory of Open Access Journals (Sweden)

    Yogen Singh

    2017-09-01

    Full Text Available Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion. A bedside point-of-care echocardiography can provide real-time hemodynamic information by assessing cardiac function, loading conditions (preload and afterload and cardiac output. The echocardiography has the ability to provide longitudinal functional assessment in real time, which makes it an ideal tool for monitoring hemodynamic assessment in neonates and children. It is indispensable in the management of patients with shock, pulmonary hypertension, and patent ductus arteriosus. The echocardiography is the gold standard diagnostic tool to assess hemodynamic stability in patients with pericardial effusion, cardiac tamponade, and cardiac abnormalities such as congenital heart defects or valvar disorders. The information from echocardiography can be used to provide targeted treatment in intensive care settings such as need of fluid resuscitation versus inotropic support, choosing appropriate inotrope or vasopressor, and in providing specific interventions such as selective pulmonary vasodilators in pulmonary hypertension. The physiological information gathered from echocardiography may help in making timely, accurate, and appropriate diagnosis and providing specific treatment in sick patients. There is no surprise that use of bedside point-of-care echocardiography is rapidly gaining interest among neonatologists and intensivists, and it is now being used in clinical decision making for patients with hemodynamic instability. Like any

  5. Hemodynamic significance of internal carotid artery disease

    DEFF Research Database (Denmark)

    Schroeder, T

    1988-01-01

    Neurologic symptoms in the region of an internal carotid artery stenosis are considered to be embolic in most instances. Only in a subgroup has carotid occlusive disease with impairment of the collateral supply, caused a state of hemodynamic failure with marked reduction of perfusion pressure....... Though unproven, it is reasonable to assume that without surgical intervention, the risk is higher than average for patients with hemodynamic failure. Equally, should there be any postoperative improvement of cerebral blood flow or neurologic deficits, it should be looked for in this group. Thus......, it is necessary to distinguish those with low perfusion pressure from the population of patients with carotid artery disease. Preoperative clinical evaluation and direct visualization of the carotid bifurcation should be supplemented by indirect physiological tests which allow assessment of collateral perfusion...

  6. The problem of assessing the viability of invasive species in the conditions of the steppe zone of Ukraine

    Directory of Open Access Journals (Sweden)

    K. K. Holoborodko

    2016-10-01

    Full Text Available This article proposes a completely new method of resolving the pressing global environmental problem of assessing the capacity of invasive organisms to adapt to new environmental conditions. A new three-step approach to the evaluation of vital and ecological functions of invasive species is recommended. In addition to classic species and population surveys, it was proposed to apply a stress-resistance biochemical assessment of invasive species. Stress resistance can be regarded as the main response of living organisms to changes in continuous environmental components. The obtained results will provide an opportunity to give a qualitative prognisis of what adaptive capacity an invasive species has,what precise ecological functions and for what time period it can perform in a new ecosystem.

  7. Novel algorithm for non-invasive assessment of fibrosis in NAFLD.

    Directory of Open Access Journals (Sweden)

    Jan-Peter Sowa

    Full Text Available INTRODUCTION: Various conditions of liver disease and the downsides of liver biopsy call for a non-invasive option to assess liver fibrosis. A non-invasive score would be especially useful to identify patients with slow advancing fibrotic processes, as in Non-Alcoholic Fatty Liver Disease (NAFLD, which should undergo histological examination for fibrosis. PATIENTS/METHODS: Classic liver serum parameters, hyaluronic acid (HA and cell death markers of 126 patients undergoing bariatric surgery for morbid obesity were analyzed by machine learning techniques (logistic regression, k-nearest neighbors, linear support vector machines, rule-based systems, decision trees and random forest (RF. Specificity, sensitivity and accuracy of the evaluated datasets to predict fibrosis were assessed. RESULTS: None of the single parameters (ALT, AST, M30, M60, HA did differ significantly between patients with a fibrosis score 1 or 2. However, combining these parameters using RFs reached 79% accuracy in fibrosis prediction with a sensitivity of more than 60% and specificity of 77%. Moreover, RFs identified the cell death markers M30 and M65 as more important for the decision than the classic liver parameters. CONCLUSION: On the basis of serum parameters the generation of a fibrosis scoring system seems feasible, even when only marginally fibrotic tissue is available. Prospective evaluation of novel markers, i.e. cell death parameters, should be performed to identify an optimal set of fibrosis predictors.

  8. Diagnostic value of quantitative stenosis predictors with coronary CT angiography compared to invasive fractional flow reserve

    International Nuclear Information System (INIS)

    Wang, Rui; Renker, Matthias; Schoepf, U. Joseph; Wichmann, Julian L.; Fuller, Stephen R.; Rier, Jeremy D.; Bayer, Richard R.; Steinberg, Daniel H.; De Cecco, Carlo N.; Baumann, Stefan

    2015-01-01

    Highlights: • Evaluation of the diagnostic performance of CCTA predictors for coronary stenosis. • TAG was unable to detect hemodynamically significant coronary lesions. • CT-FFR, LL/MLD 4 and CCO provide enhanced diagnostic performance over CCTA. • CT-FFR was the best parameter. - Abstract: Objective: To evaluate the diagnostic performance of CCTA-derived stenosis predictors including CT-FFR for the detection of ischemia-inducing stenosis compared to invasive FFR. Materials and methods: Stenosis parameters were assessed using dual-source CT (DSCT). All patients underwent both CCTA and invasive FFR within 3 months and were retrospectively analyzed. Observers visually assessed all CCTA studies and performed multiple lesion measurements. Lesion length/minimal luminal diameter 4 (LL/MLD 4 ), transluminal attenuation gradient (TAG), corrected coronary attenuation (CCO) and CT-FFR were calculated. Results: The cohort included 32 patients (58 ± 12 years, 66%male). Among 32 coronary lesions, 8 (25%) were considered hemodynamically significant with an FFR <0.80. Compared to invasive FFR, the per-vessel sensitivity and specificity of CCTA, CT-FFR, LL/MLD 4 , CCO and TAG for detecting hemodynamically significant lesions were 100% and 54%, 100% and 91%, 85% and 92%, 66% and 88%, 37% and 58%, respectively. Receiver operating characteristics analysis resulted in an area under the curve of 0.91 for CT-FFR (p = 0.0005), 0.88 for LL/MLD 4 (p < 0.0001), 0.85 for CCO (p < 0.0001). TAG with an AUC of 0.67 (p = 0.152) was unable to discriminate between vessels with or without hemodynamically significant lesions. Conclusion: CT-FFR, LL/MLD 4 and CCO provide enhanced diagnostic performance over CCTA analysis alone for discrimination of hemodynamically significant coronary stenosis

  9. Diagnostic value of quantitative stenosis predictors with coronary CT angiography compared to invasive fractional flow reserve

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Rui [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing (China); Renker, Matthias [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, 61231 Bad Nauheim (Germany); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Wichmann, Julian L. [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Fuller, Stephen R.; Rier, Jeremy D.; Bayer, Richard R.; Steinberg, Daniel H. [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); De Cecco, Carlo N. [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); Departments of Radiological Sciences, Oncology, and Pathology, University of Rome “Sapienza”-Polo Pontino, Latina, Viale Regina Elena, 324-00161 Roma (Italy); Baumann, Stefan [Heart & Vascular Center, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive Charleston, SC 29425-2260 (United States); First Department of Medicine, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany)

    2015-08-15

    Highlights: • Evaluation of the diagnostic performance of CCTA predictors for coronary stenosis. • TAG was unable to detect hemodynamically significant coronary lesions. • CT-FFR, LL/MLD{sup 4} and CCO provide enhanced diagnostic performance over CCTA. • CT-FFR was the best parameter. - Abstract: Objective: To evaluate the diagnostic performance of CCTA-derived stenosis predictors including CT-FFR for the detection of ischemia-inducing stenosis compared to invasive FFR. Materials and methods: Stenosis parameters were assessed using dual-source CT (DSCT). All patients underwent both CCTA and invasive FFR within 3 months and were retrospectively analyzed. Observers visually assessed all CCTA studies and performed multiple lesion measurements. Lesion length/minimal luminal diameter{sup 4} (LL/MLD{sup 4}), transluminal attenuation gradient (TAG), corrected coronary attenuation (CCO) and CT-FFR were calculated. Results: The cohort included 32 patients (58 ± 12 years, 66%male). Among 32 coronary lesions, 8 (25%) were considered hemodynamically significant with an FFR <0.80. Compared to invasive FFR, the per-vessel sensitivity and specificity of CCTA, CT-FFR, LL/MLD{sup 4}, CCO and TAG for detecting hemodynamically significant lesions were 100% and 54%, 100% and 91%, 85% and 92%, 66% and 88%, 37% and 58%, respectively. Receiver operating characteristics analysis resulted in an area under the curve of 0.91 for CT-FFR (p = 0.0005), 0.88 for LL/MLD{sup 4} (p < 0.0001), 0.85 for CCO (p < 0.0001). TAG with an AUC of 0.67 (p = 0.152) was unable to discriminate between vessels with or without hemodynamically significant lesions. Conclusion: CT-FFR, LL/MLD{sup 4} and CCO provide enhanced diagnostic performance over CCTA analysis alone for discrimination of hemodynamically significant coronary stenosis.

  10. Cardiac tumours: non invasive detection and assessment by gated cardiac blood pool radionuclide imaging

    International Nuclear Information System (INIS)

    Pitcher, D.; Wainwright, R.; Brennand-Roper, D.; Deverall, P.; Sowton, E.; Maisey, M.

    1980-01-01

    Four patients with cardiac tumours were investigated by gated cardiac blood pool radionuclide imaging and echocardiography. Contrast angiocardiography was performed in three of the cases. Two left atrial tumours were detected by all three techniques. In one of these cases echocardiography alone showed additional mitral valve stenosis, but isotope imaging indicated tumour size more accurately. A large septal mass was detected by all three methods. In this patient echocardiography showed evidence of left ventricular outflow obstruction, confirmed at cardiac catheterisation, but gated isotope imaging provided a more detailed assessment of the abnormal cardiac anatomy. In the fourth case gated isotope imaging detected a large right ventricular tumour which had not been identified by echocardiography. Gated cardiac blood pool isotope imaging is a complementary technique to echocardiography for the non-invasive detection and assessment of cardiac tumours. (author)

  11. Vulnerability assessment of New Jersey's food supply to invasive species: the New Jersey IMPORT project.

    Science.gov (United States)

    Gregory, Petros; Hamilton, George; Borjan, Marija; Robson, Mark

    2006-01-01

    The United States' environment and economy have been severely impacted by unintentionally introduced biological organisms for the last 100 years. Our ecosystems and biological reserves of conservation importance are regularly invaded by non-indigenous species. To help prevent future invaders from entering the ports, this project undertaken at the Port of Elizabeth proposed to: 1. Catalog the different vegetable and fruit crops entering this country; 2. Evaluate the potential risk to New Jersey crops that an introduced exotic pest might pose; and 3. Evaluate the potential that imported crops entering the U.S. have for harboring exotic pests. The New Jersey IMPORT report, or Invasive Management Promoting Open and Responsible Trade project, details a newly designed ecological risk assessment tool to evaluate entry potential of invasive pests at the Port of Elizabeth. Risk designations were assigned to shipments of four fruits; seven vegetables; and two field/forage crops based on: i) Country of origin; ii) Amounts of commodities imported; and iii) Endemic pests present in exporting countries. Between 5,000 and 180,000 tons of crops were imported into the Port of Elizabeth from October 2001 to 2003. Pest risk analyses were drafted for twenty-five intercepted insects taken from the Port Information Network. In addition, eighteen pest risk analyses were drafted for invasive fungi, bacteria, and viruses of global concern as alerted by ProMed Digest. It was concluded that three crops imported remain at high risk: apples, peppers, and tomatoes. Peaches, soybeans, lettuce, sweet corn, potatoes, squash, and eggplant imported were considered moderate risk. Blueberries, cranberries, and alfalfa were considered low risk.

  12. Stably Integrated luxCDABE for Assessment of Salmonella Invasion Kinetics

    Directory of Open Access Journals (Sweden)

    Kelly N. Flentie

    2008-09-01

    Full Text Available Salmonella Typhimurium is a common cause of gastroenteritis in humans and also localizes to neoplastic tumors in animals. Invasion of specific eukaryotic cells is a key mechanism of Salmonella interactions with host tissues. Early stages of gastrointestinal cell invasion are mediated by a Salmonella type III secretion system, powered by the adenosine triphosphatase invC. The aim of this work was to characterize the invC dependence of invasion kinetics into disparate eukaryotic cells traditionally used as models of gut epithelium or neoplasms. Thus, a nondestructive real-time assay was developed to report eukaryotic cell invasion kinetics using lux+ Salmonella that contain chromosomally integrated luxCDABE genes. Bioluminescence-based invasion assays using lux+ Salmonella exhibited inoculum dose-response correlation, distinguished invasion-competent from invasion-incompetent Salmonella, and discriminated relative Salmonella invasiveness in accordance with environmental conditions that induce invasion gene expression. In standard gentamicin protection assays, bioluminescence from lux+ Salmonella correlated with recovery of colony-forming units of internalized bacteria and could be visualized by bioluminescence microscopy. Furthermore, this assay distinguished invasion-competent from invasion-incompetent bacteria independent of gentamicin treatment in real time. Bioluminescence reported Salmonella invasion of disparate eukaryotic cell lines, including neoplastic melanoma, colon adenocarcinoma, and glioma cell lines used in animal models of malignancy. In each case, Salmonella invasion of eukaryotic cells was invC dependent.

  13. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device

    Directory of Open Access Journals (Sweden)

    Wann-Yun Shieh

    2015-05-01

    Full Text Available Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders.

  14. Comparison of Different Calibration Methods in a Non-invasive ICP Assessment Model.

    Science.gov (United States)

    Schmidt, Bernhard; Cardim, Danilo; Weinhold, Marco; Streif, Stefan; McLeod, Damian D; Czosnyka, Marek; Klingelhöfer, Jürgen

    2018-01-01

    Previously we described the method of continuous intracranial pressure (ICP) estimation using arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV). The model was constructed using reference patient data. Various individual calibration strategies were used in the current attempt to improve the accuracy of this non-invasive ICP (nICP) assessment tool. Forty-one patients (mean, 52 years; range, 18-77 years) with severe brain injuries were studied. CBFV in the middle cerebral artery (MCA), ABP and invasively assessed ICP were simultaneously recorded for 1 h. Recording was repeated at days 2, 4 and 7. In the first recording, invasively assessed ICP was recorded to calibrate the nICP procedure by means of either a constant shift of nICP (snICP), a constant shift of nICP/ABP ratio (anICP) or by including this recording for a model reconstruction (cnICP). At follow-up days, the calibrated nICP procedures were applied and the results compared to the original nICP. In 76 follow-up recordings, the mean differences (Bias), the SD and the mean absolute differences (ΔICP) between ICP and the nICP methods were (in mmHg): nICP, -5.6 ± 5.72, 6.5; snICP, +0.7 ± 6.98, 5.5, n.s.; anICP, +1.0 ± 7.22, 5.6, n.s.; cnICP, -3.4 ± 5.68, 5.4, p ICP. This overestimation could be reduced by cnICP calibration, but not completely avoided. Constant shift calibrations (snICP, anICP) decrease the Bias to ICP, but increase SD and, therefore, increase the 95% confidence interval (CI = 2 × SD). This calibration method cannot be recommended. Compared to nICP, the cnICP method reduced the Bias and slightly reduced SD, and showed significantly decreased ΔICP. Compared to snICP and anICP, the Bias was higher. This effect was probably caused by the patients with craniotomy. The cnICP calibration method using initial recordings for model reconstruction showed the best results.

  15. Impacts of invasive plants on resident animals across ecosystems, taxa, and feeding types: a global assessment.

    Science.gov (United States)

    Schirmel, Jens; Bundschuh, Mirco; Entling, Martin H; Kowarik, Ingo; Buchholz, Sascha

    2016-02-01

    As drivers of global change, biological invasions have fundamental ecological consequences. However, it remains unclear how invasive plant effects on resident animals vary across ecosystems, animal classes, and functional groups. We performed a comprehensive meta-analysis covering 198 field and laboratory studies reporting a total of 3624 observations of invasive plant effects on animals. Invasive plants had reducing (56%) or neutral (44%) effects on animal abundance, diversity, fitness, and ecosystem function across different ecosystems, animal classes, and feeding types while we could not find any increasing effect. Most importantly, we found that invasive plants reduced overall animal abundance, diversity and fitness. However, this significant overall effect was contingent on ecosystems, taxa, and feeding types of animals. Decreasing effects of invasive plants were most evident in riparian ecosystems, possibly because frequent disturbance facilitates more intense plant invasions compared to other ecosystem types. In accordance with their immediate reliance on plants for food, invasive plant effects were strongest on herbivores. Regarding taxonomic groups, birds and insects were most strongly affected. In insects, this may be explained by their high frequency of herbivory, while birds demonstrate that invasive plant effects can also cascade up to secondary consumers. Since data on impacts of invasive plants are rather limited for many animal groups in most ecosystems, we argue for overcoming gaps in knowledge and for a more differentiated discussion on effects of invasive plant on native fauna. © 2015 John Wiley & Sons Ltd.

  16. Assessment of Sleep in Patients Receiving Invasive Mechanical Ventilation in a Specialized Weaning Unit.

    Science.gov (United States)

    Huttmann, Sophie Emilia; Wilms, Katharina; Hamm, Christine; Magnet, Friederike Sophie; Windisch, Wolfram; Storre, Jan Hendrik

    2017-06-01

    A restful sleep is essential for regenerative processes and remains crucial for patients recovering from stressful periods in the intensive care unit. The current study aimed to assess sleep quality in critically ill patients receiving invasive mechanical ventilation within a specialized weaning unit in hospital. Tracheotomized subjects undergoing prolonged weaning from mechanical ventilation were included in the study. Polysomnography and gas exchange monitoring was performed during nocturnal ventilation. Subjective evaluation of sleep quality and health-related quality of life were also assessed. Nineteen subjects completed the study protocol. Sleep architecture was highly heterogeneous across individual subjects. Mean total sleep time (TST) was 273 ± 114 min, sleep efficacy 70 ± 23%, slow-wave sleep 25.7 ± 18.4%/TST, rapid eye movement sleep 9.6 ± 7.5%/TST, and arousal index 18.7 ± 12.4/h. No significant difference in sleep quality was found between subjects with successful (N = 7) or unsuccessful (N = 12) weaning. Bicarbonate levels were negatively correlated both with sleep efficacy and sleep quality, that latter of which was subjectively assessed by the subjects using a visual analogue scale. Subjects who were undergoing prolonged weaning from mechanical ventilation and admitted to a specialized weaning unit, showed reduced sleep quality with preservation of high amounts of slow-wave sleep.

  17. Investigation of the feasibility of non-invasive optical sensors for the quantitative assessment of dehydration.

    Science.gov (United States)

    Visser, Cobus; Kieser, Eduard; Dellimore, Kiran; van den Heever, Dawie; Smith, Johan

    2017-10-01

    This study explores the feasibility of prospectively assessing infant dehydration using four non-invasive, optical sensors based on the quantitative and objective measurement of various clinical markers of dehydration. The sensors were investigated to objectively and unobtrusively assess the hydration state of an infant based on the quantification of capillary refill time (CRT), skin recoil time (SRT), skin temperature profile (STP) and skin tissue hydration by means of infrared spectrometry (ISP). To evaluate the performance of the sensors a clinical study was conducted on a cohort of 10 infants (aged 6-36 months) with acute gastroenteritis. High sensitivity and specificity were exhibited by the sensors, in particular the STP and SRT sensors, when combined into a fusion regression model (sensitivity: 0.90, specificity: 0.78). The SRT and STP sensors and the fusion model all outperformed the commonly used "gold standard" clinical dehydration scales including the Gorelick scale (sensitivity: 0.56, specificity: 0.56), CDS scale (sensitivity: 1.0, specificity: 0.2) and WHO scale (sensitivity: 0.13, specificity: 0.79). These results suggest that objective and quantitative assessment of infant dehydration may be possible using the sensors investigated. However, further evaluation of the sensors on a larger sample population is needed before deploying them in a clinical setting. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  18. Suitability of the ALien Biotic IndEX (ALEX) for assessing invasion of macroalgae across different Mediterranean habitats.

    Science.gov (United States)

    Piazzi, Luigi; Gennaro, Paola; Ceccherelli, Giulia

    2015-08-15

    The ALien Biotic IndEX (ALEX) has been recently proposed to evaluate biological invasions in soft-bottom macro-invertebrate assemblages. The present paper proposes the use of ALEX in sessile assemblages of Mediterranean hard bottom habitats and tests it along gradients of invasion. For five invasive macroalgae a variable number of case studies per each of four habitats were examined from the available data sets. For each case study samples were attributed to four levels of invasion depending on the abundance of the invading macroalgae. Results showed that the application of ALEX to sessile assemblages of hard bottoms allows to qualify the level of invasion along the considered gradients. Moreover, the decline of index values matched the impact of invasion on species number of the assemblages. Results also suggest that the concurrent use of ALEX and indices of benthic quality status can be a valuable tool to assess biopollution in hard bottom habitats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Quantitative radionuclide angiography in assessment of hemodynamic changes during upright exercise: observations in normal subjects, patient with coronary artery disease and patients with aortic regurgitation

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Kane, S.A.; Segal, B.L.

    1981-01-01

    Quantitative radionuclide angiography was used to evaluate hemodynamic changes in three subject groups during symptom-limited upright exercise. The 12 normal subjects had significant increases in heart rate, stroke volume, left ventricular ejection fraction and cardiac output during exercise; changes in end-diastolic and end-systolic volumes were not significant. In the 24 patients with coronary artery disease there were significant increases in heart rate and cardiac output during exercise, but insignificant changes in end-diastolic, end-systolic and stroke volumes and ejection fraction. The change in diastolic volume in these patients was determined by the extent of coronary artery disease, propranolol therapy, end point of exercise and presence of collateral vessels. Furthermore, patients with previous myocardial infarction had a lower ejection fraction and higher end-diastolic and end-systolic volumes during exercise than those without myocardial infarction. In the 12 patients with chronic aortic regurgitation of moderate to severe degree, there was a decrease in the end-diastolic volume during exercise. This response was distinctly different from that of the normal subjects or the patients with coronary artery disease. All three groups had a significant decrease in pulmonary transit time during exercise. It is concluded that changes in cardiac output in normal subjects during upright exercise are related to augmentation of stroke volume and tachycardia, whereas in patients with coronary artery disease they are related mainly to tachycardia

  20. Non-invasive assessment of hepatic fat accumulation in chronic hepatitis C by 1H magnetic resonance spectroscopy

    International Nuclear Information System (INIS)

    Krssak, Martin; Hofer, Harald; Wrba, Fritz; Meyerspeer, Martin; Brehm, Attila; Lohninger, Alfred; Steindl-Munda, Petra; Moser, Ewald; Ferenci, Peter; Roden, Michael

    2010-01-01

    Background: Liver biopsy is the standard method for diagnosis of hepatic steatosis, but is invasive and carries some risk of morbidity. Aims and methods: Quantification of hepatocellular lipid content (HCL) with non-invasive single voxel 1 H magnetic resonance spectroscopy (MRS) at 3 T was compared with histological grading and biochemical analysis of liver biopsies in 29 patients with chronic hepatitis C. Body mass index, indices of insulin resistance (homeostasis model assessment index, HOMA-IR), serum lipids and serum liver transaminases were also quantified. Results: HCL as assessed by 1 H MRS linearly correlated (r = 0.70, p 1 H MRS (r = 0.63, p 1 H MRS is a valid and useful method for quantification of HCL content in patients with chronic hepatitis C and can be easily applied to non-invasively monitoring of steatosis during repeated follow-up measurements in a clinical setting.

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

    Science.gov (United States)

    Magder, Sheldon

    2012-10-29

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

  2. Patient-specific in vitro models for hemodynamic analysis of congenital heart disease - Additive manufacturing approach.

    Science.gov (United States)

    Medero, Rafael; García-Rodríguez, Sylvana; François, Christopher J; Roldán-Alzate, Alejandro

    2017-03-21

    Non-invasive hemodynamic assessment of total cavopulmonary connection (TCPC) is challenging due to the complex anatomy. Additive manufacturing (AM) is a suitable alternative for creating patient-specific in vitro models for flow measurements using four-dimensional (4D) Flow MRI. These in vitro systems have the potential to serve as validation for computational fluid dynamics (CFD), simulating different physiological conditions. This study investigated three different AM technologies, stereolithography (SLA), selective laser sintering (SLS) and fused deposition modeling (FDM), to determine differences in hemodynamics when measuring flow using 4D Flow MRI. The models were created using patient-specific MRI data from an extracardiac TCPC. These models were connected to a perfusion pump circulating water at three different flow rates. Data was processed for visualization and quantification of velocity, flow distribution, vorticity and kinetic energy. These results were compared between each model. In addition, the flow distribution obtained in vitro was compared to in vivo. The results showed significant difference in velocities measured at the outlets of the models that required internal support material when printing. Furthermore, an ultrasound flow sensor was used to validate flow measurements at the inlets and outlets of the in vitro models. These results were highly correlated to those measured with 4D Flow MRI. This study showed that commercially available AM technologies can be used to create patient-specific vascular models for in vitro hemodynamic studies at reasonable costs. However, technologies that do not require internal supports during manufacturing allow smoother internal surfaces, which makes them better suited for flow analyses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Hemodynamic Behavior During Hemodialysis: Effects of Dialysate Concentrations of Bicarbonate and Potassium

    Directory of Open Access Journals (Sweden)

    Bruno C. Silva

    2014-11-01

    Full Text Available Background/Aims: Ultrafiltration that occurs during hemodialysis (HD promotes profound alterations in a relatively short period of time. The dialysate content of bicarbonate (DBic and potassium (DK may have impact over intradialytic hemodynamics, which goes beyond ultrafiltration, and its impact was evaluated in a prospective cohort. Methods: 30 patients under HD were submitted to hemodynamic assessment (HA at the beginning and at the end of HD sessions, through a non-invasive method. Serum minus dialysate potassium concentration was expressed as K-Gap. Cardiac index (CI and peripheral arterial resistance (PAR variation (post-HD minus pre-HD were expressed as ΔCI and ΔPAR. Dialysate content of sodium and calcium were expressed as DNa and DCa, respectively. Results: Mean DNa, DK and DBic were, respectively, 136.4 ± 1.1, 2.1 ± 0.6 and 38.2 ± 2.1 mEq/L. In 15 patients, DCa was >1.5 mmol/L and in the other 15 patients ≤ 1.5 mmol/L. The K-Gap ranged from 1.4 to 5.1 mEq/l (median 3.0 mEq/L. There was a reduction in post-HD CI and systolic blood pressure (ΔCI = -0.72l/min/m2 and -11.3±15.1mmHg, respectively, p5, pConclusion: We confirmed that Na and Ca dialysate content exerts and important role on hemodynamic during HD. In addition, our findings pointed out that higher dialysate concentrations of bicarbonate and potassium promote lower cardiac performance at the end of hemodialysis session.

  4. Heterogeneity of hemodynamic parameters in untreated primary hypertension, and individualization of antihypertensive therapy based on noninvasive hemodynamic measurements.

    Science.gov (United States)

    Aoka, Yoshikazu; Hagiwara, Nobuhisa; Kasanuki, Hiroshi

    2013-01-01

    Noninvasive measurement of hemodynamic parameter was undertaken in 240 patients with untreated primary hypertension using impedance cardiography (ICG) in outpatient clinics. High output was defined as a cardiac index (CI) >3.6 L/minute/m(2) and high resistance was defined as the total peripheral resistance index (TPRI) >2700 dyne·s·m(2)/cm(5). Of all patients, 67% had high-resistance hypertension (high TPRI with normal or low CI), and 16% had high-output hypertension (high CI with normal TPRI). Treatment with β-blockers for high-output hypertension and with calcium channel blockers for high-resistance hypertension reduced blood pressure equally, and restored normal hemodynamic balance, as reported in studies using invasive monitoring methods. These findings suggest that it is appropriate to use noninvasive ICG measurements to guide antihypertensive therapy. Multivariate analysis showed that female gender, tachycardia, and low body mass index (BMI) were associated with high-output hypertension, but age was not. Heterogeneity of hemodynamic parameters is thought to be one of the reasons why the efficacies of antihypertensive agents differ between patients. It may be feasible to predict which antihypertensive agent would be the most effective for a particular patient based on hemodynamic measurements or combination of gender, heart rate, and BMI.

  5. Comparison of hemodynamics during hyperthermal immersion and exercise testing in apparently healthy females aged 50-60 years.

    Science.gov (United States)

    Lietava, Jan; Vohnout, Branislav; Valent, Denis; Celko, Juraj

    2004-07-01

    Owing to excessive worries regarding adverse cardiac events, hyperthermal balneotherapy for patients with coronary artery disease is underprescribed. However, very few cardiac events occur in similar heat stress during Finnish sauna bathing. Exercise testing has proven to be a safe diagnostic procedure even in survivors of myocardial infarction. We compared the effects of hyperthermal immersion and exercise testing on cardiac hemodynamics in 21 apparently healthy women aged 50-60 years. The maximal symptom-limited bicycle exercise test was performed according to the modified protocol of Wasserman. Hyperthermal immersion was carried out in 40 degrees C water and was completed by increasing the core temperature by about 2 degrees C. The left ventricular function was evaluated using continuous measurement of thoracic electric bioimpedance during both tests. The blood pressure, index of contractility and heart rate were measured directly, whereas the cardiac index, left cardiac work index and systemic vascular resistance index were calculated. The hemodynamic response, as assessed at continuous non-invasive monitoring, showed substantial differences between hyperthermal immersion and exercise testing. Overall, we found a significantly lower hemodynamic load during hyperthermal immersion in comparison with exercise testing. Entering the bath, there was a significant decrease in the left cardiac work, contractility and blood pressure. We recorded a slight increase in the heart rate towards peak hyperthermal immersion. However, other modulators such as the mean arterial pressure, index of contractility, cardiac index and left cardiac work index decreased even below resting values. Excessive hyperthermal immersion induced a lower hemodynamic load in apparently healthy women than standard maximal exercise testing.

  6. Rapid, serial, non-invasive assessment of drug efficacy in mice with autoluminescent Mycobacterium ulcerans infection.

    Science.gov (United States)

    Zhang, Tianyu; Li, Si-Yang; Converse, Paul J; Grosset, Jacques H; Nuermberger, Eric L

    2013-01-01

    Buruli ulcer (BU) caused by Mycobacterium ulcerans is the world's third most common mycobacterial infection. There is no vaccine against BU and surgery is needed for patients with large ulcers. Although recent experience indicates combination chemotherapy with streptomycin and rifampin improves cure rates, the utility of this regimen is limited by the 2-month duration of therapy, potential toxicity and required parenteral administration of streptomycin, and drug-drug interactions caused by rifampin. Discovery and development of drugs for BU is greatly hampered by the slow growth rate of M. ulcerans, requiring up to 3 months of incubation on solid media to produce colonies. Surrogate markers for evaluating antimicrobial activity in real-time which can be measured serially and non-invasively in infected footpads of live mice would accelerate pre-clinical evaluation of new drugs to treat BU. Previously, we developed bioluminescent M. ulcerans strains, demonstrating proof of concept for measuring luminescence as a surrogate marker for viable M. ulcerans in vitro and in vivo. However, the requirement of exogenous substrate limited the utility of such strains, especially for in vivo experiments. For this study, we engineered M. ulcerans strains that express the entire luxCDABE operon and therefore are autoluminescent due to endogenous substrate production. The selected reporter strain displayed a growth rate and virulence similar to the wild-type parent strain and enabled rapid, real-time monitoring of in vitro and in vivo drug activity, including serial, non-invasive assessments in live mice, producing results which correlated closely with colony-forming unit (CFU) counts for a panel of drugs with various mechanisms of action. Our results indicate that autoluminescent reporter strains of M. ulcerans are exceptional tools for pre-clinical evaluation of new drugs to treat BU due to their potential to drastically reduce the time, effort, animals, compound, and costs

  7. Rapid, serial, non-invasive assessment of drug efficacy in mice with autoluminescent Mycobacterium ulcerans infection.

    Directory of Open Access Journals (Sweden)

    Tianyu Zhang

    Full Text Available Buruli ulcer (BU caused by Mycobacterium ulcerans is the world's third most common mycobacterial infection. There is no vaccine against BU and surgery is needed for patients with large ulcers. Although recent experience indicates combination chemotherapy with streptomycin and rifampin improves cure rates, the utility of this regimen is limited by the 2-month duration of therapy, potential toxicity and required parenteral administration of streptomycin, and drug-drug interactions caused by rifampin. Discovery and development of drugs for BU is greatly hampered by the slow growth rate of M. ulcerans, requiring up to 3 months of incubation on solid media to produce colonies. Surrogate markers for evaluating antimicrobial activity in real-time which can be measured serially and non-invasively in infected footpads of live mice would accelerate pre-clinical evaluation of new drugs to treat BU. Previously, we developed bioluminescent M. ulcerans strains, demonstrating proof of concept for measuring luminescence as a surrogate marker for viable M. ulcerans in vitro and in vivo. However, the requirement of exogenous substrate limited the utility of such strains, especially for in vivo experiments.For this study, we engineered M. ulcerans strains that express the entire luxCDABE operon and therefore are autoluminescent due to endogenous substrate production. The selected reporter strain displayed a growth rate and virulence similar to the wild-type parent strain and enabled rapid, real-time monitoring of in vitro and in vivo drug activity, including serial, non-invasive assessments in live mice, producing results which correlated closely with colony-forming unit (CFU counts for a panel of drugs with various mechanisms of action.Our results indicate that autoluminescent reporter strains of M. ulcerans are exceptional tools for pre-clinical evaluation of new drugs to treat BU due to their potential to drastically reduce the time, effort, animals, compound

  8. Hemodynamic analysis of a novel bioresorbable scaffold in porcine coronary artery model

    NARCIS (Netherlands)

    Tenekecioglu, Erhan; Torii, Ryo; Bourantas, Christos V.; Cavalcante, Rafael; Sotomi, Yohei; Zeng, Yaping; Collet, Carlos; Crake, Tom; Abizaid, Alexandre; Onuma, Yoshinobu; Su, Solomon; Santoso, Teguh; Serruys, Patrick W.

    2017-01-01

    The shear stress distribution assessment can provide useful insights for the hemodynamic performance of the implanted stent/scaffold. Our aim was to investigate the effect of a novel bioresorbable scaffold, Mirage on local hemodynamics in animal models. The main epicardial coronary arteries of 7

  9. Psychomotor skills assessment by motion analysis in minimally invasive surgery on an animal organ.

    Science.gov (United States)

    Hofstad, Erlend Fagertun; Våpenstad, Cecilie; Bø, Lars Eirik; Langø, Thomas; Kuhry, Esther; Mårvik, Ronald

    2017-08-01

    A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model. The motions of the surgical tools were acquired and analyzed by 11 different motion-related metrics, i.e., a total of 19 metrics as eight of them were measured separately for each hand. We identified for which of the metrics the experts outperformed the novices. In total, two experts and 28 novices were included. The experts achieved significantly better results for 13 of the 19 instrument motion metrics. Expert performance is characterized by a low time to complete the cholecystectomy, high bimanual dexterity (instrument coordination), a limited amount of movement and low measurement of motion smoothness of the dissection instrument, and relatively high usage of the grasper to optimize tissue positioning for dissection.

  10. Post flooding damage assessment of earth dams and historical reservoirs using non-invasive geophysical techniques

    Science.gov (United States)

    Sentenac, Philippe; Benes, Vojtech; Budinsky, Vladimir; Keenan, Helen; Baron, Ron

    2017-11-01

    This paper describes the use of four geophysical techniques to map the structural integrity of historical earth reservoir embankments which are susceptible to natural decay with time. The four techniques that were used to assess the post flood damage were 1. A fast scanning technique using a dipole electromagnetic profile apparatus (GEM2), 2. Electrical Resistivity Tomography (ERT) in order to obtain a high resolution image of the shape of the damaged/seepage zone, 3. Self-Potential surveys were carried out to relate the detected seepage evolution and change of the water displacement inside the embankment, 4. The washed zone in the areas with piping was characterised with microgravimetry. The four geophysical techniques used were evaluated against the case studies of two reservoirs in South Bohemia, Czech Republic. A risk approach based on the Geophysical results was undertaken for the reservoir embankments. The four techniques together enabled a comprehensive non-invasive assessment whereby remedial action could be recommended where required. Conclusions were also drawn on the efficiency of the techniques to be applied for embankments with wood structures.

  11. [Non invasive assessment of embryo quality: proteomics, metabolomics and oocyte-cumulus dialogue].

    Science.gov (United States)

    Royère, D; Feuerstein, P; Cadoret, V; Puard, V; Uzbekova, S; Dalbies-Tran, R; Teusan, R; Houlgatte, R; Labas, V; Guérif, F

    2009-01-01

    Preimplantation embryo development is one of the key features with implantation itself to achieve a pregnancy. Assisted Reproductive Technologies both in human and animal have improved our knowledge on these events, although it remains elusive to predict embryo potential to give a baby. Among various ways to define embryo viability, noninvasive approaches get a serious advantage linked to the final transfer of the embryo. Techniques devoted to characterize the embryo secretome using proteomic or metabolomic approaches may be non invasive. Based on a direct identification of products of the embryo metabolism or an assessment of profile(s) related with embryo viability, they have greatly improved their sensitivity to allow their use in clinical embryology, once validated. Oocyte-cumulus dialogue, as a key factor for oocyte competence to meiosis and embryo development, was particularly concerned with both genomic and proteomic assessment of cumulus cells. While it is not possible to designate at the time being which among these approaches will be robust and cost-efficient enough to help routinely the clinical embryologist in assisted reproductive techniques (ART), one can predict that our ability to select the "right" embryo will combine morphological criteria already available with validated biomarkers.

  12. Using Non-Invasive Multi-Spectral Imaging to Quantitatively Assess Tissue Vasculature

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, A; Chernomordik, V; Riley, J; Hassan, M; Amyot, F; Dasgeb, B; Demos, S G; Pursley, R; Little, R; Yarchoan, R; Tao, Y; Gandjbakhche, A H

    2007-10-04

    This research describes a non-invasive, non-contact method used to quantitatively analyze the functional characteristics of tissue. Multi-spectral images collected at several near-infrared wavelengths are input into a mathematical optical skin model that considers the contributions from different analytes in the epidermis and dermis skin layers. Through a reconstruction algorithm, we can quantify the percent of blood in a given area of tissue and the fraction of that blood that is oxygenated. Imaging normal tissue confirms previously reported values for the percent of blood in tissue and the percent of blood that is oxygenated in tissue and surrounding vasculature, for the normal state and when ischemia is induced. This methodology has been applied to assess vascular Kaposi's sarcoma lesions and the surrounding tissue before and during experimental therapies. The multi-spectral imaging technique has been combined with laser Doppler imaging to gain additional information. Results indicate that these techniques are able to provide quantitative and functional information about tissue changes during experimental drug therapy and investigate progression of disease before changes are visibly apparent, suggesting a potential for them to be used as complementary imaging techniques to clinical assessment.

  13. Review of methods for developing regional probabilistic risk assessments, part 2: modeling invasive plant, insect, and pathogen species

    Science.gov (United States)

    P. B. Woodbury; D. A. Weinstein

    2010-01-01

    We reviewed probabilistic regional risk assessment methodologies to identify the methods that are currently in use and are capable of estimating threats to ecosystems from fire and fuels, invasive species, and their interactions with stressors. In a companion chapter, we highlight methods useful for evaluating risks from fire. In this chapter, we highlight methods...

  14. [Hemodynamic changes in hypoglycemic shock].

    Science.gov (United States)

    Gutiérrez, C; Piza, R; Chousleb, A; Hidalgo, M A; Ortigosa, J L

    1977-01-01

    Severe hypoglycemia may be present in seriously ill patients; if it is not corrected opportunely a series of neuroendocrinal mechanisms take place aimed at correcting metabolic alterations. These mechanisms can produce hemodynamic alterations as well. Nine mongrel dogs were studied with continuous registration of: blood pressure, central venous pressure, cardiac frequency, respiratory frequency, electrocardiogram and first derivative (Dp/Dt). Six dogs received crystalline (fast acting) insuline intravenously (group 1). After hemodynamic changes were registered hypoglycemia was corrected with 50 per cent glucose solution. Complementary insuline doses were administered to three dogs (group 2); in this group hypoglycemia was not corrected. In group 1 during hypoglycemia there was an increase in blood pressure, central venous pressure, cardiac frequency, respiratory frequency and Dp/Dt, and changes in QT and T wave on the EKG; these changes were partially reversible after hypoglycemia was corrected. The above mentioned alterations persisted in group 2, breathing became irregular irregular and respiratory arrest supervened. It can be inferred that the hemodynamic response to hypoglycemia is predominantly adrenergic. The role of catecolamines, glucocorticoides, glucagon, insuline, cyclic AMP in metabolic and hemodynamic alterations consecutive to hypoglycemia are discussed.

  15. A regional assessment of white-tailed deer effects on plant invasion

    Science.gov (United States)

    Kristine M Averill; David A Mortensen; Erica A H Smithwick; Susan Kalisz; William J McShea; Norman A Bourg; John D Parker; Alejandro A Royo; Marc D Abrams; David K Apsley; Bernd Blossey; Douglas H Boucher; Kai L Caraher; Antonio DiTommaso; Sarah E Johnson; Robert Masson; Victoria A. Nuzzo

    2017-01-01

    Herbivores can profoundly influence plant species assembly, including plant invasion, and resulting community composition. Population increases of native herbivores, e.g. white-tailed deer (Odocoileus virginianus), combined with burgeoning plant invasions raise concerns for native plant diversity and forest regeneration. While individual...

  16. Preliminary assessment of the impacts of invasive alien plants on ecosystem services in South Africa

    CSIR Research Space (South Africa)

    Van Wilgen, BW

    2006-01-01

    Full Text Available impacts on water resources. The number of invasive species considered was restricted to those with extensive current or potential distributions; 17 out of a possible 160 species in fynbos shrublands in this case. We estimate that invasive alien plants...

  17. Monitorização hemodinâmica invasiva a beira do leito: avaliação e protocolo de cuidados de enfermagem Monitorización hemodinámica invasiva a la cabecera del paciente: evaluación y protocolo del cuidado de enfermeria Invasive hemodynamic monitoring at bedside: nursing evaluation and nursing care protocol

    Directory of Open Access Journals (Sweden)

    Carla Cristina de Souza Ramos

    2008-09-01

    study aimed to establish clinical evaluation parameters essential to the patient subject to hemodynamic monitoring by Pulmonary Artery Catheter (PAC and to develop a Nursing Care Protocol to critical care patients using catheter with the nurses of an ICU in Santa Catarina State. The population consisted of a non-probabilistic intentional sample of five nurses, and the data were collected through group meetings and questionnaire. The study is presented with descriptive statistics and qualitative analyses of the subjective questions. In conclusion, the clinical evaluation criteria, essential to the patient subjected to hemodynamic monitoring, are constituted by invasive and non-invasive parameters and the protocol grounds making clinical decisions when caring for patient using PAC.

  18. Non-invasive brain stimulation to assess and modulate neuroplasticity in Alzheimer's disease.

    Science.gov (United States)

    Boggio, Paulo Sérgio; Valasek, Claudia Aparecida; Campanhã, Camila; Giglio, Ana Carolina Alem; Baptista, Nathalia Ishikawa; Lapenta, Olivia Morgan; Fregni, Felipe

    2011-10-01

    Alzheimer's disease (AD) is a neurodegenerative and progressive disease related to a gradual decline in cognitive functions such as memory, attention, perceptual-spatial abilities, language, and executive functions. Recent evidence has suggested that interventions promoting neural plasticity can induce significant cognitive gains especially in subjects at risk of or with mild AD. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive techniques that can induce significant and long-lasting changes in focal and non-focal neuroplasticity. In this review, we present initial preliminary evidence that TMS and tDCS can enhance performance in cognitive functions typically impaired in AD. Also, we reviewed the initial six studies on AD that presented early findings showing cognitive gains such as in recognition memory and language associated with TMS and tDCS treatment. In addition, we showed that TMS has also been used to assess neuroplasticity changes in AD supporting the notion that cortical excitability is changed in AD due to the neurodegenerative process. Due to the safe profile, cost of these tools, and initial clinical trials results, further studies are warranted in order to replicate and extend the initial findings of rTMS and tDCS as cognitive enhancers in AD. Further trials should explore different targets of stimulation along with different paradigms of stimulation including combination with behavioural interventions.

  19. A Microwave Ring-Resonator Sensor for Non-Invasive Assessment of Meat Aging

    Science.gov (United States)

    Jilani, Muhammad Taha; Wen, Wong Peng; Cheong, Lee Yen; ur Rehman, Muhammad Zaka

    2016-01-01

    The assessment of moisture loss from meat during the aging period is a critical issue for the meat industry. In this article, a non-invasive microwave ring-resonator sensor is presented to evaluate the moisture content, or more precisely water holding capacity (WHC) of broiler meat over a four-week period. The developed sensor has shown significant changes in its resonance frequency and return loss due to reduction in WHC in the studied duration. The obtained results are also confirmed by physical measurements. Further, these results are evaluated using the Fricke model, which provides a good fit for electric circuit components in biological tissue. Significant changes were observed in membrane integrity, where the corresponding capacitance decreases 30% in the early aging (0D-7D) period. Similarly, the losses associated with intracellular and extracellular fluids exhibit changed up to 42% and 53%, respectively. Ultimately, empirical polynomial models are developed to predict the electrical component values for a better understanding of aging effects. The measured and calculated values are found to be in good agreement. PMID:26805828

  20. A Microwave Ring-Resonator Sensor for Non-Invasive Assessment of Meat Aging

    Directory of Open Access Journals (Sweden)

    Muhammad Taha Jilnai

    2016-01-01

    Full Text Available The assessment of moisture loss from meat during the aging period is a critical issue for the meat industry. In this article, a non-invasive microwave ring-resonator sensor is presented to evaluate the moisture content, or more precisely water holding capacity (WHC of broiler meat over a four-week period. The developed sensor has shown significant changes in its resonance frequency and return loss due to reduction in WHC in the studied duration. The obtained results are also confirmed by physical measurements. Further, these results are evaluated using the Fricke model, which provides a good fit for electric circuit components in biological tissue. Significant changes were observed in membrane integrity, where the corresponding capacitance decreases 30% in the early aging (0D-7D period. Similarly, the losses associated with intracellular and extracellular fluids exhibit changed up to 42% and 53%, respectively. Ultimately, empirical polynomial models are developed to predict the electrical component values for a better understanding of aging effects. The measured and calculated values are found to be in good agreement.

  1. Role of invasive imaging in acute and long-term assessment of bioresorbable scaffold technology.

    Science.gov (United States)

    Chamié, Daniel; Garcia-Garcia, Hector; Costa, Ricardo A; Onuma, Yoshinobu; Abizaid, Alexandre; Serruys, Patrick W

    2016-11-01

    Fully bioresorbable scaffolds (BRS) represent a novel approach for the percutaneous treatment of coronary artery stenosis, providing temporary vessel scaffolding with drug-eluting capability during the restenosis-prone phase of the vascular healing. Beyond this initial critical period, when mechanical scaffolding support is no longer necessary, the device is bioresorbed, restoring the normal vascular physiology with the aim to eliminate the long-term safety concerns related to permanent metallic implants. Nonetheless, current BRS technology suffers from limited mechanical properties as compared to available metallic platforms, requiring careful attention to lesion preparation, accurate vessel sizing, and implantation technique. Intravascular imaging has played an important role in providing knowledge on the acute effects after BRS deployment, and it helped refine the current technique of BRS implantation. In addition, extensive work with multiple intravascular imaging modalities have also contributed to the understanding of the unique dynamic vascular changes that are experienced in the treated segment from post-implantation up to complete device bioresorption. In this manuscript, we review the role of invasive imaging modalities-from angiography to sound- and light-based techniques-to guide BRS implantation procedures, to assess its acute results postimplantation, and the changes experienced in the long-term until complete bioresorption has ensued. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Clinical monitoring of systemic hemodynamics in critically ill newborns.

    NARCIS (Netherlands)

    Boode, W.P. de

    2010-01-01

    Circulatory failure is a major cause of mortality and morbidity in critically ill newborn infants. Since objective measurement of systemic blood flow remains very challenging, neonatal hemodynamics is usually assessed by the interpretation of various clinical and biochemical parameters. An overview

  3. Non-invasive assessment of in-vitro embryo quality to improve transfer success

    DEFF Research Database (Denmark)

    Højbøge, Tina Rødgaard; Heegaard, Peter M. H.; Callesen, Henrik

    2015-01-01

    embryos before the transfer to a recipient still remains challenging. Presently, the predominant non-invasive technique for selecting viable embryos is based on morphology, where parameters such as rates of cleavage and blastocyst formation as well as developmental kinetics are evaluated mostly...... subjectively. The simple morphological approach is, however, inadequate for the prediction of embryo quality, and several studies have focused on developing new non-invasive methods using molecular approaches based particularly on proteomics, metabolomics and most recently small non-coding RNA, including micro......RNA. This review outlines the potential of several non-invasive in-vitro methods based on analysis of spent embryo culture medium....

  4. Non-invasive assessment of radiation injury with electrical impedance spectroscopy

    International Nuclear Information System (INIS)

    Osterman, K Sunshine; Hoopes, P Jack; De Lorenzo, Christine; Gladstone, David J; Paulsen, Keith D

    2004-01-01

    A detailed understanding of non-targeted normal tissue response is necessary for the optimization of radiation treatment plans in cancer therapy. In this study, we evaluate the ability of electrical impedance spectroscopy (EIS) to non-invasively determine and quantify the injury response in soft tissue after high dose rate (HDR) irradiation, which is characterized by large localized dose distributions possessing steep spatial gradients. The HDR after-loading technique was employed to irradiate small volumes of muscle tissue with single doses (26-52 Gy targeted 5 mm away from the source). Impedance measurements were performed on 29 rats at 1, 2 and 3 month post-irradiation, employing 31 frequencies in the 1 kHz to 1 MHz range. Over the first 3 months, conductivity increased by 48% and 26% following target doses of 52 Gy and 26 Gy 5 mm from the HDR source, respectively. Injury, assessed independently through a grid-based scoring method showed a quadratic dependence on distance from source. A significant injury (50% of cells atrophied, necrotic or degenerating) in 1.2% of the volume, accompanied by more diffuse injury (25% of cells atrophied, necrotic or degenerating) in 9% of the tissue produced a conductivity increase of 0.02 S m -1 (8% over a baseline of 0.24 S m -1 ). This was not statistically significant at p 0.01. Among treatment groups, injury differences in 22% of the volume led to statistically significant differences in conductivity of 0.07 S m -1 (23% difference in conductivity). Despite limitations, the success of EIS in detecting responses in a fraction of the tissue probed, during these early post-irradiation time-points, is encouraging. Electrical impedance spectroscopy may provide a useful metric of atrophy and the development of fibrosis secondary to radiation that could be further developed into a low-cost imaging method for radiotherapy monitoring and assessment

  5. Hemodynamic and Behavioral Differences after Administration of Meloxicam, Buprenorphine, or Tramadol as Analgesics for Telemeter Implantation in Mice

    OpenAIRE

    Rätsep, Matthew T; Barrette, Valerie F; Winterborn, Andrew; Adams, Michael A; Croy, B Anne

    2013-01-01

    Cannulation of the common carotid artery for chronic, continuous radiotelemetric recording of aortic hemodynamic properties in mice is a highly invasive recovery surgery. Radiotelemetric recording, by its continuous nature, gives the most accurate measurements of hemodynamic variables in experimental animals, and is widely used in the study of cardiovascular diseases including hypertension. The American Heart Association has recommended data acquisition by radiotelemetric recording but did no...

  6. Invasions by alien plants in the Czech Republic: a quantitative assessment across habitats

    Czech Academy of Sciences Publication Activity Database

    Chytrý, M.; Pyšek, Petr; Tichý, L.; Knollová, I.; Danihelka, Jiří

    2005-01-01

    Roč. 77, - (2005), s. 339-354 ISSN 0032-7786 Institutional research plan: CEZ:AV0Z60050516 Keywords : habitat invasibility * alien species * Czech Republic Subject RIV: EF - Botanics Impact factor: 1.545, year: 2005

  7. Rapid assessment of the invasive status of eucalyptus species in two South African provinces

    CSIR Research Space (South Africa)

    Forsyth, GG

    2004-01-01

    Full Text Available Gum trees, or eucalypts (Eucalyptus species), have been targeted for invasive alien plant clearing programmes in many parts of South Africa. This has caused some dissatisfaction where the species concerned also have useful characteristics...

  8. Assessment of Risk Factors for Possible Toxocariasis Invasion in Lugansk Region Population

    Directory of Open Access Journals (Sweden)

    L.G. Lovitskaya

    2013-11-01

    The study shows a high degree of possibility of toxocariasis invasion in population of Lugansk region. The findings once again confirm the need for creating national program for parasitosis-zoonosis prevention in Ukraine.

  9. Hemodynamic gestational adaptation in bitches

    OpenAIRE

    Almeida, Vívian Tavares de; Uscategui, Ricardo Andres Ramirez; Silva, Priscila Del Aguila da; Avante, Michele Lopes; Simões, Ana Paula Rodrigues; Vicente, Wilter Ricardo Russiano

    2017-01-01

    ABSTRACT: Throughout pregnancy, maternal hemodynamic adaptation is needed to ensure proper uterine perfusion and fetal development. When the uteroplacental vascular system is formed, starting with reduced resistance to uterine arterial flow, this results in decreased total vascular resistance, an activation of neuroendocrine vasoactive peptides, an increase in circulating blood and changes in the cardiovascular system morphophysiology to respond to the increasing demands of uterine perfusion....

  10. Echocardiographic and Hemodynamic Predictors of Survival in Precapillary Pulmonary Hypertension: Seven-Year Follow-Up.

    Science.gov (United States)

    Grapsa, Julia; Pereira Nunes, Maria Carmo; Tan, Timothy C; Cabrita, Ines Zimbarra; Coulter, Taryn; Smith, Benjamin C F; Dawson, David; Gibbs, J Simon R; Nihoyannopoulos, Petros

    2015-06-01

    In this study, we looked at the prognostic value of echocardiographic and hemodynamic measures in a large cohort of patients with precapillary pulmonary hypertension before and after initiation of treatment. Data were collected prospectively in a cohort of consecutive patients with precapillary pulmonary hypertension referred between 2002 and 2011. A range of clinical and echocardiographic variables were collected and stored on a database to assess predictors of survival. Invasive hemodynamic data including pulmonary artery pressure, pulmonary vascular resistance, capillary wedge pressure, and cardiac index were also obtained at baseline in all patients. Outcome was defined as mortality because of cardiovascular-related death. The study cohort comprised 777 patients (514 women) with precapillary pulmonary hypertension. A total of 195 (25%) died. In multivariable analysis, moderate or severe tricuspid regurgitation (hazard ratio [HR], 26.537; 95% confidence interval, 11.536-61.044; P<0.001), right ventricular myocardial performance index (HR, 3.421; 95% confidence interval, 1.777-6.584; P<0.001), and the presence of pericardial effusion (HR, 1.38; 95% confidence interval, 1.023-1.862; P=0.035) were independent predictors of mortality. High pulmonary vascular resistance and right atrial pressure by invasive hemodynamic measurements were independent predictors of mortality (HR, 1.084; 95% confidence interval, 1.041-1.130, and 1.079, respectively; 95% confidence interval, 1.049-1.111; P<0.001 for both), whereas patients with a higher cardiac index had better survival overall (HR, 0.384; 95% confidence interval, 0.307-0.481; P<0.001). Right ventricular dysfunction, moderate-severe tricuspid regurgitation, low cardiac index, and raised right atrial pressure were associated with poor survival for both pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertensive disease patients. The severity of tricuspid regurgitation, myocardial performance index

  11. Non-invasively assessing disturbance and stress in laboratory rats by scoring chromodacryorrhoea.

    Science.gov (United States)

    Mason, Georgia; Wilson, David; Hampton, Charlotte; Würbel, Hanno

    2004-06-01

    In rats, like many rodents, Harderian glands next to the orbits secrete porphyrins, lipids and other compounds. High levels of secretion lead to chromodacryorrhoea (red or "bloody" tears), often taken as a sign of stress or disease. Here, we developed a scoring system for recording chromodacryorrhoea in a quantitative way, and investigated whether the low-level, transient Harderian secretions of normal, healthy rats correlate with low to moderate levels of stress or disturbance. Rather than exposing our subjects (24 Lister Hoodeds, housed in 11 single-sex cages) experimentally to stressors, we made opportunistic use of three likely sources of low-level stress within the unit: 1) building maintenance work, taking several hours and involving several potential stressors; 2) visits by unfamiliar humans, and the other mild sources of disturbance normal in an animal unit; and 3) social status within the cage. The mean daily chromodacryorrhoea score increased most with the severe disturbance of building maintenance work (F1,9 = 602.67, p < < 0.0001), and also increased--though to a lesser extent--with the mild disturbance of visitors and similar (F1,9 = 8.77, p = 0.008), while being the subordinate member of a cage-group had a smaller effect still (F1,6 = 7.86, p = 0.03). Individual rats scored consistently across treatment conditions, and there was also significant inter-observer reliability between independent scorers. We therefore suggest that scoring chromodacryorrhoea could be a simple, practical and non-invasive way of sensitively assessing the impact on rats of housing, husbandry, or procedures.

  12. Hyperintense vessels on FLAIR: A useful non-invasive method for assessing intracerebral collaterals

    International Nuclear Information System (INIS)

    Liu Wenhua; Xu Gelin; Yue Xuanye; Wang Xiaoliang; Ma Minmin; Zhang Renliang; Wang Handong; Zhou Changsheng; Liu Xinfeng

    2011-01-01

    Objective: This study was aimed to evaluate relationship between hyperintense vessels (HV) on fluid-attenuated inversion recovery (FLAIR) and artery steno-occlusion related intracerebral collaterals. Materials and methods: A total of 233 patients with 260 atherosclerotic lesions in the M1 segment of the middle cerebral artery (MCA) were examined with FLAIR and digital subtraction angiography (DSA). HV were graded as 0, 1, 2 and 3 by its distributions in the MCA territory. Grade 0 indicated no HV; Grade 1 indicated the HV limited in Sylvian fissure; Grade 2 indicated the HV limited in Sylvian fissure and the temporal-occipital junction; Grade 3 indicated the HV extended to frontal-parietal lobes. Collateral blood flows were classified by DSA results. The relationship between HV grades and patterns of collateral flows was analyzed. Results: HV were observed in 76 out of 260 hemispheres. For patients with Grade 1 HV, most of their collateral flows (80.8%) were antegrade; for patients with Grade 2, the retrograde leptomeningeal flows were commonly manifested as anterior cerebral artery to MCA (75%); for patients with Grade 3 HV, most of the retrograde leptomeningeal flows were manifested as posterior cerebral artery to MCA (81.8%). As the grade HV increased, the frequency of retrograde leptomeningeal collateral from ACA to MCA decreased (100% to 75% and to 18.2%), and increased (0% to 25% and to 81.8%) for the retrograde leptomeningeal collateral via PCA to MCA (P < 0.001). Conclusions: The HV could assess non-invasively intracerebral collaterals in patients with steno-occlusive lesions of M1 segment of MCA.

  13. Non-invasive assessment of bone quantity and quality in human trabeculae using scanning ultrasound imaging

    Science.gov (United States)

    Xia, Yi

    Fractures and associated bone fragility induced by osteoporosis and osteopenia are widespread health threat to current society. Early detection of fracture risk associated with bone quantity and quality is important for both the prevention and treatment of osteoporosis and consequent complications. Quantitative ultrasound (QUS) is an engineering technology for monitoring bone quantity and quality of humans on earth and astronauts subjected to long duration microgravity. Factors currently limiting the acceptance of QUS technology involve precision, accuracy, single index and standardization. The objective of this study was to improve the accuracy and precision of an image-based QUS technique for non-invasive evaluation of trabecular bone quantity and quality by developing new techniques and understanding ultrasound/tissue interaction. Several new techniques have been developed in this dissertation study, including the automatic identification of irregular region of interest (iROI) in bone, surface topology mapping (STM) and mean scattering spacing (MSS) estimation for evaluating trabecular bone structure. In vitro results have shown that (1) the inter- and intra-observer errors in QUS measurement were reduced two to five fold by iROI compared to previous results; (2) the accuracy of QUS parameter, e.g., ultrasound velocity (UV) through bone, was improved 16% by STM; and (3) the averaged trabecular spacing can be estimated by MSS technique (r2=0.72, pcurrent gold-standard method, i.e., DXA, while additional information are obtained by the QUS for predicting fracture risk by monitoring of bone's quality. The developed QUS imaging technique can be used to assess bone's quantity and quality with improved accuracy and precision.

  14. Impact of Sitting or Semi-Setting Position of Patients During Breast Surgery on Hemodynamic Indexes

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    Kasra Karvandian

    2016-09-01

    Full Text Available Background: Keeping the patient in a sitting or semi-sitting position for time-consuming oncoplastic breast surgery is a major challenge for anesthesiologists due to several considerations. This cohort study was conducted on two groups of patients undergoing breast surgery.Methods: Study participants were categorized into two groups: one group was composed of normotensive women (group A and the other group comprised women with controlled hypertension (group B. After the induction of anesthesia in the supine position, the position was changed to sitting and the surgery was done in the sitting position. Hemodynamic monitoring included ECG, heart rate, non-invasive blood pressure (NIBP, invasive blood pressure (IBP, cardiac output (CO, arterial O2 saturation (SPO2, end-tidal CO2 (EtCO2, and bispectral index (BIS. The amount of administrated fluid and vasopressor was recorded for each patient. Any episode of hemodynamic instability was recorded, too.Results: Hemodynamic variation occurred in both groups, but the changes were more significant in group B and the amount of fluid and vasopressor administration was more prominent in group B. Changing the position caused no significant variation in BIS, SPO2, and EtCO2 in the two groups.Conclusions: The sitting position can be safe for time-consuming oncoplastic breast surgery using adequate hemodynamic monitoring. Hemodynamic changes are more significant in patients with controlled hypertension, and more medical interference is needed for these patients.

  15. Dynamic cerebral autoregulation measured with coherent hemodynamics spectroscopy (CHS)

    Science.gov (United States)

    Kainerstorfer, Jana M.; Sassaroli, Angelo; Tgavalekos, Kristen T.; Fantini, Sergio

    2015-03-01

    Coherent Hemodynamics Spectroscopy (CHS) is a novel technique for non-invasive measurements of local microcirculation quantities such as the capillary blood transit times and dynamic autoregulation. The basis of CHS is to measure, for instance with near-infrared spectroscopy (NIRS), peripheral coherent hemodynamic changes that are induced by controlled perturbations in the systemic mean arterial pressure (MAP). In this study, the MAP perturbation was induced by the fast release of two pneumatic cuffs placed around the subject's thighs after they were kept inflated (at 200 mmHg) for two minutes. The resulting transient changes in cerebral oxy- (O) and deoxy- (D) hemoglobin concentrations measured with NIRS on the prefrontal cortex are then described by a novel hemodynamic model, from which quantifiable parameters such as the capillary blood transit time and a cutoff frequency for cerebral autoregulation are obtained. We present results on eleven healthy volunteers in a protocol involving measurements during normal breathing and during hyperventilation, which is known to cause a hypocapnia-induced increase in cerebral autoregulation. The measured capillary transit time was unaffected by hyperventilation (normal breathing: 1.1±0.1 s; hyperventilation: 1.1±0.1 s), whereas the cutoff frequency of autoregulation, which increases for higher autoregulation efficiency, was indeed found to be significantly greater during hyperventilation (normal breathing: 0.017±0.002 Hz; hyperventilation: 0.034±0.005 Hz). These results provide a validation of local cerebral autoregulation measurements with the new technique of CHS.

  16. [Study on Indicator Densitometry Determination Method of Hemodynamic Parameters].

    Science.gov (United States)

    Liu, Guang-da; Zhou, Run-dong; Zha, Yu-tong; Cai, Jing; Niu, Jun-qi; Gao, Pu-jun; Liu, Li-li

    2016-03-01

    Measurement for hemodynamic parameters has always been a hot spot of clinical research. Methods for measuring hemodynamic parameters clinically have the problems of invasiveness, complex operation and being unfit for repeated measurement. To solve the problems, an indicator densitometry analysis method is presented based on near-infrared spectroscopy (NIRS) and indicator dilution theory, which realizes the hemodynamic parameters measured noninvasively. While the indocyanine green (ICG) was injected into human body, circulation carried the indicator mixing and diluting with the bloodstream. Then the near-nfrared probe was used to emit near-infrared light at 735, 805 and 940 nm wavelengths through the sufferer's fingertip and synchronously capture the transmission light containing the information of arterial pulse wave. By uploading the measured data, the computer would calculate the ICG concentration, establish continuous concentration curve and compute some intermediate variables such as the mean transmission time (MTT) and the initial blood ICG concentration (c(t0)). Accordingly Cardiac Output (CO) and Circulating Blood Volume (CBV) could be calculated. Compared with the clinical "gold standard" methods of thermodilution and I-131 isotope-labelling method to measure the two parameters by clinical controlled trials, ten sets of data were obtained. The maximum relative errors of this method were 8.88% and 4.28% respectively, and both of the average relative errors were below 5%. The result indicates that this method can meet the clinical accuracy requirement and can be used as a noninvasive, repeatable and applied solution for clinical hemodynamnic parameters measurement.

  17. [Non-invasive determination of cardiac output by continuous wave Doppler in air rescue service].

    Science.gov (United States)

    Knobloch, K; Hubrich, V; Rohmann, P; Lüpkemann, M; Phillips, R; Gerich, T; Krettek, C

    2005-12-01

    Determination of cardiac output (CO) enables to assess the hemodynamic situation as well as to administer optimal catecholamine therapy especially in critically compromised patients with hemodynamic instability. Invasive determination of CO is possible via a Swan-Ganz-catheter with its associated risk of implantation in the hospital. Using the Doppler technique, we evaluated the feasibility of the USCOM-system for non-invasive CO determination in preclinical emergency medicine in air rescue service. In 32 patients (17 months to 92-years-old) cardiac output was determined non-invasively (USCOM) at the scene and during the helicopter transport at Christoph 4, based at Hannover Medical School. Simultaneously, blood pressure, ECG and oxygen saturation were determined. Non-invasive CO was assessed by a suprasternal access aiming at the aorta ascendens. 19 patients were unconscious due to cardial and non-cardial reasons, and 13 were conscious (sepsis, status epilepticus, anaphylactic reaction). 7 patients were hemodynamically unstable. In three patients the monitor was used during interhospital transfer by helicopter. Non-invasively determined CO via the USCOM system was 4.8 +/- 0.7 l/min with a cardiac index of 2.4 +/- 0.3 l/m (2). Highest CO values were determined in a patient with sepsis and during a grand-mal-status in epilepsy (CO 8.2 l/min). All examinations were done by the same emergency physician of the emergency helicopter Christoph 4 immediately after arrival at the scene. The examination took on average 25 seconds. During the helicopter transport, several consecutive CO measurements were performed to assess volume and catecholamine therapy with increase of stroke volume after volume load with colloidal fluids. Using the USCOM system it is possible to determine the beat-to-beat cardiac output in air rescue service non-invasively. The emergency physician gains additional crucial hemodynamic information to diagnose and treat adequately by administration of

  18. Assessing invasion process through pathway and vector analysis: case of saltcedar (Tamarix spp.

    Directory of Open Access Journals (Sweden)

    Evangelina Natale

    2012-12-01

    Full Text Available Biological invasions are one of the most pervasive environmental threats to native ecosystems worldwide. The spontaneous spread ofsaltcedar is a particular threat to biodiversity conservation in arid and semiarid environments. In Argentina, three species belonging to this genus have been recognized as invaders. The aim of the present study was to identify main dispersal vectors and pathways to refine risk analysis and increase our ability to predict new areas at risk of Tamarix establishment. We surveyed and categorized 223 populations, 39% as invasive, 26% as established, 21% as contained and 14% as detected in nature. Dispersion of saltcedar was found to be associated with watercourses and human-driven disturbances; in addition roads were found to be relevant for the introduction of propagules in newenvironments. Considering the potential impact of saltcedar invasion and that it is an easily wind-dispersed invasive, it is necessary toimplement strategies to monitor dispersal pathways and take actions to eliminate invasion foci, particularly in vulnerable and highconservation value areas.

  19. Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

    Science.gov (United States)

    Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

    2016-01-01

    AIM: To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images

  20. Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion.

    Science.gov (United States)

    Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

    2016-05-28

    To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the

  1. The Effect of Sorafenib, Tadalafil and Macitentan Treatments on Thyroxin-Induced Hemodynamic Changes and Cardiac Abnormalities.

    Directory of Open Access Journals (Sweden)

    Nancy S Saad

    Full Text Available Multikinase inhibitors (e.g. Sorafenib, phosphodiesterase-5 inhibitors (e.g. Tadalafil, and endothelin-1 receptor blockers (e.g. Macitentan exert influential protection in a variety of animal models of cardiomyopathy; however, their effects on thyroxin-induced cardiomyopathy have never been investigated. The goal of the present study was to assess the functional impact of these drugs on thyroxin-induced hemodynamic changes, cardiac hypertrophy and associated altered responses of the contractile myocardium both in-vivo at the whole heart level and ex-vivo at the cardiac tissue level. Control and thyroxin (500 μg/kg/day-treated mice with or without 2-week treatments of sorafenib (10 mg/kg/day; I.P, tadalafil (1 mg/kg/day; I.P or 4 mg/kg/day; oral, macitentan (30 and 100 mg/kg/day; oral, and their vehicles were studied. Blood pressure, echocardiography and electrocardiogram were non-invasively evaluated, followed by ex-vivo assessments of isolated multicellular cardiac preparations. Thyroxin increased blood pressure, resulted in cardiac hypertrophy and left ventricular dysfunction in-vivo. Also, it caused contractile abnormalities in right ventricular papillary muscles ex-vivo. None of the drug treatments were able to significantly attenuate theses hemodynamic changes or cardiac abnormalities in thyroxin-treated mice. We show here for the first time that multikinase (raf1/b, VEGFR, PDGFR, phosphodiesterase-5, and endothelin-1 pathways have no major role in thyroxin-induced hemodynamic changes and cardiac abnormalities. In particular, our data show that the involvement of endothelin-1 pathway in thyroxine-induced cardiac hypertrophy/dysfunction seems to be model-dependent and should be carefully interpreted.

  2. A regional assessment of white-tailed deer effects on plant invasion

    Energy Technology Data Exchange (ETDEWEB)

    Averill, Kristine M. [Ecology Intercollege Graduate Degree Program, The Pennsylvania State University, University Park, PA, USA; Department of Plant Sciences, The Pennsylvania State University, University Park, PA, USA; Mortensen, David A. [Ecology Intercollege Graduate Degree Program, The Pennsylvania State University, University Park, PA, USA; Department of Plant Sciences, The Pennsylvania State University, University Park, PA, USA; Smithwick, Erica A. H. [Ecology Intercollege Graduate Degree Program, The Pennsylvania State University, University Park, PA, USA; Department of Geography, The Pennsylvania State University, University Park, PA, USA; Kalisz, Susan [Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, TN, USA; McShea, William J. [Smithsonian Conservation Biology Institute, Front Royal, VA, USA; Bourg, Norman A. [Smithsonian Conservation Biology Institute, Front Royal, VA, USA; Parker, John D. [Smithsonian Environmental Research Center, Edgewater, MD, USA; Royo, Alejandro A. [United States Department of Agriculture Forest Service, Northern Research Station, Irvine, PA, USA; Abrams, Marc D. [Ecology Intercollege Graduate Degree Program, The Pennsylvania State University, University Park, PA, USA; Department of Ecosystem Science and Management, The Pennsylvania State University, University Park, PA, USA; Apsley, David K. [Department of Extension, The Ohio State University, Jackson, OH, USA; Blossey, Bernd [Department of Natural Resources, Cornell University, Ithaca, NY, USA; Boucher, Douglas H. [Department of Biology, Hood College, Frederick, MD, USA; Caraher, Kai L. [Department of Biology, Hood College, Frederick, MD, USA; DiTommaso, Antonio [Soil and Crop Sciences Section, Cornell University, Ithaca, NY, USA; Johnson, Sarah E. [Ecology Intercollege Graduate Degree Program, The Pennsylvania State University, University Park, PA, USA; Department of Ecosystem Science and Management, The Pennsylvania State University, University Park, PA, USA; Masson, Robert [National Park Service, Morristown National Historical Park, Morristown, NJ, USA; Nuzzo, Victoria A. [Natural Area Consultants, Richford, NY, USA

    2017-12-07

    Herbivores can profoundly influence plant species assembly, including plant invasion, and resulting community composition. Population increases of native herbivores, e.g., white-tailed deer (Odocoileus virginianus), combined with burgeoning plant invasions raise concerns for native plant diversity and forest regeneration. While individual researchers typically test for the impact of deer on plant invasion at a few sites, the overarching influence of deer on plant invasion across regional scales is unclear. We tested the effects of deer on the abundance and diversity of introduced and native herbaceous and woody plants across 23 white-tailed deer research sites distributed across the east central and northeastern United States and representing a wide range of deer densities and invasive plant abundance and identity. Deer access/exclusion or deer population density did not affect introduced plant richness or community-level abundance. Native and total plant species richness, abundance (cover and stem density), and Shannon diversity were lower in deer-access vs. deer-exclusion plots. Among deer access plots, native species richness, native and total cover, and Shannon diversity (cover) declined as deer density increased. Deer access increased the proportion of introduced species cover (but not of species richness or stem density). As deer density increased, the proportion of introduced species richness, cover, and stem density all increased. Because absolute abundance of introduced plants was unaffected by deer, the increase in proportion of introduced plant abundance is likely an indirect effect of deer reducing native cover. Indicator species analysis revealed that deer access favored three introduced plant species, including Alliaria petiolata and Microstegium vimineum, as well as four native plant species. In contrast, deer exclusion favored three introduced plant species, including Lonicera japonica and Rosa multiflora, and fifteen native plant species. Overall

  3. Understanding misunderstandings in invasion science: why experts don’t agree on common concepts and risk assessments

    Directory of Open Access Journals (Sweden)

    Franziska Humair

    2014-01-01

    Full Text Available Understanding the diverging opinions of academic experts, stakeholders and the public is important for effective conservation management. This is especially so when a consensus is needed for action to minimize future risks but the knowledge upon which to base this action is uncertain or missing. How to manage non-native, invasive species (NIS is an interesting case in point: the issue has long been controversial among stakeholders, but publicly visible, major disagreement among experts is recent.To characterize the multitude of experts’ understanding and valuation of non-native, NIS we performed structured qualitative interviews with 26 academic experts, 13 of whom were invasion biologists and 13 landscape experts. Within both groups, thinking varied widely, not only about basic concepts (e.g., non-native, invasive but also about their valuation of effects of NIS. The divergent opinions among experts, regarding both the overall severity of the problem in Europe and its importance for ecosystem services, contrasted strongly with the apparent consensus that emerges from scientific synthesis articles and policy documents. We postulate that the observed heterogeneity of expert judgments is related to three major factors: (1 diverging conceptual understandings, (2 lack of empirical information and high scientific uncertainties due to complexities and contingencies of invasion processes, and (3 missing deliberation of values. Based on theory from science studies, we interpret the notion of an NIS as a boundary object, i.e., concepts that have a similar but not identical meaning to different groups of experts and stakeholders. This interpretative flexibility of a concept can facilitate interaction across diverse groups but bears the risk of introducing misunderstandings. An alternative to seeking consensus on exact definitions and risk assessments would be for invasive species experts to acknowledge uncertainties and engage transparently with

  4. Comparative analysis of dynamic cell viability, migration and invasion assessments by novel real-time technology and classic endpoint assays.

    Directory of Open Access Journals (Sweden)

    Ridha Limame

    Full Text Available BACKGROUND: Cell viability and motility comprise ubiquitous mechanisms involved in a variety of (pathobiological processes including cancer. We report a technical comparative analysis of the novel impedance-based xCELLigence Real-Time Cell Analysis detection platform, with conventional label-based endpoint methods, hereby indicating performance characteristics and correlating dynamic observations of cell proliferation, cytotoxicity, migration and invasion on cancer cells in highly standardized experimental conditions. METHODOLOGY/PRINCIPAL FINDINGS: Dynamic high-resolution assessments of proliferation, cytotoxicity and migration were performed using xCELLigence technology on the MDA-MB-231 (breast cancer and A549 (lung cancer cell lines. Proliferation kinetics were compared with the Sulforhodamine B (SRB assay in a series of four cell concentrations, yielding fair to good correlations (Spearman's Rho 0.688 to 0.964. Cytotoxic action by paclitaxel (0-100 nM correlated well with SRB (Rho>0.95 with similar IC(50 values. Reference cell migration experiments were performed using Transwell plates and correlated by pixel area calculation of crystal violet-stained membranes (Rho 0.90 and optical density (OD measurement of extracted dye (Rho>0.95. Invasion was observed on MDA-MB-231 cells alone using Matrigel-coated Transwells as standard reference method and correlated by OD reading for two Matrigel densities (Rho>0.95. Variance component analysis revealed increased variances associated with impedance-based detection of migration and invasion, potentially caused by the sensitive nature of this method. CONCLUSIONS/SIGNIFICANCE: The xCELLigence RTCA technology provides an accurate platform for non-invasive detection of cell viability and motility. The strong correlations with conventional methods imply a similar observation of cell behavior and interchangeability with other systems, illustrated by the highly correlating kinetic invasion profiles on

  5. [Transesophageal echocardiography in perioperative period guiding the decision making during hemodynamic instability due to atrial fibrillation].

    Science.gov (United States)

    Pontes, João Paulo Jordão; Dos Santos, Aline Tonin; Salgado Filho, Marcello Fonseca

    2018-03-27

    Atrial fibrillation is the most common cardiac arrhythmia, which may occur during the perioperative period and lead to hemodynamic instability due to loss of atrial systolic function. During atrial fibrillation management, electrical cardioversion is one of the therapeutic options in the presence of hemodynamic instability; however, it exposes the patient to thromboembolic event risks. Transesophageal echocardiography is a diagnostic tool for thrombi in the left atrium and left atrial appendage with high sensitivity and specificity, allowing early and safe cardioversion. The present case describes the use of transesophageal echocardiography to exclude the presence of thrombi in the left atrium and left atrial appendage in a patient undergoing non-cardiac surgery with atrial fibrillation of unknown duration and hemodynamic instability. Male patient, 74 years old, hypertensive, with scheduled abdominal surgery, who upon cardiac monitoring in the operating room showed atrial fibrillation undiagnosed in preoperative electrocardiogram, but hemodynamic stability. During surgery, the patient showed hemodynamic instability requiring norepinephrine at increasing doses, with no response to heart rate control. After the end of the surgery, transesophageal echocardiography was performed with a thorough evaluation of the left atrium and left atrial appendage and pulsed Doppler analysis of the left atrial appendage with mean velocity of 45cm.s -1 . Thrombus in the left atrium and left atrial appendage and other cardiac causes for hemodynamic instability were excluded. Therefore, electrical cardioversion was performed safely. After returning to sinus rhythm, the patient showed improvement in blood pressure levels, with noradrenaline discontinuation, extubation in the operating room, and admission to the intensive care unit. In addition to a tool for non-invasive hemodynamic monitoring, perioperative transesophageal echocardiography may be valuable in clinical decision making. In

  6. The assessment of angiogenesis and fibroblastic stromagenesis in hyperplastic and pre-invasive breast lesions

    Directory of Open Access Journals (Sweden)

    Louvrou Niki

    2008-04-01

    Full Text Available Abstract Background To investigate the changes of the neoplastic microenvironment during the different morphological alterations of hyperplastic and pre-invasive breast lesions. Methods 78 in situ ductal carcinomas of all degrees of differentiation, 22 atypical ductal hyperplasias, 25 in situ lobular carcinomas, 18 atypical lobular hyperplasias, 32 ductal epithelial hyperplasias of usual type and 8 flat atypias were immunohistochemically investigated for the expression of vascular endothelial growth factor (VEGF, smooth muscle actin (SMA and CD34, while microvessel density (MVD was counted using the anti-CD31 antibody. Results VEGF expression was strongly correlated with MVD in all hyperplastic and pre-invasive breast lesions (p Conclusion Angiogenesis is observed before any significant fibroblastic stromagenesis in pre-invasive breast lesions. A composite phenotype characterized by VEGF positive epithelial cells and SMA positive/CD34 negative stromal cells, is identified mostly in intermediate and high grade DCIS. These findings might imply for new therapeutic strategies using both anti-angiogenic factors and factors selectively targeting tumor stroma in order to prevent the progression of DCIS to invasive carcinoma.

  7. European map of alien plant invasions, based on the quantitative assessment across habitats

    Czech Academy of Sciences Publication Activity Database

    Chytrý, M.; Pyšek, Petr; Wild, Jan; Pino, J.; Maskell, L. C.; Vila, M.

    2009-01-01

    Roč. 15, č. 1 (2009), s. 98-107 ISSN 1366-9516 R&D Projects: GA MŠk LC06073 Grant - others:Evropská komise(XE) GOCE-CT-2003-506675 Institutional research plan: CEZ:AV0Z60050516 Keywords : plant invasions * habitat * Europe Subject RIV: EF - Botanics Impact factor: 4.224, year: 2009

  8. Assessing patterns in introduction pathways of alien species by linking major invasion data bases

    Czech Academy of Sciences Publication Activity Database

    Saul, W.-C.; Roy, H. E.; Booy, O.; Carnevali, L.; Chen, H.-J.; Genovesi, P.; Harrower, C.; Hulme, P. E.; Pagad, S.; Pergl, Jan; Jeschke, J.M.

    2017-01-01

    Roč. 54, č. 2 (2017), s. 657-669 ISSN 0021-8901 R&D Projects: GA ČR(CZ) GAP504/11/1028 Grant - others:COST(XE) TD1209 Program:FA Institutional support: RVO:67985939 Keywords : invasions * pathways * databases Subject RIV: EH - Ecology, Behaviour OBOR OECD: Biodiversity conservation Impact factor: 5.301, year: 2016

  9. The effectiveness of MR imaging in the assessment of invasive lobular carcinoma of the breast.

    NARCIS (Netherlands)

    Mann, R.M.

    2010-01-01

    Invasive lobular carcinoma (ILC) of the breast is, due to its diffuse infiltrative growth pattern, a diagnostic challenge. Even in retrospect, only up to 80% are visible at mammography. Moreover, both mammography and ultrasound tend to structurally underestimate the size of ILC. Breast magnetic

  10. A CALCIUM-BASED INVASION RISK ASSESSMENT FOR ZEBRA AND QUAGGA MUSSELS (DREISSENA SPP.)

    Science.gov (United States)

    We used calcium concentration data from over 3000 stream and river sites across the contiguous United States to classify ecoregions relative to their risk for Dreissena species invasion. We defined risk based on calcium concentrations as: very low (< 12 mg L−1), low (12–20 mg L−1...

  11. Usefulness of time-resolved projection MRA on evaluation of hemodynamics in cerebral occlusive diseases

    International Nuclear Information System (INIS)

    Oka, Yoshihisa; Kusunoki, Katsusuke; Nochide, Ichiro; Igase, Keiji; Harada, Hironobu; Sadamoto, Kazuhiko; Nagasawa, Kiyoshi

    2001-01-01

    The usefulness for evaluation of cerebral hemodynamics using time-resolved projection MRA was studied in normal volunteers and patients of cerebrovascular diseases. Six normal volunteers and ten patients with cerebrovascular occlusive diseases including 6 of IC occlusion and 4 of post EC/IC bypass surgery underwent time-resolved projection MRA on a 1.5 T clinical MRI system. Projection angiograms are acquired with 2D-fast SPGR sequence with a time resolution of approximately one image per second, 40 images being acquired consecutively before and after bolus injection Gd-DTPA. And all images were calculated by complex subtraction from the background mask in a work station. In normal volunteers, the quality of images of time-resolved projection MRA was satisfactory. The arteries from internal carotid artery through M2 segment of middle cerebral artery and all major venous systems were well portrayed. In 4 cases of IC occlusion who were assessed the collateral flow through the anterior communicating artery and posterior communicating artery, there were delayed to demonstrate the ipsilateral MCA. However, in 2 cases of IC occlusion that were assessed the collateral flow through leptomeningeal anastomosis, ipsilateral MCA and collateral circulation were not demonstrated. In all patients of post EC/IC bypass surgery, the patency of EC/IC bypass could be evaluated as properly with time-resolved projection MRA as 3D-TOF MRA. Although the temporal and spatial resolutions are insufficient, time-resolved projection MRA was power-full non-invasive method to evaluate the cerebral hemodynamics vis the basal communicating arteries in IC occlusion and identify the patency of EC/IC bypass. (author)

  12. Assessing distributions of two invasive species of contrasting habits in future climate.

    Science.gov (United States)

    Panda, Rajendra Mohan; Behera, Mukunda Dev; Roy, Partha Sarathi

    2018-05-01

    Understanding the impact of climate change on species invasion is crucial for sustainable biodiversity conservation. Through this study, we try to answer how species differing in phenological cycles, specifically Cassia tora and Lantana camara, differ in the manner in which they invade new regions in India in the future climate. Since both species occupy identical niches, exploring their invasive potential in different climate change scenarios will offer critical insights into invasion and inform ecosystem management. We use three modelling protocols (i.e., maximum entropy, generalised linear model and generalised additive model) to predict the current distribution. Projections are made for both moderate (A1B) and extreme (A2) IPCC (Intergovernmental Panel on Climate Change) scenarios for the year 2050 and 2100. The study reveals that the distributions of C. tora (annual) and L. camara (perennial) would depend on the precipitation of the warmest quarter and moisture availability. C. tora may demonstrate physiological tolerance to the mean diurnal temperature range and L. camara to the solar radiation. C. tora may invade central India, while L. camara may invade the Western Himalaya, parts of the Eastern Himalaya and the Western Ghats. The distribution ranges of both species could shift in the northern and north-eastern directions in India, owing to changes in moisture availability. The possible alterations in precipitation regimes could lead to water stress, which might have cascading effects on species invasion. L. camara might adapt to climate change better compared with C. tora. This comparative analysis of the future distributions of two invasive plants with contrasting habits demonstrates that temporal complementarity would prevail over the competition. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Hemodynamic characteristics of early stage hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kudo, Masatoshi; Tomita, Shusuke; Tochio, Hitoshi

    1992-01-01

    Hemodynamic characteristics were studied by using in vivo vascular imaging techniques in 17 resected early stage hepatocellular carcinoma (e-HCC) by comparing them with 49 resected advanced HCCs (ad-HCC) less than 3 cm in diameter. In this study, e-HCC was defined as the nodule being uniformly composed of well-differentiated HCC or adenomatous hyperplastic nodule containing well-differentiated HCC foci within the nodule. In vivo vascular imaging techniques are as follows; US angiography with intraarterial CO 2 microbubbles were performed to assess the tumor arterial vascularity, and CT during arterial portography (CTAP) was performed to assess the portal perfusion within the nodule. Of 17 e-HCC nodules 5 were hypervascular, 5 were isovascular, 4 were hypovascular, and 3 were vascular spot in hypovascular pattern in contrast to 49 ad-HCC nodules, 43 of which were hypervascular and 6 were isovascular. Of 14 e-HCCs, 9 nodules showed perfusion defect and 5 did not on CTAP, whereas all 37 ad-HCCs on which CTAP was performed, showed perfusion defect. Forty-one percent (7/17) of e-HCC showed fatty metamorphosis in contrast to 8% (4/49) of ad-HCC. In conclusion, hemodynamic characteristics of e-HCC are summarized as follows. (1) Arterial tumor neovascularization is relatively low. (2) Portal perfusion is present in some of e-HCC cases. (3) Hypoperfusion state both from arterial and portal supply is present in some of e-HCC cases. (4) Vascular spot in hypovascular pattern is characteristic arterial pattern in AH containing HCC foci. (5) Fatty metamorphosis may be related with hypoperfusion state of the nodule in e-HCC. (author)

  14. Non-invasive assessment of liver fibrosis: Between prediction/prevention of outcomes and cost-effectiveness.

    Science.gov (United States)

    Stasi, Cristina; Milani, Stefano

    2016-01-28

    The assessment of the fibrotic evolution of chronic hepatitis has always been a challenge for the clinical hepatologist. Over the past decade, various non-invasive methods have been proposed to detect the presence of fibrosis, including the elastometric measure of stiffness, panels of clinical and biochemical parameters, and combinations of both methods. The aim of this review is to analyse the most recent data on non-invasive techniques for the evaluation of hepatic fibrosis with particular attention to cost-effectiveness. We searched for relevant studies published in English using the PubMed database from 2009 to the present. A large number of studies have suggested that elastography and serum markers are useful techniques for diagnosing severe fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus patients. In addition, hepatic stiffness may also help to prognosticate treatment response to antiviral therapy. It has also been shown that magnetic resonance elastography has a high accuracy for staging and differentiating liver fibrosis. Finally, studies have shown that non-invasive methods are becoming increasingly precise in either positively identifying or excluding liver fibrosis, thus reducing the need for liver biopsy. However, both serum markers and transient elastography still have "grey area" values of lower accuracy. In this case, liver biopsy is still required to properly assess liver fibrosis. Recently, the guidelines produced by the World Health Organization have suggested that the AST-to-platelet ratio index or FIB-4 test could be utilised for the evaluation of liver fibrosis rather than other, more expensive non-invasive tests, such as elastography or FibroTest.

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

    Directory of Open Access Journals (Sweden)

    Hideki Uedono

    2015-06-01

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

  16. Neonatal Hemodynamics: From Developmental Physiology to Comprehensive Monitoring

    Directory of Open Access Journals (Sweden)

    Sabine L. Vrancken

    2018-04-01

    Full Text Available Maintenance of neonatal circulatory homeostasis is a real challenge, due to the complex physiology during postnatal transition and the inherent immaturity of the cardiovascular system and other relevant organs. It is known that abnormal cardiovascular function during the neonatal period is associated with increased risk of severe morbidity and mortality. Understanding the functional and structural characteristics of the neonatal circulation is, therefore, essential, as therapeutic hemodynamic interventions should be based on the assumed underlying (pathophysiology. The clinical assessment of systemic blood flow (SBF by indirect parameters, such as blood pressure, capillary refill time, heart rate, urine output, and central-peripheral temperature difference is inaccurate. As blood pressure is no surrogate for SBF, information on cardiac output and systemic vascular resistance should be obtained in combination with an evaluation of end organ perfusion. Accurate and reliable hemodynamic monitoring systems are required to detect inadequate tissue perfusion and oxygenation at an early stage before this result in irreversible damage. Also, the hemodynamic response to the initiated treatment should be re-evaluated regularly as changes in cardiovascular function can occur quickly. New insights in the understanding of neonatal cardiovascular physiology are reviewed and several methods for current and future neonatal hemodynamic monitoring are discussed.

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

    Science.gov (United States)

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

    2016-03-01

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

  18. A qualitative ecological risk assessment of the invasive Nile tilapia, Oreochromis niloticus in a sub-tropical African river system (Limpopo River, South Africa)

    CSIR Research Space (South Africa)

    Zengeya, TA

    2013-01-01

    Full Text Available This study outlines the development of a qualitative risk assessment method and its application as a screening tool for determining the risk of establishment and spread of the invasive Nile tilapia, Oreochromis niloticus (Linnaeus, 1758), within...

  19. Hemodynamic 3D Infrared Thermal Stereoscopic Imaging (TSI) Investiga- tion in Chronic Vascular Leg Ulcers: A Feasibility Study.

    Science.gov (United States)

    Mirabella, Carlo; Bellandi, Serena; Graziani, Gabriele; Tolomei, Leonardo; Manetti, Leonardo; Fortuna, Damiano

    2011-09-01

    Hemodynamic 3D infrared thermal stereoscopic imaging (TSI) was tested as a new non-invasive diagnostic method for studying chron- ic vascular leg ulcers. The aim was to test this new diagnostic approach in investigating mixed arterio-venous wounds. Duplex ultrasonography is the most useful test for investigating hemodynamic alterations in patients with vascular cutaneous ulcers; however, it fails to provide any information about microvascular dysfunctions, which could play a sig- nificant role in the development of skin wounds. The study of thermal patterns at the wound site represents a method of investigating cu- taneous microcirculation-temperature gradients indicating abnormal blood flow in the margins and bed of wounds with vascular disorders are well correlated with clinical findings. In order to evaluate the predominance of the arterial or venous component in vascular mixed ulcers of the leg and to understand the underlying pathology of the ulcers, 3D thermography was tested in three different hemodynamic positions. A total of 20 physiological and 20 pathological patients were assessed standing, supine, or in a discharging position (legs raised above heart level). A relatively constant temperature trend was observed in healthy subjects, while a different reaction was recorded in those with ulcerated legs. Moreover, a different temperature trend was noted among the varying hemodynamic positions and a trend differ- ence was also observed between arterial and venous ulcers in clinical investigation tests. TSI appears to be a safe, user-friendly, rapid, and promising procedure for distinguishing both arterial and ve- nous involvement in mixed arterio-venous leg ulcers. .

  20. The Value of Quality Improvement Process in the Detection and Correction of Common Errors in Echocardiographic Hemodynamic Parameters in a Busy Echocardiography Laboratory.

    Science.gov (United States)

    Fanari, Zaher; Choudhry, Usman I; Reddy, Vivek K; Eze-Nliam, Chete; Hammami, Sumaya; Kolm, Paul; Weintraub, William S; Marshall, Erik S

    2015-12-01

    Accurate assessment of cardiac structures, ventricular function, and hemodynamics is essential for any echocardiographic laboratory. Quality improvement (QI) processes described by the American Society of Echocardiography (ASE) and the Intersocietal Commission (IAC) should be instrumental in reaching this goal. All patients undergoing transthoracic echocardiogram (TTE) followed by cardiac catheterization within 24 hours at Christiana Care Health System in 2011 and 2012 were identified, with 126 and 133 cases, respectively. Hemodynamic parameters of diastolic function and pulmonary artery systolic pressure (PASP) on TTE correlated poorly with catheterization in 2011. An educational process was developed and implemented at quarterly QI meetings based on ASE and IAC recommendations to target frequently encountered errors and provide methods for improved performance. The hemodynamic parameters were then reexamined in 2012 postintervention. Following the QI process, there was significant improvement in the correlation between invasive and echocardiographic hemodynamic measurements in both systolic and diastolic function, and PASP. This reflected in significant better correlations between echo and cath LVEF [R = 0.88, ICC = 0.87 vs. R = 0.85, ICC = 0.85; P < 0.001], average E/E' and of left ventricle end-diastolic pressure (LVEDP) [R = 0.62 vs. R = 0.09, P = 0.006] and a better correlation for PASP [R = 0.77, ICC = 0.77 vs. R = 0.30, ICC = 0.31; P = 0.05] in 2012 compared to 2011. The QI process, as recommended by ASE and IAC, can allow for identification as well as rectification of quality issues in a large regional academic medical center hospital. © 2015, Wiley Periodicals, Inc.

  1. The assessment of angiogenesis and fibroblastic stromagenesis in hyperplastic and pre-invasive breast lesions

    International Nuclear Information System (INIS)

    Pavlakis, Kitty; Messini, Irene; Vrekoussis, Thomas; Yiannou, Petros; Keramopoullos, Dimitrios; Louvrou, Niki; Liakakos, Theodoros; Stathopoulos, Efstathios N

    2008-01-01

    To investigate the changes of the neoplastic microenvironment during the different morphological alterations of hyperplastic and pre-invasive breast lesions. 78 in situ ductal carcinomas of all degrees of differentiation, 22 atypical ductal hyperplasias, 25 in situ lobular carcinomas, 18 atypical lobular hyperplasias, 32 ductal epithelial hyperplasias of usual type and 8 flat atypias were immunohistochemically investigated for the expression of vascular endothelial growth factor (VEGF), smooth muscle actin (SMA) and CD34, while microvessel density (MVD) was counted using the anti-CD31 antibody. VEGF expression was strongly correlated with MVD in all hyperplastic and pre-invasive breast lesions (p < 0.05). Stromagenesis, as characterized by an increase in SMA and a decrease in CD34 positive myofibroblasts was observed mostly around ducts harboring high grade in situ carcinoma and to a lesser extent around moderately differentiated DCIS. In these two groups of in situ carcinomas, a positive correlation between MVD and SMA (p < 0.05) was observed. On the contrary, CD34 was found to be inversely related to MVD (p < 0.05). No statistically significant changes of the stromal fibroblasts were observed in low grade DCIS neither in any of the other lesions under investigation as compared to normal mammary intra- and interlobular stroma. Angiogenesis is observed before any significant fibroblastic stromagenesis in pre-invasive breast lesions. A composite phenotype characterized by VEGF positive epithelial cells and SMA positive/CD34 negative stromal cells, is identified mostly in intermediate and high grade DCIS. These findings might imply for new therapeutic strategies using both anti-angiogenic factors and factors selectively targeting tumor stroma in order to prevent the progression of DCIS to invasive carcinoma

  2. The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection.

    Science.gov (United States)

    Yu, Simon C H; Liu, Wen; Wong, Randolph H L; Underwood, Malcolm; Wang, Defeng

    2016-08-01

    We aimed to assess the potential of computational fluid dynamics simulation (CFD) in detecting changes in pressure and flow velocity in response to morphological changes in type B aortic dissection. Pressure and velocity in four morphological models of type B aortic dissection before and after closure of the entry tear were calculated with CFD and analyzed for changes among the different scenarios. The control model (Model 1) was patient specific and built from the DICOM data of CTA, which bore one entry tear and three re-entry tears. Models 2-4 were modifications of Model 1, with two re-entry tears less in Model 2, one re-entry tear more in Model 3, and a larger entry tear in Model 4. The pressure and velocity pertaining to each of the morphological models were unique. Changes in pressure and velocity findings were accountable by the changes in morphological features of the different models. There was no blood flow in the false lumen across the entry tear after its closure, the blood flow direction across the re-entry tears was reversed after closure of the entry tear. CFD simulation is probably useful to detect hemodynamic changes in the true and false lumens of type B aortic dissection in response to morphological changes, it may potentially be developed into a non-invasive and patient-specific tool for serial monitoring of hemodynamic changes of type B aortic dissection before and after treatment.

  3. The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Simon C. H., E-mail: simonyu@cuhk.edu.hk; Liu, Wen [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital (Hong Kong); Wong, Randolph H. L.; Underwood, Malcolm [The Chinese University of Hong Kong, Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital (Hong Kong); Wang, Defeng [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital (Hong Kong)

    2016-08-15

    PurposeWe aimed to assess the potential of computational fluid dynamics simulation (CFD) in detecting changes in pressure and flow velocity in response to morphological changes in type B aortic dissection.Materials and MethodsPressure and velocity in four morphological models of type B aortic dissection before and after closure of the entry tear were calculated with CFD and analyzed for changes among the different scenarios. The control model (Model 1) was patient specific and built from the DICOM data of CTA, which bore one entry tear and three re-entry tears. Models 2–4 were modifications of Model 1, with two re-entry tears less in Model 2, one re-entry tear more in Model 3, and a larger entry tear in Model 4.ResultsThe pressure and velocity pertaining to each of the morphological models were unique. Changes in pressure and velocity findings were accountable by the changes in morphological features of the different models. There was no blood flow in the false lumen across the entry tear after its closure, the blood flow direction across the re-entry tears was reversed after closure of the entry tear.ConclusionCFD simulation is probably useful to detect hemodynamic changes in the true and false lumens of type B aortic dissection in response to morphological changes, it may potentially be developed into a non-invasive and patient-specific tool for serial monitoring of hemodynamic changes of type B aortic dissection before and after treatment.

  4. Coupling ecological and social network models to assess “transmission” and “contagion” of an aquatic invasive species

    Science.gov (United States)

    Haak, Danielle M.; Fath, Brian D.; Forbes, Valery E.; Martin, Dustin R.; Pope, Kevin L.

    2017-01-01

    Network analysis is used to address diverse ecological, social, economic, and epidemiological questions, but few efforts have been made to combine these field-specific analyses into interdisciplinary approaches that effectively address how complex systems are interdependent and connected to one another. Identifying and understanding these cross-boundary connections improves natural resource management and promotes proactive, rather than reactive, decisions. This research had two main objectives; first, adapt the framework and approach of infectious disease network modeling so that it may be applied to the socio-ecological problem of spreading aquatic invasive species, and second, use this new coupled model to simulate the spread of the invasive Chinese mystery snail (Bellamya chinensis) in a reservoir network in Southeastern Nebraska, USA. The coupled model integrates an existing social network model of how anglers move on the landscape with new reservoir-specific ecological network models. This approach allowed us to identify 1) how angler movement among reservoirs aids in the spread of B. chinensis, 2) how B. chinensisalters energy flows within individual-reservoir food webs, and 3) a new method for assessing the spread of any number of non-native or invasive species within complex, social-ecological systems.

  5. Assessment of quality of life in patients who underwent minimally invasive cosmetic procedures.

    Science.gov (United States)

    de Aquino, Marcello Simão; Haddad, Alessandra; Ferreira, Lydia Masako

    2013-06-01

    There are increasingly more patients seeking minimally invasive procedures, which have become more effective and safer in reducing the signs of facial aging. This study included 40 female adult patients who voluntarily underwent selected minimally invasive procedures (filling with hyaluronic acid and botulinum toxin injection) for facial rejuvenation. All patients were followed for a period of 6 months. They were evaluated with the use of questionnaires, a quality-of-life questionnaire (DLQI), the self-esteem scale of Rosenberg (EPM/Rosenberg), and a pain scale. The minimally invasive procedures resulted in improvement in quality of life and self-esteem, which were stronger the first 3 months after the procedures but remained at a higher level than that before treatment, even after 6 months. Hyaluronic acid with lidocaine in the formula is more comfortable for the patient as it makes the injection less painful. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  6. Estimated venous return surface and cardiac output curve precisely predicts new hemodynamics after volume change.

    Science.gov (United States)

    Sugimachi, Masaru; Sunagawa, Kenji; Uemura, Kazunori; Kamiya, Atsunori; Shimizu, Shuji; Inagaki, Masashi; Shishido, Toshiaki

    2010-01-01

    In our extended Guyton's model, the ability of heart to pump blood is characterized by a cardiac output curve and the ability of vasculature to pool blood by a venous return surface. These intersect in a three-dimensional coordinate system at the operating right atrial pressure, left atrial pressure, and cardiac output. The baseline cardiac output curve and venous return surface and their changes after volume change would predict new hemodynamics. The invasive methods needed to precisely characterize cardiac output curve and venous return surface led us to aim at estimating cardiac output curve and venous return surface from a single hemodynamic measurement. Using the average values for two logarithmic function parameters, and for two slopes of a surface, we were able to estimate cardiac output curve and venous return surface. The estimated curve and surface predicted new hemodynamics after volume change precisely.

  7. Assessing likely invasion sites of Zika virus-infected mosquitoes in civilian and naval maritime ports in Florida

    Directory of Open Access Journals (Sweden)

    Kollars TM

    2017-01-01

    Full Text Available Thomas M Kollars College of Health Sciences, Liberty University, Lynchburg, VA, USA Abstract: Several mosquito species are capable of invading new geographic regions and exploiting niches that are similar to their natural home ranges where they may introduce, or reintroduce, pathogens. In addition to initial invasion, introduction of new genotypes into established populations may also occur. Zika virus is spreading throughout the world, posing significant health risks to human populations, particularly pregnant women and their infants. The first locally acquired case of Zika virus in the US occurred in July 2016 in Miami, Florida on the Atlantic coast; the first locally acquired case in another US county occurred in the Tampa, Florida area. Three port cities in Florida were chosen to assess the risk of import and spread of Zika virus: Mayport Naval Station, Miami, and Tampa. The bioagent transport and enviromental modeling system TIGER model and ArcGIS were used to analyze abiotic and biotic factors influencing potentially Zika-infected Aedes species, should they enter through these ports. The model was tested by overlaying documented and suspected concurrent Zika cases and comparing published high-risk areas for Zika virus. In addition to Zika hot zones being identified, output indicates surveillance and integrated mosquito management should expect larger zones. Surveillance sites at ports should be identified and prioritized for pathogen and vector control to reduce the import of mosquitoes infected with Zika virus. Low resolution maps often provide valuable suitability of the geographic expansion of organisms. Providing a higher resolution predictive map, identifying probable routes of invasion, and providing areas at high risk for initial invasion and control zones, will aid in controlling and perhaps eliminating the spread of arboviruses through mosquito vectors. Keywords: Aedes, Zika virus, invasive species, maritime ports, biological

  8. Hemodynamics and gas exchange during chest compressions in neonatal resuscitation.

    Directory of Open Access Journals (Sweden)

    Payam Vali

    Full Text Available Current knowledge about pulmonary/systemic hemodynamics and gas exchange during neonatal resuscitation in a model of transitioning fetal circulation with fetal shunts and fluid-filled alveoli is limited. Using a fetal lamb asphyxia model, we sought to determine whether hemodynamic or gas-exchange parameters predicted successful return of spontaneous circulation (ROSC.The umbilical cord was occluded in 22 lambs to induce asphyxial cardiac arrest. Following five minutes of asystole, resuscitation as per AHA-Neonatal Resuscitation Program guidelines was initiated. Hemodynamic parameters and serial arterial blood gases were assessed during resuscitation.ROSC occurred in 18 lambs (82% at a median (IQR time of 120 (105-180 seconds. There were no differences in hemodynamic parameters at baseline and at any given time point during resuscitation between the lambs that achieved ROSC and those that did not. Blood gases at arrest prior to resuscitation were comparable between groups. However, lambs that achieved ROSC had lower PaO2, higher PaCO2, and lower lactate during resuscitation. Increase in diastolic blood pressures induced by epinephrine in lambs that achieved ROSC (11 ±4 mmHg did not differ from those that were not resuscitated (10 ±6 mmHg. Low diastolic blood pressures were adequate to achieve ROSC.Hemodynamic parameters in a neonatal lamb asphyxia model with transitioning circulation did not predict success of ROSC. Lactic acidosis, higher PaO2 and lower PaCO2 observed in the lambs that did not achieve ROSC may represent a state of inadequate tissue perfusion and/or mitochondrial dysfunction.

  9. Transvaginal ultrasound assessment of myometrial and cervical stroma invasion in women with endometrial cancer -interobserver reproducibility among ultrasound experts and gynaecologists

    DEFF Research Database (Denmark)

    Eriksson, LS; Lindqvist, PG; Flöter Rådestad, A

    2014-01-01

    OBJECTIVES: To assess interobserver reproducibility among ultrasound experts and gynaecologists in the prediction of deep myometrial- and cervical stroma invasion by transvaginal ultrasound in women with endometrial cancer. METHODS: Video-clips of the corpus- and cervix uteri of 53 women...... with endometrial cancer, examined preoperatively by the same ultrasound expert, were integrated in a digitalized survey. Nine ultrasound experts and 9 gynaecologists evaluated presence or absence of deep myometrial- and cervical stroma invasion. Histopathology from hysterectomy specimen was used as gold standard.......001). CONCLUSION: Preoperative ultrasound assessment of deep myometrial- and cervical stroma invasion in endometrial cancer is best performed by ultrasound experts, as they show a higher degree of agreement to histopathology and higher interobserver reproducibility in the assessment of cervical stromal invasion....

  10. Risk-based probabilistic approach to assess the impact of false mussel invasions on farmed hard clams.

    Science.gov (United States)

    Liao, Chung-Min; Ju, Yun-Ru; Chio, Chia-Pin; Chen, Wei-Yu

    2010-02-01

    The purpose of this article is to provide a risk-based predictive model to assess the impact of false mussel Mytilopsis sallei invasions on hard clam Meretrix lusoria farms in the southwestern region of Taiwan. The actual spread of invasive false mussel was predicted by using analytical models based on advection-diffusion and gravity models. The proportion of hard clam colonized and infestation by false mussel were used to characterize risk estimates. A mortality model was parameterized to assess hard clam mortality risk characterized by false mussel density and infestation intensity. The published data were reanalyzed to parameterize a predictive threshold model described by a cumulative Weibull distribution function that can be used to estimate the exceeding thresholds of proportion of hard clam colonized and infestation. Results indicated that the infestation thresholds were 2-17 ind clam(-1) for adult hard clams, whereas 4 ind clam(-1) for nursery hard clams. The average colonization thresholds were estimated to be 81-89% for cultivated and nursery hard clam farms, respectively. Our results indicated that false mussel density and infestation, which caused 50% hard clam mortality, were estimated to be 2,812 ind m(-2) and 31 ind clam(-1), respectively. This study further indicated that hard clam farms that are close to the coastal area have at least 50% probability for 43% mortality caused by infestation. This study highlighted that a probabilistic risk-based framework characterized by probability distributions and risk curves is an effective representation of scientific assessments for farmed hard clam in response to the nonnative false mussel invasion.

  11. Non-invasive assessment of hepatic fat accumulation in chronic hepatitis C by {sup 1}H magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Krssak, Martin [Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna (Austria); Hofer, Harald [Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna (Austria); Wrba, Fritz [Department of Clinical Pathology, Medical University of Vienna (Austria); Meyerspeer, Martin [MR Centre-of-Excellence, Department of Radiodiagnostics, Medical University of Vienna (Austria); Center for Biomedical Engineering and Physics, Medical University of Vienna (Austria); Brehm, Attila [Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna (Austria); Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center of Diabetes Research and Department of Medicine/Metabolic Diseases, Heinrich Heine University, Duesseldorf (Germany); Lohninger, Alfred [Department of Medical Chemistry, Center for Physiology and Pathophysiology, Medical University of Vienna (Austria); Steindl-Munda, Petra [Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna (Austria); MR Centre-of-Excellence, Department of Radiodiagnostics, Medical University of Vienna (Austria); Moser, Ewald [MR Centre-of-Excellence, Department of Radiodiagnostics, Medical University of Vienna (Austria); Center for Biomedical Engineering and Physics, Medical University of Vienna (Austria); Ferenci, Peter [Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna (Austria); Roden, Michael, E-mail: michael.roden@ddz.uni-duesseldorf.d [Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna (Austria); Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center of Diabetes Research and Department of Medicine/Metabolic Diseases, Heinrich Heine University, Duesseldorf (Germany)

    2010-06-15

    Background: Liver biopsy is the standard method for diagnosis of hepatic steatosis, but is invasive and carries some risk of morbidity. Aims and methods: Quantification of hepatocellular lipid content (HCL) with non-invasive single voxel {sup 1}H magnetic resonance spectroscopy (MRS) at 3 T was compared with histological grading and biochemical analysis of liver biopsies in 29 patients with chronic hepatitis C. Body mass index, indices of insulin resistance (homeostasis model assessment index, HOMA-IR), serum lipids and serum liver transaminases were also quantified. Results: HCL as assessed by {sup 1}H MRS linearly correlated (r = 0.70, p < 0.001) with histological evaluation of liver biopsies and was in agreement with histological steatosis staging in 65% of the patients. Biochemically assessed hepatic triglyceride contents correlated with HCL measured with {sup 1}H MRS (r = 0.63, p < 0.03) and allowed discriminating between none or mild steatosis versus moderate or severe steatosis. Patients infected with hepatitis C virus genotype 3 had a higher prevalence of steatosis (62%) which was not explained by differences in body mass or whole body insulin resistance. When these patients were excluded from correlation analysis, hepatic fat accumulation positively correlated with insulin resistance in the remaining hepatitis C patients (HCL vs. HOMA-IR, r = 0.559, p < 0.020, n = 17). Conclusion: Localized {sup 1}H MRS is a valid and useful method for quantification of HCL content in patients with chronic hepatitis C and can be easily applied to non-invasively monitoring of steatosis during repeated follow-up measurements in a clinical setting.

  12. Lymphography and computed tomography in the assessment of lymphnode invasion by bladder cancer. Comparison of diagnostic value

    International Nuclear Information System (INIS)

    Leguay, O.; Bellin, M.F.; Richard, F.; Mallet, A.; Grellet, J.

    1989-01-01

    The diagnostic value of lymphography and computed tomography (CT) in the assessment of lymph node invasion by bladder cancers has been compared on the basis of 30 observations. Although computed tomography apparently yields better results (reliability: 93%) than lymphography (reliability: 87%), these findings have no statistical significance. The study of literature shows that the statistical exploitation of the results was seldom carried out. The combination of both exploration techniques seems to improve predictive values, but this improvement was not statistically significant in the study [fr

  13. Effects of Anesthetic Management on Early Postoperative Recovery, Hemodynamics and Pain After Supratentorial Craniotomy

    OpenAIRE

    Ayrian, Eugenia; Kaye, Alan David; Varner, Chelsia L.; Guerra, Carolina; Vadivelu, Nalini; Urman, Richard D.; Zelman, Vladimir; Lumb, Philip D.; Rosa, Giovanni; Bilotta, Federico

    2015-01-01

    Various clinical trials have assessed how intraoperative anesthetics can affect early recovery, hemodynamics and nociception after supratentorial craniotomy. Whether or not the difference in recovery pattern differs in a meaningful way with anesthetic choice is controversial. This review examines and compares different anesthetics with respect to wake-up time, hemodynamics, respiration, cognitive recovery, pain, nausea and vomiting, and shivering. When comparing inhalational anesthetics to in...

  14. Assessment of non-invasive ICP during CSF infusion test: an approach with transcranial Doppler.

    Science.gov (United States)

    Cardim, D; Czosnyka, M; Donnelly, J; Robba, C; Cabella, B C T; Liu, X; Cabeleira, M T; Smielewsky, P; Haubrich, C; Garnett, M R; Pickard, J D; Czosnyka, Z

    2016-02-01

    This study aimed to compare four non-invasive intracranial pressure (nICP) methods in a prospective cohort of hydrocephalus patients whose cerebrospinal fluid dynamics was investigated using infusion tests involving controllable test-rise of ICP. Cerebral blood flow velocity (FV), ICP and non-invasive arterial blood pressure (ABP) were recorded in 53 patients diagnosed for hydrocephalus. Non-invasive ICP methods were based on: (1) interaction between FV and ABP using black-box model (nICP_BB); (2) diastolic FV (nICP_FVd); (3) critical closing pressure (nICP_CrCP); (4) transcranial Doppler-derived pulsatility index (nICP_PI). Correlation between rise in ICP (∆ICP) and ∆nICP and averaged correlations for changes in time between ICP and nICP during infusion test were investigated. From baseline to plateau, all nICP estimators increased significantly. Correlations between ∆ICP and ∆nICP were better represented by nICP_PI and nICP_BB: 0.45 and 0.30 (p ICP during individual infusion test nICP_PI, nICP_BB and nICP_FVd presented similar correlations with ICP: 0.39 ± 0.40, 0.39 ± 0.43 and 0.35 ± 0.41 respectively. However, nICP_CrCP presented a weaker correlation (R = 0.29 ± 0.24). Out of the four methods, nICP_PI was the one with best performance for predicting changes in ∆ICP during infusion test, followed by nICP_BB. Unreliable correlations were shown by nICP_FVd and nICP_CrCP. Changes of ICP observed during the test were expressed by nICP values with only moderate correlations.

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

    Science.gov (United States)

    Ripollés, Javier; Espinosa, Angel; Martínez-Hurtado, Eugenio; Abad-Gurumeta, Alfredo; Casans-Francés, Rubén; Fernández-Pérez, Cristina; López-Timoneda, Francisco; Calvo-Vecino, José María

    2016-01-01

    The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014). Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary) and mortality (secondary). Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal), and predefined sensitivity analysis. 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p<0.001). No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p=0.30). Quality sensitive analyses confirmed the main overall results. Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac surgery, although it was not able to show a significant decrease in

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

    Directory of Open Access Journals (Sweden)

    Javier Ripollés

    Full Text Available Abstract Background: The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. Methods: A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014. Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary and mortality (secondary. Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal, and predefined sensitivity analysis. Results: 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p < 0.001. No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p = 0.30. Quality sensitive analyses confirmed the main overall results. Conclusions: Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac

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

    Science.gov (United States)

    Ripollés, Javier; Espinosa, Angel; Martínez-Hurtado, Eugenio; Abad-Gurumeta, Alfredo; Casans-Francés, Rubén; Fernández-Pérez, Cristina; López-Timoneda, Francisco; Calvo-Vecino, José María

    2016-01-01

    The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014). Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary) and mortality (secondary). Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal), and predefined sensitivity analysis. 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p<0.001). No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p=0.30). Quality sensitive analyses confirmed the main overall results. Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac surgery, although it was not able to show a significant decrease in

  18. Hemodynamic effects of ventricular defibrillation

    Science.gov (United States)

    Pansegrau, Donald G.; Abboud, François M.

    1970-01-01

    Hemodynamic responses to ventricular defibrillation were studied in anesthetized dogs. Observations were made on arterial, right atrial and left ventricular end-diastolic pressures, on cardiac output (dye dilution), heart rate, and right atrial electrocardiogram. Ventricular fibrillation was induced electrically with a bipolar electrode catheter placed in the right ventricle. Fibrillation was maintained for 15 or 30 sec and terminated with a 400 w sec capacitor discharge across the thoracic cage. Responses lasted 1-10 min after conversion and included a cholinergic and an adrenergic component. The cholinergic component was characterized by sinus bradycardia, periods of sinus arrest, atrioventricular block, and ventricular premature beats. The adrenergic component included increases in arterial pressure, in cardiac output, and in left ventricular stroke work at a time when left ventricular end-diastolic pressure was normal; there was no change in total peripheral resistance. The pH of arterial blood decreased slightly and pCO2 increased but pO2 and the concentration of lactate were unchanged. Bilateral vagotomy and intravenous administration of atropine blocked the cholinergic component, unmasked a sinus tachycardia, and accentuated the adrenergic component of the response. The latter was blocked by intravenous administration of propranolol and phenoxybenzamine. These responses were related primarily to conversion of ventricular fibrillation rather than to the electrical discharge of countershock because countershock without ventricular fibrillation caused more transient and smaller responses than those observed with defibrillation: furthermore, the hemodynamic effects of defibrillation were augmented by prolongation of the duration of fibrillation. The results suggest that the cholinergic component of the response may be detrimental in that it favors spontaneous recurrence of fibrillation; on the other hand, the adrenergic component may be essential for conversion

  19. Development and Assessment of a Novel Task Trainer and Targeting Tasks for Ultrasound-guided Invasive Procedures.

    Science.gov (United States)

    Nitsche, Joshua F; Shumard, Kristina M; Brost, Brian C

    2017-06-01

    The American Institute of Ultrasound in Medicine (AIUM) recommends that all providers performing ultrasound-guided invasive procedures be competent in a core set of guidance skills common to all ultrasound-guided procedures, including in-plane and out-of-plane needle guidance and needle imaging optimization techniques such as probe translation, rotation, and heel-toe standoff. To allow for the practice and assessment of these core skills, we have created a novel task trainer and set of targeting tasks, and sought to obtain validity evidence in the content and response process domains for this training and assessment system according to the Standards for Educational and Psychological Testing. We have constructed an ultrasound-guided invasive procedure training system and five targeting tasks that focused on the needle guidance skills outlined by the AIUM. All tasks were performed by obstetrics and gynecology or maternal-fetal medicine physicians with and without experience in ultrasound-guided invasive procedures during a series of simulation workshops. All participants completed a survey regarding the trainer's and the tasks' usefulness in the training of inexperienced physicians. The physicians who completed the tasks had favorable views of task trainer and curriculum. The targeting curriculum was felt to allow practice of all of the core guidance skills outlined by the AIUM. The average response provided for all of the tasks was 4.0 or greater, with half of the items having an average response of 4.5 or higher. We have constructed a task trainer that incorporates all of the core skills outlined by the AIUM. All five tasks received very favorable reviews from both experienced and inexperienced providers. Taken together, our findings suggest they have strong content and response process validity evidence. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  20. The Scandinavian multicenter hemodynamic evaluation of the SJM Regent aortic valve

    Directory of Open Access Journals (Sweden)

    Offstad Jon

    2011-12-01

    Full Text Available Abstract Background 112 patients who received small and medium sized St.Jude Regent heart valves (19-25 mm at 7 Scandinavian centers were studied between January 2003 and February 2005 to obtain non-invasive data regarding the hemodynamic performance at rest and during Dobutamine stress echocardiography (DSE testing one year after surgery. Material and methods 46 woman and 66 men, aged 61.8 ± 9.7 (18-75 years, were operated on for aortic regurgitation (17, stenosis (65, or mixed dysfunction (30. Valve sizes were 19 mm (6, 21 mm (33, 23 mm (41, 25 mm (30. Two patients receiving size 27 valves were excluded from the hemodynamic evaluation. Pledgets were used in 100 patients, everted mattress in 66 and simple interrupted sutures in 21. Valve orientation varied and was dependent on the surgeons' choice. 34 patients (30.4% underwent concomitant coronary artery surgery. Results There were two early deaths (1.8% and three late deaths, one because of pancreatic cancer. Late events during follow-up were: non structural dysfunction (1, bleeding (2, thromboembolism (2. At one year follow up 93% of the patients were in NYHA classes 1-2 versus 47.8% preoperatively. Dobutamine stress echocardiography (DSE was performed in a total of 66 and maximal peak stress was reached in 61 patients. During DSE testing, the following statistically significant changes took place: Heart rate increased by 73.0%, cardiac output by 85.5%, left ventriclular ejection fraction by 19.6%, and maximal mean prosthetic transvalvular gradient by 133.8%, whereas the effective orifice area index did not change. Left ventricular mass fell during one year from 215 ± 63 to 197 ± 62 g (p Conclusion The Dobutamine test induces a substantial stress, well suitable for echocardiographic assessment of prosthesis valve function and can be performed in the majority of the patients. The changes in pressure gradients add to the hemodynamic characteristics of the various valve sizes. In our patients

  1. Hemodynamic Effects of Glucagon - A Literature Review.

    Science.gov (United States)

    Meidahl Petersen, Kasper; Bøgevig, Søren; Holst, Jens Juul; Knop, Filip Krag; Christensen, Mikkel Bring

    2018-03-13

    Glucagon's effects on hemodynamic parameters - most notably heart rate and cardiac contractility - are overlooked. The glucagon receptor is a central target in novel and anticipated type 2 diabetes therapies and hemodynamic consequences of glucagon signaling have therefore become increasingly important. In this review we summarize and evaluate published studies on glucagon pharmacology with focus on clinical hemodynamic effects in humans. PubMed, EMBASE and the Cochrane library were searched for clinical studies concerning hemodynamic effects of glucagon (no year restriction). Papers reporting effects of a defined glucagon dose on any hemodynamic parameter were included. Reference searches were conducted in retrieved articles. Hemodynamic effects of glucagon have been investigated mainly in cohort-studies of heart failure patients receiving large glucagon bolus injections. The identified studies had shortcomings related to restricted patient groups, lack of a control group, randomization or blinding. We identified no properly conducted randomized clinical trials. The majority of human studies report stimulating effects of pharmacological glucagon doses on heart rate, cardiac contractility and blood pressure. The effects were characterized by short duration, inter-individual variation and rapid desensitization. Some studies reported no measurable effects of glucagon. The level of evidence regarding hemodynamic effects of glucagon is low and observations in published studies are inconsistent. Actual effects, inter-individual variation, dose-response relationships and possible long-term effects of supra-physiological glucagon levels warrant further investigation.

  2. Circadian health differs between boys and girls as assessed by non-invasive tools in school-aged children.

    Science.gov (United States)

    Barraco, Gloria Maria; Martínez-Lozano, Nuria; Vales-Villamarín, Claudia; Del Carmen Blaya, María; Rios, Rafael; Madrid, Juan Antonio; Fardy, Paul; Garaulet, Marta

    2018-03-21

    Assessment of circadian health is confined to adults. However, understanding circadian status of school-aged children is necessary due to its health implications. The aim was to develop 1) a protocol to assess circadian function in school-aged children by combining the best non-invasive tools previously validated in adults; 2) a score to capture circadian function in children including food timing. This protocol will allow to explore gender differences and to compare the circadian function of school-aged children with adults from the same Mediterranean area. Healthy children (8-12 y) from 3 schools in a Mediterranean area of Spain were recruited (n = 248; 125 males and 123 females). Several non-invasive tools were used: a) 7-day-diaries of food timing and food intake, physical-activity and sleep, b) Munich-chronotype-self-reported-questionnaire; c) cortisol and melatonin saliva determinations; d) 7-day-rhythms of wrist temperature (T), activity (A), position (P) and the integrative variable TAP e) 7-day-light exposure. We have constructed the first school-aged children population for the assessment of circadian function (ONTIME-Jr) and a new circadian score has been developed. Among circadian-related measures, TAP was the most suitable and reliable to determine circadian system characteristics. Circadian function was better in girls than in boys [circadian score (AU) Mean ± SD (girls, 1216 ± 153 vs. 1159 ± 173 boys, P = 0.012)], and also in school-aged children than in adults from the same Mediterranean area (Circadian-Function-Index: children 0.47 ± 0.06 vs. adults 0.45 ± 0.06 P = 0.001). A new protocol, including TAP and food timing, demonstrated to be reliable in assessing circadian function in children. These non-invasive techniques provide the wherewithal for paediatricians to assess circadian function in clinical practice. Chronobiology and childhood obesity (ONTIME-Jr: Obesity, Nutrigenetics, Timing and Mediterranean, Junior). Clinical

  3. A non-invasive method for the assessment of hemostasis in vivo by using dynamic light scattering

    Science.gov (United States)

    Fine, I.; Kaminsky, A.; Kuznik, B.; Shenkman, L.

    2012-02-01

    We present a new non-invasive method for assessing hemostasis in vivo. This method is based on the analysis of the movement characteristics of red blood cells (RBCs) during blood stasis condition. Stasis is intermittently induced by occlusion of arterial blood flow at the finger root. We assumed that under zero flow conditions, RBC movement is driven mostly by Brownian motion, and we characterized the RBC movement by utilizing the dynamic light scattering (DLS) technique in vivo. We found that during the stasis the RBCs diffusion coefficient in plasma decreases. We speculate that the RBC diffusion coefficient is most strongly related to endothelial and hemostatic activity. This assumption is supported by our findings that RBC movement, being expressed through the characteristics of the measured DLS signal, is correlative to the biological age and also is related to the coagulation factors. This new method can serve as a new diagnostic and research tool for the assessment of hemostasis and vascular function.

  4. Non-invasive sex assessment in bovine semen by Raman spectroscopy

    Science.gov (United States)

    De Luca, A. C.; Managó, S.; Ferrara, M. A.; Rendina, I.; Sirleto, L.; Puglisi, R.; Balduzzi, D.; Galli, A.; Ferraro, P.; Coppola, G.

    2014-05-01

    X- and Y-chromosome-bearing sperm cell sorting is of great interest, especially for animal production management systems and genetic improvement programs. Here, we demonstrate an optical method based on Raman spectroscopy to separate X- and Y-chromosome-bearing sperm cells, overcoming many of the limitations associated with current sex-sorting protocols. A priori Raman imaging of bull spermatozoa was utilized to select the sampling points (head-neck region), which were then used to discriminate cells based on a spectral classification model. Main variations of Raman peaks associated with the DNA content were observed together with a variation due to the sex membrane proteins. Next, we used principal component analysis to determine the efficiency of our device as a cell sorting method. The results (>90% accuracy) demonstrated that Raman spectroscopy is a powerful candidate for the development of a highly efficient, non-invasive, and non-destructive tool for sperm sexing.

  5. Non-invasive sex assessment in bovine semen by Raman spectroscopy

    International Nuclear Information System (INIS)

    De Luca, A C; Managó, S; Ferrara, M A; Rendina, I; Sirleto, L; Coppola, G; Puglisi, R; Balduzzi, D; Galli, A; Ferraro, P

    2014-01-01

    X- and Y-chromosome-bearing sperm cell sorting is of great interest, especially for animal production management systems and genetic improvement programs. Here, we demonstrate an optical method based on Raman spectroscopy to separate X- and Y-chromosome-bearing sperm cells, overcoming many of the limitations associated with current sex-sorting protocols. A priori Raman imaging of bull spermatozoa was utilized to select the sampling points (head-neck region), which were then used to discriminate cells based on a spectral classification model. Main variations of Raman peaks associated with the DNA content were observed together with a variation due to the sex membrane proteins. Next, we used principal component analysis to determine the efficiency of our device as a cell sorting method. The results (>90% accuracy) demonstrated that Raman spectroscopy is a powerful candidate for the development of a highly efficient, non-invasive, and non-destructive tool for sperm sexing. (letters)

  6. Drug detection in breath: non-invasive assessment of illicit or pharmaceutical drugs.

    Science.gov (United States)

    Trefz, Phillip; Kamysek, Svend; Fuchs, Patricia; Sukul, Pritam; Schubert, Jochen K; Miekisch, Wolfram

    2017-03-20

    Breath analysis not only holds great potential for the development of new non-invasive diagnostic methods, but also for the identification and follow up of drug levels in breath. This is of interest for both, forensic and medical science. On the one hand, the detection of drugs of abuse in exhaled breath-similar to the well-known breath alcohol tests-would be highly desirable as an alternative to blood or urine analysis in situations such as police controls for drugged driving. The non-invasive detection of drugs and their metabolites is thus of great interest in forensic science, especially since marijuana is becoming legalized in certain parts of the US and the EU. The detection and monitoring of medical drugs in exhaled breath without the need of drawing blood samples on the other hand, is of high relevance in the clinical environment. This could facilitate a more precise medication and enable therapy control without any burden to the patient. Furthermore, it could be a step towards personalized medicine. This review gives an overview of the current state of drug detection in breath, including both volatile and non-volatile substances. The review is divided into two sections. The first section deals with qualitative detection of drugs (drugs of abuse), while the second is related to quantitative drug detection (medical drugs). Chances and limitations are discussed for both aspects. The detection of the intravenous anesthetic propofol is presented as a detailed example that demonstrates the potential, requirements, pitfalls and limitations of therapeutic drug monitoring by means of breath analysis.

  7. A Novel Stretch Sensor to Measure Venous Hemodynamics

    Directory of Open Access Journals (Sweden)

    Syrpailyne Wankhar

    2018-07-01

    Full Text Available Chronic venous insufficiency is a debilitating condition causing varicose veins and venous ulcers. The pathophysiology includes reflux and venous obstruction. The diagnosis is often made by clinical examination and confirmed by Venous Doppler studies. Plethysmography helps to quantitatively examine the reflux and diagnose the burden of deep venous pathology to better understand venous hemodynamics, which is not elicited by venous duplex examination alone. However, most of these tests are qualitative, expensive, and not easily available. In this paper, we demonstrate the potential use of a novel stretch sensor in the assessment of venous hemodynamics during different maneuvers by measuring the change in calf circumference. We designed the stretch sensor by using semiconductor strain gauges pasted onto a small metal bar to form a load cell. The elastic and Velcro material attached to the load cell form a belt. It converts the change in limb circumference to a proportional tension (force of distension when placed around the calf muscle. We recorded the change in limb circumference from arrays of stretch sensors by using an in-house data acquisition system. We calculated the venous volume (VV, venous filling index (VFI, ejection fraction (EF and residual venous volume (RVV on two normal subjects and on two patients to assess venous hemodynamics. The values (VV > 60 ml, VFI 60%, RVV 2ml/s, EF 35% in patients were comparable to those reported in the literature.

  8. Assessment of knee alignment with varus and valgus force through the range of flexion with non-invasive navigation.

    Science.gov (United States)

    Henderson, F; Alho, R; Riches, P; Picard, F

    2017-08-01

    In image-free total knee arthroplasty (TKA) navigation, infra-red markers are attached to bony landmarks to provide kinematic data intra-operatively, with the aim of improving the precision of implant placement. In non-invasive navigation, infra-red markers are attached to the skin surface, with recent evidence suggesting that this can give repeatable measurements of lower limb mechanical alignment. The aim of our study was to evaluate the use of a non-invasive navigation system in the assessment of mechanical alignment with applied coronal force through the range of flexion. A previously validated non-invasive system (Physiopilot™) was tested on 23 volunteers with healthy knees. Two users performed two registrations of the software workflow on each participant's right and left knees. A force was manually applied to the end-point of varus and valgus knee laxity and the measured change in mechanical alignment was recorded. Force was applied with the knee positioned in increments of flexion from 0 to 90°. In keeping with previous studies, satisfactory values of coefficient of repeatability (CR) of 1.55 and 1.33 were found for intra-observer repeatability in measurement of supine mechanical femoro-tibial angle (MFTA) in extension, with a good inter-observer correlation of intraclass correlation coefficient (ICC) .72. However, when flexion was introduced, intra-observer and inter-observer reliability fell out with acceptable limits. Therefore, the trial did not support use of the Physiopilot™ system as a measure of MFTA when flexion is introduced. It was felt that learning-curve, soft tissue artefacts and lack of force standardisation equipment may have accounted for significant levels of error, with further studies required to address these issues.

  9. Predicting ICU hemodynamic instability using continuous multiparameter trends.

    Science.gov (United States)

    Cao, Hanqing; Eshelman, Larry; Chbat, Nicolas; Nielsen, Larry; Gross, Brian; Saeed, Mohammed

    2008-01-01

    Identifying hemodynamically unstable patients in a timely fashion in intensive care units (ICUs) is crucial because it can lead to earlier interventions and thus to potentially better patient outcomes. Current alert algorithms are typically limited to detecting dangerous conditions only after they have occurred and suffer from high false alert rates. Our objective was to predict hemodynamic instability at least two hours before a major clinical intervention (e.g., vasopressor administration), while maintaining a low false alert rate. From the MIMIC II database, containing ICU minute-by-minute heart rate (HR) and invasive arterial blood pressure (BP) monitoring trend data collected between 2001 and 2005, we identified 132 stable and 104 unstable patients that met our stability-instability criteria and had sufficient data points. We first derived additional physiological parameters of shock index, rate pressure product, heart rate variability, and two measures of trending based on HR and BP. Then we developed 220 statistical features and systematically selected a small set to use for classification. We applied multi-variable logistic regression modeling to do classification and implemented validation via bootstrapping. Area under receiver-operating curve (ROC) 0.83+/-0.03, sensitivity 0.75+/-0.06, and specificity 0.80+/-0.07; if the specificity is targeted at 0.90, then the sensitivity is 0.57+/-0.07. Based on our preliminary results, we conclude that the algorithms we developed using HR and BP trend data may provide a promising perspective toward reliable predictive alerts for hemodynamically unstable patients.

  10. [Part II: basic hemodynamic monitoring and the use of pulmonary artery catheter].

    Science.gov (United States)

    Dias, Fernando Suparregui; Rezende, Ederlon; Mendes, Ciro Leite; Réa-Neto, Alvaro; David, Cid Marcos; Schettino, Guilherme; Lobo, Suzana Margareth Ajeje; Barros, Alberto; Silva, Eliézer; Friedman, Gilberto; Amaral, José Luiz Gomes do; Park, Marcelo; Monachini, Maristela; Oliveira, Mirella Cristine de; Assunção, Murillo Santucci César; Akamine, Nelson; Mello, Patrícia Veiga C; Pereira, Renata Andréa Pietro; Costa Filho, Rubens; Araújo, Sebastião; Félix Pinto, Sérgio; Ferreira, Sérgio; Mitushima, Simone Mattoso; Agareno, Sydney; Brilhante, Yuzeth Nóbrega de Assis

    2006-03-01

    Monitoring of vital functions is one of the most important tools in the management of critically ill patients. Nowadays is possible to detect and analyze a great deal of physiologic data using a lot of invasive and non-invasive methods. The intensivist must be able to select and carry out the most appropriate monitoring technique according to the patient requirements and taking into account the benefit/risk ratio. Despite the fast development of non invasive monitoring techniques, invasive hemodynamic monitoring using Pulmonary Artery Catheter still is one of the basic procedures in Critical Care. The aim was to define recommendations about clinical utility of basic hemodynamic monitoring methods and the Use of Pulmonary Artery Catheter. Modified Delphi methodology was used to create and quantify the consensus between the participants. AMIB indicated a coordinator who invited more six experts in the area of monitoring and hemodynamic support to constitute the Consensus Advisory Board. Twenty-five physicians and nurses selected from different regions of the country completed the expert panel, which reviewed the pertinent bibliography listed at the MEDLINE in the period from 1996 to 2004. Recommendations were made based on 55 questions about the use of central venous pressure, invasive arterial pressure, pulmonary artery catheter and its indications in different settings. Evaluation of central venous pressure and invasive arterial pressure, besides variables obtained by the PAC allow the understanding of cardiovascular physiology that is of great value to the care of critically ill patients. However, the correct use of these tools is fundamental to achieve the benefits due to its use.

  11. Invasive alien species in the food chain: Advancing risk assessment models to address climate change, economics and uncertainty

    Directory of Open Access Journals (Sweden)

    Darren Kriticos

    2013-09-01

    Full Text Available Pest risk maps illustrate where invasive alien arthropods, molluscs, pathogens, and weeds might become established, spread, and cause harm to natural and agricultural resources within a pest risk area. Such maps can be powerful tools to assist policymakers in matters of international trade, domestic quarantines, biosecurity surveillance, or pest-incursion responses. The International Pest Risk Mapping Workgroup (IPRMW is a group of ecologists, economists, modellers, and practising risk analysts who are committed to improving the methods used to estimate risks posed by invasive alien species to agricultural and natural resources. The group also strives to improve communication about pest risks to biosecurity, production, and natural-resource-sector stakeholders so that risks can be better managed. The IPRMW previously identified ten activities to improve pest risk assessment procedures, among these were: “improve representations of uncertainty, … expand communications with decision-makers on the interpretation and use of risk maps, … increase international collaboration, … incorporate climate change, … [and] study how human and biological dimensions interact” (Venette et al. 2010.

  12. Optimal hemodynamic response model for functional near-infrared spectroscopy

    Directory of Open Access Journals (Sweden)

    Muhammad Ahmad Kamran

    2015-06-01

    Full Text Available Functional near-infrared spectroscopy (fNIRS is an emerging non-invasive brain imaging technique and measures brain activities by means of near-infrared light of 650-950 nm wavelengths. The cortical hemodynamic response (HR differs in attributes at different brain regions and on repetition of trials, even if the experimental paradigm is kept exactly the same. Therefore, an HR model that can estimate such variations in the response is the objective of this research. The canonical hemodynamic response function (cHRF is modeled by using two Gamma functions with six unknown parameters. The HRF model is supposed to be linear combination of HRF, baseline and physiological noises (amplitudes and frequencies of physiological noises are supposed to be unknown. An objective function is developed as a square of the residuals with constraints on twelve free parameters. The formulated problem is solved by using an iterative optimization algorithm to estimate the unknown parameters in the model. Inter-subject variations in HRF and physiological noises have been estimated for better cortical functional maps. The accuracy of the algorithm has been verified using ten real and fifteen simulated data sets. Ten healthy subjects participated in the experiment and their HRF for finger-tapping tasks have been estimated and analyzed. The statistical significance of the estimated activity strength parameters has been verified by employing statistical analysis, i.e., (t-value >tcritical and p-value < 0.05.

  13. Hemodynamic Effects of Glucagon - A Literature Review

    DEFF Research Database (Denmark)

    Meidahl Petersen, Kasper; Bøgevig, Søren; Holst, Jens Juul

    2018-01-01

    Context: Glucagon's effects on hemodynamic parameters - most notably heart rate and cardiac contractility - are overlooked. The glucagon receptor is a central target in novel and anticipated type 2 diabetes therapies and hemodynamic consequences of glucagon signaling have therefore become increas...... is low and observations in published studies are inconsistent. Actual effects, inter-individual variation, dose-response relationships and possible long-term effects of supra-physiological glucagon levels warrant further investigation....

  14. Public Perception of Invasive Plant Species: Assessing the Impact of Workshop Activities to Promote Young Students' Awareness

    Science.gov (United States)

    Schreck Reis, Catarina; Marchante, Helia; Freitas, Helena; Marchante, Elizabete

    2013-01-01

    Invasive species are one of the main threats to biodiversity worldwide. Even though they are identified and recognized as such by the Portuguese law, the majority of the population is not yet aware of this problem. Aiming to increase awareness about biological invasions among young students, a workshop on Invasive Plant Species was organized at…

  15. Central Hemodynamics and Microcirculation in Critical Conditions

    Directory of Open Access Journals (Sweden)

    A. A. Kosovskikh

    2013-01-01

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

  16. Functional assessment of cerebral artery stenosis: A pilot study based on computational fluid dynamics.

    Science.gov (United States)

    Liu, Jia; Yan, Zhengzheng; Pu, Yuehua; Shiu, Wen-Shin; Wu, Jianhuang; Chen, Rongliang; Leng, Xinyi; Qin, Haiqiang; Liu, Xin; Jia, Baixue; Song, Ligang; Wang, Yilong; Miao, Zhongrong; Wang, Yongjun; Liu, Liping; Cai, Xiao-Chuan

    2017-07-01

    The fractional pressure ratio is introduced to quantitatively assess the hemodynamic significance of severe intracranial stenosis. A computational fluid dynamics-based method is proposed to non-invasively compute the FPR CFD and compared against fractional pressure ratio measured by an invasive technique. Eleven patients with severe intracranial stenosis considered for endovascular intervention were recruited and an invasive procedure was performed to measure the distal and the aortic pressure ( P d and P a ). The fractional pressure ratio was calculated as [Formula: see text]. The computed tomography angiography was used to reconstruct three-dimensional (3D) arteries for each patient. Cerebral hemodynamics was then computed for the arteries using a mathematical model governed by Navier-Stokes equations and with the outflow conditions imposed by a model of distal resistance and compliance. The non-invasive [Formula: see text], [Formula: see text], and FPR CFD were then obtained from the computational fluid dynamics calculation using a 16-core parallel computer. The invasive and non-invasive parameters were tested by statistical analysis. For this group of patients, the computational fluid dynamics method achieved comparable results with the invasive measurements. The fractional pressure ratio and FPR CFD are very close and highly correlated, but not linearly proportional, with the percentage of stenosis. The proposed computational fluid dynamics method can potentially be useful in assessing the functional alteration of cerebral stenosis.

  17. Hemodynamics driven cardiac valve morphogenesis.

    Science.gov (United States)

    Steed, Emily; Boselli, Francesco; Vermot, Julien

    2016-07-01

    Mechanical forces are instrumental to cardiovascular development and physiology. The heart beats approximately 2.6 billion times in a human lifetime and heart valves ensure that these contractions result in an efficient, unidirectional flow of the blood. Composed of endocardial cells (EdCs) and extracellular matrix (ECM), cardiac valves are among the most mechanically challenged structures of the body both during and after their development. Understanding how hemodynamic forces modulate cardiovascular function and morphogenesis is key to unraveling the relationship between normal and pathological cardiovascular development and physiology. Most valve diseases have their origins in embryogenesis, either as signs of abnormal developmental processes or the aberrant re-expression of fetal gene programs normally quiescent in adulthood. Here we review recent discoveries in the mechanobiology of cardiac valve development and introduce the latest technologies being developed in the zebrafish, including live cell imaging and optical technologies, as well as modeling approaches that are currently transforming this field. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. Copyright © 2015. Published by Elsevier B.V.

  18. Non-invasive assessment of changes in corticomotoneuronal transmission in humans

    DEFF Research Database (Denmark)

    Taube, Wolfgang; Leukel, Christian; Nielsen, Jens Bo

    2017-01-01

    called H-reflex conditioning technique allows one to assess excitability of the fastest (monosynaptic) and also polysynaptic corticospinal pathways. Furthermore, by using two different stimulation sites, the motor cortex and the cervicomedullary junction, it allows not only differentiation between...... cortical and spinal effects but also assessment of transmission at the corticomotoneural synapse. In this manuscript, we describe how this method can be used to assess corticomotoneural transmission after low-frequency repetitive transcranial magnetic stimulation, a method that was previously shown...

  19. Non-invasive assessment of corneal crosslinking changes using polarization sensitive optical coherence tomography

    Science.gov (United States)

    Alonso-Caneiro, D.; Yamanari, M.; Fukuda, S.; Hoshi, S.; Nagase, S.; Oshika, T.; Yasuno, Y.; Collins, M.

    2013-03-01

    Collagen crosslinking (CXL) has shown promising results in the prevention of the progression of keratoconus and corneal ectasia. However, techniques for in vivo and in situ assessment of the treatment are limited. In this study, ex vivo porcine eyes were treated with a chemical CXL agent (glutaraldehyde), during which polarization sensitive optical coherence tomography (PS-OCT) recordings were acquired simultaneously to assess the sensitivity of the technique to assess changes in the cornea. The results obtained in this study suggest that PSOCT may be a suitable technique to measure CXL changes in situ and to assess the local changes in the treated region of the cornea.

  20. Rapid assessment of populations trends of invasive species: Singular Spectrum Analysis (SSA

    Directory of Open Access Journals (Sweden)

    DANA, ED

    2010-01-01

    Full Text Available Singular Spectrum Analysis (SSA is a powerful analytical approach for biodi-versity management. Its main advan-tages are due to its intuitive processing and visualization, since mathematical workflow is conceptually similar to the widely accepted Principal Components Analysis. Detailed analyses of popula-tion trends with mathematical tools are often difficult to achieve for managers by a number of reasons (large numbers or areas monitored, large number of species, insufficient statistics skills, strong knowledge level in demographic analyses, etc.. SSA has been used since the 1970’s in signal processing to clarify signal vs. noisy information, but it has also been used in climate change analy-sis and other developmental areas. Be-sides, SSA is a rapid-learning method for technicians and managers with medium level of mathematical knowledge. Free software in Unix environment is avail-able. Unfortunately, no free and friendly software is available for Win-dows SO. Although R package may offer solutions for really advanced users, it does not fit real work situations for managers of biological invasions. Cater-pillar (Gistat Group, Ltd is by now, the best option found by the author in terms of price, facility for results inter-pretation and time consumed in learn-ing. The main disadvantage is the poor content of tutorial files

  1. Controlling the invasive diatom Didymosphenia geminata: an ecotoxicity assessment of four potential biocides.

    Science.gov (United States)

    Jellyman, P G; Clearwater, S J; Clayton, J S; Kilroy, C; Blair, N; Hickey, C W; Biggs, B J F

    2011-07-01

    In 2004, an invasive mat-forming freshwater diatom, Didymosphenia geminata (didymo), was found in New Zealand causing concern with regard to potential consequences for local freshwater ecosystems. A four-stage research program was initiated to identify methods to control D. geminata. This article reports the results of Stage 2, in which four potential control compounds [Gemex™ (a chelated copper formulation), EDTA, Hydrothol®191, and Organic Interceptor™ (a pine oil formulation)] selected in Stage 1 were evaluated for their biocidal efficacy on D. geminata and effects on non-target organisms using both artificial stream and laboratory trials. Artificial stream trials evaluated the mortality rates of D. geminata and fishes to three concentrations of the four biocides, whereas laboratory toxicity trials tested the response of green alga and cladocera to a range of biocide concentrations and exposure times. In artificial stream trials, Gemex and Organic Interceptor were the most effective biocides against D. geminata for a number of measured indices; however, exposure of fishes to Organic Interceptor resulted in high mortality rates. Laboratory toxicity testing indicated that Gemex might negatively affect sensitive stream invertebrates, based on the cladoceran sensitivity at the proposed river control dose. A decision support matrix evaluated the four biocides based on nine criteria stipulated by river stakeholders (effectiveness, non-target species impacts, stalk removal, degradation profile, risks to health and safety, ease of application, neutralization potential, cost, and local regulatory requirements) and Gemex was identified as the product warranting further refinement prior to an in-river trial.

  2. Non-invasive assessment of choledocholithiasis in patients with gallstones and abnormal liver function.

    Science.gov (United States)

    Al-Jiffry, Bilal O; Elfateh, Abdeen; Chundrigar, Tariq; Othman, Bassem; Almalki, Owaid; Rayza, Fares; Niyaz, Hashem; Elmakhzangy, Hesham; Hatem, Mohammed

    2013-09-21

    To find a non-invasive strategy for detecting choledocholithiasis before cholecystectomy, with an acceptable negative rate of endoscopic retrograde cholangiopancreatography. All patients with symptomatic gallstones were included in the study. Patients with abnormal liver functions and common bile duct abnormalities on ultrasound were referred for endoscopic retrograde cholangiopancreatography. Patients with normal ultrasound were referred to magnetic resonance cholangiopancreatography. All those who had a negative magnetic resonance or endoscopic retrograde cholangiopancreatography underwent laparoscopic cholecystectomy with intraoperative cholangiography. Seventy-eight point five percent of patients had laparoscopic cholecystectomy directly with no further investigations. Twenty-one point five percent had abnormal liver function tests, of which 52.8% had normal ultrasound results. This strategy avoided unnecessary magnetic resonance cholangiopancreatography in 47.2% of patients with abnormal liver function tests with a negative endoscopic retrograde cholangiopancreatography rate of 10%. It also avoided un-necessary endoscopic retrograde cholangiopancreatography in 35.2% of patients with abnormal liver function. This strategy reduces the cost of the routine use of magnetic resonance cholangiopancreatography, in the diagnosis and treatment of common bile duct stones before laparoscopic cholecystectomy.

  3. Non-invasive baroreflex sensitivity assessment using wavelet transfer function-based time–frequency analysis

    International Nuclear Information System (INIS)

    Keissar, K; Gilad, O; Maestri, R; Pinna, G D; La Rovere, M T

    2010-01-01

    A novel approach for the estimation of baroreflex sensitivity (BRS) is introduced based on time–frequency analysis of the transfer function (TF). The TF method (TF-BRS) is a well-established non-invasive technique which assumes stationarity. This condition is difficult to meet, especially in cardiac patients. In this study, the classical TF was replaced with a wavelet transfer function (WTF) and the classical coherence was replaced with wavelet transform coherence (WTC), adding the time domain as an additional degree of freedom with dynamic error estimation. Error analysis and comparison between WTF-BRS and TF-BRS were performed using simulated signals with known transfer function and added noise. Similar comparisons were performed for ECG and blood pressure signals, in the supine position, of 19 normal subjects, 44 patients with a history of previous myocardial infarction (MI) and 45 patients with chronic heart failure. This yielded an excellent linear association (R > 0.94, p < 0.001) for time-averaged WTF-BRS, validating the new method as consistent with a known method. The additional advantage of dynamic analysis of coherence and TF estimates was illustrated in two physiological examples of supine rest and change of posture showing the evolution of BRS synchronized with its error estimations and sympathovagal balance

  4. Non-invasive assessment of equine muscular function: A case study ...

    African Journals Online (AJOL)

    Assessment of muscle function after an injury or during recovery is of great importance in the veterinary field. Accelerometry, bioimpedance analysis and mechanomyography/acoustic myography have been used to assess human muscular problems, but have not been applied to the veterinary clinic. We report the clinical ...

  5. Non-invasive assessment of equine muscular function: A case study

    Directory of Open Access Journals (Sweden)

    K.H. Riis

    2013-07-01

    Full Text Available Assessment of muscle function after an injury or during recovery is of great importance in the veterinary field. Accelerometry, bioimpedance analysis and mechanomyography/acoustic myography have been used to assess human muscular problems, but have not been applied to the veterinary clinic. We report the clinical use of these techniques in a 12-year-old Danish Warmblood horse presenting with recurring and shifting lameness. Acoustic myography, assessing both the amplitude and frequency of active muscles, was employed to locate the specific area of muscle injury, the right hip, which exhibited minimal fibre recruitment giving rise to considerable weakness. This specific region was assessed by accelerometry which revealed a normal step interval for the injured leg when compared with the contralateral, but a weaker acceleration and strike force. Finally, an assessment of muscle resistance (R and reactance (Xc using bioimpedance confirmed a regional loss of muscle mass and a loss of cellular integrity compared with the contralateral limb.

  6. Lack of evidence for an association between hemodynamic variables and hematoma growth in spontaneous intracerebral hemorrhage.

    Science.gov (United States)

    Jauch, Edward C; Lindsell, Christopher J; Adeoye, Opeolu; Khoury, Jane; Barsan, William; Broderick, Joseph; Pancioli, Arthur; Brott, Thomas

    2006-08-01

    Early hematoma expansion in spontaneous intracerebral hemorrhage (ICH) is associated with worse clinical outcome. We hypothesized that hemodynamic parameters are associated with the increase in hematoma volume owing to their relationship to blood vessel wall stresses. We performed a post hoc analysis of clinical and computed tomography (CT) data from patients enrolled in a prospective observational study of ICH patients presenting within 3 hours from symptom onset. Hematoma volumes were measured at hospital arrival and at 1 and 20 hours from presentation. Blood pressure and heart rate, recorded at 19 time points between presentation and 20 hours, were used to derive hemodynamic variables. Multivariable logistic-regression models were constructed to assess the relation between hemodynamic parameters and hematoma growth, adjusted for clinical covariates. From the original study, 98 patients underwent baseline and 1-hour CT scans; of these, 65 had 20-hour CT scans. Substantial hematoma growth was observed in 28% within the first hour. Of the 65 patients not undergoing surgery within 20 hours, 37% experienced hematoma growth by 20 hours. Neither baseline or peak hemodynamic parameters nor changes in hemodynamic parameters were significantly associated with hematoma growth at either 1 or 20 hours. We found no blood pressure or heart rate parameters, individually or in combination, that were associated with hematoma growth. Our data suggest the influence of hemodynamic parameters on vessel wall stress to be an unlikely target for intervention in reducing the risk of early hematoma growth in ICH.

  7. Relationship between systemic hemodynamics and ambulatory blood pressure level are sex dependent.

    Science.gov (United States)

    Alfie, J; Waisman, G D; Galarza, C R; Magi, M I; Vasvari, F; Mayorga, L M; Cámera, M I

    1995-12-01

    Sex-related differences in systemic hemodynamics were analyzed by means of cardiac index and systemic vascular resistance according to the level of daytime ambulatory blood pressure. In addition, we assessed the relations between ambulatory blood pressure measurements and systemic hemodynamics in male and female patients. We prospectively included 52 women and 53 men referred to our unit for evaluation of arterial hypertension. Women and men were grouped according to the level of daytime mean arterial pressure: or = 110 mm Hg. Patients underwent noninvasive evaluation of resting hemodynamics (impedance cardiography) and 24-hour ambulatory blood pressure monitoring. Compared with women men with lower daytime blood pressure had a 12% higher systemic vascular resistance index (P = NS) and a 14% lower cardiac index (P < .02), whereas men with higher daytime blood pressure had a 25% higher vascular resistance (P < .003) and a 21% lower cardiac index (P < .0004). Furthermore, in men systemic vascular resistance correlated positively with both daytime and nighttime systolic and diastolic blood pressures, whereas cardiac index correlated negatively only with daytime diastolic blood pressure. In contrast, women did not exhibit any significant correlation between hemodynamic parameters and ambulatory blood pressure measurements. In conclusion, sex-related differences in systemic hemodynamics were more pronounced in the group with higher daytime hypertension. The relations between systemic hemodynamics and ambulatory blood pressure level depended on the sex of the patient. In men a progressive circulatory impairment underlies the increasing level of ambulatory blood pressure, but this was not observed in women.

  8. Hemodynamic Consequences of Laparoscopy for Patients on Mechanical Circulatory Support.

    Science.gov (United States)

    Reich, Heidi; Ramzy, Danny; Czer, Lawrence; Esmailian, Fardad; Moriguchi, Jaime; Ihnken, Kai; Yusufali, Taizoon; D'Attellis, Nicola; Arabia, Francisco; Annamalai, Alagappan

    2015-12-01

    Technologic advances and superior survival with mechanical circulatory support (MCS) have led to an expanding population that develops intraabdominal conditions requiring intervention. Whether laparoscopy can be performed without detrimental effects on hemodynamics and device function is not well described. Effects of laparoscopy performed on MCS were retrospectively assessed. Intraoperative hemodynamics and device function were compared with the same time interval 24 hours prior to surgery using intrapatient paired t tests. Outcomes included survival, transfusion, thromboembolic events, and infection. Twelve patients with ventricular assist devices or total artificial hearts underwent laparoscopy from 2012 to 2014. Median follow-up was 116 days. Operations included cholecystectomy, diagnostic laparoscopy, gastrojejunostomy, and gastrostomy. There were no differences between preoperative and intraoperative mean arterial pressure, heart rate, and inotrope or vasopressor requirements (P > .05). Device fill volume, flow, rate, and power were unchanged (P > .05), whereas pulsatility index decreased by 0.2 (95% confidence interval, 0.03, 0.36) with laparoscopy (P = .03). All intraoperative fluctuations in hemodynamics and device function improved with reduction of pneumoperitoneum, adjusting device speed, or pharmacologic support. There were no operative mortalities. Thirty-day survival and survival to discharge were 75% and 50%, respectively. Despite antiplatelet therapy and preoperative international normalization ratio of 2.2 ± 0.9, there were no re-operations for bleeding, and 50% did not require transfusion. Two patients with recent cardiac surgery had thromboembolic events: one stroke and one device thrombus. None had postoperative bacteremia or driveline infection. Laparoscopy can be performed on MCS with low morbidity and mortality and minimal perturbations in hemodynamics and device function.

  9. Non-Invasive Assessment of Skin Barrier Properties: Investigating Emerging Tools for In Vitro and In Vivo Applications

    Directory of Open Access Journals (Sweden)

    Emer Duffy

    2017-10-01

    Full Text Available There is increasing interest in the development of non-invasive tools for studying the properties of skin, due to the potential for non-destructive sampling, reduced ethical concerns and the potential comparability of results in vivo and in vitro. The present research focuses on the use of a range of non-invasive approaches for studying skin and skin barrier properties in human skin and human skin equivalents (HSE. Analytical methods used include pH measurements, electrical sensing of the epidermis and detection of volatile metabolic skin products. Standard probe based measurements of pH and the tissue dielectric constant (TDC are used. Two other more novel approaches that utilise wearable platforms are also demonstrated here that can assess the electrical properties of skin and to profile skin volatile species. The potential utility of these wearable tools that permit repeatability of testing and comparability of results is considered through application of our recently reported impedance-based tattoo sensors and volatile samplers on both human participants and HSEs. The HSE exhibited a higher pH (6.5 and TDC (56 than human skin (pH 4.9–5.6, TDC 29–36, and the tattoo sensor revealed a lower impedance signal for HSEs, suggesting the model could maintain homeostasis, but in a different manner to human skin, which demonstrated a more highly resistive barrier. Characterisation of volatiles showed a variety of compound classes emanating from skin, with 16 and 27 compounds identified in HSEs and participants respectively. The continuing development of these tools offers potential for improved quality and relevance of data, and potential for detection of changes that are undetectable in traditional palpable and visual assessments, permitting early detection of irritant reactions.

  10. Serial assessment of pulmonary lesion volume by computed tomography allows survival prediction in invasive pulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Vehreschild, J.J.; Vehreschild, M.J.G.T. [University Hospital of Cologne, Department I of Internal Medicine, Cologne (Germany); German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne (Germany); Heussel, C.P. [Chest Clinic at University Hospital Heidelberg, Diagnostic and Interventional Radiology with Nuclear Medicine, Heidelberg (Germany); University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg (Germany); Groll, A.H. [University Children' s Hospital, Infectious Disease Research Program, Department of Paediatric Haematology/Oncology, Muenster (Germany); Silling, G. [University of Muenster, Department of Medicine A, Haematology/Oncology, Muenster (Germany); Wuerthwein, G. [University Hospital Muenster, Centre for Clinical Trials, ZKS Muenster (Germany); Brecht, M. [Chest Clinic at University Hospital Heidelberg, Diagnostic and Interventional Radiology with Nuclear Medicine, Heidelberg (Germany); Cornely, O.A. [University Hospital of Cologne, Department I of Internal Medicine, Cologne (Germany); University of Cologne, Clinical Trials Center Cologne, ZKS Koeln (BMBF 01KN1106), Cologne (Germany); Center for Integrated Oncology CIO Koeln Bonn, Cologne (Germany); University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne (Germany)

    2017-08-15

    Serial chest CT is the standard of care to establish treatment success in invasive pulmonary aspergillosis (IPA). Data are lacking how response should be defined. Digital CT images from a clinical trial on treatment of IPA were re-evaluated and compared with available biomarkers. Total volume of pneumonia was added up after manual measurement of each lesion, followed by statistical analysis. One-hundred and ninety CT scans and 309 follow-up datasets from 40 patients were available for analysis. Thirty-one were neutropenic. Baseline galactomannan (OR 4.06, 95%CI: 1.08-15.31) and lesion volume (OR 3.14, 95%CI: 0.73-13.52) were predictive of death. Lesion volume at d7 and trend between d7 and d14 were strong predictors of death (OR 20.01, 95%CI: 1.42-282.00 and OR 15.97, 95%CI: 1.62-157.32) and treatment being rated as unsuccessful (OR 4.75, 95%CI: 0.94-24.05 and OR 40.69, 95%CI: 2.55-649.03), which was confirmed by a Cox proportional hazards model using time-dependent covariates. Any increase in CT lesion volume between day 7 and day 14 was a sensitive marker of a lethal outcome (>50%), supporting a CT rescan each one and 2 weeks after initial detection of IPA. The predictive value exceeded all other biomarkers. Further CT follow-up after response at day 14 was of low additional value. (orig.)

  11. Perfusion index variations in clinically and hemodynamically stable preterm newborns in the first week of life

    Directory of Open Access Journals (Sweden)

    Farinasso Daniela

    2010-01-01

    Full Text Available Abstract Background The perfusion index, derived from the pulse oximeter signal, seems to be an accurate predictor for high illness severity in newborns. The aim of this study was to determine the perfusion index values of clinically and hemodynamically stable preterm newborns in the first week of life. Methods Perfusion index recordings were performed on the first, third and seventh day of life on 30 preterm newborns. Their state of health was assessed according to clinical and behaviour evaluation and to the Score for Neonatal Acute Physiology. Results The median(interquartile range perfusion index values were 0.9(0.6 on the first, 1.2(1.0 on the third, and 1.3(0.9 on the seventh day, with a significant increase between the first and the third day. Conclusions Perfusion index proved to be an easily applicable, non-invasive method for monitoring early postnatal changes in peripheral perfusion. Its trend during the first week of life suggests that its clinical application should take age into account. Further studies are needed to obtain reference perfusion index values from a larger sample of preterm newborns, to identify specific gestational age-related cut-off values for illness and to test the role of perfusion index in monitoring critically ill neonates.

  12. A Simple Model to Assess the Probability of Invasion in Ductal Carcinoma In Situ of the Breast Diagnosed by Needle Biopsy

    Directory of Open Access Journals (Sweden)

    Oldřich Coufal

    2014-01-01

    Full Text Available Objectives. The aim of the study was to develop a clinical prediction model for assessing the probability of having invasive cancer in the definitive surgical resection specimen in patients with biopsy diagnosis of ductal carcinoma in situ (DCIS of the breast, to facilitate decision making regarding axillary surgery. Methods. In 349 women with DCIS, predictors of invasion in the definitive resection specimen were identified. A model to predict the probability of invasion was developed and subsequently simplified to divide patients into two risk categories. The model’s performance was validated on another patient population. Results. Multivariate logistic regression revealed four independent predictors of invasion: (i suspicious (microinvasion in the biopsy specimen; (ii visibility of the lesion on ultrasonography; (iii size of the lesion on mammography >30 mm; (iv clinical palpability of the lesion. The actual frequency of invasion in the high-risk patient group in the test and validation population was 52.6% and 48.3%, respectively; in the low-risk group it was 16.8% and 7.1%, respectively. Conclusion. The model proved to have good performance. In patients with a low probability of invasion, an axillary procedure can be omitted without a substantial risk of additional surgery.

  13. Review on Invasive Tree of Heaven (Ailanthus altissima (Mill.) Swingle) Conflicting Values: Assessment of Its Ecosystem Services and Potential Biological Threat.

    Science.gov (United States)

    Sladonja, Barbara; Sušek, Marta; Guillermic, Julia

    2015-10-01

    Globally, invasions by alien plants are rapidly increasing in extent and severity, leading to large-scale ecosystem degradation. One of the most widespread invasive alien plant species in Europe and North America, Tree of Heaven (Ailanthus altissima (Mill.) Swingle) was introduced intentionally for use as an ornamental plant in the 18th century. Since then, it has spread and is now frequently found in a number of countries. Today, Tree of Heaven is considered one of the worst invasive plant species in Europe and is also listed as invasive in North America and many other countries. Millennium Ecosystem Assessment is one of many systems trying to list and categorize biological services to humans and to provide a tool for identifying services delivered by natural ecosystems. Invasive species have generally caused degradation of the services, have a major impact on the environment, and are threatening biodiversity and reducing overall species abundance and diversity. On the other hand, some invasive species can provide services useful to human well-being. In the present review A. altissima impacts on ecosystems are identified and positive influences on some ecosystem services are weighed against the negative effects on the environment and human health. The aim of the present review is to resume the general knowledge of A. altissima, group available references on distribution and ecology according to countries, compare ecosystem services provided or enhanced by A. altissima presence and the negative effects it causes, identify gaps in current knowledge, and give recommendations for future lines of research.

  14. Comparison of Visual and automated assessment of Ki-67 proliferative activity and their impact on outcome in primary operable invasive ductal breast cancer

    OpenAIRE

    Mohammed, Z M A; McMillan, D C; Elsberger, B; Going, J J; Orange, C; Mallon, E; Doughty, J C; Edwards, J

    2012-01-01

    Background: Immunohistochemistry of Ki-67 protein is widely used to assess tumour proliferation, and is an established prognostic factor in breast cancer. There is interest in automating the assessment of Ki-67 labelling index (LI) with possible benefits in handling increased workload, with improved accuracy and precision. Patients and methods: Visual and automated assessment of Ki-67 LI and survival were examined in patients with primary operable invasive ductal breast cancer. Tissue microar...

  15. Non-Invasive Assessment of Internal and External Player Load: Implications for Optimizing Athletic Performance.

    Science.gov (United States)

    Heishman, Aaron D; Curtis, Michael A; Saliba, Ethan; Hornett, Robert J; Malin, Steven K; Weltman, Arthur L

    2018-01-24

    Few data exist that assess athlete tracking and monitoring for the development of strategies to optimize performance and reduce fatigue in elite athletes. The purpose of the present study was to assess the efficacy of external load and internal stress monitoring as assessment tools for examining a performance index of fatigue. A retrospective analysis was performed on data collected over the course of the pre-season in 10 elite male NCAA Division 1 basketball players. Internal stress was assessed using Omegawave Technology readiness scores and compared to the performance index of counter-movement jump (CMJ). The external load accumulated during the previous practice, quantified by PlayerLoad™ (PL; Catapult), was compared to CMJ values and Omegawave scores. The results indicated that high, compared to low CNS Omegawave Readiness Scores (6.7±05.1, 4.5±1.2AU; p Catapult technologies provide independent information related to performance and may be effective tools for monitoring athlete performance.

  16. Optical coherence tomography: a reliable alternative to invasive histological assessment of acute wound healing in human skin?

    Science.gov (United States)

    Greaves, N S; Benatar, B; Whiteside, S; Alonso-Rasgado, T; Baguneid, M; Bayat, A

    2014-04-01

    Gold-standard assessment of acute wound healing has traditionally been through histological analysis of biopsied tissue. However, this process is invasive with recognized side-effects. Optical coherence tomography (OCT) is a noninvasive technique generating high-resolution real-time images of cutaneous architecture. To compare OCT with histological assessment of in vivo acute wound healing and ascertain the level of agreement between modalities for measurement of defined cutaneous structures. Punch biopsies (5 mm) were harvested from 50 healthy volunteers. Wounds healed by secondary intention until they were re-excised 7, 14, 21 or 28 days later depending on random group allocation. Wounds were assessed weekly for 6 weeks using OCT and compared with histological findings derived from time-matched biopsies. Dimensions of four cutaneous structures were measured using both modalities and the level of agreement was established by Bland-Altman analysis. The mean greyscale value (MGV) of the upper reticular dermis was derived from OCT images at all time points. Both techniques showed anatomical congruity in normal and wounded skin with correlating architectural changes associated with inflammatory, proliferative and remodelling wound healing phases. MGV was significantly increased 6 weeks after wounding (P = 0·001) and may represent a novel measure of wound fibrosis. Despite good association of histomorphometric values with low but consistent bias (range -4·181 to 0·431 μm), Bland-Altman plots demonstrated poor agreement between OCT and histology. Optical coherence tomography enabled accurate assessment of healing tissue comparable with histological analysis of biopsy specimens. This noninvasive tool is highly suited to wound assessment and may represent a diagnostic alternative to punch biopsies. © 2013 British Association of Dermatologists.

  17. Biodiversity of Soil Microbial Communities Following Woody Plant Invasion of Grassland: An Assessment Using Molecular Methods

    Science.gov (United States)

    Kantola, I. B.; Gentry, T. J.; Filley, T. R.; Boutton, T. W.

    2012-12-01

    Woody plants have encroached into grasslands, savannas, and other grass-dominated ecosystems throughout the world during the last century. This dramatic vegetation change is likely driven by livestock grazing, altered fire frequencies, elevated atmospheric CO2 concentrations, and/or changes in atmospheric deposition patterns. Woody invasion often results in significant changes in ecosystem function, including alterations in above- and belowground primary productivity, soil C, N, and P storage and turnover, and the size and activity of the soil microbial biomass pool. The purpose of this study was to examine the relationships and interactions between plant communities and soil microbial communities in the Rio Grande Plains region of southern Texas where grasslands have been largely replaced by woodlands. Research was conducted along a successional chronosequence representing the stages of woody plant encroachment from open grassland to closed-canopy woodland. To characterize soil microbial community composition, soil samples (0-7.5 cm) were collected in remnant grasslands (representing time 0) and near the centers of woody plant clusters, groves, and drainage woodlands ranging in age from 10 to 130 yrs. Ages of woody plant stands were determined by dendrochronology. Community DNA was extracted from each soil sample with a MoBio PowerMax Soil DNA isolation kit. The DNA concentrations were quantified on a NanoDrop ND-1000 spectrophotometer and diluted to a standard concentration. Pyrosequencing was performed by the Research and Testing Laboratory (Lubbock, TX) according to Roche 454 Titanium chemistry protocols. Samples were amplified with primers 27F and 519R for bacteria, and primers ITS1F and ITS4 for fungi. Sequences were aligned using BioEdit and the RDP Pipeline and analyzed in MOTHUR. Non-metric multidimensional scaling of the operational taxonomic units identified by pyrosequencing revealed that both bacterial and fungal community composition were

  18. Systematic comparison of non-invasive measures for the assessment of atrial fibrillation complexity: a step forward towards standardization of atrial fibrillation electrogram analysis.

    Science.gov (United States)

    Bonizzi, Pietro; Zeemering, Stef; Karel, Joël M H; Di Marco, Luigi Y; Uldry, Laurent; Van Zaen, Jérôme; Vesin, Jean-Marc; Schotten, Ulrich

    2015-02-01

    To present a comparison of electrocardiogram-based non-invasive measures of atrial fibrillation (AF) substrate complexity computed on invasive animal recordings to discriminate between short-term and long-term AF. The final objective is the selection of an optimal sub-set of measures for AF complexity assessment. High-density epicardial direct contact mapping recordings (234 leads) were acquired from the right and the left atria of 17 goats in which AF was induced for 3 weeks (short-term AF group, N = 10) and 6 months (long-term AF group, N = 7). Several non-invasive measures of AF organization proposed in the literature in the last decade were investigated to assess their power in discriminating between the short-term and long-term group. The best performing measures were identified, which when combined attained a correct classification rate of 100%. Their ability to predict standard invasive AF complexity measures was also tested, showing an average R(2) of 0.73 ± 0.04. An optimal set of measures of the AF substrate complexity was identified out of the set of non-invasive measures analysed in this study. These measures may contribute to improve patient-tailored diagnosis and therapy of sustained AF. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  19. Hemodynamic volumetry using transpulmonary ultrasound dilution (TPUD) technology in a neonatal animal model.

    Science.gov (United States)

    Vrancken, Sabine L; van Heijst, Arno F; Hopman, Jeroen C; Liem, Kian D; van der Hoeven, Johannes G; de Boode, Willem P

    2015-10-01

    To analyze changes in cardiac output and hemodynamic volumes using transpulmonary ultrasound dilution (TPUD) in a neonatal animal model under different hemodynamic conditions. 7 lambs (3.5-8.3 kg) under general anesthesia received arterial and central venous catheters. A Gore-Tex(®) shunt was surgically inserted between the descending aorta and the left pulmonary artery to mimic a patent ductus arteriosus. After shunt opening and closure, induced hemorrhagic hypotension (by repetitive blood withdrawals) and repetitive volume challenges, the following parameters were assessed using TPUD: cardiac output, active circulating volume index (ACVI), central blood volume index (CBVI) and total end-diastolic volume index (TEDVI). 27 measurement sessions were analyzed. After shunt opening, there was a significant increase in TEDVI and a significant decrease in cardiac output with minimal change in CBVI and ACVI. With shunt closure, these results reversed. After progressive hemorrhage, cardiac output and all volumes decreased significantly, except for ACVI. Following repetitive volume resuscitation, cardiac output increased and all hemodynamic volumes increased significantly. Correlations between changes in COufp and changes in hemodynamic volumes (ACVI 0.83; CBVI 0.84 and TEDVI 0.78 respectively) were (slightly) better than between changes in COufp and changes in heart rate (0.44) and central venous pressure (0.7). Changes in hemodynamic volumes using TPUD were as expected under different conditions. Hemodynamic volumetry using TPUD might be a promising technique that has the potential to improve the assessment and interpretation of the hemodynamic status in critically ill newborns and children.

  20. Non-invasive assessment of right ventricular function at rest and on exercise in obstructive airways disease

    International Nuclear Information System (INIS)

    Tweddel, A.; Martin, W.; McGhie, I.; Neilly, B.; Stevenson, R.; Hutton, I.

    1985-01-01

    Non-invasive assessment of right ventricular function is of clinical interest in the patient with obstructive airways disease. Gated Xenon 133 scanning allows right ventricular function to be evaluated in isolation from the left ventricle, and with rapid clearance from the lungs, scans may be repeated within 5 minutes. 400mBq of Xenon 133 were injected intravenously over 20 seconds and images were obtained using a mobile gamma camera. Maximal symptom limited exercise was performed on a supine bicycle ergometer. The normal range for right ventricular ejection fraction (RVEF) was obtained from 10 volunteers - 40-55% at rest rising by 5-15% during exercise. In 10 patients with acute obstructive airways disease, all had reduced RVEF 21 +- 3%. In chronic obstructive airways disease, if resting RVEF was greater than 30%, ejection fraction increased on exercise. If resting ejection fraction was abnormal than RVEF was reduced or unchanged on exercise (mean 15 +- 9%), and this was associated with dilatation of both the right ventricle and atrium. In conclusion, gated Xenon 133 offers a simple method of assessing right ventricular function at rest and on exercise in the patient with obstructive airways disease

  1. Non-Invasive Assessment of Hepatic Fibrosis by Elastic Measurement of Liver Using Magnetic Resonance Tagging Images

    Directory of Open Access Journals (Sweden)

    Xuejun Zhang

    2018-03-01

    Full Text Available To date, the measurement of the stiffness of liver requires a special vibrational tool that limits its application in many hospitals. In this study, we developed a novel method for automatically assessing the elasticity of the liver without any use of contrast agents or mechanical devices. By calculating the non-rigid deformation of the liver from magnetic resonance (MR tagging images, the stiffness was quantified as the displacement of grids on the liver image during a forced exhalation cycle. Our methods include two major processes: (1 quantification of the non-rigid deformation as the bending energy (BE based on the thin-plate spline method in the spatial domain and (2 calculation of the difference in the power spectrum from the tagging images, by using fast Fourier transform in the frequency domain. By considering 34 cases (17 normal and 17 abnormal liver cases, a remarkable difference between the two groups was found by both methods. The elasticity of the liver was finally analyzed by combining the bending energy and power spectral features obtained through MR tagging images. The result showed that only one abnormal case was misclassified in our dataset, which implied our method for non-invasive assessment of liver fibrosis has the potential to reduce the traditional liver biopsy.

  2. Combination of optoacoustics and ultrasound imaging for non-invasive, rapid assessment, and management of circulatory shock

    Science.gov (United States)

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

    2011-03-01

    We developed a noninvasive, optoacoustic diagnostic platform for monitoring of multiple physiologic variables in inpatients and outpatients. One of the most important applications of this platform is noninvasive, rapid assessment and management of circulatory shock, a common condition in critically ill patients. At present, monitoring of circulatory shock requires measurement of central venous blood oxygenation using invasive procedures such as insertion of catheters in central veins. Hemoglobin saturation below 70% in central veins indicates circulatory shock that requires immediate treatment. We built a portable optoacoustic system for noninvasive measurement of central venous oxygenation. In this study we used the optoacoustic system and clinical ultrasound imaging systems for rapid optoacoustic probing of these veins. The optoacoustic system utilizes a custom-made, sensitive optoacoustic probe that was developed in our laboratory for monitoring of blood oxygenation in deep blood vessels. The studies were performed in human subjects with different geometry (depth, size) of the veins. The ultrasound imaging systems permitted rapid identification of specific blood vessels for optoacoustic probing. We developed a novel algorithm for continuous, realtime, and precise measurement of blood oxygenation in blood vessels. Precision of central venous oxygenation measurement obtained in the study was very high: 1%. Our results indicate that the combination of optoacoustics and ultrasound imaging systems can provide more rapid and accurate assessment and management of the circulatory shock.

  3. Skin fluorescence as a clinical tool for non-invasive assessment of advanced glycation and long-term complications of diabetes

    NARCIS (Netherlands)

    Fokkens, Bernardina T.; Smit, Andries J.

    Glycation is important in the development of complications of diabetes mellitus and may have a central role in the well-described glycaemic memory effect in developing these complications. Skin fluorescence has emerged over the last decade as a non-invasive method for assessing accumulation of

  4. [18F]FLT PET for Non-Invasive Assessment of Tumor Sensitivity to Chemotherapy: Studies with Experimental Chemotherapy TP202377 in Human Cancer Xenografts in Mice

    DEFF Research Database (Denmark)

    Jensen, Mette Munk; Erichsen, Kamille Dumong; Björkling, Fredrik

    2012-01-01

    3'-deoxy-3'-[¹⁸F]fluorothymidine ([18F]FLT) is a tracer used to assess cell proliferation in vivo. The aim of the study was to use [18F]FLT positron emission tomography (PET) to study non-invasively early anti-proliferative effects of the experimental chemotherapeutic agent TP202377 in both...

  5. Predicting invasions by woody species in a temperate zone: a test of three risk assessment schemes in the Czech Republic (Central Europe)

    Czech Academy of Sciences Publication Activity Database

    Křivánek, Martin; Pyšek, Petr

    2006-01-01

    Roč. 12, - (2006), s. 319-327 ISSN 1366-9516 Institutional research plan: CEZ:AV0Z60050516 Keywords : invasion by woody species * risk assessment * forestry Subject RIV: EF - Botanics Impact factor: 3.441, year: 2006

  6. Dynamic magnetic resonance imaging for assessment of minimally invasive pelvic floor reconstruction with polypropylene implant

    Energy Technology Data Exchange (ETDEWEB)

    Siegmann, Katja C., E-mail: katja.siegmann@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Reisenauer, Christl, E-mail: christl.reisenauer@med.uni-tuebingen.de [Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen (Germany); Speck, Sina, E-mail: sina.speck@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Barth, Sonja, E-mail: sonja.barth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Kraemer, Bernhard, E-mail: bernhard.kraemer@med.uni-tuebingen.de [Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen (Germany); Claussen, Claus D., E-mail: claus.claussen@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2011-11-15

    Introduction: The purpose of the study was to assess the usefulness of dynamic MRI in patients with pelvic organ prolapse after pelvic floor repair with polypropylene mesh. Materials and methods: Fifteen consecutive patients (mean age 66.5 years) who were scheduled for either anterior (n = 9) or posterior (n = 6) pelvic floor repair were prospectively evaluated by clinical assessment and dynamic MRI 1 day before and 3 months after surgery. MRI diagnoses and MRI measurements of relevant anatomical points at rest and on straining were analysed before and after surgery. Results: At follow-up assessment 93.3% of all patients were clinically cured. Dynamic MRI showed newly developed (n = 6) or increased (n = 6) pelvic organ prolapse in 80% (n = 12) of all patients 3 months after pelvic floor repair. Most of them (n = 11; 91.7%) affected the untreated pelvic floor compartment. On straining anatomical points of reference in the anterior pelvic floor compartment were significantly (p < 0.05) elevated after anterior repair and rectal bulging was significantly (p = 0.036) reduced after posterior pelvic floor repair. Conclusions: In this study dynamic MRI could verify the effective support of anterior and posterior pelvic floor structures by anterior and posterior polypropylene implant respectively. But dynamic MRI demonstrates if one compartment of the pelvic floor is repaired another compartment frequently (73.3%) develops dysfunction. These results did not correspond to clinical symptoms on short-term follow-up (3 months). Studies with long-term follow-up are necessary to prove if dynamic MRI can reliably identify clinically significant pelvic organ prolapse after pelvic floor repair before the onset of symptoms.

  7. Invasive assessment of renal artery atherosclerotic disease and resistant hypertension before renal sympathetic denervation.

    Science.gov (United States)

    Ribichini, Flavio; Pighi, Michele; Zivelonghi, Carlo; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

    2013-01-01

    Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. The presence of a renal artery stenosis may be both a cause of secondary hypertension and a contraindication to RSD if a renal artery stent is implanted; therefore, the definition of the functional importance of a renal artery stenosis in a patient with refractory hypertension is crucial. We describe the imaging and functional intravascular assessment of an angiographically severe stenosis of the renal artery in a patient with severe refractory hypertension, by means of intravascular ultrasound (IVUS), and measurement of the translesional pressure gradient with a pressure wire. Pressure wire examination excluded any severity of the stenosis, and IVUS showed the presence of a dissected plaque that resolved spontaneously after 3 months of intensive medical therapy and high-dose statin. Subsequently the patient was treated with RSD, achieving a significant effect on blood pressure control. Intravascular imaging and functional assessment of renal artery anatomy in patients with atherosclerotic disease may prove particularly suited to patients with refractory hypertension and multilevel vascular disease who are considered for endovascular therapies, either renal artery stenting or RSD.

  8. Non invasive blood flow assessment in diabetic foot ulcer using laser speckle contrast imaging technique

    Science.gov (United States)

    Jayanthy, A. K.; Sujatha, N.; Reddy, M. Ramasubba; Narayanamoorthy, V. B.

    2014-03-01

    Measuring microcirculatory tissue blood perfusion is of interest for both clinicians and researchers in a wide range of applications and can provide essential information of the progress of treatment of certain diseases which causes either an increased or decreased blood flow. Diabetic ulcer associated with alterations in tissue blood flow is the most common cause of non-traumatic lower extremity amputations. A technique which can detect the onset of ulcer and provide essential information on the progress of the treatment of ulcer would be of great help to the clinicians. A noninvasive, noncontact and whole field laser speckle contrast imaging (LSCI) technique has been described in this paper which is used to assess the changes in blood flow in diabetic ulcer affected areas of the foot. The blood flow assessment at the wound site can provide critical information on the efficiency and progress of the treatment given to the diabetic ulcer subjects. The technique may also potentially fulfill a significant need in diabetic foot ulcer screening and management.

  9. Comfort and learnability assessment of a new soft robotic manipulator for minimally invasive surgery.

    Science.gov (United States)

    Shafti, A; Andorno, F; Marchese, N; Arolfo, S; Aydin, A; Elhage, O; Noh, Y; Wurdemann, H A; Arezzo, A; Dasgupta, P; Althoefer, K

    2015-08-01

    Laparoscopic surgeons perform precise and time consuming procedures while holding awkward poses in their upper body and arms. There is an ongoing effort to produce robotic tools for laparoscopic surgery that will simplify these tasks and reduce risk of errors to help both the surgeon and the patient. STIFF-FLOP is an ongoing EU FP7 project focusing on this by creating a stiffness controllable soft robotic manipulator. This paper reports on a study to test the soft manipulator's learnability and the effort associated with its use. The tests involved a limited prototype of the manipulator with a custom built test rig and EMG acquisition system. Task times and video recordings along with EMG waveforms from the forearm muscles of participants (n=25) were measured for objective assessment. A questionnaire was also provided to the participants for subjective assessment. The data shows that in average EMG levels were 25.9% less in RMS when using the STIFF-FLOP arm than when conventional laparoscopic tools were used. In terms of learnability, from the first to the second attempt on the STIFF-FLOP manipulator, elapsed time was reduced by an average of 32.1%. Further details and analysis of the EMG signals as well as time and questionnaire results is presented in the paper.

  10. Quantitative Assessment of Arrhythmia Using Non-linear Approach: A Non-invasive Prognostic Tool

    Science.gov (United States)

    Chakraborty, Monisha; Ghosh, Dipak

    2018-04-01

    Accurate prognostic tool to identify severity of Arrhythmia is yet to be investigated, owing to the complexity of the ECG signal. In this paper, we have shown that quantitative assessment of Arrhythmia is possible using non-linear technique based on "Hurst Rescaled Range Analysis". Although the concept of applying "non-linearity" for studying various cardiac dysfunctions is not entirely new, the novel objective of this paper is to identify the severity of the disease, monitoring of different medicine and their dose, and also to assess the efficiency of different medicine. The approach presented in this work is simple which in turn will help doctors in efficient disease management. In this work, Arrhythmia ECG time series are collected from MIT-BIH database. Normal ECG time series are acquired using POLYPARA system. Both time series are analyzed in thelight of non-linear approach following the method "Rescaled Range Analysis". The quantitative parameter, "Fractal Dimension" (D) is obtained from both types of time series. The major finding is that Arrhythmia ECG poses lower values of D as compared to normal. Further, this information can be used to access the severity of Arrhythmia quantitatively, which is a new direction of prognosis as well as adequate software may be developed for the use of medical practice.

  11. Quantitative Assessment of Arrhythmia Using Non-linear Approach: A Non-invasive Prognostic Tool

    Science.gov (United States)

    Chakraborty, Monisha; Ghosh, Dipak

    2017-12-01

    Accurate prognostic tool to identify severity of Arrhythmia is yet to be investigated, owing to the complexity of the ECG signal. In this paper, we have shown that quantitative assessment of Arrhythmia is possible using non-linear technique based on "Hurst Rescaled Range Analysis". Although the concept of applying "non-linearity" for studying various cardiac dysfunctions is not entirely new, the novel objective of this paper is to identify the severity of the disease, monitoring of different medicine and their dose, and also to assess the efficiency of different medicine. The approach presented in this work is simple which in turn will help doctors in efficient disease management. In this work, Arrhythmia ECG time series are collected from MIT-BIH database. Normal ECG time series are acquired using POLYPARA system. Both time series are analyzed in thelight of non-linear approach following the method "Rescaled Range Analysis". The quantitative parameter, "Fractal Dimension" (D) is obtained from both types of time series. The major finding is that Arrhythmia ECG poses lower values of D as compared to normal. Further, this information can be used to access the severity of Arrhythmia quantitatively, which is a new direction of prognosis as well as adequate software may be developed for the use of medical practice.

  12. A novel implantable device for a minimally invasive surgical treatment of obstructive sleep apnea: design and preclinical safety assessment

    Directory of Open Access Journals (Sweden)

    Gillis E

    2016-07-01

    Full Text Available Edward Gillis, Charles Rampersaud, Emmanuelle Pease, Paul Buscemi ReVENT Medical, Inc., Newark, CA, USA Background: In obstructive sleep apnea (OSA, occlusion of the upper airway by soft tissue causes intermittent hypoxemia and can have serious sequelae. A novel implantable medical device for OSA is composed of a linear silicone elastic element held in an extended state by a bioabsorbable external sheath. The implant is delivered to the tongue base or soft palate via a minimally invasive approach. Normal tissue healing anchors the device at the attachment points before the bioabsorbable material dissolves and the elastic element contracts to stabilize the surrounding tissue.Methods: Device prototypes were evaluated in multiple investigations: 1 a finite elements analysis model simulated the movement of the tongue base during sleep with and without the implant; 2 dynamic mechanical testing simulated 10 years’ normal use; 3 cadaveric implantations were conducted; 4 an ovine study in which implants of varying design were evaluated via gross pathology and histological assessment; and 5 a canine study in which implants of varying design in the tongue base and soft palate were evaluated via gross pathology and histological assessment.Results: 1 The implant was capable of reducing ~95% of tongue base movement during simulated sleep; 2 implants remained intact throughout the testing with no evidence of creep fatigue or change in dynamic modulus; 3 the device could be reliably deployed in the desired placement locations and was appropriate for various anatomies; and 4 all implants were well tolerated through 1 year, with minimal inflammatory responses.Conclusion: This new minimally invasive device for OSA has been demonstrated, through various bench and animal testing, to be safe, well tolerated, suitable for long-term use, and to function as intended. No adverse health consequences were observed in the animals, and histological evaluation

  13. New imaging methods for non-invasive assessment of mechanical, structural and biochemical properties of Human Achilles tendon: a mini review

    Directory of Open Access Journals (Sweden)

    Alexandre Fouré

    2016-07-01

    Full Text Available The mechanical properties of tendon play a fundamental role to passively transmit forces from muscle to bone, withstand sudden stretches and act as a mechanical buffer allowing the muscle to work more efficiently. The use of non-invasive imaging methods for the assessment of human tendon’s mechanical, structural and biochemical properties in vivo is relatively young in sports medicine, clinical practice and basic science. Non-invasive assessment of the tendon properties may enhance the diagnosis of tendon injury and the characterization of recovery treatments. While ultrasonographic imaging is the most popular tool to assess the tendon’s structural and, indirectly, mechanical properties, ultrasonographic elastography and ultra-high field magnetic resonance imaging (UHF MRI have recently emerged as potentially powerful techniques to explore tendon tissues. This paper highlights some methodological cautions associated with conventional ultrasonography and perspectives for in vivo human Achilles tendon assessment using ultrasonographic elastography and UHF MRI.

  14. An assessment of invasive plant species monitored by the Northern Research Station Forest Inventory and Analysis Program, 2005 through 2010

    Science.gov (United States)

    Cassandra M. Kurtz

    2013-01-01

    Invasive plant species are a worldwide concern due to the high ecological and economic costs associated with their presence. This document describes the plant characteristics and regional distribution of the 50 invasive plant species monitored from 2005 through 2010 on forested Phase 2 (P2) Forest Inventory and Analysis (FIA) plots in the 24 states of the Northern...

  15. A minimally invasive technique to assess several life-history characteristics of the endangered great hammerhead shark Sphyrna mokarran

    NARCIS (Netherlands)

    O'Connell, C.P.; Leurs, G.

    2016-01-01

    A dorsal-fin photo-identification technique paired with a non-invasive parallel laser photogrammetry technique was used to non-invasively identify individual Sphyrna mokarran over time. Based on the data collected over a duration of 59 days, 16 different S. mokarran (mean ± s.d. pre-caudal

  16. Invasive Species

    Science.gov (United States)

    Invasive species have significantly changed the Great Lakes ecosystem. An invasive species is a plant or animal that is not native to an ecosystem, and whose introduction is likely to cause economic, human health, or environmental damage.

  17. Non-invasive assessment of coronary artery disease with stress thallium-201 myocardial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Hirose, Yoshiaki; Hamada, Seiki; Maeno, Masakazu; Takahashi, Nobukazu; Hayashida, Kohei; Takamiya, Makoto; Miyazaki, Shun-ich; Nonogi, Hiroshi [National Cardiovascular Center, Suita, Osaka (Japan)

    1995-02-01

    Recent studies have reported a low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease. Thus this study was undertaken to reassess the ability of stress thallium-201 myocardial imaging to detect deseased coronary vessels. The subjects were 469 patients, who consisted of 397 with a significant {>=}75% stenosis and the other 72 with normal coronary vessels on coronary arteriography done within 6 months before and after thallium imaging. Using the coronary arteriogram as the arbiter, the sensitivity and specificity of stress thallium imaging were 91% and 43%, respectively. Forty-one patients with no angiographic evidence of coronary stenosis were assessed as having coronary stenosis on thallium imaging (false-positive cases). All the 41 patients had cardiovascular diseases or symptoms, such as hypertrophic cardiomyopathy, complete left bundle branch block, chest pain of unknown etiology, and abnormalities on stress ECG. This suggested the possibility that dysfunctional segments may be manifested by exercise stress even though these are not shown on coronary arteriography at rest. Thus the low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease may not contribute to the essential disadvantage of thallium imaging, but may reflect dysfunctional segments that are not shown by morphological manifestation of coronary arteriography. (N.K.).

  18. Giant lipid vesicles under electric field pulses assessed by non invasive imaging.

    Science.gov (United States)

    Mauroy, Chloé; Portet, Thomas; Winterhalder, Martin; Bellard, Elisabeth; Blache, Marie-Claire; Teissié, Justin; Zumbusch, Andreas; Rols, Marie-Pierre

    2012-10-01

    We present experimental results regarding the effects of electric pulses on giant unilamellar vesicles (GUVs). We have used phase contrast and coherent anti-Stokes Raman scattering (CARS) microscopy as relevant optical approaches to gain insight into membrane changes under electropermeabilization. No addition of exogenous molecules (lipid analogue, fluorescent dye) was needed. Therefore, experiments were performed on pure lipid systems avoiding possible artefacts linked to their use. Structural membrane changes were assessed by loss of contrast inside the GUVs due to sucrose and glucose mixing. Our observations, performed at the single vesicle level, indicate these changes are under the control of the number of pulses and field intensity. Larger number of pulses enhances membrane alterations. A threshold value of the field intensity must be applied to allow exchange of molecules between GUVs and the external medium. This threshold depends on the size of the vesicles, the larger GUVs being affected at lower electric field strengths than the smaller ones. Our experimental data are well described by a simple model in which molecule entry is driven by direct exchange. The CARS microscopic study of the effect of pulse duration confirms that pulses, in the ms time range, induce loss of lipids and membrane deformations facing the electrodes. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Non-invasive assessment of coronary artery disease with stress thallium-201 myocardial imaging

    International Nuclear Information System (INIS)

    Ishida, Yoshio; Hirose, Yoshiaki; Hamada, Seiki; Maeno, Masakazu; Takahashi, Nobukazu; Hayashida, Kohei; Takamiya, Makoto; Miyazaki, Shun-ich; Nonogi, Hiroshi

    1995-01-01

    Recent studies have reported a low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease. Thus this study was undertaken to reassess the ability of stress thallium-201 myocardial imaging to detect deseased coronary vessels. The subjects were 469 patients, who consisted of 397 with a significant ≥75% stenosis and the other 72 with normal coronary vessels on coronary arteriography done within 6 months before and after thallium imaging. Using the coronary arteriogram as the arbiter, the sensitivity and specificity of stress thallium imaging were 91% and 43%, respectively. Forty-one patients with no angiographic evidence of coronary stenosis were assessed as having coronary stenosis on thallium imaging (false-positive cases). All the 41 patients had cardiovascular diseases or symptoms, such as hypertrophic cardiomyopathy, complete left bundle branch block, chest pain of unknown etiology, and abnormalities on stress ECG. This suggested the possibility that dysfunctional segments may be manifested by exercise stress even though these are not shown on coronary arteriography at rest. Thus the low specificity of stress thallium-201 myocardial imaging in the diagnosis of coronary artery disease may not contribute to the essential disadvantage of thallium imaging, but may reflect dysfunctional segments that are not shown by morphological manifestation of coronary arteriography. (N.K.)

  20. Assessment of the perceived effects and management challenges of Mikania micrantha invasion in Chitwan National Park buffer zone community forest, Nepal.

    Science.gov (United States)

    Khadka, Akriti

    2017-04-01

    The effects of invasion by Mikania micrantha in the buffer zone of Chitwan National Park (CNP) of Nepal are well documented; however the studies were confined to appraising the perception of household and did not assess the changes in livelihood activities after the invasion. This study presents the effects of invasion of M. micrantha on the livelihood of buffer zone of the Chitwan National Park; hence addressing the gap in information and shows the complex effect of M. micrantha on rural livelihood. The study used a questionnaire survey to 170 households in the CNP of Nepal. The results indicate that the invasion of M. micrantha have negative effects on the community livelihood in the study area. Basic forest products such as fodder and fuel wood have become scarce as a result of reduction in the native plants. Also the spread of M. micrantha is creating impassable copse that destroy wildlife abode and jungle paths resulting into animals to shift their habitat to core area thereby reducing tourism revenues. Therefore, the study concludes that invasion of M. micrantha directly or indirectly is modifying the rural household livelihoods and a quick action is stipulated. Hence, a higher level body like the Ministry of Forestry or Department of National Park and Wildlife Conservation needs to take care of issues related to alien species. Correspondingly, it is also very important that people are aware and educated about alien species and their effects.

  1. Multiparametric estimation of brain hemodynamics with MR fingerprinting ASL.

    Science.gov (United States)

    Su, Pan; Mao, Deng; Liu, Peiying; Li, Yang; Pinho, Marco C; Welch, Babu G; Lu, Hanzhang

    2017-11-01

    Assessment of brain hemodynamics without exogenous contrast agents is of increasing importance in clinical applications. This study aims to develop an MR perfusion technique that can provide noncontrast and multiparametric estimation of hemodynamic markers. We devised an arterial spin labeling (ASL) method based on the principle of MR fingerprinting (MRF), referred to as MRF-ASL. By taking advantage of the rich information contained in MRF sequence, up to seven hemodynamic parameters can be estimated concomitantly. Feasibility demonstration, flip angle optimization, comparison with Look-Locker ASL, reproducibility test, sensitivity to hypercapnia challenge, and initial clinical application in an intracranial steno-occlusive process, Moyamoya disease, were performed to evaluate this technique. Magnetic resonance fingerprinting ASL provided estimation of up to seven parameters, including B1+, tissue T 1 , cerebral blood flow (CBF), tissue bolus arrival time (BAT), pass-through arterial BAT, pass-through blood volume, and pass-through blood travel time. Coefficients of variation of the estimated parameters ranged from 0.2 to 9.6%. Hypercapnia resulted in an increase in CBF by 57.7%, and a decrease in BAT by 13.7 and 24.8% in tissue and vessels, respectively. Patients with Moyamoya disease showed diminished CBF and lengthened BAT that could not be detected with regular ASL. Magnetic resonance fingerprinting ASL is a promising technique for noncontrast, multiparametric perfusion assessment. Magn Reson Med 78:1812-1823, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  2. Assessment of deep myometrial invasion of endometrial cancer on MRI: added value of second-opinion interpretations by radiologists subspecialized in gynaecologic oncology.

    Science.gov (United States)

    Woo, Sungmin; Kim, Sang Youn; Cho, Jeong Yeon; Kim, Seung Hyup

    2017-05-01

    To investigate the added value of secondary reports issued by radiologists subspecializing in gynaecologic imaging for determining deep myometrial invasion of endometrial cancer on MRI. Initial (from referring institutions) and secondary (by subspecialized radiologists) interpretations of MRI of 55 patients with endometrial cancer were retrospectively reviewed. A radiologist blinded to clinicopathological information assessed both reports for the presence of deep myometrial invasion. Reference standard was based on hysterectomy specimens. Kappa coefficients (k) were used to measure their concordance. McNemar testing and receiver operating characteristic (ROC) analysis was used to compare sensitivities, specificities and areas under the curves (AUCs). Deep myometrial invasion was present in 25 (45.5 %) patients. Among 27.3 % (15/55; k = 0.458) patients with discrepant results, secondary interpretations were correct in 10 (66.7 %) cases. Sensitivity was higher in secondary than in initial reports (76.0 % vs. 48.0 %, p = 0.039) while no significant difference was seen in specificity (70.0 % vs. 76.7 %, p = 0.668). At ROC analysis, there was a tendency for higher AUCs in secondary reports (0.785 vs 0.669, p = 0.096). Secondary readings of MRI by subspecialized gynaecologic oncologic radiologists may provide incremental value in determining deep myometrial invasion of endometrial cancer. • Deep myometrial invasion is an important prognostic factor in endometrial cancer. • Assessment of deep myometrial invasion is often discrepant between initial and secondary reports. • Secondary reports showed higher sensitivity and accuracy. • Secondary review of MRI may provide incremental value in endometrial cancer patients.

  3. Integrating local pastoral knowledge, participatory mapping, and species distribution modeling for risk assessment of invasive rubber vine (Cryptostegia grandiflora in Ethiopia's Afar region

    Directory of Open Access Journals (Sweden)

    Matthew W. Luizza

    2016-03-01

    Full Text Available The threats posed by invasive plants span ecosystems and economies worldwide. Local knowledge of biological invasions has proven beneficial for invasive species research, but to date no work has integrated this knowledge with species distribution modeling for invasion risk assessments. In this study, we integrated pastoral knowledge with Maxent modeling to assess the suitable habitat and potential impacts of invasive Cryptostegia grandiflora Robx. Ex R.Br. (rubber vine in Ethiopia's Afar region. We conducted focus groups with seven villages across the Amibara and Awash-Fentale districts. Pastoral knowledge revealed the growing threat of rubber vine, which to date has received limited attention in Ethiopia, and whose presence in Afar was previously unknown to our team. Rubber vine occurrence points were collected in the field with pastoralists and processed in Maxent with MODIS-derived vegetation indices, topographic data, and anthropogenic variables. We tested model fit using a jackknife procedure and validated the final model with an independent occurrence data set collected through participatory mapping activities with pastoralists. A Multivariate Environmental Similarity Surface analysis revealed areas with novel environmental conditions for future targeted surveys. Model performance was evaluated using area under the receiver-operating characteristic curve (AUC and showed good fit across the jackknife models (average AUC = 0.80 and the final model (test AUC = 0.96. Our results reveal the growing threat rubber vine poses to Afar, with suitable habitat extending downstream of its current known location in the middle Awash River basin. Local pastoral knowledge provided important context for its rapid expansion due to acute changes in seasonality and habitat alteration, in addition to threats posed to numerous endemic tree species that provide critical provisioning ecosystem services. This work demonstrates the utility of integrating local

  4. Integrating local pastoral knowledge, participatory mapping, and species distribution modeling for risk assessment of invasive rubber vine (Cryptostegia grandiflora) in Ethiopia’s Afar region

    Science.gov (United States)

    Luizza, Matthew; Wakie, Tewodros; Evangelista, Paul; Jarnevich, Catherine S.

    2016-01-01

    The threats posed by invasive plants span ecosystems and economies worldwide. Local knowledge of biological invasions has proven beneficial for invasive species research, but to date no work has integrated this knowledge with species distribution modeling for invasion risk assessments. In this study, we integrated pastoral knowledge with Maxent modeling to assess the suitable habitat and potential impacts of invasive Cryptostegia grandiflora Robx. Ex R.Br. (rubber vine) in Ethiopia’s Afar region. We conducted focus groups with seven villages across the Amibara and Awash-Fentale districts. Pastoral knowledge revealed the growing threat of rubber vine, which to date has received limited attention in Ethiopia, and whose presence in Afar was previously unknown to our team. Rubber vine occurrence points were collected in the field with pastoralists and processed in Maxent with MODIS-derived vegetation indices, topographic data, and anthropogenic variables. We tested model fit using a jackknife procedure and validated the final model with an independent occurrence data set collected through participatory mapping activities with pastoralists. A Multivariate Environmental Similarity Surface analysis revealed areas with novel environmental conditions for future targeted surveys. Model performance was evaluated using area under the receiver-operating characteristic curve (AUC) and showed good fit across the jackknife models (average AUC = 0.80) and the final model (test AUC = 0.96). Our results reveal the growing threat rubber vine poses to Afar, with suitable habitat extending downstream of its current known location in the middle Awash River basin. Local pastoral knowledge provided important context for its rapid expansion due to acute changes in seasonality and habitat alteration, in addition to threats posed to numerous endemic tree species that provide critical provisioning ecosystem services. This work demonstrates the utility of integrating local ecological

  5. Quantitative micro-computed tomography: a non-invasive method to assess equivalent bone mineral density.

    Science.gov (United States)

    Nazarian, Ara; Snyder, Brian D; Zurakowski, David; Müller, Ralph

    2008-08-01

    One of the many applications of micro computed tomography (microCT) is to accurately visualize and quantify cancellous bone microstructure. However, microCT based assessment of bone mineral density has yet to be thoroughly investigated. Specifically, the effects of varying imaging parameters, such as tube voltage (kVp), current (microA), integration time (ms), object to X-ray source distance (mm), projection number, detector array size and imaging media (surrounding the specimen), on the relationship between equivalent tissue density (rhoEQ) and its linear attenuation coefficient (micro) have received little attention. In this study, in house manufactured, hydrogen dipotassium phosphate liquid calibration phantoms (K2HPO4) were employed in addition to a resin embedded hydroxyapatite solid calibration phantoms supplied by Scanco Medical AG Company. Variations in current, integration time and projection number had no effect on the conversion relationship between micro and rhoEQ for the K2HPO4 and Scanco calibration phantoms [p>0.05 for all cases]. However, as expected, variations in scanning tube voltage, object to X-ray source distance, detector array size and imaging media (referring to the solution that surrounds the specimen in the imaging vial) significantly affected the conversion relationship between mu and rhoEQ for K2HPO4 and Scanco calibration phantoms [pmineral density; however, they cannot be scanned with a specimen or submerged in a different imaging media. The K2HPO4 liquid calibration phantoms provide a cost effective, easy to prepare and convenient means to perform quantitative microCT analysis using any microCT system, with the ability to choose different imaging media according to study needs. However, as with any liquid calibration phantom, they are susceptible to degradation over time.

  6. Assessment of multi-wavelength pulse photometry for non-invasive dose estimation of circulating drugs and nanoparticles

    Science.gov (United States)

    Adhikari, Pratik; Eklund, Wakako; Sherer, Eric A.; O'Neal, D. Patrick

    2016-03-01

    The feasibility of multi-wavelength photoplethysmography for the real-time sensing of absorptive and scattering agents in pulsatile blood is discussed. The use of pulsatile signals extracted from trans-illumination of an accessible section of tissue allows us to calculate the concentration of the optically extinctive species in the pulsatile blood. This technology, initially used for pulse oximetry and dye densitometry, can be applied to monitor in vivo concentration and clearance of various absorptive species. Recently, our prototype has been used monitor the concentration of therapeutic gold nanoparticles, antimalarial quinine, and the antifungal agent amphotericin B. The assessment of the optical properties, device specifications, and signal quality for each compound are presented. We observe that this technology can be used to monitor numerous extinctive drug and nano-materials that present features in the 350-1100 nm range. The rationale for using this technology in a clinical setting would be to improve outcomes by real-time pharmacological feedback and/or control at point of care in addition to the elimination of invasive blood draws for collection of data.

  7. Cytomegalovirus antibodies in dried blood spots: a minimally invasive method for assessing stress, immune function, and aging

    Directory of Open Access Journals (Sweden)

    Chyu Laura

    2011-01-01

    Full Text Available Abstract Background Cytomegalovirus (CMV is a prevalent herpesvirus with links to both stress and aging. This paper describes and validates a minimally invasive method for assessing antibodies against CMV in finger stick whole blood spot samples for use as an indirect marker of an aspect of cell-mediated immunity. Results Analysis of CMV in dried blood spot samples (DBS was based on modifications of a commercially available protocol for quantifying CMV antibodies in serum or plasma. The method was evaluated through analysis of precision, reliability, linearity, and correlation between matched serum and DBS samples collected from 75 volunteers. Correlation between DBS and plasma values was linear and high (Pearson correlation R = .96, and precision, reliability, and linearity of the DBS assay were within acceptable ranges. Conclusions The validity of a DBS assay for CMV antibodies will enable its inclusion in population-based surveys and other studies collecting DBS samples in non-clinical settings, increasing scientific understanding of the interaction of social and biological stress and immune function.

  8. Non-invasive diagnostic methods for atherosclerosis and use in assessing progression and regression in hypercholesterolemia

    International Nuclear Information System (INIS)

    Tsushima, Motoo; Fujii, Shigeki; Yutani, Chikao; Yamamoto, Akira; Naitoh, Hiroaki.

    1990-01-01

    We evaluated the wall thickening and stenosis rate (ASI), the calcification rate (ACI), and the wall thickening and calcification stenosis rate (SCI) of the lower abdominal aorta calculated by the 12 sector method from simple or enhanced computed tomography. The intra-observer variation of the calculation of ASI was 5.7% and that of ACI was 2.4%. In 9 patients who underwent an autopsy examination, ACI was significantly correlated with the rate of the calcification dimension to the whole objective area of the abdominal aorta (r=0.856, p<0.01). However, there were no correlations between ASI and the surface involvement or the atherosclerotic index obtained by the point-counting method of the autopsy materials. In the analysis of 40 patients with atherosclerotic vascular diseases, ASI and ACI were also highly correlated with the percentage volume of the arterial wall in relation to the whole volume of the observed artery (r=0.852, p<0.0001) and also the percentage calcification volume (r=0.913, p<0.0001) calculated by the computed method, respectively. The percentage of atherosclerotic vascular diseases increased in the group of both high ASI (over 10%) and high ACI (over 20%). We used SCI as a reliable index when the progression and regression of atherosclerosis was considered. Among patients of hypercholesterolemia consisting of 15 with familial hypercholesterolemia (FH) and 6 non-FH patients, the change of SCI (d-SCI) was significantly correlated with the change of total cholesterol concentration (d-TC) after the treatment (r=0.466, p<0.05) and the change of the right Achilles' tendon thickening (d-ATT) was also correlated with d-TC (r=0.634, p<0.005). However, no correlation between d-SCI and d-ATT was observed. In conclusion, CT indices of atherosclerosis were useful as a noninvasive quantitative diagnostic method and we were able to use them to assess the progression and regression of atherosclerosis. (author)

  9. Fluoroscopy assessment during anterior minimally invasive hip replacement is more accurate than with the posterior approach.

    Science.gov (United States)

    Ji, Weifeng; Stewart, Nathaniel

    2016-01-01

    Acetabular component position is important for stability and wear. Fluoroscopy can improve the accuracy of acetabular component placement in the posterior approach and the direct anterior approach (DAA). The purpose of this study was to determine if the direct anterior approach in the supine position facilitates the accurate use of fluoroscopy and improves acetabular component position. This retrospective, comparative study of 60 THAs with fluoroscopic guidance (30 in posterior approach group and 30 in DAA group) was performed by one surgeon from 2012 to 2014 at a single institution. Demographic and perioperative data were compared using the Kolmogorov-Smirnov test to determine if they were statistically different. The difference between the measured intra-operative and postoperative values for both inclination and anteversion were analysed respectively. In the posterior approach group we found an average inclination on intra-operative fluoroscopy (IFluoro) of 36.8° ± 3.72°, an average anteversion on intra-operative fluoroscopy (AFluoro) of 25.6° ± 3.64°, an average inclination on postoperative standing AP pelvis X-ray (IAP X-ray) of 39.29° ± 4.58° and an average anteversion on postoperative standing AP pelvis X-ray (AAP X-ray) of 21.31° ± 4.04°. In the DAA group we found an average DAA IFluoro of 42.32° ± 1.91°, an average DAA AFluoro of 22.3° ± 1.41°, an average DAA IAP X-ray of 42.98° ± 1.81° and an average DAA AAP X-ray of 22.88° ± 1.38°. A difference was seen in variability using Kolmogorov-Smirnov test for inclination and anteversion with significant higher variation of measurements in the posterior approach group (p = 0.022 and p fluoroscopy for inclination and anteversion. Using fluoroscopy in the direct anterior approach, we achieved better intra-operative assessment of cup orientation resulting in decreased variability of acetabular cup anteversion than when used in the posterior approach. At

  10. NON-INVASIVE METHODS OF THE WORK-UP FOR ASSESSMENT OF MORPHOLOGIC AND FUNCTIONAL STATE OF THE SIGMOID WALL

    Directory of Open Access Journals (Sweden)

    A. E. Mashkov

    2015-01-01

    Full Text Available Background: Prolonged colonic congestion in children with chronic constipation and dolichosigma are characterized  by a permanent imbalance of gut microflora, secondary inflammation and degeneration of the sigmoid wall. There is plenty of research papers on the optic non-invasive diagnostics in medicine, based on spectrophotometry and laser spectral analysis. Aim: To study morphologic and functional state  of the sigmoid wall for detection of inflammation  and  degeneration in the  sigmoid  wall and  optimization  of treatment of children with dolichosigma  and long-standing constipation. Materials and methods: From 2009 to 2014, 30 children with dolichosigma  were seen in the Department of Pediatric surgery of MONIKI. All patients  were  hospitalized  after unsuccessful conservative  treatment in in-patient  clinics of the Moscow Region. The children underwent a set of investigations  for objective assessment of degree of the secondary  inflammatory and degenerative abnormalities  in the sigmoid wall, such as microbiological assessment, cytological assessment and fluorescent  diagnostics.  Results:  There  was  no   caused  by dolichosigma. It maintains  chronic inflammation  and  may play an indirect  role in abnormalities  of gut  motor  function. Inflammatory and  degenerative abnormalities  were  confirmed by a cytological investigation  of wall-adjacent biopsy of the  sigma. The results of the  complex assessment showed  moderate inflammation  and degeneration in the  sigmoid wall in 20 children; subsequent conservative treatment of chronic colostasis was effective. Ten children had advanced secondary inflammatory and degenerative abnormalities of the  sigmoid  wall, with high  levels of elastin and collagen in the colon wall. Surgery was performed in 6 children with the highest degree of fibrous transformation of the sigma. Conclusion: Complex assessment of the sigmoid wall, including

  11. Hemodynamic significance of internal carotid artery disease

    DEFF Research Database (Denmark)

    Schroeder, T

    1988-01-01

    a significant improvement in baseline flow occur. Flow reserve determined by cerebral vasodilation, however, will improve in most patients with hemodynamic failure. In addition, some patients in the low-pressure group develop marked, but temporary, hyperperfusion after reconstruction of very high grade carotid...

  12. Central Hemodynamics for Management of Arteriosclerotic Diseases.

    Science.gov (United States)

    Hashimoto, Junichiro

    2017-08-01

    Arteriosclerosis, particularly aortosclerosis, is the most critical risk factor associated with cardiovascular, cerebrovascular, and renal diseases. The pulsatile hemodynamics in the central aorta consists of blood pressure, flow, and stiffness and substantially differs from the peripheral hemodynamics in muscular arteries. Arteriosclerotic changes with age appear earlier in the elastic aorta, and age-dependent increases in central pulse pressure are more marked than those apparent from brachial pressure measurement. Central pressure can be affected by lifestyle habits, metabolic disorders, and endocrine and inflammatory diseases in a manner different from brachial pressure. Central pulse pressure widening due to aortic stiffening increases left ventricular afterload in systole and reduces coronary artery flow in diastole, predisposing aortosclerotic patients to myocardial hypertrophy and ischemia. The widened pulse pressure is also transmitted deep into low-impedance organs such as the brain and kidney, causing microvascular damage responsible for lacunar stroke and albuminuria. In addition, aortic stiffening increases aortic blood flow reversal, which can lead to retrograde embolic stroke and renal function deterioration. Central pressure has been shown to predict cardiovascular events in most previous studies and potentially serves as a surrogate marker for intervention. Quantitative and comprehensive evaluation of central hemodynamics is now available through various noninvasive pressure/flow measurement modalities. This review will focus on the clinical usefulness and mechanistic rationale of central hemodynamic measurements for cardiovascular risk management.

  13. Force plate monitoring of human hemodynamics

    Czech Academy of Sciences Publication Activity Database

    Kříž, J.; Šeba, Petr

    2008-01-01

    Roč. 2, č. 1 (2008), s. 1-9 ISSN 1753-4631 Grant - others:GA ČR(CZ) GP202/06/P130; GA MŠk(CZ) LC06002 Institutional research plan: CEZ:AV0Z10100521 Keywords : hemodynamics * balistocardiography * pulse wave velocity Subject RIV: BO - Biophysics www.nonlinearbiomedphys.com

  14. Non-invasive assessment of distribution volume ratios and binding potential: tissue heterogeneity and interindividually averaged time-activity curves

    Energy Technology Data Exchange (ETDEWEB)

    Reimold, M.; Mueller-Schauenburg, W.; Dohmen, B.M.; Bares, R. [Department of Nuclear Medicine, University of Tuebingen, Otfried-Mueller-Strasse 14, 72076, Tuebingen (Germany); Becker, G.A. [Nuclear Medicine, University of Leipzig, Leipzig (Germany); Reischl, G. [Radiopharmacy, University of Tuebingen, Tuebingen (Germany)

    2004-04-01

    ; = distribution volume of the reference tissue). This can be explained by the fact that the distribution volume ratio (DVR=DV/DV ') obtained from averaged TAC is an approximation for {sigma}DV/ {sigma}DV ' rather than for {sigma}DVR/n. We conclude that Logan's non-invasive method and SRTM are suitable for heterogeneous tissues and that discussion of group differences in PET studies generally should include qualitative and quantitative assessment of interindividually averaged TAC. (orig.)

  15. Assessing outcomes, costs, and benefits of emerging technology for minimally invasive saphenous vein in situ distal arterial bypasses.

    Science.gov (United States)

    Piano, G; Schwartz, L B; Foster, L; Bassiouny, H S; McKinsey, J F; Rosenthal, D; Gewertz, B L

    1998-06-01

    Instrumentation for a minimally invasive angioscopic in situ peripheral arterial bypass (MIAB) with catheter-directed side-branch occlusion has recently been approved for use. Despite the attractiveness of this approach (2 short incisions), benefits such as lower morbidity and shorter hospitalizations remain undocumented. To justify wide acceptance, minimally invasive surgical techniques must match conventional procedures in durability and cost while enhancing patient comfort. Often such comparisons are difficult during the implementation phase of a new procedure. To compare the outcomes of the MIAB procedures with a concurrent group of patients undergoing conventional in situ bypass procedures. Retrospective review. University medical center. The first 20 consecutive MIAB procedures in 19 patients performed between August 1, 1995, and July 31, 1997, were compared with 19 contemporaneous consecutive conventional in situ bypass procedures performed at the same institution. Operative time, postoperative length of stay, hospital costs, complications, primary assisted and secondary patency, limb salvage, and survival. The patient groups were comparable with respect to age, sex, incidence of smoking, coronary artery disease, hypertension, diabetes, renal failure, cerebrovascular disease, indication, and distal anastomosis level. The median operative time was significantly greater for the MIAB group (6.6 hours vs 5.7 hours; P=.009), and intraoperative completion arteriography more frequently showed retained arteriovenous fistulas in the MIAB group (55% vs 21%; P=.05). The median postoperative length of stay and total cost were 6.5 days and $18,000 for the MIAB group and 8 days and $27,800 for the conventional group (P > or = .05). There were no significant differences in major complications (10% in the MIAB group vs 11% in the conventional group), wound complications (10% vs 11%, respectively), primary assisted patency at 1 year (68%+/-11% vs 78%+/-10%, respectively

  16. Introducing a prognostic score for pretherapeutic assessment of seminal vesicle invasion in patients with clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Salomon, Laurent; Porcher, Raphaeel; Anastasiadis, Aristotelis G.; Levrel, Olivier; Saint, Fabian; Taille, Alexandre de la; Vordos, Dimitrios; Cicco, Antony; Hoznek, Andras; Chopin, Dominique; Abbou, Clement-Claude; Lagrange, Jean-Leon

    2003-01-01

    Purpose: To identify prostate cancer patients who will have the most likely benefit from sparing the seminal vesicles during 3D conformal radiation therapy. Methods and materials: From 1988 to 2001, 532 patients underwent radical prostatectomy for clinically localized prostate cancer. Primary endpoint was the pathological evidence of seminal vesicle invasion. Variables for univariate and multivariate analyses were age, prostate weight, clinical stage, PSA level, Gleason score, number and site of positive prostate sextant biopsies. Multivariate logistic regression with backward stepwise variable selection was used to identify a set of independent predictors of seminal vesicle invasion, and the variable selection procedure was validated by non-parametric bootstrap. Results: Seminal vesicle invasion was reported in 14% of the cases. In univariate analysis, all variables except age and prostate weight were predictors of seminal vesicle invasion. In multivariate analysis, only the number of positive biopsies (P<0.0001), Gleason score (P<0.007) and PSA (P<0.0001) were predictors for seminal vesicles invasion. Based on the multivariate model, we were able to develop a prognostic score for seminal vesicle invasion, which allowed us to discriminate two patient groups: A group with low risk of seminal vesicles invasion (5.7%), and the second with a higher risk of seminal vesicles invasion (32.7%). Conclusions: Using the number of positive biopsies, Gleason score and PSA, it is possible to identify patients with low risk of seminal vesicles invasion. In this population, seminal vesicles might be excluded as a target volume in radiation therapy of prostate cancer

  17. Optimal hemodynamic response model for functional near-infrared spectroscopy.

    Science.gov (United States)

    Kamran, Muhammad A; Jeong, Myung Yung; Mannan, Malik M N

    2015-01-01

    Functional near-infrared spectroscopy (fNIRS) is an emerging non-invasive brain imaging technique and measures brain activities by means of near-infrared light of 650-950 nm wavelengths. The cortical hemodynamic response (HR) differs in attributes at different brain regions and on repetition of trials, even if the experimental paradigm is kept exactly the same. Therefore, an HR model that can estimate such variations in the response is the objective of this research. The canonical hemodynamic response function (cHRF) is modeled by two Gamma functions with six unknown parameters (four of them to model the shape and other two to scale and baseline respectively). The HRF model is supposed to be a linear combination of HRF, baseline, and physiological noises (amplitudes and frequencies of physiological noises are supposed to be unknown). An objective function is developed as a square of the residuals with constraints on 12 free parameters. The formulated problem is solved by using an iterative optimization algorithm to estimate the unknown parameters in the model. Inter-subject variations in HRF and physiological noises have been estimated for better cortical functional maps. The accuracy of the algorithm has been verified using 10 real and 15 simulated data sets. Ten healthy subjects participated in the experiment and their HRF for finger-tapping tasks have been estimated and analyzed. The statistical significance of the estimated activity strength parameters has been verified by employing statistical analysis (i.e., t-value > t critical and p-value < 0.05).

  18. Hemodynamic Ramp Tests in Patients With Left Ventricular Assist Devices.

    Science.gov (United States)

    Uriel, Nir; Sayer, Gabriel; Addetia, Karima; Fedson, Savitri; Kim, Gene H; Rodgers, Daniel; Kruse, Eric; Collins, Keith; Adatya, Sirtaz; Sarswat, Nitasha; Jorde, Ulrich P; Juricek, Colleen; Ota, Takeyoshi; Jeevanandam, Valluvan; Burkhoff, Daniel; Lang, Roberto M

    2016-03-01

    This study tested whether combined invasive hemodynamic and echocardiographic ramp tests can help optimize patient management. Guidelines for optimizing speed and medications in continuous flow ventricular assist device (cfLVAD) patients are mainly based on expert opinion. Thirty-five cfLVAD patients (21 HeartMate II [Thoratec, Pleasanton, California] and 14 HVAD [HeartWare International, Framingham, Massachusetts]) underwent ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP], and blood pressure) and echocardiography. Data were recorded at up to 9 speed settings. Speed changes were in steps of 400 revolutions per minute (RPM) for HeartMate II (8,000 to 12,000 RPM) and 100 RPM for HVAD (2,300 to 3,200 RPM) patients. Only 42.9% of patients had normal CVPs and PCWPs at their original RPM settings. Going from lowest to highest speeds, cardiac output improved by 0.16 ± 0.19 l/min/step (total change 1.28 ± 1.41 l/min) and PCWP decreased by 1.23 ± 0.85 mm Hg/step (total change 9.9 ± 6.5 mm Hg). CVP and systolic blood pressure did not change significantly with RPM. RPM were adjusted based on test results to achieve CVPs and PCWPs as close to normal limits as possible, which was feasible in 56% of patients. For the remainder, results indicated which type of medical management should be pursued. Use of combined hemodynamic and echocardiographic ramp tests in patients provides objective means of optimizing RPM, and has the potential to guide medical management. It remains to be tested whether this strategy has a beneficial impact on quality of life or clinical outcomes. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  19. Will climate change drive alien invasive plants into areas of high protection value? An improved model-based regional assessment to prioritise the management of invasions.

    Science.gov (United States)

    Vicente, J R; Fernandes, R F; Randin, C F; Broennimann, O; Gonçalves, J; Marcos, B; Pôças, I; Alves, P; Guisan, A; Honrado, J P

    2013-12-15

    Species distribution models (SDMs) studies suggest that, without control measures, the distribution of many alien invasive plant species (AIS) will increase under climate and land-use changes. Due to limited resources and large areas colonised by invaders, management and monitoring resources must be prioritised. Choices depend on the conservation value of the invaded areas and can be guided by SDM predictions. Here, we use a hierarchical SDM framework, complemented by connectivity analysis of AIS distributions, to evaluate current and future conflicts between AIS and high conservation value areas. We illustrate the framework with three Australian wattle (Acacia) species and patterns of conservation value in Northern Portugal. Results show that protected areas will likely suffer higher pressure from all three Acacia species under future climatic conditions. Due to this higher predicted conflict in protected areas, management might be prioritised for Acacia dealbata and Acacia melanoxylon. Connectivity of AIS suitable areas inside protected areas is currently lower than across the full study area, but this would change under future environmental conditions. Coupled SDM and connectivity analysis can support resource prioritisation for anticipation and monitoring of AIS impacts. However, further tests of this framework over a wide range of regions and organisms are still required before wide application. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Human consumption as an invasive species management strategy. A preliminary assessment of the marketing potential of invasive Asian carp in the US.

    Science.gov (United States)

    Varble, Sarah; Secchi, Silvia

    2013-06-01

    Over the past 20 years, Asian carp have invaded rivers and lakes in the Midwest and southern United States, with large negative impacts, such as encroachment on the habitat of native fish and mass die-off. They also respond to boat motors by jumping out of the water, which can cause harm to boaters and fishermen. Policymakers in the Great Lakes region between the US and Canada are worried about possible expansion of the Asian carp to their region and its effects on their fishing industry. A potential solution to the problem is to harvest Asian carp for human consumption. This study analyzes the results of the first national survey on the attitudes of US fish consumers towards Asian carp. We find that this is a potentially promising strategy. Most respondents would be willing to try a free sample of Asian carp and would be willing to pay for it. Because of the negative connotation attached to carp in general, this figure is encouraging. Creating demand for Asian carp could be a market based, cost-effective solution for a problem (invasive species) that is typically dealt with through command and control policies, if it is coupled with appropriate policies and safeguards to ensure the fish is eventually eradicated and not cultivated for profit after removal from US rivers and lakes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. On estimating intraventricular hemodynamic forces from endocardial dynamics: A comparative study with 4D flow MRI.

    Science.gov (United States)

    Pedrizzetti, Gianni; Arvidsson, Per M; Töger, Johannes; Borgquist, Rasmus; Domenichini, Federico; Arheden, Håkan; Heiberg, Einar

    2017-07-26

    Intraventricular pressure gradients or hemodynamic forces, which are their global measure integrated over the left ventricular volume, have a fundamental importance in ventricular function. They may help revealing a sub-optimal cardiac function that is not evident in terms of tissue motion, which is naturally heterogeneous and variable, and can influence cardiac adaptation. However, hemodynamic forces are not utilized in clinical cardiology due to the unavailability of simple non-invasive measurement tools. Hemodynamic forces depend on the intraventricular flow; nevertheless, most of them are imputable to the dynamics of the endocardial flow boundary and to the exchange of momentum across the mitral and aortic orifices. In this study, we introduce a simplified model based on first principles of fluid dynamics that allows estimating hemodynamic forces without knowing the velocity field inside the LV. The model is validated with 3D phase-contrast MRI (known as 4D flow MRI) in 15 subjects, (5 healthy and 10 patients) using the endocardial surface reconstructed from the three standard long-axis projections. Results demonstrate that the model provides consistent estimates for the base-apex component (mean correlation coefficient r=0.77 for instantaneous values and r=0.88 for root mean square) and good estimates of the inferolateral-anteroseptal component (r=0.50 and 0.84, respectively). The present method represents a potential integration to the existing ones quantifying endocardial deformation in MRI and echocardiography to add a physics-based estimation of the corresponding hemodynamic forces. These could help the clinician to early detect sub-clinical diseases and differentiate between different cardiac dysfunctional states. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. PET/CT colonography: a novel non-invasive technique for assessment of extent and activity of ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Das, Chandan J.; Sharma, Raju [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Makharia, Govind K.; Tiwari, Rajeew P. [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Kumar, Rakesh; Kumar, Rajender; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India)

    2010-04-15

    Extent of involvement and activity of ulcerative colitis (UC) is best evaluated by colonoscopy. Colonoscopy however carries risk during acute exacerbation. We investigated the utility of PET/CT colonography for assessment of extent and activity of UC. Within a 1-week window, 15 patients with mild to moderately active UC underwent colonoscopy and PET/CT colonography 60 min after injection of 10 mCi of {sup 18}F-fluorodeoxyglucose (FDG). PET activity score based on the amount of FDG uptake and endoscopic mucosal activity in seven colonic segments of each patient was recorded. The mean maximum standardized uptake value (SUV{sub max}) of seven segments was compared with activity in liver. A PET activity grade of 0, 1, 2 or 3 was assigned to each region depending upon their SUV{sub max} ratio (colon segment to liver). The extent of disease was left-sided colitis in five and pancolitis in ten. The mean Ulcerative Colitis Disease Activity Index (UCDAI) was 7.6. The number of segments involved as per colonoscopic evaluation and PET/CT colonography was 67 and 66, respectively. There was a good correlation for extent evaluation between the two modalities (kappa 55.3%, p = 0.02). One patient had grade 0 PET activity, nine had grade 2 and five had grade 3 PET activity. In six patients, there was one to one correlation between PET activity grades with that of endoscopic grade. One patient showed activity in the sacroiliac joint suggesting active sacroiliitis. PET/CT colonography is a novel non-invasive technique for the assessment of extent and activity of the disease in patients with UC. (orig.)

  3. Urinary exosomes: a novel means to non-invasively assess changes in renal gene and protein expression.

    Directory of Open Access Journals (Sweden)

    Silvia Spanu

    Full Text Available BACKGROUND: In clinical practice, there is a lack of markers for the non-invasive diagnosis and follow-up of kidney disease. Exosomes are membrane vesicles, which are secreted from their cells of origin into surrounding body fluids and contain proteins and mRNA which are protected from digestive enzymes by a cell membrane. METHODS: Toxic podocyte damage was induced by puromycin aminonucleoside in rats (PAN. Urinary exosomes were isolated by ultracentrifugation at different time points during the disease. Exosomal mRNA was isolated, amplified, and the mRNA species were globally assessed by gene array analysis. Tissue-specific gene and protein expression was assessed by RT-qPCR analysis and immunohistochemistry. RESULTS: Gene array analysis of mRNA isolated from urinary exosomes revealed cystatin C mRNA as one of the most highly regulated genes. Its gene expression increased 7.5-fold by day 5 and remained high with a 1.9-fold increase until day 10. This was paralleled by a 2-fold increase in cystatin C mRNA expression in the renal cortex. Protein expression in the kidneys also dramatically increased with de novo expression of cystatin C in glomerular podocytes in parts of the proximal tubule and the renal medulla. Urinary excretion of cystatin C increased approximately 2-fold. CONCLUSION: In this proof-of-concept study, we could demonstrate that changes in urinary exosomal cystatin C mRNA expression are representative of changes in renal mRNA and protein expression. Because cells lining the urinary tract produce urinary exosomal cystatin C mRNA, it might be a more specific marker of renal damage than glomerular-filtered free cystatin C.

  4. Non-invasive assessment of kidney allograft fibrosis with shear wave elastography: A radiological-pathological correlation analysis.

    Science.gov (United States)

    Ma, Maggie Km; Law, Helen Kw; Tse, Kin Sun; Chan, Kwok Wah; Chan, Gary Cw; Yap, Desmond Yh; Mok, Maggie My; Kwan, Lorraine Py; Tang, Sydney Cw; Choy, Bo Ying; Chan, Tak Mao

    2018-02-14

    To evaluate the use of shear wave elastography in assessment of kidney allograft tubulointerstitial fibrosis. Shear wave elastography assessment was carried out by two independent operators in kidney transplant recipients who underwent allograft biopsy for clinical indications (i.e. rising creatinine >15% or proteinuria >1 g/day). Allograft biopsies were interpreted by the same pathologist according to the 2013 Banff Classification. A total of 40 elastography scans were carried out (median creatinine 172.5 μmol/L [interquartile range 133.8-281.8 μmol/L]). Median tissue stiffness at the cortex (22.6 kPa [interquartile range 18.8-25.7 kPa] vs 22.3 kPa [interquartile range 19.0-26.5 kPa], P = 0.70) and medulla (15.0 kPa [interquartile range 13.7-18.0 kPa] vs 15.6 kPa [interquartile range 14.4-18.2 kPa]) showed no significant differences between the two observers. Interobserver agreement was satisfactory (intraclass correlation coefficient of the cortex 0.84, 95% CI 0.70-0.92 and intraclass correlation coefficient of the medulla 0.88, 95% CI 0.78-0.94). The areas under the receiver operating characteristic curves for detection of tubulointerstitial fibrosis were estimated to be 0.75 (95% CI 0.61-0.89), 0.85 (95% CI 0.75-0.95) and 0.65 (95% CI 0.53-0.78) for cortical, medullary tissue stiffness and serum creatinine, respectively. Shear wave elastography can be used as a non-invasive tool to evaluate kidney allograft fibrosis with reasonable interobserver agreement and superior test performance to serum creatinine in detecting early tubulointerstitial fibrosis. © 2018 The Japanese Urological Association.

  5. Assessment of cardiac function and circulatory status in critically ill patients

    Directory of Open Access Journals (Sweden)

    Gorazd Voga

    2007-12-01

    Full Text Available Background: Assessment of cardiac function and circulation is mandatory in almost all critically ill patients. In many patients morphological diagnosis of actual or pre-existing cardiac diseases and their functional consequences should be obtained.Methods: Cardiac function can be assessed by various non-invasive and invasive methods. The value of every method should be assessed according to its ability and reliability to assess preload, cardiac output and the adequacy of flow. In hemodinamically unstable patients frequent reassessment must be performed, because of rapid changes of patients’ conditions. Therefore, all methods for hemodynamic assessment in the ICU must be available on the 24 hours basis. Combined non-invasive and invasive approach to the assessment of cardiac function and circulation is preferred. After initial assessment of cardiac function according to clinical examination, electrocardiogram, chest X-ray and blood gas analysis, echocardiography is routinely used. When continuous monitoring of cardiac function is mandatory, complete invasive monitoring with pulmonary artery catheter and arterial line is employed. Monitoring of pulmonary pressures, continuous cardiac output, mixed venous blood oxygen saturation, and parameters of right ventricular function is the best choice to obtain complete information of hemodynamic situation. In patients with increased pulmonary vascular permeability the monitoring of cardiac output by pulse contour method together with measurement of intrathoracic blood volume and extravascular lung water could be even better choice.Conclusions: Assessment of cardiac function and circulatory status by rational use of various non-invasive and invasive methods is one of the essential components of critical care management.

  6. Hemodynamics in stented vertebral artery ostial stenosis based on computational fluid dynamics simulations.

    Science.gov (United States)

    Qiao, Aike; Dai, Xuan; Niu, Jing; Jiao, Liqun

    2016-01-01

    Hemodynamic factors may affect the potential occurrence of in-stent restenosis (ISR) after intervention procedure of vertebral artery ostial stenosis (VAOS). The purpose of the present study is to investigate the influence of stent protrusion length in implantation strategy on the local hemodynamics of the VAOS. CTA images of a 58-year-old female patient with posterior circulation transient ischemic attack were used to perform a 3D reconstruction of the vertebral artery. Five models of the vertebral artery before and after the stent implantation were established. Model 1 was without stent implantation, Model 2-5 was with stent protruding into the subclavian artery for 0, 1, 2, 3 mm, respectively. Computational fluid dynamics simulations based on finite element analysis were employed to mimic the blood flow in arteries and to assess hemodynamic conditions, particularly the blood flow velocity and wall shear stress (WSS). The WSS and the blood flow velocity at the vertebral artery ostium were reduced by 85.33 and 35.36% respectively after stents implantation. The phenomenon of helical flow disappeared. Hemodynamics comparison showed that stent struts that protruded 1 mm into the subclavian artery induced the least decrease in blood speed and WSS. The results suggest that stent implantation can improve the hemodynamics of VAOS, while stent struts that had protruded 1 mm into the subclavian artery would result in less thrombogenesis and neointimal hyperplasia and most likely decrease the risk of ISR.

  7. Thermal and hemodynamic response to whole-body cryostimulation in healthy subjects.

    Science.gov (United States)

    Zalewski, Pawel; Klawe, Jacek J; Pawlak, Joanna; Tafil-Klawe, Malgorzata; Newton, Julia

    2013-06-01

    Whole-body cryotherapy (WBC) is an increasing applied cryotherapeutic method, that involves application of a cryotherapeutic factor to stimulate the body by the means of intense hypothermia of virtually the body's entire area. This method is still not well recognized in Western Europe. However in recent years it is becoming increasingly popular in sports medicine and also in clinical application. Cryotherapeutic agents used in WBC are considered to be a strong stress stimulus which is associated with a variety of changes in functional parameters, particularly of the cardiovascular and autonomic nervous systems. However, such strong influence upon the entire body could be associated with the risk of unexpected reactions which might be dangerous for homeostasis. The present study evaluated the complex hemodynamic physiological reactions in response to WBC exposure in healthy subjects. Thirty healthy male volunteers participated. Each subject was exposed to WBC (-120°C) for 3-min. None of the participants had been exposed to such conditions previously. The research was conducted with modern and reliable measurements techniques, which assessed complex hemodynamic reactions and skin temperature changes non-invasively. All measurements were performed four times (before WBC, after WBC, WBC+3h and WBC+6h) with a Task Force Monitor (TFM - CNSystems, Medizintechnik, Gratz, Austria). Body superficial temperature was measured by infrared thermographic techniques - infra-red camera Flir P640 (Flir Systems Inc., Sweden). Our results show a significant decrease in heart rate, cardiac output, and increase in stroke volume, total peripheral resistance and baroreceptors reflex sensitivity. These changes were observed just after WBC exposure. At stages WBC+3h and WBC+6h there was observed a significant drop in baroreceptors reflex sensitivity due to increased thermogenesis. In conclusion, the present findings suggest that WBC strongly stimulates the baroreceptor cardiac reflex in

  8. Echocardiographic and hemodynamic determinants of right coronary artery flow reserve and phasic flow pattern in advanced non-ischemic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Mady Charles

    2007-09-01

    Full Text Available Abstract Background In patients with advanced non-ischemic cardiomyopathy (NIC, right-sided cardiac disturbances has prognostic implications. Right coronary artery (RCA flow pattern and flow reserve (CFR are not well known in this setting. The purpose of this study was to assess, in human advanced NIC, the RCA phasic flow pattern and CFR, also under right-sided cardiac disturbances, and compare with left coronary circulation. As well as to investigate any correlation between the cardiac structural, mechanical and hemodynamic parameters with RCA phasic flow pattern or CFR. Methods Twenty four patients with dilated severe NIC were evaluated non-invasively, even by echocardiography, and also by cardiac catheterization, inclusive with Swan-Ganz catheter. Intracoronary Doppler (Flowire data was obtained in RCA and left anterior descendent coronary artery (LAD before and after adenosine. Resting RCA phasic pattern (diastolic/systolic was compared between subgroups with and without pulmonary hypertension, and with and without right ventricular (RV dysfunction; and also with LAD. RCA-CFR was compared with LAD, as well as in those subgroups. Pearson's correlation analysis was accomplished among echocardiographic (including LV fractional shortening, mass index, end systolic wall stress more hemodynamic parameters with RCA phasic flow pattern or RCA-CFR. Results LV fractional shortening and end diastolic diameter were 15.3 ± 3.5 % and 69.4 ± 12.2 mm. Resting RCA phasic pattern had no difference comparing subgroups with vs. without pulmonary hypertension (1.45 vs. 1.29, p = NS either with vs. without RV dysfunction (1.47 vs. 1.23, p = NS; RCA vs. LAD was 1.35 vs. 2.85 (p Conclusion In patients with chronic advanced NIC, RCA phasic flow pattern has a mild diastolic predominance, less marked than in LAD, with no effects from pulmonary artery hypertension or RV dysfunction. There is no significant correlation between any cardiac mechanical-structural or

  9. Understanding patterns of invasion: a novel approach to assessment of podoplanin expression in the prediction of lymph node metastasis in oral squamous cell carcinoma.

    Science.gov (United States)

    Sharma, Ankita; Boaz, Karen; Natarajan, Srikant

    2018-03-01

    Cellular motility is considered to be central to the process of metastasis, and podoplanin expression can be explored as a prospective link, owing to its ability to modulate the actin cytoskeleton. We aimed to evaluate the tumoral expression of D2-40 (monoclonal antibody against podoplanin) in pathologically neck-node-negative/positive cases (pN0/N+) to characterise the pattern of invasion, potentially explaining the role of various patterns of invasion in causing tumour metastasis. Paraffin-embedded tissue blocks of 60 oral squamous cell carcinoma cases of known nodal status were selected for immunohistochemical staining of tumour (invasive front) by D2-40 along with routine staining by haematoxylin and eosin. Various staining patterns were assessed and evaluated for D2-40 expression, and correlated with nodal status. Tumoral D2-40 expression correspondingly increased with nodal metastasis (P = 0.261). Furthermore, D2-40 staining was more efficient in detecting individual tumour cells, and also characterised the motility factor irrespective of the pattern of invasion (P = 0.001). The pattern of D2-40 staining did not show a significant association with tumour grade, indicating that motility is an overlooked, albeit important, component of the pattern of invasion in routine histological grading. D2-40 expression successfully identifies the motility profile of tumour, irrespective of the pattern of invasion. The presence of larger motile islands in the tumour cohort supports the concept of 'collective cell migration'. Podoplanin also aids evasion of immune responses by inducing platelet aggregation over tumour cells, thereby favouring distant metastasis. A multivariate model using immunohistochemical staining with D2-40 provides greater sensitivity for the prediction of lymph node metastasis. © 2017 John Wiley & Sons Ltd.

  10. Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

    Science.gov (United States)

    McGee, William T; Raghunathan, Karthik; Adler, Adam C

    2015-12-01

    The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.

  11. Hemodynamic support with the pulsatile catheter pump in a sheep model of acute heart failure

    NARCIS (Netherlands)

    Li, Zhicheng; Gu, Y. John; Ye, Qing; Cheng, Shaofei; Wang, Weijun; Tang, Min; Zhao, Xiaogang; Rakhorst, Gerhard; Chen, Changzhi

    2006-01-01

    This study was aimed to mimic clinical heart failure (HF) conditions and to assess the effect of pulsatilecatheter (PUCA) pump support on hemodynamics and tissue perfusion in a sheep model of acute HF. In 14 sheep, HF was induced by partial occluding the middle left circumflex coronary artery

  12. Journal of Clinical Monitoring and Computing 2016 end of year summary : cardiovascular and hemodynamic monitoring

    NARCIS (Netherlands)

    Saugel, Bernd; Bendjelid, Karim; Critchley, Lester A.; Rex, Steffen; Scheeren, Thomas W. L.

    The assessment and optimization of cardiovascular and hemodynamic variables is a mainstay of patient management in the care for critically ill patients in the intensive care unit (ICU) or the operating room (OR). It is, therefore, of outstanding importance to meticulously validate technologies for

  13. Molecular imaging of tumor photoimmunotherapy: Evidence of photosensitized tumor necrosis and hemodynamic changes

    DEFF Research Database (Denmark)

    Kishimoto, Shun; Oshima, Nobu; Yamamoto, Kazutoshi

    2018-01-01

    of cytotoxicity based mainly on in vitro studies. To better understand the acute effects of NIR PIT, molecular imaging studies were performed to assess its cellular and vascular effects.In addition to in vitro studies for cytotoxicity of NIR PIT, the in vivo tumoricidal effects and hemodynamic changes induced...

  14. Assessment of right ventricular systolic function by tissue Doppler echocardiography

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper

    2012-01-01

    This thesis summarizes a series of studies performed in order to assess the clinical usefulness of a novel echocardiographic technology that allows non-invasive assessment of regional right ventricular myocardial velocities and deformation: tissue Doppler echocardiography. While the technology...... is a promising tool for improving our understanding of right ventricular hemodynamics, several aspects of the technology must be evaluated. The accuracy and reproducibility of the technology is evaluated in vitro, and normal values, impact of changes in loading of the right ventricle, response to exercise...... on right ventricular hemodynamics: pulmonary embolism, Arrhythmogenic right ventricular cardiomyopathy and pulmonary regurgitation, the latter in an animal model. The conclusions of the thesis are: Color tissue Doppler echocardiography accurately measures velocities, SR and strain in vitro. No systematic...

  15. Assessment of perioperative minute ventilation in obese versus non-obese patients with a non-invasive respiratory volume monitor.

    Science.gov (United States)

    Mehta, Jaideep H; Cattano, Davide; Brayanov, Jordan B; George, Edward E

    2017-04-26

    Monitoring the adequacy of spontaneous breathing is a major patient safety concern in the post-operative setting. Monitoring is particularly important for obese patients, who are at a higher risk for post-surgical respiratory complications and often have increased metabolic demand due to excess weight. Here we used a novel, noninvasive Respiratory Volume Monitor (RVM) to monitor ventilation in both obese and non-obese orthopedic patients throughout their perioperative course, in order to develop better monitoring strategies. We collected respiratory data from 62 orthopedic patients undergoing elective joint replacement surgery under general anesthesia using a bio-impedance based RVM with an electrode PadSet placed on the thorax. Patients were stratified into obese (BMI ≥ 30) and non-obese cohorts and minute ventilation (MV) at various perioperative time points was compared against each patient's predicted minute ventilation (MV PRED ) based on ideal body weight (IBW) and body surface area (BSA). The distributions of MV measurements were also compared across obese and non-obese cohorts. Obese patients had higher MV than the non-obese patients before, during, and after surgery. Measured MV of obese patients was significantly higher than their MV PRED from IBW formulas, with BSA-based MV PRED being a closer estimate. Obese patients also had greater variability in MV post-operatively when treated with standard opioid dosing. Our study demonstrated that obese patients have greater variability in ventilation post-operatively when treated with standard opioid doses, and despite overall higher ventilation, many of them are still at risk for hypoventilation. BSA-based MV PRED formulas may be more appropriate than IBW-based ones when estimating the respiratory demand of obese patients. The RVM allows for the continuous and non-invasive assessment of respiratory function in both obese and non-obese patients.

  16. Hierarchical demographic approaches for assessing invasion dynamics of non-indigenous species: An example using northern snakehead (Channa argus)

    Science.gov (United States)

    Jiao, Y.; Lapointe, N.W.R.; Angermeier, P.L.; Murphy, B.R.

    2009-01-01

    Models of species' demographic features are commonly used to understand population dynamics and inform management tactics. Hierarchical demographic models are ideal for the assessment of non-indigenous species because our knowledge of non-indigenous populations is usually limited, data on demographic traits often come from a species' native range, these traits vary among populations, and traits are likely to vary considerably over time as species adapt to new environments. Hierarchical models readily incorporate this spatiotemporal variation in species' demographic traits by representing demographic parameters as multi-level hierarchies. As is done for traditional non-hierarchical matrix models, sensitivity and elasticity analyses are used to evaluate the contributions of different life stages and parameters to estimates of population growth rate. We applied a hierarchical model to northern snakehead (Channa argus), a fish currently invading the eastern United States. We used a Monte Carlo approach to simulate uncertainties in the sensitivity and elasticity analyses and to project future population persistence under selected management tactics. We gathered key biological information on northern snakehead natural mortality, maturity and recruitment in its native Asian environment. We compared the model performance with and without hierarchy of parameters. Our results suggest that ignoring the hierarchy of parameters in demographic models may result in poor estimates of population size and growth and may lead to erroneous management advice. In our case, the hierarchy used multi-level distributions to simulate the heterogeneity of demographic parameters across different locations or situations. The probability that the northern snakehead population will increase and harm the native fauna is considerable. Our elasticity and prognostic analyses showed that intensive control efforts immediately prior to spawning and/or juvenile-dispersal periods would be more effective

  17. Non-Invasive Assessment of Sentinel Lymph Nodes That Drain the Tumoral Mammary Glands in Female Dog

    Directory of Open Access Journals (Sweden)

    Florin Gheorghe Stan

    2016-11-01

    Full Text Available Introduction: Mammary gland tumours occupy a significant place in the pathology of this species. Female dogs that are not spayed after their first heat cycle have a higher predisposition of developing mammary tumours. Most tumours metastasize at distance via the lymphatic system. In these conditions, the sentinel lymph nodes of the mammary glands must be assessed prior to surgical treatment. Aims: Considering the insufficient usage of non-invasive investigative methods of the sentinel lymph nodes, the aim of this study is to describe the sonographic anatomy of the lymph nodes that drain the mammary gland tumours in female dog. Materials and Methods: Twelve dog females presenting tumours of the cranial and caudal abdominal mammary glands (A1 and A2, inguinal mammary gland (I and cranial thoracic mammary gland (T1 were examined (group I. In addition, a control group composed of eight dog females was used (group II. The axillary and superficial inguinal lymph nodes were evaluated using an algorithm composed of gray-scale ultrasound, Doppler technique, contrast enhanced ultrasound (CEUS and real time elastography. Surgical excision of the sentinel lymph nodes was performed and samples for histopathological examination were taken. Results: The following ultrasonographic findings revealed on gray-scale examination were suspected for the metastatic infiltration: hypoechoic pattern, round shape, hillus absence and heterogenicity. Doppler technique showed an aberrant and mixed vascularisation of the lymph nodes, while the CEUS revealed incomplete enhancement of lymph nodes parenchyma. On real time elastography, the presence of blue areas in more than 50% from the lymph nodes parenchyma led us to conclude that the lymph node stiffness was caused by metastatic infiltration. Histopathological examination confirmed the presence of the metastatic infiltration in 97% of the examined lymph nodes. Conclusion: The algorithm composed of gray-scale ultrasound

  18. The Czech Surveillance System for Invasive Pneumococcal Disease, 2008-2013: A Follow-Up Assessment and Sensitivity Estimation.

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    Nina Katharina Stock

    Full Text Available Invasive pneumococcal disease (IPD is caused by Streptococcus pneumoniae and mostly presents as pneumonia, sepsis or meningitis. A notable portion of IPD cases is vaccine preventable and the pneumococcal conjugate vaccine (PCV was introduced into the routine childhood immunization programs in many countries during the last decades.Before PCV introduction in the Czech Republic in 2010, a national surveillance system for IPD was implemented in 2008 and further improved in 2011. In this study, we describe the new surveillance system for the first time and measure its sensitivity between 2010 and 2013 using the capture-recapture method. Furthermore, we describe the recent epidemiological trend of IPD, taking sensitivity estimates into account.Between 2010 and 2013 the estimated sensitivity of the overall IPD surveillance increased from 81% to 99%. The sensitivity of individual reporting sources increased from 72% to 87% for the laboratory system and from 31% to 89% for the epidemiological notification system. Crucial for this improvement was the introduction of quarterly report reminders in 2011. Due to positive source dependency, the presented sensitivity estimates are most probably overestimated and reflect the upper limit of reporting completeness. Stratification showed variation in sensitivity of reporting particularly according to region. An effect of the PVC vaccination in the Czech Republic is visible in the incidence of IPD in target age groups (<5 y. This influence was not evident in the total IPD incidence and may interfere with increasing sensitivity of reporting. In 2013, an increase in the IPD incidence was observed. This finding requires further observation and a detailed vaccine impact analysis is needed to assess the current immunization strategy.

  19. Invasive "in the cath-lab" assessment of myocardial ischemia in patients with coronary artery disease: When does the gold standard not apply?

    Science.gov (United States)

    Benenati, Stefano; De Maria, Giovanni Luigi; Scarsini, Roberto; Porto, Italo; Banning, Adrian P

    2018-01-31

    International guidelines recommend that revascularization for coronary artery disease (CAD) should be guided by evidence of myocardial ischemia. Fractional flow reserve (FFR) and instantaneous free wave ratio (iFR) are the main invasive indices for assessing the ischemic potential of angiographically intermediate coronary stenosis as a large body of evidence supports their routine application. Both indices have been tested and validated in patients with isolated stable CAD, but notably their application outside this specific context is a matter of debate and investigation. In the present review we aim to look into the available evidence about the reliability and feasibility of FFR and iFR in clinical contexts different from stable angina where these techniques have been validated. We aim to shed light on which technique can be used to invasively assess ischemia when an angiographic moderate coronary stenosis is observed in a clinical setting other than isolated stable CAD. Copyright © 2018. Published by Elsevier Inc.

  20. “The Invasion and Limits of the Catastrophe of the 13th century” in the Assessments of Contemporary Domestic and Foreign Researchers

    Directory of Open Access Journals (Sweden)

    Narozhnyi E.I.

    2017-12-01

    Full Text Available This review evaluates the works of several authors who published their articles in the journal, Stratum plus (2016, No. 5, which was entirely devoted to the issue of the Mongol-Tatar invasion. Authors from Russia, Ukraine, Belarus, Moldova and Romania assess the nature and extent of the consequences of this invasion on the European continent based on archaeological data, museum exhibits, written sources, church and household architecture. Considering the entire range of opinions expressed as a while, the review evaluates the successful attempt to address the aforementioned topics in a single issue of the journal. Thanks to the success of the attempt, this issue of the journal has become an important collection of articles for assessing the consequences of the relevant events of the 13th century. Without a doubt, this journal’s issue will not only be interesting, but also useful, for a wide range of interested readers.

  1. A global assessment of invasive plant impacts on resident species, communities and ecosystems: the interaction of impact measures, invading species’ traits and environment

    Czech Academy of Sciences Publication Activity Database

    Pyšek, Petr; Jarošík, Vojtěch; Hulme, P. E.; Pergl, Jan; Hejda, Martin; Schaffner, U.; Vila, M.

    2012-01-01

    Roč. 18, č. 5 (2012), s. 1725-1737 ISSN 1354-1013 R&D Projects: GA MŠk LC06073; GA ČR(CZ) GAP505/11/1112 Institutional research plan: CEZ:AV0Z60050516 Institutional support: RVO:67985939 Keywords : biological invasions * impact * global assessment Subject RIV: EF - Botanics Impact factor: 6.910, year: 2012

  2. Hypertrophic cardiomyopathy: Non-invasive assessment of diastolic and systolic functional parameters in relation to heart rate

    Energy Technology Data Exchange (ETDEWEB)

    Nienaber, C.A.; Geiger, M.; Clausen, A.; Kuck, K.H.; Spielmann, R.P.; Montz, R.

    1985-12-01

    To study the pathophysiologic changes in parameters of left ventricular systolic and diastolic performance as a function of increasing heart rate 14 patients with HC (32 +- 12 yrs; 11 M, 4 F) and 4 normal individuals were subjected to equilibrium radionuclide ventriculography (sup(99m)Tc-labelled red blood cells) at rest and during incremental right atrial pacing; heart rate was increased in steps of 20 beats per min from basal state to the individual symptom-limited endpoint. Thus, patients with HC demonstrated combined left ventricular diastolic and systolic abnormalities with increasing heart rate leading into a low-input low-output circulatory state. This probably explains not only the symptoms associated with HC, but also supports the concept of ''hemodynamic syncope'' in HC.

  3. Assessment of deep myometrial invasion of endometrial cancer on MRI: added value of second-opinion interpretations by radiologists subspecialized in gynaecologic oncology

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sungmin [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Cho, Jeong Yeon; Kim, Seung Hyup [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

    2017-05-15

    To investigate the added value of secondary reports issued by radiologists subspecializing in gynaecologic imaging for determining deep myometrial invasion of endometrial cancer on MRI. Initial (from referring institutions) and secondary (by subspecialized radiologists) interpretations of MRI of 55 patients with endometrial cancer were retrospectively reviewed. A radiologist blinded to clinicopathological information assessed both reports for the presence of deep myometrial invasion. Reference standard was based on hysterectomy specimens. Kappa coefficients (k) were used to measure their concordance. McNemar testing and receiver operating characteristic (ROC) analysis was used to compare sensitivities, specificities and areas under the curves (AUCs). Deep myometrial invasion was present in 25 (45.5 %) patients. Among 27.3 % (15/55; k = 0.458) patients with discrepant results, secondary interpretations were correct in 10 (66.7 %) cases. Sensitivity was higher in secondary than in initial reports (76.0 % vs. 48.0 %, p = 0.039) while no significant difference was seen in specificity (70.0 % vs. 76.7 %, p = 0.668). At ROC analysis, there was a tendency for higher AUCs in secondary reports (0.785 vs 0.669, p = 0.096). Secondary readings of MRI by subspecialized gynaecologic oncologic radiologists may provide incremental value in determining deep myometrial invasion of endometrial cancer. (orig.)

  4. Assessment of Serosal Invasion and Criteria for the Classification of Pathological (p) T4 Staging in Colorectal Carcinoma: Confusions, Controversies and Criticisms

    International Nuclear Information System (INIS)

    Stewart, Colin J. R.; Hillery, Simon; Platell, Cameron; Puppa, Giacomo

    2011-01-01

    Transmural spread by colorectal carcinoma can result in tumor invasion of the serosal surface and, hence, more likely dissemination within the peritoneal cavity and potentially to additional metastatic sites. The adverse prognostic significance of serosal invasion is widely accepted and its presence may be considered an indication for chemotherapy in patients with node negative disease. However, controversy persists regarding the most appropriate criteria for diagnosis and there are also practical difficulties associated with histological assessment in some cases. Therefore, serosal invasion may be under-diagnosed in a significant proportion of tumors, potentially leading to sub-optimal treatment of high-risk patients. The examination of multiple microscopic sections combined with ancillary studies such as cytology preparations, elastin stains, and immunohistochemistry may prove beneficial in selected problematic cases, but these are not used routinely. The relative prognostic significance of serosal invasion and of direct tumor spread to other organs, both of which are incorporated within the pT4 category of the AJCC/UICC TNM staging system, remains unclear. Further studies are required to demonstrate whether recent adjustments to the TNM staging of pT4 tumors are appropriate

  5. Integration of non-invasive biometrics with sensory analysis techniques to assess acceptability of beer by consumers.

    Science.gov (United States)

    Gonzalez Viejo, Claudia; Fuentes, Sigfredo; Howell, Kate; Torrico, Damir D; Dunshea, Frank R

    2018-03-05

    Traditional sensory tests rely on conscious and self-reported responses from participants. The integration of non-invasive biometric techniques, such as heart rate, body temperature, brainwaves and facial expressions can gather more information from consumers while tasting a product. The main objectives of this study were i) to assess significant differences between beers for all conscious and unconscious responses, ii) to find significant correlations among the different variables from the conscious and unconscious responses and iii) to develop a model to classify beers according to liking using only the unconscious responses. For this study, an integrated camera system with video and infrared thermal imagery (IRTI), coupled with a novel computer application was used. Videos and IRTI were automatically obtained while tasting nine beers to extract biometrics (heart rate, temperature and facial expressions) using computer vision analysis. Additionally, an EEG mobile headset was used to obtain brainwave signals during beer consumption. Consumers assessed foam, color, aroma, mouthfeel, taste, flavor and overall acceptability of beers using a 9-point hedonic scale with results showing a higher acceptability for beers with higher foamability and lower bitterness. i) There were non-significant differences among beers for the emotional and physiological responses, however, significant differences were found for the cognitive and self-reported responses. ii) Results from principal component analysis explained 65% of total data variability and, along with the covariance matrix (p sensory responses of participants and the biometric data obtained. There was a negative correlation between body temperature and liking of foam height and stability, and a positive correlation between theta signals and bitterness. iii) Artificial neural networks were used to develop three models with high accuracy to classify beers according to level of liking (low and high) of three sensory

  6. Biology and hemodynamics of aneurismal vasculopathies

    International Nuclear Information System (INIS)

    Pereira, Vitor Mendes; Brina, Olivier; Gonzalez, Ana Marcos; Narata, Ana Paula; Ouared, Rafik; Karl-Olof, Lovblad

    2013-01-01

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

  7. Myometrial invasion and overall staging of endometrial carcinoma: assessment using fusion of T2-weighted magnetic resonance imaging and diffusion-weighted magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Guo Y

    2017-12-01

    Full Text Available Yu Guo,1,2 Ping Wang,2 Penghui Wang,2 Wei Gao,1 Fenge Li,3 Xueling Yang,1 Hongyan Ni,2 Wen Shen,2 Zhi Guo1 1Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin, 2Department of Radiology, Tianjin First Center Hospital, The First Central Clinical College of Tianjin Medical University, Tianjin, 3Department of Gynecology, Tianjin First Center Hospital, Tianjin, People’s Republic of China Background: The age of onset of endometrial carcinoma has been decreasing in recent years. In endometrial carcinoma, it is important to accurately assess invasion depth and preoperative staging. Fusion of T2-weighted magnetic resonance imaging (T2WI and diffusion-weighted magnetic resonance imaging (DWI may contribute to the improvement of anatomical localization of lesions.Materials and methods: In our study, a total of 58 endometrial carcinoma cases were included. Based on the revised 2009 International Federation of Gynecology and Obstetrics staging system, a fusion of T2WI and DWI was utilized for the evaluation of invasion depth and determination of the overall stage. Postoperative pathologic assessment was considered as the reference standard. The consistency of T2WI image staging and pathologic staging, and the consistency of fused T2WI and DWI and pathologic staging were all analyzed using Kappa statistics.Results: Compared with the T2WI group, a significantly higher diagnostic accuracy was observed for myometrial invasion with fusion of T2WI and DWI (77.6% for T2WI; 94.8% for T2WI-DWI. For the identification of deep invasion, we calculated values for diagnostic sensitivity (69.2% for T2WI; 92.3% for T2WI-DWI, specificity (80% for T2WI; 95.6% for T2WI-DWI, positive predictive value (50% for T2WI; 85.7% for T2WI-DWI, and negative predictive value (90% for

  8. HEMODYNAMIC EFFECTS OF XENON ANESTHESIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    M. V. Bykov

    2014-01-01

    Full Text Available The study was aimed at hemodynamic effects of xenon on operative interventions in children. Patients and methods: the study involved 30 5-17-year-old children – 10 (33.3% girls and 20 (66.7% boys with ASA score 1-3 admitted for surgical treatment. The children underwent endotracheal anesthesia with xenon-oxygen mixture (Xe:O2 = 60-65:30% and fentanyl (2.5‑3.5  mcg/kg per hour for the following operations: appendectomy – 10 (33.3% patients, herniotomy – 8 (26.7% patients, Ivanissevich procedure – 6 (20.0% patients, plastic surgery of posttraumatic defects of skin and soft tissues – 4 (13.3% patients, abdominal adhesiotomy – 2 (6.7% patients. Central hemodynamics was studied echocardiographically (Philips HD 11, the Netherlands using the Teichholz technique along the cephalocaudal axis (parasternal access. Results: the anesthesia was notable for hemodynamic stability during the operation: as a result, a statistically significant (p < 0.05 increase in systolic, diastolic and mean arterial pressure by 10, 18 and 17%, respectively, was observed. Conclusion: the analysis demonstrated that xenon anesthesia improves lusitropic myocardial function statistically significantly increasing cardiac output by 12% by way of increasing stroke volume by 30%. 

  9. Effect of large fundal varices on changes in gastric mucosal hemodynamics after endoscopic variceal ligation.

    Science.gov (United States)

    Tayama, C; Iwao, T; Oho, K; Toyonaga, A; Tanikawa, K

    1998-01-01

    BACKGROUNDS AND STUDY AIMS: Effect of endoscopic variceal ligation (EVL) on gastric mucosal hemodynamics would differ in patients with and without large fundal varices. The aim of this study was to test this hypothesis. Twenty-seven patients with cirrhosis and large sized esophageal varices were prospectively studied. There were eight patients with large fundal varices and 19 patients without large fundal varices. Before EVL, gastric mucosal hemodynamics were endoscopically assessed by laser-Doppler velocimetry and reflectance spectrophotometry in the antrum and the corpus. In the reflectance spectrophotometric measurements, gastric mucosal hemoglobin content (IHb) and gastric mucosal oxygen saturation (ISO2) were determined. The severity of portal-hypertensive gastropathy (PHG) was also recorded at the antrum and the corpus. For data analysis, PHG was scored (absent, 0; mild, 1; severe, 2; bleeding, 3). These measurements were repeated after initial (three days after initial session) and repeated (seven days after last session) EVL. At the antrum, neither PHG score nor gastric mucosal hemodynamic parameters were modified after initial and repeated EVL in patients with and without large fundal varices. In addition, no significant differences of the integrated changes in PHG score and gastric mucosal hemodynamic parameters were observed in the two groups. At the corpus, PHG score significantly increased after initial and repeated EVL in patients without large fundal varices. In these patients, laser-Doppler signal and ISO2 significantly decreased and IHb significantly increased after initial and repeated EVL. In contrast, PHG score, laser-Doppler signal, and ISO2 did not change significantly in patients with large fundal varices, although IHb transiently increased after initial EVL. Furthermore, the integrated changes in PHG score and gastric mucosal hemodynamic parameters were significantly lower in patients with large fundal varices than in those without. The

  10. Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms.

    Science.gov (United States)

    Schneiders, J J; Marquering, H A; van Ooij, P; van den Berg, R; Nederveen, A J; Verbaan, D; Vandertop, W P; Pourquie, M; Rinkel, G J E; vanBavel, E; Majoie, C B L M

    2015-10-01

    Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture. A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters. In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77-8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25-6.25) remained as significant independent determinants. In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms. © 2015 by American Journal of Neuroradiology.

  11. Echocardiographic estimation of right ventricular stroke work in children with pulmonary arterial hypertension: comparison with invasive measurements.

    Science.gov (United States)

    Di Maria, Michael V; Burkett, Dale A; Younoszai, Adel K; Landeck, Bruce F; Mertens, Luc; Ivy, D Dunbar; Friedberg, Mark K; Hunter, Kendall S

    2015-11-01

    Right ventricular (RV) failure is a key determinant of mortality in children with pulmonary arterial hypertension (PAH). RV stroke work (RVSW) can be estimated as the product of RV systolic pressure and stroke volume. The authors have shown that RVSW predicts adverse outcomes in this population when derived from hemodynamic data; noninvasive assessment of RVSW may be advantageous but has not been assessed. There are few data validating noninvasive versus invasive measurements in children with PAH. The aim of this study was to compare echocardiographically derived RVSW with RVSW determined from hemodynamic data. This was a retrospective study, including subjects with idiopathic PAH and minor or repaired congenital heart disease. Forty-nine subjects were included, in whom cardiac catheterization and echocardiography were performed within 1 month. Fourteen additional patients were included in a separate cohort, in whom catheterization and echocardiography were performed simultaneously. Catheterization-derived RVSW was calculated as RV systolic pressure × (cardiac output/heart rate). Echocardiographically derived RVSW was calculated as 4 × (peak tricuspid regurgitant jet velocity)(2) × (pulmonary valve area × velocity-time integral). Statistics included the intraclass correlation coefficient and Bland-Altman analysis. Echocardiographically derived RVSW was linearly correlated with invasively derived RVSW (r = 0.74, P work was related to indexed pulmonary vascular resistance (r = 0.43, P = .002), tricuspid annular plane systolic excursion (r = 0.41, P = .004), and RV wall thickness (r = 0.62, P work, a potential novel index of RV function, can be estimated noninvasively and is related to pulmonary hemodynamics and other indices of RV performance. Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  12. 3D CBCT morphometric assessment of mental foramen in Arabic population and global comparison: imperative for invasive and non-invasive procedures in mandible.

    Science.gov (United States)

    Alam, Mohammad Khursheed; Alhabib, Selham; Alzarea, Bader K; Irshad, Muhammad; Faruqi, Saif; Sghaireen, Mohd G; Patil, Santosh; Basri, Rehana

    2018-03-01

    Recent advancements in clinical dentistry have increased the possibilities of surgical procedures in the mental region. A detailed knowledge of mental foramen (MF) morphometry is significant to preserve integrity of the mental nerve trunk in surgical interventions such as orthognathic surgery, implant placement and anaesthetic block. The aim of this study was to determine the most accurate position of the mental foramen by using new assessment approach in a sample of dental patients presenting to the specialist dental clinic, College of Dentistry, Al Jouf University, Saudi Arabia. A retrospective study was performed using cone beam computed tomography (CBCT) of 600 patients (40.1 ± 11.78 years old). Following inclusion and exclusion criteria, 395 CBCT were finally obtained and analyzed for the most accurate position of the mental foramen (MF) by OnDemand 3D software (Seoul, Korea). Prevalence of shape of MF and accessory MF were also assessed. Pearson chi-square test was employed to test significant differences between genders and races. The most common horizontal and vertical position of the mental foramen was in line with the long axis of 2nd premolar (41.3%) and below the root apex level (93.2%), respectively. The most common shape of MF was round type (72.66%). The prevalence of accessory 2MF and 3MF was 2.28% and 0.25%, respectively. New information about MF presented in this article can help anatomists, prosthodontists, orthodontists, surgeons, forensic odontologists and paleoanthropologists to predict the position of the MF and perform safer surgeries.

  13. Whole body hyperthermia by extracorporeal circulation in spontaneously breathing sarcoma patients: hemodynamics and oxygen metabolism.

    Science.gov (United States)

    Locker, Gottfried J; Fuchs, Eva-Maria; Worel, Nina; Bojic, Andja; Heinrich, Gerhard; Brodowicz, Thomas; Clodi, Martin; Funk, Georg-Christian; Knöbl, Paul; Zielinski, Christoph C; Köstler, Wolfgang J

    2011-11-01

    This phase I study was performed to evaluate the feasibility and toxicity of a new method of extracorporeal perfusion-induced whole body hyperthermia (WBHT) in patients with advanced sarcoma avoiding the need of intubation and general anesthesia. One double-lumen femoral venous access was inserted by Seldinger's technique to obtain WBHT (41.8°C for 120 minutes) via an extracorporeal circuit. No concomitant chemotherapy was applied. Up to 4 treatments of WBHT were performed under moderate sedation in 6 spontaneously breathing patients. Invasive hemodynamic monitoring was performed by use of a pulmonary artery catheter. After their first WBHT session, 2 patients were excluded from further treatment due to transient liver toxicity or catheter-related complication, so a total of 12 cycles remained for analyses. In all patients, conscious sedation resulted in sufficient spontaneous respiration without the need for mandatory ventilation. Median time to reach the target temperature was 84 minutes (range 60-142). Hemodynamic changes revealed the expected hyperdynamic state: heart rate, cardiac index, and stroke volume index significantly increased (pmean; 0.062 µg·kg¹·min⁻¹) were necessary to maintain the mean arterial blood pressure >60 mmHg. Our data demonstrate the feasibility of this method of extracorporeal WBHT without mandatory ventilation. Hemodynamic side effects in spontaneously breathing patients during perfusion-induced WBHT seem less severe than those observed in radiant heat WBHT.

  14. Clinical Implications of Cluster Analysis-Based Classification of Acute Decompensated Heart Failure and Correlation with Bedside Hemodynamic Profiles.

    Directory of Open Access Journals (Sweden)

    Tariq Ahmad

    Full Text Available Classification of acute decompensated heart failure (ADHF is based on subjective criteria that crudely capture disease heterogeneity. Improved phenotyping of the syndrome may help improve therapeutic strategies.To derive cluster analysis-based groupings for patients hospitalized with ADHF, and compare their prognostic performance to hemodynamic classifications derived at the bedside.We performed a cluster analysis on baseline clinical variables and PAC measurements of 172 ADHF patients from the ESCAPE trial. Employing regression techniques, we examined associations between clusters and clinically determined hemodynamic profiles (warm/cold/wet/dry. We assessed association with clinical outcomes using Cox proportional hazards models. Likelihood ratio tests were used to compare the prognostic value of cluster data to that of hemodynamic data.We identified four advanced HF clusters: 1 male Caucasians with ischemic cardiomyopathy, multiple comorbidities, lowest B-type natriuretic peptide (BNP levels; 2 females with non-ischemic cardiomyopathy, few comorbidities, most favorable hemodynamics; 3 young African American males with non-ischemic cardiomyopathy, most adverse hemodynamics, advanced disease; and 4 older Caucasians with ischemic cardiomyopathy, concomitant renal insufficiency, highest BNP levels. There was no association between clusters and bedside-derived hemodynamic profiles (p = 0.70. For all adverse clinical outcomes, Cluster 4 had the highest risk, and Cluster 2, the lowest. Compared to Cluster 4, Clusters 1-3 had 45-70% lower risk of all-cause mortality. Clusters were significantly associated with clinical outcomes, whereas hemodynamic profiles were not.By clustering patients with similar objective variables, we identified four clinically relevant phenotypes of ADHF patients, with no discernable relationship to hemodynamic profiles, but distinct associations with adverse outcomes. Our analysis suggests that ADHF classification using

  15. Aerial photographs as a tool for assessing the regional dynamics of the invasive plant species Heracleum mantegazzianum

    Czech Academy of Sciences Publication Activity Database

    Müllerová, Jana; Pyšek, Petr; Jarošík, Vojtěch; Pergl, Jan

    2005-01-01

    Roč. 42, č. 6 (2005), s. 1042-1053 ISSN 0021-8901 Institutional research plan: CEZ:AV0Z60050516 Keywords : rate of invasion * aerial photographs * Heracleum mantegazzianum Subject RIV: EF - Botanics Impact factor: 4.594, year: 2005

  16. Assessment of Chemical Impact of Invasive Bryozoan Pectinatella magnifica on the Environment: Cytotoxicity and Antimicrobial Activity of P. magnifica Extracts

    Czech Academy of Sciences Publication Activity Database

    Kollár, P.; Šmejkal, K.; Salmonová, H.; Vlková, E.; Lepšová-Skácelová, O.; Balounová, Z.; Rajchard, J.; Cvačka, Josef; Jaša, Libor; Babica, Pavel; Pazourek, J.

    2016-01-01

    Roč. 21, č. 11 (2016), č. článku 1476. ISSN 1420-3049 Institutional support: RVO:61388963 ; RVO:67985939 Keywords : Aeromonas * antimicrobial activity * bacteria * Bryozoa * cyanobacteria * invasive species Subject RIV: EH - Ecology, Behaviour Impact factor: 2.861, year: 2016 http://www.mdpi.com/1420-3049/21/11/1476/htm

  17. The role of CVS (and FIA) data and genetic tests in assessing species vulnerability to invasive pests and changing climate

    Science.gov (United States)

    R.A. Sniezko; H.E. Lintz

    2017-01-01

    United States tree species and their associated ecosystems, managed forests, and urban plantings are increasingly vulnerable to non-native invasive pathogens and insects as well as effects associated with a changing climate. Some species, such as whitebark pine (Pinus albicaulis), have been proposed for listing under the Endangered Species Act. To...

  18. Self-reported social functioning and prefrontal hemodynamic responses during a cognitive task in schizophrenia.

    Science.gov (United States)

    Pu, Shenghong; Nakagome, Kazuyuki; Itakura, Masashi; Yamanashi, Takehiko; Sugie, Takuya; Miura, Akehiko; Satake, Takahiro; Iwata, Masaaki; Nagata, Izumi; Kaneko, Koichi

    2015-10-30

    Impaired social functioning is a characteristic of schizophrenia that affects patients' quality of life. The aim of the study was to assess prefrontal hemodynamic responses during a cognitive task and establish its influence on psychiatric symptoms, cognitive function, global functioning, and self-reported social functioning in patients with schizophrenia. Thirty-three patients with schizophrenia and 30 age-and sex-matched healthy controls participated in the study. We measured hemodynamic responses in the prefrontal and superior temporal cortical surface areas with 52-channel near-infrared spectroscopy (NIRS) during a verbal fluency task (VFT). Self-reported social functioning was assessed using the Social Functioning Scale (SFS). Regional hemodynamic responses were significantly smaller in the prefrontal and temporal regions in subjects with schizophrenia than in the controls, and prefrontal hemodynamic responses during the VFT showed a strong correlation with SFS total scores. These results suggest an association between self-reported social functioning and prefrontal activation in subjects with schizophrenia. The present study provides evidence that NIRS imaging could be helpful in understanding the neural basis of social functioning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Quantitative Characterization of the Hemodynamic Environment in Ruptured and Unruptured Brain Aneurysms

    Science.gov (United States)

    Cebral, Juan R.; Mut, Fernando; Weir, Jane; Putman, Christopher

    2011-01-01

    Background and purpose Hemodynamics is thought to play an important role in the mechanisms of aneurysm pathogenesis, progression and rupture. The purpose of this study was to define quantitative measures related to qualitative flow characteristics previously analyzed and to investigate their relationship to aneurysm rupture. Methods The hemodynamic environments in 210 cerebral aneurysms were analyzed using image-based CFD under different flow conditions. Quantitative hemodynamic variables were defined and extracted from the simulation results. A statistical analysis of the relationship to the previous history of aneurysm rupture was performed, and the variability with flow conditions was assessed. Results Ruptured aneurysms were more likely to have larger inflow concentrations, larger maximum wall shear stress (WSS), larger shear concentrations and lower viscous dissipation ratios than unruptured aneurysms. Areas under low WSS and measures of abnormally low shear force distributions of ruptured and unruptured aneurysms were not statistically different. Although the values of hemodynamic quantities changed with different flow conditions, the statistical differences or ratios between their mean values over the ruptured and unruptured groups were maintained, for both pulsatile and steady flows. Conclusions Concentrated inflow streams and WSS distributions with elevated levels of maximal WSS and low aneurysmal viscous dissipation are statistically associated with a clinical history of prior aneurysm rupture. In contrast, the area and total viscous shear force applied in the aneurysm region subjected to abnormally low WSS levels are not. This study highlights the potential for image-based CFD for investigating aneurysm evolution mechanisms and for clinical assessment of aneurysm risks. PMID:21127144

  20. Do we need invasive confirmation of cardiac magnetic resonance results?

    Science.gov (United States)

    Siastała, Paweł; Kądziela, Jacek; Małek, Łukasz A; Śpiewak, Mateusz; Lech, Katarzyna; Witkowski, Adam

    2017-01-01

    Coronary artery revascularization is indicated in patients with documented significant obstruction of coronary blood flow associated with a large area of myocardial ischemia and/or untreatable symptoms. There are a few invasive or noninvasive methods that can provide information about the functional results of coronary artery narrowing. The application of more than one method of ischemia detection in one patient to reevaluate the indications for revascularization is used in case of atypical or no symptoms and/or borderline stenosis. To evaluate whether the results of cardiac magnetic resonance need to be reconfirmed by the invasive functional method. The hospital database revealed 25 consecutive patients with 29 stenoses who underwent cardiac magnetic resonance (CMR) and fractional flow reserve (FFR) between the end of 2010 and the end of 2014. The maximal time interval between CMR and FFR was 6 months. None of the patients experienced any clinical events or underwent procedures on coronary arteries between the studies. According to the analysis, the agreement of CMR perfusion with the FFR method was at the level of 89.7%. Assuming that FFR is the gold standard in assessing the severity of stenoses, the sensitivity of CMR perfusion was 90.9%. The percentage of non-severe lesions which were correctly identified in CMR was 88.9%. The study shows that CMR perfusion is a highly sensitive method to detect hemodynamically significant CAD and exclude nonsevere lesions. With FFR as the reference standard, the diagnostic accuracy of MR perfusion to detect ischemic CAD is high.

  1. TIME-COURSE OF HEMODYNAMIC-CHANGES AND IMPROVEMENT OF EXERCISE TOLERANCE AFTER CARDIOVERSION OF CHRONIC ATRIAL-FIBRILLATION UNASSOCIATED WITH CARDIAC-VALVE DISEASE

    NARCIS (Netherlands)

    VANGELDER, IC; CRIJNS, HJGM; BLANKSMA, PK; LANDSMAN, MLJ; POSMA, JL; VANDENBERG, MP; MEIJLER, FL; LIE, KI

    1993-01-01

    This study prospectively assessed the time course, magnitude and mechanism of the hemodynamic changes after restoration of sinus rhythm in patients with chronic atrial fibrillation (AF) unassociated with valvular disease. Severe cardiac dysfunction may occur after chronic supraventricular

  2. Time course of hemodynamic changes and improvement of exercise tolerance after cardioversion of chronic atrial fibrillation unassociated with cardiac valve disease

    NARCIS (Netherlands)

    Gelder, I.C. van; Crijns, H.J.G.M.; Blanksma, P.K.; Landsman, M.L.J.; Posma, J.L.; Berg, M.P. van den; Meijler, F.L.; Lie, K.I.

    1993-01-01

    This study prospectively assessed the time course, magnitude and mechanism of the hemodynamic changes after restoration of sinus rhythm in patients with chronic atrial fibrillation (AF) unassociated with valvular disease. Severe cardiac dysfunction may occur after chronic

  3. Techniques for Non-Invasive Monitoring of Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Agnes S. Meidert

    2018-01-01

    Full Text Available Since both, hypotension and hypertension, can potentially impair the function of vital organs such as heart, brain, or kidneys, monitoring of arterial blood pressure (BP is a mainstay of hemodynamic monitoring in acutely or critically ill patients. Arterial BP can either be obtained invasively via an arterial catheter or non-invasively. Non-invasive BP measurement provides either intermittent or continuous readings. Most commonly, an occluding upper arm cuff is used for intermittent non-invasive monitoring. BP values are then obtained either manually (by auscultation of Korotkoff sounds or palpation or automatically (e.g., by oscillometry. For continuous non-invasive BP monitoring, the volume clamp method or arterial applanation tonometry can be used. Both techniques enable the arterial waveform and BP values to be obtained continuously. This article describes the different techniques for non-invasive BP measurement, their advantages and limitations, and their clinical applicability.

  4. Invasive and non-invasive evaluation of spontaneous arteriogenesis in a novel porcine model for peripheral arterial obstructive disease.

    Science.gov (United States)

    Buschmann, Ivo R; Voskuil, Michiel; van Royen, Niels; Hoefer, Imo E; Scheffler, Klaus; Grundmann, Sebastian; Hennig, Jürgen; Schaper, Wolfgang; Bode, Christoph; Piek, Jan J

    2003-03-01

    Our current knowledge regarding the efficacy of factors stimulating collateral artery growth in the peripheral circulation primarily stems from models in small animals. However, experimental models in large sized animals are a prerequisite for extrapolation of growth factor therapy to patients with peripheral atherosclerotic obstructive disease. Therefore, we have developed a novel porcine femoral artery ligation model using non-invasive and invasive evaluation techniques. In 12 young farm pigs and nine older minipigs, a ligation of the superficial femoral artery was performed. Using an intra-arterial catheter, phosphate buffered saline (PBS) was administered with a first-pass over the collateral vascular bed. Directly after ligation as well as after 2 weeks of continuous infusion of PBS, perfusion of the leg was measured using various flow and pressure parameters. Using a pump driven extracorporal system, collateral conductance was determined under maximal vasodilatation. Conductance decreased after acute ligation to similar levels in both young farm pigs as well as the older minipigs (both 9.3% of normal perfusion) and recovered after 2 weeks to a higher value in farm pigs compared with minipigs (22.4 vs. 12.7% of normal; Parteries. To the best of our knowledge this is the first in vivo pig model for hemodynamic assessment of growth of collateral arteries in the peripheral circulation, that is suitable for evaluation of arteriogenic effects of growth factors or genes.

  5. Occupational exposure in hemodynamic; Exposicao ocupacional em hemodinamica

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-26

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

  6. Hemodynamic and neuropathological analysis in rats with aluminum trichloride-induced Alzheimer's disease.

    Science.gov (United States)

    Chen, Szu-Ming; Fan, Chi-Chen; Chiue, Ming-Shiuan; Chou, Chi; Chen, Jyh-Horng; Hseu, Ruey-Shyang

    2013-01-01

    Hemodynamic normality is crucial to maintaining the integrity of cerebral vessels and, therefore, preserving the cognitive functions of Alzheimer's disease patients. This study investigates the implications of the hemodynamic changes and the neuropathological diversifications of AlCl3-induced AD. The experimental animals were 8- to 12-wk-old male Wistar rats. The rats were randomly divided into 2 groups: a control group and a (+)control group. Food intake, water intake, and weight changes were recorded daily for 22 wk. Synchronously, the regional cerebral blood flow (rCBF) of the rats with AlCl3-induced AD were measured using magnetic resonance imaging (MRI). The hemorheological parameters were analyzed using a computerized auto-rotational rheometer. The brain tissue of the subjects was analyzed using immunohistological chemical (IHC) staining to determine the beta-amyloid (Aβ) levels. The results of hemodynamic analysis revealed that the whole blood viscosity (WBV), fibrinogen, plasma viscosity and RBC aggregation index (RAI) in (+)control were significantly higher than that of control group, while erythrocyte electrophoresis (EI) of whole blood in (+)control were significantly lower than that of control group. The results of acetylcholinesterase-RBC (AChE-RBC)in the (+)control group was significantly higher than that of the control group. The results also show that the reduction of rCBF in rats with AlCl3-induced AD was approximately 50% to 60% that of normal rats. IHC stain results show that significantly more Aβ plaques accumulated in the hippocampus and cortex of the (+)control than in the control group. The results accentuate the importance of hemorheology and reinforce the specific association between hemodynamic and neuropathological changes in rats with AlCl3-induced AD. Hemorheological parameters, such as WBV and fibrinogen, and AChE-RBC were ultimately proven to be useful biomarkers of the severity and progression of AD patients. In addition, the

  7. Time-Series Interactions of Gene Expression, Vascular Growth and Hemodynamics during Early Embryonic Arterial Development.

    Science.gov (United States)

    Goktas, Selda; Uslu, Fazil E; Kowalski, William J; Ermek, Erhan; Keller, Bradley B; Pekkan, Kerem

    2016-01-01

    The role of hemodynamic forces within the embryo as biomechanical regulators for cardiovascular morphogenesis, growth, and remodeling is well supported through the experimental studies. Furthermore, clinical experience suggests that perturbed flow disrupts the normal vascular growth process as one etiology for congenital heart diseases (CHD) and for fetal adaptation to CHD. However, the relationships between hemodynamics, gene expression and embryonic vascular growth are poorly defined due to the lack of concurrent, sequential in vivo data. In this study, a long-term, time-lapse optical coherence tomography (OCT) imaging campaign was conducted to acquire simultaneous blood velocity, pulsatile micro-pressure and morphometric data for 3 consecutive early embryonic stages in the chick embryo. In conjunction with the in vivo growth and hemodynamics data, in vitro reverse transcription polymerase chain reaction (RT-PCR) analysis was performed to track changes in transcript expression relevant to histogenesis and remodeling of the embryonic arterial wall. Our non-invasive extended OCT imaging technique for the microstructural data showed continuous vessel growth. OCT data coupled with the PIV technique revealed significant but intermitted increases in wall shear stress (WSS) between first and second assigned stages and a noticeable decrease afterwards. Growth rate, however, did not vary significantly throughout the embryonic period. Among all the genes studied, only the MMP-2 and CASP-3 expression levels remained unchanged during the time course. Concurrent relationships were obtained among the transcriptional modulation of the genes, vascular growth and hemodynamics-related changes. Further studies are indicated to determine cause and effect relationships and reversibility between mechanical and molecular regulation of vasculogenesis.

  8. Time-Series Interactions of Gene Expression, Vascular Growth and Hemodynamics during Early Embryonic Arterial Development.

    Directory of Open Access Journals (Sweden)

    Selda Goktas

    Full Text Available The role of hemodynamic forces within the embryo as biomechanical regulators for cardiovascular morphogenesis, growth, and remodeling is well supported through the experimental studies. Furthermore, clinical experience suggests that perturbed flow disrupts the normal vascular growth process as one etiology for congenital heart diseases (CHD and for fetal adaptation to CHD. However, the relationships between hemodynamics, gene expression and embryonic vascular growth are poorly defined due to the lack of concurrent, sequential in vivo data. In this study, a long-term, time-lapse optical coherence tomography (OCT imaging campaign was conducted to acquire simultaneous blood velocity, pulsatile micro-pressure and morphometric data for 3 consecutive early embryonic stages in the chick embryo. In conjunction with the in vivo growth and hemodynamics data, in vitro reverse transcription polymerase chain reaction (RT-PCR analysis was performed to track changes in transcript expression relevant to histogenesis and remodeling of the embryonic arterial wall. Our non-invasive extended OCT imaging technique for the microstructural data showed continuous vessel growth. OCT data coupled with the PIV technique revealed significant but intermitted increases in wall shear stress (WSS between first and second assigned stages and a noticeable decrease afterwards. Growth rate, however, did not vary significantly throughout the embryonic period. Among all the genes studied, only the MMP-2 and CASP-3 expression levels remained unchanged during the time course. Concurrent relationships were obtained among the transcriptional modulation of the genes, vascular growth and hemodynamics-related changes. Further studies are indicated to determine cause and effect relationships and reversibility between mechanical and molecular regulation of vasculogenesis.

  9. Low-dose esmolol: hemodynamic response to endotracheal intubation in normotensive patients

    Directory of Open Access Journals (Sweden)

    Suresh Lakshmanappa

    2012-06-01

    Full Text Available Abstract Purpose: Endotracheal intubation is a frequently utilized and highly invasive component of anesthesia that is often accompanied by potentially harmful hemodynamic pressor responses. The purpose of this study was to investigate the efficiency of a single pre-induction 1 mg/kg bolus injection of esmolol for attenuating these hemodynamic responses to endotracheal intubation in normotensive patients. Material and methods: The study was composed of 100 randomly selected male and female patients between the ages of 18 and 60 that were scheduled for elective surgery and belonged to ASA grade I or II. Two minutes prior to intubation the control group received 10 mL of saline (n=50 and the experimental group received an injection of esmolol 1 mg/kg diluted to 10 mL (n=50. Heart rate (HR, systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, and rate pressure product (RPP were compared to basal values before receiving medication (T-0, during pre-induction (T-1, induction (T-2, intubation (T-3, and post-intubation at 1 (T-4, 3 (T-6, 5 (T-8, and 10 (T-13 minutes. Results: Esmolol significantly attenuated the hemodynamic responses to endotracheal intubation at the majority of measured points. Attenuation of HR (10.8%, SBP (7.04%, DBP (3.99%, MAP (5%, and RPP (16.9% was observed in the esmolol group when compared to the control group values. Conclusions: A single pre-induction 1 mg/kg bolus injection of esmolol successfully attenuated the hemodynamic pressor response in normotensive patients. A significant attenuation of heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure was observed at the majority of measured time points in the esmolol administered group compared to the control group. [J Contemp Med 2012; 2(2.000: 69-76

  10. Accuracy of contrast-enhanced breast ultrasound for pre-operative tumor size assessment in patients diagnosed with invasive ductal carcinoma of the breast

    Science.gov (United States)

    van Esser, S.; Veldhuis, W.B.; van Hillegersberg, R.; van Diest, P.J.; Stapper, G.; ElOuamari, M.; Borel Rinkes, I.H.M.; Mali, W.P.Th.M.

    2007-01-01

    Abstract Our aim was to assess the feasibility and accuracy of contrast-enhanced ultrasound (CEUS) of the breast with SonoVue microbubbles for pre-operative size measurement of invasive breast carcinomas. Seven patients diagnosed with nine invasive breast carcinomas prospectively underwent gray-scale ultrasound and CEUS of the breast according to a standardized protocol. CEUS of the breast was performed by a Philips iU22 scanner equipped with a 4–8 MHz linear array transducer. We used a single dose of 2.4 ml SonoVue as contrast agent. Breast lesion morphology was scored according to the sonographic BI-RADS lexicon criteria and classified accordingly. The greatest tumor dimensions on gray-scale ultrasound and CEUS of the breast were finally compared with the greatest histopathologic tumor sizes. Gray-scale ultrasound underestimated the histopathologic tumor size in 6/9 cases (67%), whereas CEUS of the breast underestimated tumor size in only 3/9 (33%) cases. CEUS of the breast was significantly more accurate for tumor size assessment. Greatest tumor dimension as measured with gray-scale ultrasound of the breast was within 2 mm of the pathologic tumor size in only 2/9 cases (22%), whereas CEUS of the breast accurately assessed tumor size within 2 mm of pathologic tumor size in 6/9 (67%) of the cases (P<0.05). CEUS of the breast proved to be a feasible and safe procedure. It is more accurate than gray-scale ultrasound of the breast for pre-operative size assessment of invasive ductal breast carcinomas. PMID:17513187

  11. Hemodynamic stress distribution reflects ischemic clinical symptoms of patients with moyamoya disease.

    Science.gov (United States)

    Takahashi, Satoshi; Tanizaki, Yoshio; Kimura, Hiroaki; Akaji, Kazunori; Nakazawa, Masaki; Yoshida, Kazunari; Mihara, Ban

    2015-11-01

    Currently, the probability of diagnosing asymptomatic moyamoya disease is increasing. In this study, we consider a less invasive method for predicting future ischemic symptoms in patients with moyamoya disease. We reviewed cerebral blood flow (CBF)-related data obtained by xenon CT imaging (XeCT) in six patients with ischemic-type or asymptomatic moyamoya disease. The data were obtained as volume data using a 320-row CT, and applied to the automated region-of-interest-determining software (3DSRT) and converted to standardized images. Eight CBF-related parameters, including CBF value, cerebrovascular reserve capacity (CVRC), and hemodynamic distribution (hdSD), were compared between asymptomatic hemispheres and ischemic symptomatic hemispheres. A significant difference was determined by a two-sample t test. A difference with p<0.05 was considered significant. When statistically significant differences between parameters of asymptomatic hemispheres and ischemic symptomatic hemispheres were identified, cut-off points were calculated with receiver operating characteristic (ROC) curves. Change in the parameters before and after bypass surgery was also assessed. Of the eight CBF-related parameters evaluated, statistically significant differences between the asymptomatic hemispheres and ischemic hemispheres were observed in the CBF value of the MCA region (CBF-MCA), both at rest and after acetazolamide loading, and in the hdSD, also both at rest and after acetazolamide loading. Of the four statistically significant parameters, ROC analysis revealed that the hdSD at rest and CBF-MCA after acetazolamide loading were the most sensitive and specific parameters (threshold 1.2, sensitivity 1, specificity 1 for hdSD at rest, and threshold 26.44mL/100g/min, sensitivity 1, specificity 1 for CBF-MCA after acetazolamide loading). From the CBF data obtained both before and after surgery from the three patients who had undergone direct bypass surgeries, the hdSD was higher than the

  12. Assessment of the inflammatory factor as well as invasion and apoptosis gene expression in endometriosis model rats after mifepristone intervention

    Directory of Open Access Journals (Sweden)

    Yan Xu

    2017-05-01

    Full Text Available Objective: To study the effect of mifepristone intervention on the inflammatory factor as well as invasion and apoptosis gene expression in endometriosis lesions of endometriosis model rats. Method: SD female rats were selected as experimental animals, divided into model group (EMs group and mifepristone group (RU486 group and made into endometriosis models, then the EMs group received saline intervention and RU486 group received 2.6 mg/kg/d RU486 intervention. 4 weeks after intervention, endometriosis lesions were anatomized to determine the expression of inflammatory factors (COX-2, PGE2, TNF-α, IL-1β and IL-6, invasion genes (OPN, MMP2, MMP9, uPA and S100A6 as well as apoptosis genes (Bcl-2, Livin, Smac and PTEN. Results: COX-2, PGE2, TNF-α, IL-1β, IL-6, OPN, MMP2, MMP9, uPA, S100A6, Bcl-2 and Livin protein expression in endometriosis lesions of Ru486 group were significantly lower than those of EMs group while Smac and PTEN protein expression were higher than those of EMs group. Conclusion: Mifepristone for endometriosis model rats can inhibit the expression of inflammatory factors, invasion genes and anti-apoptosis genes, and increase the expression of pro-apoptosis genes.

  13. [Isotopic study of cardiac hemodynamics after multiple valve prothesis (author's transl)].

    Science.gov (United States)

    Schicha, H; Becker, V; Both, A; Lösse, B; Krian, A; Feinendegen, L E

    1977-08-01

    The radiocardiography of the minimal transit times (MTTs) produces cardiologically useful hemodynamic data also in such instances where invasive techniques with the cardiac catheter are technically difficult, as is the case in patients with multiple valve prothesis. The present study reports on MTT measurements in 9 patients with tricuspidal prothesis, 8 of which had additional mitralvalve prothesis and 2 additional aortic valve prothesis. The measurements were made with Tc-99m Pertechnetate, and an Anger camera with electronic data processing was used as detector system. The results indicate that following implantation of valve prothesis the hemodynamic state remained essentially disturbed. The pathologically altered transit times are an expression of disturbed volume ratios. The transit times in the atria remained prolonged by an average factor of 4-5. The ejection of the left ventricle stayed diminished more pronounced than on the right. The values of one patient who was examined before and after implantation of the prothesis in mitral and tricuspidal position, also showed a worsening of the data especially in the atria. Because the cardiac function study with radioisotopes is non invasive, simple, and fast, and leads to only a minor radiation burden, the method may be repeated and without hazard used for control follow-ups.

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

    Science.gov (United States)

    Vedula, Vijay; Feinstein, Jeffrey; Marsden, Alison

    2016-11-01

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

  15. Physiology of school burnout in medical students: Hemodynamic and autonomic functioning

    Directory of Open Access Journals (Sweden)

    Ross W. May

    2016-09-01

    Full Text Available This study investigated the relationship between burnout and hemodynamic and autonomic functioning in both medical students (N = 55 and premedical undergraduate students (N = 77. Questionnaires screened for health related issues and assessed school burnout and negative affect symptomatology (anxiety and depression. Continuous beat-to-beat blood pressure (BP through finger plethysmography and electrocardiogram (ECG monitoring was conducted during conditions of baseline and cardiac stress induced via the cold pressor task to produce hemodynamic, heart rate variability, and blood pressure variability indices. Independent sample t-tests demonstrated that medical students had significantly higher school burnout scores compared to their undergraduate counterparts. Controlling for age, BMI, anxiety and depressive symptoms, multiple regression analyses indicated that school burnout was a stronger predictor of elevated hemodynamics (blood pressure, decreased heart rate variability, decreased markers of vagal activity and increased markers of sympathetic tone at baseline for medical students than for undergraduates. Analyses of physiological values collected during the cold pressor task indicated greater cardiac hyperactivity for medical students than for undergraduates. The present study supports previous research linking medical school burnout to hemodynamic and autonomic functioning, suggests biomarkers for medical school burnout, and provides evidence that burnout may be implicated as a physiological risk factor in medical students. Study limitations and potential intervention avenues are discussed.

  16. Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: Comparison with conventional panoramic radiography

    Energy Technology Data Exchange (ETDEWEB)

    Momin, Mohammad A. [Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: momin.orad@tmd.ac.jp; Okochi, Kiyoshi [Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: kiyoshi.orad@tmd.ac.jp; Watanabe, Hiroshi [Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: hiro.orad@tmd.ac.jp; Imaizumi, Akiko [Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: ima.orad@tmd.ac.jp; Omura, Ken [Oral Surgery, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: omura.osur@tmd.ac.jp; Amagasa, Teruo [Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: t-amagasa.mfs@tmd.ac.jp; Okada, Norihiko [Diagnostic Oral Pathology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: nokd.opth@tmd.ac.jp; Ohbayashi, Naoto [Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: nao.orad@tmd.ac.jp; Kurabayashi, Tohru [Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8549 (Japan)], E-mail: kura.orad@tmd.ac.jp

    2009-10-15

    Purpose: To evaluate the diagnostic accuracy of cone-beam CT in assessing mandibular invasion by lower gingival carcinoma and compare it with that of panoramic radiography. Patients and methods: Fifty patients with squamous cell carcinoma of the lower gingiva who were examined by both panoramic radiography and cone-beam CT before surgery were included in this study. Five radiologists used a 6-point rating scale to independently evaluate cone-beam CT and panoramic images for the presence or absence of alveolar bone and mandibular canal involvement by tumor. Using the histopathogical findings as the gold standard, we calculated and compared the area under the receiver operating characteristic curve (Az value) and the sensitivity and specificity of the two imaging modalities. Results: In evaluations of both alveolar bone and mandibular canal involvement, the mean Az value for cone-beam CT (0.918 and 0.977, respectively) was significantly higher than that for panoramic radiography (0.793 and 0.872, respectively). The mean sensitivity for cone-beam CT (89% and 99%, respectively) was significantly higher than that for panoramic radiography (73% and 56%, respectively). There was no significant difference in the mean specificity. While cone-beam CT could provide high-resolution three-dimensional images, the image quality around the alveolar crest was often hampered by severe dental artifacts and image noise, resulting in difficulties in detecting subtle alveolar invasion. Conclusion: Cone-beam CT was significantly superior to panoramic radiography in evaluating mandibular invasion by lower gingival carcinoma. Its diagnostic value in detecting subtle alveolar invasion, however, may be limited by severe dental artifacts and image noise.

  17. Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: comparison with conventional panoramic radiography.

    Science.gov (United States)

    Momin, Mohammad A; Okochi, Kiyoshi; Watanabe, Hiroshi; Imaizumi, Akiko; Omura, Ken; Amagasa, Teruo; Okada, Norihiko; Ohbayashi, Naoto; Kurabayashi, Tohru

    2009-10-01

    To evaluate the diagnostic accuracy of cone-beam CT in assessing mandibular invasion by lower gingival carcinoma and compare it with that of panoramic radiography. Fifty patients with squamous cell carcinoma of the lower gingiva who were examined by both panoramic radiography and cone-beam CT before surgery were included in this study. Five radiologists used a 6-point rating scale to independently evaluate cone-beam CT and panoramic images for the presence or absence of alveolar bone and mandibular canal involvement by tumor. Using the histopathogical findings as the gold standard, we calculated and compared the area under the receiver operating characteristic curve (Az value) and the sensitivity and specificity of the two imaging modalities. In evaluations of both alveolar bone and mandibular canal involvement, the mean Az value for cone-beam CT (0.918 and 0.977, respectively) was significantly higher than that for panoramic radiography (0.793 and 0.872, respectively). The mean sensitivity for cone-beam CT (89% and 99%, respectively) was significantly higher than that for panoramic radiography (73% and 56%, respectively). There was no significant difference in the mean specificity. While cone-beam CT could provide high-resolution three-dimensional images, the image quality around the alveolar crest was often hampered by severe dental artifacts and image noise, resulting in difficulties in detecting subtle alveolar invasion. Cone-beam CT was significantly superior to panoramic radiography in evaluating mandibular invasion by lower gingival carcinoma. Its diagnostic value in detecting subtle alveolar invasion, however, may be limited by severe dental artifacts and image noise.

  18. Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: Comparison with conventional panoramic radiography

    International Nuclear Information System (INIS)

    Momin, Mohammad A.; Okochi, Kiyoshi; Watanabe, Hiroshi; Imaizumi, Akiko; Omura, Ken; Amagasa, Teruo; Okada, Norihiko; Ohbayashi, Naoto; Kurabayashi, Tohru

    2009-01-01

    Purpose: To evaluate the diagnostic accuracy of cone-beam CT in assessing mandibular invasion by lower gingival carcinoma and compare it with that of panoramic radiography. Patients and methods: Fifty patients with squamous cell carcinoma of the lower gingiva who were examined by both panoramic radiography and cone-beam CT before surgery were included in this study. Five radiologists used a 6-point rating scale to independently evaluate cone-beam CT and panoramic images for the presence or absence of alveolar bone and mandibular canal involvement by tumor. Using the histopathogical findings as the gold standard, we calculated and compared the area under the receiver operating characteristic curve (Az value) and the sensitivity and specificity of the two imaging modalities. Results: In evaluations of both alveolar bone and mandibular canal involvement, the mean Az value for cone-beam CT (0.918 and 0.977, respectively) was significantly higher than that for panoramic radiography (0.793 and 0.872, respectively). The mean sensitivity for cone-beam CT (89% and 99%, respectively) was significantly higher than that for panoramic radiography (73% and 56%, respectively). There was no significant difference in the mean specificity. While cone-beam CT could provide high-resolution three-dimensional images, the image quality around the alveolar crest was often hampered by severe dental artifacts and image noise, resulting in difficulties in detecting subtle alveolar invasion. Conclusion: Cone-beam CT was significantly superior to panoramic radiography in evaluating mandibular invasion by lower gingival carcinoma. Its diagnostic value in detecting subtle alveolar invasion, however, may be limited by severe dental artifacts and image noise.

  19. Integrating subsistence practice and species distribution modeling: assessing invasive elodea’s potential impact on Native Alaskan subsistence of Chinook salmon and whitefish

    Science.gov (United States)

    Luizza, Matthew; Evangelista, Paul; Jarnevich, Catherine S.; West, Amanda; Stewart, Heather

    2016-01-01

    Alaska has one of the most rapidly changing climates on earth and is experiencing an accelerated rate of human disturbance, including resource extraction and transportation infrastructure development. Combined, these factors increase the state’s vulnerability to biological invasion, which can have acute negative impacts on ecological integrity and subsistence practices. Of growing concern is the spread of Alaska’s first documented freshwater aquatic invasive plant Elodea spp. (elodea). In this study, we modeled the suitable habitat of elodea using global and state-specific species occurrence records and environmental variables, in concert with an ensemble of model algorithms. Furthermore, we sought to incorporate local subsistence concerns by using Native Alaskan knowledge and available statewide subsistence harvest data to assess the potential threat posed by elodea to Chinook salmon (Oncorhynchus tshawytscha) and whitefish (Coregonus nelsonii) subsistence. State models were applied to future climate (2040–2059) using five general circulation models best suited for Alaska. Model evaluations indicated that our results had moderate to strong predictability, with area under the receiver-operating characteristic curve values above 0.80 and classification accuracies ranging from 66 to 89 %. State models provided a more robust assessment of elodea habitat suitability. These ensembles revealed different levels of management concern statewide, based on the interaction of fish subsistence patterns, known spawning and rearing sites, and elodea habitat suitability, thus highlighting regions with additional need for targeted monitoring. Our results suggest that this approach can hold great utility for invasion risk assessments and better facilitate the inclusion of local stakeholder concerns in conservation planning and management.

  20. Integrating subsistence practice and species distribution modeling: assessing invasive elodea's potential impact on Native Alaskan subsistence of Chinook salmon and whitefish

    Science.gov (United States)

    Luizza, Matthew W.; Evangelista, Paul H.; Jarnevich, Catherine S.; West, Amanda; Stewart, Heather

    2016-07-01

    Alaska has one of the most rapidly changing climates on earth and is experiencing an accelerated rate of human disturbance, including resource extraction and transportation infrastructure development. Combined, these factors increase the state's vulnerability to biological invasion, which can have acute negative impacts on ecological integrity and subsistence practices. Of growing concern is the spread of Alaska's first documented freshwater aquatic invasive plant Elodea spp. (elodea). In this study, we modeled the suitable habitat of elodea using global and state-specific species occurrence records and environmental variables, in concert with an ensemble of model algorithms. Furthermore, we sought to incorporate local subsistence concerns by using Native Alaskan knowledge and available statewide subsistence harvest data to assess the potential threat posed by elodea to Chinook salmon ( Oncorhynchus tshawytscha) and whitefish ( Coregonus nelsonii) subsistence. State models were applied to future climate (2040-2059) using five general circulation models best suited for Alaska. Model evaluations indicated that our results had moderate to strong predictability, with area under the receiver-operating characteristic curve values above 0.80 and classification accuracies ranging from 66 to 89 %. State models provided a more robust assessment of elodea habitat suitability. These ensembles revealed different levels of management concern statewide, based on the interaction of fish subsistence patterns, known spawning and rearing sites, and elodea habitat suitability, thus highlighting regions with additional need for targeted monitoring. Our results suggest that this approach can hold great utility for invasion risk assessments and better facilitate the inclusion of local stakeholder concerns in conservation planning and management.

  1. Hemodynamic management of septic shock: is it time for "individualized goal-directed hemodynamic therapy" and for specifically targeting the microcirculation?

    Science.gov (United States)

    Saugel, Bernd; Trepte, Constantin J; Heckel, Kai; Wagner, Julia Y; Reuter, Daniel A

    2015-06-01

    Septic shock is a life-threatening condition in both critically ill medical patients and surgical patients during the perioperative phase. In septic shock, specific alterations in global cardiovascular dynamics (i.e., the macrocirculation) and in the microcirculatory blood flow (i.e., the microcirculation) have been described. However, the presence and degree of microcirculatory failure are in part independent from systemic macrohemodynamic variables. Macrocirculatory and microcirculatory failure can independently induce organ dysfunction. We review current diagnostic and therapeutic approaches for the assessment and optimization of both the macrocirculation and the microcirculation in septic shock. There are various technologies for the determination of macrocirculatory hemodynamic variables. We discuss the data on early goal-directed therapy for the resuscitation of the macrocirculation. In addition, we describe the concept of "individualized goal-directed hemodynamic therapy." Technologies to assess the local microcirculation are also available. However, adequate resuscitation goals for the optimization of the microcirculation still need to be defined. At present, we are not ready to specifically monitor and target the microcirculation in clinical routine outside studies. In the future, concepts for an integrative approach for individualized hemodynamic management of the macrocirculation and in parallel the microcirculation might constitute a huge opportunity to define additional resuscitation end points in septic shock.

  2. Diastolic pressure underestimates age-related hemodynamic impairment.

    Science.gov (United States)

    Galarza, C R; Alfie, J; Waisman, G D; Mayorga, L M; Cámera, L A; del Río, M; Vasvari, F; Limansky, R; Farías, J; Tessler, J; Cámera, M I

    1997-10-01

    It has been hypothesized that as large arteries become more rigid with age, the pattern of hypertension changes from diastolic to systolic. Thus, diastolic blood pressure (DBP) may lose its ability to reflect the increase in vascular resistance with age. To assess this, we studied the age-related changes in blood pressure pattern and its steady-state and pulsatile determinants. We performed an epidemiological analysis based on a national survey of 10,462 subjects from Argentina. A hemodynamic analysis (impedance cardiography) was then carried out in 636 consecutive hypertensive patients (age, 25 to 74 years). Whereas the rate of increment in the prevalence of mild to moderate hypertension (MMH) reached a plateau after the sixth decade, isolated and borderline systolic forms of hypertension began a steep and sustained rise. Among patients with MMH, DBP remained stable from the third to the seventh decade, whereas SBP maintained a sustained increase. Despite similar DBP, the systemic vascular resistance index increased 47% (P<.01) and the cardiac index decreased 27% (P<.01), whereas the ratio of stroke volume to pulse pressure, an index of arterial compliance, decreased 45% (P<.01). However, there were no significant differences between older patients with MMH and those with isolated systolic hypertension in the level of SBP, vascular resistance, stroke volume, and cardiac index. Compared with age-matched normotensive control subjects, the ratio of stroke volume to pulse pressure was much more reduced in isolated systolic hypertension (48%) than in MMH (30%). In summary, the present study, carried out in a large sample of hypertensive subjects with a wide age range, showed a simultaneous impairment in vascular resistance and arterial compliance associated with aging in different patterns of hypertension. The magnitude of these changes, with opposite effects on DBP but additive effects on SBP, suggests that a hemodynamic mechanism could determine the transition in the

  3. Evaluation of functional severity of coronary artery disease and fluid dynamics' influence on hemodynamic parameters: A review.

    Science.gov (United States)

    Govindaraju, Kalimuthu; Badruddin, Irfan Anjum; Viswanathan, Girish N; Ramesh, S V; Badarudin, A

    2013-05-01

    Coronary Artery Disease (CAD) is responsible for most of the deaths in patients with cardiovascular diseases. Diagnostic coronary angiography analysis offers an anatomical knowledge of the severity of the stenosis. The functional or physiological significance is more valuable than the anatomical significance of CAD. Clinicians assess the functional severity of the stenosis by resorting to an invasive measurement of the pressure drop and flow. Hemodynamic parameters, such as pressure wire assessment fractional flow reserve (FFR) or Doppler wire assessment coronary flow reserve (CFR) are well-proven techniques to evaluate the physiological significance of the coronary artery stenosis in the cardiac catheterization laboratory. Between the two techniques mentioned above, the FFR is seen as a very useful index. The presence of guide wire reduces the coronary flow which causes the underestimation of pressure drop across the stenosis which leads to dilemma for the clinicians in the assessment of moderate stenosis. In such condition, the fundamental fluid mechanics is useful in the development of new functional severity parameters such as pressure drop coefficient and lesion flow coefficient. Since the flow takes place in a narrowed artery, the blood behaves as a non-Newtonian fluid. Computational fluid dynamics (CFD) allows a complete coronary flow simulation to study the relationship between the pressure and flow. This paper aims at explaining (i) diagnostic modalities for the evaluation of the CAD and valuable insights regarding FFR in the evaluation of the functional severity of the CAD (ii) the role of fluid dynamics in measuring the severity of CAD. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Non-invasive assessment of liver fibrosis with impulse elastography: comparison of Supersonic Shear Imaging with ARFI and FibroScan®.

    Science.gov (United States)

    Cassinotto, Christophe; Lapuyade, Bruno; Mouries, Amaury; Hiriart, Jean-Baptiste; Vergniol, Julien; Gaye, Delphine; Castain, Claire; Le Bail, Brigitte; Chermak, Faiza; Foucher, Juliette; Laurent, François; Montaudon, Michel; De Ledinghen, Victor

    2014-09-01

    Non-invasive assessment of liver fibrosis by elastography is a rapidly developing field with frequent technological innovations. The aim of this study was to assess the diagnostic performances of Supersonic Shear Imaging (SSI) for the diagnosis of liver fibrosis in chronic liver disease. A total of 349 consecutive patients with chronic liver diseases who underwent liver biopsy from November 2011 to October 2013 were prospectively enrolled. For each patient, liver stiffness was assessed by SSI, ARFI, FibroScan® (M probe for patients with BMI liver biopsy. Areas under the receiver operating curves (AUROCs) were performed and compared for each degree of liver fibrosis. SSI, FibroScan®, and ARFI correlated significantly with histological fibrosis score (r=0.79, pliver fibrosis in chronic liver diseases, comparing favourably to FibroScan® and ARFI. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  5. The clinical importance of air plethysmography in the assessment of chronic venous disease

    Directory of Open Access Journals (Sweden)

    Nei Rodrigues Alves Dezotti

    Full Text Available Abstract Air plethysmography is a non-invasive test that can quantify venous reflux and obstruction by measuring volume changes in the leg. Its findings correlate with clinical and hemodynamic measures. It can quantitatively assess several components of venous hemodynamics: valvular reflux, calf muscle pump function, and venous obstruction. Although clinical uses of air plethysmography have been validated, it is used almost exclusively for medical research. Air plethysmography can be used to assess chronic venous disease, to evaluate improvement after venous surgery, to diagnose acute and past episodes of deep venous thrombosis, to evaluate compression stocking therapy, to study the physiological implications of high-heeled shoes in healthy women, and even to evaluate the probability of ulcer healing.

  6. Review: hemodynamic response to carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Penney, D.G.

    1988-04-01

    Historically, and at present, carbon monoxide is a major gaseous poison responsible for widespread morbidity and mortality. From threshold to maximal nonlethal levels, a variety of cardiovascular changes occur, both immediately and in the long term, whose homeostatic function it is to renormalize tissue oxygen delivery. However, notwithstanding numerous studies over the past century, the literature remains equivocal regarding the hemodynamic responses in animals and humans, although CO hypoxia is clearly different in several respects from hypoxic hypoxia. Factors complicating interpretation of experimental findings include species, CO dose level and rate, route of CO delivery, duration, level of exertion, state of consciousness, and anesthetic agent used. Augmented cardiac output usually observed with moderate COHb may be compromised in more sever poisoning for the same reasons, such that regional or global ischemia result. The hypotension usually seen in most animal studies is thought to be a primary cause of CNS damage resulting from acute CO poisoning, yet the exact mechanism(s) remains unproven in both animals and humans, as does the way in which CO produces hypotension. This review briefly summarizes the literature relevant to the short- and long-term hemodynamic responses reported in animals and humans. It concludes by presenting an overview using data from a single species in which the most complete work has been done to date.

  7. Cerebral hemodynamics and functional prognosis in hydrocephalus

    International Nuclear Information System (INIS)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime

    1989-01-01

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

  8. Cerebral hemodynamics and functional prognosis in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-11-01

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

  9. Hemodynamic Simulations in Dialysis Access Fistulae

    Science.gov (United States)

    McGah, Patrick; Leotta, Daniel; Beach, Kirk; Riley, James; Aliseda, Alberto

    2010-11-01

    Arteriovenous fistulae are created surgically to provide adequate access for dialysis in patients with End-Stage Renal Disease. It has long been hypothesized that the hemodynamic and mechanical forces (such as wall shear stress, wall stretch, or flow- induced wall vibrations) constitute the primary external influence on the remodeling process. Given that nearly 50% of fistulae fail after one year, understanding fistulae hemodynamics is an important step toward improving patency in the clinic. We perform numerical simulations of the flow in patient-specific models of AV fistulae reconstructed from 3D ultrasound scans with physiologically-realistic boundary conditions also obtained from Doppler ultrasound. Comparison of the flow features in different geometries and configurations e.g. end-to-side vs. side-to-side, with the in vivo longitudinal outcomes will allow us to hypothesize which flow conditions are conducive to fistulae success or failure. The flow inertia and pulsatility in the simulations (mean Re 700, max Re 2000, Wo 4) give rise to complex secondary flows and coherent vortices, further complicating the spatio- temporal variability of the wall pressure and shear stresses. Even in mature fistulae, the anastomotic regions are subjected to non-physiological shear stresses (>10.12pcPa) which may potentially lead to complications.

  10. Patient-Specific Modeling of Intraventricular Hemodynamics

    Science.gov (United States)

    Vedula, Vijay; Marsden, Alison

    2017-11-01

    Heart disease is the one of the leading causes of death in the world. Apart from malfunctions in electrophysiology and myocardial mechanics, abnormal hemodynamics is a major factor attributed to heart disease across all ages. Computer simulations offer an efficient means to accurately reproduce in vivo flow conditions and also make predictions of post-operative outcomes and disease progression. We present an experimentally validated computational framework for performing patient-specific modeling of intraventricular hemodynamics. Our modeling framework employs the SimVascular open source software to build an anatomic model and employs robust image registration methods to extract ventricular motion from the image data. We then employ a stabilized finite element solver to simulate blood flow in the ventricles, solving the Navier-Stokes equations in arbitrary Lagrangian-Eulerian (ALE) coordinates by prescribing the wall motion extracted during registration. We model the fluid-structure interaction effects of the cardiac valves using an immersed boundary method and discuss the potential application of this methodology in single ventricle physiology and trans-catheter aortic valve replacement (TAVR). This research is supported in part by the Stanford Child Health Research Institute and the Stanford NIH-NCATS-CTSA through Grant UL1 TR001085 and partly through NIH NHLBI R01 Grant 5R01HL129727-02.

  11. Tiling array-CGH for the assessment of genomic similarities among synchronous unilateral and bilateral invasive breast cancer tumor pairs

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    Ringnér Markus

    2008-07-01

    Full Text Available Abstract Background Today, no objective criteria exist to differentiate between individual primary tumors and intra- or intermammary dissemination respectively, in patients diagnosed with two or more synchronous breast cancers. To elucidate whether these tumors most likely arise through clonal expansion, or whether they represent individual primary tumors is of tumor biological interest and may have clinical implications. In this respect, high resolution genomic profiling may provide a more reliable approach than conventional histopathological and tumor biological factors. Methods 32 K tiling microarray-based comparative genomic hybridization (aCGH was used to explore the genomic similarities among synchronous unilateral and bilateral invasive breast cancer tumor pairs, and was compared with histopathological and tumor biological parameters. Results Based on global copy number profiles and unsupervised hierarchical clustering, five of ten (p = 1.9 × 10-5 unilateral tumor pairs displayed similar genomic profiles within the pair, while only one of eight bilateral tumor pairs (p = 0.29 displayed pair-wise genomic similarities. DNA index, histological type and presence of vessel invasion correlated with the genomic analyses. Conclusion Synchronous unilateral tumor pairs are often genomically similar, while synchronous bilateral tumors most often represent individual primary tumors. However, two independent unilateral primary tumors can develop synchronously and contralateral tumor spread can occur. The presence of an intraductal component is not informative when establishing the independence of two tumors, while vessel invasion, the presence of which was found in clustering tumor pairs but not in tumor pairs that did not cluster together, supports the clustering outcome. Our data suggest that genomically similar unilateral tumor pairs may represent a more aggressive disease that requires the addition of more severe treatment modalities, and

  12. The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

    NARCIS (Netherlands)

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

    2014-01-01

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

  13. Hemodynamic effects of sevoflurane versus propofol anesthesia for ...

    African Journals Online (AJOL)

    Adele

    cryotherapy, radiofrequency does not induce hemodynamic instability. In an animal study, hepatic artery blood flow and peripheral blood pressure did not change significantly during peritoneal insufflation for radiofrequency ablation surgery.8. We did not intend to investigate the effects of LRFA itself on the hemodynamics.

  14. The value of ultrasound contrast for assessing cancer cell proliferation and invasion function as well as angiogenesis in lesions of in patients with gastric cancer

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    Qin Yang

    2017-06-01

    Full Text Available Objective: To study the value of ultrasound contrast for assessing cancer cell proliferation and invasion as well as angiogenesis in lesions of in patients with gastric cancer. Methods: A total of 39 patients with gastric cancer and 48 patients with gastric ulcer who were treated in our hospital between August 2012 and May 2016 were included in gastric cancer group and gastric ulcer group respectively, and 50 healthy subjects who accepted gastroscopy in our hospital during the same period were included in normal control group. The day after admission, color Doppler diasonograph was used to test the gastric ultrasound contrast parameters; fluorescence quantitative PCR method was used to detect the proliferation and invasion gene mRNA expression in stomach tissue; enzyme-linked immunosorbent assay (ELISA was used to detect the serum angiogenesis index levels. Results: Ultrasound contrast parameters ET and TTP levels of gastric cancer group and gastric ulcer group were significantly lower than those of normal control group, and ultrasound contrast parameters ET and TTP levels of gastric cancer group were significantly lower than those of gastric ulcer group; Stat3, Survivin, Bcl-2, 毬-catenin, eIF4E, CD44, UHRF1 and c-met mRNA expression in tissue as well as VEGF, EGFR, HIF-毩 and Ang-2 levels in serum of gastric cancer group were higher than those of gastric ulcer group and normal control group while E-cadherin mRNA expression in tissue was lower than those of gastric ulcer group and normal control group; Spearman correlation analysis showed that ultrasound contrast parameters ET and TTP levels were correlated with the cancer cell proliferation and invasion function as well as angiogenesis indexes in lesions. Conclusion: Ultrasound contrast parameters can accurately assess the malignant degree of gastric cancer, and is expected to become the reliable means for early diagnosis and treatment guidance of gastric cancer in the future.

  15. Morphologic and hemodynamic analysis of paraclinoid aneurysms: ruptured versus unruptured.

    Science.gov (United States)

    Liu, Jian; Xiang, Jianping; Zhang, Ying; Wang, Yang; Li, Haiyun; Meng, Hui; Yang, Xinjian

    2014-11-01

    In order to determine the risk factors related to aneurysm rupture, we studied the aneurysms at the paraclinoid segment of the internal carotid artery by applying morphologic and hemodynamic numerical analyzes. 107 patients with 110 paraclinoid aneurysms (26 ruptured, 84 unruptured) were analyzed using computational fluid dynamics based on patient-specific three-dimensional geometrical models. A series of morphologic and hemodynamic parameters were evaluated to find the potential indicators of aneurysm rupture. Aneurysms with an irregular shape accounted for 23.1% of the ruptured group and only 8.3% of the unruptured group. The difference was statistically significant (p=0.042, χ(2) test). Ruptured paraclinoid aneurysms were found to be significantly smaller than unruptured aneurysms (p=0.041), which is different from the results of most previous studies. Energy loss (EL) and inflow concentration showed a level of statistical significance to assess the risk of rupture in paraclinoid aneurysms. By multivariate logistic regression analysis, aneurysm shape (regular or irregular), EL and inflow concentration were retained as independently significant parameters. The odds of rupture were increased by 1.65 times for a 10% increase in EL, by 4.88 times for an aneurysm with an irregular shape and by 2.91 times for an aneurysm with concentrated inflow jet. Irregular shape, larger EL and concentrated inflow jet were independently associated with the rupture status of paraclinoid aneurysms. These findings need to be further confirmed based on large multicenter and multipopulation data. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Directory of Open Access Journals (Sweden)

    Y K Sanadhya

    2013-01-01

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

  17. Assessing tumor progression factors by somatic gene transfer into a mouse model: Bcl-xL promotes islet tumor cell invasion.

    Directory of Open Access Journals (Sweden)

    Yi-Chieh Nancy Du

    2007-10-01

    Full Text Available Tumors develop through multiple stages, implicating multiple effectors, but the tools to assess how candidate genes contribute to stepwise tumor progression have been limited. We have developed a novel system in which progression of phenotypes in a mouse model of pancreatic islet cell tumorigenesis can be used to measure the effects of genes introduced by cell-type-specific infection with retroviral vectors. In this system, bitransgenic mice, in which the rat insulin promoter (RIP drives expression of both the SV40 T antigen (RIP-Tag and the receptor for subgroup A avian leukosis virus (RIP-tva, are infected with avian viral vectors carrying cDNAs encoding candidate progression factors. Like RIP-Tag mice, RIP-Tag; RIP-tva bitransgenic mice develop isolated carcinomas by approximately 14 wk of age, after progression through well-defined stages that are similar to aspects of human tumor progression, including hyperplasia, angiogenesis, adenoma, and invasive carcinoma. When avian retroviral vectors carrying a green fluorescent protein marker were introduced into RIP-Tag; RIP-tva mice by intra-cardiac injection at the hyperplastic or early dysplastic stage of tumorigenesis, approximately 20% of the TVA-positive cells were infected and expressed green fluorescent proteins as measured by flow cytometry. Similar infection with vectors carrying cDNA encoding either of two progression factors, a dominant-negative version of cadherin 1 (dnE-cad or Bcl-xL, accelerated the formation of islet tumors with invasive properties and pancreatic lymph node metastasis. To begin studying the mechanism by which Bcl-xL, an anti-apoptotic protein, promotes invasion and metastasis, RIP-Tag; RIP-tva pancreatic islet tumor cells were infected in vitro with RCASBP-Bcl-xL. Although no changes were observed in rates of proliferation or apoptosis, Bcl-xL altered cell morphology, remodeled the actin cytoskeleton, and down-regulated cadherin 1; it also induced cell migration and

  18. Uncharismatic Invasives

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    Clark, Jonathan L.

    2015-05-01

    Full Text Available Although philosophers have examined the ethics of invasive species management, there has been little research approaching this topic from a descriptive, ethnographic perspective. In this article I examine how invasive species managers think about the moral status of the animals they seek to manage. I do so through a case study of Oregon’s efforts to manage the invasive species that are rafting across the Pacific attached to tsunami debris in the wake of the Japanese tsunami of 2011. Focusing on the state’s response to a dock that washed ashore on Agate Beach with various marine invertebrates attached to it, I argue that these animals’ position on two intersecting scales of moral worth—the sociozoologic scale and the phylogenetic scale—rendered them unworthy of moral consideration.

  19. Hemodynamic Stability during Induction of Anesthesia in Elderly Patients: Propofol + Ketamine versus Propofol + Etomidate

    Directory of Open Access Journals (Sweden)

    Hamzeh Hosseinzadeh

    2013-07-01

    Conclusion: Both methods of induction -ketamine + propofol and etomidate + propofol- are effective in maintaining hemodynamic stability and preventing hemodynamic changes due to propofol administration.

  20. Modificações da hemodinâmica fetal pelo estímulo sonoro: avaliação pela dopplervelocimetria colorida Vibro-acoustic stimulation induced hemodynamic fetal changes assessed by color doppler

    Directory of Open Access Journals (Sweden)

    Francisco Mauad Filho

    1999-04-01

    Full Text Available Objetivos: verificar se ocorrem ou não alterações hemodinâmicas na aréria cerebral média (ACM aferido pela dopplervelocimetria colorida após realização de um estímulo sonoro. Métodos: trinta fetos de gestantes consideradas clinicamente normais com idade gestacional igual ou superior a 28 semanas foram submetidos a um estímulo sonoro. Examinamos as alterações da velocidade sangüínea na ACM fetal por meio do índice de resistência e da freqüência cardíaca fetal, pelo doppler colorido, antes e depois do estímulo acústico. Resultados: a média da freqüência cardíaca fetal (FCF antes do estímulo sonoro foi de 142,41 batimentos por minuto (bpm com desvio padrão de 9,01 e faixa de variação de 122 a 162 bpm. Após o estímulo sonoro, a média da FCF foi de 159,44 bpm com desvio padrão de 15,49, com faixa de variação de 130 a 187 bpm (pPurpose: to determine the possible occurrence of hemodynamic changes in the middle cerebral artery of the fetus (MCA using color doppler after vibro-acoustic stimulation. Methods: thirty fetuses from pregnant women considered to be clinically normal, with a gestational age of 28 weeks or more were submitted to vibro-acoustic stimulation. We examined the changes in blood flow rate in the middle cerebral artery of the fetus on the basis of resistance index (RI and fetal heart rate (FHR by color doppler before and after the sound stimulus. Results: mean FHR before vibro-acoustic stimulation was 142.41 beats per minute (bpm with a standard deviation of 9.01 and a range of 122 to 162 bpm. After stimulation, mean FHR was 159.44 bpm with a standard deviation of 15.49 and a range of 130 to 187 bpm (p<0.01. Mean RI in the MCA of the fetuses was 75.89% (range: 64 to 91% before the experiment. After the vibro-acoustic stimulation, mean RI was 66.93% (range: 47 to 83%; p < 0.01. Conclusions: we observed that a sound stimulus provokes the well-known immediate and significant elevation of FHR and a

  1. Role and Effectiveness of Percutaneous Arterial Embolization in Hemodynamically Unstable Patients with Ruptured Splanchnic Artery Pseudoaneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Eveno, Clarisse, E-mail: clarisse.eveno@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Dautry, Raphael, E-mail: raphael.dautry@lrb.aphp.fr; Guerrache, Youcef, E-mail: docyoucef05@yahoo.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Camus, Marine, E-mail: marine.camus@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Boudiaf, Mourad, E-mail: mourad.boudiaf@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Gayat, Etienne, E-mail: etienne.gayat@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Dref, Olivier Le, E-mail: olivier.ledref@lrb.aphp.fr; Sirol, Marc, E-mail: marc.sirol@lrb.aphp.fr; Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France)

    2015-08-15

    PurposeTo assess the role and effectiveness of percutaneous arterial embolization (TAE) in patients with hemodynamic instability due to hypovolemic shock secondary to ruptured splanchnic artery pseudoaneurysms (SAPA).Materials and MethodsSeventeen patients (11 men, 6 women; mean age, 53 years) with hemodynamic instability (systolic blood pressure <90 mmHg) due to hypovolemic shock secondary to ruptured SAPA were treated by TAE. Clinical files, multidetector row computed tomography angiography, and angiographic examinations along with procedure details were reviewed.ResultsSeventeen SAPAs were present, predominantly located on gastroduodenal or pancreatic arteries (9/17; 53 %). Angiography showed extravasation of contrast medium from SAPA in 15/17 patients (88 %). Technical success rate of TAE was 100 %. TAE was performed using metallic coils in all patients (100 %), in association with gelatin sponge in 5/17 patients (29 %). TAE allowed controlling the bleeding and returning to normal hemodynamic status in 16/17 patients (94 %). In 1/17 patient (6 %), surgery was needed to definitively control the bleeding. The mortality and morbidity rate of TAE at 30 days were 0 and 12 %, respectively. Morbidity consisted in coil migration in 1/17 patient (6 %) and transient serum liver enzyme elevation in 1/17 patient (6 %).ConclusionTAE is an effective and safe treatment option for ruptured SAPA in hemodynamically unstable patients, with a success rate of 94 %. Our results suggest that TAE should be the favored option in patients with hemodynamic instability due to ruptured SAPA.

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

    Directory of Open Access Journals (Sweden)

    Kondratiev V.А.

    2016-05-01

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

  3. Comparative study of intravenously administered clonidine and magnesium sulfate on hemodynamic responses during laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Nand Kishore Kalra

    2011-01-01

    Full Text Available Background: Both magnesium and clonidine are known to inhibit catecholamine and vasopressin release and attenuate hemodynamic response to pneumoperitoneum. This randomized, double blinded, placebo controlled study has been designed to assess which agent attenuates hemodynamic stress response to pneumoperitoneum better. Materials and Methods: 120 patients undergoing elective laparoscopic cholecystectomy were randomized into 4 groups of 30 each. Group K patients received 50 ml normal saline over a period of 15 min after induction and before pneumoperitoneum, group M patients received 50 mg/kg of magnesium sulfate in normal saline (total volume 50 ml over same time duration. Similarly group C1 patients received 1 μg/kg clonidine and group C2 1.5 μg/kg clonidine respectively in normal saline (total volume 50 ml. Blood pressure and heart rate were recorded before induction (baseline value, at the end of infusions and every 5 min after pneumoperitoneum. Statistical Analysis: Paired t test was used for intra-group comparison and ANOVA for inter-group comparison. Results: Systolic blood pressure was significantly higher in control group as compared to all other groups during pneumoperitoneum. On comparing patients in group M and group C1, no significant difference in systolic BP was found at any time interval. Patients in group C2 showed best control of systolic BP. As compared to group M and group C1, BP was significantly lower at 10, 30 and 40 min post pneumoperitoneum. No significant episodes of hypotension were found in any of the groups. Extubation time and time to response to verbal command like eye opening was significantly longer in group M as compared to other groups. Conclusion: Administration of magnesium sulfate or clonidine attenuates hemodynamic response to pneumoperitoneum. Although magnesium sulfate 50 mg/kg produces hemodynamic stability comparable to clonidine 1 μg/kg, clonidine in doses of 1.5μg/kg blunts the hemodynamic response

  4. Valve mediated hemodynamics and their association with distal ascending aortic diameter in bicuspid aortic valve subjects.

    Science.gov (United States)

    Raghav, Vrishank; Barker, Alex J; Mangiameli, Daniel; Mirabella, Lucia; Markl, Michael; Yoganathan, Ajit P

    2018-01-01

    Valve mediated hemodynamics have been postulated to contribute to pathology of the ascending aorta (AAo). The objective of this study is to assess the association of aortic valve morphology and hemodynamics with downstream AAo size in subjects with bicuspid aortic valve (BAV) disease. Four-dimensional flow MRI at 1.5 or 3 Tesla was used to evaluate the hemodynamics in the proximal AAo of 52 subjects: size-matched controls with tricuspid aortic valves (n = 24, mid ascending aorta [MAA] diameter = 38.0 ± 4.9 mm) and BAV patients with aortic dilatation (n = 14 right and left coronary leaflet fusion [RL]-BAV, MAA diameter = 38.1 ± 5.3 mm; n = 14 right and noncoronary leaflet fusion [RN]-BAV, MAA diameter = 36.5 ± 6.6 mm). A validated semi-automated technique was used to evaluate hemodynamic metrics (flow angle, flow displacement, and jet quadrant) and valve morphology (orifice circularity) for all subjects. Regression analysis of these metrics to AAo diameter was performed. RN-BAV subjects displayed a stronger correlation between hemodynamic metrics in the proximal AAo with diameter in the distal AAo compared with size-matched tricuspid aortic valve (TAV) controls and RL-BAV subjects. The distal AAo diameter was found to be strongly correlated to the upstream flow displacement (R 2 adjusted = 0.75) and flow angle (R 2 adjusted = 0.66) measured at the sino-tubular junction (STJ). Orifice circularity was also strongly correlated (R 2 adjusted = 0.53) to the distal AAo diameter in RN-BAV subjects. For TAV controls and RL-BAV subjects, correlations were weaker (R 2 adjusted valve morphology metrics. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:246-254. © 2017 International Society for Magnetic Resonance in Medicine.

  5. Lights, camera…citizen science: assessing the effectiveness of smartphone-based video training in invasive plant identification.

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    Jared Starr

    Full Text Available The rapid growth and increasing popularity of smartphone technology is putting sophisticated data-collection tools in the hands of more and more citizens. This has exciting implications for the expanding field of citizen science. With smartphone-based applications (apps, it is now increasingly practical to remotely acquire high quality citizen-submitted data at a fraction of the cost of a traditional study. Yet, one impediment to citizen science projects is the question of how to train participants. The traditional "in-person" training model, while effective, can be cost prohibitive as the spatial scale of a project increases. To explore possible solutions, we analyze three training models: 1 in-person, 2 app-based video, and 3 app-based text/images in the context of invasive plant identification in Massachusetts. Encouragingly, we find that participants who received video training were as successful at invasive plant identification as those trained in-person, while those receiving just text/images were less successful. This finding has implications for a variety of citizen science projects that need alternative methods to effectively train participants when in-person training is impractical.

  6. Cliff stability assessment using electrical resistivity tomography at the historic WWII D-Day invasion site, Pointe du Hoc, France

    Science.gov (United States)

    Everett, M. E.; Udphuay, S.; Warden, R.

    2007-05-01

    The 1944 D-Day invasion site at Pointe du Hoc, Normandy, France is an important WWII battlefield and cultural resource but is at risk from chalk cliff collapse. The American Battle Monuments Commission tasked us to evaluate the geohazard to the observation post and other cliff-side buildings of historical significance. Geophysical multi-electrode resistivity profiling is used to study cliff stability and the condition of the observation- post foundations. Preliminary 2-D geological interpretations are provided of individual profiles. The copious steel, concrete and void spaces at the site renders hydrogeological interpretation challenging but tractable. The cliff face appears to be relatively intact and well-drained. Several routes taken by groundwater into fractures within the chalk were identified mainly on the western side of the site. The eastern side is drier and somewhat sheltered from the Atlantic storms but may contain large void spaces that could efficiently transmit groundwater flow during heavy precipitation events, thereby imperiling the major antiaircraft gun emplacement occupied by Col. Rudder in the early days of the Allied invasion. The forward German observation post perched close to the sea stack, which now hosts the U.S. Ranger memorial, may be moving with the soil and not securely anchored to bedrock. A complex failure mechanism is identified as a combination of groundwater dissolution of the fractured chalk and sea wave attack at the cliff base.

  7. Hemodynamic instability in the critically ill neonate: An approach to cardiovascular support based on disease pathophysiology.

    Science.gov (United States)

    Giesinger, Regan E; McNamara, Patrick J

    2016-04-01

    Hemodynamic disturbance in the sick neonate is common, highly diverse in underlying pathophysiology and dynamic. Dysregulated systemic and cerebral blood flow is hypothesized to have a negative impact on neurodevelopmental outcome and survival. An understanding of the physiology of the normal neonate, disease pathophysiology, and the properties of vasoactive medications may improve the quality of care and lead to an improvement in survival free from disability. In this review we present a modern approach to cardiovascular therapy in the sick neonate based on a more thoughtful approach to clinical assessment and actual pathophysiology. Targeted neonatal echocardiography offers a more detailed insight into disease processes and offers longitudinal assessment, particularly response to therapeutic intervention. The pathophysiology of common neonatal conditions and the properties of cardiovascular agents are described. In addition, we outline separate treatment algorithms for various hemodynamic disturbances that are tailored to clinical features, disease characteristics and echocardiographic findings. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  8. Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients

    Directory of Open Access Journals (Sweden)

    Shinya Yamazaki

    2008-09-01

    Full Text Available Shinya Yamazaki, Hiroyoshi Kawaai, Shigeo Sasaki, Kazuhiro Shimamura, Hiroshi Segawa, Takahiro SaitoSpecial Care Department in Dentistry, Ohu University Dental Hospital, Koriyama city, Fukushima prefecture, JapanAbstract: The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases. The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%, checking vital signs after an interview (15.3%, and monitoring under sedation (13.3%. There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management.Keywords: online, high-risk patient, dental treatment, medical cooperation, medical accident, risk management

  9. [HER-2 oncogene amplification assessment in invasive breast cancer by dual-color in situ hybridization (dc-CISH): a comparative study with fluorescent in situ hybridization (FISH)].

    Science.gov (United States)

    Akhdar, Abbas; Bronsard, Marc; Lemieux, Renald; Geha, Sameh

    2011-12-01

    The amplification of the gene encoding for the human epidermal growth factor receptor 2 (HER-2 oncogene), located on chromosome 17 (17q21-q22), or the overexpression of this receptor have prognostic and therapeutic implications in invasive breast cancer. An evaluation of the HER-2 status by immunohistochemistry (IHC) is performed on all invasive breast cancer cases. Fluorescent in situ hybridization (FISH) is considered as the gold standard for the detection of HER-2 gene amplification for IHC equivocal cases (score 2+). A more recent in situ hybridization technique, the dual-color chromogenic in situ hybridization (dc-CISH), has been proposed as an alternative to FISH. The aim of this study was to measure the correlation between dc-CISH and FISH for HER-2 oncogene amplification assessment in invasive breast cancer. We built four tissue micro-array (TMA) blocs with 100 breast invasive cancer cases that had been previously tested by IHC for HER-2 detection: 10 score 0 cases, 10 score 3+cases, 39 score 1+and 41 score 2+cases. Both FISH and dc-CISH techniques were applied on all TMA cases as well as on two additional slides serving as controls. Interpretation of dc-CISH was carried out by a pathologist using an optical microscope. For FISH, the interpretation was done by a professional from the medical genetics department using a fluorescent microscope linked to a computer system for image capturing and analysis. The interpretation of the HER-2/CEN-17 ratio for both tests was in accordance with the values of the updated recommendations from the Canadian National Consensus Meeting on HER-2/neu testing in breast cancer and from the ASCO/CAP. Among the 100 cases initially included in the study, eight were excluded from the analysis due to sampling or technical flaws. From the 92 remaining cases, we obtained a concordance of 97.8% (90/92 cases) between the two techniques (Kappa coefficient 0.97, 95% confidence interval). The correlation coefficient (rho) between ratios

  10. Influence of passive stretching on inhibition of disuse atrophy and hemodynamics of rat soleus muscle

    OpenAIRE

    Kimura, Shigefumi; Inaoka, Pleiades Tiharu; Yamazaki, Toshiaki

    2012-01-01

    The purpose of this study was to determine the infl uence of passive stretching on inhibition of disuse atrophy and hemodynamics among longitudinal regions of the rat soleus muscle. Disuse muscle atrophy was induced by hindlimb suspension for two weeks. Muscle blood flow was evaluated using thallium-201 (201Tl) which is a radiotracer that has been reported to be useful to assess blood perfusion in skeletal muscle. Thirty-nine male Wistar rats were divided randomly into 5 groups: control (C: n...

  11. Hemodynamic traveling waves in human visual cortex.

    Directory of Open Access Journals (Sweden)

    Kevin M Aquino

    Full Text Available Functional MRI (fMRI experiments rely on precise characterization of the blood oxygen level dependent (BOLD signal. As the spatial resolution of fMRI reaches the sub-millimeter range, the need for quantitative modelling of spatiotemporal properties of this hemodynamic signal has become pressing. Here, we find that a detailed physiologically-based model of spatiotemporal BOLD responses predicts traveling waves with velocities and spatial ranges in empirically observable ranges. Two measurable parameters, related to physiology, characterize these waves: wave velocity and damping rate. To test these predictions, high-resolution fMRI data are acquired from subjects viewing discrete visual stimuli. Predictions and experiment show strong agreement, in particular confirming BOLD waves propagating for at least 5-10 mm across the cortical surface at speeds of 2-12 mm s-1. These observations enable fundamentally new approaches to fMRI analysis, crucial for fMRI data acquired at high spatial resolution.

  12. Rationale, design and goals of the HeartFlow assessing diagnostic value of non-invasive FFRCT in Coronary Care (ADVANCE) registry

    DEFF Research Database (Denmark)

    Chinnaiyan, Kavitha M; Akasaka, Takashi; Amano, Tetsuya

    2017-01-01

    BACKGROUND: Coronary CT angiography (CTA) is a reliable tool for the detection of coronary artery disease (CAD) that conveys significant prognostic information. It does not provide data on the hemodynamic significance of a given lesion, particularly in intermediate-grade stenosis. Fractional flow...

  13. Detecting an elusive invasive species: a diagnostic PCR to detect Burmese python in Florida waters and an assessment of persistence of environmental DNA.

    Science.gov (United States)

    Piaggio, Antoinette J; Engeman, Richard M; Hopken, Matthew W; Humphrey, John S; Keacher, Kandy L; Bruce, William E; Avery, Michael L

    2014-03-01

    Recent studies have demonstrated that detection of environmental DNA (eDNA) from aquatic vertebrates in water bodies is possible. The Burmese python, Python bivittatus, is a semi-aquatic, invasive species in Florida where its elusive nature and cryptic coloration make its detection difficult. Our goal was to develop a diagnostic PCR to detect P. bivittatus from water-borne eDNA, which could assist managers in monitoring this invasive species. First, we used captive P. bivittatus to determine whether reptilian DNA could be isolated and amplified from water samples. We also evaluated the efficacy of two DNA isolation methods and two DNA extraction kits commonly used in eDNA preparation. A fragment of the mitochondrial cytochrome b gene from P. bivittatus was detected in all water samples isolated with the sodium acetate precipitate and the QIAamp DNA Micro Kit. Next, we designed P. bivittatus-specific primers and assessed the degradation rate of eDNA in water. Our primers did not amplify DNA from closely related species, and we found that P. bivittatus DNA was consistently detectable up to 96 h. Finally, we sampled water from six field sites in south Florida. Samples from five sites, where P. bivittatus has been observed, tested positive for eDNA. The final site was negative and had no prior documented evidence of P. bivittatus. This study shows P. bivittatus eDNA can be isolated from water samples; thus, this method is a new and promising technique for the management of invasive reptiles. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  14. Social cognition and prefrontal hemodynamic responses during a working memory task in schizophrenia.

    Science.gov (United States)

    Pu, Shenghong; Nakagome, Kazuyuki; Yamada, Takeshi; Itakura, Masashi; Yamanashi, Takehiko; Yamada, Sayaka; Masai, Mieko; Miura, Akihiko; Yamauchi, Takahira; Satake, Takahiro; Iwata, Masaaki; Nagata, Izumi; Roberts, David L; Kaneko, Koichi

    2016-03-01

    Social cognition is an important determinant of functional impairment in schizophrenia, but its relationship with the prefrontal functional abnormalities associated with the condition is still unclear. The present study aimed to explore the relationship between social cognition and prefrontal function in patients with schizophrenia using 52-channel near-infrared spectroscopy (NIRS). Twenty-six patients with schizophrenia and 26 age-, gender-, and intelligence quotient-matched healthy controls (HCs) participated in the study. Hemodynamic responses in the prefrontal and superior temporal cortical regions were assessed during a working memory task using NIRS. Social cognition was assessed using the Social Cognition Screening Questionnaire (SCSQ). The observed hemodynamic responses were significantly reduced in the lateral prefrontal cortex (PFC), the frontopolar cortex, and temporal regions in subjects with schizophrenia compared to HCs. Additionally, lateral PFC hemodynamic responses assessed during the working memory task demonstrated a strong positive correlation with the SCSQ theory of mind (ToM) subscale score even after controlling for working memory performance. These results suggest that ToM integrity is closely related to lateral PFC functional abnormalities found in patients with schizophrenia. In addition, this study provides evidence to suggest that NIRS could be used to identify biomarkers of social cognition function in subjects with schizophrenia.

  15. Ionizing radiation occupational exposure in the hemodynamics services

    International Nuclear Information System (INIS)

    Gronchi, Claudia Carla

    2004-01-01

    The purpose of this research is to study the ionizing radiation occupational exposure in the hemodynamic services of two large scale hospitals (Hospital A and Hospital B) of the Sao Paulo city. The research looked into annual doses that 279 professionals of the hemodynamic services were exposed to between 1991 and 2002. The data analyzed was collected from the database of the Instituto de Pesquisas Energeticas e Nucleares (IPEN) for Hospital A, and from the Radiological Protection Department of Hospital B. Besides this, measures of hands and crystalline lens equivalent doses were performed during hemodynamic procedures of the physicians, assistant physicians and nursing assistants with TL dosimeters (CaSO 4 :Dy + Teflon R) produced at IPEN. The safety procedures adopted by the hospitals were verified with the aid of a specific questionnaire for the hemodynamic services. Finally, a profile of the professionals that work in cardiac catheterism laboratories of the hemodynamic services was delineated, considering the variables of individual monitoring time, age and sex. This study allowed for observation of the behavior of the professionals' annual doses of these hemodynamic services in relation to the Comissao Nacional de Energia Nuclear and the Secretaria de Vigilancia Sanitaria limits. It showed that the annual doses of the same specialized occupations would vary from one hospital to another. It further showed the need of individual monitoring of the physicians' unprotected body parts (hands and crystalline lens) during the hemodynamic procedures. (author)

  16. Assessment of microbiological air quality in hemato-oncology units and its relationship with the occurrence of invasive fungal infections: an integrative review

    Directory of Open Access Journals (Sweden)

    Mayra Goncalves Menegueti

    2013-07-01

    Full Text Available Worldwide aging of the human population has promoted an increase in the incidence of neoplasia, including hematological cancers, which render patients particularly vulnerable to invasive fungal infections. For this reason, air filtration in hemato-oncology units has been recommended. However, scarce literature has assessed the impact of microbiological air quality on the occurrence of fungal infections in this population. We performed an integrative review of studies in the MEDLINE database that were published between January 1980 and October 2012, using the following combinations of keywords: air × quality × HEPA, air × quality × hematology, and airborne fungal infections. The search yielded only 13 articles, suggesting that high-efficiency filtering of the ambient air in hemato-oncology units can prevent the incidence of invasive fungal infections. However, no randomized clinical trial was found to confirm this suggestion. Currently, there is no consensus about the maximum allowable count of fungi in the air, which complicates filtration monitoring, including filter maintenance and replacement, and needs to be addressed in future studies.

  17. Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Lian-Ming [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Renji Hospital, Shanghai (China); Wayne State University, Department of Radiology, Detroit, MI (United States); Xu, Jian-Rong; Gu, Hai-Yan; Hua, Jia [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Renji Hospital, Shanghai (China); Haacke, E.M.; Hu, Jiani [Wayne State University, Department of Radiology, Detroit, MI (United States)

    2013-02-15

    To obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January1995 to March 2012. Pooled estimation data were obtained by statistical analysis. Eleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05). CE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making. (orig.)

  18. Permanent education that approaches radiation protection in hemodynamic service

    International Nuclear Information System (INIS)

    Flor, Rita de Cassia; Anjos, Djeniffer Valdirene dos

    2011-01-01

    In the hemodynamic services that apply ionizing radiation yet exist the necessity of capacitation of workers for actuation in those areas. So, this qualitative study performed in a hemodynamic service at Sao Jose, Santa Catarina, Brazil, had the objective to analyse how are developed the permanent education programs and the real necessity of workers. The results have shown that the workers are longing for their qualification and formation, as generally they are admitted with not any qualification for those services. So, the workers that realize the on duty hemodynamic service praxis must do it in a conscious manner and the E P is a way for to adopt good practice in radiological protection

  19. Assessment and prediction of the invasiveness of some alien plants in conditions of climate change in the steppe Dnieper region

    Directory of Open Access Journals (Sweden)

    Y. V. Lykholat

    2017-02-01

    Full Text Available The flora of the steppe Dnieper region is characterized by an abundance of naturalized alien species, some of which colonised over the last decade. Climate change, associated primarily with increasing temperature, became clearly manifested in this period. We tested the hypothesis that there is an association between climate change and the initiation of invasiveness of some alien plant species in the steppe Dnieper region. For this purpose, comparative studies of the distribution boundaries of naturalized alien trees, shrubs and herbaceous plants were conducted. Along the research route numerous 5–10-year-old broadleaf linden trees (Tilia platyphyllos Scop. were found in the man-made plantation communities of Dnipro city in areas with moist soil; seeded undergrowth was located at a significant distance from the adult linden plants. Numerous groups of young 7–10-year-old plants of the smoke trees (Cotinus coggygria Scop., which had a seed origin, were found in the shelterbelt and urban recreational plantations. Young 10–12-year-old virginal and generative plants of the black cherry (Padus serotina Ehrh. were found in large numbers in both the semi-natural and artificial plant communities at great distances from the adult trees. The alien plant species common hackberry (Celtis occidentalis L. showed the ability to form fairly sparse seminal seedlings, which was presented by the plants at the age of 4–7 years in both the natural and urban plant communities. The perennial herbaceous plant common milkweed (Asclepias syriaca L. was found in the course of the research in ruderal habitats, urban plant communities, and also in the agrocoenoses. The common milkweed reached its greatest abundance in fields of winter crops, where the spread of this species was accompanied by a sharp decrease in the number of other species of segetal plants. Our study results confirm that the extension of the distribution boundaries of alien species over the last

  20. Baseline Hemodynamics and Response to Contrast Media During Diagnostic Cardiac Catheterization Predict Adverse Events in Heart Failure Patients.

    Science.gov (United States)

    Denardo, Scott J; Vock, David M; Schmalfuss, Carsten M; Young, Gregory D; Tcheng, James E; O'Connor, Christopher M

    2016-07-01

    Contrast media administered during cardiac catheterization can affect hemodynamic variables. However, little is documented about the effects of contrast on hemodynamics in heart failure patients or the prognostic value of baseline and changes in hemodynamics for predicting subsequent adverse events. In this prospective study of 150 heart failure patients, we measured hemodynamics at baseline and after administration of iodixanol or iopamidol contrast. One-year Kaplan-Meier estimates of adverse event-free survival (death, heart failure hospitalization, and rehospitalization) were generated, grouping patients by baseline measures of pulmonary capillary wedge pressure (PCWP) and cardiac index (CI), and by changes in those measures after contrast administration. We used Cox proportional hazards modeling to assess sequentially adding baseline PCWP and change in CI to 5 validated risk models (Seattle Heart Failure Score, ESCAPE [Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness], CHARM [Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity], CORONA [Controlled Rosuvastatin Multinational Trial in Heart Failure], and MAGGIC [Meta-Analysis Global Group in Chronic Heart Failure]). Median contrast volume was 109 mL. Both contrast media caused similarly small but statistically significant changes in most hemodynamic variables. There were 39 adverse events (26.0%). Adverse event rates increased using the composite metric of baseline PCWP and change in CI (Pcontrast correlated with the poorest prognosis. Adding both baseline PCWP and change in CI to the 5 risk models universally improved their predictive value (P≤0.02). In heart failure patients, the administration of contrast causes small but significant changes in hemodynamics. Calculating baseline PCWP with change in CI after contrast predicts adverse events and increases the predictive value of existing models. Patients with elevated baseline PCWP and

  1. Sensitivity of spontaneous baroreflex control of the heart and hemodynamic parameters are not influenced by the menstrual cycle

    NARCIS (Netherlands)

    Vollebregt, Karlijn C.; Seesing, Lobke; Rang, Saskia; Boer, Kees; Wolf, Hans

    2006-01-01

    OBJECTIVE: The purpose of this study was to evaluate if hemodynamic parameters and sympathetic activity vary between the follicular and luteal phase of the menstrual cycle before using sympathetic activity in pre-pregnancy risk assessment for preeclampsia. METHODS: We studied 39 healthy women at

  2. Assessment of early-stage optic nerve invasion in retinoblastoma using high-resolution 1.5 Tesla MRI with surface coils: a multicentre, prospective accuracy study with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve J. [Institut Curie, Department of Radiology, Paris (France); Institut CURIE, Imaging Department, Paris (France); Graaf, Pim de; Rodjan, Firazia; Jong, Marcus C. de; Castelijns, Jonas A. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Galluzzi, Paolo [Neuroimaging and Neurointerventional Unit (NINT) Azienda Ospedaliera e Universitaria Senese, Siena (Italy); Cosker, Kristel; Savignoni, Alexia [Institut Curie, Department of Biostatistics, Paris (France); Maeder, Philippe [Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Department of Radiology, Lausanne (Switzerland); Goericke, Sophia [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Aerts, Isabelle [Institut Curie, Department of Pediatric Oncology, Paris (France); Desjardins, Laurence [Institut Curie, Department of Ophthalmology, Paris (France); Moll, Annette C. [VU University Medical Center, Department of Ophthalmology, Amsterdam (Netherlands); Hadjistilianou, Theodora [Azienda Ospedaliera Universitaria Senese, Department of Ophthalmology, Siena (Italy); Toti, Paolo [University of Siena, Department of Medical Biotechnologies, Pathology Unit, Siena (Italy); Valk, Paul van der [VU University Medical Center, Department of Pathology, Amsterdam (Netherlands); Sastre-Garau, Xavier [Institut Curie, Department of Biopathology, Paris (France); Collaboration: European Retinoblastoma Imaging Collaboration (ERIC)

    2015-05-01

    To assess the accuracy of high-resolution (HR) magnetic resonance imaging (MRI) in diagnosing early-stage optic nerve (ON) invasion in a retinoblastoma cohort. This IRB-approved, prospective multicenter study included 95 patients (55 boys, 40 girls; mean age, 29 months). 1.5-T MRI was performed using surface coils before enucleation, including spin-echo unenhanced and contrast-enhanced (CE) T1-weighted sequences (slice thickness, 2 mm; pixel size <0.3 x 0.3 mm{sup 2}). Images were read by five neuroradiologists blinded to histopathologic findings. ROC curves were constructed with AUC assessment using a bootstrap method. Histopathology identified 41 eyes without ON invasion and 25 with prelaminar, 18 with intralaminar and 12 with postlaminar invasion. All but one were postoperatively classified as stage I by the International Retinoblastoma Staging System. The accuracy of CE-T1 sequences in identifying ON invasion was limited (AUC = 0.64; 95 % CI, 0.55 - 0.72) and not confirmed for postlaminar invasion diagnosis (AUC = 0.64; 95 % CI, 0.47 - 0.82); high specificities (range, 0.64 - 1) and negative predictive values (range, 0.81 - 0.97) were confirmed. HR-MRI with surface coils is recommended to appropriately select retinoblastoma patients eligible for primary enucleation without the risk of IRSS stage II but cannot substitute for pathology in differentiating the first degrees of ON invasion. (orig.)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  4. Hemodynamic and respiratory effects of pneumoperitoneum and PEEP during laparoscopic pelvic lymphadenectomy in dogs.

    Science.gov (United States)

    Luz, C M; Polarz, H; Böhrer, H; Hundt, G; Dörsam, J; Martin, E

    1994-01-01

    Extended laparoscopic operations are being performed increasingly in high-risk patients. To assess the effects of increased intraabdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on the hemodynamic and respiratory system during extended procedures a carbon dioxide pneumoperitoneum was artificially induced in 10 dogs undergoing laparoscopic pelvic lymphadenectomy. An increase in IAP up to 15 mmHg had no negative effect on the cardiovascular system. However, the combination of an increased IAP (10-15 mmHg) with PEEP (8 cmH2O) markedly depressed the hemodynamic variables. Measurement of arterial carbon dioxide and fractional end-tidal carbon dioxide revealed significant CO2 retention. We conclude from the results that laparoscopic pelvic lymphadenectomy should be performed in high-risk patients only under general anesthesia with expanded cardiopulmonary monitoring.

  5. Effect on hemodynamics of a liquid meal alone and in combination with propranolol in cirrhosis

    DEFF Research Database (Denmark)

    Bendtsen, F; Simonsen, L; Henriksen, Jens Henrik Sahl

    1992-01-01

    Thirteen patients with alcoholic cirrhosis had splanchnic and systemic hemodynamics assessed before and after ingestion of a standard liquid meal of 700 kcal (consisting of isocaloric proteins, lipids, and carbohydrates). Half of the patients (n = 6) were randomized to a treatment group receiving...... intravenous infusion of propranolol in combination with the meal. No significant effects were observed on systemic hemodynamics after the meal alone. Heart rate (-14%; P less than 0.01) and cardiac index (-24%; P less than 0.01) decreased after meal in combination with propranolol. The mean hepatic venous...... pressure gradient increased significantly after ingestion of the meal alone with a maximal effect after 30 minutes (+13%; P less than 0.05) and returned to baseline values after 2 hours. Meal in combination with propranolol had no significant effect on the hepatic venous pressure gradient. Hepatic blood...

  6. Journal of Clinical Monitoring and Computing 2017 end of year summary: cardiovascular and hemodynamic monitoring.

    Science.gov (United States)

    Saugel, Bernd; Bendjelid, Karim; Critchley, Lester A H; Scheeren, Thomas W L

    2018-02-26

    Hemodynamic monitoring provides the basis for the optimization of cardiovascular dynamics in intensive care medicine and anesthesiology. The Journal of Clinical Monitoring and Computing (JCMC) is an ideal platform to publish research related to hemodynamic monitoring technologies, cardiovascular (patho)physiology, and hemodynamic treatment strategies. In this review, we discuss selected papers published on cardiovascular and hemodynamic monitoring in the JCMC in 2017.

  7. Overview of Five-Years of Experience Performing Non-Invasive Fetal Sex Assessment in Maternal Blood

    Directory of Open Access Journals (Sweden)

    Maria Jose Trujillo-Tiebas

    2013-05-01

    Full Text Available Since the discovery of the presence of fetal DNA in maternal blood, non-invasive fetal sex determination has been the test most widely translated into clinical practice. To date there is no agreement between the different laboratories performing such tests in relation to which is the best protocol. As a consequence there are almost as many protocols as laboratories offering the service, using different methodologies and thus obtaining different diagnostic accuracies. By the end of 2007, after a validation study performed in 316 maternal samples collected between the 5th and 12th week of gestation, the fetal sex determination was incorporated into clinical practice in our Service. The test is performed in the first trimester of pregnancy, and it is offered as part of the genetic counseling process for couples at risk of X-linked disorders. As a general rule and in order to avoid misdiagnosis, two samples at different gestational ages are tested per patient. The analysis is performed by the study of the SRY gene by RT-PCR. Two hundred and twenty six pregnancies have been tested so far in these 5 years. Neither false positives nor false negatives diagnoses have been registered, thus giving a diagnostic accuracy of 100%.

  8. Non-invasive imaging techniques in assessing non-alcoholic fatty liver disease: a current status of available methods.

    Science.gov (United States)

    Lăpădat, A M; Jianu, I R; Ungureanu, B S; Florescu, L M; Gheonea, D I; Sovaila, S; Gheonea, I A

    2017-01-01

    Non-alcoholic fatty liver disease (NAFLD) is an ailment affecting and increasing a number of people worldwide diagnosed via non-invasive imaging techniques, at a time when a minimum harm caused by medical procedures is rightfully emphasized, more sought after, than ever before. Liver steatosis should not be taken lightly even if its evolution is largely benign as it has the potential to develop into non-alcoholic steatohepatitis (NASH) or even more concerning, hepatic cirrhosis, and hepatocellular carcinoma (HCC). Traditionally, liver biopsy has been the standard for diagnosing this particular liver disease, but nowadays, a consistent number of imagistic methods are available for diagnosing hepatosteatosis and choosing the one appropriate to the clinical context is the key. Although different in sensitivity and specificity when it comes to determining the hepatic fat fraction (FF), these imaging techniques possessing a diverse availability, operating difficulty, cost, and reproducibility are invaluable to any modern physician. Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), elastography, and spectroscopy will be discussed in order to lay out the advantages and disadvantages of their diagnostic potential and application. Although imagistics has given physicians a valuable insight into the means of managing NAFLD, the current methods are far from perfect, but given the time, they will surely be improved and the use of liver biopsy will be completely removed.

  9. Non-invasive assessment of reproductive status and stress in captive Asian elephants in three south Indian zoos.

    Science.gov (United States)

    Kumar, Vinod; Palugulla Reddy, Vivekananda; Kokkiligadda, Adiseshu; Shivaji, Sisinthy; Umapathy, Govindhaswamy

    2014-05-15

    Asian elephants in captivity need immediate attention to be bred so as to meet the increasing demand for captive elephants and to overcome the dependence on supplementing the captive stock with wild animals. Unfortunately, captive breeding programs across the globe have met with limited success and therefore more effort is needed to improve breeding in captivity. Endocrine profiling of reproductive hormones (progestagens and androgens) and the stress hormone (glucocorticoids) could facilitate better management and breeding strategies. In the present study, we investigated reproductive and stress physiology of 12 captive Asian elephants for 10-27 months using a non-invasive method based on steroid analysis of 1700 elephant dung samples. Most of the elephants were cycling regularly. Males during musth showed increased fecal androgen metabolite concentrations and exhibited a slight increase in fecal glucocorticoid metabolite levels. Elephants used in public festivals and processions showed significantly increased in faecal glucocorticoid metabolite levels. The results indicate that captive elephants require periodic health care, better husbandry practices and scientific management for sustainable captive population. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Impact of a Monoplane Hemodynamic TEE (hTEE) Monitoring Device on Decision Making in a Heterogeneous Hemodynamically Unstable Intensive Care Unit Population: A Prospective, Observational Study.

    Science.gov (United States)

    Hlaing, Maung; He, Jianghua; Haglund, Nicholas; Takayama, Hiroo; Flynn, Brigid C

    2017-10-18

    This prospective observational study was undertaken to evaluate the utility of a miniature transesophageal echocardiography probe (ImaCor hemodynamic [hTEE]) in the management of hemodynamically unstable intensive care unit patients with and without various forms of mechanical circulatory support. A prospective observational study. A single tertiary care cardiothoracic and surgical intensive care unit. Fifty-three cardiothoracic and surgical intensive care unit patients undergoing miniature transesophageal echocardiography examinations. All patients had hemodynamic instability as defined by necessity of mechanical circulatory support (MCS) devices or vasoactive medications. From April 2012 to February 2014, 53 hemodynamically unstable intensive care unit patients received an examination with the miniature transesophageal echocardiography probe when deemed necessary by the intensivist for rapid and/or ongoing transesophageal echocardiographic examinations. Twenty-eight of the examinations were performed in patients with MCS devices (53%). The remainder of examinations (n = 25, 47%) were performed in patients after other cardiothoracic surgery or noncardiac surgery with cardiac complications. The measured endpoint was determination of usefulness of management guidance due to the miniature transesophageal echocardiographic examination as assessed by the intensivist caring for the patient. The incidence of hTEE imaging provoking a change in management also was recorded. Overall, of the 53 examinations, 77% (n = 41) provided useful information to the management. Of the 25 examinations in patients without MCS, 92% (n = 23) of the examinations were useful in guiding management. Among the 28 examinations in patients with MCS devices, 64% (n = 18) of examinations were useful in guiding management (odds ratio = 0.156; 95% confidence interval, 0.015-0.899; p = 0.022). Eight of the 53 examinations (15%) were deemed to have "poor image quality" by the echocardiographer. Age

  11. Assessing environmental risks for established invasive weeds: Dalmatian (Linaria dalmatica) and yellow (L. vulgaris) toadflax in North America

    Science.gov (United States)

    Sharlene E. Sing; Robert K. D. Peterson

    2011-01-01

    Environmental risk assessments characterizing potential environmental impacts of exotic weeds are more abundant and comprehensive for potential or new invaders than for widespread and well-established species such as Dalmatian (Linaria dalmatica [L.] Mill.) and yellow (L. vulgaris Mill.) toadflax. Specific effects evaluated in our assessment of environmental risks...

  12. Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients

    OpenAIRE

    Yamazaki, Shinya

    2008-01-01

    Shinya Yamazaki, Hiroyoshi Kawaai, Shigeo Sasaki, Kazuhiro Shimamura, Hiroshi Segawa, Takahiro SaitoSpecial Care Department in Dentistry, Ohu University Dental Hospital, Koriyama city, Fukushima prefecture, JapanAbstract: The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring sys...

  13. Hemodynamic effects of intravenous nicardipine in severely pre-eclamptic women with a hypertensive crisis.

    Science.gov (United States)

    Cornette, J; Buijs, E A B; Duvekot, J J; Herzog, E; Roos-Hesselink, J W; Rizopoulos, D; Meima, M; Steegers, E A P

    2016-01-01

    Nicardipine permits rapid control of blood pressure in women with severe pre-eclampsia (PE) and hypertensive crisis. Our objective was to investigate its maternal and fetal hemodynamic effects. Ten severely pre-eclamptic pregnant women who required intravenous nicardipine for severe hypertension were included in this prospective observational trial. Maternal macrocirculation was assessed by transthoracic echocardiography. Maternal microcirculatory perfusion was examined sublingually with the sidestream dark field imaging technique. Fetal hemodynamics were assessed by Doppler examinations of the uteroplacental and fetal circulations. Maternal cardiac output, total vascular resistance, mitral E/A ratio and capillary heterogeneity index, uterine artery pulsatility index and fetal cerebroplacental ratio were considered primary outcomes. Paired measurements, obtained before administration of nicardipine infusion and after stabilization of blood pressure, were compared. Administration of nicardipine significantly reduced the mean arterial blood pressure (median