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Sample records for perfusion diffusion confusion

  1. Reduce Confusion about Diffusion.

    ERIC Educational Resources Information Center

    Hebrank, Mary R.

    1997-01-01

    Presents activities that allow students to explore the fundamental but poorly understood concept of diffusion by appealing to their kinesthetic senses first, then challenging their analytical skills as they try to deduce the mathematical principle involved. Presents a computer simulation of diffusion and discusses diffusion's limitations and…

  2. Demonstrating Diffusion: Why the Confusion?

    ERIC Educational Resources Information Center

    Panizzon, Debra Lee

    1998-01-01

    Examines the principles of diffusion and how it may be confused with convection. Suggests that educators may be misleading students and clouding their understanding of the process. Provides two contemporary examples to explain the process of diffusion and how it differs from convection. (Author/CCM)

  3. Living with Technology Diffusion Confusion.

    ERIC Educational Resources Information Center

    Isaak, Troy; Ward, John

    This paper is a report on the implementation of a project to diffuse technology throughout a teacher education program in elementary education at Millersville University (Pennsylvania). Rather than relying on a single technology course in a preservice program, students develop technology skills in a variety of courses in the education sequence and…

  4. Confusion

    MedlinePlus

    ... or drug intoxication Brain tumor Head trauma or head injury ( concussion ) Fever Fluid and electrolyte imbalance Illness in ... someone with diabetes Confusion came on after a head injury The person becomes unconscious at any time If ...

  5. Scintigraphic perfusion patterns in patients with diffuse lung disease

    SciTech Connect

    Newman, G.E.; Sullivan, D.C.; Gottschalk, A.; Putman, C.E.

    1982-04-01

    Perfusion scintigrams of 55 patients with radiographic evidence of diffuse lung disease were reviewed. Thirty-nine had acute and/or chronic changes caused by congestive heart failure, and 16 had diffuse reticulonodular disease. A normal or near-normal perfusion pattern was seen in 40/55 (73%), and this finding was equally common in the two groups. The authors conclude that perfusion scintigraphy is useful in excluding pulmonary embolism in patients with radiographic evidence of diffuse, symmetrical lung disease.

  6. Using Diffusion of Innovations Theory to implement the confusion assessment method for the intensive care unit.

    PubMed

    Bowen, Constance Mary; Stanton, Marietta; Manno, Martin

    2012-01-01

    Routine screening of mechanically ventilated patients for delirium is essential for prompt recognition and management; however, this represents a change in practice. Rogers' Diffusion of Innovations Theory can be useful as a strategy to facilitate adoption of a practice change. This case study describes the effectiveness of identifying barriers to a change in practice and developing strategies, specific to Rogers' innovation decision process, for implementing the Confusion Assessment Method for the intensive care unit. PMID:22367153

  7. Diffusion and perfusion MRI of the lung and mediastinum.

    PubMed

    Henzler, Thomas; Schmid-Bindert, Gerald; Schoenberg, Stefan O; Fink, Christian

    2010-12-01

    With ongoing technical improvements such as multichannel MRI, systems with powerful gradients as well as the development of innovative pulse sequence techniques implementing parallel imaging, MRI has now entered the stage of a radiation-free alternative to computed tomography (CT) for chest imaging in clinical practice. Whereas in the past MRI of the lung was focused on morphological aspects, current MRI techniques also enable functional imaging of the lung allowing for a comprehensive assessment of lung disease in a single MRI exam. Perfusion imaging can be used for the visualization of regional pulmonary perfusion in patients with different lung diseases such as lung cancer, chronic obstructive lung disease, pulmonary embolism or for the prediction of postoperative lung function in lung cancer patients. Over the past years diffusion-weighted MR imaging (DW-MRI) of the thorax has become feasible with a significant reduction of the acquisition time, thus minimizing artifacts from respiratory and cardiac motion. In chest imaging, DW-MRI has been mainly suggested for the characterization of lung cancer, lymph nodes and pulmonary metastases. In this review article recent MR perfusion and diffusion techniques of the lung and mediastinum as well as their clinical applications are reviewed. PMID:20627435

  8. Diffusion and Perfusion: The Keys to Fat Grafting

    PubMed Central

    Khouri, Roger K.; Khouri, Raoul-Emil R.; Lujan-Hernandez, Jorge R.; Khouri, Khalil R.; Lancerotto, Luca

    2014-01-01

    Background: Fat grafting is now widely used in plastic surgery. Long-term graft retention can be unpredictable. Fat grafts must obtain oxygen via diffusion until neovascularization occurs, so oxygen delivery may be the overarching variable in graft retention. Methods: We studied the peer-reviewed literature to determine which aspects of a fat graft and the microenvironment surrounding a fat graft affect oxygen delivery and created 3 models relating distinct variables to oxygen delivery and graft retention. Results: Our models confirm that thin microribbons of fat maximize oxygen transport when injected into a large, compliant, well-vascularized recipient site. The “Microribbon Model” predicts that, in a typical human, fat injections larger than 0.16 cm in radius will have a region of central necrosis. Our “Fluid Accommodation Model” predicts that once grafted tissues approach a critical interstitial fluid pressure of 9 mm Hg, any additional fluid will drastically increase interstitial fluid pressure and reduce capillary perfusion and oxygen delivery. Our “External Volume Expansion Effect Model” predicts the effect of vascular changes induced by preoperative external volume expansion that allow for greater volumes of fat to be successfully grafted. Conclusions: These models confirm that initial fat grafting survival is limited by oxygen diffusion. Preoperative expansion increases oxygen diffusion capacity allowing for additional graft retention. These models provide a scientific framework for testing the current fat grafting theories. PMID:25426403

  9. Contrast-enhanced diffuse optical tomography of brain perfusion in humans using ICG

    NASA Astrophysics Data System (ADS)

    Habermehl, Christina; Schmitz, Christoph; Steinbrink, Jens

    2012-02-01

    Regular monitoring of brain perfusion at the bedside in neurointensive care is desirable. Currently used imaging modalities are not suited for constant monitoring and often require a transport of the patient. Noninvasive near infrared spectroscopy (NIRS) in combination with an injection of a safe dye (indocyanine green, ICG) could serve as a quasi-continuous brain perfusion monitor. In this work, we evaluate prerequisites for the development of a brain perfusion monitor using continuous wave (cw) NIRS technique. We present results from a high-resolution diffuse optical tomography (HR-DOT) experiment in humans demonstrating the separation of signals from skin from the brain. This technique can help to monitor neurointensive care patients on a regular basis, detecting changes in cortical perfusion in time.

  10. Perfusion and diffusion MRI of glioblastoma progression in a four-year prospective temozolomide clinical trial

    SciTech Connect

    Leimgruber, Antoine; Ostermann, Sandrine; Yeon, Eun Jo; Buff, Evelyn; Maeder, Philippe P.; Stupp, Roger; Meuli, Reto A. . E-mail: Reto.Meuli@chuv.ch

    2006-03-01

    Purpose: This study was performed to determine the impact of perfusion and diffusion magnetic resonance imaging (MRI) sequences on patients during treatment of newly diagnosed glioblastoma. Special emphasis has been given to these imaging technologies as tools to potentially anticipate disease progression, as progression-free survival is frequently used as a surrogate endpoint. Methods and Materials: Forty-one patients from a phase II temolozomide clinical trial were included. During follow-up, images were integrated 21 to 28 days after radiochemotherapy and every 2 months thereafter. Assessment of scans included measurement of size of lesion on T1 contrast-enhanced, T2, diffusion, and perfusion images, as well as mass effect. Classical criteria on tumor size variation and clinical parameters were used to set disease progression date. Results: A total of 311 MRI examinations were reviewed. At disease progression (32 patients), a multivariate Cox regression determined 2 significant survival parameters: T1 largest diameter (p < 0.02) and T2 size variation (p < 0.05), whereas perfusion and diffusion were not significant. Conclusion: Perfusion and diffusion techniques cannot be used to anticipate tumor progression. Decision making at disease progression is critical, and classical T1 and T2 imaging remain the gold standard. Specifically, a T1 contrast enhancement over 3 cm in largest diameter together with an increased T2 hypersignal is a marker of inferior prognosis.

  11. Phase-based metamorphosis of diffusion lesion in relation to perfusion values in acute ischemic stroke.

    PubMed

    Rekik, Islem; Allassonnière, Stéphanie; Luby, Marie; Carpenter, Trevor K; Wardlaw, Joanna M

    2015-01-01

    Examining the dynamics of stroke ischemia is limited by the standard use of 2D-volume or voxel-based analysis techniques. Recently developed spatiotemporal models such as the 4D metamorphosis model showed promise for capturing ischemia dynamics. We used a 4D metamorphosis model to evaluate acute ischemic stroke lesion morphology from the acute diffusion-weighted imaging (DWI) to final T2-weighted imaging (T2-w). In 20 representative patients, we metamorphosed the acute lesion to subacute lesion to final infarct. From the DWI lesion deformation maps we identified dynamic lesion areas and examined their association with perfusion values inside and around the lesion edges, blinded to reperfusion status. We then tested the model in ten independent patients from the STroke Imaging Repository (STIR). Perfusion values varied widely between and within patients, and were similar in contracting and expanding DWI areas in many patients in both datasets. In 25% of patients, the perfusion values were higher in DWI-contracting than DWI-expanding areas. A similar wide range of perfusion values and ongoing expansion and contraction of the DWI lesion were seen subacutely. There was more DWI contraction and less expansion in patients who received thrombolysis, although with widely ranging perfusion values that did not differ. 4D metamorphosis modeling shows promise as a method to improve use of multimodal imaging to understand the evolution of acute ischemic tissue towards its fate. PMID:26288755

  12. Diffusion-perfusion relationships in skeletal muscle: models and experimental evidence from inert gas washout.

    PubMed

    Piiper, J; Meyer, M

    1984-01-01

    In order to study the dependence of blood-tissue gas exchange upon diffusion, the simultaneous washout of two inert gases of differing diffusivity was investigated in isolated-perfused dog gastrocnemius preparations. The muscles were equilibrated with CH4 and SF6 via arterial blood. The washout kinetics were determined from venous blood samples analyzed by gas chromatography. The results revealed the following features: The washout of the test gases was pronouncedly multi-exponential, and could be described by three exponential components when analyzed to 5% of the initial value. The non-exponential washout was attributed to unequal distribution of capillary blood flow to tissue volume. The mean ratio of washout rate constants CH4/SF6 was within 1.10-1.25 and was even smaller than the ratio expected for pure perfusion limitation (1.46). Therefore, no evidence for effective tissue-blood diffusion limitation was obtained. The observed washout rate constant ratio could be explained by a model with veno-arterial back diffusion which more strongly retards washout kinetics of the better diffusible gas (CH4) as compared to the less diffusible gas (SF6). PMID:6731103

  13. Diffusing capacities and ventilation: perfusion ratios in patients with the clinical syndrome of alveolar capillary block

    PubMed Central

    Arndt, Hartmut; King, Thomas K. C.; Briscoe, William A.

    1970-01-01

    Studies were performed on 10 patients with the clinical syndrome of alveolar capillary block while each patient was breathing four different inspired oxygen mixtures. The data were interpreted using the principle of the Bohr integral isopleth with which alveolar oxygen tension in the differently ventilated parts of the lung can initially be treated as unknown. It is then possible to determine the distribution of ventilation, of perfusion, of diffusing capacity, of lung volume, and of alveolar and end capillary blood oxygen tension in the variously functioning parts of the lung. In two patients shunts were the major factor interfering with oxygen transfer. In four others inequalities in ventilation: perfusion ratios and in diffusing capacity in different parts of the lung were the factors interfering with oxygen transfer. In four more patients ventilation: perfusion ratios were the same throughout the lung, the only disturbance of oxygen transfer being in the total diffusing capacity or in its distribution between the different parts of the lung. PMID:5411791

  14. Validation of diffuse correlation spectroscopy for muscle blood flow with concurrent arterial spin labeled perfusion MRI

    NASA Astrophysics Data System (ADS)

    Yu, Guoqiang; Floyd, Thomas F.; Durduran, Turgut; Zhou, Chao; Wang, Jiongjiong; Detre, John A.; Yodh, Arjun G.

    2007-02-01

    Calf blood flow was measured simultaneously in healthy human subjects (n = 7) during cuff inflation and deflation using near-infrared diffuse correlation spectroscopy (DCS) and arterial spin labeled perfusion MRI (ASL-MRI). The DCS and ASL-MRI data exhibited highly correlated absolute and relative dynamic flow responses in each individual (p < 0.001). Peak flow variations during hyperemia were also significantly correlated, though more for relative (p = 0.003) than absolute (p = 0.016) flow. Repeated measurement variation was less than 8% for both modalities. The results provide much needed quantitative blood flow validation of the diffuse optical correlation method in humans.

  15. Comparison of stroke infarction between CT perfusion and diffusion weighted imaging: preliminary results

    NASA Astrophysics Data System (ADS)

    Abd. Rahni, Ashrani Aizzuddin; Arka, Israna Hossain; Chellappan, Kalaivani; Mukari, Shahizon Azura; Law, Zhe Kang; Sahathevan, Ramesh

    2016-03-01

    In this paper we present preliminary results of comparison of automatic segmentations of the infarct core, between that obtained from CT perfusion (based on time to peak parameter) and diffusion weighted imaging (DWI). For each patient, the two imaging volumes were automatically co-registered to a common frame of reference based on an acquired CT angiography image. The accuracy of image registration is measured by the overlap of the segmented brain from both images (CT perfusion and DWI), measured within their common field of view. Due to the limitations of the study, DWI was acquired as a follow up scan up to a week after initial CT based imaging. However, we found significant overlap of the segmented brain (Jaccard indices of approximately 0.8) and the percentage of infarcted brain tissue from the two modalities were still fairly highly correlated (correlation coefficient of approximately 0.9). The results are promising with more data needed in future for clinical inference.

  16. Multiparametric Characterization of Grade 2 Glioma Subtypes Using Magnetic Resonance Spectroscopic, Perfusion, and Diffusion Imaging1

    PubMed Central

    Bian, Wei; Khayal, Inas S; Lupo, Janine M; McGue, Colleen; Vandenberg, Scott; Lamborn, Kathleen R; Chang, Susan M; Cha, Soonmee; Nelson, Sarah J

    2009-01-01

    BACKGROUND AND PURPOSE: The purpose of this study was to derive quantitative parameters from magnetic resonance (MR) spectroscopic, perfusion, and diffusion imaging of grade 2 gliomas according to the World Health Organization and to investigate how these multiple imaging modalities can contribute to evaluating their histologic subtypes and spatial characteristics. MATERIALS AND METHODS: MR spectroscopic, perfusion, and diffusion images from 56 patients with newly diagnosed grade 2 glioma (24 oligodendrogliomas, 18 astrocytomas, and 14 oligoastrocytomas) were retrospectively studied. Metabolite intensities, relative cerebral blood volume (rCBV), and apparent diffusion coefficient (ADC) were statistically evaluated. RESULTS: The 75th percentile rCBV and median ADC were significantly different between oligodendrogliomas and astrocytomas (P < .0001) and between oligodendrogliomas and oligoastrocytomas (P < .001). Logistic regression analysis identified both 75th percentile rCBV and median ADC as significant variables in the differentiation of oligodendrogliomas from astrocytomas and oligoastrocytomas. Group differences in metabolite intensities were not significant, but there was a much larger variation in the volumes and maximum values of metabolic abnormalities for patients with oligodendroglioma compared with the other tumor subtypes. CONCLUSIONS: Perfusion and diffusion imaging provide quantitative MR parameters that can help to differentiate grade 2 oligodendrogliomas from grade 2 astrocytomas and oligoastrocytomas. The large variations in the magnitude and spatial extent of the metabolic lesions between patients and the fact that their values are not correlated with the other imaging parameters indicate that MR spectroscopic imaging may provide complementary information that is helpful in targeting therapy, evaluating residual disease, and assessing response to therapy. PMID:19956389

  17. Methylene blue treatment delays progression of perfusion-diffusion mismatch to infarct in permanent ischemic stroke

    PubMed Central

    Rodriguez, Pavel; Jiang, Zhao; Huang, Shiliang; Shen, Qiang; Duong, Timothy Q

    2016-01-01

    Stroke is a leading cause of morbidity and mortality in the world. Low-dose methylene blue (MB), which has been used safely to treat methemoglobinemia and cyanide poisoning in humans, has energy enhancing and antioxidant properties. We tested the hypothesis that methylene blue treatment delays progression of at-risk tissue (ca. perfusion-diffusion mismatch) to infarct in permanent middle cerebral artery occlusion in rats at two MB treatment doses. Serial MRI was used to evaluate MB treatment efficacy. The major findings were: (i) MB significantly prolonged the perfusion-diffusion mismatch, (ii) MB mildly increased the CBF in the hypoperfused tissue, (iii) MB did not change the final infarct volume in permanent ischemic stroke, and (iv) there were no dose-dependent effects on mismatch progression for the 1 and 3mg/kg doses studied. This neuroprotective effect is likely the result of sustained ATP production and increased CBF to tissue at risk. This work has the potential to readily lead to clinical stroke trials given MB's excellent safety profile. PMID:25218555

  18. Prognostic value of combined visualization of MR diffusion and perfusion maps in glioblastoma.

    PubMed

    Deike, Katerina; Wiestler, Benedikt; Graf, Markus; Reimer, Caroline; Floca, Ralf O; Bäumer, Philipp; Kickingereder, Philipp; Heiland, Sabine; Schlemmer, Heinz-Peter; Wick, Wolfgang; Bendszus, Martin; Radbruch, Alexander

    2016-02-01

    We analyzed whether the combined visualization of decreased apparent diffusion coefficient (ADC) values and increased cerebral blood volume (CBV) in perfusion imaging can identify prognosis-related growth patterns in patients with newly diagnosed glioblastoma. Sixty-five consecutive patients were examined with diffusion and dynamic susceptibility-weighted contrast-enhanced perfusion weighted MRI. ADC and CBV maps were co-registered on the T1-w image and a region of interest (ROI) was manually delineated encompassing the enhancing lesion. Within this ROI pixels with ADC values the 70th percentile (CBVmax) and the intersection of pixels with ADCmin and CBVmax were automatically calculated and visualized. Initially, all tumors with a mean intersection greater than the upper quartile of the normally distributed mean intersection of all patients were subsumed to the first growth pattern termed big intersection (BI). Subsequently, the remaining tumors' growth patterns were categorized depending on the qualitative representation of ADCmin, CBVmax and their intersection. Log-rank test exposed a significantly longer overall survival of BI (n = 16) compared to non-BI group (n = 49) (p = 0.0057). Thirty-one, four and 14 patients of the non-BI group were classified as predominant ADC-, CBV- and mixed growth group, respectively. In a multivariate Cox regression model, the BI-, CBV- and mixed groups had significantly lower adjusted hazard ratios (p-value, α(Bonferroni) < 0.006) when compared to the reference group ADC: 0.29 (0.0027), 0.11 (0.038) and 0.33 (0.0059). Our study provides evidence that the combination of diffusion and perfusion imaging allows visualization of different glioblastoma growth patterns that are associated with prognosis. A possible biological hypothesis for this finding could be the interpretation of the ADCmin fraction as the invasion-front of tumor cells while the CBVmax fraction might represent

  19. Comparison of Perfusion- and Diffusion-weighted Imaging Parameters in Brain Tumor Studies Processed Using Different Software Platforms

    PubMed Central

    Milchenko, Mikhail V.; Rajderkar, Dhanashree; LaMontagne, Pamela; Massoumzadeh, Parinaz; Bogdasarian, Ronald; Schweitzer, Gordon; Benzinger, Tammie; Marcus, Dan; Shimony, Joshua S.; Fouke, Sarah Jost

    2015-01-01

    Rationale and Objectives To compare quantitative imaging parameter measures from diffusion- and perfusion-weighted imaging magnetic resonance imaging (MRI) sequences in subjects with brain tumors that have been processed with different software platforms. Materials and Methods Scans from 20 subjects with primary brain tumors were selected from the Comprehensive Neuro-oncology Data Repository at Washington University School of Medicine (WUSM) and the Swedish Neuroscience Institute. MR images were coregistered, and each subject's data set was processed by three software packages: 1) vendor-specific scanner software, 2) research software developed at WUSM, and 3) a commercially available, Food and Drug Administration–approved, processing platform (Nordic Ice). Regions of interest (ROIs) were chosen within the brain tumor and normal nontumor tissue. The results obtained using these methods were compared. Results For diffusion parameters, including mean diffusivity and fractional anisotropy, concordance was high when comparing different processing methods. For perfusion-imaging parameters, a significant variance in cerebral blood volume, cerebral blood flow, and mean transit time (MTT) values was seen when comparing the same raw data processed using different software platforms. Correlation was better with larger ROIs (radii ≥ 5 mm). Greatest variance was observed in MTT. Conclusions Diffusion parameter values were consistent across different software processing platforms. Perfusion parameter values were more variable and were influenced by the software used. Variation in the MTT was especially large suggesting that MTT estimation may be unreliable in tumor tissues using current MRI perfusion methods. PMID:25088833

  20. Temporal Evolution of Ischemic Lesions in Nonhuman Primates: A Diffusion and Perfusion MRI Study

    PubMed Central

    Zhang, Xiaodong; Tong, Frank; Li, Chun-Xia; Yan, Yumei; Kempf, Doty; Nair, Govind; Wang, Silun; Muly, E. Chris; Zola, Stuart; Howell, Leonard

    2015-01-01

    Background and Purpose Diffusion-weighted imaging (DWI) and perfusion MRI were used to examine the spatiotemporal evolution of stroke lesions in adult macaques with ischemic occlusion. Methods Permanent MCA occlusion was induced with silk sutures through an interventional approach via the femoral artery in adult rhesus monkeys (n = 8, 10–21 years old). The stroke lesions were examined with high-resolution DWI and perfusion MRI, and T2-weighted imaging (T2W) on a clinical 3T scanner at 1–6, 48, and 96 hours post occlusion and validated with H&E staining. Results The stroke infarct evolved via a natural logarithmic pattern with the mean infarct growth rate = 1.38 ± 1.32 ml per logarithmic time scale (hours) (n = 7) in the hyperacute phase (1–6 hours). The mean infarct volume after 6 hours post occlusion was 3.6±2.8 ml (n = 7, by DWI) and increased to 3.9±2.9 ml (n = 5, by T2W) after 48 hours, and to 4.7±2.2ml (n = 3, by T2W) after 96 hours post occlusion. The infarct volumes predicted by the natural logarithmic function were correlated significantly with the T2W-derived lesion volumes (n = 5, r = 0.92, p = 0.01) at 48 hours post occlusion. The final infarct volumes derived from T2W were correlated significantly with those from H&E staining (r = 0.999, p < 0.0001, n = 4). In addition, the diffusion-perfusion mismatch was visible generally at 6 hours but nearly diminished at 48 hours post occlusion. Conclusion The infarct evolution follows a natural logarithmic pattern in the hyperacute phase of stroke. The logarithmic pattern of evolution could last up to 48 hours after stroke onset and may be used to predict the infarct volume growth during the acute phase of ischemic stroke. The nonhuman primate model, MRI protocols, and post data processing strategy may provide an excellent platform for characterizing the evolution of acute stroke lesion in mechanistic studies and therapeutic interventions of stroke disease. PMID:25659092

  1. Alveolar ventilation to perfusion heterogeneity and diffusion impairment in a mathematical model of gas exchange

    NASA Technical Reports Server (NTRS)

    Vidal Melo, M. F.; Loeppky, J. A.; Caprihan, A.; Luft, U. C.

    1993-01-01

    This study describes a two-compartment model of pulmonary gas exchange in which alveolar ventilation to perfusion (VA/Q) heterogeneity and impairment of pulmonary diffusing capacity (D) are simultaneously taken into account. The mathematical model uses as input data measurements usually obtained in the lung function laboratory. It consists of two compartments and an anatomical shunt. Each compartment receives fractions of alveolar ventilation and blood flow. Mass balance equations and integration of Fick's law of diffusion are used to compute alveolar and blood O2 and CO2 values compatible with input O2 uptake and CO2 elimination. Two applications are presented. The first is a method to partition O2 and CO2 alveolar-arterial gradients into VA/Q and D components. The technique is evaluated in data of patients with chronic obstructive pulmonary disease (COPD). The second is a theoretical analysis of the effects of blood flow variation in alveolar and blood O2 partial pressures. The results show the importance of simultaneous consideration of D to estimate VA/Q heterogeneity in patients with diffusion impairment. This factor plays an increasing role in gas alveolar-arterial gradients as severity of COPD increases. Association of VA/Q heterogeneity and D may produce an increase of O2 arterial pressure with decreasing QT which would not be observed if only D were considered. We conclude that the presented computer model is a useful tool for description and interpretation of data from COPD patients and for performing theoretical analysis of variables involved in the gas exchange process.

  2. Analytical estimation of ultrasound properties, thermal diffusivity, and perfusion using magnetic resonance-guided focused ultrasound temperature data

    NASA Astrophysics Data System (ADS)

    Dillon, C. R.; Borasi, G.; Payne, A.

    2016-01-01

    For thermal modeling to play a significant role in treatment planning, monitoring, and control of magnetic resonance-guided focused ultrasound (MRgFUS) thermal therapies, accurate knowledge of ultrasound and thermal properties is essential. This study develops a new analytical solution for the temperature change observed in MRgFUS which can be used with experimental MR temperature data to provide estimates of the ultrasound initial heating rate, Gaussian beam variance, tissue thermal diffusivity, and Pennes perfusion parameter. Simulations demonstrate that this technique provides accurate and robust property estimates that are independent of the beam size, thermal diffusivity, and perfusion levels in the presence of realistic MR noise. The technique is also demonstrated in vivo using MRgFUS heating data in rabbit back muscle. Errors in property estimates are kept less than 5% by applying a third order Taylor series approximation of the perfusion term and ensuring the ratio of the fitting time (the duration of experimental data utilized for optimization) to the perfusion time constant remains less than one.

  3. Analytical estimation of ultrasound properties, thermal diffusivity, and perfusion using magnetic resonance-guided focused ultrasound temperature data.

    PubMed

    Dillon, C R; Borasi, G; Payne, A

    2016-01-21

    For thermal modeling to play a significant role in treatment planning, monitoring, and control of magnetic resonance-guided focused ultrasound (MRgFUS) thermal therapies, accurate knowledge of ultrasound and thermal properties is essential. This study develops a new analytical solution for the temperature change observed in MRgFUS which can be used with experimental MR temperature data to provide estimates of the ultrasound initial heating rate, Gaussian beam variance, tissue thermal diffusivity, and Pennes perfusion parameter. Simulations demonstrate that this technique provides accurate and robust property estimates that are independent of the beam size, thermal diffusivity, and perfusion levels in the presence of realistic MR noise. The technique is also demonstrated in vivo using MRgFUS heating data in rabbit back muscle. Errors in property estimates are kept less than 5% by applying a third order Taylor series approximation of the perfusion term and ensuring the ratio of the fitting time (the duration of experimental data utilized for optimization) to the perfusion time constant remains less than one. PMID:26741344

  4. Perfusion and diffusion sensitive 13C stimulated-echo MRSI for metabolic imaging of cancer.

    PubMed

    Larson, Peder E Z; Hurd, Ralph E; Kerr, Adam B; Pauly, John M; Bok, Robert A; Kurhanewicz, John; Vigneron, Daniel B

    2013-06-01

    Metabolic imaging with hyperpolarized [1-(13)C]-pyruvate can rapidly probe tissue metabolic profiles in vivo and has been shown to provide cancer imaging biomarkers for tumor detection, progression, and response to therapy. This technique uses a bolus injection followed by imaging within 1-2 minutes. The observed metabolites include vascular components and their generation is also influenced by cellular transport. These factors complicate image interpretation, especially since [1-(13)C]lactate, a metabolic product that is a biomarker of cancer, is also produced by red blood cells. It would be valuable to understand the distribution of metabolites between the vasculature, interstitial space, and intracellular compartments. The purpose of this study was to better understand this compartmentalization by using a perfusion and diffusion-sensitive stimulated-echo acquisition mode (STEAM) MRSI acquisition method tailored to hyperpolarized substrates. Our results in mouse models showed that among metabolites, the injected substrate (13)C-pyruvate had the largest vascular fraction overall while (13)C-alanine had the smallest vascular fraction. We observed a larger vascular fraction of pyruvate and lactate in the kidneys and liver when compared to back muscle and prostate tumor tissue. Our data suggests that (13)C-lactate in prostate tumor tissue voxels was the most abundant labeled metabolite intracellularly. This was shown in STEAM images that highlighted abnormal cancer cell metabolism and suppressed vascular (13)C metabolite signals. PMID:23260391

  5. Production of Xylella fastidiosa diffusible signal factor in transgenic grape causes pathogen confusion and reduction in severity of Pierce's disease.

    PubMed

    Lindow, Steven; Newman, Karyn; Chatterjee, Subhadeep; Baccari, Clelia; Lavarone, Anthony T; Ionescu, Michael

    2014-03-01

    The rpfF gene from Xylella fastidiosa, encoding the synthase for diffusible signal factor (DSF), was expressed in 'Freedom' grape to reduce the pathogen's growth and mobility within the plant. Symptoms in such plants were restricted to near the point of inoculation and incidence of disease was two- to fivefold lower than in the parental line. Both the longitudinal and lateral movement of X. fastidiosa in the xylem was also much lower. DSF was detected in both leaves and xylem sap of RpfF-expressing plants using biological sensors, and both 2-Z-tetradecenoic acid, previously identified as a component of X. fastidiosa DSF, and cis-11-methyl-2-dodecenoic acid were detected in xylem sap using electrospray ionization mass spectrometry. A higher proportion of X. fastidiosa cells adhered to xylem vessels of the RpfF-expressing line than parental 'Freedom' plants, reflecting a higher adhesiveness of the pathogen in the presence of DSF. Disease incidence in RpfF-expressing plants in field trials in which plants were either mechanically inoculated with X. fastidiosa or subjected to natural inoculation by sharpshooter vectors was two- to fourfold lower in than that of the parental line. The number of symptomatic leaves on infected shoots was reduced proportionally more than the incidence of infection, reflecting a decreased ability of X. fastidiosa to move within DSF-producing plants. PMID:24499029

  6. A practical assessment of magnetic resonance diffusion-perfusion mismatch in acute stroke: observer variation and outcome.

    PubMed

    Kane, I; Hand, P J; Rivers, C; Armitage, P; Bastin, M E; Lindley, R; Dennis, M; Wardlaw, J M

    2009-11-01

    MR diffusion/perfusion mismatch may help identify patients for acute stroke treatment, but mixed results from clinical trials suggest that further evaluation of the mismatch concept is required. To work effectively, mismatch should predict prognosis on arrival at hospital. We assessed mismatch duration and associations with functional outcome in acute stroke. We recruited consecutive patients with acute stroke, recorded baseline clinical variables, performed MR diffusion and perfusion imaging and assessed 3-month functional outcome. We assessed practicalities, agreement between mismatch on mean transit time (MTT) or cerebral blood flow (CBF) maps, visually and with lesion volume, and the relationship of each to functional outcome. Of 82 patients starting imaging, 14 (17%) failed perfusion imaging. Overall, 42% had mismatch (56% at <6 h; 41% at 12-24 h; 23% at 24-48 h). Agreement for mismatch by visual versus volume assessment was fair using MTT (kappa 0.59, 95% CI 0.34-0.84) but poor using CBF (kappa 0.24, 95% CI 0.01-0.48). Mismatch by either definition was not associated with functional outcome, even when the analysis was restricted to just those with mismatch. Visual estimation is a reasonable proxy for mismatch volume on MTT but not CBF. Perfusion is more difficult for acute stroke patients than diffusion imaging. Mismatch is present in many patients beyond 12 h after stroke. Mismatch alone does not distinguish patients with good and poor prognosis; both can do well or poorly. Other factors, e.g. reperfusion, may influence outcome more strongly, even in patients without mismatch. PMID:19536582

  7. WE-G-18C-09: Separating Perfusion and Diffusion Components From Diffusion Weighted MRI of Rectum Tumors Based On Intravoxel Incoherent Motion (IVIM) Analysis

    SciTech Connect

    Tyagi, N; Wengler, K; Mazaheri, Y; Hunt, M; Deasy, J; Gollub, M

    2014-06-15

    Purpose: Pseudodiffusion arises from the microcirculation of blood in the randomly oriented capillary network and contributes to the signal decay acquired using a multi-b value diffusion weighted (DW)-MRI sequence. This effect is more significant at low b-values and should be properly accounted for in apparent diffusion coefficient (ADC) calculations. The purpose of this study was to separate perfusion and diffusion component based on a biexponential and a segmented monoexponential model using IVIM analysis Methods. The signal attenuation is modeled as S(b) = S0[(1−f)exp(−bD) + fexp(−bD*)]. Fitting the biexponetial decay leads to the quantification of D, the true diffusion coefficient, D*, the pseudodiffusion coefficient, and f, the perfusion fraction. A nonlinear least squares fit and two segmented monoexponential models were used to derive the values for D, D*,‘and f. In the segmented approach b = 200 s/mm{sup 2} was used as the cut-off value for calculation of D. DW-MRI's of a rectum cancer patient were acquired before chemotherapy, before radiation therapy (RT), and 4 weeks into RT and were investigated as an example case. Results: Mean ADC for the tumor drawn on the DWI cases was 0.93, 1.0 and 1.13 10{sup −3}×mm{sup 2}/s before chemotherapy, before RT and 4 weeks into RT. The mean (D.10{sup −3} × mm{sup 2}/s, D* 10{sup −3} × mm{sup 2}/s, and f %) based on biexponential fit was (0.67, 18.6, and 27.2%), (0.72, 17.7, and 28.9%) and (0.83,15.1, and 30.7%) at these time points. The mean (D, D* f) based on segmented fit was (0.72, 10.5, and 12.1%), (0.72, 8.2, and 17.4%) and (.82, 8.1, 16.5%) Conclusion: ADC values are typically higher than true diffusion coefficients. For tumors with significant perfusion effect, ADC should be analyzed at higher b-values or separated from the perfusion component. Biexponential fit overestimates the perfusion fraction because of increased sensitivity to noise at low b-values.

  8. Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI.

    PubMed

    Liu, Y; Karonen, J O; Vanninen, R L; Nuutinen, J; Perkiö, J; Vainio, P A; Soimakallio, S; Aronen, H J

    2003-06-01

    Diffusion and perfusion weighted MRI have been widely used in ischaemic stroke. We studied 17 patients in whom ischaemic areas showed an ischaemic core, an area of infarct growth and hypoperfused but ultimately surviving tissue. Apparent diffusion coefficients (ADC) were measured on days 1, 2, and 8 in the three subregions and in contralateral control areas. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were measured in these regions on day 1 perfusion maps. On day 1, the ischaemic core had very low ADC and CBF and increased MTT. The ADC in the ischaemic core gradually increased during the week. The area of infarct growth on day 1 had slightly but significantly decreased ADC (96% of control, P=0.028), moderately decreased CBF and increased MTT. On day 1 the hypoperfused but surviving tissue had slightly but significantly increased ADC (103% of control, P=0.001), mildly decreased CBF and increased CBV and MTT. The ADC of the area of infarct growth decreased to the same level as in the ischaemic core on days 2 and 8. That of surviving tissue was still above normal on day 2 (103% of control), but had returned to the normal level by day 8. Measurement of ADC combined with perfusion MRI may help distinguish different subregions in acutely hypoperfused brain. PMID:12750863

  9. Cerebral hemodynamics in human acute ischemic stroke: a study with diffusion- and perfusion-weighted magnetic resonance imaging and SPECT.

    PubMed

    Liu, Y; Karonen, J O; Vanninen, R L; Ostergaard, L; Roivainen, R; Nuutinen, J; Perkiö, J; Könönen, M; Hämäläinen, A; Vanninen, E J; Soimakallio, S; Kuikka, J T; Aronen, H J

    2000-06-01

    Nineteen patients with acute ischemic stroke (<24 hours) underwent diffusion-weighted and perfusion-weighted (PWI) magnetic resonance imaging at the acute stage and 1 week later. Eleven patients also underwent technetium-99m ethyl cysteinate dimer single-photon emission computed tomography (SPECT) at the acute stage. Relative (ischemic vs. contralateral control) cerebral blood flow (relCBF), relative cerebral blood volume, and relative mean transit time were measured in the ischemic core, in the area of infarct growth, and in the eventually viable ischemic tissue on PWI maps. The relCBF was also measured from SPECT. There was a curvilinear relationship between the relCBF measured from PWI and SPECT (r = 0.854; P < 0.001). The tissue proceeding to infarction during the follow-up had significantly lower initial CBF and cerebral blood volume values on PWI maps (P < 0.001) than the eventually viable ischemic tissue had. The best value for discriminating the area of infarct growth from the eventually viable ischemic tissue was 48% for PWI relCBF and 87% for PWI relative cerebral blood volume. Combined diffusion and perfusion-weighted imaging enables one to detect hemodynamically different subregions inside the initial perfusion abnormality. Tissue survival may be different in these subregions and may be predicted. PMID:10894174

  10. [Simultaneous analysis of the distribution of ventilation and diffusive conductance to perfusion in the lungs].

    PubMed

    Yamaguchi, K

    1989-12-01

    Theoretical analysis and experimental observations were performed to establish an essential method allowing demonstration of the characteristics of distribution of ventilation (VA) as well as of diffusive conductance (G) to perfusion (Q) in the lungs. O2, CO2 and CO binding to hemoglobin molecules within erythrocytes, together with six inert gases including SF6, ethane, cyclopropane, halothane, diethyl ether and acetone, possessing various degrees of solubility in blood and different degrees of diffusibility in lung tissue were used as indicator gases. Fifteen patients with interstitial pneumonia of unknown etiology, placed in a supine position, were given a mixture of 21% O2 and 0.1% CO in N2 as the inspired gas and normal saline containing appropriate amounts of the six inert gases via the antecubital vein. After a steady state was established, the expired gas was collected and both arterial and mixed venous blood were simultaneously sampled through the catheter inserted either into the femoral or pulmonary artery. The concentrations of the indicator gases in the samples were measured by gas chromatography, with electrodes or with Scholander gas analyzer. Assuming that the mass transfer efficiency of a given indicator gas at each gas exchange unit would be limited by the ratio of VA to Q (VA/Q) and by that of G/Q, the data obtained from the human subjects were analyzed in terms of a lung model having 20 units along the VA/Q and G/Q axes, respectively. The numerical analysis including the procedure of a simultaneous Bohr integration for O2, CO2 and CO in a pulmonary capillary and the method of weighted least-squares combined with the idea of constrained optimization permitted the data to be transformed into a virtually continuous distribution of Q against VA/Q and G/Q axes. The numerical procedure was strictly tested based on many artificial distributions of VA/Q and G/Q ratios, showing that it could characterize distributions containing up to at least two modes

  11. Myocardial function and perfusion in the CREST syndrome variant of progressive systemic sclerosis. Exercise radionuclide evaluation and comparison with diffuse scleroderma

    SciTech Connect

    Follansbee, W.P.; Curtiss, E.I.; Medsger, T.A. Jr.; Owens, G.R.; Steen, V.D.; Rodnan, G.P.

    1984-09-01

    Myocardial function and perfusion were evaluated in 22 patients with progressive systemic sclerosis with the CREST syndrome using exercise and radionuclide techniques, pulmonary function testing, and chest roentgenography. The results were compared with a similar study of 26 patients with progressive systemic sclerosis with diffuse scleroderma. The prevalence of thallium perfusion abnormalities was similar in the groups with CREST syndrome and diffuse scleroderma, (64 percent versus 77 percent), but the defects were significantly smaller in the CREST syndrome (p less than 0.01). Reperfusion thallium defects in the absence of extramural coronary artery disease were seen in 38 percent of patients with diffuse scleroderma. This finding was not seen in any of the patients with the CREST syndrome. In diffuse scleroderma, abnormalities of both right and left ventricular function were related to larger thallium perfusion defects. In the CREST syndrome, abnormalities of left ventricular function were minor, were seen only during exercise, and were unrelated to thallium perfusion defects. Abnormal resting right ventricular function was seen in 36 percent of the patients with the CREST syndrome and was associated with an isolated decrease in diffusing capacity of carbon monoxide. It is concluded that the cardiac manifestations of the CREST syndrome are distinct from those found in diffuse scleroderma. Unlike diffuse scleroderma, abnormalities of left ventricular function in the CREST syndrome are minor and are unrelated to abnormalities of coronary perfusion. Right ventricular dysfunction in the CREST syndrome appears to be primarily related to pulmonary vascular disease.

  12. Apolipoprotein E polymorphism and acute ischemic stroke: a diffusion- and perfusion-weighted magnetic resonance imaging study.

    PubMed

    Liu, Yawu; Laakso, Mikko P; Karonen, Jari O; Vanninen, Ritva L; Nuutinen, Juho; Soimakallio, Seppo; Aronen, Hannu J

    2002-11-01

    Diffusion- and perfusion-weighted magnetic resonance imaging (MRI) was used to study the putative effects of apolipoprotein E (ApoE) polymorphism in stroke. Thirty-one patients with acute stroke, comparative for age and gender were scanned, nine of whom were ApoE allele epsilon 4 carriers. Initially, less than 24 hours from the onset of stroke, the epsilon 4 carriers had significantly smaller volumes of hypoperfusion on relative cerebral blood volume map (P = 0.001), and smaller infarct volumes (P = 0.008) compared with the noncarriers. By day 8, this difference in the infarct volumes had disappeared, suggesting relatively enhanced infarct growth. On average, the total infarct volume increased 145% of the initial infarct volume in the epsilon 4 carriers, and 84% in the noncarriers. There were strong correlations between the imaging findings and clinical status initially and with the outcome 3 months after the stroke in the epsilon 4 noncarriers, but, with a single exception at acute phase, a lack thereof in the epsilon 4 carriers. These patterns were virtually similar in a subgroup of patients with middle cerebral artery stroke. These data support the hypothesis of increased general vulnerability of the brain in the epsilon 4 carriers. Thus, the effects of ApoE polymorphism should be accounted for when interpreting diffusion- and perfusion-weighted MRI studies, particularly if predicting lesion growth. PMID:12439291

  13. Design and testing of diffuse reflectance sensor for continuous monitoring of cutaneous blood perfusion

    NASA Astrophysics Data System (ADS)

    Zakharov, P.; Talary, M. S.; Caduff, A.

    2009-07-01

    A dual-wavelength reflectance optical sensor for monitoring cutaneous blood perfusion is presented as a part of multisensor glucose monitoring system. A Monte-Carlo simulation of partial differential pathlengths has been used for the optimization of the distance from light source to detector. The simulation indicated that the light pathlength within the upper vascularised skin layers increases before reaching saturation at separation distances larger than 3 mm. Thus the sensor sensitivity does not benefit from larger source-detector distances. At the same time with a higher separation of the detector from the source, the intensity exponentially decreases while undesirable sensitivity to the muscle perfusion increases. The hardware prototype has been developed based on the simulation findings and tested in a laboratory setting and in a home use study by patients with diabetes. For both testing procedures the optical sensor demonstrated high sensitivity to perfusion changes. The effect of initial cutaneous blood increase under the sensor has been observed which can be associated with pressure-induced vasodilation as a response to the sensor application.

  14. Quantitative Perfusion- and Diffusion-Weighted Magnetic Resonance Imaging of Gastrointestinal Cancers Treated With Multikinase Inhibitors: A Pilot Study

    PubMed Central

    Keene, Kimberly S.; Sarver, David B.; Lee, S. Kyle; Beasley, T. Mark; Morgan, Desiree E.; Posey, James A.

    2014-01-01

    ABSTRACT BACKGROUND: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) are often used to detect the early response of solid tumors to an effective therapy. The early changes in intratumoral physiological parameters measured by DCE-MRI/DWI have been evaluated as surrogate biomarkers allowing a tailored treatment for the individual patient. METHODS: Patients with newly diagnosed, biopsy-proven, treatment-naïve gastrointestinal stromal tumor (GIST) or hepatocellular carcinoma (HCC) were enrolled prospectively after institutional review board (IRB)–approved informed consent (5 patients per tumor type). Patients with GIST were treated with sunitinib over 6 weeks. DCE-MRI/DWI was applied before therapy (baseline imaging) and at 2 and 6 weeks after therapy initiation. Patients with HCC were treated with radiation during the first 2 weeks and then with sorafenib for the next 6 weeks. DCE-MRI/DWI was applied in all patients with HCC before and after radiation therapy and at the end of sorafenib therapy. Tumor volume, perfusion parameters (Ktrans, the forward volume-transfer constant, and kep, the reverse reflux-rate constant) and the apparent diffusion coefficient (ADC) were measured. RESULTS: During 2 weeks of sunitinib therapy, GIST volume, Ktrans, and kep decreased 32 ± 13, 45 ± 24, and 42 ± 15%, respectively, whereas ADC increased 76 ± 24%. After 6 weeks of sunitinib therapy, GIST volume, Ktrans, and kep decreased 56 ± 7, 70 ± 7, and 50 ± 12%, respectively, whereas ADC increased 85 ± 33%. After completion of radiation therapy, HCC volume, Ktrans, and kep decreased 34 ± 14, 35 ± 12, and 4 ± 21%, respectively, but ADC increased 21 ± 9%. During the entire 10-week therapeutic period, HCC volume, Ktrans, and kep decreased 65 ± 15, 40 ± 9, and 26 ± 2%, respectively, whereas ADC increased 28 ± 10%. CONCLUSION: DCE-MRI/DWI can measure the perfusion and diffusion changes in GISTs or HCCs treated with

  15. Confusion, Conflict--Cooperation?

    ERIC Educational Resources Information Center

    Lind, Joan Dyste

    1982-01-01

    Ethnocentrism and cultural isolation characterize current curriculum on western civilization. By adopting an interdisciplinary approach, and after overcoming the dual hurdles of confusion and interpersonal conflict in the disciplines, the college curriculum may begin to change this trend. (MSE)

  16. Successful outcome after endovascular thrombolysis for acute ischemic stroke with basis on perfusion-diffusion mismatch after 24 h of symptoms onset

    PubMed Central

    Mattei, Tobias A.; Rehman, Azeem A.; Goulart, Carlos R.; Sória, Marília G.; Rizelio, Vanessa; Meneses, Murilo S.

    2016-01-01

    Background: Although intravenous thrombolysis is the Food and Drug Administration-approved treatment for acute ischemic stroke (AIS) within 3 h, combined intravenous and intra-arterial thrombolysis with endovascular techniques may be able to extend this traditional time window. Case Description: We present the clinical evolution of a 45-year-old male presenting with acute left hemiparesis. Magnetic resonance imaging revealed a small diffusion restriction at the right basal ganglia with perfusion compromise in the entire right middle cerebral artery (MCA) territory. Angiography revealed a complete occlusion of MCA at its M1 segment. The patient underwent endovascular mechanical thrombectomy with additional intra-arterial thrombolysis more than 24 hours after the onset of the initial symptoms and experienced complete vessel recanalization. At 1 year, the patient had global independence with minor residual motor impairment in the left arm. Conclusions: We report the case of a successful thrombolytic therapy following AIS performed more than 24 h after the initial symptoms based on the presence of a perfusion-diffusion mismatch. This report is expected to stimulate the development of future prospective studies with special focus on the role of perfusion-diffusion mismatch in patient selection for treatment of AIS, especially in those presenting outside the traditional time window. PMID:27313971

  17. LISA source confusion

    SciTech Connect

    Crowder, Jeff; Cornish, Neil J.

    2004-10-15

    The Laser Interferometer Space Antenna will detect thousands of gravitational wave sources. Many of these sources will be overlapping in the sense that their signals will have a nonzero cross correlation. Such overlaps lead to source confusion, which adversely affects how well we can extract information about the individual sources. Here we study how source confusion impacts parameter estimation for galactic compact binaries, with emphasis on the effects of the number of overlaping sources, the time of observation, the gravitational wave frequencies of the sources, and the degree of the signal correlations. Our main findings are that the parameter resolution decays exponentially with the number of overlapping sources and superexponentially with the degree of cross correlation. We also find that an extended mission lifetime is key to disentangling the source confusion as the parameter resolution for overlapping sources improves much faster than the usual square root of the observation time.

  18. Is Neurolaw Conceptually Confused?

    PubMed

    Levy, Neil

    2014-06-01

    In Minds, Brains, and Law, Michael Pardo and Dennis Patterson argue that current attempts to use neuroscience to inform the theory and practice of law founder because they are built on confused conceptual foundations. Proponents of neurolaw attribute to the brain or to its parts psychological properties that belong only to people; this mistake vitiates many of the claims they make. Once neurolaw is placed on a sounder conceptual footing, Pardo and Patterson claim, we will see that its more dramatic claims are false or meaningless, though it might be able to provide inductive evidence for particular less dramatic claims (that a defendant may be lying, or lacks control over their behavior, for instance). In response, I argue that the central conceptual confusions identified by Pardo and Patterson are not confusions at all. Though some of the claims made by its proponents are hasty and sometimes they are confused, there are no conceptual barriers to attributing psychological properties to brain states. Neuroscience can play a role in producing evidence that is more reliable than subjective report or behavior; it therefore holds out the possibility of dramatically altering our self-conception as agents and thereby the law. PMID:25009442

  19. Histiocytosis X. Unusual-confusing features of eosinophilic granuloma.

    PubMed

    Pomeranz, S J; Proto, A V

    1986-01-01

    We report our experience with seven cases of eosinophilic granuloma in which unusual and/or confusing features were encountered. These features include: histologic confusion with desquamative interstitial pneumonitis, diffuse histiocytic lymphoma, eosinophilic pneumonia; cysts filled with air and/or fluid; radiographic onset in the eighth decade of life; intratracheal mass; and focal parenchymal consolidation. PMID:3484446

  20. Quantitative MR evaluation of atrophy, as well as perfusion and diffusion alterations within hippocampi in patients with Alzheimer’s disease and mild cognitive impairment

    PubMed Central

    Zimny, Anna; Bladowska, Joanna; Neska, Małgorzata; Petryszyn, Kamila; Guziński, Maciej; Szewczyk, Paweł; Leszek, Jerzy; Sąsiadek, Marek

    2013-01-01

    Background The aim of this study was to evaluate atrophy rates, perfusion, and diffusion disturbances within the hippocampus, which is the site of characteristic changes in Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Material/Methods Thirty patients with AD (mean age 71.2 yrs) – 34 with MCI (mean age 67.7 yrs) and 20 healthy controls (mean age 68.1 yrs) – underwent structural MR examination followed by perfusion and diffusion-weighted imaging on a 1.5 T scanner. Visual rating of hippocampal atrophy, planimetric measurements of hippocampal formation (HF) and perihippocampal fluid spaces (PFSs), and values of relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) were assessed. The results were correlated with the MMSE scores. Results In AD we found decreased size of HF and increased diameters of PFSs and ADC values, compared to MCI and control group. Compared to normal controls, the MCI group showed decreased HF size and increased diameters of only medial PFS. There were no differences in rCBV values among all the subject groups. Planimetric measurements of hippocampal atrophy showed the highest accuracy in diagnosing AD and MCI. In all patients, the increased rates of hippocampal atrophy correlated with the increased ADC values. In MCI, MMSE scores correlated with the HF size and ADC values. Conclusions In AD and MCI, hippocampal atrophy is associated with decreased tissue integrity without coexisting perfusion disturbances. Of all evaluated hippocampal measurements, atrophy rates seem to be the most useful parameters in detecting changes among AD, MCI, and control subjects. PMID:23377218

  1. Multimodal imaging in diagnosis of Alzheimer's disease and amnestic mild cognitive impairment: value of magnetic resonance spectroscopy, perfusion, and diffusion tensor imaging of the posterior cingulate region.

    PubMed

    Zimny, Anna; Szewczyk, Pawel; Trypka, Elzbieta; Wojtynska, Renata; Noga, Leszek; Leszek, Jerzy; Sasiadek, Marek

    2011-01-01

    The purpose of this study was to assess metabolic, perfusion, and microstructural changes within the posterior cingulate area in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) using advanced MR techniques such as: spectroscopy (MRS), perfusion weighted imaging (PWI), and diffusion tensor imaging (DTI). Thirty patients with AD (mean age 71.5 y, MMSE 18), 23 with aMCI (mean age 66 y, MMSE 27.4), and 15 age-matched normal controls (mean age 69 y, MMSE 29.5) underwent conventional MRI followed by MRS, PWI, and DTI on 1.5 Tesla MR unit. Several metabolite ratios (N-acetylaspartate [NAA]/creatine [Cr], choline [Ch]/Cr, myoinositol [mI]/Cr, mI/NAA, mI/Cho) as well as parameters of cerebral blood volume relative to cerebellum and fractional anisotropy were obtained in the posterior cingulate region. The above parameters were correlated with the results of neuropsychological tests. AD patients showed significant abnormalities in all evaluated parameters while subjects with aMCI showed only perfusion and diffusion changes in the posterior cingulate area. Only PWI and DTI measurements revealed significant differences among the three evaluated subject groups. DTI, PWI, and MRS results showed significant correlations with neuropsychological tests. DTI changes correlated with both PWI and MRS abnormalities. Of neuroimaging methods, DTI revealed the highest accuracy in diagnosis of AD and aMCI (0.95, 0.79) followed by PWI (0.87, 0.67) and MRS (0.82, 0.47), respectively. In conclusion, AD is a complex pathology regarding both grey and white matter. DTI seems to be the most useful imaging modality to distinguish between AD, aMCI, and control group, followed by PWI and MRS. PMID:21841260

  2. Intravoxel Incoherent Motion MR Imaging: Comparison of Diffusion and Perfusion Characteristics for Differential Diagnosis of Soft Tissue Tumors

    PubMed Central

    Du, Jun; Li, Kun; Zhang, Weisheng; Wang, Shaowu; Song, Qingwei; Liu, Ailian; Miao, Yanwei; Lang, Zhijin; Zhang, Lina; Zheng, Minting

    2015-01-01

    Abstract We used intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) to explore the possibility of preoperative diagnosis of soft tissue tumors (STTs). This prospective study enrolled 23 patients. Conventional MRI and IVIM examinations were performed on a 3.0T MR imager. Eight (35%) hemangiomas, 11 (47%) benign soft tissue tumors excluding hemangiomas (BSTTEHs) and 4 soft tissue sarcomas (STSs) were assessed. The mean tumor size was about 1652.36 ± 233.66 mm2. Ten b values (0–800 s/mm2) were used to evaluate diffusion and perfusion characteristics of IVIM. IVIM parameters (ADCstandard, ADCslow, ADCfast, and f) of STTs were measured and evaluated for differentiating hemangiomas, BSTTEHs, and STSs. ADCslow and ADCfast value were different for hemangiomas, BSTTEHs, and STSs separately (P < 0.001, P < 0.001, and P = 0.001). ADCslow, cut-off value smaller than 0.93 × 10–3 mm2/s, was the best parameter to differ STSs (0.689 ± 0.173 × 10−3 mm2/s) from hemangiomas (0.933 ± 0.237 × 10−3 mm2/s) and BSTTEHs (1.156 ± 0.120 × 10−3 mm2/s) (P = 0.001). ADCslow (0.93 × 10−3 mm2/s

  3. Current concepts on magnetic resonance imaging (MRI) perfusion-diffusion assessment in acute ischaemic stroke: a review & an update for the clinicians.

    PubMed

    Roldan-Valadez, Ernesto; Lopez-Mejia, Mariana

    2014-12-01

    Recently, several medical societies published joint statements about imaging recommendations for acute stroke and transient ischaemic attack patients. In following with these published guidelines, we considered it appropriate to present a brief, practical and updated review of the most relevant concepts on the MRI assessment of acute stroke. Basic principles of the clinical interpretation of diffusion, perfusion, and MRI angiography (as part of a global MRI protocol) are discussed with accompanying images for each sequence. Brief comments on incidence and differential diagnosis are also included, together with limitations of the techniques and levels of evidence. The purpose of this article is to present knowledge that can be applied in day-to-day clinical practice in specialized stroke units or emergency rooms to attend patients with acute ischaemic stroke or transient ischaemic attack according to international standards. PMID:25758570

  4. WE-G-18C-02: Estimation of Optimal B-Value Set for Obtaining Apparent Diffusion Coefficient Free From Perfusion in Non-Small Cell Lung Cancer

    SciTech Connect

    Karki, K; Hugo, G; Ford, J; Saraiya, S; Weiss, E; Olsen, K; Groves, R

    2014-06-15

    Purpose: Diffusion-weighted MRI (DW-MRI) is increasingly being investigated for radiotherapy planning and response assessment. Selection of a limited number of b-values in DW-MRI is important to keep geometrical variations low and imaging time short. We investigated various b-value sets to determine an optimal set for obtaining monoexponential apparent diffusion coefficient (ADC) close to perfusion-insensitive intravoxel incoherent motion (IVIM) model ADC (ADCIVIM) in nonsmall cell lung cancer. Methods: Seven patients had 27 DW-MRI scans before and during radiotherapy in a 1.5T scanner. Respiratory triggering was applied to the echo-planar DW-MRI with TR=4500ms approximately, TE=74ms, pixel size=1.98X1.98mm{sub 2}, slice thickness=4–6mm and 7 axial slices. Diffusion gradients were applied to all three axes producing traceweighted images with eight b-values of 0–1000μs/μm{sup 2}. Monoexponential model ADC values using various b-value sets were compared to ADCIVIM using all b-values. To compare the relative noise in ADC maps, intra-scan coefficient of variation (CV) of active tumor volumes was computed. Results: ADCIVIM, perfusion coefficient and perfusion fraction for tumor volumes were in the range of 880-1622 μm{sup 2}/s, 8119-33834 μm{sup 2}/s and 0.104–0.349, respectively. ADC values using sets of 250, 800 and 1000; 250, 650 and 1000; and 250–1000μs/μm{sup 2} only were not significantly different from ADCIVIM(p>0.05, paired t-test). Error in ADC values for 0–1000, 50–1000, 100–1000, 250–1000, 500–1000, and three b-value sets- 250, 500 and 1000; 250, 650 and 1000; and 250, 800 and 1000μs/μm{sup 2} were 15.0, 9.4, 5.6, 1.4, 11.7, 3.7, 2.0 and 0.2% relative to the reference-standard ADCIVIM, respectively. Mean intrascan CV was 20.2, 20.9, 21.9, 24.9, 32.6, 25.8, 25.4 and 24.8%, respectively, whereas that for ADCIVIM was 23.3%. Conclusion: ADC values of two 3 b-value sets

  5. Diffusion, perfusion and the exclusion principles in the structural and functional organization of the living cell: reappraisal of the properties of the 'ground substance'.

    PubMed

    Wheatley, Denys N

    2003-06-01

    The thesis is presented that only within very small microdomains of the cell internum might diffusion operate in the sorting of molecular affinities. Much of cell metabolism is guided and controlled in rate by the speed with which molecules that have to interact encounter one another. What is clear, however, is that the cell does not have a single 'modus operandi' but has the choice of many different strategies, each of which can contribute in different proportion to the rate of ongoing activity. It is probably our own desire to simplify things and use the most (or more) probable strategy that confines our appreciation of the overall robustness of the cell as a 'survival machine'. The main operative process at any given time (perfusion, diffusion or whatever) has always to be considered very carefully in relation to the organisational structure of the cell, which can be transient and fickle but nevertheless has been seen as involving an extensive cytomatrix, a ground substance, within an aqueous environment in which the degree of water structuring is even more fickle. PMID:12756276

  6. Diffusion and Perfusion MRI to Differentiate Treatment-Related Changes Including Pseudoprogression from Recurrent Tumors in High-Grade Gliomas with Histopathologic Evidence

    PubMed Central

    Prager, A.J.; Martinez, N.; Beal, K.; Omuro, A.; Zhang, Z.; Young, R.J.

    2016-01-01

    BACKGROUND AND PURPOSE Treatment-related changes and recurrent tumors often have overlapping features on conventional MR imaging. The purpose of this study was to assess the utility of DWI and DSC perfusion imaging alone and in combination to differentiate treatment-related effects and recurrent high-grade gliomas. MATERIALS AND METHODS We retrospectively identified 68 consecutive patients with high-grade gliomas treated by surgical resection followed by radiation therapy and temozolomide, who then developed increasing enhancing mass lesions indeterminate for treatment-related changes versus recurrent tumor. All lesions were diagnosed by histopathology at repeat surgical resection. ROI analysis was performed of the enhancing lesion on the ADC and DSC maps. Measurements made by a 2D ROI of the enhancing lesion on a single slice were recorded as ADCLesion and rCBVLesion, and measurements made by the most abnormal small fixed diameter ROI as ADCROI and rCBVROI. Statistical analysis was performed with Wilcoxon rank sum tests with P = .05. RESULTS Ten of the 68 patients (14.7%) had treatment-related changes, while 58 patients (85.3%) had recurrent tumor only (n = 19) or recurrent tumor mixed with treatment effect (n = 39). DWI analysis showed higher ADCLesion in treatment-related changes than in recurrent tumor (P = .003). DSC analysis revealed lower relative cerebral blood volume (rCBV)Lesion and rCBVROI in treatment-related changes (P=.003 andP=.011, respectively). Subanalysis of patients with suspected pseudoprogression also revealed higher ADCLesion (P = .001) and lower rCBVLesion (P = .028) and rCBVROI (P = .032) in treatment-related changes. Applying a combined ADCLesion and rCBVLesion model did not outperform either the ADC or rCBV metric alone. CONCLUSIONS Treatment-related changes showed higher diffusion and lower perfusion than recurrent tumor. Similar correlations were found for patients with suspected pseudoprogression. PMID:25593202

  7. The role of diffusion and perfusion weighted imaging in the differential diagnosis of cerebral tumors: a review and future perspectives

    PubMed Central

    2014-01-01

    The role of conventional Magnetic Resonance Imaging (MRI) in the detection of cerebral tumors has been well established. However its excellent soft tissue visualization and variety of imaging sequences are in many cases non-specific for the assessment of brain tumor grading. Hence, advanced MRI techniques, like Diffusion-Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI) and Dynamic-Susceptibility Contrast Imaging (DSCI), which are based on different contrast principles, have been used in the clinical routine to improve diagnostic accuracy. The variety of quantitative information derived from these techniques provides significant structural and functional information in a cellular level, highlighting aspects of the underlying brain pathophysiology. The present work, reviews physical principles and recent results obtained using DWI/DTI and DSCI, in tumor characterization and grading of the most common cerebral neoplasms, and discusses how the available MR quantitative data can be utilized through advanced methods of analysis, in order to optimize clinical decision making. PMID:25609475

  8. Confusion background from compact binaries

    NASA Astrophysics Data System (ADS)

    Regimbau, T.; Hughes, Scott A.

    2010-05-01

    Double neutron stars are one of the most promizing sources for terrestrial gravitational wave interferometers. For actual interferometers and their planned upgrades, the probability of having a signal present in the data is small, but as the sensitivity improves, the detection rate increases and the waveforms may start to overlap, creating a confusion background, ultimately limiting the capabilities of future detectors. The third generation Einstein Telescope, with an horizon of z > 1 and very low frequency "seismic wall" may be affected by such confusion noise. At a minimum, careful data analysis will be require to separate signals which will appear confused. This result should be borne in mind when designing highly advanced future instruments.

  9. In vivo evaluation of brain damage in the course of systemic lupus erythematosus using magnetic resonance spectroscopy, perfusion-weighted and diffusion-tensor imaging.

    PubMed

    Zimny, A; Szmyrka-Kaczmarek, M; Szewczyk, P; Bladowska, J; Pokryszko-Dragan, A; Gruszka, E; Wiland, P; Sasiadek, M

    2014-01-01

    Twenty-two neuropsychiatric (NPSLE) and 13 systemic lupus erythematosus (SLE) patients with a normal appearing brain on plain magnetic resonance (MR) as well as 20 age-matched healthy controls underwent MR spectroscopy (MRS), perfusion-weighted (PWI) and diffusion-tensor imaging (DTI). In MRS NAA/Cr, Cho/Cr and mI/Cr ratios were calculated from the posterior cingulate cortex and left parietal white matter. In PWI, values of cerebral blood volume (CBV) were assessed from 14 regions, including gray and white matter. In DTI fractional anisotropy (FA) values were obtained from 14 white matter tracts including projection, commissural and association fibers. All MR measurements were correlated with clinical data. SLE and NPSLE patients showed significantly (p < 0.05) lower NAA/Cr ratios within both evaluated regions and FA values within the cingulum, as well as a tendency to cortical hypoperfusion. Compared to SLE, NPSLE subjects revealed lower FA values within a wide range of association fibers and corpus callosum. Advanced MR techniques are capable of in vivo detection of complex microstructural brain damage in SLE and NPSLE subjects regarding neuronal loss, mild hypoperfusion and white matter disintegrity. MRS and DTI seem to show the highest usefulness in depicting early changes in normal appearing gray and white matter in SLE patients. PMID:24192079

  10. Confusion

    MedlinePlus

    ... imbalance Illness in an elderly person, such as loss of brain function ( dementia ) Illness in a person with existing neurological disease, such as a stroke Infections Lack of sleep (sleep deprivation) Low blood sugar Low levels of oxygen (for ...

  11. A hybrid microfluidic platform for cell-based assays via diffusive and convective trans-membrane perfusion

    PubMed Central

    Vereshchagina, Elizaveta; Mc Glade, Declan; Glynn, Macdara; Ducrée, Jens

    2013-01-01

    We present a novel 3D hybrid assembly of a polymer microfluidic chip with polycarbonate track-etched membrane (PCTEM) enabling membrane-supported cell culture. Two chip designs have been developed to establish either diffusive or convective reagent delivery using the integrated PCTEM. While it is well suited to a range of cell-based assays, we specifically employ this platform for the screening of a common antitumor chemotoxic agent (mitomycin C – MMC) on the HL60 myeloid leukemia cell line. The toxic activity of MMC is based on the generation of severe DNA damage in the cells. Using either mode of operation, the HL60 cells were cultured on-chip before, during, and after exposure to MMC at concentrations ranging from 0 to 50 μM. Cell viability was analysed off-chip by the trypan blue dye exclusion assay. The results of the on-chip viability assay were found to be consistent with those obtained off-chip and indicated ca. 40% cell survival at MMC concentration of 50 μM. The catalogue of capabilities of the here described cell assay platform comprises of (i) the culturing of cells either under shear-free conditions or under induced through-membrane flows, (ii) the tight time control of the reagent exposure, (iii) the straightforward assembly of devices, (iv) the flexibility on the choice of the membrane, and, prospectively, (v) the amenability for large-scale parallelization. PMID:24404021

  12. Concussion is confusing us all

    PubMed Central

    Sharp, David J

    2015-01-01

    It is time to stop using the term concussion as it has no clear definition and no pathological meaning. This confusion is increasingly problematic as the management of ‘concussed’ individuals is a pressing concern. Historically, it has been used to describe patients briefly disabled following a head injury, with the assumption that this was due to a transient disorder of brain function without long-term sequelae. However, the symptoms of concussion are highly variable in duration, and can persist for many years with no reliable early predictors of outcome. Using vague terminology for post-traumatic problems leads to misconceptions and biases in the diagnostic process, producing uninterpretable science, poor clinical guidelines and confused policy. We propose that the term concussion should be avoided. Instead neurologists and other healthcare professionals should classify the severity of traumatic brain injury and then attempt to precisely diagnose the underlying cause of post-traumatic symptoms. PMID:25977270

  13. Central Nervous System Lymphoma in a 3-Year-Old Male Suffering from a Severe Juvenile Xanthogranuloma – the Usefulness of Perfusion Weighted Imaging and Diffusion Weighted Imaging in the Diagnostics of Pediatric Brain Tumors

    PubMed Central

    Neska-Matuszewska, Małgorzata; Zimny, Anna; Kałwak, Krzysztof; Sąsiadek, Marek J.

    2015-01-01

    Summary Background Primary Central Nervous System Lymphomas (PCNSLs) are rare, malignant brain tumors derived from lymphocytes B. Juvenile xanthogranuloma (JXG) is a non-Langerhans histiocytic cell disorder in children which mostly affects the skin. Rare fatalities have been reported in extracutaneous manifestation. Brain magnetic resonance imaging (MRI) is a method of choice in the diagnostics of all neoplastic CNS lesions. Perfusion weighted imaging (PWI) and diffusion weighted imaging (DWI) allow for more detailed analysis of brain tumors including the rate of neoangiogenesis and cellularity. We presented a pediatric patient suffering from JXG with CNS involvement and the role of brain MRI including DWI and PWI in the evaluation of brain focal lesions. Case Report A 3-year-old male with severe JXG underwent two stem cell transplantations with a development of neurological complications. The patient underwent emergency CT and MRI which revealed a non-specific enhancing focal brain lesion. In DWI it showed restricted diffusion while PWI revealed low values of rCBV and the signal intensity curve returning above the baseline level. Advanced MRI techniques such as DWI and PWI suggested PCNSL. Stereotactic biopsy confirmed PCNSL due to Ebstein-Barr virus reactivation. Conclusions The use of advanced MRI sequences is important to differentiate brain lesions in pediatric patients. The use of PWI and DWI facilitated the diagnosis of PCNSL. It is important to remember that PCNSLs show a very typical pattern of changes visualized with MRI such as: usually strong homogenous enhancement, restricted diffusion and low perfusion. PMID:25624957

  14. Estimation of optimal b-value sets for obtaining apparent diffusion coefficient free from perfusion in non-small cell lung cancer

    NASA Astrophysics Data System (ADS)

    Karki, Kishor; Hugo, Geoffrey D.; Ford, John C.; Olsen, Kathryn M.; Saraiya, Siddharth; Groves, Robert; Weiss, Elisabeth

    2015-10-01

    The purpose of this study was to determine optimal sets of b-values in diffusion-weighted MRI (DW-MRI) for obtaining monoexponential apparent diffusion coefficient (ADC) close to perfusion-insensitive intravoxel incoherent motion (IVIM) model ADC (ADCIVIM) in non-small cell lung cancer. Ten subjects had 40 DW-MRI scans before and during radiotherapy in a 1.5 T MRI scanner. Respiratory triggering was applied to the echo-planar DW-MRI with \\text{TR}≈ 4500 ms, TE  =  74 ms, eight b-values of 0-1000 μs μm-2, pixel size  =  1.98× 1.98 mm2, slice thickness  =  6 mm, interslice gap  =  1.2 mm, 7 axial slices and total acquisition time ≈6 min. One or more DW-MRI scans together covered the whole tumour volume. Monoexponential model ADC values using various b-value sets were compared to reference-standard ADCIVIM values using all eight b-values. Intra-scan coefficient of variation (CV) of active tumour volumes was computed to compare the relative noise in ADC maps. ADC values for one pre-treatment DW-MRI scan of each of the 10 subjects were computed using b-value pairs from DW-MRI images synthesized for b-values of 0-2000 μs μm-2 from the estimated IVIM parametric maps and corrupted by various Rician noise levels. The square root of mean of squared error percentage (RMSE) of the ADC value relative to the corresponding ADCIVIM for the tumour volume of the scan was computed. Monoexponential ADC values for the b-value sets of 250 and 1000; 250, 500 and 1000; 250, 650 and 1000; 250, 800 and 1000; and 250-1000 μs μm-2 were not significantly different from ADCIVIM values (p>0.05 , paired t-test). Mean error in ADC values for these sets relative to ADCIVIM were within 3.5%. Intra-scan CVs for these sets were comparable to that for ADCIVIM. The monoexponential ADC values for other sets—0-1000 50-1000 100-1000 500-1000 and 250 and 800 μs μm-2 were significantly different from the ADCIVIM values. From Rician noise simulation

  15. Analyzing phonetic confusions using formal concept analysis.

    PubMed

    Peláez-Moreno, C; García-Moral, A I; Valverde-Albacete, F J

    2010-09-01

    Confusion matrices have been used as a tool for the analysis of speech perception or human speech recognition (HSR) for decades. However, they are rarely employed in automatic speech recognition (ASR) mainly due to the lack of a systematic procedure for their exploration. The generalization of formal concept analysis employed in this paper provides a conceptual interpretation of confusion matrices that enables the analysis of the structure of confusions for both human and machine performances. Generalized formal concept analysis transforms confusion matrices into ordered lattices of confusion events, supporting classic results in HSR that identify a hierarchy of virtual articulatory-acoustic channels. Translating this technique into ASR, a detailed map of the relationships among the speech units employed in the system can be traced to make different sources of confusions apparent: the influence of the lexicon, segmentation errors, dialectal variations or limitations of the feature extraction procedures, among others. PMID:20815472

  16. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    PubMed Central

    Copen, William A.; Morais, Livia T.; Wu, Ona; Schwamm, Lee H.; Schaefer, Pamela W.; González, R. Gilberto; Yoo, Albert J.

    2015-01-01

    Background and Purpose In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured “ischemic core.” The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI), but many authors suggest that maps of regional cerebral blood volume (CBV) derived from computed tomography perfusion imaging (CTP) can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume. Methods 58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: “objective absolute,” i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9–2.5 mL/100 g), “objective relative,” whose six thresholds (51%-60%) were fractions of mean contralateral CBV, and “subjective,” in which two radiologists (R1, R2) outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred. Results DWI was positive in 72% (42/58) of patients. CBV maps’ sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156–699 mL for objective absolute thresholds, and 127–200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124

  17. CT and MRI of diffuse lobar involvement pattern in liver pathology.

    PubMed

    Karçaaltincaba, Muşturay; Sirlin, Claude B

    2011-12-01

    Focal, segmental, and diffuse liver pathologies have been described in the literature. This article describes a pattern in which liver pathology is confined to a lobe. This lobar pattern has not been described previously to our knowledge. Herein, we illustrate computed tomography (CT) and magnetic resonance imaging (MRI) findings of diffuse lobar involvement patterns in various liver conditions. Diffuse lobar involvement can be observed in benign (steatosis, hepatic iron overload, cholestasis, perfusion alterations, infarction, alveolar hydatid cysts, trauma, and hemangiomas) and primary malignant (hepatocellular carcinoma) pathologies. Diffuse lobar involvement in metastatic disease appears to be rare. Due in part to their potentially unusual appearances, the diagnosis of lobar pathologies using imaging can be challenging, and entities with lobar patterns can cause diagnostic confusion. Liver MRI can be used as a problem-solving tool for diffuse lobar pathologies detected on ultrasonography and CT. Inand out-of-phase MRI can help in the assessment of lobar fat accumulation. PMID:21053176

  18. Web life: Confused at a Higher Level

    NASA Astrophysics Data System (ADS)

    2010-08-01

    This two-person blog owes its name to Enrico Fermi, who supposedly informed a visiting lecturer that although he used to be confused about the lecture topic, "having listened to your lecture, I am still confused. But on a higher level".

  19. Core Knowledge Confusions among University Students

    ERIC Educational Resources Information Center

    Lindeman, Marjaana; Svedholm, Annika M.; Takada, Mikito; Lonnqvist, Jan-Erik; Verkasalo, Markku

    2011-01-01

    Previous studies have demonstrated that university students hold several paranormal beliefs and that paranormal beliefs can be best explained with core knowledge confusions. The aim of this study was to explore to what extent university students confuse the core ontological attributes of lifeless material objects (e.g. a house, a stone), living…

  20. Consumer Confusion: Reduction Strategies in Higher Education

    ERIC Educational Resources Information Center

    Drummond, Graeme

    2004-01-01

    This paper highlights the increasingly important topic of consumer confusion. Drawing parallels with experiences in the private sector, the concept of consumer confusion is explored within the higher education sector; what causes the phenomenon, how do consumers react to it and how can it be negated/minimised? The expansion and commercialisation…

  1. The Confusion of Molecular Particles with Substances.

    ERIC Educational Resources Information Center

    Selley, N. J.

    1978-01-01

    Objects to the idea of treating molecular particles, such as molecules and atoms, as equal in kind to substances when discussing chemical reactions, thus confusing their different roles in the theory of matter. (GA)

  2. Pulmonary ventilation/perfusion scan

    MedlinePlus

    V/Q scan; Ventilation/perfusion scan; Lung ventilation/perfusion scan ... A pulmonary ventilation/perfusion scan is actually two tests. They may be done separately or together. During the perfusion scan, a health ...

  3. Time-resolved multi-channel optical system for assessment of brain oxygenation and perfusion by monitoring of diffuse reflectance and fluorescence

    NASA Astrophysics Data System (ADS)

    Milej, D.; Gerega, A.; Kacprzak, M.; Sawosz, P.; Weigl, W.; Maniewski, R.; Liebert, A.

    2014-03-01

    Time-resolved near-infrared spectroscopy is an optical technique which can be applied in tissue oxygenation assessment. In the last decade this method is extensively tested as a potential clinical tool for noninvasive human brain function monitoring and imaging. In the present paper we show construction of an instrument which allows for: (i) estimation of changes in brain tissue oxygenation using two-wavelength spectroscopy approach and (ii) brain perfusion assessment with the use of single-wavelength reflectometry or fluorescence measurements combined with ICG-bolus tracking. A signal processing algorithm based on statistical moments of measured distributions of times of flight of photons is implemented. This data analysis method allows for separation of signals originating from extra- and intracerebral tissue compartments. In this paper we present compact and easily reconfigurable system which can be applied in different types of time-resolved experiments: two-wavelength measurements at 687 and 832 nm, single wavelength reflectance measurements at 760 nm (which is at maximum of ICG absorption spectrum) or fluorescence measurements with excitation at 760 nm. Details of the instrument construction and results of its technical tests are shown. Furthermore, results of in-vivo measurements obtained for various modes of operation of the system are presented.

  4. Dichotic Listening and Left-Right Confusion

    ERIC Educational Resources Information Center

    Hirnstein, Marco

    2011-01-01

    The present study examined the relationship between individual differences in dichotic listening (DL) and the susceptibility to left-right confusion (LRC). Thirty-six men and 59 women completed a consonant-vowel DL test, a behavioral LRC task, and an LRC self-rating questionnaire. Significant negative correlations between overall DL accuracy and…

  5. Avogadro Number and Mole: A Royal Confusion.

    ERIC Educational Resources Information Center

    Emiliani, Cesare

    1991-01-01

    There is a great deal of confusion in physics and chemistry textbooks, dictionaries, manuals, and handbooks about the definition of Avogadro's number and the term "mole." Avogadro's number is defined simply as the number of atomic mass units in one gram. Mole is defined as the mass of one Avogadro number of identical items. (Author/PR)

  6. Confusion between Odds and Probability, a Pandemic?

    ERIC Educational Resources Information Center

    Fulton, Lawrence V.; Mendez, Francis A.; Bastian, Nathaniel D.; Musal, R. Muzaffer

    2012-01-01

    This manuscript discusses the common confusion between the terms probability and odds. To emphasize the importance and responsibility of being meticulous in the dissemination of information and knowledge, this manuscript reveals five cases of sources of inaccurate statistical language imbedded in the dissemination of information to the general…

  7. When is stacking confusing? The impact of confusion on stacking in deep H I galaxy surveys

    NASA Astrophysics Data System (ADS)

    Jones, Michael G.; Haynes, Martha P.; Giovanelli, Riccardo; Papastergis, Emmanouil

    2016-01-01

    We present an analytic model to predict the H I mass contributed by confused sources to a stacked spectrum in a generic H I survey. Based on the ALFALFA (Arecibo Legacy Fast ALFA) correlation function, this model is in agreement with the estimates of confusion present in stacked Parkes telescope data, and was used to predict how confusion will limit stacking in the deepest Square Kilometre Array precursor H I surveys. Stacking with LADUMA (Looking At the Distant Universe with MeerKAT) and DINGO UDEEP (Deep Investigation of Neutral Gas Origins - Ultra Deep) data will only be mildly impacted by confusion if their target synthesized beam size of 10 arcsec can be achieved. Any beam size significantly above this will result in stacks that contain a mass in confused sources that is comparable to (or greater than) that which is detectable via stacking, at all redshifts. CHILES (COSMOS H I Large Extragalactic Survey) 5 arcsec resolution is more than adequate to prevent confusion influencing stacking of its data, throughout its bandpass range. FAST (Five hundred metre Aperture Spherical Telescope) will be the most impeded by confusion, with H I surveys likely becoming heavily confused much beyond z = 0.1. The largest uncertainties in our model are the redshift evolution of the H I density of the Universe and the H I correlation function. However, we argue that the two idealized cases we adopt should bracket the true evolution, and the qualitative conclusions are unchanged regardless of the model choice. The profile shape of the signal due to confusion (in the absence of any detection) was also modelled, revealing that it can take the form of a double Gaussian with a narrow and wide component.

  8. Perfusion visualization and analysis for pulmonary embolism

    NASA Astrophysics Data System (ADS)

    Vaz, Michael S.; Kiraly, Atilla P.; Naidich, David P.; Novak, Carol L.

    2005-04-01

    Given the nature of pulmonary embolism (PE), timely and accurate diagnosis is critical. Contrast enhanced high-resolution CT images allow physicians to accurately identify segmental and sub-segmental emboli. However, it is also important to assess the effect of such emboli on the blood flow in the lungs. Expanding upon previous research, we propose a method for 3D visualization of lung perfusion. The proposed method allows users to examine perfusion throughout the entire lung volume at a single glance, with areas of diminished perfusion highlighted so that they are visible independent of the viewing location. This may be particularly valuable for better accuracy in assessing the extent of hemodynamic alterations resulting from pulmonary emboli. The method also facilitates user interaction and may help identify small peripheral sub-segmental emboli otherwise overlooked. 19 patients referred for possible PE were evaluated by CT following the administration of IV contrast media. An experienced thoracic radiologist assessed the 19 datasets with 17 diagnosed as being positive for PE with multiple emboli. Since anomalies in lung perfusion due to PE can alter the distribution of parenchymal densities, we analyzed features collected from histograms of the computed perfusion maps and demonstrate their potential usefulness as a preliminary test to suggest the presence of PE. These histogram features also offer the possibility of distinguishing distinct patterns associated with chronic PE and may even be useful for further characterization of changes in perfusion or overall density resulting from associated conditions such as pneumonia or diffuse lung disease.

  9. Applying the concept of consumer confusion to healthcare: development and validation of a patient confusion model.

    PubMed

    Gebele, Christoph; Tscheulin, Dieter K; Lindenmeier, Jörg; Drevs, Florian; Seemann, Ann-Kathrin

    2014-01-01

    As patient autonomy and consumer sovereignty increase, information provision is considered essential to decrease information asymmetries between healthcare service providers and patients. However, greater availability of third party information sources can have negative side effects. Patients can be confused by the nature, as well as the amount, of quality information when making choices among competing health care providers. Therefore, the present study explores how information may cause patient confusion and affect the behavioral intention to choose a health care provider. Based on a quota sample of German citizens (n = 198), the present study validates a model of patient confusion in the context of hospital choice. The study results reveal that perceived information overload, perceived similarity, and perceived ambiguity of health information impact the affective and cognitive components of patient confusion. Confused patients have a stronger inclination to hastily narrow down their set of possible decision alternatives. Finally, an empirical analysis reveals that the affective and cognitive components of patient confusion mediate perceived information overload, perceived similarity, and perceived ambiguity of information. PMID:25595013

  10. An analysis of auditory alphabet confusions.

    PubMed

    Walker, M E

    1989-04-01

    The present study, using the nonhierarchical overlapping clustering algorithm MAPCLUS to fit the Shepard-Arabie (1979) ADCLUS model, attempted to derive a set of features that would accurately describe the auditory alphabet confusions present in the data matrices of Conrad (1964) and Hull (1973). Separate nine-cluster solutions accounted for 80% and 89% of the variance in the matrices, respectively. The clusters revealed that the most frequently confused letter names contained common vowels and phonetically similar consonants. Further analyses using INDCLUS, an individual differences extension of the MAPCLUS algorithm and ADCLUS model, indicated that while the patterns of errors in the two matrices were remarkably similar, some differences were also apparent. These differences reflected the differing amounts of background noise present in the two studies. PMID:2710632

  11. Confusion and hypnotics in demented patients

    PubMed Central

    Mead, M. G.; Castleden, C. M.

    1982-01-01

    Eleven elderly confused patients were given a single dose of chlormethiazole, temazepam and placebo on separate nights with-in a 10-day period. There was no statistically significant difference between the three treatments the next morning in any of the tests, which included subjective and objective measures of mental ability, orientation and hangover effect. These results mirror those previously found in normal, healthy, elderly patients, and do not therefore support the contention that hypnotics increase confusion in demented patients, or that such patients are more sensitive to their actions. Indeed, plasma drug concentrations were on average twice as high in demented as in normal elderly subjects, thus raising the possibility of decreased sensitivity in the demented group. There was little correlation between plasma concentration and pharmacological effect. PMID:6130151

  12. Analyzing Mode Confusion via Model Checking

    NASA Technical Reports Server (NTRS)

    Luettgen, Gerald; Carreno, Victor

    1999-01-01

    Mode confusion is one of the most serious problems in aviation safety. Today's complex digital flight decks make it difficult for pilots to maintain awareness of the actual states, or modes, of the flight deck automation. NASA Langley leads an initiative to explore how formal techniques can be used to discover possible sources of mode confusion. As part of this initiative, a flight guidance system was previously specified as a finite Mealy automaton, and the theorem prover PVS was used to reason about it. The objective of the present paper is to investigate whether state-exploration techniques, especially model checking, are better able to achieve this task than theorem proving and also to compare several verification tools for the specific application. The flight guidance system is modeled and analyzed in Murphi, SMV, and Spin. The tools are compared regarding their system description language, their practicality for analyzing mode confusion, and their capabilities for error tracing and for animating diagnostic information. It turns out that their strengths are complementary.

  13. Medial perirhinal cortex disambiguates confusable objects

    PubMed Central

    Tyler, Lorraine K.; Monsch, Andreas U.; Taylor, Kirsten I.

    2012-01-01

    Our brain disambiguates the objects in our cluttered visual world seemingly effortlessly, enabling us to understand their significance and to act appropriately. The role of anteromedial temporal structures in this process, particularly the perirhinal cortex, is highly controversial. In some accounts, the perirhinal cortex is necessary for differentiating between perceptually and semantically confusable objects. Other models claim that the perirhinal cortex neither disambiguates perceptually confusable objects nor plays a unique role in semantic processing. One major hurdle to resolving this central debate is the fact that brain damage in human patients typically encompasses large portions of the anteromedial temporal lobe, such that the identification of individual substructures and precise neuroanatomical locus of the functional impairments has been difficult. We tested these competing accounts in patients with Alzheimer’s disease with varying degrees of atrophy in anteromedial structures, including the perirhinal cortex. To assess the functional contribution of each anteromedial temporal region separately, we used a detailed region of interest approach. From each participant, we obtained magnetic resonance imaging scans and behavioural data from a picture naming task that contrasted naming performance with living and non-living things as a way of manipulating perceptual and semantic confusability; living things are more similar to one another than non-living things, which have more distinctive features. We manually traced neuroanatomical regions of interest on native-space cortical surface reconstructions to obtain mean thickness estimates for the lateral and medial perirhinal cortex and entorhinal cortex. Mean cortical thickness in each region of interest, and hippocampal volume, were submitted to regression analyses predicting naming performance. Importantly, atrophy of the medial perirhinal cortex, but not lateral perirhinal cortex, entorhinal cortex or

  14. Keats'"Negative Capability" and "Disinterestedness": A Confusion of Ideals

    ERIC Educational Resources Information Center

    Guilhamet, Leon M.

    1970-01-01

    Though the moral and poetic realms need not be kept separate, keats saw the relationship between them in a confused way....(This article is) an attempt to specify the sources of the confusion in Keats's mind." (Author)

  15. Confusion and Complex Learning during Interactions with Computer Learning Environments

    ERIC Educational Resources Information Center

    Lehman, Blair; D'Mello, Sidney; Graesser, Art

    2012-01-01

    Folk wisdom holds that being confused is detrimental to learning. However, research on emotions and learning suggest a somewhat more complex relationship between confusion and learning outcomes. In fact, it has been proposed that impasses that trigger states of cognitive disequilibrium and confusion can create opportunities for deep learning of…

  16. Making Sense of Confusion: Relating Performance, Confidence, and Self-Efficacy to Expressions of Confusion in an Introductory Physics Class

    ERIC Educational Resources Information Center

    Dowd, Jason E.; Araujo, Ives; Mazur, Eric

    2015-01-01

    Although confusion is generally perceived to be negative, educators dating as far back as Socrates, who asked students to question assumptions and wrestle with ideas, have challenged this notion. Can confusion be productive? How should instructors interpret student expressions of confusion? During two semesters of introductory physics that…

  17. Confusion and its dynamics during device comprehension with breakdown scenarios.

    PubMed

    D'Mello, Sidney; Graesser, Art

    2014-09-01

    The incidence and dynamics of confusion during complex learning and problem solving were investigated in an experiment where participants first read illustrated texts on everyday devices (e.g., an electric bell) followed by breakdown scenarios reflecting device malfunctions (e.g., "When a person rang the bell there was a short ding and then no sound was heard"). The breakdown scenarios were expected to trigger impasses and put participants in a state of cognitive disequilibrium where they would experience confusion and engage in effortful confusion resolution activities in order to restore equilibrium. The results confirmed that participants reported more confusion when presented with the breakdown scenarios compared to control scenarios that involved focusing on important device components in the absence of malfunctions. A second-by-second analysis of the dynamics of confusion yielded two characteristic trajectories that distinguished participants who partially resolved their confusion from those who remained confused. Participants who were successful in partial confusion resolution while processing the breakdowns outperformed their counterparts on knowledge assessments after controlling for scholastic aptitude, engagement, and frustration. This effect was amplified for those who were highly confused by the breakdowns. There was no direct breakdown vs. control effect on learning, but being actively engaged and partially resolving confusion during breakdown processing were positive predictors of increased learning with the breakdown compared to control scenarios. Implications of our findings for theories that highlight the role of impasses, cognitive disequilibrium, and confusion to learning are discussed. PMID:24973629

  18. Myocardial infarction--fusion or confusion?

    PubMed

    Ardhanari, Sivakumar; Shah, Ashok J; Thakur, Ranjan K

    2009-09-01

    A patient with a dualchamber pacemaker with dynamic atrioventricular delay (AVD) experienced acute substernal chest pain. The rhythm strip in the ambulance showed intermittent ST elevation in the inferior leads. An emergent cardiac catheterization revealed nonobstructive coronary artery disease. Rate-responsive dual-chamber pacing with dynamic AVD was responsible for varying devvgrees of ventricular fusion due to competition with the patient's normal conduction. Intermittent ST elevation, evident only during ventricular fusion should have suggested secondary ventricular repolarization and not myocardial injury, but concomitant chest pain and inconspicuous bipolar pacing artifacts added to the confusion. Ventricular pacing may not only mask acute ST-T changes due to myocardial injury, but can also mimic acute myocardial infarction. PMID:19726827

  19. EBM, HTA, and CER: Clearing the Confusion

    PubMed Central

    Luce, Bryan R; Drummond, Michael; Jönsson, Bengt; Neumann, Peter J; Schwartz, J Sanford; Siebert, Uwe; Sullivan, Sean D

    2010-01-01

    Context: The terms evidence-based medicine (EBM), health technology assessment (HTA), comparative effectiveness research (CER), and other related terms lack clarity and so could lead to miscommunication, confusion, and poor decision making. The objective of this article is to clarify their definitions and the relationships among key terms and concepts. Methods: This article used the relevant methods and policy literature as well as the websites of organizations engaged in evidence-based activities to develop a framework to explain the relationships among the terms EBM, HTA, and CER. Findings: This article proposes an organizing framework and presents a graphic demonstrating the differences and relationships among these terms and concepts. Conclusions: More specific terminology and concepts are necessary for an informed and clear public policy debate. They are even more important to inform decision making at all levels and to engender more accountability by the organizations and individuals responsible for these decisions. PMID:20579285

  20. Why the confusion in Hashimoto's encephalopathy?

    PubMed

    Jayasekera, Bodiabaduge A P; McShane, Michael Anthony; Roy, Prem; Anand, Geetha

    2011-01-01

    A 13-year-old girl presented with an afebrile seizure followed by prolonged confusion and visual hallucinations. Initial investigations in the form of blood tests, cerebrospinal fluid analysis and head imaging by CT, were normal. She represented with two further episodes within a period of 3 weeks. Further investigations considering infective, metabolic and some autoimmune causes of encephalopathy were negative. An MRI head scan was normal. Thyroid function testing disclosed primary hypothyroidism and elevated antithyroid antibodies. She responded well to glucocorticoid therapy for presumed Hashimoto's encephalopathy (HE). HE describes patients with various neurological manifestations with elevated titres of antithyroid antibodies. There are no clear criteria for diagnosis, with many cases labelled as HE. Responses to corticosteroid therapy are favourable. In patients with unexplained encephalopathy, HE should be considered given the favourable response to glucocorticoid therapy. PMID:22691944

  1. Econometric models for predicting confusion crop ratios

    NASA Technical Reports Server (NTRS)

    Umberger, D. E.; Proctor, M. H.; Clark, J. E.; Eisgruber, L. M.; Braschler, C. B. (Principal Investigator)

    1979-01-01

    Results for both the United States and Canada show that econometric models can provide estimates of confusion crop ratios that are more accurate than historical ratios. Whether these models can support the LACIE 90/90 accuracy criterion is uncertain. In the United States, experimenting with additional model formulations could provide improved methods models in some CRD's, particularly in winter wheat. Improved models may also be possible for the Canadian CD's. The more aggressive province/state models outperformed individual CD/CRD models. This result was expected partly because acreage statistics are based on sampling procedures, and the sampling precision declines from the province/state to the CD/CRD level. Declining sampling precision and the need to substitute province/state data for the CD/CRD data introduced measurement error into the CD/CRD models.

  2. Experimental glomerulonephritis in the isolated perfused rat kidney.

    PubMed Central

    Couser, W G; Steinmuller, D R; Stilmant, M M; Salant, D J; Lowenstein, L M

    1978-01-01

    The development of immune deposits on the subepithelial surface of the glomerular capillary wall was studied in isolated rat kidneys perfused at controlled perfusion pressure, pH, temperature, and flow rates with recirculating oxygenated perfusate containing bovine serum albumin (BSA) in buffer and sheep antibody to rat proximal tubular epithelial cell brush border antigen (Fx1A). Control kidney were perfused with equal concentrations of non-antibody immunoglobulin (Ig)G. Renal function was monitored by measuring inulin clearance, sodium reabsorption, and urine flow as well as BSA excretion and fractional clearance. Perfused kidneys were studied by light, immunofluorescence, and electron microscopy. All kidneys perfused with anti-Fx1A developed diffuse, finely granular deposits of IgG along the glomerular capillary wall by immunofluorescence. Electron microscopy revealed these deposits to be localized exclusively in the subepithelial space and slit pores. Similar deposits were produced in a nonrecirculating perfusion system, thereby excluding the formation of immune complexes in the perfusate caused by renal release of tubular antigen. Control kidneys perfused with nonantibody IgG did not develop glomerular immune deposits. Renal function and BSA excretion were the same in experimental and control kidneys. Glomerular deposits in antibody perfused kidneys were indistinguishable from deposits in rats injected with anti-Fx1A or immunized with Fx1A to produce autologous immune complex nephropathy. These studies demonstrate that subepithelial immune deposits can be produced in the isolated rat kidney by perfusion with specific antibody to Fx1A in the absence of circulating immune complexes. In this model deposits result from in situ complex formation rather than circulating immune complex deposition. Images PMID:372233

  3. Star Confusion Effect on SIM PlanetQuest Astrometric Performance

    NASA Technical Reports Server (NTRS)

    Zhai, C.; Yu, M.; Milman, M.; Fathpour, N.; Morales, M.; Nemati, B.; Regehr, M.; Heflin, M.; Sievers, L.

    2007-01-01

    SIM PlanetQuest will measure star positions to an accuracy of a few microarcseconds using precise white light fringe measurements. One challenge for SIM observation scenario is "star confusion," where multiple stars are present in the instrument field of view. This is especially relevant for observing dim science targets because the density of number of stars increases rapidly with star magnitude. We study the effect of star confusion on the SIM astrometric performance due to systematic fringe errors caused by the extra photons from the confusion star(s}. Since star confusion from multiple stars may be analyzed as a linear superposition of the effect from single star confusion, we quantify the astrometric errors due to single star confusion surveying over many spectral types, including AOV, FOV, K5III, and MOV, and for various visual magnitude differences. To the leading order, the star confusion effect is characterized by the magnitude difference, spectral difference, and the angular separation between the target and confusion stars.Strategies for dealing with star confusion are presented. For example, since the presence of additional sources in the field of view leads to inconsistent delay estimates from different channels, with sufficient signal to noise ratio, the star confusion can be detected using chi-square statistics of fringe measurements from multiple spectral channels. An interesting result is that the star confusion can be detected even though the interferometer cannot resolve the separation between the target and confusion stars when their spectra are sufficiently different. Other strategies for mitigating the star confusion effect are also discussed.

  4. Making sense of confusion: Relating performance, confidence, and self-efficacy to expressions of confusion in an introductory physics class

    NASA Astrophysics Data System (ADS)

    Dowd, Jason E.; Araujo, Ives; Mazur, Eric

    2015-06-01

    Although confusion is generally perceived to be negative, educators dating as far back as Socrates, who asked students to question assumptions and wrestle with ideas, have challenged this notion. Can confusion be productive? How should instructors interpret student expressions of confusion? During two semesters of introductory physics that involved Just-in-Time Teaching (JiTT) and research-based reading materials, we evaluated performance on reading assignments while simultaneously measuring students' self-assessment of their confusion over the preclass reading material (N =137 ; Nfall=106 , Nspring=88 ). We examined the relationship between confusion and correctness, confidence in reasoning, and (in the spring) precourse self-efficacy. We find that student expressions of confusion before coming to class are negatively related to correctness on preclass content-related questions, confidence in reasoning on those questions, and self-efficacy, but weakly positively related to final grade when controlling for these factors (β =0.23 , p =0.03 ).

  5. Intraosseous haemangioma: semantic and medical confusion.

    PubMed

    Kadlub, N; Dainese, L; Coulomb-L'Hermine, A; Galmiche, L; Soupre, V; Lepointe, H Ducou; Vazquez, M-P; Picard, A

    2015-06-01

    The literature is rich in case reports of intraosseous haemangioma, although most of these are actually cases of venous or capillary malformations. To illustrate this confusion in terminology, we present three cases of slow-flow vascular malformations misnamed as intraosseous haemangioma. A retrospective study of children diagnosed with intraosseous haemangioma was conducted. Clinical and radiological data were evaluated. Histopathological examinations and immunohistochemical studies were redone by three independent pathologists to classify the lesions according to the International Society for the Study of Vascular Anomalies (ISSVA) and World Health Organization (WHO) classifications. Three children who had presented with jaw haemangiomas were identified. Computed tomography scan patterns were not specific. All tumours were GLUT-1-negative and D2-40-negative. The lesions were classified as central haemangiomas according to the WHO, and as slow-flow malformations according to the ISSVA. The classification of vascular anomalies is based on clinical, radiological, and histological differences between vascular tumours and malformations. Based on this classification, the evolution of the lesion can be predicted and adequate treatment applied. The binary ISSVA classification is widely accepted and should be applied for all vascular lesions. PMID:25703595

  6. Ex vivo lung perfusion.

    PubMed

    Reeb, Jeremie; Cypel, Marcelo

    2016-03-01

    Lung transplantation is an established life-saving therapy for patients with end-stage lung disease. Unfortunately, greater success in lung transplantation is hindered by a shortage of lung donors and the relatively poor early-, mid-, and long-term outcomes associated with severe primary graft dysfunction. Ex vivo lung perfusion has emerged as a modern preservation technique that allows for a more accurate lung assessment and improvement in lung quality. This review outlines the: (i) rationale behind the method; (ii) techniques and protocols; (iii) Toronto ex vivo lung perfusion method; (iv) devices available; and (v) clinical experience worldwide. We also highlight the potential of ex vivo lung perfusion in leading a new era of lung preservation. PMID:26700566

  7. "Apparent Weight": A Concept that Is Confusing and Unnecessary

    ERIC Educational Resources Information Center

    Bartlett, Albert A.

    2010-01-01

    Two recent articles make prominent use of the concept of "apparent weight." The concept of "apparent weight" leads to two confusing inconsistencies. We need to know that with very little change in our representations, we can give our students an improved understanding of "weight" without ever having to invent the appealing but confusing concept of…

  8. Clustering, Seriation, and Subset Extraction of Confusion Data

    ERIC Educational Resources Information Center

    Brusco, Michael J.; Steinley, Douglas

    2006-01-01

    The study of confusion data is a well established practice in psychology. Although many types of analytical approaches for confusion data are available, among the most common methods are the extraction of 1 or more subsets of stimuli, the partitioning of the complete stimulus set into distinct groups, and the ordering of the stimulus set. Although…

  9. Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct

    PubMed Central

    Bhattacharyya, S.; Cai, X.; Klein, J. P.

    2014-01-01

    The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation. PMID:24817791

  10. Dyscalculia, dysgraphia, and left-right confusion from a left posterior peri-insular infarct.

    PubMed

    Bhattacharyya, S; Cai, X; Klein, J P

    2014-01-01

    The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation. PMID:24817791

  11. Distribution of perfusion.

    PubMed

    Glenny, Robb; Robertson, H Thomas

    2011-01-01

    Local driving pressures and resistances within the pulmonary vascular tree determine the distribution of perfusion in the lung. Unlike other organs, these local determinants are significantly influenced by regional hydrostatic and alveolar pressures. Those effects on blood flow distribution are further magnified by the large vertical height of the human lung and the relatively low intravascular pressures in the pulmonary circulation. While the distribution of perfusion is largely due to passive determinants such as vascular geometry and hydrostatic pressures, active mechanisms such as vasoconstriction induced by local hypoxia can also redistribute blood flow. This chapter reviews the determinants of regional lung perfusion with a focus on vascular tree geometry, vertical gradients induced by gravity, the interactions between vascular and surrounding alveolar pressures, and hypoxic pulmonary vasoconstriction. While each of these determinants of perfusion distribution can be examined in isolation, the distribution of blood flow is dynamically determined and each component interacts with the others so that a change in one region of the lung influences the distribution of blood flow in other lung regions. PMID:23737171

  12. Importance of capillary perfusion.

    PubMed

    Hardaway, R M

    1979-11-01

    Perfusion is more critical than oxygen in the maintenance of cell viability. A high hematocrit or high fibrinogen level increases blood viscosity and predisposes to disseminated intravascular coagulation. It is recommended that a hematocrit of about 30 be maintained in periods of circulatory stress such as shock or extracorporeal circulation. PMID:495856

  13. Regional Myocardial Perfusion Rates in Patients with Coronary Artery Disease

    PubMed Central

    Cannon, Paul J.; Dell, Ralph B.; Dwyer, Edward M.

    1972-01-01

    Regional myocardial perfusion rates were estimated from the myocardial washout of 133Xenon in 24 patients with heart disease whose coronary arteriograms were abnormal and 17 similar subjects whose coronary arteriograms were judged to be normal. Disappearance rates of 133Xe from multiple areas of the heart were monitored externally with a multiple-crystal scintillation camera after the isotope had been injected into a coronary artery and local myocardial perfusion rates were calculated by the Kety formula. The mean myocardial perfusion rates in the left ventricle exceeded those in the right ventricle or atrial regions in subjects without demonstrable coronary artery disease. In this group there was a significant lack of homogeneity of local perfusion rates in left ventricular myocardium; the mean coefficient of variation of left ventricular local perfusion rates was 15.8%. In the patients with radiographically demonstrable coronary artery disease, a variety of myocardial perfusion patterns were observed. Local capillary blood flow rates were depressed throughout the myocardium of patients with diffuse coronary disease but were subnormal only in discrete myocardial regions of others with localized occlusive disease. Local myocardial perfusion rates were similar to those found in the group with normal coronary arteriograms in patients with slight degrees of coronary disease and in those areas of myocardium distal to marked coronary constrictions or occlusions which were well supplied by collateral vessels. In subjects with right coronary disease, the mean right ventricular perfusion rates were significantly subnormal; in seven subjects of this group perfusion of the inferior left ventricle by a dominant right coronary artery was absent or depressed. The average mean left ventricular perfusion rate of 12 subjects with significant disease of two or more branches of the left coronary artery was significantly lower than that of the group with normal left coronary

  14. Incidence and Prevalence: Confusion in Need of Clarification.

    ERIC Educational Resources Information Center

    Marozas, Donald S.; And Others

    1980-01-01

    Confusing definitions presented in textbooks are reviewed. Many texts used the terms incidence and prevalence interchangeably, some did not define the terms at all, and others presented completely contradictory definitions. A definition is recommended for use and clarification. (Author)

  15. PREVENTING SURGICAL CONFUSIONS IN OPHTHALMOLOGY (AN AMERICAN OPHTHALMOLGICAL SOCIETY THESIS)

    PubMed Central

    Simon, John W.

    2007-01-01

    Purpose Surgical confusions have been rarely studied, especially in ophthalmology. The author hypothesized that such confusions occur rarely but are unacceptable in the public, legal, and regulatory arenas; often occur in circumstances presenting predictable risk; more often involve wrong lens implant than wrong eye, procedure, or patient; and can be prevented by following the Universal Protocol. Methods A retrospective series of 106 cases occurring between 1982 and 2005 included 42 closed files from the Ophthalmic Mutual Insurance Company and 64 cases reported to the New York State Health Department. Records were grouped by procedure planned and analyzed to answer these questions: How did the error occur? By whom and when was the error recognized? Who was responsible? Was the patient informed? What was done to the patient? What was the outcome? What liability payments were made? What policy changes or sanctions resulted? Was the error preventable by following the Universal Protocol? Results The most common confusion was wrong lens implant, accounting for 67 (63%) of the 106 cases. Wrong eye surgery occurred in 15 cases, wrong eye blocks in 14, wrong patient/procedure in 8, and wrong corneal transplant in 2. In 16 cases, the Universal Protocol would have been unlikely to prevent the confusion. Conclusions Surgical confusions occur infrequently and usually cause little or no permanent injury, but they may be devastating to the patient, the physician, and the profession. Measures to prevent such confusions, including the Universal Protocol and related checklists, deserve the acceptance, support, and active participation of ophthalmologists. PMID:18427628

  16. A disposable flexible skin patch for clinical optical perfusion monitoring at multiple depths

    NASA Astrophysics Data System (ADS)

    Farkas, Dana L.; Kolodziejski, Noah J.; Stapels, Christopher J.; McAdams, Daniel R.; Fernandez, Daniel E.; Podolsky, Matthew J.; Christian, James F.; Ward, Brent B.; Vartarian, Mark; Feinberg, Stephen E.; Lee, Seung Yup; Parikh, Urmi; Mycek, Mary-Ann; Joyner, Michael J.; Johnson, Christopher P.; Paradis, Norman A.

    2016-03-01

    Stable, relative localization of source and detection fibers is necessary for clinical implementation of quantitative optical perfusion monitoring methods such as diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS). A flexible and compact device design is presented as a platform for simultaneous monitoring of perfusion at a range of depths, enabled by precise location of optical fibers in a robust and secure adhesive patch. We will discuss preliminary data collected on human subjects in a lower body negative pressure model for hypovolemic shock. These data indicate that this method facilitates simple and stable simultaneous monitoring of perfusion at multiple depths and within multiple physiological compartments.

  17. The diffusion of ions in unconsolidated sediments

    USGS Publications Warehouse

    Manheim, F. T.

    1970-01-01

    Diffusion in unconsolidated sediments generally proceeds at rates ranging from half to one twentieth of those applying to diffusion of ions and molecules in free solution. Diffusion rates are predictable with respect to porosity and path tortuosity in host sediments, and can be conveniently measured by determinations of electrical resistivity on bulk sediment samples. Net ion flux is further influenced by reactions of diffusing species with enclosing sediments, but such influences should not be confused with or lumped with diffusion processes. ?? 1970.

  18. Regulation of skeletal muscle perfusion during exercise

    NASA Technical Reports Server (NTRS)

    Delp, M. D.; Laughlin, M. H.

    1998-01-01

    For exercise to be sustained, it is essential that adequate blood flow be provided to skeletal muscle. The local vascular control mechanisms involved in regulating muscle perfusion during exercise include metabolic control, endothelium-mediated control, propagated responses, myogenic control, and the muscle pump. The primary determinant of muscle perfusion during sustained exercise is the metabolic rate of the muscle. Metabolites from contracting muscle diffuse to resistance arterioles and act directly to induce vasodilation, or indirectly to inhibit noradrenaline release from sympathetic nerve endings and oppose alpha-adrenoreceptor-mediated vasoconstriction. The vascular endothelium also releases vasodilator substances (e.g., prostacyclin and nitric oxide) that are prominent in establishing basal vascular tone, but these substances do not appear to contribute to the exercise hyperemia in muscle. Endothelial and smooth muscle cells may also be involved in propagating vasodilator signals along arterioles to parent and daughter vessels. Myogenic autoregulation does not appear to be involved in the exercise hyperemia in muscle, but the rhythmic propulsion of blood from skeletal muscle veins facilitates venous return to the heart and muscle perfusion. It appears that the primary determinants of sustained exercise hyperemia in skeletal muscle are metabolic vasodilation and increased vascular conductance via the muscle pump. Additionally, sympathetic neural control is important in regulating muscle blood flow during exercise.

  19. Source confusion as an explanation of cultivation: a test of the mechanisms underlying confusion of fiction with reality on television.

    PubMed

    Koolstra, Cees M

    2007-02-01

    Cultivation studies have found evidence that heavy television viewers adopt a world view congruent with how the world is portrayed in fictional television programs. An explanation is that viewers may remember fictional TV stories as realistic stories or news (fiction-to-news confusion). Until now, fiction-to-news confusion was found only if at least a week evolved between watching TV and asking viewers what was remembered. The present study conducted with a purposive sample of students and employees of a college in The Netherlands (N=96; M age = 28.6 yr., SD = 10.9) indicates that fiction-to-news confusions can also occur almost immediately after watching. In addition, whereas earlier research suggests that fiction-to-news confusions are associated with heavy viewing, i.e., more confusion when more hours per day are spent on TV viewing in leisure time, and faulty memory, the present study more specifically suggests that participants make many fiction-to-news confusions when they are exposed to relatively many fictional TV fragments that contain threatening, violent events. PMID:17450970

  20. Lung Ventilation/Perfusion Scan

    MedlinePlus

    ... from the NHLBI on Twitter. What Is a Lung Ventilation/Perfusion Scan? A lung ventilation/perfusion scan, or VQ scan, is a ... that measures air and blood flow in your lungs. A VQ scan most often is used to ...

  1. Diagnosing acute lacunar infarction using CT perfusion.

    PubMed

    Cao, Wenjie; Yassi, Nawaf; Sharma, Gagan; Yan, Bernard; Desmond, Patricia M; Davis, Stephen M; Campbell, Bruce C V

    2016-07-01

    The value of CT perfusion (CTP) in detecting acute lacunar infarcts (LACI) has not been well established. We tested the sensitivity of CTP for LACI. CTP maps of consecutive stroke patients from 2009-2013 were examined. MRI diffusion imaging was used to identify those with LACI. Two stroke neurologists independently evaluated the CTP maps for evidence of a perfusion lesion in a deep perforating artery territory. Cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to maximum (Tmax) maps were first examined in isolation and then in combination. Inter-observer agreement was measured using Cohen's κ. The lesions identified were later confirmed against the diffusion MRI reference and the sensitivity and specificity of CTP maps calculated. A total of 63 patient scans were analysed. There were 32 patients with MRI-confirmed LACI within the coverage of CTP; 18 in the striatum, 10 thalamic, and four in the corona radiata. Another 31 patients had normal MRI. Inter-rater agreement was good (κ=0.83). Sensitivity (blinded consensus) was highest for MTT (56.2%) compared to Tmax (25%, p<0.001), CBV (9.3%, p=0.021) and CBF (43.7%, p<0.001). MTT maps enable detection of a significant proportion of LACI using CTP. PMID:26899357

  2. (abstract) An All Sky Cirrus Confusion Noise Map for WIRE

    NASA Technical Reports Server (NTRS)

    Gautier, T. N.

    1996-01-01

    The Wide Field Infrared Explorer (WIRE) is a Small Explorer (SMEX) satellite scheduled for launch in 1998 which will carry out a sky survey of at least 100 square degrees in the wavelength regions of 9-15(micro)m and 21-27(micro)m with spatial resolution of approximately 20 arcsec and sensitivity exceeding 0.6mJy. At this sensitivity level WIRE observations can be seriously affected by the confusion noise contribution from the infrared cirrus emission, so the WIRE survey must be planned with some knowledge of the expected level of cirrus confusion. Production of a cirrus confusion noise map with 0.5 degree resolution based on the spatial power spectral density of the cirrus emission in the IRAS ISSA data is in progess using the method described by Gauthier, et al. Spectrally resolved power spectra density data is obtained from the ISSA maps with a wavelet transform technique.

  3. Addressing the Philosophical Confusion Regarding Constructivism in Chemical Education

    NASA Astrophysics Data System (ADS)

    Bernal, Pedro J.

    2006-02-01

    In the Chemical Education Today section of the May 2003 issue of this Journal , Eric Scerri wrote about the consequences of what he regards as a philosophical confusion in the work of constructivist chemical education researchers. This issue has important implications for both the teaching and practice of science. I offer a view of the confusion that places the emphasis on the careless use of philosophical terms that Scerri noted and on the tendency of psychological constructivists to go from psychological premises to unwarranted epistemological conclusions.

  4. Circle of least confusion of a spherical reflector.

    PubMed

    Hosken, Robert W

    2007-06-01

    A simple, tractable equation is provided for determining the size and location of the circle of least confusion of a concave spherical reflector. This method is exact for the object at infinity and with wave effects neglected. Designers of large radius Arecibo-like telescopes, both radio and optical, with symmetrical, spherical primaries should find the method useful. The mathematical results are valid for apertures with an angle of incidence up to 45 degrees. Comparisons of the location of the disk of least confusion with longitudinal spherical aberration and the radius of the disk with transverse spherical aberration are presented. PMID:17514263

  5. Ex vivo lung perfusion.

    PubMed

    Machuca, Tiago N; Cypel, Marcelo

    2014-08-01

    Lung transplantation (LTx) is an established treatment option for eligible patients with end-stage lung disease. Nevertheless, the imbalance between suitable donor lungs available and the increasing number of patients considered for LTx reflects in considerable waitlist mortality. Among potential alternatives to address this issue, ex vivo lung perfusion (EVLP) has emerged as a modern preservation technique that allows for more accurate lung assessment and also improvement of lung function. Its application in high-risk donor lungs has been successful and resulted in safe expansion of the donor pool. This article will: (I) review the technical details of EVLP; (II) the rationale behind the method; (III) report the worldwide clinical experience with the EVLP, including the Toronto technique and others; (IV) finally, discuss the growing literature on EVLP application for donation after cardiac death (DCD) lungs. PMID:25132972

  6. Ex vivo lung perfusion

    PubMed Central

    Machuca, Tiago N.

    2014-01-01

    Lung transplantation (LTx) is an established treatment option for eligible patients with end-stage lung disease. Nevertheless, the imbalance between suitable donor lungs available and the increasing number of patients considered for LTx reflects in considerable waitlist mortality. Among potential alternatives to address this issue, ex vivo lung perfusion (EVLP) has emerged as a modern preservation technique that allows for more accurate lung assessment and also improvement of lung function. Its application in high-risk donor lungs has been successful and resulted in safe expansion of the donor pool. This article will: (I) review the technical details of EVLP; (II) the rationale behind the method; (III) report the worldwide clinical experience with the EVLP, including the Toronto technique and others; (IV) finally, discuss the growing literature on EVLP application for donation after cardiac death (DCD) lungs. PMID:25132972

  7. RTI Confusion in the Case Law and the Legal Commentary

    ERIC Educational Resources Information Center

    Zirkel, Perry A.

    2011-01-01

    This article expresses the position that the current legal commentary and cases do not sufficiently differentiate response to intervention (RTI) from the various forms of general education interventions that preceded it, thus compounding confusion in professional practice as to legally defensible procedures for identifying children as having a…

  8. John Wilson's Confused "Perspectives on the Philosophy of Education"

    ERIC Educational Resources Information Center

    Standish, Paul

    2006-01-01

    In his "Perspectives on the Philosophy of Education" John Wilson laments the confusion that surrounds the current state of the philosophy of education. Unlike other branches of philosophy, he claims, it is not clear what the philosophy of education is about, and a snapshot of current work in the field reveals its lack of coherence. To remedy this…

  9. Remembering Actions: An Analysis of the Sources of Children's Confusions.

    ERIC Educational Resources Information Center

    Foley, Mary Ann; Aman, Christine

    Involving children 7 and 10 years of age, two experiments aimed to clarify the basis of children's confusion about actions they performed and actions they imagined performing. In experiment 1, subjects were assigned to one of three conditions, each involving two different types of tracing exercises. Children traced simple or complex pictures by…

  10. Toxic "ictal" confusion in middle age: treatment with benzodiazepines.

    PubMed Central

    Van Sweden, B

    1985-01-01

    In adult and elderly non-epileptic subjects psychoactive drugs may cause an altered state of consciousness and repetitive irritative EEG discharges. The neurotoxic pathogenesis of this drug-induced confusion and the differentiation from absence status are discussed. Dramatic relief by intravenous benzodiazepines is detailed. Recovery is complete and prognosis is excellent on withdrawal of the offending drug. PMID:2860211

  11. Women, Education and the Law: Vouchers, Tax Credits, & Legal Confusion

    ERIC Educational Resources Information Center

    First, Patricia F.

    2003-01-01

    In early 2003, two distinguished researchers in school law analyzed aspects of the law vis-a-vis vouchers and tax credits and the public schools (McCarthy, 2003; Welner, 2003). The issues were confusing, and the author wondered how educators and the public responded. How can policy makers make reasonable decisions about public education without a…

  12. Class and Culture: Sources of Confusion in Educational Sociology

    ERIC Educational Resources Information Center

    Wrigley, Terry

    2013-01-01

    This paper reiterates the centrality of economics (relations of production) in Marxist models of class, while avoiding the crude determinism which results from a neglect of cultural aspects of class formation. It explores the confusion in education and educational sociology arising from non-Marxist conceptions of class which place an exaggerated…

  13. Alleviating the Common Confusion Caused by Polarity in Electrochemistry.

    ERIC Educational Resources Information Center

    Moran, P. J.; Gileadi, E.

    1989-01-01

    Discussed is some of the confusion encountered in electrochemistry due to misunderstandings of sign conventions and simple mathematical errors. Clarified are issues involving emf series, IUPAC sign conventions, calculation of cell potentials, reference electrodes, the polarity of electrodes in electrochemical devices, and overpotential. (CW)

  14. Confusion in the Periodic Table of the Elements.

    ERIC Educational Resources Information Center

    Fernelius, W. C.; Powell, W. H.

    1982-01-01

    Discusses long (expanded), short (condensed), and pyramidal periodic table formats and documents events leading to a periodic table in which subgroups (families) are designated with the letters A and B, suggesting that this format is confusing for those consulting the table. (JN)

  15. {sup 99m}Tc radiopharmaceuticals for brain perfusion imaging

    SciTech Connect

    Deutsch, E.; Volkert, W.A.

    1991-12-31

    It is well established that small, neutral, lipophilic technetium complexes can diffuse into the brain and then be trapped intracellularly by a variety of mechanisms. A more detailed understanding of the structural and chemical parameters which promote efficient diffusion into the brain, and which underlie the trapping mechanisms, will be necessary to delineate the clinical relevance of current agents, and to design improved technetium 99 pharmaceuticals. Current technetium 99 brain-perfusion imaging agents do not show ideal characteristics of brain uptake and retention. Furthermore, significant fractions of the technetium 99 complexes are lost between site of injection and the brain. Thus, it is difficult to use these current agents to quantitate regional cerebral blood flow. Nevertheless, these agents are proving extremely valuable for the SPECT evaluation of abnormalities in brain perfusion patients with neurological disorders.

  16. Hydrostatic determinants of cerebral perfusion

    SciTech Connect

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

    1986-05-01

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

  17. CAD of myocardial perfusion

    NASA Astrophysics Data System (ADS)

    Storm, Corstiaan J.; Slump, Cornelis H.

    2007-03-01

    Our purpose is in the automated evaluation of the physiological relevance of lesions in coronary angiograms. We aim to extract as much as possible quantitative information about the physiological condition of the heart from standard angiographic image sequences. Coronary angiography is still the gold standard for evaluating and diagnosing coronary abnormalities as it is able to locate precisely the coronary artery lesions. The dimensions of the stenosis can be assessed nowadays successfully with image processing based Quantitative Coronary Angiography (QCA) techniques. Our purpose is to assess the clinical relevance of the pertinent stenosis. We therefore analyze the myocardial perfusion as revealed in standard angiographic image sequences. In a Region-of-Interest (ROI) on the angiogram (without an overlaying major blood vessel) the contrast is measured as a function of time (the so-called time-density curve). The required hyperemic state of exercise is induced artificially by the injection of a vasodilator drug e.g. papaverine. In order to minimize motion artifacts we select based on the recorded ECG signal end-diastolic images in both a basal and a hyperemic run in the same projection to position the ROI. We present the development of the algorithms together with results of a small study of 20 patients which have been catheterized following the standard protocol.

  18. Measuring velocity and temperature profile sectional pipeline behind confuser

    NASA Astrophysics Data System (ADS)

    Siažik, Ján; Malcho, Milan; Lenhard, Richard; Novomestský, Marcel

    2016-06-01

    The article deals with the measuring of temperature and velocity profile in area behind confuser in real made scale model of bypass. For proper operation of the equipment it is necessary to know the actual flow in the pipe. Bypasses have wide application and can be also associated with devices for heat recovery, heat exchangers different designs in which may be used in certain circumstances. In the present case, the heat that would otherwise has not been used is used for heating of insulators, and heating the air in the spray-dryer. The measuring principle was verify how the above-mentioned temperature and velocity profile decomposition above confuser on real made scale model.

  19. RESOLVING THE RADIO SOURCE BACKGROUND: DEEPER UNDERSTANDING THROUGH CONFUSION

    SciTech Connect

    Condon, J. J.; Cotton, W. D.; Fomalont, E. B.; Kellermann, K. I.; Miller, N.; Perley, R. A.; Scott, D.; Vernstrom, T.; Wall, J. V.

    2012-10-10

    We used the Karl G. Jansky Very Large Array to image one primary beam area at 3 GHz with 8'' FWHM resolution and 1.0 {mu}Jy beam{sup -1} rms noise near the pointing center. The P(D) distribution from the central 10 arcmin of this confusion-limited image constrains the count of discrete sources in the 1 < S({mu}Jy) < 10 range. At this level, the brightness-weighted differential count S {sup 2} n(S) is converging rapidly, as predicted by evolutionary models in which the faintest radio sources are star-forming galaxies; and Almost-Equal-To 96% of the background originating in galaxies has been resolved into discrete sources. About 63% of the radio background is produced by active galactic nuclei (AGNs), and the remaining 37% comes from star-forming galaxies that obey the far-infrared (FIR)/radio correlation and account for most of the FIR background at {lambda} Almost-Equal-To 160 {mu}m. Our new data confirm that radio sources powered by AGNs and star formation evolve at about the same rate, a result consistent with AGN feedback and the rough correlation of black hole and stellar masses. The confusion at centimeter wavelengths is low enough that neither the planned Square Kilometre Array nor its pathfinder ASKAP EMU survey should be confusion limited, and the ultimate source detection limit imposed by 'natural' confusion is {<=}0.01 {mu}Jy at {nu} = 1.4 GHz. If discrete sources dominate the bright extragalactic background reported by ARCADE 2 at 3.3 GHz, they cannot be located in or near galaxies and most are {<=}0.03 {mu}Jy at 1.4 GHz.

  20. MR Perfusion Imaging in Acute Ischemic Stroke

    PubMed Central

    Copen, William A.; Schaefer, Pamela W.; Wu, Ona

    2011-01-01

    MR perfusion imaging offers the potential for measuring brain perfusion in acute stroke patients, at a time when treatment decisions based upon these measurements may affect outcomes dramatically. Rapid advancements in both acute stroke therapy and perfusion imaging techniques have resulted in continuing redefinition of the role that perfusion imaging should play in patient management. This review first discusses the basic pathophysiology of acute stroke, with specific attention to alterations in the various perfusion-related parameters that can be studied by MR perfusion imaging. Although these parameters are sometimes treated as somewhat interchangeable, they reveal greatly different information about brain perfusion. Therefore, subsequent discussion of the utility of different kinds of perfusion images focuses on the differences between them, as well as important artifacts that can complicate their interpretation. Finally, research on the continually evolving role of MR perfusion imaging in acute stroke care is summarized. PMID:21640299

  1. Detecting Mode Confusion Through Formal Modeling and Analysis

    NASA Technical Reports Server (NTRS)

    Miller, Steven P.; Potts, James N.

    1999-01-01

    Aircraft safety has improved steadily over the last few decades. While much of this improvement can be attributed to the introduction of advanced automation in the cockpit, the growing complexity of these systems also increases the potential for the pilots to become confused about what the automation is doing. This phenomenon, often referred to as mode confusion, has been involved in several accidents involving modern aircraft. This report describes an effort by Rockwell Collins and NASA Langley to identify potential sources of mode confusion through two complementary strategies. The first is to create a clear, executable model of the automation, connect it to a simulation of the flight deck, and use this combination to review of the behavior of the automation and the man-machine interface with the designers, pilots, and experts in human factors. The second strategy is to conduct mathematical analyses of the model by translating it into a formal specification suitable for analysis with automated tools. The approach is illustrated by applying it to a hypothetical, but still realistic, example of the mode logic of a Flight Guidance System.

  2. Computed tomography perfusion imaging in spectacular shrinking deficit.

    PubMed

    Lee, Vivien H; John, Sayona; Mohammad, Yousef; Prabhakaran, Shyam

    2012-02-01

    Spectacular shrinking deficit (SSD) is characterized by abrupt onset of a major hemispheric stroke syndrome, followed by dramatic and rapid improvement. We retrospectively identified patients with SSD diagnosed at our institution between December 1, 2007, and June 30, 2009. We reviewed computed tomography perfusion (CTP) imaging to determine perfusion defect as a measure of initial ischemic penumbra, and magnetic resonance imaging diffusion-weighted imaging (DWI) to determine the final infarct core. Among the 472 consecutive ischemic stroke patients, 126 (27%) presented with major hemispheric ischemic stroke syndrome, defined as National Institutes of Health Stroke Scale score (NIHSS) ≥8 in the territory of the middle cerebral artery (MCA) or internal carotid artery (ICA). Out of these patients, we identified 8 SSD patients with available CTP data. In these 8 patients, the mean time to dramatic recovery was 3.4 hours (range, 0.75-7 hours), and the mean time from onset to CTP was 12.7 hours (range, 3-30 hours). All 8 patients had perfusion abnormalities in portions of the MCA territory (partial MCA territory in 5 patients and complete MCA territory in 3 patients). The mean time from onset to MRI DWI was 15.5 hours (range, 7.9-34 hours). Restricted diffusion was present in all patients in the corresponding MCA distribution. Vascular imaging revealed MCA occlusion in 2 patients. Cervical vascular imaging revealed carotid occlusion in 2 patients and high-grade carotid stenosis in 2 patients. The stroke mechanisms were cardioembolism in 2 patients, large artery in 4 patients, and unknown in 2 patients. Four patients had repeat CTP imaging available that demonstrated eventual resolution of the perfusion defect. SSD is associated with a "shrinking" clinical syndrome and a "shrinking" perfusion pattern on CTP that lags behind clinical recovery. CTP imaging corroborates that a larger territory is at risk in SSD and contributes to better understanding of SSD. PMID:20702113

  3. Self-rated right-left confusability and performance on the Money Road-Map Test.

    PubMed

    Yamashita, Hikari

    2013-09-01

    This study assessed the relationship between self-rated right-left confusability and performance on the Money Road-Map Test (MRMT). Eighty-six undergraduate university students (44 women and 42 men) rated right-left subjective confusability using a questionnaire, and then completed the MRMT. Low- and high-confusability groups were determined using self-rated confusability scores. The high-confusability participants were less accurate and slower than the low-confusability participants in completing the MRMT. Self-confusability ratings significantly correlated with both accuracy scores and completion times on the MRMT. Although, women showed a significantly greater inclination than men to judge themselves as being more prone to confusion in right-left discrimination, the male advantage was not observed in terms of accuracy of response: there was a significant difference only in the completion time on the MRMT. PMID:22965921

  4. Acute subendocardial infarction with diffuse intense Tc-99m PYP uptake and minimal Tl-201 abnormality.

    PubMed

    Taki, J; Taki, S; Ichiyanagi, K; Akashi, Y; Hisada, K

    1992-08-01

    Tc-99m PYP scintigraphy performed on a patient with severe anterior chest pain showed diffuse intense uptake with central decreased activity corresponding to the left ventricular cavity. Tl-201 myocardial perfusion scintigraphy at rest revealed a minimal perfusion abnormality with decreased apical uptake in the lateral view. Because of these findings, diffuse subendocardial infarction was suggested. PMID:1387053

  5. Spectral Confusion for Cosmological Surveys of Redshifted C II Emission

    NASA Astrophysics Data System (ADS)

    Kogut, A.; Dwek, E.; Moseley, S. H.

    2015-06-01

    Far-infrared cooling lines are ubiquitous features in the spectra of star-forming galaxies. Surveys of redshifted fine-structure lines provide a promising new tool to study structure formation and galactic evolution at redshifts including the epoch of reionization as well as the peak of star formation. Unlike neutral hydrogen surveys, where the 21 cm line is the only bright line, surveys of redshifted fine-structure lines suffer from confusion generated by line broadening, spectral overlap of different lines, and the crowding of sources with redshift. We use simulations to investigate the resulting spectral confusion and derive observing parameters to minimize these effects in pencil-beam surveys of redshifted far-IR line emission. We generate simulated spectra of the 17 brightest far-IR lines in galaxies, covering the 150–1300 μm wavelength region corresponding to redshifts 0 < z < 7, and develop a simple iterative algorithm that successfully identifies the 158 μm [C ii] line and other lines. Although the [C ii] line is a principal coolant for the interstellar medium, the assumption that the brightest observed lines in a given line of sight are always [C ii] lines is a poor approximation to the simulated spectra once other lines are included. Blind line identification requires detection of fainter companion lines from the same host galaxies, driving survey sensitivity requirements. The observations require moderate spectral resolution 700 < R < 4000 with angular resolution between 20″ and 10‧, sufficiently narrow to minimize confusion yet sufficiently large to include a statistically meaningful number of sources.

  6. Retrograde heart perfusion: the Langendorff technique of isolated heart perfusion.

    PubMed

    Bell, Robert M; Mocanu, Mihaela M; Yellon, Derek M

    2011-06-01

    In the late 19th century, a number of investigators were working on perfecting isolated heart model, but it was Oscar Langendorff who, in 1895, pioneered the isolated perfused mammalian heart. Since that time, the Langendorff preparation has evolved and provided a wealth of data underpinning our understanding of the fundamental physiology of the heart: its contractile function, coronary blood flow regulation and cardiac metabolism. In more recent times, the procedure has been used to probe pathophysiology of ischaemia/reperfusion and disease states, and with the dawn of molecular biology and genetic manipulation, the Langendorff perfused heart has remained a stalwart tool in the study of the impact upon the physiology of the heart by pharmacological inhibitors and targeted deletion or up-regulation of genes and their impact upon intracellular signalling and adaption to clinically relevant stressful stimuli. We present here the basic structure of the Langendorff system and the fundamental experimental rules which warrant a viable heart preparation. In addition, we discuss the use of the isolated retrograde perfused heart in the model of ischaemia-reperfusion injury ex-vivo, and its applicability to other areas of study. The Langendorff perfusion apparatus is highly adaptable and this is reflected not only in the procedure's longevity but also in the number of different applications to which it has been turned. PMID:21385587

  7. A Formal Methods Approach to the Analysis of Mode Confusion

    NASA Technical Reports Server (NTRS)

    Butler, Ricky W.; Miller, Steven P.; Potts, James N.; Carreno, Victor A.

    2004-01-01

    The goal of the new NASA Aviation Safety Program (AvSP) is to reduce the civil aviation fatal accident rate by 80% in ten years and 90% in twenty years. This program is being driven by the accident data with a focus on the most recent history. Pilot error is the most commonly cited cause for fatal accidents (up to 70%) and obviously must be given major consideration in this program. While the greatest source of pilot error is the loss of situation awareness , mode confusion is increasingly becoming a major contributor as well. The January 30, 1995 issue of Aviation Week lists 184 incidents and accidents involving mode awareness including the Bangalore A320 crash 2/14/90, the Strasbourg A320 crash 1/20/92, the Mulhouse-Habsheim A320 crash 6/26/88, and the Toulouse A330 crash 6/30/94. These incidents and accidents reveal that pilots sometimes become confused about what the cockpit automation is doing. Consequently, human factors research is an obvious investment area. However, even a cursory look at the accident data reveals that the mode confusion problem is much deeper than just training deficiencies and a lack of human-oriented design. This is readily acknowledged by human factors experts. It seems that further progress in human factors must come through a deeper scrutiny of the internals of the automation. It is in this arena that formal methods can contribute. Formal methods refers to the use of techniques from logic and discrete mathematics in the specification, design, and verification of computer systems, both hardware and software. The fundamental goal of formal methods is to capture requirements, designs and implementations in a mathematically based model that can be analyzed in a rigorous manner. Research in formal methods is aimed at automating this analysis as much as possible. By capturing the internal behavior of a flight deck in a rigorous and detailed formal model, the dark corners of a design can be analyzed. This paper will explore how formal

  8. Bilateral basal Xe-133 retention and ventilation/perfusion patterns in mild and subclinical congestive heart failure

    SciTech Connect

    Lee, H.K.; Skarzynski, J.J.; Spadaro, A. )

    1989-12-01

    The Xe-133 ventilation pattern in congestive heart failure (CHF) was assessed using 24 inpatient ventilation/perfusion studies performed to rule out pulmonary embolism. Patients with histories of CHF, myocardial infarction (MI), and cardiomyopathy were included in the study. Frank pulmonary edema, pulmonary embolism, and other known lung diseases such as chronic obstructive lung disease, tumor, and pneumonia were excluded. Fifteen of the 24 patients had abnormal ventilation scans. Twelve of the 15 showed bilateral basal Xe-133 retention on washout; the remaining 3 showed diffuse, posterior regional retention. On perfusion scans, 14 of the 15 abnormal ventilation patients showed evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, or patchy perfusion, and all of them had a history of CHF or cardiac disease. Nine of the 24 patients had normal ventilation scans, including normal washout patterns. Seven of the nine had normal perfusion (p less than 0.01). Four of the nine normal ventilation patients had a history of cardiac disease or CHF but no recent acute MI. Bilateral basal regional Xe-133 retention, coupled with perfusion scan evidence of CHF such as inverted perfusion gradient, enlarged cardiac silhouette, and patchy perfusion pattern, appears to be a sensitive and characteristic ventilation/perfusion finding in mild or subclinical CHF.

  9. Developing a tissue perfusion sensor.

    PubMed

    Harvey, S L R; Parker, K H; O'Hare, D

    2007-01-01

    The development of a electrochemical tissue perfusion sensor is presented. The sensor is a platinum/platinum ring-disc microelectrode that relies on the principle of collector-generator to monitor mass transport within its vicinity. Tissue perfusion is a mass transport mechanism that describes the movement of respiratory gases, nutrients and metabolites in tissue. The sensor's capability of detecting perfusion at the cellular level in a continuous fashion is unique. This sensor will provide insight into the way nutrients and metabolites are transported in tissue especially in cases were perfusion is low such as in wounds or ischemic tissue. We present experimental work for the development and testing of the sensors in vitro. Experimental flow recordings in free steam solutions as well as the flow through tissue-like media are shown. Tests on post operative human tissue are also presented. The sensor's feature such as the continuous recoding capacities, spatial resolution and the measurement range from ml/min to microl/min are highlighted. PMID:18002549

  10. The Cook Mountain problem: Stratigraphic reality and semantic confusion

    SciTech Connect

    Ewing, T.E. |

    1994-12-31

    Historical inconsistency as to what constitutes the Cook Mountain Formation illustrates the semantic confusion resulting from extending surface-derived stratigraphic names into the subsurface without a full understanding of basin architecture. At the surface, the Cook Mountain Formation consists of fossilerous marine shale, glaucony and marl, and marginal-marine sandstone and shale between the nonmarine Sparta Formation sandstones below and the nonmarine Yegua Formation sandstones and lignitic shales above. Fossils are abundant, including the benthic foraminifer Ceratobulimina eximia. As subsurface exploration began, the first occurrence of Ceratobulimina eximia {open_quotes}Cerat{close_quotes} was used as the top of the marine {open_quotes}Cook Mountain Shale{close_quotes} below the Yegua section. Downdip, the overlying Yegua was found to become a sequence of marine shales and marginal-marine sandstones, the lower part of which yielded {open_quotes}Cerat{close_quotes}. Because of this, the lower sandstones were called {open_quotes}Cook Mountain{close_quotes} in many fields. At the Yegua shelf margin, {open_quotes}Cerat{close_quotes} is absent. Different exploration teams have used their own definitions for {open_quotes}Cook Mountain{close_quotes}, leading to substantial confusion.

  11. Auditory versus phonetic accounts of observed confusions between consonant phonemes.

    PubMed

    Soli, S D; Arabie, P

    1979-07-01

    The utility of phonetic features versus acoustic properties for describing perceptual relations among speech sounds was evaluated with a multidimensional scaling analysis of Miller and Nicely's [J. Acoust. Soc. Am. 27, 338-352 (1955)] consonant confusions data. The INDSCAL method and program were employed with the original data log transformed to enhance consistency with the linear INDSCAL model. A four-dimensional solution accounted for 69% of the variance and was best characterized in terms of acoustic properties of the speech signal, viz., temporal relationship of periodicity and burst onset, shape of voiced first formanant transition, shape of voiced second formanant transition, and amount of initial spectral dispersion, rather than in terms of phonetic features. The amplitude and spectral location of acoustic energy specifying each perceptual dimension were found to determine a dimension's perceptual effect as the signal was degraded by masking noise and bandpass filtering. Consequently, the perceptual bases of identification confusions between pairs of syllables were characterized in terms of the shared acoustic properties which remained salient in the degraded speech. Implications of these findings for feature-based accounts of perceptual relationships between phonemes are considered. PMID:489832

  12. Countering Climate Confusion in the Classroom: New Methods and Initiatives

    NASA Astrophysics Data System (ADS)

    McCaffrey, M.; Berbeco, M.; Reid, A. H.

    2014-12-01

    Politicians and ideologues blocking climate education through legislative manipulation. Free marketeers promoting the teaching of doubt and controversy to head off regulation. Education standards and curricula that skim over, omit, or misrepresent the causes, effects, risks and possible responses to climate change. Teachers who unknowingly foster confusion by presenting "both sides" of a phony scientific controversy. All of these contribute to dramatic differences in the quality and quantity of climate education received by U.S. students. Most U.S. adults and teens fail basic quizzes on energy and climate basics, in large part, because climate science has never been fully accepted as a vital component of a 21st-century science education. Often skipped or skimmed over, human contributions to climate change are sometimes taught as controversy or through debate, perpetuating a climate of confusion in many classrooms. This paper will review recent history of opposition to climate science education, and explore initial findings from a new survey of science teachers on whether, where and how climate change is being taught. It will highlight emerging effective pedagogical practices identified in McCaffrey's Climate Smart & Energy Wise, including the role of new initiatives such as the Next Generation Science Standards and Green Schools, and detail efforts of the Science League of America in countering denial and doubt so that educators can teach consistently and confidently about climate change.

  13. Delusional Confusion of Dreaming and Reality in Narcolepsy

    PubMed Central

    Wamsley, Erin; Donjacour, Claire E.H.M.; Scammell, Thomas E.; Lammers, Gert Jan; Stickgold, Robert

    2014-01-01

    Study Objectives: We investigated a generally unappreciated feature of the sleep disorder narcolepsy, in which patients mistake the memory of a dream for a real experience and form sustained delusions about significant events. Design: We interviewed patients with narcolepsy and healthy controls to establish the prevalence of this complaint and identify its predictors. Setting: Academic medical centers in Boston, Massachusetts and Leiden, The Netherlands. Participants: Patients (n = 46) with a diagnosis of narcolepsy with cataplexy, and age-matched healthy healthy controls (n = 41). Interventions: N/A. Measurements and Results: “Dream delusions” were surprisingly common in narcolepsy and were often striking in their severity. As opposed to fleeting hypnagogic and hypnopompic hallucinations of the sleep/wake transition, dream delusions were false memories induced by the experience of a vivid dream, which led to false beliefs that could persist for days or weeks. Conclusions: The delusional confusion of dreamed events with reality is a prominent feature of narcolepsy, and suggests the possibility of source memory deficits in this disorder that have not yet been fully characterized. Citation: Wamsley E; Donjacour CE; Scammell TE; Lammers GJ; Stickgold R. Delusional confusion of dreaming and reality in narcolepsy. SLEEP 2014;37(2):419-422. PMID:24501437

  14. "Matching" ventilation/perfusion images in fat embolization.

    PubMed

    Skarzynski, J J; Slavin, J D; Spencer, R P; Karimeddini, M K

    1986-01-01

    Forty-eight hours after fracture of the tibia and fibula, a 27-year-old man developed the triad of findings noted in the fat embolism syndrome (neurologic changes, respiratory distress, and petechiae). An initially normal chest-x-ray, which progressed to one of bilateral fluffy diffuse infiltrates, aided in making the diagnosis. Ventilation/perfusion lung images were performed at the time of the radiographic changes and showed "matching" defects. Transcapillary passage of lipid breakdown products was considered to be the cause. While all parts of the lung showed reduced ventilation/perfusion, the upper half of the lung fields was affected more prominently, as opposed to emboli of venous origin, which most frequently involve the lung bases. PMID:3943243

  15. Effects of lung ventilation–perfusion and muscle metabolism–perfusion heterogeneities on maximal O2 transport and utilization

    PubMed Central

    Cano, I; Roca, J; Wagner, P D

    2015-01-01

    Previous models of O2 transport and utilization in health considered diffusive exchange of O2 in lung and muscle, but, reasonably, neglected functional heterogeneities in these tissues. However, in disease, disregarding such heterogeneities would not be justified. Here, pulmonary ventilation–perfusion and skeletal muscle metabolism–perfusion mismatching were added to a prior model of only diffusive exchange. Previously ignored O2 exchange in non-exercising tissues was also included. We simulated maximal exercise in (a) healthy subjects at sea level and altitude, and (b) COPD patients at sea level, to assess the separate and combined effects of pulmonary and peripheral functional heterogeneities on overall muscle O2 uptake ( and on mitochondrial (). In healthy subjects at maximal exercise, the combined effects of pulmonary and peripheral heterogeneities reduced arterial () at sea level by 32 mmHg, but muscle by only 122 ml min−1 (–3.5%). At the altitude of Mt Everest, lung and tissue heterogeneity together reduced by less than 1 mmHg and by 32 ml min−1 (–2.4%). Skeletal muscle heterogeneity led to a wide range of potential among muscle regions, a range that becomes narrower as increases, and in regions with a low ratio of metabolic capacity to blood flow, can exceed that of mixed muscle venous blood. For patients with severe COPD, peak was insensitive to substantial changes in the mitochondrial characteristics for O2 consumption or the extent of muscle heterogeneity. This integrative computational model of O2 transport and utilization offers the potential for estimating profiles of both in health and in diseases such as COPD if the extent for both lung ventilation–perfusion and tissue metabolism–perfusion heterogeneity is known. PMID:25640017

  16. [Pleasure and confusion. A footnote to Freud's translations of Mill].

    PubMed

    Molnar, Michael

    2014-01-01

    In 1863 Theodor Gomperz came to England to propose to Helen Taylor Mill, step-daughter of J. S. Mill. For several months he delayed the proposal while studying transcripts of the Philodemus papyri in the Bodleian Library. There a threatening note, supposedly left on his desk, triggered an attack of paranoia. My study of this incident, initially a mere footnote, expanded into an examination of the obscure causes of this attack. The philosophical question of the nature of desire and the researcher's passion to reconstruct a fragmented classical text are related to Gomperz's unfocussed relationship with both Mill and his step-daughter, and his ensuing confusion between reality and fantasy. The incident is considered paradigmatic of the perils of scholarly research, when the desire to possess knowledge becomes entangled with transferential relationships. PMID:24988804

  17. States of confusion: Jurisdictional variation in Australian medicines nomenclature.

    PubMed

    Hope, Denise; King, Michelle

    2015-06-01

    In December 2000, the Galbally Review recommended Australia achieve national uniformity in drugs and poisons legislation. While the Commonwealth Poisons Standard classifies and schedules medicines and poisons, the Australian States and Territories are responsible for regulating the supply of medicines and poisons through individual medicines legislation. In December 2013, this legislation was examined to identify the nomenclature used to describe medicines. The research found considerable variation across jurisdictions in terms of the nomenclature used, in particular the terms used for Schedules in the State and Territory legislation were often inconsistent with each other and the terms used in the Poisons Standard. Of most concern is that the same term may be used to describe different medicines in different jurisdictions, leading to possible confusion for health practitioners working across jurisdictions as is now possible under national registration. It is therefore imperative that national uniformity of drugs and poisons legislation is achieved to facilitate a common practice reference. PMID:26349380

  18. Visualizing confusion matrices for multidimensional signal detection correlational methods

    NASA Astrophysics Data System (ADS)

    Zhou, Yue; Wischgoll, Thomas; Blaha, Leslie M.; Smith, Ross; Vickery, Rhonda J.

    2013-12-01

    Advances in modeling and simulation for General Recognition Theory have produced more data than can be easily visualized using traditional techniques. In this area of psychological modeling, domain experts are struggling to find effective ways to compare large-scale simulation results. This paper describes methods that adapt the web-based D3 visualization framework combined with pre-processing tools to enable domain specialists to more easily interpret their data. The D3 framework utilizes Javascript and scalable vector graphics (SVG) to generate visualizations that can run readily within the web browser for domain specialists. Parallel coordinate plots and heat maps were developed for identification-confusion matrix data, and the results were shown to a GRT expert for an informal evaluation of their utility. There is a clear benefit to model interpretation from these visualizations when researchers need to interpret larger amounts of simulated data.

  19. Acute postictal confusion and violence: Two cases with unfortunate outcomes☆

    PubMed Central

    Grant, Arthur C.; Koziorynska, Ewa; Lushbough, Catherine; Maus, Douglas; Mortati, Katherine

    2013-01-01

    Patients with temporal lobe epilepsy (TLE) often have a brief postictal state characterized by confusion and disorientation. Less common postictal behaviors include wandering and violence — both reactive and spontaneous. We describe two male patients with left TLE and unusual postictal states that led to unfortunate outcomes. The first patient's postictal state included an intense urge to peregrinate, as well as reactive violence. When a frightened houseguest prevented the patient from exiting his bedroom during a postictal state, the patient climbed out the window and fell to his death. The second patient's postictal state included menacing posturing, loud exclamation of guttural sounds or profanities, clapping or smacking his hands together, and punching nearby objects. During a postictal state at home, he grabbed a bat and destroyed furnishings. After he had two seizures at work followed by his typical postictal state, he was dismissed because of his perceived threat to coworkers. PMID:25667832

  20. High levels of confusion for cholesterol awareness campaigns.

    PubMed

    Hall, Danika V

    2008-09-15

    Earlier this year, two industry-sponsored advertising campaigns for cholesterol awareness that target the general public were launched in Australia. These campaigns aimed to alert the public to the risks associated with having high cholesterol and encouraged cholesterol testing for wider groups than those specified by the National Heart Foundation. General practitioners should be aware of the potential for the two campaigns to confuse the general public as to who should be tested, and where. The campaign sponsors (Unilever Australasia and Pfizer) each have the potential to benefit by increased market share for their products, and increased profits. These disease awareness campaigns are examples of what is increasingly being termed "condition branding" by pharmaceutical marketing experts. PMID:18803537

  1. EFFECT OF VENTILATION AND PERFUSION IMBALANCE ON INERT GAS REBREATHING VARIABLES

    EPA Science Inventory

    The effects of ventilation-to-perfusion (Va/Qc) maldistribution within the lungs on measured multiple gas rebreathing variables were studied in 14 dogs. The rebreathing method (using He, C18C, and C2H2) allows for measurements of pulmonary capillary blood flow (Qc), diffusing cap...

  2. Ex vivo lung graft perfusion.

    PubMed

    Briot, Raphaël; Gennai, Stéphane; Maignan, Maxime; Souilamas, Redha; Pison, Christophe

    2016-04-01

    This review proposes an update of the state of the art and the ongoing clinical trials of ex vivo lung perfusion for lung transplantation in patients. Ex vivo lung perfusion techniques (EVLP) can be used to evaluate a lung graft outside of the body. The goal of EVLP is to study the functional status of lung grafts that were first rejected for transplantation because they did not match all criteria for a conventional transplantation. After an EVLP evaluation, some of these lungs may be requalified for a possible transplantation in patients. This article proposes an overview of the developments of EVLP techniques. During EVLP, the perfusion and ventilation of the isolated lung preparation are very progressive in order to avoid oedema due to ischaemia-reperfusion injuries. Lung evaluation is mainly based on gasometric (PaO2/FiO2) and rheological criteria (low pulmonary arterial resistance). Several series of patients transplanted with EVLP evaluated lungs have been recently published with promising results. EVLP preparations also allow a better understanding of the physiopathology and treatments of ischaemia-reperfusion injuries. Organ procurements from "non-heart-beating" donors will probably require a wider application of these ex vivo techniques. The development of semi-automated systems might facilitate the clinical use of EVLP techniques. PMID:26746565

  3. Intestinal perfusion monitoring using photoplethysmography

    NASA Astrophysics Data System (ADS)

    Akl, Tony J.; Wilson, Mark A.; Ericson, M. Nance; Coté, Gerard L.

    2013-08-01

    In abdominal trauma patients, monitoring intestinal perfusion and oxygen consumption is essential during the resuscitation period. Photoplethysmography is an optical technique potentially capable of monitoring these changes in real time to provide the medical staff with a timely and quantitative measure of the adequacy of resuscitation. The challenges for using optical techniques in monitoring hemodynamics in intestinal tissue are discussed, and the solutions to these challenges are presented using a combination of Monte Carlo modeling and theoretical analysis of light propagation in tissue. In particular, it is shown that by using visible wavelengths (i.e., 470 and 525 nm), the perfusion signal is enhanced and the background contribution is decreased compared with using traditional near-infrared wavelengths leading to an order of magnitude enhancement in the signal-to-background ratio. It was further shown that, using the visible wavelengths, similar sensitivity to oxygenation changes could be obtained (over 50% compared with that of near-infrared wavelengths). This is mainly due to the increased contrast between tissue and blood in that spectral region and the confinement of the photons to the thickness of the small intestine. Moreover, the modeling results show that the source to detector separation should be limited to roughly 6 mm while using traditional near-infrared light, with a few centimeters source to detector separation leads to poor signal-to-background ratio. Finally, a visible wavelength system is tested in an in vivo porcine study, and the possibility of monitoring intestinal perfusion changes is showed.

  4. Perfusion Angiography of the Foot in Patients with Critical Limb Ischemia: Description of the Technique

    SciTech Connect

    Jens, Sjoerd Marquering, Henk A.; Koelemay, Mark J. W.; Reekers, Jim A.

    2015-02-15

    ObjectiveTo study the feasibility of 2D perfusion imaging in critical limb ischemia (CLI).Methods/ResultsPerfusion angiography is a new technology which was tested in 18 patients with CLI of the foot. A standardized protocol was used with a catheter placed at the mid-part of the popliteal artery, and a total of 9 cc of non-ionic iodinated contrast material was injected at a rate of 3 cc/sec. The technology is based on early cardiology research where iodinated contrast agents were used for imaging of cardiac perfusion. During the first pass of the contrast, there is a significant diffusion of the contrast agents into the interstitial space, particularly for non-ionic and low-molecular-weight compounds.DiscussionThe original angiography data can be used to make a time–density curve, which represents the actual perfusion of the foot in time. Angiographic perfusion imaging is a post-processing modality for which no extra contrast or radiation is needed. With this technique, it is possible to get more information about the perfusion status and microcirculation of the foot. This is a step toward functional imaging in CLI patients.

  5. Ultrasound perfusion signal processing for tumor detection

    NASA Astrophysics Data System (ADS)

    Kim, MinWoo; Abbey, Craig K.; Insana, Michael F.

    2016-04-01

    Enhanced blood perfusion in a tissue mass is an indication of neo-vascularity and a sign of a potential malignancy. Ultrasonic pulsed-Doppler imaging is a preferred modality for noninvasive monitoring of blood flow. However, the weak blood echoes and disorganized slow flow make it difficult to detect perfusion using standard methods without the expense and risk of contrast enhancement. Our research measures the efficiency of conventional power-Doppler (PD) methods at discriminating flow states by comparing measurement performance to that of an ideal discriminator. ROC analysis applied to the experimental results shows that power Doppler methods are just 30-50 % efficient at perfusion flows less than 1ml/min, suggesting an opportunity to improve perfusion assessment through signal processing. A new perfusion estimator is proposed by extending the statistical discriminator approach. We show that 2-D perfusion color imaging may be enhanced using this approach.

  6. Myocardial perfusion imaging using contrast echocardiography.

    PubMed

    Pathan, Faraz; Marwick, Thomas H

    2015-01-01

    Microbubbles are an excellent intravascular tracer, and both the rate of myocardial opacification (analogous to coronary microvascular perfusion) and contrast intensity (analogous to myocardial blood volume) provide unique insights into myocardial perfusion. A strong evidence base has been accumulated to show comparability with nuclear perfusion imaging and incremental diagnostic and prognostic value relative to wall motion analysis. This technique also provides the possibility to measure myocardial perfusion at the bedside. Despite all of these advantages, the technique is complicated, technically challenging, and has failed to scale legislative and financial hurdles. The development of targeted imaging and therapeutic interventions will hopefully rekindle interest in this interesting modality. PMID:25817740

  7. Estimating a regional ventilation-perfusion index

    PubMed Central

    Muller, P A; Li, T; Isaacson, D; Newell, J C; Saulnier, G J; Kao, Tzu-Jen; Ashe, Jeffrey

    2015-01-01

    This is a methods paper, where an approximation to the local ventilation-perfusion ratio is derived. This approximation, called the ventilation-perfusion index since it is not exactly the physiological ventilation-perfusion ratio, is calculated using conductivity reconstructions obtained using electrical impedance tomography. Since computation of the ventilation-perfusion index only requires knowledge of the internal conductivity, any conductivity reconstruction method may be used. The method is explained, and results are presented using conductivities obtained from two EIT systems, one using an iterative method and the other a linearization method. PMID:26006279

  8. Assessment of the kidneys: magnetic resonance angiography, perfusion and diffusion

    PubMed Central

    2011-01-01

    Renal magnetic resonance (MR) imaging has undergone major improvements in the past several years. This review focuses on the technical basics and clinical applications of MR angiography (MRA) with the goal of enabling readers to acquire high-resolution, high quality renal artery MRA. The current role of contrast agents and their safe use in patients with renal impairment is discussed. In addition, an overview of promising techniques on the horizon for renal MR is provided. The clinical value and specific applications of renal MR are critically discussed. PMID:22085467

  9. Ventilation-perfusion matching during exercise

    NASA Technical Reports Server (NTRS)

    Wagner, P. D.

    1992-01-01

    In normal subjects, exercise widens the alveolar-arterial PO2 difference (P[A-a]O2) despite a more uniform topographic distribution of ventilation-perfusion (VA/Q) ratios. While part of the increase in P(A-a)O2 (especially during heavy exercise) is due to diffusion limitation, a considerable amount is caused by an increase in VA/Q mismatch as detected by the multiple inert gas elimination technique. Why this occurs is unknown, but circumstantial evidence suggests it may be related to interstitial pulmonary edema rather than to factors dependent on ventilation, airway gas mixing, airway muscle tone, or pulmonary vascular tone. In patients with lung disease, the gas exchange consequences of exercise are variable. Thus, arterial PO2 may increase, remain the same, or fall. In general, patients with advanced chronic obstructive pulmonary disease (COPD) or interstitial fibrosis who exercise show a fall in PO2. This is usually not due to worsening VA/Q relationships but mostly to the well-known fall in mixed venous PO2, which itself results from a relatively smaller increase in cardiac output than VO2. However, in interstitial fibrosis (but not COPD), there is good evidence that a part of the fall in PO2 on exercise is caused by alveolar-capillary diffusion limitation of O2 transport; in COPD (but not interstitial fibrosis), a frequent additional contributing factor to the hypoxemia of exercise is an inadequate ventilatory response, such that minute ventilation does not rise as much as does CO2 production or O2 uptake, causing arterial PCO2 to increase and PO2 to fall.

  10. Quantification of brain perfusion with tracers retained by the brain

    SciTech Connect

    Pupi, A.; Bacciottini, L.; De Cristofaro, M.T.R.; Formiconi, A.R.; Castagnoli, A.

    1991-12-31

    Almost a decade ago, tracers, labelled with {sup 123}I and {sup 99m}Tc, that are retained by the brain, started to be used for studies of regional brain perfusion (regional cerebral blood flow, rCBF). To date, these tracers have been used for brain perfusion imaging with SPECT in brain disorders as well as for physiological activation protocols. Only seldom, however, have they been used in protocols that quantitatively measure rCBF. Nevertheless, comparative studies with perfusion reference tracers have repeatedly demonstrated that the brain uptake of these brain-retained tracers is correlated to perfusion, the major determinant of the distribution of these tracers in the brain. The brain kinetics of {sup 99m}Tc HMPAO, which is the tracer most commonly used, was described with a two-compartment tissue model. The theoretical approach, which is, in itself, sufficient for modeling quantitative measurements with {sup 99m}Tc HMPAO, initially suggested the possibility of empirically narrowing the distance between the brain`s regional uptake of the tracer and rCBF with a linearization algorithm which uses the cerebellum as the reference region. The value of this empirical method is hampered by the fact that the cerebellum can be involved in cerebrovascular disease (i.e. cerebellar diaschisis) as well as in several other brain disorders (e.g. anxiety, and dementia of the Alzheimer type). It also was proposed that different reference regions (occipital, whole slice, or whole brain) should be selected in relation to the brain disorder under study. However, this approach does not solve the main problem because it does not equip us with a reliable tool to evaluate rCBF with a high predictive value, and, at the same time, to reduce intersubject variability. The solution would be to measure a quantitative parameter which directly reflects rCBF, such as the unidirectional influx constant of the freely diffusible flow-limited tracers. 45 refs., 3 figs., 1 tab.

  11. Contrast, contours and the confusion effect in dazzle camouflage

    PubMed Central

    Scott-Samuel, Nicholas E.; Cuthill, Innes C.

    2016-01-01

    ‘Motion dazzle camouflage’ is the name for the putative effects of highly conspicuous, often repetitive or complex, patterns on parameters important in prey capture, such as the perception of speed, direction and identity. Research into motion dazzle camouflage is increasing our understanding of the interactions between visual tracking, the confusion effect and defensive coloration. However, there is a paucity of research into the effects of contrast on motion dazzle camouflage: is maximal contrast a prerequisite for effectiveness? If not, this has important implications for our recognition of the phenotype and understanding of the function and mechanisms of potential motion dazzle camouflage patterns. Here we tested human participants' ability to track one moving target among many identical distractors with surface patterns designed to test the influence of these factors. In line with previous evidence, we found that targets with stripes parallel to the object direction of motion were hardest to track. However, reduction in contrast did not significantly influence this result. This finding may bring into question the utility of current definitions of motion dazzle camouflage, and means that some animal patterns, such as aposematic or mimetic stripes, may have previously unrecognized multiple functions. PMID:27493775

  12. Discrete representation of perceptual structure underlying consonant confusions.

    PubMed

    Soli, S D; Arabie, P; Carroll, J D

    1986-03-01

    The perceptual representation of speech is generally assumed to be discrete rather than continuous, pointing to the need for general discrete analytic models to represent observed perceptual similarities among speech sounds. The INDCLUS (INdividual Differences CLUStering) model and algorithm [J.D. Carroll and P. Arabie, Psychometrika 48, 157-169 (1983)] can provide this generality, representing symmetric three-way similarity data (stimuli X stimuli X conditions) as an additive combination of overlapping, and generally not hierarchial, clusters whose weights (which are numerical values gauging the importance of the clusters) vary both as a function of the cluster and condition being considered. INDCLUS was used to obtain a discrete representation of underlying perceptual structure in the Miller and Nicely consonant confusion data [G.A. Miller and P.E. Nicely, J. Acoust. Soc. Am. 27, 338-352 (1955)]. A 14-cluster solution accounted for 82.9% of total variance across the 17 listening conditions. The cluster composition and the variations in cluster weights as a function of stimulus degradation were interpreted in terms of the common and unique perceptual attributes of the consonants within each cluster. Low-pass filtering and noise masking selectively degraded unique attributes, especially the cues for place of articulation, while high-pass filtering degraded both unique and common attributes. The clustering results revealed that perceptual similarities among consonants are accurately modeled by additive combinations of their specific and discrete acoustic attributes whose weights are determined by the nature of the stimulus degradation. PMID:3958325

  13. Coherence, competence, and confusion in narratives of middle childhood.

    PubMed

    Weinstein, Lissa; Shustorovich, Ellen

    2011-01-01

    Middle childhood is a pivotal time in character development during which enduring internal structures are formed. Fiction can offer insights into the cognitive and affective shifts of this developmental phase and how they are transformed in adulthood. While the success of beloved books for latency age children lies in the solutions they offer to the conflict between the pull toward independence and the pull back to the safety of childhood, the enduring stories for adults about children in their middle years can be seen as works of mourning for the relationship with the parents and the childhood self, but more importantly as attempts to transform their experience of middle childhood through the retrospective creation of a coherence that was initially absent. Thematic and structural elements distinguish two groups of stories for adults: the first appears to solve the conflicts of this period by importing adult knowledge and perspective into the narrative of childhood; the second describes the unconscious disorganizing aspects of this period, thereby offering readers a chance to reorganize their own memories, to make a coherent whole out of the fragmented, the confusing, and the unresolved. PMID:26027140

  14. Contrast, contours and the confusion effect in dazzle camouflage.

    PubMed

    Hogan, Benedict G; Scott-Samuel, Nicholas E; Cuthill, Innes C

    2016-07-01

    'Motion dazzle camouflage' is the name for the putative effects of highly conspicuous, often repetitive or complex, patterns on parameters important in prey capture, such as the perception of speed, direction and identity. Research into motion dazzle camouflage is increasing our understanding of the interactions between visual tracking, the confusion effect and defensive coloration. However, there is a paucity of research into the effects of contrast on motion dazzle camouflage: is maximal contrast a prerequisite for effectiveness? If not, this has important implications for our recognition of the phenotype and understanding of the function and mechanisms of potential motion dazzle camouflage patterns. Here we tested human participants' ability to track one moving target among many identical distractors with surface patterns designed to test the influence of these factors. In line with previous evidence, we found that targets with stripes parallel to the object direction of motion were hardest to track. However, reduction in contrast did not significantly influence this result. This finding may bring into question the utility of current definitions of motion dazzle camouflage, and means that some animal patterns, such as aposematic or mimetic stripes, may have previously unrecognized multiple functions. PMID:27493775

  15. Objections, confusion among pharmacists threaten access to emergency contraception.

    PubMed

    Cohen, S A

    1999-06-01

    Emergency contraception (EC) involves women taking a high dose of regular oral contraceptives very shortly after unprotected intercourse. Specifically, emergency contraceptive pills (ECPs) can prevent pregnancy if taken within 72 hours of intercourse in cases of known or suspected contraception failure or when no contraception was used. Adherence to this approach is now widely accepted as capable of dramatically contributing toward the reduction of unintended pregnancies and subsequent abortions. However, in the media and in political debates, ECPs are often confused with mifepristone (RU-486), which is clearly an abortion-inducing drug. The misconception that EC is a method of abortion must be corrected. For example, in some cases, pharmacists refuse to fill prescriptions for ECPs, presumably because they believe they are facilitating abortion. Wal-Mart, one of the country's largest drug retailers, has decided to not sell ECPs. A concerted public education effort is needed to make more people both aware and properly informed of EC in the US. Educational efforts targeted to physicians and women over the past several years appear to have already resulted in a marked increase in the knowledge and use of EC nationwide. Those efforts were likely bolstered by the 1998 US Food and Drug Administration approval, for the first time, of an oral contraception regimen to be packaged and marketed in the US specifically for postcoital use. PMID:12295186

  16. The Legal Dimension of RTI--Confusion Confirmed: A Response to Walker and Daves

    ERIC Educational Resources Information Center

    Zirkel, Perry A.

    2012-01-01

    In this issue of "Learning Disability Quarterly" (LDQ), Professors Daves and Walker reply to my earlier LDQ article on confusion in the cases and commentary about the legal dimension of RTI. In this brief rejoinder, I show that their reply confirms rather than resolves the confusion in their original commentary in 2010. This persistent problem…

  17. The Role of Source Confusions in Television's Cultivation of Social Reality Judgments.

    ERIC Educational Resources Information Center

    Mares, Marie-Louise

    1996-01-01

    Examines whether errors in memory (specifically source confusions) contribute to the link between television viewing and social reality judgments. Finds that a manipulation of the visual similarity of the news and fictional programming affected subjects' tendency to make source confusions. (RS)

  18. Annual Percentage Rate and Annual Effective Rate: Resolving Confusion in Intermediate Accounting Textbooks

    ERIC Educational Resources Information Center

    Vicknair, David; Wright, Jeffrey

    2015-01-01

    Evidence of confusion in intermediate accounting textbooks regarding the annual percentage rate (APR) and annual effective rate (AER) is presented. The APR and AER are briefly discussed in the context of a note payable and correct formulas for computing each is provided. Representative examples of the types of confusion that we found is presented…

  19. The Lost Lamb: A Literature Review on the Confusion of College Students in China

    ERIC Educational Resources Information Center

    Dong, Jianmei; Han, Fubin

    2010-01-01

    With the development of mass higher education in China, confusion--a contradictory state between college students' awareness of employment, learning, morality, and their own behavior and societal requirements--is proving a ubiquitous problem among college students. His confusion has garnered much social attention. In this paper, the origins of…

  20. Visual and Acoustic Confusability of Target Letters and the Word Superiority Effect.

    ERIC Educational Resources Information Center

    Chastain, Garvin; And Others

    The hypothesis that word context reduces visual rather than acoustic confusion between possible targets was tested in a series of experiments. All involved tachistoscopic presentation of letter strings followed by a pattern mask. Data from eight college students showed that target letters that are confusable only visually and acoustically ("b" and…

  1. Confusion: acetaminophen dosing changes based on NO evidence in adults.

    PubMed

    Krenzelok, Edward P; Royal, Mike A

    2012-06-01

    Acetaminophen (paracetamol) plays a vital role in American health care, with in excess of 25 billion doses being used annually as a nonprescription medication. Over 200 million acetaminophen-containing prescriptions, usually in combination with an opioid, are dispensed annually. While acetaminophen is recognized as a safe and effective analgesic and antipyretic, it is also associated with significant morbidity and mortality (hepatotoxicity) if doses in excess of the therapeutic amount are ingested inappropriately. The maximum daily therapeutic dose of 3900-4000 mg was established in separate actions in 1977 and 1988, respectively, via the Food and Drug Administration (FDA) monograph process for nonprescription medications. The FDA has conducted multiple advisory committee meetings to evaluate acetaminophen and its safety profile, and has suggested (but not mandated) a reduction in the maximum daily dosage from 3900-4000 mg to 3000-3250 mg. In 2011, McNeil, the producer of the Tylenol® brand of acetaminophen, voluntarily reduced the maximum daily dose of its 500 mg tablet product to 3000 mg/day, and it has pledged to change the labeling of its 325 mg/tablet product to reflect a maximum of 3250 mg/day. Generic manufacturers have not changed their dosing regimens and they have remained consistent with the established monograph dose. Therefore, confusion will be inevitable as both consumers and health care professionals try to determine the proper therapeutic dose of acetaminophen. Which is the correct dose of acetaminophen: 3000 mg if 500 mg tablets are used, 3250 mg with 325 mg tablets, or 3900 mg when 650 mg arthritis-strength products are used? PMID:22530736

  2. Long term perfusion system supporting adipogenesis

    PubMed Central

    Abbott, Rosalyn D.; Raja, Waseem K.; Wang, Rebecca Y.; Stinson, Jordan A.; Glettig, Dean L.; Burke, Kelly A.; Kaplan, David L.

    2015-01-01

    Adipose tissue engineered models are needed to enhance our understanding of disease mechanisms and for soft tissue regenerative strategies. Perfusion systems generate more physiologically relevant and sustainable adipose tissue models, however adipocytes have unique properties that make culturing them in a perfusion environment challenging. In this paper we describe the methods involved in the development of two perfusion culture systems (2D and 3D) to test their applicability for long term in vitro adipogenic cultures. It was hypothesized that a silk protein biomaterial scaffold would provide a 3D framework, in combination with perfusion flow, to generate a more physiologically relevant sustainable adipose tissue engineered model than 2D cell culture. Consistent with other studies evaluating 2D and 3D culture systems for adipogenesis we found that both systems successfully model adipogensis, however 3D culture systems were more robust, providing the mechanical structure required to contain the large, fragile adipocytes that were lost in 2D perfused culture systems. 3D perfusion also stimulated greater lipogenesis and lipolysis and resulted in decreased secretion of LDH compared to 2D perfusion. Regardless of culture configuration (2D or 3D) greater glycerol was secreted with the increased nutritional supply provided by perfusion of fresh media. These results are promising for adipose tissue engineering applications including long term cultures for studying disease mechanisms and regenerative approaches, where both acute (days to weeks) and chronic (weeks to months) cultivation are critical for useful insight. PMID:25843606

  3. Myocardial perfusion with rubidium-82. III. Theory relating severity of coronary stenosis to perfusion deficit

    SciTech Connect

    Mullani, N.A.

    1984-11-01

    The relation between the quantitative perfusion deficit, as measured by emission computerized tomography, and the severity of coronary artery stenosis is important for the noninvasive clinical evaluation of coronary artery disease in man. Positron emission tomography allows direct noninvasive measurement of myocardial perfusion and quantification of the size of the perfusion defect. Given this important imformation, a mathematical model has been derived to gauge the severity of a coronary stenosis from quantitative perfusion measurements in the normal and poststenotic regions of the heart. The theoretical basis is presented for relating regional myocardial perfusion and regional perfusion resistance to total, coronary blood flow and resistance at normal resting flow and during maximal coronary vasodilation. The concept of perfusion reserve is presented as a clinical measure of the severity of a stenosis.

  4. Investigation of source-detector separation optimization for an implantable perfusion and oxygenation sensor for liver blood vessels

    NASA Astrophysics Data System (ADS)

    Baba, J. S.; Akl, T. J.; Coté, G. L.; Wilson, M. A.; Ericson, M. N.

    2011-03-01

    An implanted system is being developed to monitor transplanted liver health during the critical 7-10 day period posttransplantation. The unit will monitor organ perfusion and oxygen consumption using optically-based probes placed on both the inflow and outflow blood vessels, and on the liver parenchymal surface. Sensing probes are based on a 3- wavelength LED source and a photodiode detector. Sample diffuse reflectance is measured at 735, 805, and 940 nm. To ascertain optimal source-to-photodetector spacing for perfusion measurement in blood vessels, an ex vivo study was conducted. In this work, a dye mixture simulating 80% blood oxygen saturation was developed and perfused through excised porcine arteries while collecting data for various preset probe source-to-photodetector spacings. The results from this study demonstrate a decrease in the optical signal with decreasing LED drive current and a reduction in perfusion index signal with increasing probe spacing. They also reveal a 2- to 4-mm optimal range for blood vessel perfusion probe source-to-photodetector spacing that allows for sufficient perfusion signal modulation depth with maximized signal to noise ratio (SNR). These findings are currently being applied to guide electronic configuration and probe placement for in vivo liver perfusion porcine model studies.

  5. Dependence of Brain Intravoxel Incoherent Motion Perfusion Parameters on the Cardiac Cycle

    PubMed Central

    Federau, Christian; Hagmann, Patric; Maeder, Philippe; Müller, Markus; Meuli, Reto; Stuber, Matthias; O’Brien, Kieran

    2013-01-01

    Measurement of microvascular perfusion with Intravoxel Incoherent Motion (IVIM) MRI is gaining interest. Yet, the physiological influences on the IVIM perfusion parameters (“pseudo-diffusion” coefficient D*, perfusion fraction f, and flow related parameter fD*) remain insufficiently characterized. In this article, we hypothesize that D* and fD*, which depend on blood speed, should vary during the cardiac cycle. We extended the IVIM model to include time dependence of D* = D*(t), and demonstrate in the healthy human brain that both parameters D* and fD* are significantly larger during systole than diastole, while the diffusion coefficient D and f do not vary significantly. The results non-invasively demonstrate the pulsatility of the brain’s microvasculature. PMID:24023649

  6. Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion

    PubMed Central

    Advani, Rajiv; Kurz, Kathinka D.; Kurz, Martin W.

    2014-01-01

    Background. Metabolic syndromes such as Wernicke's encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT) including a CT perfusion (CTP) scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke's encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report. PMID:24716022

  7. Assessment of foot perfusion in patients with a diabetic foot ulcer.

    PubMed

    Forsythe, Rachael O; Hinchliffe, Robert J

    2016-01-01

    Assessment of foot perfusion is a vital step in the management of patients with diabetic foot ulceration, in order to understand the risk of amputation and likelihood of wound healing. Underlying peripheral artery disease is a common finding in patients with foot ulceration and is associated with poor outcomes. Assessment of foot perfusion should therefore focus on identifying the presence of peripheral artery disease and to subsequently estimate the effect this may have on wound healing. Assessment of perfusion can be difficult because of the often complex, diffuse and distal nature of peripheral artery disease in patients with diabetes, as well as poor collateralisation and heavy vascular calcification. Conventional methods of assessing tissue perfusion in the peripheral circulation may be unreliable in patients with diabetes, and it may therefore be difficult to determine the extent to which poor perfusion contributes to foot ulceration. Anatomical data obtained on cross-sectional imaging is important but must be combined with measurements of tissue perfusion (such as transcutaneous oxygen tension) in order to understand the global and regional perfusion deficit present in a patient with diabetic foot ulceration. Ankle-brachial pressure index is routinely used to screen for peripheral artery disease, but its use in patients with diabetes is limited in the presence of neuropathy and medial arterial calcification. Toe pressure index may be more useful because of the relative sparing of pedal arteries from medial calcification but may not always be possible in patients with ulceration. Fluorescence angiography is a non-invasive technique that can provide rapid quantitative information about regional tissue perfusion; capillaroscopy, iontophoresis and hyperspectral imaging may also be useful in assessing physiological perfusion but are not widely available. There may be a future role for specialized perfusion imaging of these patients, including magnetic resonance

  8. TISSUE ENGINEERING PERFUSABLE CANCER MODELS

    PubMed Central

    Fong, E.L.; Santoro, M.; Farach-Carson, M.C.; Kasper, F.K.; Mikos, A.G.

    2014-01-01

    The effect of fluid flow on cancer progression is currently not well understood, highlighting the need for perfused tumor models to close this gap in knowledge. Enabling biological processes at the cellular level to be modeled with high spatiotemporal control, microfluidic tumor models have demonstrated applicability as platforms to study cell-cell interactions, effect of interstitial flow on tumor migration and the role of vascular barrier function. To account for the multi-scale nature of cancer growth and invasion, macroscale models are also necessary. The consideration of fluid dynamics within tumor models at both the micro- and macroscopic levels may greatly improve our ability to more fully mimic the tumor microenvironment. PMID:24634812

  9. Optical modeling toward optimizing monitoring of intestinal perfusion in trauma patients

    SciTech Connect

    Akl, Tony; Wilson, Mark A.; Ericson, Milton Nance; Cote, Gerard L.

    2013-01-01

    Trauma is the number one cause of death for people between the ages 1 and 44 years in the United States. In addition, according to the Centers of Disease Control and Prevention, injury results in over 31 million emergency department visits annually. Minimizing the resuscitation period in major abdominal injuries increases survival rates by correcting impaired tissue oxygen delivery. Optimization of resuscitation requires a monitoring method to determine sufficient tissue oxygenation. Oxygenation can be assessed by determining the adequacy of tissue perfusion. In this work, we present the design of a wireless perfusion and oxygenation sensor based on photoplethysmography. Through optical modeling, the benefit of using the visible wavelengths 470, 525 and 590nm (around the 525nm hemoglobin isobestic point) for intestinal perfusion monitoring is compared to the typical near infrared (NIR) wavelengths (805nm isobestic point) used in such sensors. Specifically, NIR wavelengths penetrate through the thin intestinal wall (~4mm) leading to high background signals. However, these visible wavelengths have two times shorter penetration depth that the NIR wavelengths. Monte-Carlo simulations show that the transmittance of the three selected wavelengths is lower by 5 orders of magnitude depending on the perfusion state. Due to the high absorbance of hemoglobin in the visible range, the perfusion signal carried by diffusely reflected light is also enhanced by an order of magnitude while oxygenation signal levels are maintained. In addition, short source-detector separations proved to be beneficial for limiting the probing depth to the thickness of the intestinal wall.

  10. A spatially-distributed computational model to quantify behaviour of contrast agents in MR perfusion imaging

    PubMed Central

    Cookson, A.N.; Lee, J.; Michler, C.; Chabiniok, R.; Hyde, E.; Nordsletten, D.; Smith, N.P.

    2014-01-01

    Contrast agent enhanced magnetic resonance (MR) perfusion imaging provides an early, non-invasive indication of defects in the coronary circulation. However, the large variation of contrast agent properties, physiological state and imaging protocols means that optimisation of image acquisition is difficult to achieve. This situation motivates the development of a computational framework that, in turn, enables the efficient mapping of this parameter space to provide valuable information for optimisation of perfusion imaging in the clinical context. For this purpose a single-compartment porous medium model of capillary blood flow is developed which is coupled with a scalar transport model, to characterise the behaviour of both blood-pool and freely-diffusive contrast agents characterised by their ability to diffuse through the capillary wall into the extra-cellular space. A parameter space study is performed on the nondimensionalised equations using a 2D model for both healthy and diseased myocardium, examining the sensitivity of system behaviour to Peclet number, Damköhler number (Da), diffusivity ratio and fluid porosity. Assuming a linear MR signal response model, sample concentration time series data are calculated, and the sensitivity of clinically-relevant properties of these signals to the model parameters is quantified. Both upslope and peak values display significant non-monotonic behaviour with regard to the Damköhler number, with these properties showing a high degree of sensitivity in the parameter range relevant to contrast agents currently in use. However, the results suggest that signal upslope is the more robust and discerning metric for perfusion quantification, in particular for correlating with perfusion defect size. Finally, the results were examined in the context of nonlinear signal response, flow quantification via Fermi deconvolution and perfusion reserve index, which demonstrated that there is no single best set of contrast agent parameters

  11. Induction of Hepatic and Endothelial Differentiation by Perfusion in a Three-Dimensional Cell Culture Model of Human Fetal Liver

    PubMed Central

    Pekor, Christopher; Gerlach, Jörg C.; Nettleship, Ian

    2015-01-01

    The development of functional engineered tissue constructs depends on high cell densities and appropriate vascularization. In this study we implemented a four-compartment three-dimensional perfusion bioreactor culture model for studying the effects of medium perfusion on endothelial, hepatic, and hematopoietic cell populations of primary human fetal liver in an in vivo-like environment. Human fetal liver cells were cultured in bioreactors configured to provide either perfusion or diffusion conditions. Metabolic activities of the cultures were monitored daily by measuring glucose consumption and lactate production. Cell viability during culture was analyzed by lactate dehydrogenase activity. Hepatic functionality was determined by the release of albumin and alpha-fetoprotein (AFP) in culture medium samples. After 4 days of culture, cells were analyzed for the expression of a variety of endothelial, hepatic, and hematopoietic genes, as well as the surface marker expression of CD31 and CD34 in flow cytometry. We found that medium perfusion increased the gene expression of endothelial markers such as CD31, von Willebrand factor (vWF), CD140b, CD309, and CD144 while decreasing the gene expression of the erythrocyte-surface marker CD235a. Hepatic differentiation was promoted under perfusion conditions as demonstrated by lower AFP and higher albumin secretion compared with cultures not exposed to medium perfusion. Additionally, cultures exposed to medium perfusion gave higher rates of glucose consumption and lactate production, indicating increased metabolic activity. In conclusion, high-density bioreactors configured to provide constant medium perfusion significantly induced hepatic and endothelial cell differentiation and provided improved conditions for the culture of human fetal liver cells compared with cultures without perfusion. PMID:25559936

  12. Induction of Hepatic and Endothelial Differentiation by Perfusion in a Three-Dimensional Cell Culture Model of Human Fetal Liver.

    PubMed

    Pekor, Christopher; Gerlach, Jörg C; Nettleship, Ian; Schmelzer, Eva

    2015-07-01

    The development of functional engineered tissue constructs depends on high cell densities and appropriate vascularization. In this study we implemented a four-compartment three-dimensional perfusion bioreactor culture model for studying the effects of medium perfusion on endothelial, hepatic, and hematopoietic cell populations of primary human fetal liver in an in vivo-like environment. Human fetal liver cells were cultured in bioreactors configured to provide either perfusion or diffusion conditions. Metabolic activities of the cultures were monitored daily by measuring glucose consumption and lactate production. Cell viability during culture was analyzed by lactate dehydrogenase activity. Hepatic functionality was determined by the release of albumin and alpha-fetoprotein (AFP) in culture medium samples. After 4 days of culture, cells were analyzed for the expression of a variety of endothelial, hepatic, and hematopoietic genes, as well as the surface marker expression of CD31 and CD34 in flow cytometry. We found that medium perfusion increased the gene expression of endothelial markers such as CD31, von Willebrand factor (vWF), CD140b, CD309, and CD144 while decreasing the gene expression of the erythrocyte-surface marker CD235a. Hepatic differentiation was promoted under perfusion conditions as demonstrated by lower AFP and higher albumin secretion compared with cultures not exposed to medium perfusion. Additionally, cultures exposed to medium perfusion gave higher rates of glucose consumption and lactate production, indicating increased metabolic activity. In conclusion, high-density bioreactors configured to provide constant medium perfusion significantly induced hepatic and endothelial cell differentiation and provided improved conditions for the culture of human fetal liver cells compared with cultures without perfusion. PMID:25559936

  13. Ventilation-perfusion imaging in pulmonary papillomatosis

    SciTech Connect

    Espinola, D.; Rupani, H.; Camargo, E.E.; Wagner, H.N. Jr.

    1981-11-01

    Three children with laryngeal papillomas involving the lungs had serial ventilation-perfusion scintigrams to assess results of therapy designed to reduce the bronchial involvement. Different imaging patterns were observed depending on size, number, and location of lesions. In early parenchymal involvement a ventilation-perfusion mismatch was seen. The initial and follow-up studies correlated well with clinical and radiographic findings. This noninvasive procedure is helpful in evaluating ventilatory and perfusion impairment in these patients as well as their response to treatment.

  14. Cochlear perfusion with a viscous fluid.

    PubMed

    Wang, Yi; Olson, Elizabeth S

    2016-07-01

    The flow of viscous fluid in the cochlea induces shear forces, which could provide benefit in clinical practice, for example to guide cochlear implant insertion or produce static pressure to the cochlear partition or wall. From a research standpoint, studying the effects of a viscous fluid in the cochlea provides data for better understanding cochlear fluid mechanics. However, cochlear perfusion with a viscous fluid may damage the cochlea. In this work we studied the physiological and anatomical effects of perfusing the cochlea with a viscous fluid. Gerbil cochleae were perfused at a rate of 2.4 μL/min with artificial perilymph (AP) and sodium hyaluronate (Healon, HA) in four different concentrations (0.0625%, 0.125%, 0.25%, 0.5%). The different HA concentrations were applied either sequentially in the same cochlea or individually in different cochleae. The perfusion fluid entered from the round window and was withdrawn from basal scala vestibuli, in order to perfuse the entire perilymphatic space. Compound action potentials (CAP) were measured after each perfusion. After perfusion with increasing concentrations of HA in the order of increasing viscosity, the CAP thresholds generally increased. The threshold elevation after AP and 0.0625% HA perfusion was small or almost zero, and the 0.125% HA was a borderline case, while the higher concentrations significantly elevated CAP thresholds. Histology of the cochleae perfused with the 0.0625% HA showed an intact Reissner's membrane (RM), while in cochleae perfused with 0.125% and 0.25% HA RM was torn. Thus, the CAP threshold elevation was likely due to the broken RM, likely caused by the shear stress produced by the flow of the viscous fluid. Our results and analysis indicate that the cochlea can sustain, without a significant CAP threshold shift, up to a 1.5 Pa shear stress. Beside these finding, in the 0.125% and 0.25% HA perfusion cases, a temporary CAP threshold shift was observed, perhaps due to the presence and

  15. Luminal distension as a possible consequence of experimental intestinal perfusion

    PubMed Central

    Wingate, David; Hyams, Ashley; Phillips, Sidney

    1974-01-01

    In an experimental jejunal perfusion study, distress in healthy subjects occurred during eight out of 16 perfusions in which intestinal secretion was provoked. Calculation demonstrates the volumetric consequences of inadequate recovery of secretory perfusates, and analysis of the perfusion studies shows that distress was significantly associated with poor recovery of the perfusate. These observations are pertinent to increasing interest in the phenomenon of intestinal fluid secretion. PMID:4435588

  16. Perfusion education and training in Europe.

    PubMed

    Merkle, Frank

    2006-01-01

    Perfusion education and training varies considerably throughout Europe. Unlike in the US, where a common curriculum for perfusion education has been established, each European country has its own education system. This fact is further complicated by a multitude of national languages and cultures. Thus, perfusion education programmes vary, not only in content, but also in their academic levels. This article aims to give a comprehensive overview of the situation in each of the 20 member states of the European Board of Cardiovascular Perfusion (EBCP). The EBCP delegates were polled for a description of the process of training and education of clinical perfusionists in their respective countries. Following the initial delegate poll in 2001, an update of the material was performed in spring 2005. In summary, training of clinical perfusionists in Europe varies considerably between countries. A professional body is necessary to oversee the training process and to guarantee a minimum level of clinical competency for cardiovascular perfusionists. PMID:16485693

  17. Uterine perfusion model for analyzing barriers to transport in fibroids.

    PubMed

    Stirland, Darren L; Nichols, Joseph W; Jarboe, Elke; Adelman, Marisa; Dassel, Mark; Janát-Amsbury, Margit-Maria; Bae, You Han

    2015-09-28

    This project uses an ex vivo human perfusion model for studying transport in benign, fibrous tumors. The uterine arteries were cannulated to perfuse the organ with a buffer solution containing blood vessel stain and methylene blue to analyze intratumoral transport. Gross examination revealed tissue expansion effects and a visual lack of methylene blue in the fibroids. Some fibroids exhibited regions with partial methylene blue penetration into the tumor environment. Histological analysis comparing representative sections of fibroids and normal myometrium showed a smaller number of vessels with decreased diameters within the fibroid. Imaging of fluorescently stained vessels exposed a stark contrast between fluorescence within the myometrium and relatively little within the fibroid tissues. Imaging at higher magnification revealed that fibroid blood vessels were indeed perfused and stained with the lipophilic membrane dye; however, the vessels were only the size of small capillaries and the blood vessel coverage was only 12% that of the normal myometrium. The majority of sampled fibroids had a strong negative correlation (Pearson's r=-0.68 or beyond) between collagen and methylene blue staining. As methylene blue was able to passively diffuse into fibroid tissue, the true barrier to transport in these fibroids is likely high interstitial fluid pressure, correlating with high collagen content and solid stress observed in the fibroid tissue. Fibroids had an average elevated interstitial fluid pressure of 4mmHg compared to -1mmHg in normal myometrium. Our findings signify relationships between drug distribution in fibroids and between vasculature characteristics, collagen levels, and interstitial fluid pressure. Understanding these barriers to transport can lead to developments in drug delivery for the treatment of uterine fibroids and tumors of similar composition. PMID:26184049

  18. Myocardial perfusion imaging with 201Tl.

    PubMed

    Pagnanelli, Robert A; Basso, Danny A

    2010-03-01

    The object of this review is to provide information about (201)Tl-thallous chloride in radionuclide myocardial perfusion imaging. This technique has experienced a recent resurgence because of the shortage of (99m)Tc. After reading this article, the technologist will be able to describe the properties and uptake mechanism of (201)Tl, the procedure for myocardial perfusion imaging with this agent, and the advantages and disadvantages of thallium, compared with the technetium agents. PMID:20159930

  19. Improved exercise myocardial perfusion during lidoflazine therapy

    SciTech Connect

    Shapiro, W.; Narahara, K.A.; Park, J.

    1983-11-01

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a study of 6 patients with severe classic angina pectoris, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise.

  20. Methodology for ventilation/perfusion SPECT.

    PubMed

    Bajc, Marika; Neilly, Brian; Miniati, Massimo; Mortensen, Jan; Jonson, Björn

    2010-11-01

    Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices in all projections as well as in rotating volume images based upon maximum intensity projections. Probabilistic interpretation of V/Q SPECT should be replaced by a holistic interpretation strategy on the basis of all relevant information about the patient and all ventilation/perfusion patterns. PE is diagnosed when there is more than one subsegment showing a V/Q mismatch representing an anatomic lung unit. Apart from pulmonary embolism, other pathologies should be identified and reported, for example, obstructive disease, heart failure, and pneumonia. Pitfalls exist both with respect to imaging technique and scan interpretation. PMID:20920632

  1. Experiences with the magnetism of conducting loops: Historical instruments, experimental replications, and productive confusions

    NASA Astrophysics Data System (ADS)

    Cavicchi, Elizabeth

    2003-02-01

    This study investigates nineteenth century laboratory work on electromagnetism through historical accounts and experimental replications. Oersted found that when a magnetic needle was placed in varying positions around a conducting wire, its orientation changed: in moving from a spot above the wire to one below, its sense inverted. This behavior was confusing and provocative. Early experimenters such as Johann Schweigger, Johann Poggendorff, and James Cumming engaged it by bending wire into loops. These loops, which increased the magnetic effect on a compass placed within, also provided evidence of their understanding and confusion. Coiling conducting wires around iron magnetized it, but when some wires coiled oppositely from others, the effect diminished. This effect confused contemporaries of Joseph Henry who made electromagnets, and amateurs later in the century who constructed multisection induction coils. I experienced these confusions myself while working with multilayer coils and induction coils that I made to replicate the historical instruments. This study shows how confusion can be a productive element in learning, by engaging learners to ask questions and invent experiments. By providing space for learners' confusions, teachers can support the development of their students' physical understandings.

  2. Gravitational-wave confusion background from cosmological compact binaries: Implications for future terrestrial detectors

    NASA Astrophysics Data System (ADS)

    Regimbau, T.; Hughes, Scott A.

    2009-03-01

    Increasing the sensitivity of a gravitational-wave (GW) detector improves our ability to measure the characteristics of detected sources. It also increases the number of weak signals that contribute to the data. Because GW detectors have nearly all-sky sensitivity, they can be subject to a confusion limit: Many sources which cannot be distinguished may be measured simultaneously, defining a stochastic noise floor to the sensitivity. For GW detectors operating at present and for their planned upgrades, the projected event rate is sufficiently low that we are far from the confusion-limited regime. However, some detectors currently under discussion may have large enough reach to binary inspiral that they enter the confusion-limited regime. In this paper, we examine the binary inspiral confusion limit for terrestrial detectors. We consider a broad range of inspiral rates in the literature, several planned advanced gravitational-wave detectors, and the highly advanced “Einstein telescope” design. Though most advanced detectors will not be impacted by this limit, the Einstein telescope with a very low-frequency “seismic wall” may be subject to confusion noise. At a minimum, careful data analysis will be require to separate signals which will appear confused. This result should be borne in mind when designing highly advanced future instruments.

  3. The relationship between magical thinking, inferential confusion and obsessive-compulsive symptoms.

    PubMed

    Goods, N A R; Rees, C S; Egan, S J; Kane, R T

    2014-01-01

    Inferential confusion is an under-researched faulty reasoning process in obsessive-compulsive disorder (OCD). Based on an overreliance on imagined possibilities, it shares similarities with the extensively researched construct of thought-action fusion (TAF). While TAF has been proposed as a specific subset of the broader construct of magical thinking, the relationship between inferential confusion and magical thinking is unexplored. The present study investigated this relationship, and hypothesised that magical thinking would partially mediate the relationship between inferential confusion and obsessive-compulsive symptoms. A non-clinical sample of 201 participants (M = 34.94, SD = 15.88) were recruited via convenience sampling. Regression analyses found the hypothesised mediating relationship was supported, as magical thinking did partially mediate the relationship between inferential confusion and OC symptoms. Interestingly, inferential confusion had the stronger relationship with OC symptoms in comparison to the other predictor variables. Results suggest that inferential confusion can both directly and indirectly (via magical thinking) impact on OC symptoms. Future studies with clinical samples should further investigate these constructs to determine whether similar patterns emerge, as this may eventually inform which cognitive errors to target in treatment of OCD. PMID:25265223

  4. Hypothermic machine perfusion of the liver and the critical balance between perfusion pressures and endothelial injury.

    PubMed

    't Hart, N A; van der Plaats, A; Leuvenink, H G D; van Goor, H; Wiersema-Buist, J; Verkerke, G J; Rakhorst, G; Ploeg, R J

    2005-01-01

    Hypothermic machine perfusion (HMP) provides better protection against cold ischemic injury than cold storage in marginal donor kidneys. Also, in liver transplantation a switch from static cold storage to HMP could be beneficial as it would allow longer preservation times and the use of marginal donors. A critical question concerning application of HMP in liver preservation is the crucial balance between perfusion pressure and occurrence of endothelial injury. Rat livers were cold-perfused for 24 hours to study perfusion pressures for both hepatic artery and portal vein. Cold storage served as control and was compared to HMP-preserved livers using a mean arterial perfusion pressure of 25 mm Hg and a portal perfusion pressure of 4 mm Hg (25% of normothermic liver circulation) and to HMP at 50 mm Hg and 8 mm Hg perfusion, respectively (50% of normothermic liver circulation). UW solution was enriched with 14.9 micromol/L propidium iodide (PI) to stain for dead cells and with an additional 13.5 micromol/L acridine orange to stain for viable hepatocytes. A low PI-positive cell count was found using HMP at 25% of normal circulation compared to cold storage. The PI count was high for the HMP group perfused at just 50% of normal circulation compared to HMP at 25% and compared to cold storage. In summary, for liver HMP, perfusion at 25% showed complete perfusion with minimal cellular injury. HMP using perfusion pressures of 25 mm Hg for the hepatic artery and 4 mm Hg for the portal vein is feasible without induction of endothelial injury. PMID:15808634

  5. Tissue Thermal Property Reconstruction by Stopping Heating And Perfusion

    NASA Astrophysics Data System (ADS)

    Sumi, C.; Uchida, T.; Ooba, T.; Inoue, K.

    In this paper, we report robust noninvasive techniques for reconstructing the thermal properties of living tissues, such as thermal conductivity, thermal capacity and thermal diffusivity, for the diagnosis, monitoring and planning of thermal treatments such as high-intensity focus ultrasound (HIFU). Internal tissue temperature distributions can be measured using ultrasonic imaging or magnetic resonance imaging. Provided that the reference thermal properties of living tissues are given in the region of interest (ROI) as initial conditions, we can determine thermal property distributions by solving bioheat transfer equations as simultaneous first-order partial differential equations having temperature distributions as inhomogeneous coefficients. By using the reported technique, the perfusion by blood flow and thermal sources or sinks can also be reconstructed. However, in this study, we perform reconstruction after stopping heating and perfusion; only the thermal properties of living tissues can be reconstructed under such conditions. Simulations were conducted to verify the feasibility of the reconstruction. A minimally invasive thermal treatment will be realized by using our proposed reconstruction technique.

  6. Brain perfusion in acute and chronic hyperglycemia in rats

    SciTech Connect

    Kikano, G.E.; LaManna, J.C.; Harik, S.I. )

    1989-08-01

    Recent studies show that acute and chronic hyperglycemia cause a diffuse decrease in regional cerebral blood flow and that chronic hyperglycemia decreases the brain L-glucose space. Since these changes can be caused by a decreased density of perfused brain capillaries, we used 30 adult male Wistar rats to study the effect of acute and chronic hyperglycemia on (1) the brain intravascular space using radioiodinated albumin, (2) the anatomic density of brain capillaries using alkaline phosphatase histochemistry, and (3) the fraction of brain capillaries that are perfused using the fluorescein isothiocyanate-dextran method. Our results indicate that acute and chronic hyperglycemia do not affect the brain intravascular space nor the anatomic density of brain capillaries. Also, there were no differences in capillary recruitment among normoglycemic, acutely hyperglycemic, and chronically hyperglycemic rats. These results suggest that the shrinkage of the brain L-glucose space in chronic hyperglycemia is more likely due to changes in the blood-brain barrier permeability to L-glucose.

  7. Noninvasive cerebral perfusion imaging in high-risk neonates.

    PubMed

    Goff, Donna A; Buckley, Erin M; Durduran, Turgut; Wang, Jiongjong; Licht, Daniel J

    2010-02-01

    Advances in medical and surgical care of the high-risk neonate have led to increased survival. A significant number of these neonates suffer from neurodevelopmental delays and failure in school. The focus of clinical research has shifted to understanding events contributing to neurological morbidity in these patients. Assessing changes in cerebral oxygenation and regulation of cerebral blood flow (CBF) is important in evaluating the status of the central nervous system. Traditional CBF imaging methods fail for both ethical and logistical reasons. Optical near infrared spectroscopy (NIRS) is increasingly being used for bedside monitoring of cerebral oxygenation and blood volume in both very low birth weight infants and neonates with congenital heart disease. Although trends in CBF may be inferred from changes in cerebral oxygenation and/or blood volume, NIRS does not allow a direct measure of CBF in these populations. Two relatively new modalities, arterial spin-labeled perfusion magnetic resonance imaging and optical diffuse correlation spectroscopy, provide direct, noninvasive measures of cerebral perfusion suitable for the high-risk neonates. Herein we discuss the instrumentation, applications, and limitations of these noninvasive imaging techniques for measuring and/or monitoring CBF. PMID:20109972

  8. Perfusion measures from dynamic ICG scanning laser ophthalmoscopy

    NASA Astrophysics Data System (ADS)

    Larkin, Sean; Invernizzi, Alessandro; Beecher, David; Staurenghi, Giovanni; Holmes, Tim

    2010-02-01

    Movies acquired from fundus imaging using Indocyanine Green (ICG) and a scanning laser ophthalmoscope provide information for identifying vascular and other retinal abnormalities. Today, the main limitation of this modality is that it requires esoteric training for interpretation. A straightforward interpretation of these movies by objective measurements would aid in eliminating this training barrier. A software program has been developed and tested that produces and visualizes 2D maps of perfusion measures. The program corrects for frame-to-frame misalignment caused by eye motion, including rigid misalignment and warp. The alignment method uses a cross-correlation operation that automatically detects the distance due to motion between adjacent frames. The d-ICG movie is further corrected by removing flicker and vignetting artifacts. Each pixel in the corrected movie sequence is fit with a least-squares spline to yield a smooth intensity temporal profile. From the dynamics of these intensity curves, several perfusion measures are calculated. The most effective of these measures include a metric that represents the amount of time required for a vessel to fill with dye, a metric that represents the diffusion of dye, and a metric that is affected by local blood volume. These metrics are calculated from movies acquired before and after treatment for a neovascular condition. A comparison of these before and after measures may someday provide information to the clinician that helps them to evaluate disease progression and response to treatment.

  9. [Pulmonary ventilation/perfusion ratio].

    PubMed

    Guenard, H

    1987-01-01

    The ratios of ventilatory (V) and perfusion (Q) flow rates in the lung are to a large extent responsible for the efficiency of gas exchange. In a simplified monocompartmental model of the lung, the arterial partial pressure of a given gas (Pa) is a function of several factors: the solubility of this gas in blood, its venous and inspired partial pressures and the V/Q ratio. In a multicompartemental model, the mean arterial partial pressure of the gas is a function of the individual values of Pa in each compartment as well as the distribution of V/Q ratios in the lung and the relationship between the concentration and the partial pressure of the gas. The heterogeneity of the distribution of V/Q results from those of both V and Q. Two factors are mainly responsible for this heterogeneity: the gravity and the morphometric characteristics of bronchi and vessels. V/Q ratios are partially controlled at least in low V/Q compartments since hypoxia in these compartments leads to pulmonary arteriolar vasoconstriction. However lungs V/Q ratios range from 0.1 to 10 with a mode around 1. Age, muscular exercise, posture, accelerations, anesthesia, O2 breathing, pulmonary pathology are factors which may alter the distribution of V/Q ratios. PMID:3332289

  10. Fluorescence-based enhanced reality (FLER) for real-time estimation of bowel perfusion in minimally invasive surgery

    NASA Astrophysics Data System (ADS)

    Diana, Michele

    2016-03-01

    Pre-anastomotic bowel perfusion is a key factor for a successful healing process. Clinical judgment has limited accuracy to evaluate intestinal microperfusion. Fluorescence videography is a promising tool for image-guided intraoperative assessment of the bowel perfusion at the future anastomotic site in the setting of minimally invasive procedures. The standard configuration for fluorescence videography includes a Near-Infrared endoscope able to detect the signal emitted by a fluorescent dye, more frequently Indocyanine Green (ICG), which is administered by intravenous injection. Fluorescence intensity is proportional to the amount of fluorescent dye diffusing in the tissue and consequently is a surrogate marker of tissue perfusion. However, fluorescence intensity alone remains a subjective approach and an integrated computer-based analysis of the over-time evolution of the fluorescence signal is required to obtain quantitative data. We have developed a solution integrating computer-based analysis for intra-operative evaluation of the optimal resection site, based on the bowel perfusion as determined by the dynamic fluorescence intensity. The software can generate a "virtual perfusion cartography", based on the "fluorescence time-to-peak". The virtual perfusion cartography can be overlapped onto real-time laparoscopic images to obtain the Enhanced Reality effect. We have defined this approach FLuorescence-based Enhanced Reality (FLER). This manuscript describes the stepwise development of the FLER concept.

  11. Effects of Steroid Hormones on Sex Differences in Cerebral Perfusion

    PubMed Central

    Ghisleni, Carmen; Bollmann, Steffen; Biason-Lauber, Anna; Poil, Simon-Shlomo; Brandeis, Daniel; Martin, Ernst; Michels, Lars; Hersberger, Martin; Suckling, John

    2015-01-01

    Sex differences in the brain appear to play an important role in the prevalence and progression of various neuropsychiatric disorders, but to date little is known about the cerebral mechanisms underlying these differences. One widely reported finding is that women demonstrate higher cerebral perfusion than men, but the underlying cause of this difference in perfusion is not known. This study investigated the putative role of steroid hormones such as oestradiol, testosterone, and dehydroepiandrosterone sulphate (DHEAS) as underlying factors influencing cerebral perfusion. We acquired arterial spin labelling perfusion images of 36 healthy adult subjects (16 men, 20 women). Analyses on average whole brain perfusion levels included a multiple regression analysis to test for the relative impact of each hormone on the global perfusion. Additionally, voxel-based analyses were performed to investigate the sex difference in regional perfusion as well as the correlations between local perfusion and serum oestradiol, testosterone, and DHEAS concentrations. Our results replicated the known sex difference in perfusion, with women showing significantly higher global and regional perfusion. For the global perfusion, DHEAS was the only significant predictor amongst the steroid hormones, showing a strong negative correlation with cerebral perfusion. The voxel-based analyses revealed modest sex-dependent correlations between local perfusion and testosterone, in addition to a strong modulatory effect of DHEAS in cortical, subcortical, and cerebellar regions. We conclude that DHEAS in particular may play an important role as an underlying factor driving the difference in cerebral perfusion between men and women. PMID:26356576

  12. GPU-accelerated voxelwise hepatic perfusion quantification.

    PubMed

    Wang, H; Cao, Y

    2012-09-01

    Voxelwise quantification of hepatic perfusion parameters from dynamic contrast enhanced (DCE) imaging greatly contributes to assessment of liver function in response to radiation therapy. However, the efficiency of the estimation of hepatic perfusion parameters voxel-by-voxel in the whole liver using a dual-input single-compartment model requires substantial improvement for routine clinical applications. In this paper, we utilize the parallel computation power of a graphics processing unit (GPU) to accelerate the computation, while maintaining the same accuracy as the conventional method. Using compute unified device architecture-GPU, the hepatic perfusion computations over multiple voxels are run across the GPU blocks concurrently but independently. At each voxel, nonlinear least-squares fitting the time series of the liver DCE data to the compartmental model is distributed to multiple threads in a block, and the computations of different time points are performed simultaneously and synchronically. An efficient fast Fourier transform in a block is also developed for the convolution computation in the model. The GPU computations of the voxel-by-voxel hepatic perfusion images are compared with ones by the CPU using the simulated DCE data and the experimental DCE MR images from patients. The computation speed is improved by 30 times using a NVIDIA Tesla C2050 GPU compared to a 2.67 GHz Intel Xeon CPU processor. To obtain liver perfusion maps with 626 400 voxels in a patient's liver, it takes 0.9 min with the GPU-accelerated voxelwise computation, compared to 110 min with the CPU, while both methods result in perfusion parameters differences less than 10(-6). The method will be useful for generating liver perfusion images in clinical settings. PMID:22892645

  13. FATTY ACID CHAIN-ELONGATION IN PERFUSED RAT HEART: SYNTHESIS OF STEAROYLCARNITINE FROM PERFUSED PALMITATE

    PubMed Central

    Kerner, Janos; Minkler, Paul E.; Lesnefsky, Edward J.; Hoppel, Charles L.

    2009-01-01

    Rat hearts perfused for up to 60 min in the working mode with palmitate, but not with glucose, resulted in substantial formation of palmitoylcarnitine and stearoylcarnitine. To test whether lipolysis of endogenous lipids was responsible for the increased stearoylcarnitine content or whether some of the perfused palmitate underwent chain elongation, hearts were perfused with hexadecanoic-16,16,16-d3 acid (M+3). The pentafluorophenacyl ester of deuterium labeled stearoylcarnitine had an M+3 (639.4 m/z) compared to the unlabeled M+0 (636.3 m/z) consistent with a direct chain elongation of the perfused palmitate. Furthermore, the near equal isotope enrichment of palmitoyl- (90.2 ± 5.8 %) and stearoylcarnitine (78.0 ± 7.1 %) suggest that both palmitoyl- and stearoyl-CoA have ready access to mitochondrial carnitine palmitoyltransferase and that most of the stearoylcarnitine is derived from the perfused palmitate. PMID:17761175

  14. Radionuclide cerebral perfusion imaging: Normal pattern

    SciTech Connect

    Goldsmith, S.J.; Stritzke, P.; Losonczy, M.; Vallabhajosula, S.; Holan, V.; DaCosta, M.; Muzinic, M.

    1991-12-31

    Regional cerebral perfusion imaging using a new class of {sup 99m}Tc and {sup 123}I labeled compounds which traverse the blood brain barrier and SPECT imaging technology provides an opportunity to assess this physiologic phenomenon during normal cerebral function and as a manifestation of disease in the central nervous system disease. These applications pose a challenge to the nuclear medicine physician for several reasons: (a) the complex and somewhat unfamiliar functional anatomy, (b) the marked regional differences in regional cerebral perfusion at rest, (c) the lack of understanding of the effect of variations in ambient conditions on regional cerebral perfusion. The difficulties in interpretation are augmented by the display itself. There is frequently no difficulty in differentiating between gray and white matter. However, the frequently used {open_quotes}hot body{close_quotes} color maps, introduce a good deal of contrast, producing displays with apparent interruption in regional cortical perfusion whereas black and white displays provide minimal contrast in the regional cortical activity. The authors sought to define how much variation in regional cerebral perfusion is {open_quotes}allowed{close_quotes} under controlled conditions, to establish a basis to interpret if changes in the environment, psychological interventions, or disease states are accompanied by a measurable change. 2 figs., 1 tab.

  15. Pulmonary perfusion during anesthesia and mechanical ventilation.

    PubMed

    Hedenstierna, G

    2005-06-01

    Cardiac output and the pulmonary perfusion can be affected by anesthesia and by mechanical ventilation. The changes contribute to impeded oxygenation of the blood. The major determinant of perfusion distribution in the lung is the relation between alveolar and pulmonary capillary pressures. Perfusion increases down the lung, due to hydrostatic forces. Since atelectasis is located in dependent lung regions, perfusion of non-ventilated lung parenchyma is common, producing shunt of around 8-10% of cardiac output. In addition, non-gravitational inhomogeneity of perfusion, that can be greater than the gravitational inhomogeneity, adds to impeded oxygenation of blood. Essentially all anaesthetics exert some, although mild, cardiodepressant action with one exception, ketamine. Ketamine may also increase pulmonary artery pressure, whereas other agents have little effect on pulmonary vascular tone. Mechanical ventilation impedes venous return and pushes blood flow downwards to dependent lung regions, and the effect may be striking with higher levels of PEEP. During one-lung anesthesia, there is shunt blood flow both in the non-ventilated and the ventilated lung, and shunt can be much larger in the ventilated lung than thought of. Recruitment manoeuvres shall be directed to the ventilated lung and other physical and pharmacological measures can be taken to manipulate blood flow in one lung anesthesia. PMID:15886595

  16. Perfusion harmonic imaging of the human brain

    NASA Astrophysics Data System (ADS)

    Metzler, Volker H.; Seidel, Guenter; Wiesmann, Martin; Meyer, Karsten; Aach, Til

    2003-05-01

    The fast visualisation of cerebral microcirculation supports diagnosis of acute cerebrovascular diseases. However, the commonly used CT/MRI-based methods are time consuming and, moreover, costly. Therefore we propose an alternative approach to brain perfusion imaging by means of ultrasonography. In spite of the low signal/noise-ratio of transcranial ultrasound and the high impedance of the skull, flow images of cerebral blood flow can be derived by capturing the kinetics of appropriate contrast agents by harmonic ultrasound image sequences. In this paper we propose three different methods for human brain perfusion imaging, each of which yielding flow images indicating the status of the patient's cerebral microcirculation by visualising local flow parameters. Bolus harmonic imaging (BHI) displays the flow kinetics of bolus injections, while replenishment (RHI) and diminution harmonic imaging (DHI) compute flow characteristics from contrast agent continuous infusions. RHI measures the contrast agents kinetics in the influx phase and DHI displays the diminution kinetics of the contrast agent acquired from the decay phase. In clinical studies, BHI- and RHI-parameter images were found to represent comprehensive and reproducible distributions of physiological cerebral blood flow. For DHI it is shown, that bubble destruction and hence perfusion phenomena principally can be displayed. Generally, perfusion harmonic imaging enables reliable and fast bedside imaging of human brain perfusion. Due to its cost efficiency it complements cerebrovascular diagnostics by established CT/MRI-based methods.

  17. A NOVEL TECHNIQUE TO IMPROVE PHOTOMETRY IN CONFUSED IMAGES USING GRAPHS AND BAYESIAN PRIORS

    SciTech Connect

    Safarzadeh, Mohammadtaher; Ferguson, Henry C.; Lu, Yu; Inami, Hanae; Somerville, Rachel S.

    2015-01-10

    We present a new technique for overcoming confusion noise in deep far-infrared Herschel space telescope images making use of prior information from shorter λ < 2 μm wavelengths. For the deepest images obtained by Herschel, the flux limit due to source confusion is about a factor of three brighter than the flux limit due to instrumental noise and (smooth) sky background. We have investigated the possibility of de-confusing simulated Herschel PACS 160 μm images by using strong Bayesian priors on the positions and weak priors on the flux of sources. We find the blended sources and group them together and simultaneously fit their fluxes. We derive the posterior probability distribution function of fluxes subject to these priors through Monte Carlo Markov Chain (MCMC) sampling by fitting the image. Assuming we can predict the FIR flux of sources based on the ultraviolet-optical part of their SEDs to within an order of magnitude, the simulations show that we can obtain reliable fluxes and uncertainties at least a factor of three fainter than the confusion noise limit of 3σ {sub c} = 2.7 mJy in our simulated PACS-160 image. This technique could in principle be used to mitigate the effects of source confusion in any situation where one has prior information of positions and plausible fluxes of blended sources. For Herschel, application of this technique will improve our ability to constrain the dust content in normal galaxies at high redshift.

  18. Spectroscopic confusion: its impact on current and future extragalactic H I surveys

    NASA Astrophysics Data System (ADS)

    Jones, Michael G.; Papastergis, Emmanouil; Haynes, Martha P.; Giovanelli, Riccardo

    2015-05-01

    We present a comprehensive model to predict the rate of spectroscopic confusion in H I surveys, and demonstrate good agreement with the observable confusion in existing surveys. Generically the action of confusion on the H I mass function was found to be a suppression of the number count of sources below the `knee', and an enhancement above it. This results in a bias, whereby the `knee' mass is increased and the faint end slope is steepened. For ALFALFA and HIPASS, we find that the maximum impact this bias can have on the Schechter fit parameters is similar in magnitude to the published random errors. On the other hand, the impact of confusion on the H I mass functions of upcoming medium depth interferometric surveys, will be below the level of the random errors. In addition, we find that previous estimates of the number of detections for upcoming surveys with Square Kilometre Array-precursor telescopes may have been too optimistic, as the framework implemented here results in number counts between 60 and 75 per cent of those previously predicted, while accurately reproducing the counts of existing surveys. Finally, we argue that any future single dish, wide area surveys of H I galaxies would be best suited to focus on deep observations of the local Universe (z < 0.05), as confusion may prevent them from being competitive with interferometric surveys at higher redshift, while their lower angular resolution allows their completeness to be more easily calibrated for nearby extended sources.

  19. Effect of methotrexate on perfusion and nitrogen-13 glutamate uptake in the Walker-256 carcinosarcoma

    SciTech Connect

    Knapp, W.H.; Panzer, M.; Helus, F.; Layer, K.; Sinn, H.J.; Ostertag, H.

    1988-02-01

    The tissue uptake of (/sup 13/N)glutamate (glu) was related to that of (/sup 11/C)butanol (but), a highly diffusible perfusion tracer. In 25 rats bearing Walker-256 carcinomas tumor-to-muscle glu uptake averaged 6.34 +/- 2.84 (s.d.) prior to interventions and the respective uptake of but was 6.79 +/- 3.08 (y = 0.03 + 0.94x). One hour after selective intraarterial administration of methotrexate (mtx), glu uptake fell by 47%, whereas blood flow remained within the pretreatment range (N = 9). Four hours after mtx, perfusion was reduced by approximately 40%, and 2 days later both perfusion and glu uptake reached extremely low levels. No significant difference in the effect of 10 and 50 mg/kg mtx was observed. Regional tissue mtx uptake estimations using /sup 77/Br-labeled bromomethotrexate did not reveal any significant uptake in muscle. The relationship between tumor-to-muscle uptake of glu and but (/sup 13/N//sup 11/C-index) was 0.94 +/- 0.015 (s.e.m., N = 25) before intervention. After methotrexate (1 hr, 4 hr, and 2 days) this index was 0.58 +/- 0.06 (N = 9), and 0.85 +/- 0.04 (N = 11) and 1.03 +/- 0.05 (N = 5), respectively. These values demonstrate an early mtx-induced uncoupling of glu uptake with respect to perfusion.

  20. In vitro performance of a perfusion and oxygenation optical sensor using a unique liver phantom

    NASA Astrophysics Data System (ADS)

    Akl, Tony J.; King, Travis J.; Long, Ruiqi; Ericson, M. N.; Wilson, Mark A.; McShane, Michael J.; Coté, Gerard L.

    2012-03-01

    Between the years 1999 and 2008, on average 2,052 people died per year on the waiting list for liver transplants. Monitoring perfusion and oxygenation in transplanted organs in the 7 to 14 days period post-transplant can enhance graft and patient survival rates, and resultantly increase the availability of organs. In this work, we present in vitro results using a unique liver phantom that support the ability of our sensor to detect perfusion changes in the portal vein at low levels (50 mL/min . 4.5% of normal level). Our sensor measures diffuse reflection from three wavelengths (735, 805 and 940 nm) around the hemoglobin isobestic point (805 nm) to determine perfusion and oxygenation separately. To assess the sensitivity of our sensor to flow changes in the low range, we used two peristaltic pumps to pump a dye solution mimicking the optical properties of oxygenated blood, at various rates, through a PDMS based phantom mimicking the optical properties of liver tissue. The collected pulsatile signal increased by 120% (2.2X) for every 100 mL/min flow rise for all three wavelengths in the range 50 to 500 mL/min. In addition, we used different dye mixtures to mimic oxygenation changes at constant perfusion/flow levels. The optical properties of the dye mixtures mimic oxygen saturations ranging between 0 and 100%. The sensor was shown to be sensitive to changes in oxygen saturations above 50%.

  1. In vivo perfusion assessment of an anastomosis surgery on porcine intestinal model (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Le, Hanh N. D.; Opferman, Justin; Decker, Ryan; Cheon, Gyeong W.; Kim, Peter C. W.; Kang, Jin U.; Krieger, Axel

    2016-04-01

    Anastomosis, the connection of two structures, is a critical procedure for reconstructive surgery with over 1 million cases/year for visceral indication alone. However, complication rates such as strictures and leakage affect up to 19% of cases for colorectal anastomoses and up to 30% for visceral transplantation anastomoses. Local ischemia plays a critical role in anastomotic complications, making blood perfusion an important indicator for tissue health and predictor for healing following anastomosis. In this work, we apply a real time multispectral imaging technique to monitor impact on tissue perfusion due to varying interrupted suture spacing and suture tensions. Multispectral tissue images at 470, 540, 560, 580, 670 and 760 nm are analyzed in conjunction with an empirical model based on diffuse reflectance process to quantify the hemoglobin oxygen saturation within the suture site. The investigated tissues for anastomoses include porcine small (jejunum and ileum) and large (transverse colon) intestines. Two experiments using interrupted suturing with suture spacing of 1, 2, and 3 mm and tension levels from 0 N to 2.5 N are conducted. Tissue perfusion at 5, 10, 20 and 30 min after suturing are recorded and compared with the initial normal state. The result indicates the contrast between healthy and ischemic tissue areas and assists the determination of suturing spacing and tension. Therefore, the assessment of tissue perfusion will permit the development and intra-surgical monitoring of an optimal suture protocol during anastomosis with less complications and improved functional outcome.

  2. Whole-Brain CT Perfusion to Quantify Acute Ischemic Penumbra and Core.

    PubMed

    Lin, Longting; Bivard, Andrew; Krishnamurthy, Venkatesh; Levi, Christopher R; Parsons, Mark W

    2016-06-01

    Purpose To validate the use of perfusion computed tomography (CT) with whole-brain coverage to measure the ischemic penumbra and core and to compare its performance to that of limited-coverage perfusion CT. Materials and Methods Institutional ethics committee approval and informed consent were obtained. Patients (n = 296) who underwent 320-detector CT perfusion within 6 hours of the onset of ischemic stroke were studied. First, the ischemic volume at CT perfusion was compared with the penumbra and core reference values at magnetic resonance (MR) imaging to derive CT perfusion penumbra and core thresholds. Second, the thresholds were tested in a different group of patients to predict the final infarction at diffusion-weighted imaging 24 hours after CT perfusion. Third, the change in ischemic volume delineated by the optimal penumbra and core threshold was determined as the brain coverage was gradually reduced from 160 mm to 20 mm. The Wilcoxon signed-rank test, concordance correlation coefficient (CCC), and analysis of variance were used for the first, second, and third steps, respectively. Results CT perfusion at penumbra and core thresholds resulted in the least volumetric difference from MR imaging reference values with delay times greater than 3 seconds and delay-corrected cerebral blood flow of less than 30% (P = .34 and .33, respectively). When the thresholds were applied to the new group of patients, prediction of the final infarction was allowed with delay times greater than 3 seconds in patients with no recanalization of the occluded artery (CCC, 0.96 [95% confidence interval: 0.92, 0.98]) and with delay-corrected cerebral blood flow less than 30% in patients with complete recanalization (CCC, 0.91 [95% confidence interval: 0.83, 0.95]). However, the ischemic volume with a delay time greater than 3 seconds was underestimated when the brain coverage was reduced to 80 mm (P = .04) and the core volume measured as cerebral blood flow less than 30% was

  3. Cardiac tissue engineering using perfusion bioreactor systems

    PubMed Central

    Radisic, Milica; Marsano, Anna; Maidhof, Robert; Wang, Yadong; Vunjak-Novakovic, Gordana

    2009-01-01

    This protocol describes tissue engineering of synchronously contractile cardiac constructs by culturing cardiac cell populations on porous scaffolds (in some cases with an array of channels) and bioreactors with perfusion of culture medium (in some cases supplemented with an oxygen carrier). The overall approach is ‘biomimetic’ in nature as it tends to provide in vivo-like oxygen supply to cultured cells and thereby overcome inherent limitations of diffusional transport in conventional culture systems. In order to mimic the capillary network, cells are cultured on channeled elastomer scaffolds that are perfused with culture medium that can contain oxygen carriers. The overall protocol takes 2–4 weeks, including assembly of the perfusion systems, preparation of scaffolds, cell seeding and cultivation, and on-line and end-point assessment methods. This model is well suited for a wide range of cardiac tissue engineering applications, including the use of human stem cells, and high-fidelity models for biological research. PMID:18388955

  4. Perfusion and ventilation of isolated canine lungs

    PubMed Central

    Otto, T. J.; Trenkner, M.; Stopczyk, A.; Gawdziński, M.; Chełstowska, B.

    1968-01-01

    In order to evaluate methods of preserving lungs for use in transplantation, experiments on 28 mongrel dogs were carried out. Two methods were tried—first, mechanical respiration of isolated lungs under deep hypothermia, with the vascular bed filled with blood; and, secondly, the perfusion of isolated lungs with the aid of a modified DeWall's apparatus. Allogenic transplantations of lungs preserved in both ways were carried out. Gasometric and histological examinations of preserved lungs, before and after transplantation, were performed. The best results were obtained with perfusion under hypothermic conditions; ventilation without perfusion resulted in failure. Lung transplantation was successful when, after being preserved, the lung remained unchanged. Major discrepancies between the macroscopic and microscopic findings in preserved lungs were observed. An original classification of the changes occurring in preserved lungs is proposed. PMID:4886091

  5. Perfusion in Britain: the early days.

    PubMed

    Braimbridge, Mark V

    2004-07-01

    Experimental perfusion was largely the province of Germany in the nineteenth century but in the mid-twentieth century the focus of perfusion switched to the USA with the explosive clinical advances of Lillehei, Kirklin and Cooley. British clinical perfusion started with Melrose in 1953 at the Postgraduate Medical School in London but, as in other centres at that time, stopped due to the high mortality. The arrival of hands-on experience of American expertise via returning research fellows and other visitors to the USA enabled the first successful on-going series to begin at the Hammersmith Hospital with Cleland in 1957 and then to spread around the country. The various problems of those early 1950s days are described in the units starting then. PMID:15376765

  6. Myocardial perfusion scintigraphy: the evidence.

    PubMed

    Underwood, S R; Anagnostopoulos, C; Cerqueira, M; Ell, P J; Flint, E J; Harbinson, M; Kelion, A D; Al-Mohammad, A; Prvulovich, E M; Shaw, L J; Tweddel, A C

    2004-02-01

    This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by

  7. Biomimetic direction of arrival estimation for resolving front-back confusions in hearing aids.

    PubMed

    Archer-Boyd, Alan W; Whitmer, William M; Brimijoin, W Owen; Soraghan, John J

    2015-05-01

    Sound sources at the same angle in front or behind a two-microphone array (e.g., bilateral hearing aids) produce the same time delay and two estimates for the direction of arrival: A front-back confusion. The auditory system can resolve this issue using head movements. To resolve front-back confusion for hearing-aid algorithms, head movement was measured using an inertial sensor. Successive time-delay estimates between the microphones are shifted clockwise and counterclockwise by the head movement between estimates and aggregated in two histograms. The histogram with the largest peak after multiple estimates predicted the correct hemifield for the source, eliminating the front-back confusions. PMID:25994734

  8. Biomimetic direction of arrival estimation for resolving front-back confusions in hearing aids

    PubMed Central

    Archer-Boyd, Alan W.; Whitmer, William M.; Brimijoin, W. Owen; Soraghan, John J.

    2015-01-01

    Sound sources at the same angle in front or behind a two-microphone array (e.g., bilateral hearing aids) produce the same time delay and two estimates for the direction of arrival: A front-back confusion. The auditory system can resolve this issue using head movements. To resolve front-back confusion for hearing-aid algorithms, head movement was measured using an inertial sensor. Successive time-delay estimates between the microphones are shifted clockwise and counterclockwise by the head movement between estimates and aggregated in two histograms. The histogram with the largest peak after multiple estimates predicted the correct hemifield for the source, eliminating the front-back confusions. PMID:25994734

  9. Characteristics of Patients Who Report Confusion After Reading Their Primary Care Clinic Notes Online.

    PubMed

    Root, Joseph; Oster, Natalia V; Jackson, Sara L; Mejilla, Roanne; Walker, Jan; Elmore, Joann G

    2016-01-01

    Patient access to online electronic medical records (EMRs) is increasing and may offer benefits to patients. However, the inherent complexity of medicine may cause confusion. We elucidate characteristics and health behaviors of patients who report confusion after reading their doctors' notes online. We analyzed data from 4,528 patients in Boston, MA, central Pennsylvania, and Seattle, WA, who were granted online access to their primary care doctors' clinic notes and who viewed at least one note during the 1-year intervention. Three percent of patients reported confusion after reading their visit notes. These patients were more likely to be at least 70 years of age (p < .0001), have fewer years of education (p < .0017), be unemployed (p < .0001), have lower levels of self-reported health (p < .0043), and worry more after reading visit notes (relative risk [RR] 4.83; confidence interval [CI] 3.17, 7.36) compared to patients who were not confused. In adjusted analyses, they were less likely to report feeling more in control of their health (RR 0.42; CI 0.25, 0.71), remembering their care plan (RR 0.26; CI 0.17, 0.42), and understanding their medical conditions (RR 0.32; CI 0.19, 0.54) as a result of reading their doctors' notes compared to patients who were not confused. Patients who were confused by reading their doctors' notes were less likely to report benefits in health behaviors. Understanding this small subset of patients is a critical step in reducing gaps in provider-patient communication and in efforts to tailor educational approaches for patients. PMID:26529325

  10. Indication Alerts Intercept Drug Name Confusion Errors during Computerized Entry of Medication Orders

    PubMed Central

    Galanter, William L.; Bryson, Michelle L.; Falck, Suzanne; Rosenfield, Rachel; Laragh, Marci; Shrestha, Neeha; Schiff, Gordon D.; Lambert, Bruce L.

    2014-01-01

    Background Confusion between similar drug names is a common cause of potentially harmful medication errors. Interventions to prevent these errors at the point of prescribing have had limited success. The purpose of this study is to measure whether indication alerts at the time of computerized physician order entry (CPOE) can intercept drug name confusion errors. Methods and Findings A retrospective observational study of alerts provided to prescribers in a public, tertiary hospital and ambulatory practice with medication orders placed using CPOE. Consecutive patients seen from April 2006 through February 2012 were eligible if a clinician received an indication alert during ordering. A total of 54,499 unique patients were included. The computerized decision support system prompted prescribers to enter indications when certain medications were ordered without a coded indication in the electronic problem list. Alerts required prescribers either to ignore them by clicking OK, to place a problem in the problem list, or to cancel the order. Main outcome was the proportion of indication alerts resulting in the interception of drug name confusion errors. Error interception was determined using an algorithm to identify instances in which an alert triggered, the initial medication order was not completed, and the same prescriber ordered a similar-sounding medication on the same patient within 5 minutes. Similarity was defined using standard text similarity measures. Two clinicians performed chart review of all cases to determine whether the first, non-completed medication order had a documented or non-documented, plausible indication for use. If either reviewer found a plausible indication, the case was not considered an error. We analyzed 127,458 alerts and identified 176 intercepted drug name confusion errors, an interception rate of 0.14±.01%. Conclusions Indication alerts intercepted 1.4 drug name confusion errors per 1000 alerts. Institutions with CPOE should consider

  11. Object Sizes from Reionization to the Present, and the Natural Confusion Limit Expected in Ultradeep Surveys

    NASA Astrophysics Data System (ADS)

    Windhorst, R.; Cohen, S.; Jansen, R.; Odewahn, S.; Driver, S.; Kawata, D.; Gibson, B.; Gardner, J. P.; Hopkins, A.

    2002-12-01

    We discuss the ph natural confusion limit for the 6m James Webb Space Telescope (JWST; launch planned in 2010), and for the Square Kilometer Array (SKA; becoming reality in a decade). First, we summarize the observed half-light radius vs. flux relation for the galaxy population from the RC3 level to the HDF limit. Together with size estimates from hierarchical models fainter than J(1.35μ )AB~=28 mag and model extrapolations of the faint galaxy counts from JAB~=28 to 34 mag, we estimate the ph natural confusion limit for JWST due to the finite object sizes. A rather unexpected result is that for ultradeep surveys with ~=0.1" FWHM resolution, the ph natural confusion limit may become ph more important in the definition of faint source samples than the traditional surface brightness (SB) limits. This may already be somewhat visible in the deepest HDF images for AB>=25 mag. This does, however, ph not mean that the deepest JWST samples will be fundamentally limited by ph natural confusion. Instead, for JAB>=28--30 mag, faint objects seen by JWST are likely mostly unresolved at 0.08" FWHM. In this case, the deepest JWST images will be limited only by ph instrumental confusion (i.e., by the telescope FWHM), which doesn't set in until around JAB>=33.5 mag. Last, we compute the SKA ph natural confusion limit from the JWST results, assuming that the same population of faint irregular, peculiar and merging/star-forming objects that dominates the faint galaxy counts likely dominates the radio source counts at nanoJansky levels. The SKA will need to have resolutions better than 50--100 m.a.s. (FWHM) to not run into the ph instrumental confusion limit at nanoJy levels. At S1.4~=10 nanoJy, the SKA will likely not run into the ph natural confusion limit, ph if the slope of the nanoJy counts remains below γ <=1.7 ph and if the ratio of radio to optical--near-IR sizes remains close to unity. We acknowledge funding from NASA Grant NAG5-12460.

  12. Subsyllabic structure reflected in letter confusability effects in Korean word recognition.

    PubMed

    Lee, Chang H; Taft, Marcus

    2011-02-01

    Korean subsyllabic structure was investigated by observing the pattern of responses arising from letter transpositions within a syllable in the Hangul script. Experiment 1 revealed no confusions when the onset and coda of one syllable of a disyllabic word were transposed. This was also the case in Experiment 2, where the transposition took place within a syllable having a coda composed of two consonants. However, confusion with the baseword was observed when the two consonants within the complex coda were themselves transposed. These results are taken to support the view that Hangul (and possibly all concatenating orthographic scripts) is processed based on its onset, vowel, and coda structure. PMID:21327354

  13. Holographic diffusers

    NASA Astrophysics Data System (ADS)

    Wadle, Stephen; Wuest, Daniel; Cantalupo, John; Lakes, Roderic S.

    1994-01-01

    Holographic diffusers are prepared using silver halide (Agfa 8E75 and Kodak 649F) and photopolymer (Polaroid DMP 128 and DuPont 600, 705, and 150 series) media. It is possible to control the diffusion angle in three ways: by selection of the properties of the source diffuser, by control of its subtended angle, and by selection of the holographic medium. Several conventional diffusers based on refraction or scattering of light are examined for comparison.

  14. Effects of laser acupuncture on blood perfusion rate

    NASA Astrophysics Data System (ADS)

    Wang, Xian-ju; Zeng, Chang-chun; Liu, Han-ping; Liu, Song-hao; Liu, Liang-gang

    2006-09-01

    Based on Pennes equation, the influences of the intensity and the impulse frequency of laser acupuncture on the point tissues' blood flow perfusion rate are discussed. We find that the blood perfusion rate of point tissue increases with the intensity of laser acupuncture increasing. After impulse laser acupuncture the point tissue blood perfusion rate increase little, but after continuum laser acupuncture the point tissues blood perfusion rate increase much.

  15. Diffusion MRI

    NASA Astrophysics Data System (ADS)

    Fukuyama, Hidenao

    Recent advances of magnetic resonance imaging have been described, especially stressed on the diffusion sequences. We have recently applied the diffusion sequence to functional brain imaging, and found the appropriate results. In addition to the neurosciences fields, diffusion weighted images have improved the accuracies of clinical diagnosis depending upon magnetic resonance images in stroke as well as inflammations.

  16. The prognostic value of non-perfusion variables obtained during vasodilator stress myocardial perfusion imaging.

    PubMed

    Bajaj, Navkaranbir S; Singh, Siddharth; Farag, Ayman; El-Hajj, Stephanie; Heo, Jack; Iskandrian, Ami E; Hage, Fadi G

    2016-06-01

    Myocardial perfusion imaging (MPI) is an established diagnostic test that provides useful prognostic data in patients with known or suspected coronary artery disease. In more than half of the patients referred for stress testing, vasodilator stress is used in lieu of exercise. Unlike exercise, vasodilator stress does not provide information on exercise and functional capacity, heart rate recovery, and chronotropy, and ECG changes are less frequent. These non-perfusion data provide important prognostic and patient management information. Further, event rates in patients undergoing vasodilator MPI are higher than in those undergoing exercise MPI and even in those with normal images probably due to higher pretest risk. However, there are a number of non-perfusion variables that are obtained during vasodilator stress testing, which have prognostic relevance but their use has not been well emphasized. The purpose of this review is to summarize the prognostic values of these non-perfusion data obtained during vasodilator MPI. PMID:26940574

  17. Gradient-enhanced FAWSETS perfusion measurements

    NASA Astrophysics Data System (ADS)

    Marro, Kenneth I.; Lee, Donghoon; Hyyti, Outi M.

    2005-08-01

    This work describes the use of custom-built gradients to enhance skeletal muscle perfusion measurements acquired with a previously described arterial spin labeling technique known as FAWSETS (flow-driven arterial water stimulation with elimination of tissue signal). Custom-built gradients provide active control of the static magnetic field gradient on which FAWSETS relies for labeling. This allows selective, 180° modulations of the phase of the perfusion component of the signal. Phase cycling can then be implemented to eliminate all extraneous components leaving a signal that exclusively reflects capillary-level perfusion. Gradient-enhancement substantially reduces acquisition time and eliminates the need to acquire an ischemic signal to quantify perfusion. This removes critical obstacles to application of FAWSETS in organs other than skeletal muscle and makes the measurements more desirable for clinical environments. The basic physical principles of gradient-enhancement are demonstrated in flow phantom experiments and in vivo utility is demonstrated in rat hind limb during stimulated exercise.

  18. Urate synthesis in the perfused chick liver

    PubMed Central

    Barratt, Eileen; Buttery, Peter J.; Boorman, K. Neil

    1974-01-01

    Urate synthesis was studied in a perfused chicken liver preparation. The perfused liver had an ATP/ADP ratio of 0.29±0.05(6) compared with 0.34±0.07(10) in liver obtained from chicks under ether anaesthesia. Lactate/pyruvate ratios were 9.4±1.7(5) in the perfused liver and 14.8±1.8(5) in the rapidly sampled liver. Urate synthesis was only marginally stimulated by glycine, glutamine, aspartic acid or NH4Cl, but significant increases were observed with phosphoribosyl pyrophosphate, aminoimidazolecarboxylic acid riboside, inosine, inosinic acid and xanthine. Urate synthesis from glycine, glutamine, NH4Cl, asparagine, alanine, histidine and a mixture of 21 amino acids was obtained on inclusion of insulin in the perfusion medium. Evidence for the inclusion of the carbon of histidine into uric acid was obtained. Aspects of the energy consumption associated with the conversion of excess of amino acid into uric acid are considered. PMID:4462579

  19. Automated sonographic evaluation of testicular perfusion

    NASA Astrophysics Data System (ADS)

    Thierman, Jonathan S.; Clement, Gregory T.; Kalish, Leslie A.; O'Kane, Patrick L.; Frauscher, Ferdinand; Paltiel, Harriet J.

    2006-07-01

    Contrast-enhanced ultrasound (US) imaging is potentially applicable to the investigation of vascular disorders of the testis. We investigated the ability of two automated computer algorithms to analyse contrast-enhanced pulse inversion US data in a rabbit model of unilateral testicular ischaemia and to correctly determine relative testicular perfusion: nonlinear curve fitting of the US backscatter intensity as a function of time; and spectral analysis of the intensity time trace. We compared (i) five metrics based on the algorithmic data to testicular perfusion ratios obtained with radiolabelled microspheres, a reference standard; (ii) qualitative assessment of the US images by two independent readers blinded to the side of the experimental and control testes to the radiolabelled microsphere perfusion ratios; and (iii) results of the algorithmically-derived metrics to the qualitative assessments of the two readers. For the curve fit method, the algorithmically-derived metrics agreed with the reference standard in 54% to 68% of all cases. For the spectral method, the results agreed in 70% of all cases. The two readers agreed with the reference standard in 40% and 35% of all cases, respectively. These results suggest that automated methods of analysis may provide useful information in the assessment of testicular perfusion.

  20. Asynchronicity of Facial Blood Perfusion in Migraine

    PubMed Central

    Zaproudina, Nina; Teplov, Victor; Nippolainen, Ervin; Lipponen, Jukka A.; Kamshilin, Alexei A.; Närhi, Matti; Karjalainen, Pasi A.; Giniatullin, Rashid

    2013-01-01

    Asymmetrical changes in blood perfusion and asynchronous blood supply to head tissues likely contribute to migraine pathophysiology. Imaging was widely used in order to understand hemodynamic variations in migraine. However, mapping of blood pulsations in the face of migraineurs has not been performed so far. We used the Blood Pulsation Imaging (BPI) technique, which was recently developed in our group, to establish whether 2D-imaging of blood pulsations parameters can reveal new biomarkers of migraine. BPI characteristics were measured in migraineurs during the attack-free interval and compared to healthy subjects with and without a family history of migraine. We found a novel phenomenon of transverse waves of facial blood perfusion in migraineurs in contrast to healthy subjects who showed synchronous blood delivery to both sides of the face. Moreover, the amplitude of blood pulsations was symmetrically distributed over the face of healthy subjects, but asymmetrically in migraineurs and subjects with a family history of migraine. In the migraine patients we found a remarkable correlation between the side of unilateral headache and the direction of the blood perfusion wave. Our data suggest that migraine is associated with lateralization of blood perfusion and asynchronous blood pulsations in the facial area, which could be due to essential dysfunction of the autonomic vascular control in the face. These findings may further enhance our understanding of migraine pathophysiology and suggest new easily available biomarkers of this pathology. PMID:24324592

  1. Simplified prototyping of perfusable polystyrene microfluidics

    PubMed Central

    Tran, Reginald; Ahn, Byungwook; R. Myers, David; Qiu, Yongzhi; Sakurai, Yumiko; Moot, Robert; Mihevc, Emma; Trent Spencer, H.; Doering, Christopher; A. Lam, Wilbur

    2014-01-01

    Cell culture in microfluidic systems has primarily been conducted in devices comprised of polydimethylsiloxane (PDMS) or other elastomers. As polystyrene (PS) is the most characterized and commonly used substrate material for cell culture, microfluidic cell culture would ideally be conducted in PS-based microsystems that also enable tight control of perfusion and hydrodynamic conditions, which are especially important for culture of vascular cell types. Here, we report a simple method to prototype perfusable PS microfluidics for endothelial cell culture under flow that can be fabricated using standard lithography and wet laboratory equipment to enable stable perfusion at shear stresses up to 300 dyn/cm2 and pumping pressures up to 26 kPa for at least 100 h. This technique can also be extended to fabricate perfusable hybrid PS-PDMS microfluidics of which one application is for increased efficiency of viral transduction in non-adherent suspension cells by leveraging the high surface area to volume ratio of microfluidics and adhesion molecules that are optimized for PS substrates. These biologically compatible microfluidic devices can be made more accessible to biological-based laboratories through the outsourcing of lithography to various available microfluidic foundries. PMID:25379106

  2. Nuclear cardiology: Myocardial perfusion and function

    SciTech Connect

    Seldin, D.W. )

    1991-08-01

    Myocardial perfusion studies continue to be a major focus of research, with new investigations of the relationship of exercise-redistribution thallium imaging to diagnosis, prognosis, and case management. The redistribution phenomenon, which seemed to be fairly well understood a few years ago, is now recognized to be much more complex than originally thought, and various strategies have been proposed to clarify the meaning of persistent defects. Pharmacologic intervention with dipyridamole and adenosine has become available as an alternative to exercise, and comparisons with exercise imaging and catheterization results have been described. Thallium itself is no longer the sole single-photon perfusion radiopharmaceutical; two new technetium agents are now widely available. In addition to perfusion studies, advances in the study of ventricular function have been made, including reports of studies performed in conjunction with technetium perfusion studies, new insights into cardiac physiology, and the prognostic and case-management information that function studies provide. Finally, work has continued with monoclonal antibodies for the identification of areas of myocyte necrosis. 41 references.

  3. Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death.

    PubMed

    Liu, Q; Nassar, A; Farias, K; Buccini, L; Mangino, M J; Baldwin, W; Bennett, A; O'Rourke, C; Iuppa, G; Soliman, B G; Urcuyo-Llanes, D; Okamoto, T; Uso, T D; Fung, J; Abu-Elmagd, K; Miller, C; Quintini, C

    2016-03-01

    The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs. PMID:26663737

  4. Confusion and the Older Adult. Module A-8. Block A. Basic Knowledge of the Aging Process.

    ERIC Educational Resources Information Center

    Harvey, Dexter; Cap, Orest

    This instructional module on confusion and the older adult is one in a block of 10 modules designed to provide the human services worker who works with older adults with basic information regarding the aging process. An introduction provides an overview of the module content. A listing of general objectives follows. Three sections present…

  5. Clearing the Confusion: Response-to-Intervention as a Set of Principles

    ERIC Educational Resources Information Center

    Barnes, Aaron C.; Harlacher, Jason E.

    2008-01-01

    Response-to-Intervention is a new method of service delivery being implemented in schools. However, the lack of emphasis on the flexible nature of Response-to-Intervention and the varying descriptions of its features within the literature may lead to confusion among school professionals. In order to provide more uniformity among the literature, 5…

  6. Confusions and Contradictions in Family Policy Developments: Application of a Model.

    ERIC Educational Resources Information Center

    Zimmerman, Shirley L.

    1982-01-01

    Applies a model of change to an analysis of recent developments in family policy. The model includes such concepts as cultural values, ideology, purposive group action, and structural relations. Clarifies some of the contradictions and confusions of recent political and organizational developments concerning families. (Author/RC)

  7. Compounding Confusion? When Illustrative Practical Work Falls Short of Its Purpose--A Case Study

    ERIC Educational Resources Information Center

    Haigh, Mavis; France, Beverley; Gounder, Roshni

    2012-01-01

    Illustrative practical work is commonly used in chemistry education to enrich students' understandings of chemical phenomena. However, it is possible that such practical work may not serve to foster understanding but rather cause further confusion. This paper reports the struggles experienced by a group of senior (Year 12) secondary chemistry…

  8. It Was the Most Confusing To Read; It Became Easier To Understand.

    ERIC Educational Resources Information Center

    Lambert, Michele

    1999-01-01

    Describes a writing assignment in which students read only the first two paragraphs of Charles Dickens's novel "A Tale of Two Cities" and then, after some brainstorming and prewriting, write a paragraph or two modeled on those, explaining the confusion and turmoil of the present day. Notes how Dickens's expressions become more familiar and his…

  9. Mental Rotation Does Not Account for Sex Differences in Left-Right Confusion

    ERIC Educational Resources Information Center

    Ocklenburg, Sebastian; Hirnstein, Marco; Ohmann, Hanno Andreas; Hausmann, Markus

    2011-01-01

    Several studies have demonstrated that women believe they are more prone to left-right confusion (LRC) than men. However, while some studies report that there is also a sex difference in LRC tasks favouring men, others report that men and women perform equally well. Recently, it was suggested that sex differences only emerge in LRC tasks when they…

  10. Vowel Confusion Patterns in Adults during Initial 4 Years of Implant Use

    ERIC Educational Resources Information Center

    Vaalimaa, Taina T.; Sorri, Martti J.; Laitakari, Jaakko; Sivonen, Ville; Muhli, Arto

    2011-01-01

    This study investigated adult cochlear implant users' (n == 39) vowel recognition and confusions by an open-set syllable test during 4 years of implant use, in a prospective repeated-measures design. Subjects' responses were coded for phoneme errors and estimated by the generalized mixed model. Improvement in overall vowel recognition was highest…

  11. The Treatment of Six Sigma in Introductory Operations Management Textbooks: Clearing Up the Confusion

    ERIC Educational Resources Information Center

    Ravinder, Handanhal; Misra, Ram B.

    2016-01-01

    This paper critically examines the treatment of the statistical basis for Six Sigma and process capability in popular operations management textbooks. It discusses areas of confusion and suggest ways of treating the topic that make sense to instructors as well as students. Even though Six Sigma was introduced almost 30 years ago, misconceptions…

  12. 17 CFR 260.7a-32 - Incorporation by reference rendering document incomplete, unclear, or confusing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Incorporation by reference rendering document incomplete, unclear, or confusing. 260.7a-32 Section 260.7a-32 Commodity and Securities... OF 1939 Incorporation by Reference § 260.7a-32 Incorporation by reference rendering...

  13. 17 CFR 260.7a-32 - Incorporation by reference rendering document incomplete, unclear, or confusing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Incorporation by reference rendering document incomplete, unclear, or confusing. 260.7a-32 Section 260.7a-32 Commodity and Securities... OF 1939 Incorporation by Reference § 260.7a-32 Incorporation by reference rendering...

  14. 17 CFR 260.7a-32 - Incorporation by reference rendering document incomplete, unclear, or confusing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Incorporation by reference rendering document incomplete, unclear, or confusing. 260.7a-32 Section 260.7a-32 Commodity and Securities... OF 1939 Incorporation by Reference § 260.7a-32 Incorporation by reference rendering...

  15. 17 CFR 260.7a-32 - Incorporation by reference rendering document incomplete, unclear, or confusing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Incorporation by reference rendering document incomplete, unclear, or confusing. 260.7a-32 Section 260.7a-32 Commodity and Securities... OF 1939 Incorporation by Reference § 260.7a-32 Incorporation by reference rendering...

  16. 17 CFR 260.7a-32 - Incorporation by reference rendering document incomplete, unclear, or confusing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Incorporation by reference rendering document incomplete, unclear, or confusing. 260.7a-32 Section 260.7a-32 Commodity and Securities... OF 1939 Incorporation by Reference § 260.7a-32 Incorporation by reference rendering...

  17. Perception and Confusion of Speech Sounds by Adults with a Cochlear Implant

    ERIC Educational Resources Information Center

    Rodvik, Arne K.

    2008-01-01

    The aim of this pilot study was to identify the most common speech sound confusions of 5 Norwegian cochlear implanted post-lingually deafened adults. We played recorded nonwords, aCa, iCi and bVb, to our informants, asked them to repeat what they heard, recorded their repetitions and transcribed these phonetically. We arranged the collected data…

  18. The Susceptibility of Young Preschoolers to Source Similarity Effects: Confusing Story or Video Events with Reality

    ERIC Educational Resources Information Center

    Thierry, Karen L.; Pipe, Margaret-Ellen

    2009-01-01

    This study examined children's tendency to confuse events that varied in source similarity, which was manipulated using different media of event presentation. In Experiment 1, children in two age groups (3- and 4-year-olds and 5- and 6-year-olds) experienced a live presentation of an event, and another event was either heard from a story (low…

  19. Molecular techniques for detection of confused flour beetle infestations in stored products

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tribolium confusum (confused flour beetle) is a stored-product pest which contaminates a wide range of food products, from flour and cereals to spices. The insect reduces food quality and is responsible for large economic losses every year. Although a number of methods for detection of stored-produc...

  20. A Hierarchy of "Confusable" High-Frequency Words in Isolation and Context.

    ERIC Educational Resources Information Center

    Krieger, Veronica K.

    1981-01-01

    The study assessed the degree to which two sets of disabled readers (17 clinic students with a mean CA of 9 years and 13 fourth-grade disabled readers) commonly and identically confuse high frequency sight words in isolation and context. (Author/CL)

  1. Psychometric properties of the Flemish translation of the NEECHAM Confusion Scale

    PubMed Central

    Milisen, Koen; Foreman, Marquis D; Hendrickx, Annik; Godderis, Jan; Abraham, Ivo L; Broos, Paul LO; De Geest, Sabina

    2005-01-01

    Background Determination of a patient's cognitive status by use of a valid and reliable screening instrument is of major importance as early recognition and accurate diagnosis of delirium is necessary for effective management. This study determined the reliability, validity and diagnostic value of the Flemish translation of the NEECHAM Confusion Scale. Methods A sample of 54 elderly hip fracture patients with a mean age of 80.9 years (SD = 7.85) were included. To test the psychometric properties of the NEECHAM Confusion Scale, performance on the NEECHAM was compared to the Confusion Assessment Method (CAM) and the Mini-Mental State Examination (MMSE), by using aggregated data based on 5 data collection measurement points (repeated measures). The CAM and MMSE served as gold standards. Results The alpha coefficient for the total NEECHAM score was high (0.88). Principal components analysis yielded a two-component solution accounting for 70.8% of the total variance. High correlations were found between the total NEECHAM scores and total MMSE (0.75) and total CAM severity scores (-0.73), respectively. Diagnostic values using the CAM algorithm as gold standard showed 76.9% sensitivity, 64.6% specificity, 13.5% positive and 97.5% negative predictive values, respectively. Conclusion This validation of the Flemish version of the NEECHAM Confusion Scale adds to previous evidence suggesting that this scale holds promise as a valuable screening instrument for delirium in clinical practice. Further validation studies in diverse clinical populations; however, are needed. PMID:15792498

  2. Confusing Aspects in the Calculation of the Electrostatic Potential of an Infinite Line of Charge

    ERIC Educational Resources Information Center

    Jimenez, J. L.; Campos, I.; Roa-Neri, J. A. E.

    2012-01-01

    In this work we discuss the trick of eliminating infinite potential of reference arguing that it corresponds to a constant of integration, in the problem of determining the electrostatic potential of an infinite line of charge with uniform density, and show how the problem must be tackled properly. The usual procedure is confusing for most…

  3. Straw Men and False Dichotomies: Overcoming Philosophical Confusion in Chemical Education

    ERIC Educational Resources Information Center

    Taber, Keith S.

    2010-01-01

    Constructivism has been widely considered the most influential perspective in science education research for some decades, and has been the basis of widespread pedagogic advice in many educational contexts. Yet it has been claimed in this "Journal" that the philosophical basis of constructivist thought in chemical education is confused, and…

  4. Mirror-Image Confusions: Implications for Representation and Processing of Object Orientation

    ERIC Educational Resources Information Center

    Gregory, Emma; McCloskey, Michael

    2010-01-01

    Perceiving the orientation of objects is important for interacting with the world, yet little is known about the mental representation or processing of object orientation information. The tendency of humans and other species to confuse mirror images provides a potential clue. However, the appropriate characterization of this phenomenon is not…

  5. Delictual Negligence of Educators in Schools: The Confusing Influence of the "in loco parentis" Doctrine

    ERIC Educational Resources Information Center

    Potgieter, Johan

    2004-01-01

    This article points out that the "in loco parentis" maxim is partly to blame for introducing the confusing "reasonable parent" doctrine as the test for delictual negligence of educators in the school context. It is argued that the standard of care exercised by parents over their children is not appropriate to determine the negligence of educators.…

  6. Confusion and Slurred Speech in a 34-Year-Old Woman from India

    PubMed Central

    Chugh, Chandril; Wadhwani, N.; Biller, José

    2011-01-01

    A 34-year-old woman from India, presented with episodes of confusion and progressive speech deterioration. She also had a painless neck “lump”, which persisted despite antibiotics. She was diagnosed to have a space occupying lesion in the left parietal lobe, which was subsequently biopsied. PMID:21687701

  7. Energy and the Confused Student IV: A Global Approach to Energy

    ERIC Educational Resources Information Center

    Jewett, John W., Jr.

    2008-01-01

    Energy is a critical concept in physics problem-solving, but is often a major source of confusion for students if the presentation is not carefully crafted by the instructor or the textbook. In the first three articles in this series we discussed several issues related to the teaching of energy concepts. We have saved a major single issue for this…

  8. Is the Word-Superiority Effect in Target Search Tasks Based on Perceptual Confusions?

    ERIC Educational Resources Information Center

    Chastain, Garvin; And Others

    It has been hypothesized that letters in orthographic strings (those that follow the rules of English) are more accurately identified than letters in nonorthographic strings because confusions about the positions of letters are more likely in nonorthographic strings. This hypothesis was tested by giving 16 college students a set of targets, one of…

  9. Attempting To Understand the Class Size and Pupil-Teacher Ratio (PTR) Confusion: A Pilot Study.

    ERIC Educational Resources Information Center

    Achilles, C. M.; Sharp, Mark; Nye, B. A.

    Confusion over the concepts of class size and pupil-teacher ratio (PTR) creates a conundrum for researchers, policy makers, and practitioners. An examination of how these two concepts are different is presented in this paper. A review of the literature suggests that class-size reduction makes a positive overall difference in student achievement,…

  10. Factors in myocardial "perfusion" imaging with ultrafast MRI and Gd-DTPA administration.

    PubMed

    Burstein, D; Taratuta, E; Manning, W J

    1991-08-01

    Ultrafast magnetic resonance imaging (MRI) and first pass observation of an interstitial contrast agent are currently being used to study myocardial perfusion. Image intensity, however, is a function of several parameters, including the delivery of the contrast agent to the interstitium (coronary flow rate and diffusion into the interstitium) and the relaxation properties of the tissue (contrast agent concentration, proton exchange rates, and relative intra- and extracellular volume fractions). In this study, image intensity during gadopentetate dimeglumine (Gd-DTPA) administration with T1-weighted ultrafast MR imaging was assessed in an isolated heart preparation. With increasing Gd-DTPA concentration, the steady-state myocardial image intensity increased but the time to reach steady state remained unchanged, resulting in an increased slope of image intensity change. A range of physiologic perfusion pressures (and resulting coronary flow rates) had insignificant effects on kinetics of Gd-DTPA wash-in or steady-state image intensity, suggesting that diffusion of Gd-DTPA into the interstitium is the rate limiting step in image intensity change with this preparation. Following global ischemia and reperfusion, transmural differences in the slope of image intensity change were apparent. However, the altered steady-state image intensity (due to postischemic edema) makes interpretation of this finding difficult. The studies described here demonstrate that although Gd-DTPA administration combined with ultrafast imaging may be a sensitive indicator of perfusion abnormalities, factors other than perfusion will affect image intensity. Extensive studies will be required before image intensity with this protocol is fully understood. PMID:1775055

  11. Clinical Neuroimaging Using Arterial Spin-Labeled Perfusion MRI

    PubMed Central

    Wolf, Ronald L.; Detre, John A.

    2007-01-01

    SUMMARY The two most common methods for measuring perfusion with MRI are based on dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL). Although clinical experience to date is much more extensive with DSC perfusion MRI, ASL methods offer several advantages. The primary advantages are that completely noninvasive absolute cerebral blood flow (CBF) measurements are possible with relative insensitivity to permeability, and that multiple repeated measurements can be obtained to evaluate one or more interventions or to perform perfusion-based functional MRI. ASL perfusion and perfusion-based fMRI methods have been applied in many clinical settings, including acute and chronic cerebrovascular disease, CNS neoplasms, epilepsy, aging and development, neurodegenerative disorders, and neuropsychiatric diseases. Recent technical advances have improved the sensitivity of ASL perfusion MRI, and increasing use is expected in the coming years. This review focuses on ASL perfusion MRI and applications in clinical neuroimaging. PMID:17599701

  12. NET Confusion

    PubMed Central

    Malachowa, Natalia; Kobayashi, Scott D.; Quinn, Mark T.; DeLeo, Frank R.

    2016-01-01

    Neutrophils are arguably the most important white blood cell for defense against bacterial and fungal infections. These leukocytes are produced in high numbers on a daily basis in humans and are recruited rapidly to injured/infected tissues. Phagocytosis and subsequent intraphagosomal killing and digestion of microbes have historically been the accepted means by which neutrophils carry out their role in innate host defense. Indeed, neutrophils contain and produce numerous cytotoxic molecules, including antimicrobial peptides, proteases, and reactive oxygen species, that are highly effective at killing the vast majority of ingested microbes. On the other hand, it is these characteristics – high numbers and toxicity – that endow neutrophils with the potential to injure and destroy host tissues. This potential is borne out by many inflammatory processes and diseases. Therefore, it is not surprising that host mechanisms exist to control virtually all steps in the neutrophil activation process and to prevent unintended neutrophil activation and/or lysis during the resolution of inflammatory responses or during steady-state turnover. The notion that neutrophil extracellular traps (NETs) form by cytolysis as a standard host defense mechanism seems inconsistent with these aforementioned neutrophil “containment” processes. It is with this caveat in mind that we provide perspective on the role of NETs in human host defense and disease. PMID:27446089

  13. NET Confusion.

    PubMed

    Malachowa, Natalia; Kobayashi, Scott D; Quinn, Mark T; DeLeo, Frank R

    2016-01-01

    Neutrophils are arguably the most important white blood cell for defense against bacterial and fungal infections. These leukocytes are produced in high numbers on a daily basis in humans and are recruited rapidly to injured/infected tissues. Phagocytosis and subsequent intraphagosomal killing and digestion of microbes have historically been the accepted means by which neutrophils carry out their role in innate host defense. Indeed, neutrophils contain and produce numerous cytotoxic molecules, including antimicrobial peptides, proteases, and reactive oxygen species, that are highly effective at killing the vast majority of ingested microbes. On the other hand, it is these characteristics - high numbers and toxicity - that endow neutrophils with the potential to injure and destroy host tissues. This potential is borne out by many inflammatory processes and diseases. Therefore, it is not surprising that host mechanisms exist to control virtually all steps in the neutrophil activation process and to prevent unintended neutrophil activation and/or lysis during the resolution of inflammatory responses or during steady-state turnover. The notion that neutrophil extracellular traps (NETs) form by cytolysis as a standard host defense mechanism seems inconsistent with these aforementioned neutrophil "containment" processes. It is with this caveat in mind that we provide perspective on the role of NETs in human host defense and disease. PMID:27446089

  14. Cold Confusion.

    ERIC Educational Resources Information Center

    Fogle, Pamela W.

    1991-01-01

    Public relations issues arising from the University of Utah's controversial announcement of research claiming achievement of nuclear fusion at room temperature are discussed. They include problems occurring before and after the initial press conference, secrecy vs. openness, research ethics, and effects lasting past the original incident and…

  15. Caffeine Confusion

    MedlinePlus

    ... natural chemical found in tea leaves, coffee beans, cacao (the stuff used to make chocolate), and cola ... foods and drinks, such as coffee, tea, hot cocoa, soda, chocolate, and some medicines . When humans drink ...

  16. Multi-modality imaging for the assessment of myocardial perfusion with emphasis on stress perfusion CT and MR imaging.

    PubMed

    Ko, Sung Min; Hwang, Hweung Kon; Kim, Sung Mok; Cho, Ihn Ho

    2015-06-01

    High-quality and non-invasive diagnostic tools for assessing myocardial ischemia are necessary for therapeutic decisions regarding coronary artery disease. Myocardial perfusion has been studied using myocardial contrast echo perfusion, single-photon emission computed tomography, positron emission tomography, cardiovascular magnetic resonance, and, more recently, computed tomography. The addition of coronary computed tomography angiography to myocardial perfusion imaging improves the specificity and overall diagnostic accuracy of detecting the hemodynamic significance of coronary artery stenosis. This study reviews the benefits, limitations, and imaging findings of various imaging modalities for assessing myocardial perfusion, with particular emphasis on stress perfusion computed tomography and cardiovascular magnetic resonance imaging. PMID:25809387

  17. Luminal perfusion of isolated gastric glands.

    PubMed

    Waisbren, S J; Geibel, J; Boron, W F; Modlin, I M

    1994-04-01

    We have extended to rabbit gastric glands the technique for perfusing single isolated renal tubules. We isolated glands by hand dissection and used concentric glass pipettes to hold them and perfuse their lumina. Parietal cells (PCs), which tended to be located toward the gland opening, were identified by their pyramidal shape, large size, and autofluorescence. Chief cells (CCs) were identified by their round shape and smaller size. In some experiments, we perfused the lumen with hydroxypyrenetrisulfonate, a pH-sensitive fluorophore, at pH 7.4 and used digital image processing to monitor luminal pH (pH1). Solutions were buffered with N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid to pH 7.4 at 37 degrees C. With fast perfusion, we found no evidence of decreased pH1, even with stimulation by 10 microM carbachol. With slow perfusion, pH1 often fell below the dye's sensitive range (pH < 5), especially at low perfusate buffering power. In other experiments, we loaded cells with the pH-sensitive dye 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein and monitored intracellular pH (pHi) in multiple individual PCs and CCs in a single gland. Mean pHi was 7.21 +/- 0.02 (n = 136 cells) for PCs and 7.27 +/- 0.03 (n = 103) for CCs. To examine the response to decreased pH1 and basolateral pH (pHb), we lowered pHb to 6.4 or lowered pH1 to 3.4 or 1.4. Lowering pHb to 6.4 for approximately 1 min caused pHi to fall reversibly by 0.39 +/- 0.05 (n = 53) in PCs and 0.58 +/- 0.03 (n = 50) in CCs. Lowering pH1 to 3.4 or 1.4 caused no significant pHi changes in PCs (n = 38 and 82) or in CCs (n = 44 and 77). Carbachol did not affect the response to changes in pH1 or pHb. We conclude that the apical surfaces of PCs and CCs are unusually resistant to extreme pH gradients. PMID:8178950

  18. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.

    PubMed

    McCaffrey, Ruth; Locsin, Rozzano

    2006-01-01

    The purpose of this study was to examine the effects of music listening in older adults following hip or knee surgery. Acute confusion and pain after surgery can increase length of stay and reduce function. Study results demonstrate a reduction in acute confusion and pain and improved ambulation and higher satisfaction scores in older adults who listened to music. PMID:16974175

  19. Perfusion techniques for minimally invasive valve procedures.

    PubMed

    de Jong, A; Popa, B A; Stelian, E; Karazanishvili, L; Lanzillo, G; Simonini, S; Renzi, L; Diena, M; Tesler, U F

    2015-05-01

    In this paper, we present, in detail, the simplified perfusion technique that we have adopted since January 2009 and that we have utilized in 200 cases for cardiac minimally invasive valvular procedures that were performed through a right lateral mini-thoracotomy in the 3(rd)-4(th) intercostal space. Cardiopulmonary bypass was achieved by means of the direct cannulation of the ascending aorta and the insertion of a percutaneous venous cannula in the femoral vein. A flexible aortic cross-clamp was applied through the skin incision and cardioplegic arrest was obtained with the antegrade delivery of a crystalloid solution. Gravity drainage was enhanced by vacuum-assisted aspiration. There were no technical complications related to this perfusion technique that we have adopted in minimally invasive surgical procedures. PMID:25280878

  20. Assessment of cerebral perfusion in childhood strokes

    SciTech Connect

    Gates, G.F.; Fishman, L.S.; Segall, H.D.

    1982-11-01

    Thirty-three children who had strokes were studied by dynamic and static scintigraphy, 29 by CT scanning, and 10 by cerebral angiography. The accuracy of dynamic scintigraphy in stroke detection during the first week of clinical symptoms was 94% while CT scanning was 60% accurate and static scintigraphy 11% accurate. During the second week the accuracy of CT scanning increased to 100%, but static scintigraphy improved to only 50%. Fifty percent of scintiangiograms performed during the first week showed either luxuriant perfusion or flip-flop patterns. In some patients these two flow patterns changed to that of cerebral hemispheric ischemia after going through a phase during which perfusion appeared to be equal in the two hemispheres. Dynamic scintigraphy is believed to be the test of choice for stroke detection in children during the first week.

  1. Visual analysis of longitudinal brain tumor perfusion

    NASA Astrophysics Data System (ADS)

    Glaßer, Sylvia; Oeltze, Steffen; Preim, Uta; Bjørnerud, Atle; Hauser, Helwig; Preim, Bernhard

    2013-02-01

    In clinical research on diagnosis and evaluation of brain tumors, longitudinal perfusion MRI studies are acquired for tumor grading as well as to monitor and assess treatment response and patient prognosis. Within this work, we demonstrate how visual analysis techniques can be adapted to multidimensional datasets from such studies within a framework to support the computer-aided diagnosis of brain tumors. Our solution builds on two innovations: First, we introduce a pipeline yielding comparative, co-registered quantitative perfusion parameter maps over all time steps of the longitudinal study. Second, based on these time-dependent parameter maps, visual analysis methods were developed and adapted to reveal valuable insight into tumor progression, especially regarding the clinical research area of low grade glioma transformation into high grade gliomas. Our examination of four longitudinal brain studies demonstrates the suitability of the presented visual analysis methods and comprises new possibilities for the clinical researcher to characterize the development of low grade gliomas.

  2. Gluconeogenesis in the perfused rat liver.

    PubMed

    Hems, R; Ross, B D; Berry, M N; Krebs, H A

    1966-11-01

    1. A modification of the methods of Miller and of Schimassek for the perfusion of the isolated rat liver, suitable for the study of gluconeogenesis, is described. 2. The main modifications concern the operative technique (reducing the period of anoxia during the operation to 3min.) and the use of aged (non-glycolysing) red cells in the semi-synthetic perfusion medium. 3. The performance of the perfused liver was tested by measuring the rate of gluconeogenesis, of urea synthesis and the stability of adenine nucleotides. Higher rates of gluconeogenesis (1mumole/min./g.) from excess of lactate and of urea synthesis from excess of ammonia (4mumoles/min./g. in the presence of ornithine) were observed than are likely to occur in vivo where rates are limited by the rate of supply of precursor. The concentrations of the three adenine nucleotides in the liver tissue were maintained within 15% over a perfusion period of 135min. 4. Ca(2+), Na(+), K(+), Mg(2+) and phosphate were found to be required at physiological concentrations for optimum gluconeogenesis but bicarbonate and carbon dioxide could be largely replaced by phosphate buffer without affecting the rate of gluconeogenesis. 5. Maximal gluconeogenesis did not decrease maximal urea synthesis in the presence of ornithine and ammonia and vice versa. This indicates that the energy requirements were not limiting the rates of gluconeogenesis or of urea synthesis. 6. Addition of lactate, and especially ammonium salts, increased the uptake of oxygen more than expected on the basis of the ATP requirements of the gluconeogenesis and urea synthesis. PMID:5966267

  3. Dynamic CT perfusion measurement in a cardiac phantom.

    PubMed

    Ziemer, Benjamin P; Hubbard, Logan; Lipinski, Jerry; Molloi, Sabee

    2015-10-01

    Widespread clinical implementation of dynamic CT myocardial perfusion has been hampered by its limited accuracy and high radiation dose. The purpose of this study was to evaluate the accuracy and radiation dose reduction of a dynamic CT myocardial perfusion technique based on first pass analysis (FPA). To test the FPA technique, a pulsatile pump was used to generate known perfusion rates in a range of 0.96-2.49 mL/min/g. All the known perfusion rates were determined using an ultrasonic flow probe and the known mass of the perfusion volume. FPA and maximum slope model (MSM) perfusion rates were measured using volume scans acquired from a 320-slice CT scanner, and then compared to the known perfusion rates. The measured perfusion using FPA (P(FPA)), with two volume scans, and the maximum slope model (P(MSM)) were related to known perfusion (P(K)) by P(FPA) = 0.91P(K) + 0.06 (r = 0.98) and P(MSM) = 0.25P(K) - 0.02 (r = 0.96), respectively. The standard error of estimate for the FPA technique, using two volume scans, and the MSM was 0.14 and 0.30 mL/min/g, respectively. The estimated radiation dose required for the FPA technique with two volume scans and the MSM was 2.6 and 11.7-17.5 mSv, respectively. Therefore, the FPA technique can yield accurate perfusion measurements using as few as two volume scans, corresponding to approximately a factor of four reductions in radiation dose as compared with the currently available MSM. In conclusion, the results of the study indicate that the FPA technique can make accurate dynamic CT perfusion measurements over a range of clinically relevant perfusion rates, while substantially reducing radiation dose, as compared to currently available dynamic CT perfusion techniques. PMID:26156231

  4. Inhomogeneity of pulmonary perfusion during sustained microgravity

    NASA Technical Reports Server (NTRS)

    Prisk, G. Kim; Guy, Harold J. B.; Elliott, Ann R.; West, John B.

    1994-01-01

    The effects of gravity on the inhomogeneity of pulmonary perfusion in man were studied by performing hyperventilation-breathhold single-breath measurements before, during and after 9 days of continuous exposure to microgravity. In microgravity the indicators of inhomogeneity of perfusion, especially the size of cardiogenic oscillations in expired CO2 and the height of phase 4, were both markedly reduced. Cardiogenic oscillations were reduced to approximately 60 of their preflight standing size, while the height of phase 4 was between 0 and -8% (a terminal fall became a small terminal rise) of preflights standing. The terminal change in CO2 was nearly abolished in microgravity indicating more uniformity of blood flow between lung units that close at the end of expiration and units that remain open. This may result from the disappearance of gravity-dependent topographical inequality of blood flow. The residual cardiographic oscillations in expired CO2 imply a persisting inhomogeneity of perfusion in the absence of gravity at a level larger than acinar.

  5. Perfusion computed tomography in renal cell carcinoma.

    PubMed

    Das, Chandan J; Thingujam, Usha; Panda, Ananya; Sharma, Sanjay; Gupta, Arun Kumar

    2015-07-28

    Various imaging modalities are available for the diagnosis, staging and response evaluation of patients with renal cell carcinoma (RCC). While contrast enhanced computed tomography (CT) is used as the standard of imaging for size, morphological evaluation and response assessment in RCC, a new functional imaging technique like perfusion CT (pCT), goes down to the molecular level and provides new perspectives in imaging of RCC. pCT depicts regional tumor perfusion and vascular permeability which are indirect parameters of tumor angiogenesis and thereby provides vital information regarding tumor microenvironment. Also response evaluation using pCT may predate the size criteria used in Response Evaluation Criteria in Solid Tumors, as changes in the perfusion occurs earlier following tissue kinase inhibitors before any actual change in size. This may potentially help in predicting prognosis, better selection of therapy and more accurate and better response evaluation in patients with RCC. This article describes the techniques and role of pCT in staging and response assessment in patients with RCCs. PMID:26217456

  6. Noncontact blood perfusion mapping in clinical applications

    NASA Astrophysics Data System (ADS)

    Iakovlev, Dmitry; Dwyer, Vincent; Hu, Sijung; Silberschmidt, Vadim

    2016-04-01

    Non-contact imaging photoplethysmography (iPPG) to detect pulsatile blood microcirculation in tissue has been selected as a successor to low spatial resolution and slow scanning blood perfusion techniques currently employed by clinicians. The proposed iPPG system employs a novel illumination source constructed of multiple high power LEDs with narrow spectral emission, which are temporally modulated and synchronised with a high performance sCMOS sensor. To ensure spectrum stability and prevent thermal wavelength drift due to junction temperature variations, each LED features a custom-designed thermal management system to effectively dissipate generated heat and auto-adjust current flow. The use of a multi-wavelength approach has resulted in simultaneous microvascular perfusion monitoring at various tissue depths, which is an added benefit for specific clinical applications. A synchronous detection algorithm to extract weak photoplethysmographic pulse-waveforms demonstrated robustness and high efficiency when applied to even small regions of 5 mm2. The experimental results showed evidences that the proposed system could achieve noticeable accuracy in blood perfusion monitoring by creating complex amplitude and phase maps for the tissue under examination.

  7. Parallel perfusion imaging processing using GPGPU

    PubMed Central

    Zhu, Fan; Gonzalez, David Rodriguez; Carpenter, Trevor; Atkinson, Malcolm; Wardlaw, Joanna

    2012-01-01

    Background and purpose The objective of brain perfusion quantification is to generate parametric maps of relevant hemodynamic quantities such as cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) that can be used in diagnosis of acute stroke. These calculations involve deconvolution operations that can be very computationally expensive when using local Arterial Input Functions (AIF). As time is vitally important in the case of acute stroke, reducing the analysis time will reduce the number of brain cells damaged and increase the potential for recovery. Methods GPUs originated as graphics generation dedicated co-processors, but modern GPUs have evolved to become a more general processor capable of executing scientific computations. It provides a highly parallel computing environment due to its large number of computing cores and constitutes an affordable high performance computing method. In this paper, we will present the implementation of a deconvolution algorithm for brain perfusion quantification on GPGPU (General Purpose Graphics Processor Units) using the CUDA programming model. We present the serial and parallel implementations of such algorithms and the evaluation of the performance gains using GPUs. Results Our method has gained a 5.56 and 3.75 speedup for CT and MR images respectively. Conclusions It seems that using GPGPU is a desirable approach in perfusion imaging analysis, which does not harm the quality of cerebral hemodynamic maps but delivers results faster than the traditional computation. PMID:22824549

  8. Whole Animal Perfusion Fixation for Rodents

    PubMed Central

    Gage, Gregory J.; Kipke, Daryl R.; Shain, William

    2012-01-01

    The goal of fixation is to rapidly and uniformly preserve tissue in a life-like state. While placing tissue directly in fixative works well for small pieces of tissue, larger specimens like the intact brain pose a problem for immersion fixation because the fixative does not reach all regions of the tissue at the same rate 5,7. Often, changes in response to hypoxia begin before the tissue can be preserved 12. The advantage of directly perfusing fixative through the circulatory system is that the chemical can quickly reach every corner of the organism using the natural vascular network. In order to utilize the circulatory system most effectively, care must be taken to match physiological pressures 3. It is important to note that physiological pressures are dependent on the species used. Techniques for perfusion fixation vary depending on the tissue to be fixed and how the tissue will be processed following fixation. In this video, we describe a low-cost, rapid, controlled and uniform fixation procedure using 4% paraformaldehyde perfused via the vascular system: through the heart of the rat to obtain the best possible preservation of the brain for immunohistochemistry. The main advantage of this technique (vs. gravity-fed systems) is that the circulatory system is utilized most effectively. PMID:22871843

  9. Prolonged confusion with nocturnal wandering arising from NREM and REM sleep: a case report.

    PubMed

    Kushida, C A; Clerk, A A; Kirsch, C M; Hotson, J R; Guilleminault, C

    1995-11-01

    A 51-year-old man with Machado-Joseph disease had a 3-year history of prolonged confusion following nightly nocturnal wandering. Polysomnography with videotape monitoring revealed 19- to 120-minute sleepwalking episodes emerging from non-rapid eye movement (NREM) sleep and occasionally from rapid eye movement (REM) sleep, followed by 22-47 minutes of prolonged confusion and disorientation. The patient also had a periodic limb movement disorder and obstructive sleep apnea syndrome. Excessive daytime sleepiness was evident by results from the Epworth Sleepiness Scale and Multiple Sleep Latency Test. A sleep-deprived electroencephalogram (EEG) and a polysomnogram with an expanded EEG montage before and during these episodes revealed no epileptiform activity. A contrast-enhanced brain magnetic resonance imaging (MRI) scan demonstrated findings consistent only with Machado-Joseph disease. The patient improved with a combination of temazepam and carbidopa-levodopa. PMID:8638068

  10. Aggressive aneurysmal bone cyst of the maxilla confused with telangiectatic osteosarcoma.

    PubMed

    Lee, Hyun-Min; Cho, Kyu-Sup; Choi, Kyung-Un; Roh, Hwan-Jung

    2012-06-01

    Aneurysmal bone cyst (ABC) is a benign, expansile lesion typically affecting the long bones and vertebrae of patients younger than 20 years. Approximately 2% of ABCs occur in the head and neck region, most commonly affecting the mandible. Although the most common co-existing lesion associated with ABCs is the giant cell tumor, ABCs can be radiologically confused with telangiectatic osteosarcoma in cases of aggressive behavior and rapid growth. Here, we report a case of an aggressive ABC of the maxilla confused with telangiectatic osteosarcoma in a patient who underwent several operations for an osteoblastoma that was diagnosed histopathologically. This case highlights the need for a differential diagnosis both radiologically and histopathologically, because ABCs can easily be interpreted as a giant cell tumor or an osteoblastoma, and, on occasion, can be mistaken for osteogenic malignancies. PMID:21862268

  11. Ontological confusions but not mentalizing abilities predict religious belief, paranormal belief, and belief in supernatural purpose.

    PubMed

    Lindeman, Marjaana; Svedholm-Häkkinen, Annika M; Lipsanen, Jari

    2015-01-01

    The current research tested the hypothesis that the abilities for understanding other people's minds give rise to the cognitive biases that underlie supernatural beliefs. We used structural equation modeling (N=2789) to determine the roles of various mentalizing tendencies, namely self-reported affective and cognitive empathy (i.e., mind reading), actual cognitive and affective empathic abilities, hyper-empathizing, and two cognitive biases (core ontological confusions and promiscuous teleology) in giving rise to supernatural beliefs. Support for a path from mentalizing abilities through cognitive biases to supernatural beliefs was weak. The relationships of mentalizing abilities with supernatural beliefs were also weak, and these relationships were not substantially mediated by cognitive biases. Core ontological confusions emerged as the best predictor, while promiscuous teleology predicted only a small proportion of variance. The results were similar for religious beliefs, paranormal beliefs, and for belief in supernatural purpose. PMID:25460380

  12. Autonomous technology - sources of confusion: a model for explanation and prediction of conceptual shifts.

    PubMed

    Stensson, Patrik; Jansson, Anders

    2014-01-01

    Today, autonomous is often used for technology with a more intelligent self-management capability than common automation. This concept usage is maladaptive, ignoring both the distinction between autonomy and heteronomy according to Kant's categorical imperative and that the meaning of autonomy implies qualities technology cannot have. Being autonomous is about having the right to be wrong, a right justified by accountability and insightful understanding of real-life values, and it is about being externally uncontrollable. The contemporary use of autonomy as well as similar concepts is discussed and a model is presented showing how six sources of confusion interact in a vicious circle that impede human authority and autonomy. Our goal is to sort out these confusions and contribute to a development in which the different roles of machines and people, and human responsibilities, are explicated rather than blurred, which should facilitate the forming of truly beneficial and complementary systems. PMID:24308694

  13. Getting the Picture: Iconicity Does Not Affect Representation-Referent Confusion

    PubMed Central

    Wimmer, Marina C.; Robinson, Elizabeth J.; Koenig, Laura; Corder, Emma

    2014-01-01

    Three experiments examined 3- to 5-year-olds' (N = 428) understanding of the relationship between pictorial iconicity (photograph, colored drawing, schematic drawing) and the real world referent. Experiments 1 and 2 explored pictorial iconicity in picture-referent confusion after the picture-object relationship has been established. Pictorial iconicity had no effect on referential confusion when the referent changed after the picture had been taken/drawn (Experiment 1) and when the referent and the picture were different from the outset (Experiment 2). Experiment 3 investigated whether children are sensitive to iconicity to begin with. Children deemed photographs from a choice of varying iconicity representations as best representations for object reference. Together, findings suggest that iconicity plays a role in establishing a picture-object relation per se but is irrelevant once children have accepted that a picture represents an object. The latter finding may reflect domain general representational abilities. PMID:25247708

  14. Linguistic confusion in economics: utility, causality, product differentiation, and the supply of natural resources.

    PubMed

    Simon, J L

    1982-01-01

    Lack of careful attention to the language used in the discussion of economic concepts has resulted in considerable confusion and error. 2 frequent sources of confusion include tautology and the absence of operational definitions of concepts. This paper outlines a more effective scientific practice through reference to 2 economic examples: 1) the concept of utility, where it is demonstrated that choice of an operational definition of the concept facilitates interpersonal comparisons; and 2) causality, where a multidimensional operational definition is needed to discriminate among the various meanings of the term in theoretical, empirical, and policy contexts. The paper further discusses the example of natural resource scarcity, where application of the term "finite" reveals that there is no empirical evidence of physical limits to growth in the use of resources. A more appropriate measure of scarcity is the economic concept of price. PMID:12265949

  15. Specification of IRAS confused regions. Rept. for 11 Jan-11 May 90

    SciTech Connect

    Kennealy, J.P.; Woodward, C.E.; Korte, R.M.

    1990-06-19

    This document reports on the efforts to define the IRAS confused regions. The subset will be limited by the availability of survey data in the regions which are identified as point source confused by the current (Ver 2.0) IRAS point source catalog (PSC). Available coincident AO data will be an important validation source. The sensitivity and spatial resolution capabilities of the IRAS telescope failed to resolve individual sources in many regions of high source density. Approximately 10% of the sources catalogued in the PSC are tagged as 'confused' in some way; the location of a source, the number of sources at a location, the temporal occurrence and variation of a source, and/or the intensity of a source(s) was not discernible by the source identification/discrimination methods used to compile the PSC. In these regions of infrared clutter, the PSC can underestimate the number of point sources by as much as a factor of 3 to 5 in the IRAS Bands 1 and 2 (12 and 25 micrometers respectively). Analysis for improved source counts is designed to enhance the description and spatial definition of the mid- and long wavelength infrared celestial background, and includes generation of high spatial resolution images of the confused regions. Analysis of these images will improve the accuracy of source counts, locations, and flux estimates in the PSC. More detailed knowledge of the high source density regions will improve our ability to understand star formation and galactic evolution. It will also greatly improve our knowledge of a type of celestial background which presents a serious clutter problem for space-born surveillance system sensors.

  16. Vowel identity between note labels confuses pitch identification in non-absolute pitch possessors.

    PubMed

    Brancucci, Alfredo; Dipinto, Rosanna; Mosesso, Ilaria; Tommasi, Luca

    2009-01-01

    The simplest and likeliest assumption concerning the cognitive bases of absolute pitch (AP) is that at its origin there is a particularly skilled function which matches the height of the perceived pitch to the verbal label of the musical tone. Since there is no difference in sound frequency resolution between AP and non-AP (NAP) musicians, the hypothesis of the present study is that the failure of NAP musicians in pitch identification relies mainly in an inability to retrieve the correct verbal label to be assigned to the perceived musical note. The primary hypothesis is that, when asked to identify tones, NAP musicians confuse the verbal labels to be attached to the stimulus on the basis of their phonetic content. Data from two AP tests are reported, in which subjects had to respond in the presence or in the absence of visually presented verbal note labels (fixed Do solmization). Results show that NAP musicians confuse more frequently notes having a similar vowel in the note label. They tend to confuse e.g. a 261 Hz tone (Do) more often with Sol than, e.g., with La. As a second goal, we wondered whether this effect is lateralized, i.e. whether one hemisphere is more responsible than the other in the confusion of notes with similar labels. This question was addressed by observing pitch identification during dichotic listening. Results showed that there is a right hemispheric disadvantage, in NAP but not AP musicians, in the retrieval of the verbal label to be assigned to the perceived pitch. The present results indicate that absolute pitch has strong verbal bases, at least from a cognitive point of view. PMID:19621074

  17. DISENTANGLING CONFUSED STARS AT THE GALACTIC CENTER WITH LONG-BASELINE INFRARED INTERFEROMETRY

    SciTech Connect

    Stone, Jordan M.; Eisner, J. A.; Monnier, J. D.; Woillez, J.; Wizinowich, P.; Pott, J.-U.; Ghez, A. M. E-mail: jeisner@email.arizona.edu

    2012-08-01

    We present simulations of Keck Interferometer ASTRA and VLTI GRAVITY observations of mock star fields in orbit within {approx}50 mas of Sgr A*. Dual-field phase referencing techniques, as implemented on ASTRA and planned for GRAVITY, will provide the sensitivity to observe Sgr A* with long-baseline infrared interferometers. Our results show an improvement in the confusion noise limit over current astrometric surveys, opening a window to study stellar sources in the region. Since the Keck Interferometer has only a single baseline, the improvement in the confusion limit depends on source position angles. The GRAVITY instrument will yield a more compact and symmetric point-spread function, providing an improvement in confusion noise which will not depend as strongly on position angle. Our Keck results show the ability to characterize the star field as containing zero, few, or many bright stellar sources. We are also able to detect and track a source down to m{sub K} {approx} 18 through the least confused regions of our field of view at a precision of {approx}200 {mu}as along the baseline direction. This level of precision improves with source brightness. Our GRAVITY results show the potential to detect and track multiple sources in the field. GRAVITY will perform {approx}10 {mu}as astrometry on an m{sub K} = 16.3 source and {approx}200 {mu}as astrometry on an m{sub K} = 18.8 source in 6 hr of monitoring a crowded field. Monitoring the orbits of several stars will provide the ability to distinguish between multiple post-Newtonian orbital effects, including those due to an extended mass distribution around Sgr A* and to low-order general relativistic effects. ASTRA and GRAVITY both have the potential to detect and monitor sources very close to Sgr A*. Early characterizations of the field by ASTRA, including the possibility of a precise source detection, could provide valuable information for future GRAVITY implementation and observation.

  18. Confusion about Cadmium Risks: The Unrecognized Limitations of an Extrapolated Paradigm

    PubMed Central

    Bernard, Alfred

    2015-01-01

    Background Cadmium (Cd) risk assessment presently relies on tubular proteinuria as a critical effect and urinary Cd (U-Cd) as an index of the Cd body burden. Based on this paradigm, regulatory bodies have reached contradictory conclusions regarding the safety of Cd in food. Adding to the confusion, epidemiological studies implicate environmental Cd as a risk factor for bone, cardiovascular, and other degenerative diseases at exposure levels that are much lower than points of departure used for setting food standards. Objective The objective was to examine whether the present confusion over Cd risks is not related to conceptual or methodological problems. Discussion The cornerstone of Cd risk assessment is the assumption that U-Cd reflects the lifetime accumulation of the metal in the body. The validity of this assumption as applied to the general population has been questioned by recent studies revealing that low-level U-Cd varies widely within and between individuals depending on urinary flow, urine collection protocol, and recent exposure. There is also evidence that low-level U-Cd increases with proteinuria and essential element deficiencies, two potential confounders that might explain the multiple associations of U-Cd with common degenerative diseases. In essence, the present Cd confusion might arise from the fact that this heavy metal follows the same transport pathways as plasma proteins for its urinary excretion and the same transport pathways as essential elements for its intestinal absorption. Conclusions The Cd risk assessment paradigm needs to be rethought taking into consideration that low-level U-Cd is strongly influenced by renal physiology, recent exposure, and factors linked to studied outcomes. Citation Bernard A. 2016. Confusion about cadmium risks: the unrecognized limitations of an extrapolated paradigm. Environ Health Perspect 124:1–5; http://dx.doi.org/10.1289/ehp.1509691 PMID:26058085

  19. Towards robust deconvolution of low-dose perfusion CT: sparse perfusion deconvolution using online dictionary learning.

    PubMed

    Fang, Ruogu; Chen, Tsuhan; Sanelli, Pina C

    2013-05-01

    Computed tomography perfusion (CTP) is an important functional imaging modality in the evaluation of cerebrovascular diseases, particularly in acute stroke and vasospasm. However, the post-processed parametric maps of blood flow tend to be noisy, especially in low-dose CTP, due to the noisy contrast enhancement profile and the oscillatory nature of the results generated by the current computational methods. In this paper, we propose a robust sparse perfusion deconvolution method (SPD) to estimate cerebral blood flow in CTP performed at low radiation dose. We first build a dictionary from high-dose perfusion maps using online dictionary learning and then perform deconvolution-based hemodynamic parameters estimation on the low-dose CTP data. Our method is validated on clinical data of patients with normal and pathological CBF maps. The results show that we achieve superior performance than existing methods, and potentially improve the differentiation between normal and ischemic tissue in the brain. PMID:23542422

  20. Towards robust deconvolution of low-dose perfusion CT: Sparse perfusion deconvolution using online dictionary learning

    PubMed Central

    Fang, Ruogu; Chen, Tsuhan; Sanelli, Pina C.

    2014-01-01

    Computed tomography perfusion (CTP) is an important functional imaging modality in the evaluation of cerebrovascular diseases, particularly in acute stroke and vasospasm. However, the post-processed parametric maps of blood flow tend to be noisy, especially in low-dose CTP, due to the noisy contrast enhancement profile and the oscillatory nature of the results generated by the current computational methods. In this paper, we propose a robust sparse perfusion deconvolution method (SPD) to estimate cerebral blood flow in CTP performed at low radiation dose. We first build a dictionary from high-dose perfusion maps using online dictionary learning and then perform deconvolution-based hemodynamic parameters estimation on the low-dose CTP data. Our method is validated on clinical data of patients with normal and pathological CBF maps. The results show that we achieve superior performance than existing methods, and potentially improve the differentiation between normal and ischemic tissue in the brain. PMID:23542422

  1. Constructing bis(porphyrinato) rare earth double-decker complexes involving N-confused porphyrin.

    PubMed

    Zhang, Yuehong; Cao, Wei; Wang, Kang; Jiang, Jianzhuang

    2014-06-28

    Reaction of metal-free N-confused 5,10,15,20-tetrakis(4-chlorophenyl)porphyrin (H2NTClPP) with metal-free 5,10,15,20-tetrakis[(4-tert-butyl)phenyl]porphyrin (H2TBPP) in the presence of M(III)(acac)3·nH2O (acac = acetylacetonate) in refluxing 1,2,4-trichlorobenzene (TCB) led to the isolation of heteroleptic bis(porphyrinato) rare earth compounds M(III)(HNTClPP)(TBPP) (M = La, Pr) (1, 2) in 6.7-10% yield. These represent the first examples of sandwich-type porphyrin rare earth double-decker complexes that involve N-confused porphyrin ligand. Different from their homoleptic bis(porphyrinato) rare earth double-decker counterparts HM(III)(TBPP)2 (M = La, Pr) (3, 4), the acidic proton in the heteroleptic analogues was revealed to localize at the inverted pyrrole nitrogen atom of the N-confused porphyrin ligand on the basis of NMR spectroscopic studies. Nevertheless, their heteroleptic bis(porphyrinato) sandwich molecular nature was confirmed on the basis of single crystal X-ray diffraction analysis over the praseodymium double-decker complex. PMID:24809442

  2. Notation Confusion of Symmetry Species for Molecules with Several Large-Amplitude Internal Motions

    NASA Astrophysics Data System (ADS)

    Groner, P.

    2011-06-01

    The Mulliken convention has become the standard notation for symmetry species (irreducible representations) of point groups for quasi-rigid molecules. No such convention exists for symmetry species of symmetry groups for semi-rigid or non-rigid molecules with large amplitude internal motions (LAMs). As a result, we have a situation where we create notations in a do-it-yourself fashion or adopt them from the literature, sometimes even without proper reference to its derivation or to the character table on which it is based. This may be just a nuisance for those who are comfortable enough with group theory and molecular symmetry groups to figure "it" out, but it represents a real problem for everybody else. The notation confusion is illustrated with examples from the literature (both old and new) on molecules with two or more LAMs. Most authors use the notation introduced by Myers and Wilson for molecules such as acetone or propane. No universal notation is in use for molecules with two methyl groups but lower overall symmetry. For example, the notation G_1_8 is used for one of these groups. As it turns out, different people use the same notation for different groups. This presentation is an attempt to bring some light into the dark and to combat confusion with a call for an anti-confusion convention. R. S. Mulliken, Phys. Rev. 43, 279 (1933). R. J. Myers, E. B. Wilson, J. Chem. Phys. 33, 186 (1960).

  3. Minimizing Confusion and Disorientation: Cognitive Support Work in Informal Dementia Caregiving

    PubMed Central

    Berry, Brandon

    2015-01-01

    Drawing from ethnographic fieldwork and in-depth interviews, I explain how informal dementia caregivers attempt to reduce the affected individual’s moments of confusion and disorientation through cognitive support work. I identify three stages through which such support takes shape and then gradually declines in usage. In a first stage, family members collaborate with affected individuals to first identify and then to avoid “triggers” that elicit sudden bouts of confusion. In a second stage, caregivers lose the effective collaboration of the affected individual and begin unilateral attempts to minimize confused states through pre-emptive conversational techniques, third-party interactional support, and social-environment shifts. In a third stage, caregivers learn that the affected individual has reached a level of impairment that does not respond well to efforts at reduction and begin abandoning strategies. I identify the motivations driving cognitive support work and discuss the role of lay health knowledge in dementia caregiving. I conclude by considering the utility of cognitive support as a concept within dementia caregiving. PMID:24984915

  4. Productive confusions: learning from simulations of pandemic virus outbreaks in Second Life

    NASA Astrophysics Data System (ADS)

    Cárdenas, Micha; Greci, Laura S.; Hurst, Samantha; Garman, Karen; Hoffman, Helene; Huang, Ricky; Gates, Michael; Kho, Kristen; Mehrmand, Elle; Porteous, Todd; Calvitti, Alan; Higginbotham, Erin; Agha, Zia

    2011-03-01

    Users of immersive virtual reality environments have reported a wide variety of side and after effects including the confusion of characteristics of the real and virtual worlds. Perhaps this side effect of confusing the virtual and real can be turned around to explore the possibilities for immersion with minimal technological support in virtual world group training simulations. This paper will describe observations from my time working as an artist/researcher with the UCSD School of Medicine (SoM) and Veterans Administration San Diego Healthcare System (VASDHS) to develop trainings for nurses, doctors and Hospital Incident Command staff that simulate pandemic virus outbreaks. By examining moments of slippage between realities, both into and out of the virtual environment, moments of the confusion of boundaries between real and virtual, we can better understand methods for creating immersion. I will use the mixing of realities as a transversal line of inquiry, borrowing from virtual reality studies, game studies, and anthropological studies to better understand the mechanisms of immersion in virtual worlds. Focusing on drills conducted in Second Life, I will examine moments of training to learn the software interface, moments within the drill and interviews after the drill.

  5. Hypersensitive bladder: a solution to confused terminology and ignorance concerning interstitial cystitis.

    PubMed

    Homma, Yukio

    2014-04-01

    Taxonomy or nomenclature concerning interstitial cystitis and its related symptom syndromes is in a state of confusion. After analyzing the reasons for confusion in regard to three components (disease name, symptoms, Hunner's lesion), I would like to propose a new term, "hypersensitive bladder", taking after overactive bladder, as a solution. Hypersensitive bladder symptoms are defined as "increased bladder sensation, usually associated with urinary frequency and nocturia, with or without bladder pain." The proposal of hypersensitive bladder is based on: (i) it does not appear a symptom syndrome, but a disease by ending with an organ name, "bladder"; (ii) it does not contain confusable symptom terms (pain and urgency), but indicates irritative symptoms including pain and urgency; and (iii) it suggests pathophysiological hyperactivity of sensory nerves. Interstitial cystitis is defined by three requirements: (i) hypersensitive bladder symptoms; (ii) bladder pathology; and (iii) no other diseases, where bladder pathology should be clearly stated either as Hunner's lesion or glomerulations after hydrodistention. Hypersensitive bladder can be used for the condition with hypersensitive bladder symptoms, but no obvious disease explaining hypersensitive bladder symptoms identified. Interstitial cystitis is a representative disease causing hypersensitive bladder symptoms, most typically with pain, but might be painless and indistinguishable from overactive bladder. Introducing hypersensitive bladder as a counter concept of overactive bladder into bladder dysfunction taxonomy will facilitate clinical practice and research progress, and attract considerable attention from the medical world. PMID:24807494

  6. CT Perfusion Dynamics of Intracranial Tuberculomas

    PubMed Central

    N., Jayakumar Peruvumba; Shivashankar, Ravishankar

    2015-01-01

    Aims To study perfusion characteristics of intracranial tuberculomas and analyze changes with anti tubercular treatment. Materials and Methods Nineteen patients of histologically proven intracranial tuberculomas were included in the study of which 9 were not on antitubercular treatment and ten were on antitubercular treatment (6 patients on treatment for less than 2 months and 4 were more than 6 months). All patients underwent CT perfusion (CTP) and CTP parameters like rCBV and rCBF were obtained from entire lesion, center and capsule of lesions and compared. Results CTP parameters like rCBF and rCBV were significantly low in all the three ROIs in the group not on treatment compared to that of on treatment ; rCBF and rCBV of entire lesion (p=0.018 and p=0.005 respectively), capsule (p=0.045 and p=0.010 respectively) and center of the lesion (p=0.020 and p=0.009) respectively). Tuberculomas on antitubercular treatment of more than six months showed reduced rCBF and rCBV in entire lesion (p=0.01 & p=0.01 respectively), capsule (p=0.04 & p=0.03 respectively) and center (p=0.08 & p=0.05 respectively) compared to those on treatment for less than two months. Similarly tuberculomas on treatment for six months did not show significant difference in rCBF and rCBV compared to tuberculomas who were not on treatment. Tuberculomas on treatment for less than two months showed statistically increased rCBF and rCBV in entire lesion (p=0.01 & p=0.04 respectively), capsule (p=0.03 & p=0.01 respectively) and center (p= 0.03 &=0.01) compared to those not on treatment. Conclusion Intracranial tuberculomas not on treatment and those on treatment for around six months show low perfusion and tuberculomas on treatment for less than two months show high perfusion. These findings suggest that serial perfusion profiles of tuberculomas on treatment could possibly be seen as surrogate markers of response to treatment. PMID:26155528

  7. Vaneless diffusers

    NASA Astrophysics Data System (ADS)

    Senoo, Y.

    The influence of vaneless diffusers on flow in centrifugal compressors, particularly on surge, is discussed. A vaneless diffuser can demonstrate stable operation in a wide flow range only if it is installed with a backward leaning blade impeller. The circumferential distortion of flow in the impeller disappears quickly in the vaneless diffuser. The axial distortion of flow at the diffuser inlet does not decay easily. In large specific speed compressors, flow out of the impeller is distorted axially. Pressure recovery of diffusers at distorted inlet flow is considerably improved by half guide vanes. The best height of the vanes is a little 1/2 diffuser width. In small specific speed compressors, flow out of the impeller is not much distorted and pressure recovery can be predicted with one-dimensional flow analysis. Wall friction loss is significant in narrow diffusers. The large pressure drop at a small flow rate can cause the positive gradient of the pressure-flow rate characteristic curve, which may cause surging.

  8. Developing a Benchmarking Process in Perfusion: A Report of the Perfusion Downunder Collaboration

    PubMed Central

    Baker, Robert A.; Newland, Richard F.; Fenton, Carmel; McDonald, Michael; Willcox, Timothy W.; Merry, Alan F.

    2012-01-01

    Abstract: Improving and understanding clinical practice is an appropriate goal for the perfusion community. The Perfusion Downunder Collaboration has established a multi-center perfusion focused database aimed at achieving these goals through the development of quantitative quality indicators for clinical improvement through benchmarking. Data were collected using the Perfusion Downunder Collaboration database from procedures performed in eight Australian and New Zealand cardiac centers between March 2007 and February 2011. At the Perfusion Downunder Meeting in 2010, it was agreed by consensus, to report quality indicators (QI) for glucose level, arterial outlet temperature, and pCO2 management during cardiopulmonary bypass. The values chosen for each QI were: blood glucose ≥4 mmol/L and ≤10 mmol/L; arterial outlet temperature ≤37°C; and arterial blood gas pCO2 ≥ 35 and ≤45 mmHg. The QI data were used to derive benchmarks using the Achievable Benchmark of Care (ABC™) methodology to identify the incidence of QIs at the best performing centers. Five thousand four hundred and sixty-five procedures were evaluated to derive QI and benchmark data. The incidence of the blood glucose QI ranged from 37–96% of procedures, with a benchmark value of 90%. The arterial outlet temperature QI occurred in 16–98% of procedures with the benchmark of 94%; while the arterial pCO2 QI occurred in 21–91%, with the benchmark value of 80%. We have derived QIs and benchmark calculations for the management of several key aspects of cardiopulmonary bypass to provide a platform for improving the quality of perfusion practice. PMID:22730861

  9. A Phantom Tissue System for the Calibration of Perfusion Measurements

    PubMed Central

    Mudaliar, Ashvinikumar V.; Ellis, Brent E.; Ricketts, Patricia L.; Lanz, Otto I.; Scott, Elaine P.; Diller, Thomas E.

    2008-01-01

    A convenient method for testing and calibrating surface perfusion sensors has been developed. A phantom tissue model is used to simulate the nondirectional blood flow of tissue perfusion. A computational fluid dynamics (CFD) model was constructed in Fluent® to design the phantom tissue and validate the experimental results. The phantom perfusion system was used with a perfusion sensor based on clearance of thermal energy. A heat flux gage measures the heat flux response of tissue when a thermal event (convective cooling) is applied. The blood perfusion and contact resistance are estimated by a parameter estimation code. From the experimental and analytical results, it was concluded that the probe displayed good measurement repeatability and sensitivity. The experimental perfusion measurements in the tissue were in good agreement with those of the CFD models and demonstrated the value of the phantom tissue system. PMID:19045509

  10. [Study on intestinal absorption features of oligosaccharides in Morinda officinalis How. with sigle-pass perfusion].

    PubMed

    Deng, Shao-Dong; Zhang, Peng; Lin, Li; Xiao, Feng-Xia; Lin, Jing-Ran

    2015-01-01

    To study the in situ intestinal absorption of five oligosaccharides contained in Morinda officinalis How. (sucrose, kestose, nystose, 1F-Fructofuranosyinystose and Bajijiasu). The absorption of the five oligosaccharides in small intestine (duodenum, jejunum and ileum) and colon of rats and their contents were investigated by using in situ single-pass perfusion model and HPLC-ELSD. The effects of drug concentration, pH in perfusate and P-glycoprotein inhibitor on the intestinal absorption were investigated to define the intestinal absorption mechanism of the five oligosaccharides in rats. According to the results, all of the five oligosaccharides were absorbed in the whole intestine, and their absorption rates were affected by the pH of the perfusion solution, drug concentration and intestinal segments. Verapamil Hydrochloride could significantly increase the absorptive amount of sucrose and Bajijiasu, suggesting sucrose and Bajijiasu are P-gp's substrate. The five oligosaccharides are absorbed mainly through passive diffusion in the intestinal segments, without saturated absorption. They are absorbed well in all intestines and mainly in duodenum and jejunum. PMID:25993803

  11. A Device for Long-Term Perfusion, Imaging, and Electrical Interfacing of Brain Tissue In vitro

    PubMed Central

    Killian, Nathaniel J.; Vernekar, Varadraj N.; Potter, Steve M.; Vukasinovic, Jelena

    2016-01-01

    Distributed microelectrode array (MEA) recordings from consistent, viable, ≥500 μm thick tissue preparations over time periods from days to weeks may aid in studying a wide range of problems in neurobiology that require in vivo-like organotypic morphology. Existing tools for electrically interfacing with organotypic slices do not address necrosis that inevitably occurs within thick slices with limited diffusion of nutrients and gas, and limited removal of waste. We developed an integrated device that enables long-term maintenance of thick, functionally active, brain tissue models using interstitial perfusion and distributed recordings from thick sections of explanted tissue on a perforated multi-electrode array. This novel device allows for automated culturing, in situ imaging, and extracellular multi-electrode interfacing with brain slices, 3-D cell cultures, and potentially other tissue culture models. The device is economical, easy to assemble, and integrable with standard electrophysiology tools. We found that convective perfusion through the culture thickness provided a functional benefit to the preparations as firing rates were generally higher in perfused cultures compared to their respective unperfused controls. This work is a step toward the development of integrated tools for days-long experiments with more consistent, healthier, thicker, and functionally more active tissue cultures with built-in distributed electrophysiological recording and stimulation functionality. The results may be useful for the study of normal processes, pathological conditions, and drug screening strategies currently hindered by the limitations of acute (a few hours long) brain slice preparations. PMID:27065793

  12. Measurement of continuous distributions of ventilation-perfusion ratios - Theory

    NASA Technical Reports Server (NTRS)

    Wagner, P. D.; Saltzman, H. A.; West, J. B.

    1974-01-01

    The resolution of the technique considered is sufficient to describe smooth distributions containing blood flow to unventilated regions (shunt), ventilation to unperfused regions (dead space), and up to three additional modes over the range of finite ventilation-perfusion ratios. In particular, areas whose ventilation-perfusion ratios are low can be separated from unventilated regions and those whose ventilation-perfusion ratios are high can similarly be distinguished from unperfused areas.

  13. A method of thymic perfusion and its evaluation

    PubMed Central

    Ekwueme, O.

    1973-01-01

    The development and evaluation of a method of isolated ex vivo perfusion of the rabbit thymus using diluted autologous blood is described. The data indicate that the viability of the preparation is maintained at a satisfactory level during the period of perfusion. These results suggest that the isolated perfused thymus would be a useful new approach to studies of thymus function. ImagesFig. 2Fig. 8Fig. 9Fig. 10Fig. 11 PMID:4747584

  14. Perfusion Scintigraphy and Patient Selection for Lung Volume Reduction Surgery

    PubMed Central

    Chandra, Divay; Lipson, David A.; Hoffman, Eric A.; Hansen-Flaschen, John; Sciurba, Frank C.; DeCamp, Malcolm M.; Reilly, John J.; Washko, George R.

    2010-01-01

    Rationale: It is unclear if lung perfusion can predict response to lung volume reduction surgery (LVRS). Objectives: To study the role of perfusion scintigraphy in patient selection for LVRS. Methods: We performed an intention-to-treat analysis of 1,045 of 1,218 patients enrolled in the National Emphysema Treatment Trial who were non–high risk for LVRS and had complete perfusion scintigraphy results at baseline. The median follow-up was 6.0 years. Patients were classified as having upper or non–upper lobe–predominant emphysema on visual examination of the chest computed tomography and high or low exercise capacity on cardiopulmonary exercise testing at baseline. Low upper zone perfusion was defined as less than 20% of total lung perfusion distributed to the upper third of both lungs as measured on perfusion scintigraphy. Measurements and Main Results: Among 284 of 1,045 patients with upper lobe–predominant emphysema and low exercise capacity at baseline, the 202 with low upper zone perfusion had lower mortality with LVRS versus medical management (risk ratio [RR], 0.56; P = 0.008) unlike the remaining 82 with high perfusion where mortality was unchanged (RR, 0.97; P = 0.62). Similarly, among 404 of 1,045 patients with upper lobe–predominant emphysema and high exercise capacity, the 278 with low upper zone perfusion had lower mortality with LVRS (RR, 0.70; P = 0.02) unlike the remaining 126 with high perfusion (RR, 1.05; P = 1.00). Among the 357 patients with non–upper lobe–predominant emphysema (75 with low and 282 with high exercise capacity) there was no improvement in survival with LVRS and measurement of upper zone perfusion did not contribute new prognostic information. Conclusions: Compared with optimal medical management, LVRS reduces mortality in patients with upper lobe–predominant emphysema when there is low rather than high perfusion to the upper lung. PMID:20538961

  15. Diffusion barriers

    NASA Technical Reports Server (NTRS)

    Nicolet, M. A.

    1983-01-01

    The choice of the metallic film for the contact to a semiconductor device is discussed. One way to try to stabilize a contact is by interposing a thin film of a material that has low diffusivity for the atoms in question. This thin film application is known as a diffusion barrier. Three types of barriers can be distinguished. The stuffed barrier derives its low atomic diffusivity to impurities that concentrate along the extended defects of a polycrystalline layer. Sacrificial barriers exploit the fact that some (elemental) thin films react in a laterally uniform and reproducible fashion. Sacrificial barriers have the advantage that the point of their failure is predictable. Passive barriers are those most closely approximating an ideal barrier. The most-studied case is that of sputtered TiN films. Stuffed barriers may be viewed as passive barriers whose low diffusivity material extends along the defects of the polycrystalline host.

  16. Diffuse radiation

    NASA Technical Reports Server (NTRS)

    1981-01-01

    A diffuse celestial radiation which is isotropic at least on a course scale were measured from the soft X-ray region to about 150 MeV, at which energy the intensity falls below that of the galactic emission for most galactic latitudes. The spectral shape, the intensity, and the established degree of isotropy of this diffuse radiation already place severe constraints on the possible explanations for this radiation. Among the extragalactic theories, the more promising explanations of the isotropic diffuse emission appear to be radiation from exceptional galaxies from matter antimatter annihilation at the boundaries of superclusters of galaxies of matter and antimatter in baryon symmetric big bang models. Other possible sources for extragalactic diffuse gamma radiation are discussed and include normal galaxies, clusters of galaxies, primordial cosmic rays interacting with intergalactic matter, primordial black holes, and cosmic ray leakage from galaxies.

  17. Diffusion–Perfusion Mismatch: An Opportunity for Improvement in Cortical Function

    PubMed Central

    Motta, Melissa; Ramadan, Amanda; Hillis, Argye E.; Gottesman, Rebecca F.; Leigh, Richard

    2015-01-01

    Objective: There has been controversy over whether diffusion–perfusion mismatch provides a biomarker for the ischemic penumbra. In the context of clinical stroke trials, regions of the diffusion–perfusion mismatch that do not progress to infarct in the absence of reperfusion are considered to represent “benign oligemia.” However, at least in some cases (particularly large vessel stenosis), some of this hypoperfused tissue may remain dysfunctional for a prolonged period without progressing to infarct and may recover function if eventually reperfused. We hypothesized that patients with persistent diffusion–perfusion mismatch using a hypoperfusion threshold of 4–5.9 s delay on time-to-peak (TTP) maps at least sometimes have persistent cognitive deficits relative to those who show some reperfusion of this hypoperfused tissue. Methods: We tested this hypothesis in 38 patients with acute ischemic stroke who had simple cognitive tests (naming or line cancelation) and MRI with diffusion and perfusion imaging within 24 h of onset and again within 10 days, most of whom had large vessel stenosis or occlusion. Results: A persistent perfusion deficit of 4–5.9 s delay in TTP on follow up MRI was associated with a persistent cognitive deficit at that time point (p < 0.001). When we evaluated only patients who did not have infarct growth (n = 14), persistent hypoperfusion (persistent mismatch) was associated with a lack of cognitive improvement compared with those who had reperfused. The initial volume of hypoperfusion did not correlate with the later infarct volume (progression to infarct), but change in volume of hypoperfusion correlated with change in cognitive performance (p = 0.0001). Moreover, multivariable regression showed that the change in volume of hypoperfused tissue of 4–5.9 s delay (p = 0.002), and change in volume of ischemic tissue on diffusion weighted imaging (p = 0.02) were independently associated with change in

  18. Extracorporeal Free Flap Perfusion in Case of Prolonged Ischemia Time

    PubMed Central

    Präbst, K.; Beier, J. P.; Meyer, A.; Horch, R. E.

    2016-01-01

    Summary: In free flap surgery, a clinically established concept still has to be found for the reduction of ischemia-related cell damage in the case of prolonged ischemia. Although promising results using extracorporeal free flap perfusion in the laboratory have been published in the past, until now this concept has not yet paved its way into clinical routine. This might be due to the complexity of perfusion systems and a lack of standardized tools. Here, we want to present the results of the first extracorporeal free flap perfusion in a clinical setting using a simple approach without the application of a complex perfusion machinery. PMID:27200244

  19. New imaging technology: measurement of myocardial perfusion by contrast echocardiography

    NASA Technical Reports Server (NTRS)

    Rubin, D. N.; Thomas, J. D.

    2000-01-01

    Myocardial perfusion imaging has long been a goal for the non-invasive echocardiographic assessment of the heart. However, many factors at play in perfusion imaging have made this goal elusive. Harmonic imaging and triggered imaging with newer contrast agents have made myocardial perfusion imaging potentially practical in the very near future. The application of indicator dilution theory to the coronary circulation and bubble contrast agents is fraught with complexities and sources of error. Therefore, quantification of myocardial perfusion by non-invasive echocardiographic imaging requires further investigation in order to make this technique clinically viable.

  20. Perfusion CT imaging of the liver: review of clinical applications

    PubMed Central

    Oğul, Hayri; Kantarcı, Mecit; Genç, Berhan; Pirimoğlu, Berhan; Çullu, Neşat; Kızrak, Yeşim; Yılmaz, Ömer; Karabulut, Nevzat

    2014-01-01

    Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemotherapy, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases. PMID:24834487

  1. Radionuclide Tracers for Myocardial Perfusion Imaging and Blood Flow Quantification.

    PubMed

    deKemp, Robert A; Renaud, Jennifer M; Klein, Ran; Beanlands, Rob S B

    2016-02-01

    Myocardial perfusion imaging is performed most commonly using Tc-99m-sestamibi or tetrofosmin SPECT as well as Rb-82-rubidium or N-13-ammonia PET. Diseased-to-normal tissue contrast is determined by the tracer retention fraction, which decreases nonlinearly with flow. Reduced tissue perfusion results in reduced tracer retention, but the severity of perfusion defects is typically underestimated by 20% to 40%. Compared to SPECT, retention of the PET tracers is more linearly related to flow, and therefore, the perfusion defects are measured more accurately using N-13-ammonia or Rb-82. PMID:26590778

  2. Gas exchange and ventilation-perfusion relationships in the lung.

    PubMed

    Petersson, Johan; Glenny, Robb W

    2014-10-01

    This review provides an overview of the relationship between ventilation/perfusion ratios and gas exchange in the lung, emphasising basic concepts and relating them to clinical scenarios. For each gas exchanging unit, the alveolar and effluent blood partial pressures of oxygen and carbon dioxide (PO2 and PCO2) are determined by the ratio of alveolar ventilation to blood flow (V'A/Q') for each unit. Shunt and low V'A/Q' regions are two examples of V'A/Q' mismatch and are the most frequent causes of hypoxaemia. Diffusion limitation, hypoventilation and low inspired PO2 cause hypoxaemia, even in the absence of V'A/Q' mismatch. In contrast to other causes, hypoxaemia due to shunt responds poorly to supplemental oxygen. Gas exchanging units with little or no blood flow (high V'A/Q' regions) result in alveolar dead space and increased wasted ventilation, i.e. less efficient carbon dioxide removal. Because of the respiratory drive to maintain a normal arterial PCO2, the most frequent result of wasted ventilation is increased minute ventilation and work of breathing, not hypercapnia. Calculations of alveolar-arterial oxygen tension difference, venous admixture and wasted ventilation provide quantitative estimates of the effect of V'A/Q' mismatch on gas exchange. The types of V'A/Q' mismatch causing impaired gas exchange vary characteristically with different lung diseases. PMID:25063240

  3. Dizzy and confused: a step-by-step evaluation of the clinician's favorite chief complaint.

    PubMed

    Kulstad, Christine; Hannafin, Blaine

    2010-08-01

    This article covers the general approach to patients who present to the emergency department with a complaint of dizziness or vertigo, and altered mentation. Patients' histories and physical examination findings are discussed first, then a pertinent differential diagnosis, ranging from neurological causes and poor perfusion states to toxicologic causes, is described along with the distinguishing features and potential diagnostic pitfalls of each problem. Case scenarios are presented and the treatment and disposition of patients from the emergency department are discussed. PMID:20709238

  4. Clearance of. cap alpha. -aminoisobutyric acid during in-situ perfusion of the guinea pig placenta

    SciTech Connect

    Kelman, B.J.; Sikov, M.R.

    1983-05-01

    Extensive investigation of the transport of ..cap alpha..-aminoisobutyric acid (AIB; a nonmetabolized amino acid) has shown that AIB is actively transported from mother to fetus across the hemochorial placenta of the guinea pig. As a step towards clarifying the relative rolls of active and passive movements of amino acids across the placenta, it would be useful to obtain concurrent measurements of transplacental movements of a substance which crosses the placenta rapidly by simple diffusion (water) and of a substance which is actively transported across the placenta (AIB). In our study, placentas from guinea pigs between 59 and 61 days of gestation were perfused in situ through cannulated umbilical vessels with the maternal circulation left intact. Tritiated water and /sup 14/C-AIB were injected into a maternal jugular vein and maternal blood samples were obtained at 1 to 10 minute intervals; perfusate samples were collected sequentially after one pass through the placenta. Clearance of /sup 14/C-AIB from mother to fetus (AIB/sub MF/) and AIB concentrations in placental tissue, maternal plasma, and perfusate were consistent in magnitude with data obtained by other invetigators who have clearly shown an active transport of AIB in the placenta. On the other hand, in this study AIB/sub MF/ ranged from approximately 50% to 96% of the clearance of /sup 3/H-labeled water from mother to fetus (T/sub MF/) and that changes in AIB/sub MF/ correlated closely with changes in T/sub MF/ in all perfusions. Thus, it appears that AIB/sub MF/ closely paralleled T/sub MF/ and these data suggest that a relatively large component of AIB/sub MF/ is of passive origin in the in situ placenta.

  5. IN VITRO BIODISTRIBUTION OF SILVER NANOPARTICLES IN ISOLATED PERFUSED PORCINE SKIN FLAPS

    PubMed Central

    Leavens, Teresa L.; Monteiro-Riviere, Nancy A.; Inman, Alfred O.; Brooks, James D.; Oldenburg, Steven J.; Riviere, Jim E.

    2012-01-01

    Nanomaterials increasingly are playing a role in society for uses ranging from biomedicine to microelectronics; however pharmacokinetic studies, which will be necessary for human health risk assessments, are limited. Currently the most widely used nanoparticle in consumer products is silver (Ag). The objective of this study was to quantify the local biodistribution of two types of Ag nanoparticles, Ag-citrate and Ag-silica, in the isolated perfused porcine skin flap (IPPSF). IPPSFs were perfused for 4 h with 0.84 μg/ml Ag-citrate or 0.48 μg/ml Ag-silica followed by a 4-h perfusion with media only during a washout phase. Arterial and venous concentrations of Ag were measured in the media by ICP-OES. Venous concentrations of Ag for both types of nanoparticles were best fit with a two compartment model. The normalized volumes of distribution estimated from the noncompartmental analysis of the venous concentrations indicated distribution of Ag greater than the vascular space, however, because total Ag was measured, the extravascular distribution could be attributed to diffusion of Ag ions. The estimated clearance for both types of Ag nanoparticles was 1 ml/min, which was equal to the flap perfusion rate, indicating no detectable elimination of Ag from the system. By 4 hrs following infusion of the Ag nanoparticles, the recovery of Ag in the venous effluent was 90 ± 5.0% and 87 ± 22 % of the infused Ag for Ag-citrate and Ag-silica, respectively. PMID:22760951

  6. Hippocampal Dysfunction in Gulf War Veterans: Investigation with ASL Perfusion MR Imaging and Physostigmine Challenge

    PubMed Central

    Li, Xiufeng; Spence, Jeffrey S.; Buhner, David M.; Hart, John; Cullum, C. Munro; Biggs, Melanie M.; Hester, Andrea L.; Odegard, Timothy N.; Carmack, Patrick S.; Haley, Robert W.

    2011-01-01

    Purpose: To determine, with arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging and physostigmine challenge, if abnormal hippocampal blood flow in ill Gulf War veterans persists 11 years after initial testing with single photon emission computed tomography and nearly 20 years after the 1991 Gulf War. Materials and Methods: The local institutional review board approved this HIPAA-compliant study. Veterans were screened for contraindications and gave written informed consent before the study. In a semiblinded retrospective protocol, veterans in three Gulf War illness groups—syndrome 1 (impaired cognition), syndrome 2 (confusion-ataxia), and syndrome 3 (central neuropathic pain)—and a control group received intravenous infusions of saline in an initial session and physostigmine in a second session, 48 hours later. Each infusion was followed by measurement of hippocampal regional cerebral blood flow (rCBF) with pulsed ASL. A mixed-effects linear model adjusted for age was used to test for differences in rCBF after the cholinergic challenge across the four groups. Results: Physostigmine significantly decreased hippocampal rCBF in control subjects (P < .0005) and veterans with syndrome 1 (P < .05) but significantly increased hippocampal rCBF in veterans with syndrome 2 (P < .005) and veterans with syndrome 3 (P < .002). The abnormal increase in rCBF was found to have progressed to the left hippocampus of the veterans with syndrome 2 and to both hippocampi of the veterans with syndrome 3. Conclusion: Chronic hippocampal perfusion dysfunction persists or worsens in veterans with certain Gulf War syndromes. ASL MR imaging examination of hippocampal rCBF in a cholinergic challenge experiment may be useful as a diagnostic test for this condition. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101715/-/DC1 PMID:21914840

  7. The effects of perfusion conditions on melphalan distribution in the isolated perfused rat hindlimb bearing a human melanoma xenograft.

    PubMed

    Wu, Z Y; Smithers, B M; Parsons, P G; Roberts, M S

    1997-01-01

    An isolated rat hindlimb perfusion model carrying xenografts of the human melanoma cell line MM96 was used to study the effects of perfusion conditions on melphalan distribution. Krebs-Henseleit buffer and Hartmann's solution containing 4.7% bovine serum albumin (BSA) or 2.8% dextran 40 were used as perfusates. Melphalan concentrations in perfusate, tumour nodules and normal tissues were measured using high-performance liquid chromatography (HPLC). Increasing the perfusion flow rates (from 4 to 8 ml min(-1)) resulted in higher tissue blood flow (determined with 51Cr-labelled microspheres) and melphalan uptake by tumour and normal tissues. The distribution of melphalan within tumour nodules and normal tissues was similar for both Krebs-Henseleit buffer and Hartmann's solution; however, tissue concentrations of melphalan were significantly higher for a perfusate containing 2.8% dextran 40 than for one containing 4.7% BSA. The melphalan concentration in the tumour was one-third of that found in the skin if the perfusate contained 4.7% BSA. In conclusion, this study has shown that a high perfusion flow enhances the delivery of melphalan into implanted tumour nodules and normal tissues, and a perfusate with low melphalan binding (no albumin) is preferred for maximum uptake of drug by the tumour. PMID:9099965

  8. The Theos/ComRes survey into public perception of Darwinism in the UK: a recipe for confusion.

    PubMed

    Baker, Sylvia

    2012-04-01

    A survey of the general public in the UK, conducted in 2008, suggested that more than half of the British population are unconvinced by Darwinism. That survey, conducted by the polling company ComRes on behalf of the theological think-tank Theos, reported its full findings in March 2009 and found them to be "complex and confused." This paper argues that the confusion identified may have been partly engendered by the way in which the survey questionnaire was constructed and that the survey itself, not simply its respondents, was confused. A source of the confusion, it is argued, could be found, first, in the definitions used for the four positions of young earth creationism, theistic evolution, atheistic evolution and intelligent design. Second, a failure to define the key terms "evolution" and "science," used in some of the survey questions, resulted in responses that were difficult to interpret. PMID:23045881

  9. Conceptions about the mind-body problem and their relations to afterlife beliefs, paranormal beliefs, religiosity, and ontological confusions.

    PubMed

    Riekki, Tapani; Lindeman, Marjaana; Lipsanen, Jari

    2013-01-01

    We examined lay people's conceptions about the relationship between mind and body and their correlates. In Study 1, a web survey (N = 850) of reflective dualistic, emergentistic, and monistic perceptions of the mind-body relationship, afterlife beliefs (i.e., common sense dualism), religiosity, paranormal beliefs, and ontological confusions about physical, biological, and psychological phenomena was conducted. In Study 2 (N = 73), we examined implicit ontological confusions and their relations to afterlife beliefs, paranormal beliefs, and religiosity. Correlation and regression analyses showed that reflective dualism, afterlife beliefs, paranormal beliefs, and religiosity were strongly and positively related and that reflective dualism and afterlife beliefs mediated the relationship between ontological confusions and religious and paranormal beliefs. The results elucidate the contention that dualism is a manifestation of universal cognitive processes related to intuitions about physical, biological, and psychological phenomena by showing that especially individuals who confuse the distinctive attributes of these phenomena tend to set the mind apart from the body. PMID:25247011

  10. Analytic Confusion Matrix Bounds for Fault Detection and Isolation Using a Sum-of-Squared- Residuals Approach

    NASA Technical Reports Server (NTRS)

    Simon, Dan; Simon, Donald L.

    2009-01-01

    Given a system which can fail in 1 or n different ways, a fault detection and isolation (FDI) algorithm uses sensor data in order to determine which fault is the most likely to have occurred. The effectiveness of an FDI algorithm can be quantified by a confusion matrix, which i ndicates the probability that each fault is isolated given that each fault has occurred. Confusion matrices are often generated with simulation data, particularly for complex systems. In this paper we perform FDI using sums of squares of sensor residuals (SSRs). We assume that the sensor residuals are Gaussian, which gives the SSRs a chi-squared distribution. We then generate analytic lower and upper bounds on the confusion matrix elements. This allows for the generation of optimal sensor sets without numerical simulations. The confusion matrix bound s are verified with simulated aircraft engine data.

  11. Reduced Discrimination in the Tritanopic Confusion Line for Congenital Color Deficiency Adults.

    PubMed

    Costa, Marcelo F; Goulart, Paulo R K; Barboni, Mirella T S; Ventura, Dora F

    2016-01-01

    In congenital color blindness the red-green discrimination is impaired resulting in an increased confusion between those colors with yellow. Our post-receptoral physiological mechanisms are organized in two pathways for color perception, a red-green (protanopic and deuteranopic) and a blue-yellow (tritanopic). We argue that the discrimination losses in the yellow area in congenital color vision deficiency subjects could generate a subtle loss of discriminability in the tritanopic channel considering discrepancies with yellow perception. We measured color discrimination thresholds for blue and yellow of tritanopic channel in congenital color deficiency subjects. Chromaticity thresholds were measured around a white background (0.1977 u', 0.4689 v' in the CIE 1976) consisting of a blue-white and white-yellow thresholds in a tritanopic color confusion line of 21 congenital colorblindness subjects (mean age = 27.7; SD = 5.6 years; 14 deuteranomalous and 7 protanomalous) and of 82 (mean age = 25.1; SD = 3.7 years) normal color vision subjects. Significant increase in the whole tritanopic axis was found for both deuteranomalous and protanomalous subjects compared to controls for the blue-white (F 2,100 = 18.80; p < 0.0001) and white-yellow (F 2,100 = 22.10; p < 0.0001) thresholds. A Principal Component Analysis (PCA) found a weighting toward to the yellow thresholds induced by deuteranomalous subjects. In conclusion, the discrimination in the tritanopic color confusion axis is significantly reduced in congenital color vision deficiency compared to normal subjects. Since yellow discrimination was impaired the balance of the blue-yellow channels is impaired justifying the increased thresholds found for blue-white discrimination. The weighting toward the yellow region of the color space with the deuteranomalous contributing to that perceptual distortion is discussed in terms of physiological mechanisms. PMID:27065909

  12. Dream-reality confusion in borderline personality disorder: a theoretical analysis.

    PubMed

    Skrzypińska, Dagna; Szmigielska, Barbara

    2015-01-01

    This paper presents an analysis of dream-reality confusion (DRC) in relation to the characteristics of borderline personality disorder (BPD), based on research findings and theoretical considerations. It is hypothesized that people with BPD are more likely to experience DRC compared to people in non-clinical population. Several variables related to this hypothesis were identified through a theoretical analysis of the scientific literature. Sleep disturbances: problems with sleep are found in 15-95.5% of people with BPD (Hafizi, 2013), and unstable sleep and wake cycles, which occur in BPD (Fleischer et al., 2012), are linked to DRC. Dissociation: nearly two-thirds of people with BPD experience dissociative symptoms (Korzekwa and Pain, 2009) and dissociative symptoms are correlated with a fantasy proneness; both dissociative symptoms and fantasy proneness are related to DRC (Giesbrecht and Merckelbach, 2006). Negative dream content: People with BPD have nightmares more often than other people (Semiz et al., 2008); dreams that are more likely to be confused with reality tend to be more realistic and unpleasant, and are reflected in waking behavior (Rassin et al., 2001). Cognitive disturbances: Many BPD patients experience various cognitive disturbances, including problems with reality testing (Fiqueierdo, 2006; Mosquera et al., 2011), which can foster DRC. Thin boundaries: People with thin boundaries are more prone to DRC than people with thick boundaries, and people with BPD tend to have thin boundaries (Hartmann, 2011). The theoretical analysis on the basis of these findings suggests that people who suffer from BPD may be more susceptible to confusing dream content with actual waking events. PMID:26441768

  13. Dream-reality confusion in borderline personality disorder: a theoretical analysis

    PubMed Central

    Skrzypińska, Dagna; Szmigielska, Barbara

    2015-01-01

    This paper presents an analysis of dream-reality confusion (DRC) in relation to the characteristics of borderline personality disorder (BPD), based on research findings and theoretical considerations. It is hypothesized that people with BPD are more likely to experience DRC compared to people in non-clinical population. Several variables related to this hypothesis were identified through a theoretical analysis of the scientific literature. Sleep disturbances: problems with sleep are found in 15–95.5% of people with BPD (Hafizi, 2013), and unstable sleep and wake cycles, which occur in BPD (Fleischer et al., 2012), are linked to DRC. Dissociation: nearly two-thirds of people with BPD experience dissociative symptoms (Korzekwa and Pain, 2009) and dissociative symptoms are correlated with a fantasy proneness; both dissociative symptoms and fantasy proneness are related to DRC (Giesbrecht and Merckelbach, 2006). Negative dream content: People with BPD have nightmares more often than other people (Semiz et al., 2008); dreams that are more likely to be confused with reality tend to be more realistic and unpleasant, and are reflected in waking behavior (Rassin et al., 2001). Cognitive disturbances: Many BPD patients experience various cognitive disturbances, including problems with reality testing (Fiqueierdo, 2006; Mosquera et al., 2011), which can foster DRC. Thin boundaries: People with thin boundaries are more prone to DRC than people with thick boundaries, and people with BPD tend to have thin boundaries (Hartmann, 2011). The theoretical analysis on the basis of these findings suggests that people who suffer from BPD may be more susceptible to confusing dream content with actual waking events. PMID:26441768

  14. IMAGING THE EPOCH OF REIONIZATION: LIMITATIONS FROM FOREGROUND CONFUSION AND IMAGING ALGORITHMS

    SciTech Connect

    Vedantham, Harish; Udaya Shankar, N.; Subrahmanyan, Ravi

    2012-02-01

    Tomography of redshifted 21 cm transition from neutral hydrogen using Fourier synthesis telescopes is a promising tool to study the Epoch of Reionization (EoR). Limiting the confusion from Galactic and extragalactic foregrounds is critical to the success of these telescopes. The instrumental response or the point-spread function (PSF) of such telescopes is inherently three dimensional with frequency mapping to the line-of-sight (LOS) distance. EoR signals will necessarily have to be detected in data where continuum confusion persists; therefore, it is important that the PSF has acceptable frequency structure so that the residual foreground does not confuse the EoR signature. This paper aims to understand the three-dimensional PSF and foreground contamination in the same framework. We develop a formalism to estimate the foreground contamination along frequency, or equivalently LOS dimension, and establish a relationship between foreground contamination in the image plane and visibility weights on the Fourier plane. We identify two dominant sources of LOS foreground contamination-'PSF contamination' and 'gridding contamination'. We show that PSF contamination is localized in LOS wavenumber space, beyond which there potentially exists an 'EoR window' with negligible foreground contamination where we may focus our efforts to detect EoR. PSF contamination in this window may be substantially reduced by judicious choice of a frequency window function. Gridding and imaging algorithms create additional gridding contamination and we propose a new imaging algorithm using the Chirp Z Transform that significantly reduces this contamination. Finally, we demonstrate the analytical relationships and the merit of the new imaging algorithm for the case of imaging with the Murchison Widefield Array.

  15. Reduced Discrimination in the Tritanopic Confusion Line for Congenital Color Deficiency Adults

    PubMed Central

    Costa, Marcelo F.; Goulart, Paulo R. K.; Barboni, Mirella T. S.; Ventura, Dora F.

    2016-01-01

    In congenital color blindness the red–green discrimination is impaired resulting in an increased confusion between those colors with yellow. Our post-receptoral physiological mechanisms are organized in two pathways for color perception, a red–green (protanopic and deuteranopic) and a blue–yellow (tritanopic). We argue that the discrimination losses in the yellow area in congenital color vision deficiency subjects could generate a subtle loss of discriminability in the tritanopic channel considering discrepancies with yellow perception. We measured color discrimination thresholds for blue and yellow of tritanopic channel in congenital color deficiency subjects. Chromaticity thresholds were measured around a white background (0.1977 u′, 0.4689 v′ in the CIE 1976) consisting of a blue–white and white–yellow thresholds in a tritanopic color confusion line of 21 congenital colorblindness subjects (mean age = 27.7; SD = 5.6 years; 14 deuteranomalous and 7 protanomalous) and of 82 (mean age = 25.1; SD = 3.7 years) normal color vision subjects. Significant increase in the whole tritanopic axis was found for both deuteranomalous and protanomalous subjects compared to controls for the blue–white (F2,100 = 18.80; p < 0.0001) and white–yellow (F2,100 = 22.10; p < 0.0001) thresholds. A Principal Component Analysis (PCA) found a weighting toward to the yellow thresholds induced by deuteranomalous subjects. In conclusion, the discrimination in the tritanopic color confusion axis is significantly reduced in congenital color vision deficiency compared to normal subjects. Since yellow discrimination was impaired the balance of the blue–yellow channels is impaired justifying the increased thresholds found for blue–white discrimination. The weighting toward the yellow region of the color space with the deuteranomalous contributing to that perceptual distortion is discussed in terms of physiological mechanisms. PMID:27065909

  16. Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI.

    PubMed

    Gorkem, Sureyya Burcu; Kutuk, Mehmet Serdar; Doganay, Selim; Gunes, Tamer; Yildiz, Karamehmet; Kucukaydin, Mustafa

    2016-01-01

    The aim of this study is to evaluate perfusional changes in brain and placenta of omphalopagus conjoined twins and to compare them with singleton fetuses by using diffusion weighted imaging and apparent diffusion coefficient. Fetal MRIs of 28-week-old omphalopagus conjoined twins with a shared liver with two separate gallbladders and portal and hepatic venous systems and three singleton fetuses with unilateral borderline ventriculomegaly at the same gestational week as control group were enrolled retrospectively. There was a significant decrease in ADC values of brain regions (p = 0.018) and placenta (p = 0.005) of conjoined twins compared to the control group. The decreased ADC values in placenta and brain regions in conjoined twins might be due to decreased placental perfusion compared to singleton pregnancy. Our results would be a keystone for future studies which will compare larger group of monochorionic multiple pregnancies with singleton pregnancies. PMID:27034830

  17. Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

    PubMed Central

    Kutuk, Mehmet Serdar; Doganay, Selim; Gunes, Tamer; Yildiz, Karamehmet; Kucukaydin, Mustafa

    2016-01-01

    The aim of this study is to evaluate perfusional changes in brain and placenta of omphalopagus conjoined twins and to compare them with singleton fetuses by using diffusion weighted imaging and apparent diffusion coefficient. Fetal MRIs of 28-week-old omphalopagus conjoined twins with a shared liver with two separate gallbladders and portal and hepatic venous systems and three singleton fetuses with unilateral borderline ventriculomegaly at the same gestational week as control group were enrolled retrospectively. There was a significant decrease in ADC values of brain regions (p = 0.018) and placenta (p = 0.005) of conjoined twins compared to the control group. The decreased ADC values in placenta and brain regions in conjoined twins might be due to decreased placental perfusion compared to singleton pregnancy. Our results would be a keystone for future studies which will compare larger group of monochorionic multiple pregnancies with singleton pregnancies. PMID:27034830

  18. Specklinia dunstervillei, a New Species Long Confused with Specklinia endotrachys (Orchidaceae: Pleurothallidinae)

    PubMed Central

    Karremans, Adam P.; Pupulin, Franco; Gravendeel, Barbara

    2015-01-01

    Specklinia dunstervillei is described as a new species in recognition of the distinctness of a Venezuelan species related to and confused with Specklinia endotrachys. It was illustrated for the first time by G. C. K. Dunsterville in 1963 from a plant collected in Trujillo on the Cordillera de Merida. The newly named species can be easily recognized by its small habit, short leaves and small reddish-orange flowers, the non-ascending dorsal sepal and the obtuse petals that are shortly apiculate. Specklinia dunstervillei is formally described and illustrated once again and compared morphologically and genetically with its closest relatives. PMID:26207634

  19. Obsolete ideas and logical confusions can be obstacles for biogerontology research.

    PubMed

    Le Bourg, Eric

    2013-04-01

    Some misconceptions can be an obstacle for biogerontology research. These misconceptions can be classified in two categories: (1) obsolete ideas in biology, for example "aging has a universal cause" and "living beings are like machines", and (2) conceptual and logical confusions, such as "longevity is not dependent on other life-history traits", "between-groups variability allows to infer conclusions about individual variability", and "the burden of the proof lies with the opponents to the hypothesis". This opinion article describes these problems in the hope it will help to overcome them. PMID:23543307

  20. Confusion and clairvoyance: some remarks on the composite hypothesis testing problem

    NASA Astrophysics Data System (ADS)

    Theiler, James

    2012-06-01

    This paper discusses issues related to the inherent ambiguity of the composite hypothesis testing problem, a problem that is central to the detection of target signals in cluttered backgrounds. In particular, the paper examines the recently proposed method of continuum fusion (which, because it combines an ensemble of clairvoyant detectors, might also be called clairvoyant fusion), and its relationship to other strategies for composite hypothesis testing. A specific example involving the affine subspace model adds to the confusion by illustrating irreconcilable differences between Bayesian and non-Bayesian approaches to target detection.

  1. MULTISPECTRAL REMOTE SENSING OF CARBONATE ROCKS IN THE CONFUSION RANGE, UTAH.

    USGS Publications Warehouse

    Crowley, James K.

    1984-01-01

    Multispectral imagery recorded by the NASA/Bendix 24-channel aircraft scanner over the Confusion Range, Utah, proved to be extremely sensitive to lithologic variations in exposed carbonate rocks. Major carbonate units within a 16-km**2 study area were readily distinguished, and some aspects of their structure and stratigraphy could be inferred from image spectral signatures. Spectral data channels centered at 1. 6 and 2. 2 mu m accounted for much of the data sensitivity to lithologic differences. Rock texture, organic matter content, and weathering expression were important lithologic factors producing spectral variation.

  2. The Herschel cold debris disks: Confusion with the extragalactic background at 160 μm

    SciTech Connect

    Gáspár, András; Rieke, George H.

    2014-03-20

    The Herschel 'DUst around NEarby Stars' (DUNES) survey has found a number of debris disk candidates that are apparently very cold, with temperatures near 22 K. It has proven difficult to fit their spectral energy distributions with conventional models for debris disks. Given this issue, we carefully examine the alternative explanation that the detections arise from confusion with infrared cirrus and/or background galaxies that are not physically associated with the foreground stars. We find that such an explanation is consistent with all of these detections.

  3. Adaptive Doppler separation by quadratic detection of distance-confused radar signals

    NASA Astrophysics Data System (ADS)

    de Reffye, Jerome

    1988-02-01

    Possible improvements in the Doppler radar processing necessary to separate two targets whose distance ranges are confused are considered, with special attention given to the case of the detection of a missile in the presence of an aircraft. Real-time adaptive filtering methods are developed which permit the rejection of harmonics in nonwhite noise. Procedures for the quadratic integration of frequency-modulated signals representing the missile in the acceleration phase are then studied. Finally, the developed techniques are applied to a nonlinear problem.

  4. Coinheritance of Gaucher disease and α-thalassemia resulting in confusion between two inherited hematologic diseases

    PubMed Central

    Miri-Moghaddam, Ebrahim; Velayati, Arash; Naderi, Majid; Tayebi, Nahid; Sidransky, Ellen

    2012-01-01

    Gaucher type 1 disease has a wide spectrum of phenotypes ranging from asymptomatic individuals to patients with massive hepatosplenomegaly and bone involvement. In most, anemia, thrombocytopenia and splenomegaly are the primary manifestations at diagnosis, findings shared by the hemoglobinopathies. Here we report the co-inheritance of α-thalassemia and Gaucher disease in a consanguineous family followed in Iran, which resulted in confusion regarding the diagnosis. This report emphasizes the need to independently establish the diagnosis of every affected member of a family to ensure appropriate management and therapeutic decisions. PMID:20846888

  5. Magnetic Resonance Perfusion Imaging in the Study of Language

    ERIC Educational Resources Information Center

    Hillis, Argye E.

    2007-01-01

    This paper provides a brief review of various uses of magnetic resonance perfusion imaging in the investigation of brain/language relationships. The reviewed studies illustrate how perfusion imaging can reveal areas of brain where dysfunction due to low blood flow is associated with specific language deficits, and where restoration of blood flow…

  6. Perfusion Electronic Record Documentation Using Epic Systems Software.

    PubMed

    Riley, Jeffrey B; Justison, George A

    2015-12-01

    The authors comment on Steffens and Gunser's article describing the University of Wisconsin adoption of the Epic anesthesia record to include perfusion information from the cardiopulmonary bypass patient experience. We highlight the current-day lessons and the valuable quality and safety principles the Wisconsin-Epic model anesthesia-perfusion record provides. PMID:26834289

  7. Sustained ventilation: perfusion imbalance during hemodialysis.

    PubMed

    Milner, L S; Rothberg, A D; Thomson, P D; Stothart, M

    1983-06-01

    Five children between the ages of 6 and 15 years, who required chronic hemodialysis (HD) for renal failure, were studied to evaluate the central and pulmonary effects of HD on gas exchange. Acetate dialysate was used, and dialysate pO2 and pCO2, arterial pO2 and pCO2, endtidal CO2 and minute ventilation were measured pre-HD and 15, 30, 60, 120 and 240 minutes after commencement of HD. Arterial-alveolar CO2 gradient (aADCO2) was calculated to determine the ventilation: perfusion (V/Q) status. Minute ventilation did not change significantly from the pre-HD value of 8.9 +/- 1.1 l/min (mean +/- SD). The aADCO2 increased significantly from 3.2 +/- 3.7 mmHg to 8.4 +/- 2.4 mmHg at 15 mins (p less than .01) and was still elevated at 120 mins. (9.1 +/- 3.4 mmHg, p less than .02). There was a weak but significant inverse relationship between aADCO2 and arterial pO2 (r -0.42, p less than 0.05). The results suggest that, in these children, dialysed at altitude, dialysis-related hypoxemia appears to be the result of a sustained V/Q mismatch, possibly related to a decrease in pulmonary perfusion. PMID:6413444

  8. The pediatric template of brain perfusion

    PubMed Central

    Avants, Brian B; Duda, Jeffrey T; Kilroy, Emily; Krasileva, Kate; Jann, Kay; Kandel, Benjamin T; Tustison, Nicholas J; Yan, Lirong; Jog, Mayank; Smith, Robert; Wang, Yi; Dapretto, Mirella; Wang, Danny J J

    2015-01-01

    Magnetic resonance imaging (MRI) captures the dynamics of brain development with multiple modalities that quantify both structure and function. These measurements may yield valuable insights into the neural patterns that mark healthy maturation or that identify early risk for psychiatric disorder. The Pediatric Template of Brain Perfusion (PTBP) is a free and public neuroimaging resource that will help accelerate the understanding of childhood brain development as seen through the lens of multiple modality neuroimaging and in relation to cognitive and environmental factors. The PTBP uses cross-sectional and longitudinal MRI to quantify cortex, white matter, resting state functional connectivity and brain perfusion, as measured by Arterial Spin Labeling (ASL), in 120 children 7–18 years of age. We describe the PTBP and show, as a demonstration of validity, that global summary measurements capture the trajectories that demarcate critical turning points in brain maturation. This novel resource will allow a more detailed understanding of the network-level, structural and functional landmarks that are obtained during normal adolescent brain development. PMID:25977810

  9. Hepatic perfusion abnormalities during CT angiography: Detection and interpretation

    SciTech Connect

    Freeny, P.C.; Marks, W.M.

    1986-06-01

    Twenty-seven perfusion abnormalities were detected in 17 of 50 patients who underwent computed tomographic angiography (CTA) of the liver. All but one of the perfusion abnormalities occurred in patients with primary or metastatic liver tumors. Perfusion abnormalities were lobar in nine cases, segmental in 11, and subsegmental in seven; 14 were hypoperfusion and 13 were hyperperfusion abnormalities. The causes for the abnormalities included nonperfusion of a replaced hepatic artery (n = 11), cirrhosis and nodular regeneration (n = 3), altered hepatic hemodynamics (e.g., siphoning, laminar flow) caused by tumor (n = 7), contrast media washout from a nonperfused vessel (n = 1), compression of adjacent hepatic parenchyma (n = 1), and unknown (n = 4). Differentiation of perfusion abnormalities from tumor usually can be made by comparing the morphology of the known tumor with the suspected perfusion abnormality, changes of each on delayed CTA scans, and review of initial angiograms and other imaging studies.

  10. [Ocular perfusion pressure and its relevance for glaucoma].

    PubMed

    Schmidl, D; Werkmeister, R; Garhöfer, G; Schmetterer, L

    2015-02-01

    Ocular perfusion pressure is defined as the difference between arterial and venous pressure in ocular vessels. In practice, mean arterial pressure is used to substitute for arterial pressure in ocular vessels while intraocular pressure gives an estimate for ocular venous pressure. This results in a value that is easy to calculate and which is of importance since several studies have shown that it is correlated to the prevalence, incidence and progression of primary open angle glaucoma. Today, ocular perfusion pressure is used to estimate individual risks. Since no target value for ocular perfusion pressure can be defined, direct therapeutic intervention is difficult. Still, it has to be kept in mind that lowering intraocular pressure automatically leads to an increase in ocular perfusion pressure. The present article also points out problems and limitations in the concept of ocular perfusion pressure and suggests possible solutions for these problems in the future. PMID:25700252

  11. Nifedipine and thallium-201 myocardial perfusion in progressive systemic sclerosis

    SciTech Connect

    Kahan, A.; Devaux, J.Y.; Amor, B.; Menkes, C.J.; Weber, S.; Nitenberg, A.; Venot, A.; Guerin, F.; Degeorges, M.; Roucayrol, J.C.

    1986-05-29

    Heart disease in patients with progressive systemic sclerosis may be due in part to myocardial ischemia caused by a disturbance of the coronary microcirculation. To determine whether abnormalities of myocardial perfusion in this disorder are potentially reversible, we evaluated the effect of the coronary vasodilator nifedipine on myocardial perfusion assessed by thallium-201 scanning in 20 patients. Thallium-201 single-photon-emission computerized tomography was performed under control conditions and 90 minutes after 20 mg of oral nifedipine. The mean (+/- SD) number of left ventricular segments with perfusion defects decreased from 5.3 +/- 2.0 to 3.3 +/- 2.2 after nifedipine (P = 0.0003). Perfusion abnormalities were quantified by a perfusion score (0 to 2.0) assigned to each left ventricular segment and by a global perfusion score (0 to 18) for the entire left ventricle. The mean perfusion score in segments with resting defects increased from 0.97 +/- 0.24 to 1.26 +/- 0.44 after nifedipine (P less than 0.00001). The mean global perfusion score increased from 11.2 +/- 1.7 to 12.8 +/- 2.4 after nifedipine (P = 0.003). The global perfusion score increased by at least 2.0 in 10 patients and decreased by at least 2.0 in only 1. These observations reveal short-term improvement in thallium-201 myocardial perfusion with nifedipine in patients with progressive systemic sclerosis. The results are consistent with a potentially reversible abnormality of coronary vasomotion in this disorder, but the long-term therapeutic effects of nifedipine remain to be determined.

  12. Defusing Diffusion

    ERIC Educational Resources Information Center

    Dou, Remy; Hogan, DaNel; Kossover, Mark; Spuck, Timothy; Young, Sarah

    2013-01-01

    Diffusion has often been taught in science courses as one of the primary ways by which molecules travel, particularly within organisms. For years, classroom teachers have used the same common demonstrations to illustrate this concept (e.g., placing drops of food coloring in a beaker of water). Most of the time, the main contributor to the motion…

  13. Relativistic diffusion

    NASA Astrophysics Data System (ADS)

    Haba, Z.

    2009-02-01

    We discuss relativistic diffusion in proper time in the approach of Schay (Ph.D. thesis, Princeton University, Princeton, NJ, 1961) and Dudley [Ark. Mat. 6, 241 (1965)]. We derive (Langevin) stochastic differential equations in various coordinates. We show that in some coordinates the stochastic differential equations become linear. We obtain momentum probability distribution in an explicit form. We discuss a relativistic particle diffusing in an external electromagnetic field. We solve the Langevin equations in the case of parallel electric and magnetic fields. We derive a kinetic equation for the evolution of the probability distribution. We discuss drag terms leading to an equilibrium distribution. The relativistic analog of the Ornstein-Uhlenbeck process is not unique. We show that if the drag comes from a diffusion approximation to the master equation then its form is strongly restricted. The drag leading to the Tsallis equilibrium distribution satisfies this restriction whereas the one of the Jüttner distribution does not. We show that any function of the relativistic energy can be the equilibrium distribution for a particle in a static electric field. A preliminary study of the time evolution with friction is presented. It is shown that the problem is equivalent to quantum mechanics of a particle moving on a hyperboloid with a potential determined by the drag. A relation to diffusions appearing in heavy ion collisions is briefly discussed.

  14. Demonstrating Diffusion

    ERIC Educational Resources Information Center

    Foy, Barry G.

    1977-01-01

    Two demonstrations are described. Materials and instructions for demonstrating movement of molecules into cytoplasm using agar blocks, phenolphthalein, and sodium hydroxide are given. A simple method for demonstrating that the rate of diffusion of a gas is inversely proportional to its molecular weight is also presented. (AJ)

  15. Relativistic diffusion.

    PubMed

    Haba, Z

    2009-02-01

    We discuss relativistic diffusion in proper time in the approach of Schay (Ph.D. thesis, Princeton University, Princeton, NJ, 1961) and Dudley [Ark. Mat. 6, 241 (1965)]. We derive (Langevin) stochastic differential equations in various coordinates. We show that in some coordinates the stochastic differential equations become linear. We obtain momentum probability distribution in an explicit form. We discuss a relativistic particle diffusing in an external electromagnetic field. We solve the Langevin equations in the case of parallel electric and magnetic fields. We derive a kinetic equation for the evolution of the probability distribution. We discuss drag terms leading to an equilibrium distribution. The relativistic analog of the Ornstein-Uhlenbeck process is not unique. We show that if the drag comes from a diffusion approximation to the master equation then its form is strongly restricted. The drag leading to the Tsallis equilibrium distribution satisfies this restriction whereas the one of the Jüttner distribution does not. We show that any function of the relativistic energy can be the equilibrium distribution for a particle in a static electric field. A preliminary study of the time evolution with friction is presented. It is shown that the problem is equivalent to quantum mechanics of a particle moving on a hyperboloid with a potential determined by the drag. A relation to diffusions appearing in heavy ion collisions is briefly discussed. PMID:19391727

  16. The neural correlates of sex differences in left-right confusion.

    PubMed

    Hjelmervik, Helene; Westerhausen, René; Hirnstein, Marco; Specht, Karsten; Hausmann, Markus

    2015-06-01

    Difficulties in left-right discrimination (LRD) are commonly experienced in everyday life situations. Here we investigate the neurocognitive mechanisms of LRD and the specific role of left angular gyrus. Given that previous behavioral research reported women to be more susceptible to left-right confusion, the current study focuses particularly on the neural basis of sex differences in LRD while controlling for potential menstrual cycle effects (repeated measures design). 16 women and 15 men were presented pictures of pointing hands in various orientations (rotated versus non-rotated) and were asked to identify them as left or right hands. Results revealed that LRD was particularly associated with activation in inferior parietal regions, extending into the right angular gyrus. Irrespective of menstrual cycle phase, women, relative to men, recruited more prefrontal areas, suggesting higher top-down control in LRD. For the subset of rotated stimuli as compared to the non-rotated, we found leftward asymmetry for both men and women, although women scored significantly lower. We conclude that there are sex differences in the neurocognitive mechanisms underlying LRD. Although the angular gyrus is involved in LRD, several other parietal areas are at least as critical. Moreover, the hypothesis that more left-right confusion is due to more bilateral activation (in women) can be rejected. PMID:25776218

  17. Regarding the confusion between the population concept and Mayr's "population thinking".

    PubMed

    Hey, Jody

    2011-12-01

    Ernst Mayr said that one of Darwin's greatest contributions was to show scholars the way to population thinking, and to help them discard a mindset of typological thinking. Population thinking rejects a focus on a central representative type, and emphasizes the variation among individuals. However, Mayr's choice of terms has led to confusion, particularly among biologists who study natural populations. Both population thinking and the concept of a biological population were inspired by Darwin, and from Darwin the chain for both concepts runs through Francis Galton who introduced the statistical usage of "population" that appears in Mayr's population thinking. It was Galton's "population" that was modified by geneticists and biometricians in the early 20th century to refer to an interbreeding and evolving community of organisms. Under this meaning, a population is a biological entity and so paradoxically population thinking, which emphasizes variation at the expense of dwelling on entities, is usually not about populations. Mayr did not address the potential for misunderstanding but for him the important part of the population concept was that the organisms within a population were variable, and so he probably thought there should not be confusion between population thinking and the concept of a population. PMID:22384747

  18. Perceptions of the Role of the Doctor of Nursing Practice-Prepared Nurse: Clarity or Confusion.

    PubMed

    Udlis, Kimberly A; Mancuso, Josephine M

    2015-01-01

    Confusion and disagreement about the DNP degree and its implications continues despite the rapid and steady growth of DNP programs. There is a paucity of literature that examines nurses' perceptions of the role of the DNP-prepared nurse. The purpose of this study was to explore how nurses perceive the role of the DNP-prepared nurse and identify areas of ambiguity in understanding the roles that DNP-prepared nurses fulfill. A descriptive, cross-sectional design, using self-administered questionnaires, explored the perceptions of n = 340 nurses with various educational levels and backgrounds. Descriptives of the sample and instruments were conducted as well as chi-square analyses to detect differences in perceptions across levels of education. Results indicated that nurses clearly supported the DNP degree with a focus on the improvement of health care outcomes through the roles of leadership in health organizations, policy, interprofessionalism, and translation of evidence into practice. Multiple areas of confusion concerning the role of DNP-prepared nurse existed in academia, academia leadership, and scholarship. In order to reduce role ambiguity, the distinctive contributions of the DNP-prepared nurse must be embraced, valued, and operationalized. Otherwise, the role of the DNP-prepared nurse will continue to be discussed, debated, and challenged. PMID:26194957

  19. [Confusion as a presentation symptom of pseudomigraine with pleocytosis in a paediatric patient].

    PubMed

    Soto-Insuga, V; López-Villanueva, L; Rodrigo, M; Mois Aroyo, I; Losada, R; Soriano-Guillén, L

    2014-06-01

    Transient headache and neurological deficits with cerebrospinal fluid lymphocytic pleocytosis (Handl) syndrome is a rare condition of unknown origin that is characterized by episodes of severe headache, transient neurological deficits that recur over less than 3 months, and lymphocytic pleocytosis in CSF. We report the case of a 14 year-old girl who presented with headache and vomiting that lasted 4 days, later combined with a clinical presentation of confusion, with a decrease in the level of consciousness, aphasia, peripheral facial paralysis, ataxia and fever for 24 hours. CSF analysis showed pleocytosis (110 cells/ml) and proteinorrachia (87 mg/dl). Electroencephalogram in the acute time showed generalized slowing, and later a focal slowing in the left hemisphere. She suffered 7 episodes of migraine (severe headache and vomiting) in the following two months, remaining asymptomatic thereafter. This is the first pediatric case published in the literature that presents with an agitated and/or confused state. This condition must be considered in the differential diagnosis of patients with headache and acute altered level of consciousness, in order to avoid prolonged treatments or unnecessary invasive testing. PMID:24286871

  20. New Structural Interpretation of the Central Confusion Range, Western Utah, Based On Balanced Cross Sections

    NASA Astrophysics Data System (ADS)

    Yezerski, D.; Greene, D. C.

    2009-12-01

    The Confusion Range is a topographically low mountain range in the Basin and Range of west-central Utah, located east of and in the hanging wall of the Snake Range core complex. Previous workers have used a gravity sliding model to interpret the Confusion Range as a large structural trough or synclinorium (e.g. Hose, 1977). Based on existing mapping (Hose, 1965; Hintze, 1974) and new field data, we use balanced and restored cross sections to reinterpret the structure of the Confusion Range as an east-vergent fold-and-thrust belt formed during the Sevier Orogeny. The Confusion Range consists of Cambro-Ordovician through Triassic strata, with predominantly thick-bedded, competent carbonate rocks in the lower Paleozoic (lPz) section and incompetent shales and thin-bedded carbonates in the upper Paleozoic (uPz) section. The contrasting mechanical behavior of these stratigraphic sections results in faulted folds within uPz carbonates above detachments in shale-rich units, deforming in response to ramp-flat thrust faulting of the underlying lPz units. East of the axis of the Conger Mountain (Mtn) syncline, we attribute the increase in structural elevation of lPz rocks to a subsurface thrust sheet consisting of lPz strata that advanced eastward via a high-angle ramp from a lower detachment in the Kanosh Shale to an upper detachment in the Pilot Shale. The doubling of lPz strata that resulted continues through the eastern Confusion Range where a series of small-displacement thrust faults comprising the Kings Canyon thrust system gently tilt strata to the west. In the Conger Range, west of the Conger Mtn syncline, our analysis focuses on reinterpreting the geometrically unlikely folding depicted in previous cross sections as more admissible, fault-cored, asymmetric, detached folding. In our interpretation, resistance created by a steeply-dipping thrust ramp in the lPz section west of Conger Mtn resulted in folding of uPz strata into an east-vergent anticline. Continued east

  1. Measuring perfusion with light (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Jansen, Sanne M. A.; de Bruin, Daniel M.; Faber, Dirk J.; van Leeuwen, Ton G.

    2016-03-01

    There is no gold standard test for perfusion evaluation in surgery. Optical Imaging techniques are able to image tissue at high resolution and in real-time. Laser Speckle Contrast Imaging, Optical Coherence Tomography, Sidestream Darkfield and Incident Darkfield all use the interaction of light with tissue to create an image. To test their feasibility and explore validity in a controlled setting, we created a phantom with the optical properties of tissue and microvascular channels of 30-400 micrometer. With a Hamilton Syringe Pump we mimicked blood flow velocities of 0-20 mm/sec. Images of all different modalities at different blood flow velocities were compared in terms of imaging depth, resoluation and hemodynamic parameters.

  2. Adenosine thallium 201 myocardial perfusion scintigraphy

    SciTech Connect

    Verani, M.S. )

    1991-07-01

    Pharmacologic coronary vasodilation as an adjunct to myocardial perfusion imaging has become increasingly important in the evaluation of patients with coronary artery disease, in view of the large number of patients who cannot perform an adequate exercise test or in whom contraindications render exercise inappropriate. Adenosine is a very potent coronary vasodilator and when combined with thallium 201 scintigraphy produces images of high quality, with the added advantages of a very short half-life (less than 10 seconds) and the ability to adjust the dose during the infusion, which may enhance safety and curtail the duration of side effects. The reported sensitivity and specificity of adenosine thallium 201 scintigraphy for the detection of coronary artery disease are high and at least comparable with imaging after exercise or dipyridamole administration. 23 refs.

  3. Hydrogels for Engineering of Perfusable Vascular Networks

    PubMed Central

    Liu, Juan; Zheng, Huaiyuan; Poh, Patrina S. P.; Machens, Hans-Günther; Schilling, Arndt F.

    2015-01-01

    Hydrogels are commonly used biomaterials for tissue engineering. With their high-water content, good biocompatibility and biodegradability they resemble the natural extracellular environment and have been widely used as scaffolds for 3D cell culture and studies of cell biology. The possible size of such hydrogel constructs with embedded cells is limited by the cellular demand for oxygen and nutrients. For the fabrication of large and complex tissue constructs, vascular structures become necessary within the hydrogels to supply the encapsulated cells. In this review, we discuss the types of hydrogels that are currently used for the fabrication of constructs with embedded vascular networks, the key properties of hydrogels needed for this purpose and current techniques to engineer perfusable vascular structures into these hydrogels. We then discuss directions for future research aimed at engineering of vascularized tissue for implantation. PMID:26184185

  4. Low dose CT perfusion using k-means clustering

    NASA Astrophysics Data System (ADS)

    Pisana, Francesco; Henzler, Thomas; Schönberg, Stefan; Klotz, Ernst; Schmidt, Bernhard; Kachelrieß, Marc

    2016-03-01

    We aim at improving low dose CT perfusion functional parameters maps and CT images quality, preserving quantitative information. In a dynamic CT perfusion dataset, each voxel is measured T times, where T is the number of acquired time points. In this sense, we can think about a voxel as a point in a T-dimensional space, where the coordinates of the voxels would be the values of its time attenuation curve (TAC). Starting from this idea, a k-means algorithm was designed to group voxels in K classes. A modified guided time-intensity profile similarity (gTIPS) filter was implemented and applied only for those voxels belonging to the same class. The approach was tested on a digital brain perfusion phantom as well as on clinical brain and body perfusion datasets, and compared to the original TIPS implementation. The TIPS filter showed the highest CNR improvement, but lowest spatial resolution. gTIPS proved to have the best combination of spatial resolution and CNR improvement for CT images, while k-gTIPS was superior to both gTIPS and TIPS in terms of perfusion maps image quality. We demonstrate k-means clustering analysis can be applied to denoise dynamic CT perfusion data and to improve functional maps. Beside the promising results, this approach has the major benefit of being independent from the perfusion model employed for functional parameters calculation. No similar approaches were found in literature.

  5. Ex vivo lung perfusion in Brazil

    PubMed Central

    Abdalla, Luis Gustavo; Braga, Karina Andrighetti de Oliveira; Nepomuceno, Natalia Aparecida; Fernandes, Lucas Matos; Samano, Marcos Naoyuki; Pêgo-Fernandes, Paulo Manuel

    2016-01-01

    Objective: To evaluate the use of ex vivo lung perfusion (EVLP) clinically to prepare donor lungs for transplantation. Methods: A prospective study involving EVLP for the reconditioning of extended-criteria donor lungs, the criteria for which include aspects such as a PaO2/FiO2 ratio < 300 mmHg. Between February of 2013 and February of 2014, the lungs of five donors were submitted to EVLP for up to 4 h each. During EVLP, respiratory mechanics were continuously evaluated. Once every hour during the procedure, samples of the perfusate were collected and the function of the lungs was evaluated. Results: The mean PaO2 of the recovered lungs was 262.9 ± 119.7 mmHg at baseline, compared with 357.0 ± 108.5 mmHg after 3 h of EVLP. The mean oxygenation capacity of the lungs improved slightly over the first 3 h of EVLP-246.1 ± 35.1, 257.9 ± 48.9, and 288.8 ± 120.5 mmHg after 1, 2, and 3 h, respectively-without significant differences among the time points (p = 0.508). The mean static compliance was 63.0 ± 18.7 mmHg, 75.6 ± 25.4 mmHg, and 70.4 ± 28.0 mmHg after 1, 2, and 3 h, respectively, with a significant improvement from hour 1 to hour 2 (p = 0.029) but not from hour 2 to hour 3 (p = 0.059). Pulmonary vascular resistance remained stable during EVLP, with no differences among time points (p = 0.284). Conclusions: Although the lungs evaluated remained under physiological conditions, the EVLP protocol did not effectively improve lung function, thus precluding transplantation. PMID:27167429

  6. Diffusion bonding

    DOEpatents

    Anderson, Robert C.

    1976-06-22

    1. A method for joining beryllium to beryllium by diffusion bonding, comprising the steps of coating at least one surface portion of at least two beryllium pieces with nickel, positioning a coated surface portion in a contiguous relationship with an other surface portion, subjecting the contiguously disposed surface portions to an environment having an atmosphere at a pressure lower than ambient pressure, applying a force upon the beryllium pieces for causing the contiguous surface portions to abut against each other, heating the contiguous surface portions to a maximum temperature less than the melting temperature of the beryllium, substantially uniformly decreasing the applied force while increasing the temperature after attaining a temperature substantially above room temperature, and maintaining a portion of the applied force at a temperature corresponding to about maximum temperature for a duration sufficient to effect the diffusion bond between the contiguous surface portions.

  7. CT Perfusion of the Liver: Principles and Applications in Oncology

    PubMed Central

    Kim, Se Hyung; Kamaya, Aya

    2014-01-01

    With the introduction of molecularly targeted chemotherapeutics, there is an increasing need for defining new response criteria for therapeutic success because use of morphologic imaging alone may not fully assess tumor response. Computed tomographic (CT) perfusion imaging of the liver provides functional information about the microcirculation of normal parenchyma and focal liver lesions and is a promising technique for assessing the efficacy of various anticancer treatments. CT perfusion also shows promising results for diagnosing primary or metastatic tumors, for predicting early response to anticancer treatments, and for monitoring tumor recurrence after therapy. Many of the limitations of early CT perfusion studies performed in the liver, such as limited coverage, motion artifacts, and high radiation dose of CT, are being addressed by recent technical advances. These include a wide area detector with or without volumetric spiral or shuttle modes, motion correction algorithms, and new CT reconstruction technologies such as iterative algorithms. Although several issues related to perfusion imaging—such as paucity of large multicenter trials, limited accessibility of perfusion software, and lack of standardization in methods—remain unsolved, CT perfusion has now reached technical maturity, allowing for its use in assessing tumor vascularity in larger-scale prospective clinical trials. In this review, basic principles, current acquisition protocols, and pharmacokinetic models used for CT perfusion imaging of the liver are described. Various oncologic applications of CT perfusion of the liver are discussed and current challenges, as well as possible solutions, for CT perfusion are presented. © RSNA, 2014 Online supplemental material is available for this article. PMID:25058132

  8. Ventilation-perfusion inequality in chronic obstructive pulmonary disease.

    PubMed Central

    Wagner, P D; Dantzker, D R; Dueck, R; Clausen, J L; West, J B

    1977-01-01

    A multiple inert gas elimination method was used to study the mechanism of impaired gas exchange in 23 patients with advanced chronic obstructive pulmonary disease (COPD). Three patterns of ventilation-perfusion (Va/Q) inequality were found: (a) A pattern with considerable regions of high (greater than 3) VA/Q, none of low (less than 0.1) VA/Q, and essentially no shunt. Almost all patients with type A COPD showed this pattern, and it was also seen in some patients with type B. (b) A pattern with large amounts of low but almost none of high VA/Q, and essentially no shunt. This pattern was found in 4 of 12 type B patients and 1 of type A. (c) A pattern with both low and high VA/Q areas was found in the remaining 6 patients. Distributions with high VA/Q areas occurred mostly in patients with greatly increased compliance and may represent loss of blood-glow due to alveolar wall destruction. Similarly, well-defined modes of low VA/Q areas were seen mostly in patients with severe cough and sputum and may be due to reduced ventilation secondary to mechanical airways obstruction or distortion. There was little change in the VA/Q distributions on exercise or on breathing 100% O2. The observed patterns of VA/Q inequality and shunt accounted for all of the hypoxemia at rest and during exercise. There was therefore no evidence for hypoxemia caused by diffusion impairment. Patients with similar arterial blood gases often had dissimilar VA/Q patterns. As a consequence the pattern of VA/Q inequality could not necessarily be inferred from the arterial PO2 and PCO2. PMID:833271

  9. Contactless mapping of rhythmical phenomena in tissue perfusion using PPGI

    NASA Astrophysics Data System (ADS)

    Huelsbusch, Markus; Blazek, Vladimir

    2002-04-01

    This paper presents the experimental setup and preliminary results of a near infrared CCD camera based Photoplethysmography Imaging (PPGI) system, which has been shown to be suitable for contactless and spatially resolved assessment of rhythmical blood volume changes in the skin. To visualize the complex rhythmical patterns in the dermal perfusion the Wavelet Transform is utilized. It is able to jointly assess time and frequency behavior of signals and thus allows to analyze instationary oscillations and variabilities in the different human rhythmics. The presented system is expected to provide new insights into the functional sequences of physiological tissue perfusion as well as of the perfusion status in ulcer formation and wound healing.

  10. Perfusion CT imaging of treatment response in oncology.

    PubMed

    Prezzi, Davide; Khan, Aisha; Goh, Vicky

    2015-12-01

    Perfusion CT was first described in the 1970s but has become accepted as a clinical technique in recent years. In oncological practice Perfusion CT allows the downstream effects of therapies on the tumour vasculature to be monitored. From the dynamic changes in tumour and vascular enhancement following intravenous iodinated contrast agent administration, qualitative and quantitative parameters may be derived that reflect tumour perfusion, blood volume, and microcirculatory changes with treatment. This review outlines the mechanisms of action of available therapies and state-of-the-art imaging practice. PMID:25864440

  11. Deep Vein Thrombosis Presenting on Pulmonary Ventilation and Perfusion Scintigraphy.

    PubMed

    Itani, Malak; Fair, Joanna; Hillman, Zachary; Behnia, Fatemeh; Elojeimy, Saeed

    2016-10-01

    A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with Tc-DTPA [diethylene triamine pentaacetic acid aerosol] and Tc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little Tc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal Tc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound. Careful attention to relative radiotracer count rates on VQ scans is crucial to ensure diagnostic utility. In addition, abnormal low perfusion radiotracer counts may unveil other pathology with important clinical implications. PMID:27556796

  12. Prognostic value of normal regadenoson stress perfusion cardiovascular magnetic resonance

    PubMed Central

    2013-01-01

    Background Regadenoson is a vasodilator stress agent that selectively activates the A2A receptor. Compared to adenosine, regadenoson is easier to administer and results in fewer side effects. Although extensively studied in patients undergoing nuclear perfusion imaging (MPI), its use for perfusion cardiovascular magnetic resonance (CMR) is not well described. The aim of this study was to determine the prognostic value of a normal regadenoson perfusion CMR in patients with known or suspected coronary artery disease. Methods Patients with known or suspected coronary artery disease were prospectively enrolled to receive perfusion CMR (Philips 1.5 T) with regadenoson. Three short-axis slices of the left ventricle (LV) were obtained during first pass of contrast using a hybrid GRE-EPI pulse sequence (0.075 mmol/kg Gadolinium-DTPA-BMA at 4 ml/sec). Imaging was performed 1 minute after injection of regadenoson (0.4 mg) and repeated 15 minutes after reversal of hyperemia with aminophylline (125 mg). Perfusion defects were documented if they persisted for ≥2 frames after peak enhancement of the LV cavity. CMR was considered abnormal if there was a resting wall motion abnormality, decreased LVEF (<40%), presence of LGE, or the presence of a perfusion defect during hyperemia. All patients were followed for a minimum of 1 year for major adverse cardiovascular event (MACE) defined as coronary revascularization, non-fatal myocardial infarction, and cardiovascular death. Results 149 patients were included in the final analysis. Perfusion defects were noted in 43/149 (29%) patients; 59/149 (40%) had any abnormality on CMR. During the mean follow-up period of 24 ± 9 months, 17/149 (11.4%) patients experienced MACE. The separation in the survival distributions for those with perfusion defects and those without perfusion defects was highly significant (log-rank p = 0.0001). When the absence of perfusion defects was added to the absence of other resting CMR

  13. EFFECT ON PERFUSION VALUES OF SAMPLING INTERVAL OF CT PERFUSION ACQUISITIONS IN NEUROENDOCRINE LIVER METASTASES AND NORMAL LIVER

    PubMed Central

    Ng, Chaan S.; Hobbs, Brian P.; Wei, Wei; Anderson, Ella F.; Herron, Delise H.; Yao, James C.; Chandler, Adam G.

    2014-01-01

    Objective To assess the effects of sampling interval (SI) of CT perfusion acquisitions on CT perfusion values in normal liver and liver metastases from neuroendocrine tumors. Methods CT perfusion in 16 patients with neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction, for tumor and normal liver. CT perfusion values for the reference sampling interval of 0.5s (SI0.5) were compared with those of SI datasets of 1s, 2s, 3s and 4s, using mixed-effects model analyses. Results Increases in SI beyond 1s were associated with significant and increasing departures of CT perfusion parameters from reference values at SI0.5 (p≤0.0009). CT perfusion values deviated from reference with increasing uncertainty with increasing SIs. Findings for normal liver were concordant. Conclusion Increasing SIs beyond 1s yield significantly different CT perfusion parameter values compared to reference values at SI0.5. PMID:25626401

  14. Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report

    PubMed Central

    2010-01-01

    Background Acute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology. Case presentation We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under medical observation the patient fully recovered within three weeks. Conclusions Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy. PMID:20712856

  15. Confusing criminal and civil law: when may a hospital refuse to release a dead body?

    PubMed

    Gallagher, Steven B

    2014-12-01

    A United Kingdom bereavement advice group has expressed concern that hospitals in Britain may be acting "illegally" in refusing to release dead bodies to relatives unless they provide evidence that funeral arrangements have been made. In some cases, hospitals may have refused to release a body to anyone other than an undertaker. The charity argues that this behaviour constitutes the common law offence of preventing the lawful burial of a body. This article considers the confusion that may occur between this offence and interference with the right to possession of a body for lawful burial. The conclusion is that it is extremely unlikely a hospital or its employees would fall foul of the criminal law in refusing to release a dead body and may be liable in the civil courts if they release a body to someone who does not have the duty and consequent right to possession of the body for lawful burial. PMID:25715539

  16. Middle aged male with recurrent episodes of confusion, aggressive behavior and loss of consciousness.

    PubMed

    Hernán, Martínez José; Bueno, Orengo Solalba; Rosa, Jose; Lopez, Melvin; Carlos, Cortes; Ramos, Luis; Mendoza, Adalberto; Tejedor, Begoña

    2011-01-01

    We report a case of a 63 years-old-male with repeated bouts of confusion, aggressive behavior, dizziness and loss of consciousness occurring over a year. Such episodes increased in frequency and severity over time and were treated at the Emergency Room with intravenous dextrose solutions. Admitted at San Juan Bautista Medical Center due to severe hypoglycemia. Laboratory evaluation and prolong fasting ruled out an insulinoma or surreptitious administration of insulin or sulfonylurea. A CT scan of the abdomen and pelvis with oral contrast demonstrated a huge intra-abdominal mass invading the mesentery with herniated components laterally in the right lower quadrant. Patient underwent surgical resection of the abdominal mass. Histological description demonstrated a neoplastic pattern. Immunohistochemistry was compatible with an undifferentiated Synovial Sarcoma. PMID:21696101

  17. Confusing sterile neutrinos with deviation from tribimaximal mixing at neutrino telescopes

    SciTech Connect

    Awasthi, Ram Lal; Choubey, Sandhya

    2007-12-01

    We expound on the impact of extra sterile species on the ultra high energy neutrino fluxes in neutrino telescopes. We use three types of well-known flux ratios and compare the values of these flux ratios in the presence of sterile neutrinos, with those predicted by deviation from the tribimaximal mixing scheme. We show that in the upcoming neutrino telescopes, it is easy to confuse the signature of sterile neutrinos with that of the deviation from tribimaximal mixing. We also show that if the measured flux ratios acquire a value well outside the range predicted by the standard scenario with three active neutrinos only, it might be possible to tell the presence of extra sterile neutrinos by observing ultra high energy neutrinos in future neutrino telescopes.

  18. The treatment of actinomycosis mimicking a retained root tip: a confusing case

    PubMed Central

    2016-01-01

    Actinomycosis is an infection caused by the actinomyces genus and is associated with trauma or previous infection. A 58-year-old male patient was referred from a private dental clinic for root extraction of the lower right molar. The x-ray showed fractured root-like material distal to the distal root of the lower right second molar. A biopsy during extraction of the root-like material was performed, which revealed a sequestrum with actinomycosis by a pathological examination. In this case, the radiopacity of the suspicious lesion was higher than that of the surrounding alveolar bone, which confused it with the root tip. The diagnosis of actinomycosis required long-term antimicrobial therapy, which is very different from simple extraction or removal of sequestrum. PMID:27595087

  19. The treatment of actinomycosis mimicking a retained root tip: a confusing case.

    PubMed

    Cho, Ju Yeon

    2016-08-01

    Actinomycosis is an infection caused by the actinomyces genus and is associated with trauma or previous infection. A 58-year-old male patient was referred from a private dental clinic for root extraction of the lower right molar. The x-ray showed fractured root-like material distal to the distal root of the lower right second molar. A biopsy during extraction of the root-like material was performed, which revealed a sequestrum with actinomycosis by a pathological examination. In this case, the radiopacity of the suspicious lesion was higher than that of the surrounding alveolar bone, which confused it with the root tip. The diagnosis of actinomycosis required long-term antimicrobial therapy, which is very different from simple extraction or removal of sequestrum. PMID:27595087

  20. Magnetic circular dichroism spectroscopy of N-confused porphyrin and its ionized forms.

    PubMed

    Ziegler, Christopher J; Erickson, Nathan R; Dahlby, Michael R; Dalby, Michael R; Nemykin, Victor N

    2013-11-14

    N-Confused porphyrin (NCP) and its externally methylated variant (MeNCP) were investigated using UV-vis and magnetic circular dichrosim (MCD) spectroscopies. In addition to evaluating the spectroscopy of the neutral compounds, the acid/base chemistry of these macrocycles was examined by the same methods. NCP exhibits two tautomeric states depending on the polarity of the solvent, and their protonation/deprotonation chemistries also differ depending on solvent polarity. DFT and TDDFT calculations were employed to evaluate the observed spectroscopic changes. Using both experimental and calculated results, we were able to determine the sites of protonation/deprotonation for both tautomeric forms of NCP. Inspection of the MCD Faraday B terms for all of the macrocycles presented in this report showed that the ΔHOMO > ΔLUMO condition is maintained in all cases, and these observations were in good agreement with the DFT calculations. PMID:24131398

  1. [Etymological confusion in Japanese terms for the testis: past and present].

    PubMed

    Tomoyoshi, T

    1985-02-01

    In Japan, two scientific words are used for the testis, SEISO and KOGAN. SEISO is the word accepted by most of the bioscience societies and etymologically means the nest of sperms. KOGAN, is a word of Chinese origin and mainly used by urologists. Its etymologic meaning is unclear. About one to two hundreds years ago, many classical Japanese books of medicine used EKIGAN the Chinese character of which is quite similar to KOGAN, and which etymologically was described as "pleasure balls of man" by a contemporary anatomist in Japan, although I presume it was intended to mean "a couple of balls, side by side". In order to avoid terminologic confusion, SEISO, the standard word used in many academic fields, is recommended for universal use not only in scientific papers but in daily language in Japan. PMID:3893068

  2. Colour change in cyanosis and the confusions of congenital colour vision deficient observers.

    PubMed

    McNamara, Renae; Taylor, Clair M; McKenzie, David K; Coroneo, Minas T; Dain, Stephen J

    2010-09-01

    Visual recognition of cyanosis is an important clinical activity. While pulse oximetry is almost universal in the hospital environment, there are circumstances where it is not available or may be unreliable. Cyanosis recognition is affected by lighting colour. In addition, there is, mainly anecdotal, evidence that people with greater colour vision deficiencies (CVDs) have particular difficulty and there is no effective lighting strategy to assist in the observation. The change of blood colour with oxygenation has been shown to lie close to the direction of colour confusions made by congenital red-green dichromats. The important sites of observation are lips, nail beds and palm creases. 10 subjects who were known to be chronically hypoxaemic were recruited from the chronic respiratory program. Their blood oxygen saturation (SpO(2)) varied from 84% to 96% pre-exercise, and 61-84% post-exercise. Ten normal subjects were recruited whose SpO(2) was 99% or 100%. The spectral radiances of lips, nail beds and palm creases were measured using a telespectroradiometer and compared with the spectral radiances of a white tile of known spectral reflectances measured in the same location. This is a non-contact method of measurement, avoiding the blanching caused by pressure of contact methods. The spectral reflectances were calculated, and the chromaticities calculated for a Planckian radiator T = 4000K. Measurements on lips yielded the most consistent results. The colour changes pre- and post-exercise and compared with normal colour lie generally along a deutan confusion line. These results show the direction of the colour change and confirm the, previously anecdotal, difficulties in detecting cyanosis by observers with CVDs. PMID:20883357

  3. A Re-Examination of the History of Etiologic Confusion between Dengue and Chikungunya.

    PubMed

    Kuno, Goro

    2015-11-01

    Contrary to the perception of many researchers that the recent invasion of chikungunya (CHIK) in the Western Hemisphere marked the first episode in history, a recent publication reminded them that CHIK had prevailed in the West Indies and southern regions of the United States from 1827-1828 under the guise of "dengue" (DEN), and that many old outbreaks of so-called "dengue" actually represented the CHIK cases erroneously identified as "dengue." In hindsight, this confusion was unavoidable, given that the syndromes of the two diseases-transmitted by the same mosquito vector in urban areas-are very similar, and that specific laboratory-based diagnostic techniques for these diseases did not exist prior to 1940. While past reviewers reclassified problematic "dengue" outbreaks as CHIK, primarily based on manifestation of arthralgia as a marker of CHIK, they neither identified the root cause of the alleged misdiagnosis nor did they elaborate on the negative consequences derived from it. This article presents a reconstructed history of the genesis of the clinical definition of dengue by emphasizing problems with the definition, subsequent confusion with CHIK, and the ways in which physicians dealt with the variation in dengue-like ("dengue") syndromes. Then, the article identifies in those records several factors complicating reclassification, based on current practice and standards. These factors include terms used for characterizing joint problems, style of documenting outbreak data, frequency of manifestation of arthralgia, possible involvement of more than one agent, and occurrence of the principal vector. The analysis of those factors reveals that while some of the old "dengue" outbreaks, including the 1827-1828 outbreaks in the Americas, are compatible with CHIK, similar reclassification of other "dengue" outbreaks to CHIK is difficult because of a combination of the absence of pathognomonic syndrome in these diseases and conflicting background information. PMID

  4. A Re-Examination of the History of Etiologic Confusion between Dengue and Chikungunya

    PubMed Central

    Kuno, Goro

    2015-01-01

    Contrary to the perception of many researchers that the recent invasion of chikungunya (CHIK) in the Western Hemisphere marked the first episode in history, a recent publication reminded them that CHIK had prevailed in the West Indies and southern regions of the United States from 1827–1828 under the guise of “dengue” (DEN), and that many old outbreaks of so-called “dengue” actually represented the CHIK cases erroneously identified as “dengue.” In hindsight, this confusion was unavoidable, given that the syndromes of the two diseases—transmitted by the same mosquito vector in urban areas—are very similar, and that specific laboratory-based diagnostic techniques for these diseases did not exist prior to 1940. While past reviewers reclassified problematic “dengue” outbreaks as CHIK, primarily based on manifestation of arthralgia as a marker of CHIK, they neither identified the root cause of the alleged misdiagnosis nor did they elaborate on the negative consequences derived from it. This article presents a reconstructed history of the genesis of the clinical definition of dengue by emphasizing problems with the definition, subsequent confusion with CHIK, and the ways in which physicians dealt with the variation in dengue-like (“dengue”) syndromes. Then, the article identifies in those records several factors complicating reclassification, based on current practice and standards. These factors include terms used for characterizing joint problems, style of documenting outbreak data, frequency of manifestation of arthralgia, possible involvement of more than one agent, and occurrence of the principal vector. The analysis of those factors reveals that while some of the old “dengue” outbreaks, including the 1827–1828 outbreaks in the Americas, are compatible with CHIK, similar reclassification of other “dengue” outbreaks to CHIK is difficult because of a combination of the absence of pathognomonic syndrome in these diseases and

  5. In-vivo quantitative evaluation of perfusion zones and perfusion gradient in the deep inferior epigastric artery perforator flap

    NASA Astrophysics Data System (ADS)

    Saint-Cyr, Michel; Lakhiani, Chrisovalantis; Cheng, Angela; Mangum, Michael; Liang, Jinyang; Teotia, Sumeet; Livingston, Edward H.; Zuzak, Karel J.

    2013-03-01

    The selection of well-vascularized tissue during DIEP flap harvest remains controversial. While several studies have elucidated cross-midline perfusion, further characterization of perfusion to the ipsilateral hemiabdomen is necessary for minimizing rates of fat necrosis or partial fat necrosis in bilateral DIEP flaps. Eighteen patients (29 flaps) underwent DIEP flap harvest using a prospectively designed protocol. Perforators were marked and imaged with a novel system for quantitatively measuring tissue oxygenation, the Digital Light Hyperspectral Imager. Images were then analyzed to determine if perforator selection influenced ipsilateral flap perfusion. Flaps based on a single lateral row perforator (SLRP) were found to have a higher level of hemoglobin oxygenation in Zone I (mean %HbO2 = 76.1) compared to single medial row perforator (SMRP) flaps (%HbO2 = 71.6). Perfusion of Zone III relative to Zone I was similar between SLRP and SMRP flaps (97.4% vs. 97.9%, respectively). These differences were not statistically significant (p>0.05). Perfusion to the lateral edge of the flap was slightly greater for SLRP flaps compared SMRP flaps (92.1% vs. 89.5%, respectively). SMRP flaps had superior perfusion travelling inferiorly compared to SLRP flaps (88.8% vs. 83.9%, respectively). Overall, it was observed that flaps were better perfused in the lateral direction than inferiorly. Significant differences in perfusion gradients directed inferiorly or laterally were observed, and perforator selection influenced perfusion in the most distal or inferior aspects of the flap. This suggests broader clinical implications for flap design that merit further investigation.

  6. Quantum diffusion

    SciTech Connect

    Habib, S.

    1994-10-01

    We consider a simple quantum system subjected to a classical random force. Under certain conditions it is shown that the noise-averaged Wigner function of the system follows an integro-differential stochastic Liouville equation. In the simple case of polynomial noise-couplings this equation reduces to a generalized Fokker-Planck form. With nonlinear noise injection new ``quantum diffusion`` terms rise that have no counterpart in the classical case. Two special examples that are not of a Fokker-Planck form are discussed: the first with a localized noise source and the other with a spatially modulated noise source.

  7. DIFFUSION PUMP

    DOEpatents

    Levenson, L.

    1963-09-01

    A high-vacuum diffusion pump is described, featuring a novel housing geometry for enhancing pumping speed. An upright, cylindrical lower housing portion is surmounted by a concentric, upright, cylindrical upper housing portion of substantially larger diameter; an uppermost nozzle, disposed concentrically within the upper portion, is adapted to eject downwardly a conical sheet of liquid outwardly to impinge upon the uppermost extremity of the interior wall of the lower portion. Preferably this nozzle is mounted upon a pedestal rising coaxially from within the lower portion and projecting up into said upper portion. (AEC)

  8. Spatial distribution of ventilation and perfusion: mechanisms and regulation.

    PubMed

    Glenny, Robb W; Robertson, H Thomas

    2011-01-01

    With increasing spatial resolution of regional ventilation and perfusion, it has become more apparent that ventilation and blood flow are quite heterogeneous in the lung. A number of mechanisms contribute to this regional variability, including hydrostatic gradients, pleural pressure gradients, lung compressibility, and the geometry of the airway and vascular trees. Despite this marked heterogeneity in both ventilation and perfusion, efficient gas exchange is possible through the close regional matching of the two. Passive mechanisms, such as the shared effect of gravity and the matched branching of vascular and airway trees, create efficient gas exchange through the strong correlation between ventilation and perfusion. Active mechanisms that match local ventilation and perfusion play little if no role in the normal healthy lung but are important under pathologic conditions. PMID:23737178

  9. Metabolism of 7-ethyoxycoumarin by Isolated Perfused Rainbow Trout Livers

    EPA Science Inventory

    Isolated trout livers were perfused using methods designed to preserve tissue viability and function. Liver performance was evaluated by measuring O2 consumption, vascular resistance, K+ leakage, glucose flux, lactate flux, alanine aminotransferase leakage, and metabolic clearanc...

  10. Pulmonary ventilation and perfusion studies in lung cancer

    SciTech Connect

    Narabayashi, I.; Otsuka, N.

    1984-02-01

    In 46 patients with bronchogenic carcinoma, the diagnostic significance of pulmonary ventilation images by the continuous inhalation of Kr-81m gas, which has an extremely short half life, was studied in comparison with pulmonary perfusion images with Tc-99m MAA. The data were processed using digital analysis techniques. There were 15 cases with discrepancies between ventilation and perfusion. The V/Q ratios of the affected lung among the 43 patients showed values above 1.2 in nine cases and below 0.8 in six cases. The Kr-81m ventilation and Tc-99m perfusion images were compared before and after radiation therapy in eight patients. It was possible to assess the therapeutic effect on regional ventilation and regional perfusion, which could not be evaluated by chest x-ray alone, under the same conditions of normal breathing.

  11. Ultra-Low Dose Lung CT Perfusion Regularized by a Previous Scan

    PubMed Central

    Yu, Hengyong; Zhao, Shiying; Hoffman, Eric A.; Wang, Ge

    2009-01-01

    Rationale and Objectives Our previous scan regularized reconstruction (PSRR) method is proposed to reduce radiation dose and applied for lung perfusion studies. The normal and ultra-low dose lung CT perfusion studies are compared in terms of estimation accuracy of pulmonary functional parameters. Materials and Methods A sequences of sheep lung scans were performed in three prone, anesthetized sheep at normal and ultra-low doses. A scan protocol was developed for the ultra-low dose studies with ECG gating - time point one for a normal x-ray dose scan (100kV/150mAs) and time points 2–21 for low dose scans (80kV/17mAs). A nonlinear diffusion-based post-filtering (NDPF) method was applied to the difference images between the low-dose images and the high-quality reference image. The final images at 20 time points were generated by fusing the reference image with the filtered difference images. Results The power spectra of perfusion images and coherences with the normal scans show a great improvement in image quality of the ultra-low dose scans with PSRR relative to that without RSRR. The Gamma variate-fitting and the repeatability of the measurements of the mean transit time demonstrate that the key parameters of lung functions can be reliably accessed using PSRR. The variability of the ultra-low dose scan results obtained using PSRR is not substantially different from that between two normal dose scans. Conclusions Our studies have shown that a ~90% reduction in radiation dose is achievable using PSRR without compromising the quantitative CT measurements of regional lung functions. PMID:19201366

  12. Acyloin production from aldehydes in the perfused rat heart: the potential role of pyruvate dehydrogenase.

    PubMed Central

    Montgomery, J A; Jetté, M; Huot, S; Des Rosiers, C

    1993-01-01

    Aldehydes represent an important class of cytotoxic products derived from free radical-induced lipid peroxidation which may contribute to reperfusion injury following myocardial infarct. Metabolism of aldehydes in the heart has not been well characterized aside from conjugation of unsaturated aldehydes with glutathione. However, aliphatic aldehydes like hexanal do not form stable glutathione conjugates. We have recently demonstrated in vitro that pig heart pyruvate dehydrogenase catalyses a reaction between pyruvate and saturated aldehydes to produce acyloins (3-hydroxyalkan-2-ones). In the present study, rat hearts were perfused with various aldehydes and pyruvate. Acyloins were generated from saturated aldehydes (butanal, hexanal or nonanal), but not from 2-hexanal (an unsaturated aldehyde) or malondialdehyde. Hearts perfused with 2 mM pyruvate and 10-100 microM hexanal rapidly took up hexanal in a dose-related manner (140-850 nmol/min), and released 3-hydroxyoctan-2-one (0.7-30 nmol/min), 2,3-octanediol (0-12 nmol/min) and hexanol (10-200 nmol/min). Small quantities of hexanoic acid (about 10 nmol/min) were also released. The rate of release of acyloin metabolites rose with increased concentration of hexanal, whereas hexanol release attained a plateau when hexanal infusion concentrations rose above 50 microM. Up to 50% of hexanal uptake could be accounted for by metabolite release. Less than 0.5% of hexanal uptake was found to be bound to acid-precipitable macromolecules. When hearts perfused with 50 microM hexanal and 2 mM pyruvate were subjected to a 15 min ischaemic period, the rates of release of 2,3-octanediol, 3-hydroxyoctan-2-one, hexanol and hexanoate during the reperfusion period were not significantly different from those in the pre-ischaemic period. Our results indicate that saturated aldehydes can be metabolically converted by the heart into stable diffusible compounds. PMID:8379929

  13. Arterial Perfusion Imaging–Defined Subvolume of Intrahepatic Cancer

    SciTech Connect

    Wang, Hesheng; Farjam, Reza; Feng, Mary; Hussain, Hero; Ten Haken, Randall K.; Lawrence, Theodore S.; Cao, Yue

    2014-05-01

    Purpose: To assess whether an increase in a subvolume of intrahepatic tumor with elevated arterial perfusion during radiation therapy (RT) predicts tumor progression after RT. Methods and Materials: Twenty patients with unresectable intrahepatic cancers undergoing RT were enrolled in a prospective, institutional review board–approved study. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was performed before RT (pre-RT), after delivering ∼60% of the planned dose (mid-RT) and 1 month after completion of RT to quantify hepatic arterial perfusion. The arterial perfusions of the tumors at pre-RT were clustered into low-normal and elevated perfusion by a fuzzy clustering-based method, and the tumor subvolumes with elevated arterial perfusion were extracted from the hepatic arterial perfusion images. The percentage changes in the tumor subvolumes and means of arterial perfusion over the tumors from pre-RT to mid-RT were evaluated for predicting tumor progression post-RT. Results: Of the 24 tumors, 6 tumors in 5 patients progressed 5 to 21 months after RT completion. Neither tumor volumes nor means of tumor arterial perfusion at pre-RT were predictive of treatment outcome. The mean arterial perfusion over the tumors increased significantly at mid-RT in progressive tumors compared with the responsive tumors (P=.006). From pre-RT to mid-RT, the responsive tumors had a decrease in the tumor subvolumes with elevated arterial perfusion (median, −14%; range, −75% to 65%), whereas the progressive tumors had an increase of the subvolumes (median, 57%; range, −7% to 165%) (P=.003). Receiver operating characteristic analysis of the percentage change in the subvolume for predicting tumor progression post-RT had an area under the curve of 0.90. Conclusion: The increase in the subvolume of the intrahepatic tumor with elevated arterial perfusion during RT has the potential to be a predictor for tumor progression post-RT. The tumor subvolume could be a radiation

  14. Arterial Perfusion Imaging-Defined Subvolume of Intrahepatic Cancer

    PubMed Central

    Wang, Hesheng; Farjam, Reza; Feng, Mary; Hussain, Hero; Ten Haken, Randall K.; Lawrence, Theodore S.; Cao, Yue

    2014-01-01

    Purpose To assess whether an increase in a subvolume of intrahepatic tumor with elevated arterial perfusion during radiation therapy (RT) predicts tumor progression post RT. Methods and Materials Twenty patients with unresectable intrahepatic cancers undergoing RT were enrolled in a prospective IRB-approved study. Dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) were performed prior to RT (pre-RT), after delivering ~60% of the planned dose (mid-RT) and one month after completion of RT to quantify hepatic arterial perfusion. The arterial perfusions of the tumors at pre-RT were clustered into low-normal and elevated perfusion by a fuzzy clustering-based method, and the tumor subvolumes with elevated arterial perfusion were extracted from the hepatic arterial perfusion images. The percentage changes in the tumor subvolumes and means of arterial perfusion over the tumors from pre-RT to mid-RT were evaluated for predicting tumor progression post-RT. Results Of the 24 tumors, 6 tumors in 5 patients progressed 5–21 months after RT completion. Neither tumor volumes nor means of tumor arterial perfusion at pre-RT were predictive of treatment outcome. The mean arterial perfusion over the tumors increased significantly at mid-RT in progressive tumors comparing to the responsive ones (p=0.006). From pre-RT to mid-RT, the responsive tumors had a decrease in the tumor subvolumes with elevated arterial perfusion (median: −14%, range: −75% – 65%), while the progressing tumors had an increase of the subvolumes (median: 57%, range: −7% – 165%) (p=0.003). Receiver operating characteristic (ROC) analysis of the percentage change in the subvolume for predicting tumor progression post-RT had an area under the curve (AUC) of 0.90. Conclusion The increase in the subvolume of the intrahepatic tumor with elevated arterial perfusion during RT has the potential to be a predictor for tumor progression post-RT. The tumor subvolume could be a radiation boost candidate

  15. A perfusion chamber for physiological studies with acutely dissociated neurons.

    PubMed

    Wonderlin, W F; Weinreich, D

    1987-11-01

    We describe a recording chamber that immobilizes acutely dissociated neurons on an ultra-fine mesh grid positioned above a moving stream of perfusate. This chamber is easily fabricated and has two attributes for single-electrode voltage-clamp or patch-clamp recording: (1) shallow immersion (less than 20 micron) of the neurons, and (2) stable recording with rapid perfusion rates. PMID:3695568

  16. Perfusion of nonventilated lung: failure of hypoxic vasoconstriction

    SciTech Connect

    Sostman, H.D.; Neumann, R.D.; Gottschalk, A.; Greenspan, R.H.

    1983-07-01

    Alveolar hypoxia is a well established cause of regional vasoconstriction such that nonventilated segments are not perfused. The paradoxical situation of retained perfusion of nonventilated lung has seldom been discussed. Three clinical examples are illustrated. In each case coexistent chronic obstructive lung disease may have contributed to this unexpected finding by reducing pulmonary vascular capacity such that blood flow diversion from hypoxic segments was not possible.

  17. Evaluation of Microvascular Perfusion and Resuscitation after Severe Injury.

    PubMed

    Lee, Yann-Leei L; Simmons, Jon D; Gillespie, Mark N; Alvarez, Diego F; Gonzalez, Richard P; Brevard, Sidney B; Frotan, Mohammad A; Schneider, Andrew M; Richards, William O

    2015-12-01

    Achieving adequate perfusion is a key goal of treatment in severe trauma; however, tissue perfusion has classically been measured by indirect means. Direct visualization of capillary flow has been applied in sepsis, but application of this technology to the trauma population has been limited. The purpose of this investigation was to compare the efficacy of standard indirect measures of perfusion to direct imaging of the sublingual microcirculatory flow during trauma resuscitation. Patients with injury severity scores >15 were serially examined using a handheld sidestream dark-field video microscope. In addition, measurements were also made from healthy volunteers. The De Backer score, a morphometric capillary density score, and total vessel density (TVD) as cumulative vessel area within the image, were calculated using Automated Vascular Analysis (AVA3.0) software. These indices were compared against clinical and laboratory parameters of organ function and systemic metabolic status as well as mortality. Twenty severely injured patients had lower TVD (X = 14.6 ± 0.22 vs 17.66 ± 0.51) and De Backer scores (X = 9.62 ± 0.16 vs 11.55 ± 0.37) compared with healthy controls. These scores best correlated with serum lactate (TVD R(2) = 0.525, De Backer R(2) = 0.576, P < 0.05). Mean arterial pressure, heart rate, oxygen saturation, pH, bicarbonate, base deficit, hematocrit, and coagulation parameters correlated poorly with both TVD and De Backer score. Direct measurement of sublingual microvascular perfusion is technically feasible in trauma patients, and seems to provide real-time assessment of microcirculatory perfusion. This study suggests that in severe trauma, many indirect measurements of perfusion do not correlate with microvascular perfusion. However, visualized perfusion deficiencies do reflect a shift toward anaerobic metabolism. PMID:26736167

  18. Simulation in perfusion: where do we go from here?

    PubMed

    Fernandez, Adam

    2010-01-01

    Simulation is a common training modality used in aviation, the nuclear industry and by many medical specialties. The adoption of simulation by introductory perfusion education for beginning students and continuing medical education by cardiovascular perfusion has not kept pace with other fields and this paper explores issues connected with simulation in other professions, including training as it currently exists, access to simulator technology, and what could be achieved by utilizing simulator technology. PMID:20159937

  19. Diurnal Curve of the Ocular Perfusion Pressure

    PubMed Central

    Moreira, TCA; Bezerra, BSP; Vianello, MP; Corradi, J; Dorairaj, SK; Prata, TS

    2016-01-01

    ABSTRACT Purpose: To describe the diurnal variation of the ocular perfusion pressure (OPP) in normal, suspects and glaucoma patients. Materials and methods: Seventy-nine subjects were enrolled in a prospective study. The diurnal curve of intraocular pressure (IOP) was performed and blood pressure measurements were obtained. Each participant was grouped into one of the following based upon the clinical evaluation of the optic disk, IOP and standard achromatic perimetry (SAP): 18 eyes were classified as normal (normal SAP, normal optic disk evaluation and IOP < 21 mm Hg in two different measurements), 30 eyes as glaucoma suspect (GS) (normal SAP and mean deviation (MD), C/D ration > 0.5 or asymmetry > 0.2 and/or ocular hypertension), 31 eyes as early glaucoma (MD < -6 dB, glaucomatous optic neuropathy and SAP and MDs on SAP. Standard achromatic perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Intraocular pressure and blood pressure measurements were taken at 6 am, 9 am, 12, 3 and 6 pm. The patients stayed in the seated position for 5 minutes prior to blood pressure measurements. Results: The mean IOP values in all groups did not follow any regular pattern. The peak IOP was found to be greater in suspect [18.70 ± 3.31 (mm Hg ± SD)] and glaucoma (18.77 ± 4.30 mm Hg) patients as compared to normal subjects (16.11 ± 2.27 mm Hg). In studying the diurnal variation of the OPP, we found lower values at 3 pm in normals (34.21 ± 2.07 mm Hg), at 9 am in suspects (54.35 ± 3.32 mm Hg) and at 12 pm in glaucoma patients (34.84 ± 1.44 mm Hg). Conclusion: Each group has a specific OPP variation during the day with the most homogeneous group being the suspect one. It is important to keep studying the IOP and OPP variation for increased comprehension of the pathophysiology of glaucomatous optic neuropathy. How to cite this article: Kanadani FN, Moreira TCA, Bezerra BSP, Vianello MP, Corradi J, Dorairaj SK, Prata TS. Diurnal Curve of the Ocular Perfusion

  20. Transepithelial transport of glutathione in isolated perfused small intestine

    SciTech Connect

    Hagen, T.M.; Jones, D.P.

    1986-03-01

    Uptake of GSH was studied in isolated perfused segment of jejunum in the adult rat. Krebs-Henseleit buffer was infused through the superior mesenteric artery and fractions were collected from the portal vein. The maintenance of vascular and epithelial integrity was established by lack of transfer of /sup 14/C-inulin or /sup 14/C-polyethylene glycol from the lumen to the perfusate. (glycine-2-/sup 3/H)GSH was introduced in the lumen and perfusate fractions collected every min. With 1 mM GSH and 10 mM Gly in the lumen, transport into the perfusate was 220 nmol/min. Analysis by HPLC showed that 80% was at the intact tripeptide, GSH. No cysteinylgylcine was detected in the perfusate. Pretreatment of the segment with 0.25 mM acivicin and 1 mM buthionine sulfoximine had no significant effect on GSH transport rate, thus showing that degradation and resynthesis of GSH did not contribute to the appearance of GSH in the perfusate. GSH transport was inhibited 50% by replacing lumenal NaCl with choline Cl. Addition of 10 mM ..gamma..-Clu-Glu or 10 mM ophthalmic acid decreased the rat of transport by 60-70%. These results establish that transepithelial transport of intact GSH occurs in rat small intestine. This may allow utilization of dietary GSH or reutilization of biliary GSH. In addition, the results suggest that oral GSH may be of therapeutic benefit.

  1. A pump-free membrane-controlled perfusion microfluidic platform.

    PubMed

    Goral, Vasiliy N; Tran, Elizabeth; Yuen, Po Ki

    2015-09-01

    In this article, we present a microfluidic platform for passive fluid pumping for pump-free perfusion cell culture, cell-based assay, and chemical applications. By adapting the passive membrane-controlled pumping principle from the previously developed perfusion microplate, which utilizes a combination of hydrostatic pressure generated by different liquid levels in the wells and fluid wicking through narrow strips of a porous membrane connecting the wells to generate fluid flow, a series of pump-free membrane-controlled perfusion microfluidic devices was developed and their use for pump-free perfusion cell culture and cell-based assays was demonstrated. Each pump-free membrane-controlled perfusion microfluidic device comprises at least three basic components: an open well for generating fluid flow, a micron-sized deep chamber/channel for cell culture or for fluid connection, and a wettable porous membrane for controlling the fluid flow. Each component is fluidically connected either by the porous membrane or by the micron-sized deep chamber/channel. By adapting and incorporating the passive membrane-controlled pumping principle into microfluidic devices, all the benefits of microfluidic technologies, such as small sample volumes, fast and efficient fluid exchanges, and fluid properties at the micro-scale, can be fully taken advantage of with this pump-free membrane-controlled perfusion microfluidic platform. PMID:26392835

  2. Integrating evidence-based perfusion into practices: the International Consortium for Evidence-Based Perfusion.

    PubMed

    Likosky, Donald S

    2006-12-01

    There is surmounting pressure for clinicians domestically and abroad not only to practice evidence-based perfusion, but also to supplement practice with documentation thereof. In this editorial, I shall describe an international initiative aimed at embracing this dictum from patients, regulatory bodies, and payers. "Research is the only hope that the future will be different than the past"- Daniel Mintz, MD "Practical men who believe themselves to be quite exempt from any intellectual influences are usually the slaves of some defunct economist.... It is ideas not vested interests which are dangerous for good or evil."-John Maynard Keynes. PMID:17312899

  3. Integrating Evidence-Based Perfusion Into Practices: The International Consortium for Evidence-Based Perfusion

    PubMed Central

    Likosky, Donald S.

    2006-01-01

    Abstract: There is surmounting pressure for clinicians domestically and abroad not only to practice evidence-based perfusion, but also to supplement practice with documentation thereof. In this editorial, I shall describe an international initiative aimed at embracing this dictum from patients, regulatory bodies, and payers. “Research is the only hope that the future will be different than the past”—Daniel Mintz, MD “Practical men who believe themselves to be quite exempt from any intellectual influences are usually the slaves of some defunct economist…. It is ideas not vested interests which are dangerous for good or evil.”—John Maynard Keynes PMID:17312899

  4. Particle size effects on protein and virus-like particle adsorption on perfusion chromatography media.

    PubMed

    Wu, Yige; Abraham, Dicky; Carta, Giorgio

    2015-01-01

    The resin structure, chromatographic behavior, and adsorption kinetics of proteins and virus-like-particles (VLPs) are studied for POROS HS 20 and POROS HS 50 (23 and 52 μm mean diameter, respectively) to determine the effects of particle size on perfusion chromatography and to determine the predictive ability of available models. Transmission electron microscopy (TEM) and inverse size-exclusion chromatography (iSEC) show similar structures for the two resins, both containing 200-1000 nm pores that transect a network of much smaller pores. For non-binding conditions, trends of the height equivalent to a theoretical plate (HETP) as a function of reduced velocity are consistent with perfusion. The estimated intraparticle flow fractions for these conditions are 0.0018 and 0.00063 for POROS HS 20 and HS 50, respectively. For strong binding conditions, confocal laser scanning microscopy (CLSM) shows asymmetrical intraparticle concentrations profiles and enhanced rates of IgG adsorption on POROS HS 20 at 1000 cm/h. The corresponding effective diffusivity under flow is 2-3 times larger than for non-flow conditions and much larger than observed for POROS HS 50, consistent with available models. For VLPs, however, adsorption is confined to a thin layer near the particle surface for both resins, suggesting that the bound VLPs block the pores. PMID:25512122

  5. Perfusion Angiography in Acute Ischemic Stroke.

    PubMed

    Scalzo, Fabien; Liebeskind, David S

    2016-01-01

    Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA) remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF) and cerebral blood volume (CBV), mean transit time (MTT), time-to-peak (TTP), and T max, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA) and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely. PMID:27446232

  6. Myocardial perfusion echocardiography and coronary microvascular dysfunction

    PubMed Central

    Barletta, Giuseppe; Del Bene, Maria Riccarda

    2015-01-01

    Our understanding of coronary syndromes has evolved in the last two decades out of the obstructive atherosclerosis of epicardial coronary arteries paradigm to include anatomo-functional abnormalities of coronary microcirculation. No current diagnostic technique allows direct visualization of coronary microcirculation, but functional assessments of this circulation are possible. This represents a challenge in cardiology. Myocardial contrast echocardiography (MCE) was a breakthrough in echocardiography several years ago that claimed the capability to detect myocardial perfusion abnormalities and quantify coronary blood flow. Research demonstrated that the integration of quantitative MCE and fractional flow reserve improved the definition of ischemic burden and the relative contribution of collaterals in non-critical coronary stenosis. MCE identified no-reflow and low-flow within and around myocardial infarction, respectively, and predicted the potential functional recovery of stunned myocardium using appropriate interventions. MCE exhibited diagnostic performances that were comparable to positron emission tomography in microvascular reserve and microvascular dysfunction in angina patients. Overall, MCE improved echocardiographic evaluations of ischemic heart disease in daily clinical practice, but the approval of regulatory authorities is lacking. PMID:26730291

  7. Myocardial perfusion echocardiography and coronary microvascular dysfunction.

    PubMed

    Barletta, Giuseppe; Del Bene, Maria Riccarda

    2015-12-26

    Our understanding of coronary syndromes has evolved in the last two decades out of the obstructive atherosclerosis of epicardial coronary arteries paradigm to include anatomo-functional abnormalities of coronary microcirculation. No current diagnostic technique allows direct visualization of coronary microcirculation, but functional assessments of this circulation are possible. This represents a challenge in cardiology. Myocardial contrast echocardiography (MCE) was a breakthrough in echocardiography several years ago that claimed the capability to detect myocardial perfusion abnormalities and quantify coronary blood flow. Research demonstrated that the integration of quantitative MCE and fractional flow reserve improved the definition of ischemic burden and the relative contribution of collaterals in non-critical coronary stenosis. MCE identified no-reflow and low-flow within and around myocardial infarction, respectively, and predicted the potential functional recovery of stunned myocardium using appropriate interventions. MCE exhibited diagnostic performances that were comparable to positron emission tomography in microvascular reserve and microvascular dysfunction in angina patients. Overall, MCE improved echocardiographic evaluations of ischemic heart disease in daily clinical practice, but the approval of regulatory authorities is lacking. PMID:26730291

  8. Perfusion Angiography in Acute Ischemic Stroke

    PubMed Central

    Liebeskind, David S.

    2016-01-01

    Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA) remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF) and cerebral blood volume (CBV), mean transit time (MTT), time-to-peak (TTP), and Tmax, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA) and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely. PMID:27446232

  9. New Trends in Radionuclide Myocardial Perfusion Imaging

    PubMed Central

    Hung, Guang-Uei; Wang, Yuh-Feng; Su, Hung-Yi; Hsieh, Te-Chun; Ko, Chi-Lun; Yen, Ruoh-Fang

    2016-01-01

    Radionuclide myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) has been widely used clinically as one of the major functional imaging modalities for patients with coronary artery disease (CAD) for decades. Ample evidence has supported the use of MPI as a useful and important tool in the diagnosis, risk stratification and treatment planning for CAD. Although popular in the United States, MPI has become the most frequently used imaging modality among all nuclear medicine tests in Taiwan. However, it should be acknowledged that MPI SPECT does have its limitations. These include false-positive results due to certain artifacts, false-negative due to balanced ischemia, complexity and adverse reaction arising from current pharmacological stressors, time consuming nature of the imaging procedure, no blood flow quantitation and relatively high radiation exposure. The purpose of this article was to review the recent trends in nuclear cardiology, including the utilization of positron emission tomography (PET) for MPI, new stressor, new SPECT camera with higher resolution and higher sensitivity, dynamic SPECT protocol for blood flow quantitation, new software of phase analysis for evaluation of LV dyssynchrony, and measures utilized for reducing radiation exposure of MPI. PMID:27122946

  10. In Vitro Perfused Human Capillary Networks

    PubMed Central

    Moya, Monica L.; Hsu, Yu-Hsiang; Lee, Abraham P.; Hughes, Christopher C.W.

    2013-01-01

    Replicating in vitro the complex in vivo tissue microenvironment has the potential to transform our approach to medicine and also our understanding of biology. In order to accurately model the 3D arrangement and interaction of cells and extracellular matrix, new microphysiological systems must include a vascular supply. The vasculature not only provides the necessary convective transport of oxygen, nutrients, and waste in 3D culture, but also couples and integrates the responses of organ systems. Here we combine tissue engineering and microfluidic technology to create an in vitro 3D metabolically active stroma (∼1 mm3) that, for the first time, contains a perfused, living, dynamic, interconnected human capillary network. The range of flow rate (μm/s) and shear rate (s−1) within the network was 0–4000 and 0–1000, respectively, and thus included the normal physiological range. Infusion of FITC dextran demonstrated microvessels (15–50 μm) to be largely impermeable to 70 kDa. Our high-throughput biology-directed platform has the potential to impact a broad range of fields that intersect with the microcirculation, including tumor metastasis, drug discovery, vascular disease, and environmental chemical toxicity. PMID:23320912

  11. Terminological confusions and problems at the interface between the crystal field Hamiltonians and the zero-field splitting Hamiltonians-Survey of the CF=ZFS confusion in recent literature

    NASA Astrophysics Data System (ADS)

    Rudowicz, Czesław; Karbowiak, Mirosław

    2014-10-01

    The single transition ions in various crystals or molecules as well as the exchange coupled systems (ECS) of transition ions, especially the single molecule magnets (SMM) or molecular nanomagnets (MNM), have been extensively studied in recent decades using electron magnetic resonance (EMR), optical spectroscopy, and magnetic measurements. Interpretation of magnetic and spectroscopic properties of transition ions is based on two physically distinct types of Hamiltonians: the physical crystal field (CF), or equivalently ligand field (LF), Hamiltonians and the effective spin Hamiltonians (SH), which include the zero-field splitting (ZFS) Hamiltonians. Survey of recent literature has revealed a number of terminological confusions and specific problems occurring at the interface between these Hamiltonians (denoted CF (LF)↔SH (ZFS)). Elucidation of sloppy or incorrect usage of crucial notions, especially those describing or parameterizing crystal fields and zero field splittings, is a very challenging task that requires several reviews. Here we focus on the prevailing confusion between the CF (LF) and SH (ZFS) quantities, denoted as the CF=ZFS confusion, which consists in referring to the parameters (or Hamiltonians), which are the true ZFS (or SH) quantities, as purportedly the CF (LF) quantities. The inverse ZFS=CF confusion, which pertains to the cases of labeling the true CF (LF) quantities as purportedly the ZFS quantities, is considered in a follow-up paper. The two reviews prepare grounds for a systematization of nomenclature aimed at bringing order to the zoo of different Hamiltonians. Specific cases of the CF=ZFS confusion identified in the recent textbooks, review articles, and SMM (MNM)- and EMR-related papers are surveyed and the pertinent misconceptions are outlined. The consequences of the terminological confusions go far beyond simple semantic issues or misleading keyword classifications of papers in journals and scientific databases. Serious

  12. Color-Doppler sonographic tissue perfusion measurements reveal significantly diminished renal cortical perfusion in kidneys with vesicoureteral reflux

    PubMed Central

    Scholbach, T. M.; Sachse, C.

    2016-01-01

    Vesicoureteral reflux (VUR) and its sequelae may lead to reduced renal perfusion and loss of renal function. Methods to describe and monitor tissue perfusion are needed. We investigated dynamic tissue perfusion measurement (DTPM) with the PixelFlux-software to measure microvascular changes in the renal cortex in 35 children with VUR and 28 healthy children. DTPM of defined horizontal slices of the renal cortex was carried out. A kidney was assigned to the “low grade reflux”-group if the reflux grade of the voiding cystourethrogram was 1 to 3 and to the “high grade reflux”-group if the reflux grade was 4 to 5. Kidneys with VUR showed a significantly reduced cortical perfusion. Compared to healthy kidneys, this decline reached in low and high grade refluxes within the proximal 50% of the cortex: 3% and 12 %, in the distal 50% of the cortex: 21% and 44 % and in the most distal 20 % of the cortex 41% and 44%. DTPM reveals a perfusion loss in kidneys depending on the degree of VUR, which is most pronounced in the peripheral cortex. Thus, DTPM offers the tool to evaluate microvascular perfusion, to help planning treatment decisions in children with VUR. PMID:27051133

  13. Spectroscopy of free-base N-confused tetraphenylporphyrin radical anion and radical cation.

    PubMed

    Alemán, Elvin A; Manríquez Rocha, Juan; Wongwitwichote, Wongwit; Godínez Mora-Tovar, Luis Arturo; Modarelli, David A

    2011-06-23

    The radical anions and radical cations of the two tautomers (1e and 1i) of 5,10,15,20-tetraphenyl N-confused free-base porphyrin have been studied using a combination of cyclic voltammetry, steady state absorption spectroscopy, and computational chemistry. N-Confused porphyrins (NCPs), alternatively called 2-aza-21-carba-5,10,15,20-tetraphenylporphyrins or inverted porphyrins, are of great interest for their potential as building blocks in assemblies designed for artificial photosynthesis, and understanding the absorption spectra of the corresponding radical ions is paramount to future studies in multicomponent arrays where electron-transfer reactions are involved. NCP 1e was shown to oxidize at a potential of E(ox) 0.65 V vs Fc(+)|Fc in DMF and reduce at E(red) -1.42 V, while the corresponding values for 1i in toluene were E(ox) 0.60 V and E(red) -1.64 V. The geometries of these radical ions were computed at the B3LYP/6-31+G(d)//B3LYP/6-31G(d) level in the gas phase and in solution using the polarizable continuum model (PCM). From these structures and that of H(2)TPP and its corresponding radical ions, the computed redox potentials for 1e and 1i were calculated using the Born-Haber cycle. While the computed reduction potentials and electron affinities were in excellent agreement with the experimental reduction potentials, the calculated oxidation potentials displayed a somewhat less ideal relationship with experiment. The absorption spectra of the four radical ions were also measured experimentally, with radical cations 1e(•+) and 1i(•+) displaying significant changes in the Soret and Q-band regions as well as new low energy absorption bands in the near-IR region. The changes in the absorption spectra of radical anions 1e(•-) and 1i(•-) were not as dramatic, with the changes occurring only in the Soret and Q-band regions. These results were favorably modeled using time-dependent density functional calculations at the TD-B3LYP/6-31+G(d)//B3LYP/6-31G

  14. Assessment of the best flow model to characterize diffuse correlation spectroscopy data acquired directly on the brain.

    PubMed

    Verdecchia, Kyle; Diop, Mamadou; Morrison, Laura B; Lee, Ting-Yim; St Lawrence, Keith

    2015-11-01

    Diffuse correlation spectroscopy (DCS) is a non-invasive optical technique capable of monitoring tissue perfusion. The normalized temporal intensity autocorrelation function generated by DCS is typically characterized by assuming that the movement of erythrocytes can be modeled as a Brownian diffusion-like process instead of by the expected random flow model. Recently, a hybrid model, referred to as the hydrodynamic diffusion model, was proposed, which combines the random and Brownian flow models. The purpose of this study was to investigate the best model to describe autocorrelation functions acquired directly on the brain in order to avoid confounding effects of extracerebral tissues. Data were acquired from 11 pigs during normocapnia and hypocapnia, and flow changes were verified by computed tomography perfusion (CTP). The hydrodynamic diffusion model was found to provide the best fit to the autocorrelation functions; however, no significant difference for relative flow changes measured by the Brownian and hydrodynamic diffusion models was observed. PMID:26600995

  15. Anticardiolipin antibodies in HIV infection: association with cerebral perfusion defects as detected by 99mTc-HMPAO SPECT.

    PubMed Central

    Rubbert, A; Bock, E; Schwab, J; Marienhagen, J; Nüsslein, H; Wolf, F; Kalden, J R

    1994-01-01

    Anticardiolipin antibodies (ACA) belong to a heterogeneous group of antibodies directed against negatively charged phospholipids. In patients with rheumatic disorders, their presence has been correlated to the occurrence of thromboembolic complications, thrombocytopenia, abortions and other disease manifestations. Several studies have revealed the detection of mostly high-titre ACA in a significant proportion of HIV-infected patients without any known clinical relationship. In our study, ACA were detected in 17/34 HIV-infected patients, and their presence was significantly associated with the detection of cerebral perfusion abnormalities by 99mTc-HMPAO SPECT. SPECT scans were classified as normal or as focal or diffuse defects in uptake. Most patients (13/16) with cerebral perfusion defects had elevated ACA titres in contrast to 4/18 patients with normal SPECT findings (P = 0.002). Focal uptake defects were always associated with the presence of ACA. No correlation to clinical features or other laboratory parameters was evident. Our results suggest a possible implication of autoimmune mechanisms in the pathogenesis of cerebral perfusion abnormalities detected by SPECT scanning in HIV-infected patients. However, further studies are needed to evaluate the clinical significance and to develop possible therapeutic consequences. Images Fig. 1 Fig. 2 Fig. 3 PMID:7994900

  16. The in vitro growth of a three-dimensional human dermal replacement using a single-pass perfusion system.

    PubMed

    Halberstadt, C R; Hardin, R; Bezverkov, K; Snyder, D; Allen, L; Landeen, L

    1994-04-01

    A human dermal replacement has been developed by seeding human neonatal dermal fibroblasts onto a biosorbable polyglactin (polyglycolide/polylactide) mesh and culturing in a bioreactor. The mesh provides the proper environment for the cells to attach, grow in a three-dimensional array, and establish a tissue matrix over a 2- to 3-week culture period. The dermal replacement has been characterized and found to contain a variety of naturally occurring dermal matrix proteins, including fibronectin, glycosaminoglycans, and collagen types I and III. To efficiently and reproducibly produce this dermal tissue equivalent, a closed, single-pass perfusion system was developed and compared with a static process. In the single-pas perfusion system, growth medium (containing ascorbic acid) was perfused around the 4 x 6 in. pieces of mesh at specific flow rates determined by nutrient consumption and waste production rates. The flow rates used for this system indicate that a diffusion-limited regime exists with a mean residence time greater than 1 h for essential nutrients and factors. By controlling glucose concentrations in the system to a delta of 0.70 g/L from the inlet to the outlet of the bioreactor, it took 6 fewer days to grow a tissue similar to that produced by the static system. PMID:18615797

  17. Asymmetrical transfer of alpha-aminoisobutyric acid (AIB), leucine and lysine across the in vitro perfused human placenta.

    PubMed

    Schneider, H; Proegler, M; Sodha, R; Dancis, J

    1987-01-01

    The mechanism for establishing transplacental gradients for leucine, lysine and alpha-aminoisobutyric acid (AIB) has been investigated in the perfused human placenta. Experiments were done with either the maternal or the fetal circulation closed and the donor circulation open. Transfer of the amino acids towards the fetal side was more rapid than it was in the reverse direction. When the maternal perfusate was recirculated, the amino acid concentrations were maintained at a considerably lower level in the maternal circulation than in the open fetal circuit. When the fetal circuit was closed, the concentrations approached or slightly exceeded those in the maternal perfusate over a period of three hours. Within the placenta, higher concentrations were established during the experiments with transfer towards the fetal side than in the reverse direction. Of the three amino acids, leucine was transferred most rapidly across the placenta while AIB reached the highest concentrations in the placental tissue. The asymmetry of the transplacental amino acid flux is favoured by rapid uptake from the maternal circulation and transfer towards the fetus. Both rates exceed those observed in the reverse direction. The transfer rate of D-leucine was 1.7 times that of L-glucose. For in vitro studies of the transfer rate of physiological compounds a correction for diffusion is required. The results may differ considerably depending on which marker is used as the basis. PMID:3112761

  18. Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke

    NASA Astrophysics Data System (ADS)

    Steinkellner, Oliver; Gruber, Clemens; Wabnitz, Heidrun; Jelzow, Alexander; Steinbrink, Jens; Fiebach, Jochen B.; MacDonald, Rainer; Obrig, Hellmuth

    2010-11-01

    We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

  19. Establishing the diffuse correlation spectroscopy signal relationship with blood flow.

    PubMed

    Boas, David A; Sakadžić, Sava; Selb, Juliette; Farzam, Parisa; Franceschini, Maria Angela; Carp, Stefan A

    2016-07-01

    Diffuse correlation spectroscopy (DCS) measurements of blood flow rely on the sensitivity of the temporal autocorrelation function of diffusively scattered light to red blood cell (RBC) mean square displacement (MSD). For RBCs flowing with convective velocity [Formula: see text], the autocorrelation is expected to decay exponentially with [Formula: see text], where [Formula: see text] is the delay time. RBCs also experience shear-induced diffusion with a diffusion coefficient [Formula: see text] and an MSD of [Formula: see text]. Surprisingly, experimental data primarily reflect diffusive behavior. To provide quantitative estimates of the relative contributions of convective and diffusive movements, we performed Monte Carlo simulations of light scattering through tissue of varying vessel densities. We assumed laminar vessel flow profiles and accounted for shear-induced diffusion effects. In agreement with experimental data, we found that diffusive motion dominates the correlation decay for typical DCS measurement parameters. Furthermore, our model offers a quantitative relationship between the RBC diffusion coefficient and absolute tissue blood flow. We thus offer, for the first time, theoretical support for the empirically accepted ability of the DCS blood flow index ([Formula: see text]) to quantify tissue perfusion. We find [Formula: see text] to be linearly proportional to blood flow, but with a proportionality modulated by the hemoglobin concentration and the average blood vessel diameter. PMID:27335889

  20. Comments on "Molecular diffusion and the sedimentary environment: results from the in situ determination of whole sediment diffusion coefficients" by P. E. Kepkay, R. C. Cooke and A. J. Bowen

    NASA Astrophysics Data System (ADS)

    Westrich, Joseph T.; Krom, Michael D.; Berner, Robert A.

    1982-11-01

    The contention of Kepkay et al. (1981), that the description of transport of dissolved sulfate in sediments must explicitly include the effects of bacterial sulfate reduction, is shown to be conceptually confusing and unnecessary. Moreover, during their own measurements of diffusion coefficients it is unlikely that they were, in fact, bothered by sulfate reduction.

  1. Testing a Poisson Counter Model for Visual Identification of Briefly Presented, Mutually Confusable Single Stimuli in Pure Accuracy Tasks

    ERIC Educational Resources Information Center

    Kyllingsbaek, Soren; Markussen, Bo; Bundesen, Claus

    2012-01-01

    The authors propose and test a simple model of the time course of visual identification of briefly presented, mutually confusable single stimuli in pure accuracy tasks. The model implies that during stimulus analysis, tentative categorizations that stimulus i belongs to category j are made at a constant Poisson rate, v(i, j). The analysis is…

  2. (1) Request for a binding decision on whether Ferdinanda (Compositae) and Ferdinandea (Rubiaceae) are sufficiently alike to be confused

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The genus Ferdinandusa is an attractive, widespread shrub in tropical America, a member of the family Rubiaceae, and is sometimes cultivated for its bright showy flowers. It is a later name for the genus Ferdinandea, which has been confused with the genus Ferdinanda. By officially establishing that ...

  3. The Polish language version of the Confusion Assessment Method - a questionnaire for the screening of consciousness disorders.

    PubMed

    Świerzy, Krzysztof A; Pudlo, Robert; Wesołowski, Bartosz; Garbacz, Marcin; Morawski, Michał; Jaworska, Izabela; Sołtysik, Mariusz; Zembala, Marian

    2016-06-01

    Confusion on a somatic basis is a dangerous problem mainly related with aging of the population. Data says that consciousness disorders concern 10-15% of patients in general wards, and up to 50% of patients admitted to geriatric wards. The persistence of the symptoms of confusion results in increase of agitation, disorganization, fear, which increases the risk of self-injuries of patients, it causes the need for parenteral feeding and hydratation, as well as maintaining water balance, and also disturbs cooperation, worsening the course and prognosis of the primary disease. It is believed that consciousness disorders are one of the most difficult diagnostic problems and the most difficult therapy problem among psychotic disorders. So far in Poland there have been no screening evaluation tools to assess the occurrence of confusion on the somatic basis. The purpose of this paper is to introduce the Polish translation of the widely used scale to assess consciousness disorders, intended also for middle personnel of health care - Confusion Assessment Method (CAM). Numerous studies over 16 years established the position of CAM as an exceptionally effective standardized diagnostic test, specifying the sensitivity of 94-100%, specificity from 90-95%, positive predictive value of 91-94%, negative predictive value of 90-100%. The questionnaire and instructions of its interpretation have been translated by doctors with active help from the original creators of CAM. Further studies are required in order to validate and determine the effectiveness of the newly formed diagnostic tool. PMID:27516799

  4. Energy and Matter: Differences in Discourse in Physical and Biological Sciences Can Be Confusing for Introductory Biology Students

    ERIC Educational Resources Information Center

    Hartley, Laurel M.; Momsen, Jennifer; Maskiewicz, April; D'Avanzo, Charlene

    2012-01-01

    Biology majors often take introductory biology, chemistry, and physics courses during their first two years of college. The various and sometimes conflicting discourse about and explanations of matter and energy in these courses may contribute to confusion and alternative conceptions (those that differ from scientific consensus) in biology…

  5. The separate roles of the reflective mind and involuntary inhibitory control in gatekeeping paranormal beliefs and the underlying intuitive confusions.

    PubMed

    Svedholm, Annika M; Lindeman, Marjaana

    2013-08-01

    Intuitive thinking is known to predict paranormal beliefs, but the processes underlying this relationship, and the role of other thinking dispositions, have remained unclear. Study 1 showed that while an intuitive style increased and a reflective disposition counteracted paranormal beliefs, the ontological confusions suggested to underlie paranormal beliefs were predicted by individual differences in involuntary inhibitory processes. When the reasoning system was subjected to cognitive load, the ontological confusions increased, lost their relationship with paranormal beliefs, and their relationship with weaker inhibition was strongly accentuated. These findings support the argument that the confusions are mainly intuitive and that they therefore are most discernible under conditions in which inhibition is impaired, that is, when thinking is dominated by intuitive processing. Study 2 replicated the findings on intuitive and reflective thinking and paranormal beliefs. In Study 2, ontological confusions were also related to the same thinking styles as paranormal beliefs. The results support a model in which both intuitive and non-reflective thinking styles and involuntary inhibitory processes give way to embracing culturally acquired paranormal beliefs. PMID:23848383

  6. Avoiding Infusion Confusion Kindergarten through 3rd Grade. A Practical Handbook for Infusing Environmental Activities into Your Classroom.

    ERIC Educational Resources Information Center

    Hayden, Harvey; And Others

    To some educators, infusing environmental education into different subject areas at different levels may seem like an insurmountable task. This handbook was developed to take the guesswork out of this process and alleviate the fear and confusion that may result. It was designed to assist with infusing awareness and attitude activities into the…

  7. Avoiding Infusion Confusion 4th through 6th Grades. A Practical Handbook for Infusing Environmental Activities into Your Classroom.

    ERIC Educational Resources Information Center

    Hayden, Harvey; And Others

    To some educators, infusing environmental education into different subject areas at different levels may seem like an insurmountable task. This handbook was developed to take the guesswork out of this process and alleviate the fear and confusion that may result. It was designed to assist with infusing knowledge and attitude activities into the…

  8. The Polish language version of the Confusion Assessment Method – a questionnaire for the screening of consciousness disorders

    PubMed Central

    Pudlo, Robert; Wesołowski, Bartosz; Garbacz, Marcin; Morawski, Michał; Jaworska, Izabela; Sołtysik, Mariusz; Zembala, Marian

    2016-01-01

    Confusion on a somatic basis is a dangerous problem mainly related with aging of the population. Data says that consciousness disorders concern 10-15% of patients in general wards, and up to 50% of patients admitted to geriatric wards. The persistence of the symptoms of confusion results in increase of agitation, disorganization, fear, which increases the risk of self-injuries of patients, it causes the need for parenteral feeding and hydratation, as well as maintaining water balance, and also disturbs cooperation, worsening the course and prognosis of the primary disease. It is believed that consciousness disorders are one of the most difficult diagnostic problems and the most difficult therapy problem among psychotic disorders. So far in Poland there have been no screening evaluation tools to assess the occurrence of confusion on the somatic basis. The purpose of this paper is to introduce the Polish translation of the widely used scale to assess consciousness disorders, intended also for middle personnel of health care – Confusion Assessment Method (CAM). Numerous studies over 16 years established the position of CAM as an exceptionally effective standardized diagnostic test, specifying the sensitivity of 94-100%, specificity from 90-95%, positive predictive value of 91-94%, negative predictive value of 90-100%. The questionnaire and instructions of its interpretation have been translated by doctors with active help from the original creators of CAM. Further studies are required in order to validate and determine the effectiveness of the newly formed diagnostic tool. PMID:27516799

  9. Is It Just Me, or Are There Other Parents and Teachers Out There Confused about SOL Reading Assessments?

    ERIC Educational Resources Information Center

    Bintz, William P.

    1998-01-01

    Describes an incident involving the author, his daughter, and sample items from a Standards of Learning (SOL) assessment. Elaborates on the author's increasing confusion with SOL assessments, especially in reading. Proposes that educators spend less time testing kids and more time "testing their theories" so that assessments better reflect recent…

  10. Avoiding Infusion Confusion 7th through 9th Grades. A Practical Handbook for Infusing Environmental Activities into Your Classroom.

    ERIC Educational Resources Information Center

    Hayden, Harvey; And Others

    To some educators, infusing environmental education into different subject areas at different levels may seem like an insurmountable task. This handbook was developed to take the guesswork out of this process and alleviate the fear and confusion that may result. It was designed to assist with infusing knowledge, skill and attitude activities into…

  11. Energy and the Confused Student V: The Energy/Momentum Approach to Problems Involving Rotating and Deformable Systems

    ERIC Educational Resources Information Center

    Jewett, John W., Jr.

    2008-01-01

    Energy is a critical concept in physics problem-solving, but is often a major source of confusion for students if the presentation is not carefully crafted by the instructor or the textbook. A common approach to problems involving deformable or rotating systems that has been discussed in the literature is to employ the work-kinetic energy theorem…

  12. The Role of Source Confusion in Cultivation Effects May Depend on Processing Strategy: A Comment on Mares (1996).

    ERIC Educational Resources Information Center

    Shrum, L. J.

    1997-01-01

    States M.L. Mares presents evidence that source confusions play a role in the cultivation effect. Clarifies some of Mares' findings that have implications for the heuristic model of cultivation effects and shows that Mares' findings are compatible with and can be integrated into the heuristic processing model. Discusses implications of Mares'…

  13. Conceptions about the mind-body problem and their relations to afterlife beliefs, paranormal beliefs, religiosity, and ontological confusions

    PubMed Central

    Riekki, Tapani; Lindeman, Marjaana; Lipsanen, Jari

    2013-01-01

    We examined lay people’s conceptions about the relationship between mind and body and their correlates. In Study 1, a web survey (N = 850) of reflective dualistic, emergentistic, and monistic perceptions of the mind-body relationship, afterlife beliefs (i.e., common sense dualism), religiosity, paranormal beliefs, and ontological confusions about physical, biological, and psychological phenomena was conducted. In Study 2 (N = 73), we examined implicit ontological confusions and their relations to afterlife beliefs, paranormal beliefs, and religiosity. Correlation and regression analyses showed that reflective dualism, afterlife beliefs, paranormal beliefs, and religiosity were strongly and positively related and that reflective dualism and afterlife beliefs mediated the relationship between ontological confusions and religious and paranormal beliefs. The results elucidate the contention that dualism is a manifestation of universal cognitive processes related to intuitions about physical, biological, and psychological phenomena by showing that especially individuals who confuse the distinctive attributes of these phenomena tend to set the mind apart from the body. PMID:25247011

  14. Clinical relevance of ventilation-perfusion inequality determined by inert gas elimination.

    PubMed

    Rodriguez-Roisin, R; Wagner, P D

    1990-04-01

    The first part of this review deals with the basic mechanisms and factors determining hypoxaemia and hypercapnia and the different approaches used in clinical practice and in clinical research to assess the presence of ventilation-perfusion mismatching, shunt and diffusion limitation for oxygen, and more specifically the multiple inert gas elimination technique (MIGET), in pulmonary medicine. The second part reviews three different respiratory disorders where the complex interplay between intrapulmonary and extrapulmonary factors regulating oxygen are essentially interpreted through the results afforded by the MIGET over the last decade. The gas exchange response to bronchodilators in bronchial asthma, an airway disease, and then the major determinants governing abnormal gas exchange in acute pulmonary embolism, a pulmonary vascular disorder, and during haemodialysis, a respiratory entity of extrapulmonary origin, are successively explored in the light of the inert gas method. PMID:2163880

  15. Perfusion Shift from White to Gray Matter May Account for Processing Speed Deficits in Schizophrenia

    PubMed Central

    Wright, Susan N.; Hong, L. Elliot; Winkler, Anderson M.; Chiappelli, Joshua; Nugent, Katie; Muellerklein, Florian; Du, Xioming; Rowland, Laura M.; Wang, Danny J. J.; Kochunov, Peter

    2016-01-01

    Reduced speed of cerebral information processing is a cognitive deficit associated with schizophrenia. Normal information processing speed (PS) requires intact white matter (WM) physiology to support information transfer. In a cohort of 107 subjects (47/60 patients/controls), we demonstrate that PS deficits in schizophrenia patients are explained by reduced WM integrity, which is measured using diffusion tensor imaging, mediated by the mismatch in WM/gray matter blood perfusion, and measured using arterial spin labeling. Our findings are specific to PS, and testing this hypothesis for patient-control differences in working memory produces no explanation. We demonstrate that PS deficits in schizophrenia can be explained by neurophysiological alterations in cerebral WM. Whether the disproportionately low WM integrity in schizophrenia is due to illness or secondary due to this disorder deserves further examination. PMID:26108347

  16. Evaluation of mechanical and morphologic features of PLLA membranes as supports for perfusion cells culture systems.

    PubMed

    Montesanto, S; Brucato, V; La Carrubba, V

    2016-12-01

    Porous biodegradable PLLA membranes, which can be used as supports for perfusion cell culture systems were designed, developed and characterized. PLLA membranes were prepared via diffusion induced phase separation (DIPS). A glass slab was coated with a binary PLLA-dioxane solution (8wt.% PLLA) via dip coating, then pool immersed in two subsequent coagulation baths, and finally dried in a humidity-controlled environment. Surface and mechanical properties were evaluated by measuring pore size, porosity via scanning electron microscopy, storage modulus, loss modulus and loss angle by using a dynamic mechanical analysis (DMA). Cell adhesion assays on different membrane surfaces were also performed by using a standard count method. Results provide new insights into the foaming methods for producing polymeric membranes and supply indications on how to optimise the fabrication parameters to design membranes for tissue cultures and regeneration. PMID:27612778

  17. Perfusion shift from white to gray matter may account for processing speed deficits in schizophrenia.

    PubMed

    Wright, Susan N; Hong, L Elliot; Winkler, Anderson M; Chiappelli, Joshua; Nugent, Katie; Muellerklein, Florian; Du, Xioming; Rowland, Laura M; Wang, Danny J J; Kochunov, Peter

    2015-10-01

    Reduced speed of cerebral information processing is a cognitive deficit associated with schizophrenia. Normal information processing speed (PS) requires intact white matter (WM) physiology to support information transfer. In a cohort of 107 subjects (47/60 patients/controls), we demonstrate that PS deficits in schizophrenia patients are explained by reduced WM integrity, which is measured using diffusion tensor imaging, mediated by the mismatch in WM/gray matter blood perfusion, and measured using arterial spin labeling. Our findings are specific to PS, and testing this hypothesis for patient-control differences in working memory produces no explanation. We demonstrate that PS deficits in schizophrenia can be explained by neurophysiological alterations in cerebral WM. Whether the disproportionately low WM integrity in schizophrenia is due to illness or secondary due to this disorder deserves further examination. PMID:26108347

  18. Coronary artery occlusion extends perfusion territory boundaries through microvascular collaterals.

    PubMed

    Cicutti, N; Rakusan, K; Downey, H F

    1994-01-01

    Simultaneous in vivo infusions of two different colored 10 microns microsphere suspensions into the left anterior descending (LAD; red spheres) and left circumflex (LCx; blue spheres) coronary arteries of nine anesthetized dogs identified a specific region of canine myocardium perfused by both arterial branches. Subsequently, the LAD was ligated and a third (green) set of micropheres was infused into the patent LCx artery. Analysis of 40 microns serial sections of tissue revealed interface zones with capillaries perfused by both arteries. The first zone, defined as the Interface Transistion Zone (ITZ) was formed by an intermingling of microvessels supplied by the parent arteries of the adjacent perfusion territories; it separated tissue containing only one or the other colored microspheres. Another zone, defined as the Boundary Watershed Zone was located within the ITZ and had capillaries containing both red and blue microspheres. The width of ITZ was 53377 +/- 817 microns (mean +/- SD), and the width of the BWZ was 3358 +/- 618 microns. Green microspheres, infused into the LCx following coronary occlusion were also found in the ITZ and BWZ. Furthermore, capillaries perfused exclusively by the LAD before occlusion (tissue with red but not blue microspheres) adjacent to the perfusion interface contained green microspheres as well as red/green aggregates, indicating lateral extension of the LCx perfusion territory. This extension of the LCx territory was quantitated by comparing the location at which densities of green microspheres or green/red aggregates decreased abruptly compared to the location of the original ITZ and BWZ boundaries, respectively. Results showed that LAD occlusion caused a 24% expansion of the ITZ and a 48% expansion of the BWZ. In addition, all expansions were significantly greater in subepicardial compared to subendocardial regions (p < 0.001). These results clearly demonstrate the capability of microvascular anastomoses in providing blood flow

  19. Parametric perfusion imaging based on low-cost ultrasound platform.

    PubMed

    Gu, Xiaolin; Zhong, Hui; Wan, Mingxi; Hu, Xiaowen; Lv, Dan; Shen, Liang; Zhang, Xiaomei

    2010-01-01

    In this study, we attempted to implement parametric perfusion imaging to quantify blood perfusion based on modified low-cost ultrasound platform. A novel ultrasound contrast-specific imaging method called pulse-inversion harmonic sum-squared-differences (PIHSSD) was proposed for improving the sensitivity for detecting contrast agents and the accuracy of parametric perfusion imaging, which combined pulse-inversion harmonic (PIH) with pulse-inversion sum-squared-differences (PISSD) threshold-based decision. PIHSSD method just involved simple operations including addition and multiplication and was easy to realize. The sequences of contrast images without logarithmic compression were used to acquire time intensity curves (TICs) from numerous equal-sized regions-of-interest (ROI) covering the entire image plane. Parametric perfusion images were obtained based on the parameters extracted from the TICs, including peak value (PV), area under curve (AUC), mean transit time (MTT), peak value time (PVT), peak width (PW) and climbing rate (CR). Flow phantom was used for validation and the results suggested that PIHSSD method provided 9.6 to 20.3 dB higher contrast-to-tissue ratio (CTR) than PIH method. The results of the experiments of rabbit kidney also showed that the CTR of PIHSSD images was higher than that of PIH images, and the parametric perfusion images based on PIHSSD method provided more accurate quantification of blood perfusion compared with those based on PIH and PISSD methods. It demonstrated that the parametric perfusion imaging achieved good performance though implemented on low-cost ultrasound platform. (E-mail: mxwan@mail.xjtu.edu.cn). PMID:19931972

  20. HIV vaccine knowledge and beliefs among communities at elevated risk: conspiracies, questions and confusion.

    PubMed

    Roberts, Kathleen Johnston; Newman, Peter A; Duan, Naihua; Rudy, Ellen T

    2005-12-01

    HIV vaccines offer the best long-term hope of controlling the AIDS pandemic. We explored HIV vaccine knowledge and beliefs among communities at elevated risk for HIV/AIDS. Participants (N=99; median age=33 years; 48% female; 22% African-American; 44% Latino; 28% white; 6% other) were recruited from seven high-risk venues in Los Angeles, California, using purposive, venue-based sampling. Results from nine focus groups revealed: 1) mixed beliefs and conspiracy theories about the existence of HIV vaccines; 2) hopefulness and doubts about future HIV vaccine availability; 3) lack of information about HIV vaccines; and 4) confusion about vaccines and how they work. Tailored HIV vaccine education that addresses the current status of HIV vaccine development and key vaccine concepts is warranted among communities at risk. Ongoing dialogue among researchers, public health practitioners and communities at risk may provide a vital opportunity to dispel misinformation and rumors and to cultivate trust, which may facilitate HIV vaccine trial participation and uptake of future HIV vaccines. PMID:16396058

  1. Other-self confusions in action memory: The role of motor processes.

    PubMed

    Lindner, Isabel; Schain, Cécile; Echterhoff, Gerald

    2016-04-01

    People can come to falsely remember performing actions that they have not actually performed. Common accounts of such false action memories have invoked source confusion from the overlap of sensory features but largely ignored the role of motor processes. We addressed this lacuna with a paradigm in which participants first perform (vs. do not perform) actions and then observe another person performing some of the non-performed actions. In this paradigm, observation of videos showing another's actions can later induce false self-attributions of these actions, the observation-inflation effect. Contrary to a sensory-feature account but consistent with a motor-simulation account, we found the effect even with perceptually impoverished action videos in which the majority of sensory features is absent, but motion cues are preserved (Experiment 1). We then created conditions during action observation that should (vs. should not) impede motor simulation. As predicted we found that the effect of observation was reduced when participants executed movements that were incongruent (vs. congruent) with the observed actions (Experiment 2). We discuss the processes that can produce associations of self with observed others' actions and later affect observers' action memory. PMID:26803394

  2. The complete mitochondrial genome of the confused flour beetle Tribolium confusum (Coleoptera: Tenebrionidae).

    PubMed

    Ou, Jing; Yao, Fu-Jiao; Li, Ya-Xiao; Yang, Yan; Jin, Cheng; Wei, Zhao-Ming

    2016-09-01

    Flour beetles of the genus Tribolium are economically important as destructive cosmopolitan pests of stored flour, corn, peanuts, and other dried agricultural products. The confused flour beetle Tribolium confusum Jacquelin du Val (1868) is one of the most important pest species of flour beetle. Here we sequenced and characterized the complete mitochondrial genome of T. confusum, the entire sequence is 15,813 bp in size with 72.8% AT content. It consists of 13 protein-coding genes (PCGs), 22 transfer RNA (tRNA), 2 ribosomal RNA (rRNA) genes and one major non-coding AT-rich region. The mitogenome of T. confusum exhibits a gene arrangement and content identical to the most common type in insects. All PCGs are start with a typical ATN initiation codon, except for the cox1, which use AAC as its start codon instead of ATN. Ten genes use standard complete termination codon (six TAA, three TAG), whereas the cox2, cox3, nad4 and nad5 genes end with single T. Except for trnS1 ((AGN)), all tRNA genes display typical secondary cloverleaf structures as those of other insects. The sizes of the large and small ribosomal RNA genes are 1277 and 773 bp, respectively. The AT content of the AT-rich region is 79.5%. The 5 bp conserved motif TACTA was found in the intergenic region between trnS2 ((UCN)) and nad1. PMID:25693711

  3. Eta Car: The Good, the Bad and the Ugly of Nebular and Stellar Confusion

    NASA Technical Reports Server (NTRS)

    Gull, T.R.; Sonneborn, G.; Jensen, A.G.; Nielsen, K.E.; Vieira Kover, G.; Hillier, D.J.

    2008-01-01

    Observations in the far-UV provide a unique opportunity to investigate the very massive star Eta Car and its hot binary companion, Eta Car B. Eta Car was observed with FUSE over a large portion of the 5.54 year spectroscopic period before and after the 2003.5 minimum. The observed spectrum is defined by strong stellar wind signatures, primarily from Eta Car A, complicated by the strong absorptions of the ejecta surrounding Eta Car plus interstellar absorption. The Homunculus and Little Homunculus are massive bipolar ejecta historically associable with LBV outbursts in the 1840s and the 1890s and are linked to absorptions at -513 and -146 km/s, respectively. The FUSE spectra are confused by the extended nebulosity and thermal drifting of the FUSE co-pointed instruments. Interpretation is further complicated by two B-stars sufficiently close to h Car to be included most of the time in the large FUSE aperture. Followup observations partially succeeded in obtaining spectra of at least one of these B-stars through the smaller apertures, allowing potential separation of the B-star contributions and h Car. A complete analysis of all available spectra is currently underway. Our ultimate goals are to directly detect the hot secondary star if possible with FUSE and to identify the absorption contributions to the overall spectrum especially of the stellar members and the massive ejecta.

  4. Denisovans, Melanesians, Europeans, and Neandertals: The Confusion of DNA Assumptions and the Biological Species Concept.

    PubMed

    Caldararo, Niccolo

    2016-08-01

    A number of recent articles have appeared on the Denisova fossil remains and attempts to produce DNA sequences from them. One of these recently appeared in Science by Vernot et al. (Science 352:235-239, 2016). We would like to advance an alternative interpretation of the data presented. One concerns the problem of contamination/degradation of the determined DNA sequenced. Just as the publication of the first Neandertal sequence included an interpretation that argued that Neandertals had not contributed any genes to modern humans, the Denisovan interpretation has considerable influence on ideas regarding human evolution. The new papers, however, confuse established ideas concerning the nature of species, as well as the use of terms like premodern, Archaic Homo, and Homo heidelbergensis. Examination of these problems presents a solution by means of reinterpreting the results. Given the claims for gene transfer among a number of Mid Pleistocene hominids, it may be time to reexamine the idea of anagenesis in hominid evolution. PMID:27517578

  5. HIV vaccine knowledge and beliefs among communities at elevated risk: conspiracies, questions and confusion.

    PubMed Central

    Roberts, Kathleen Johnston; Newman, Peter A.; Duan, Naihua; Rudy, Ellen T.

    2005-01-01

    HIV vaccines offer the best long-term hope of controlling the AIDS pandemic. We explored HIV vaccine knowledge and beliefs among communities at elevated risk for HIV/AIDS. Participants (N=99; median age=33 years; 48% female; 22% African-American; 44% Latino; 28% white; 6% other) were recruited from seven high-risk venues in Los Angeles, California, using purposive, venue-based sampling. Results from nine focus groups revealed: 1) mixed beliefs and conspiracy theories about the existence of HIV vaccines; 2) hopefulness and doubts about future HIV vaccine availability; 3) lack of information about HIV vaccines; and 4) confusion about vaccines and how they work. Tailored HIV vaccine education that addresses the current status of HIV vaccine development and key vaccine concepts is warranted among communities at risk. Ongoing dialogue among researchers, public health practitioners and communities at risk may provide a vital opportunity to dispel misinformation and rumors and to cultivate trust, which may facilitate HIV vaccine trial participation and uptake of future HIV vaccines. PMID:16396058

  6. Too much of a good thing? Variety is confusing in mate choice

    PubMed Central

    Lenton, Alison P.; Francesconi, Marco

    2011-01-01

    Choice variety is supposed to increase the likelihood that a chooser's preferences are satisfied. To assess the effects of variety on real-world mate choice, we analysed human dating decisions across 84 speed-dating events (events in which people go on a series of sequential ‘mini-dates’). Results showed that choosers made fewer proposals (positive dating decisions) at events in which the available dates showed greater variety across such attributes as age, height, occupation and education, and this effect was particularly strong when choosers were confronted with a larger number of opposite-sex speed daters. Additionally, participants attending events in which the available options showed greater variety across these attributes were less likely to choose the consensually preferred mate option and more likely to choose no one at all. In contexts in which time is a limited resource, choice variety—rather than facilitating choice quality or increasing choosiness—is confusing and potentially detrimental to choice quality. PMID:21367779

  7. Perceptual confusions of American-English vowels and consonants by native Arabic bilinguals.

    PubMed

    Shafiro, Valeriy; Levy, Erika S; Khamis-Dakwar, Reem; Kharkhurin, Anatoliy

    2013-06-01

    This study investigated the perception of American-English (AE) vowels and consonants by young adults who were either (a) early Arabic-English bilinguals whose native language was Arabic or (b) native speakers of the English dialects spoken in the United Arab Emirates (UAE), where both groups were studying. In a closed-set format, participants were asked to identify 12 AE vowels presented in /hVd/ context and 20 AE consonants (C) in three vocalic contexts: /aCa/, /iCi/, and /uCu/. Both native Arabic and native English groups demonstrated high accuracy in identification of vowels (70 and 80% correct, respectively) and consonants (94 and 95% correct, respectively). For both groups, the least-accurately identified vowels were /o/, /(see text)/, /ae/, while most consonant errors were found for /(see text)/, which was most frequently confused with /v/. However, for both groups, identification of /(see text)/ was vocalic-context dependent, with most errors occurring in liCil context and fewest errors occurring in luCu/ context. Lack of significant group differences suggests that speech sound identification patterns, including phonetic context effects for /(see text)/, were influenced more by the local English dialects than by listeners' Arabic language background. The findings also demonstrate consistent perceptual error patterns among listeners despite considerable variation in their native and second language dialectal backgrounds. PMID:23905278

  8. Clarifying the confusion: old-growth savannahs and tropical ecosystem degradation.

    PubMed

    Veldman, Joseph W

    2016-09-19

    Ancient tropical grassy biomes are often misrecognized as severely degraded forests. I trace this confusion to several factors, with roots in the nineteenth century, including misinterpretations of the nature of fire in savannahs, attempts to reconcile savannah ecology with Clementsian succession, use of physiognomic (structural) definitions of savannah and development of tropical degradation frameworks focused solely on forests. Towards clarity, I present two models that conceptualize the drivers of ecosystem degradation as operating in both savannahs and forests. These models highlight how human-induced environmental changes create ecosystems with superficially similar physiognomies but radically different conservation values. Given the limitation of physiognomy to differentiate savannahs from severely degraded forests, I present an alternative approach based on floristic composition. Data from eastern lowland Bolivia show that old-growth savannahs can be reliably distinguished by eight grass species and that species identity influences ecosystem flammability. I recommend that scientists incorporate savannahs in tropical degradation frameworks alongside forests, and that savannah be qualified as old-growth savannah in reference to ancient grassy biomes or derived savannah in reference to deforestation. These conceptual advances will require attention not only to tree cover, but also to savannah herbaceous plant species and their ecologies.This article is part of the themed issue 'Tropical grassy biomes: linking ecology, human use and conservation'. PMID:27502372

  9. A 12-consonant confusion study on a multiple-channel cochlear implant patient.

    PubMed

    Dowell, R C; Martin, L F; Tong, Y C; Clark, G M; Seligman, P M; Patrick, J F

    1982-12-01

    A consonant confusion study was undertaken on a multiple-channel cochlear implant patient using a wearable speech processing device. This patient suffered from total bilateral deafness acquired postlingually. The consonants /b/, /p/, /m/, /v/, /f/, /d/, /t/, /n/, /z/, /s/, /g/, /k/ were presented in a VCV context with the vowel /a/ as in father by a male and female speaker under three conditions: lipreading alone; electrical stimulation alone using the wearable speech processor and multiple-channel cochlear implant; lipreading in conjunction with electrical stimulation. No significant difference was detected between the results for the male and female speakers. The percentage correct scores for the pooled results of both speakers were lipreading alone--30%; electrical stimulation alone--48%; lipreading with electrical stimulation--70%. Performance was significantly better for lipreading with electrical stimulation than for lipreading alone and for electrical stimulation alone than for lipreading alone. An information transmission analysis demonstrated the effective integration of visual and auditory information for lipreading with electrical stimulation. There was a significant improvement in performance for the electrical stimulation alone condition over the 2 months of the study in contrast to no such improvement for lipreading alone. PMID:6897661

  10. Eta Car: The Good, the Bad and the Ugly of Nebular and Stellar Confusion

    NASA Astrophysics Data System (ADS)

    Nielsen, K. E.; Kober, G. Vieira; Gull, T. R.; Iping, R.; Hillier, D. J.; Sonneborn, G.; Jensen, A. G.

    2009-05-01

    Observations in the far-UV provide a unique opportunity to investigate the very massive star η Car and its hot binary companion, η Car B. η Car was observed with FUSE over a large portion of the 5.54 year spectroscopic period before and after the 2003.5 minimum. The observed spectrum is defined by strong stellar wind signatures, primarily from η Car A, complicated by the strong absorptions of the ejecta surrounding η Car plus interstellar absorption. The Homunculus and Little Homunculus are massive bipolar ejecta historically associable with LBV outbursts in the 1840s and the 1890s and are linked to absorptions at -513 and -146 km s-1, respectively. The FUSE spectra are confused by the extended nebulosity and thermal drifting of the FUSE co-pointed instruments. Interpretation is further complicated by two B-stars sufficiently close to η Car to be included most of the time in the large FUSE aperture. Followup observations partially succeeded in obtaining spectra of at least one of these B-stars through the smaller apertures, allowing potential separation of the B-star contributions and η Car. A complete analysis of all available spectra is currently underway. Our ultimate goals are to directly detect the hot secondary star if possible with FUSE and to identify the absorption contributions to the overall spectrum especially of the stellar members and the massive ejecta.

  11. Analysis of perceptual confusions between nine sets of consonant-vowel sounds in normal and dyslexic adults.

    PubMed

    Cornelissen, P L; Hansen, P C; Bradley, L; Stein, J F

    1996-06-01

    It is widely accepted that most developmental dyslexics perform poorly on tasks which assess phonological awareness. One reason for this association might be that the early or "input" phonological representations of speech sounds are distorted or noisy in some way. We have attempted to test this hypothesis directly. In Experiment 1, we measured the confusions that adult dyslexics and controls made when they listened to nine randomly presented consonant-vowel (CV) segments [sequence: see text] under four conditions of increasing white noise masking. Subjects could replay stimuli and were under no obligation to respond quickly. Responses were selected with a computer mouse from a set of nine letter-strings, corresponding to the auditory stimuli, presented on a VDU. While the overall pattern of confusions made by dyslexics and controls was very similar for this stimulus set, dyslexics confused [sequence: see text] significantly more than did controls. In Experiment 2, subjects heard each stimulus once only and were forced to respond as quickly as possible. Under these timed conditions, the pattern of confusions made by dyslexics and controls was the same as before, but dyslexics took longer to respond than controls. The slower responses of dyslexics in Experiment 2 could have arisen because: (a) they were slower at processing the auditory stimuli than controls, (b) they had worse visual pattern memory for letter strings than controls, (c) they were slower than controls at using the computer mouse. In Experiments 3, 4 and 5 subjects carried out control tasks which eliminated each of these possibilities and confirmed that the results from the auditory tasks genuinely reflected subjects' speech perception. We propose that the fine structure of dyslexics' input phonological representations should be further explored with this confusion paradigm by using other speech sounds containing VCs, CCVs and VCCs. PMID:8706379

  12. Perfusion imaging with non-contrast ultrasound

    NASA Astrophysics Data System (ADS)

    Tierney, Jaime E.; Dumont, Douglas M.; Byram, Brett C.

    2016-04-01

    A Doppler ultrasound clutter filter that enables estimation of low velocity blood flow could considerably improve ultrasound as a tool for clinical diagnosis and monitoring, including for the evaluation of vascular diseases and tumor perfusion. Conventional Doppler ultrasound is currently used for visualizing and estimating blood flow. However, conventional Doppler is limited by frame rate and tissue clutter caused by involuntary movement of the patient or sonographer. Spectral broadening of the clutter due to tissue motion limits ultrasound's ability to detect blood flow less than about 5mm/s at an 8MHz center frequency. We propose a clutter filtering technique that may increase the sensitivity of Doppler measurements to at least as low as 0.41mm/s. The proposed filter uses an adaptive demodulation scheme that decreases the bandwidth of the clutter. To test the performance of the adaptive demodulation method at removing sonographer hand motion, six volunteer subjects acquired data from a basic quality assurance phantom. Additionally, to test initial in vivo feasibility, an arterial occlusion reactive hyperemia study was performed to assess the efficiency of the proposed filter at preserving signals from blood velocities 2mm/s or greater. The hand motion study resulted in initial average bandwidths of 577Hz (28.5mm/s), which were decreased to 7.28Hz (0.36mm/s) at -60 dB at 3cm using our approach. The in vivo power Doppler study resulted in 15.2dB and 0.15dB dynamic ranges between the lowest and highest blood flow time points for the proposed filter and conventional 50Hz high pass filter, respectively.

  13. Modelling of temperature and perfusion during scalp cooling

    NASA Astrophysics Data System (ADS)

    Janssen, F. E. M.; Van Leeuwen, G. M. J.; Van Steenhoven, A. A.

    2005-09-01

    Hair loss is a feared side effect of chemotherapy treatment. It may be prevented by cooling the scalp during administration of cytostatics. The supposed mechanism is that by cooling the scalp, both temperature and perfusion are diminished, affecting drug supply and drug uptake in the hair follicle. However, the effect of scalp cooling varies strongly. To gain more insight into the effect of cooling, a computer model has been developed that describes heat transfer in the human head during scalp cooling. Of main interest in this study are the mutual influences of scalp temperature and perfusion during cooling. Results of the standard head model show that the temperature of the scalp skin is reduced from 34.4 °C to 18.3 °C, reducing tissue blood flow to 25%. Based upon variations in both thermal properties and head anatomies found in the literature, a parameter study was performed. The results of this parameter study show that the most important parameters affecting both temperature and perfusion are the perfusion coefficient Q10 and the thermal resistances of both the fat and the hair layer. The variations in the parameter study led to skin temperature ranging from 10.1 °C to 21.8 °C, which in turn reduced relative perfusion to 13% and 33%, respectively.

  14. Hyperventilation induces release of cytokines from perfused mouse lung.

    PubMed

    von Bethmann, A N; Brasch, F; Nüsing, R; Vogt, K; Volk, H D; Müller, K M; Wendel, A; Uhlig, S

    1998-01-01

    Artificial mechanical ventilation represents a major cause of iatrogenic lung damage in intensive care. It is largely unknown which mediators, if any, contribute to the onset of such complications. We investigated whether stress caused by artificial mechanical ventilation leads to induction, synthesis, and release of cytokines or eicosanoids from lung tissue. We used the isolated perfused and ventilated mouse lung where frequent perfusate sampling allows determination of mediator release into the perfusate. Hyperventilation was executed with either negative (NPV) or positive pressure ventilation (PPV) at a transpulmonary pressure that was increased 2.5-fold above normal. Both modes of hyperventilation resulted in an approximately 1.75-fold increased expression of tumor necrosis factor alpha (TNFalpha) and interleukin-6 (IL-6) mRNA, but not of cyclooxygenase-2 mRNA. After switching to hyperventilation, prostacyclin release into the perfusate increased almost instantaneously from 19 +/- 17 pg/min to 230 +/- 160 pg/min (PPV) or 115 +/- 87 pg/min (NPV). The enhancement in TNFalpha and IL-6 production developed more slowly. In control lungs after 150 min of perfusion and ventilation, TNFalpha and IL-6 production was 23 +/- 20 pg/min and 330 +/- 210 pg/min, respectively. In lungs hyperventilated for 150 min, TNFalpha and IL-6 production were increased to 287 +/- 180 pg/min and more than 1,000 pg/min, respectively. We conclude that artificial ventilation might cause pulmonary and systemic adverse reactions by inducing the release of mediators into the circulation. PMID:9445308

  15. Real-time vascular mechanosensation through ex vivo artery perfusion

    PubMed Central

    2014-01-01

    Background Cell-based perfusion studies have provided great insight into fluid-sensing mechanisms, such as primary cilia in the renal and vascular systems. However, the intrinsic limitations of in vitro cell culture, such as the inability to reflect cellular organization within tissues, has distanced observed paradigms from possible clinical developments. Here we describe a protocol that applies ex vivo artery perfusion and calcium imaging to observe real-time cellular responses to fluid-shear stress. Results Through our ex vivo artery perfusion method, we were able to simulate physiological flow and initiate distinct fluid shear stress mechanosensory responses, as well as induced acetylcholine responses in mouse aortic tissue. The observed calcium profiles confirm results found through previous in vitro cell culture experiments. The overall procedure, including dissection, sample preparation and perfusion, takes around 3 hours to complete. Conclusion Through our unique method, we are able to induce laminar flow within intact mouse aortic tissue and illicit subsequent cellular responses. This method of ex vivo artery perfusion provides the opportunity to bridge the novel findings of in vitro studies with subsequent physiological models of fluid-shear stress mechanosensation in vascular tissues. PMID:24685068

  16. Perfused Multiwell Plate for 3D Liver Tissue Engineering

    PubMed Central

    Domansky, Karel; Inman, Walker; Serdy, James; Dash, Ajit; Lim, Matthew H. M.

    2014-01-01

    In vitro models that capture the complexity of in vivo tissue and organ behaviors in a scalable and easy-to-use format are desirable for drug discovery. To address this, we have developed a bioreactor that fosters maintenance of 3D tissue cultures under constant perfusion and we have integrated multiple bioreactors into an array in a multiwell plate format. All bioreactors are fluidically isolated from each other. Each bioreactor in the array contains a scaffold that supports formation of hundreds of 3D microscale tissue units. The tissue units are perfused with cell culture medium circulated within the bioreactor by integrated pneumatic diaphragm micropumps. Electronic controls for the pumps are kept outside the incubator and connected to the perfused multiwell by pneumatic lines. The docking design and open-well bioreactor layout make handling perfused multiwell plates similar to using standard multiwell tissue culture plates. A model of oxygen consumption and transport in the circulating culture medium was used to predict appropriate operating parameters for primary liver cultures. Oxygen concentrations at key locations in the system were then measured as a function of flow rate and time after initiation of culture to determine oxygen consumption rates. After seven days in culture, tissue formed from cells seeded in the perfused multiwell reactor remained functionally viable as assessed by immunostaining for hepatocyte and liver sinusoidal endothelial cell (LSEC) phenotypic markers. PMID:20024050

  17. Renal vascular perfusion index in a canine model.

    PubMed

    Shau, Yio-Wha; Pao, Sun-Hua; Chou, Nai-Kuan; Chang, King-Jen; Shyu, Jeou-Jong

    2009-01-01

    Decreased renal perfusion plays an important role in the progression toward renal failure. In this study, a novel measure was proposed to quantify renal perfusion using canine model. Serial renal vascular images at different vascular areas including the whole vascular tree, interlobar, arcuate and interlobular vessels were captured. Image processing software was designed to analyze the changes of power Doppler intensity of colored pixels within regions-of-interest (ROI). For a given ROI, the power Doppler vascular index (PDVI) was found to fluctuate with the cardiac cycle. It was also noted that the power Doppler signals generated by arterial vessels have different fluctuating waveforms and different phase compared with the signal derived from venous vessels. A power Doppler correlation-map was developed to differentiate the arteries and veins in the ROI. Using the serial power Doppler images and the derived flow direction information, the interlobular perfusion can be strongly quantified. The renal vascular perfusion index (RVPI) defined as the ratio of PDVI(max) versus PDVI(min) was significantly higher in the interlobular vessel areas than three other areas for seven healthy dogs. The RVPI resembles the systolic/diastolic (S/D) ratio that commonly reflects arterial hemodynamics. RVPI and power Doppler correlation-map reveal more "dynamic" sense of vascular perfusion and provide a novel approach for the examination of renal function in clinical practice. PMID:18805627

  18. Tomographic digital subtraction angiography for lung perfusion estimation in rodents

    SciTech Connect

    Badea, Cristian T.; Hedlund, Laurence W.; De Lin, Ming; Boslego Mackel, Julie S.; Samei, Ehsan; Allan Johnson, G.

    2007-05-15

    In vivo measurements of perfusion present a challenge to existing small animal imaging techniques such as magnetic resonance microscopy, micro computed tomography, micro positron emission tomography, and microSPECT, due to combined requirements for high spatial and temporal resolution. We demonstrate the use of tomographic digital subtraction angiography (TDSA) for estimation of perfusion in small animals. TDSA augments conventional digital subtraction angiography (DSA) by providing three-dimensional spatial information using tomosynthesis algorithms. TDSA is based on the novel paradigm that the same time density curves can be reproduced in a number of consecutive injections of {mu}L volumes of contrast at a series of different angles of rotation. The capabilities of TDSA are established in studies on lung perfusion in rats. Using an imaging system developed in-house, we acquired data for four-dimensional (4D) imaging with temporal resolution of 140 ms, in-plane spatial resolution of 100 {mu}m, and slice thickness on the order of millimeters. Based on a structured experimental approach, we optimized TDSA imaging providing a good trade-off between slice thickness, the number of injections, contrast to noise, and immunity to artifacts. Both DSA and TDSA images were used to create parametric maps of perfusion. TDSA imaging has potential application in a number of areas where functional perfusion measurements in 4D can provide valuable insight into animal models of disease and response to therapeutics.

  19. Diffusion-weighted imaging of pancreatic cancer.

    PubMed

    De Robertis, Riccardo; Tinazzi Martini, Paolo; Demozzi, Emanuele; Dal Corso, Flavia; Bassi, Claudio; Pederzoli, Paolo; D'Onofrio, Mirko

    2015-10-28

    Magnetic resonance imaging (MRI) is a reliable and accurate imaging method for the evaluation of patients with pancreatic ductal adenocarcinoma (PDAC). Diffusion-weighted imaging (DWI) is a relatively recent technological improvement that expanded MRI capabilities, having brought functional aspects into conventional morphologic MRI evaluation. DWI can depict the random diffusion of water molecules within tissues (the so-called Brownian motions). Modifications of water diffusion induced by different factors acting on the extracellular and intracellular spaces, as increased cell density, edema, fibrosis, or altered functionality of cell membranes, can be detected using this MR sequence. The intravoxel incoherent motion (IVIM) model is an advanced DWI technique that consent a separate quantitative evaluation of all the microscopic random motions that contribute to DWI, which are essentially represented by molecular diffusion and blood microcirculation (perfusion). Technological improvements have made possible the routine use of DWI during abdominal MRI study. Several authors have reported that the addition of DWI sequence can be of value for the evaluation of patients with PDAC, especially improving the staging; nevertheless, it is still unclear whether and how DWI could be helpful for identification, characterization, prognostic stratification and follow-up during treatment. The aim of this paper is to review up-to-date literature data regarding the applications of DWI and IVIM to PDACs. PMID:26516428

  20. Diffusion-weighted imaging of pancreatic cancer

    PubMed Central

    De Robertis, Riccardo; Tinazzi Martini, Paolo; Demozzi, Emanuele; Dal Corso, Flavia; Bassi, Claudio; Pederzoli, Paolo; D’Onofrio, Mirko

    2015-01-01

    Magnetic resonance imaging (MRI) is a reliable and accurate imaging method for the evaluation of patients with pancreatic ductal adenocarcinoma (PDAC). Diffusion-weighted imaging (DWI) is a relatively recent technological improvement that expanded MRI capabilities, having brought functional aspects into conventional morphologic MRI evaluation. DWI can depict the random diffusion of water molecules within tissues (the so-called Brownian motions). Modifications of water diffusion induced by different factors acting on the extracellular and intracellular spaces, as increased cell density, edema, fibrosis, or altered functionality of cell membranes, can be detected using this MR sequence. The intravoxel incoherent motion (IVIM) model is an advanced DWI technique that consent a separate quantitative evaluation of all the microscopic random motions that contribute to DWI, which are essentially represented by molecular diffusion and blood microcirculation (perfusion). Technological improvements have made possible the routine use of DWI during abdominal MRI study. Several authors have reported that the addition of DWI sequence can be of value for the evaluation of patients with PDAC, especially improving the staging; nevertheless, it is still unclear whether and how DWI could be helpful for identification, characterization, prognostic stratification and follow-up during treatment. The aim of this paper is to review up-to-date literature data regarding the applications of DWI and IVIM to PDACs. PMID:26516428

  1. Conformity or Confusion? Changing Higher Education Grading Scales as a Part of the Bologna Process: The Cases of Denmark, Norway and Sweden

    ERIC Educational Resources Information Center

    Dahl, Bettina; Lien, Eirik; Lindberg-Sand, Asa

    2009-01-01

    The aim of the Bologna Process is to make higher education systems across Europe more transparent. It is crucial for this purpose that confusion concerning the characteristics of the systems should be replaced by conformity. But, as we will show, conformity brought about at one level may create confusion at another. The curricular aspect of the…

  2. Are We Collectively Guilty of Complacency? An Update on the Continued Confusion over What Is Academic Freedom and What May Become a Battle for Academic Freedom

    ERIC Educational Resources Information Center

    Birtwistle, Tim

    2006-01-01

    Academic freedom has, since 2004, increasingly made the headlines of the higher education papers and journals in the United Kingdom. New legislation has added to the confusion in terms of what law applies and what might apply. This article provides an updated analysis of this confused area. (Contains 14 notes.)

  3. Liver diffusion-weighted MR imaging: the tower of Babel?

    PubMed

    Guiu, Boris; Cercueil, Jean-Pierre

    2011-03-01

    There is a growing amount of literature regarding diffusion-weighted imaging (DWI) of the liver. The apparent diffusion coefficient (ADC) was introduced in 1986 and is used extensively in studies. However, methods for calculating ADC vary considerably and the value of the ADC strongly depends on the b values chosen for its calculation. Indeed, the ADC incorporates the effects of both diffusion and perfusion, which can vary independently. Since signal attenuation as a function of b follows a bi-exponential pattern, other diffusion/perfusion coefficients can be calculated using DWI, and these may provide more meaningful measurements than the ADC. The absence of standardization for both the terminology and the methodology in DWI of the liver makes it difficult for readers to understand the technique used and strongly limits comparisons between studies. Here, we review the main principles of DWI of the liver, the limits of the ADC, and the exciting capabilities of multi-parametric DWI. We also insisted on the need for a common language for DWI of the liver. PMID:21110195

  4. Does the history of food energy units suggest a solution to "Calorie confusion"?

    PubMed

    Hargrove, James L

    2007-01-01

    The Calorie (kcal) of present U.S. food labels is similar to the original French definition of 1825. The original published source (now available on the internet) defined the Calorie as the quantity of heat needed to raise the temperature of 1 kg of water from 0 to 1 degrees C. The Calorie originated in studies concerning fuel efficiency for the steam engine and had entered dictionaries by 1840. It was the only energy unit in English dictionaries available to W.O. Atwater in 1887 for his popular articles on food and tables of food composition. Therefore, the Calorie became the preferred unit of potential energy in nutrition science and dietetics, but was displaced when the joule, g-calorie and kcal were introduced. This article will explain the context in which Nicolas Clément-Desormes defined the original Calorie and the depth of his collaboration with Sadi Carnot. It will review the history of other energy units and show how the original Calorie was usurped during the period of international standardization. As a result, no form of the Calorie is recognized as an SI unit. It is untenable to continue to use the same word for different thermal units (g-calorie and kg-calorie) and to use different words for the same unit (Calorie and kcal). The only valid use of the Calorie is in common speech and public nutrition education. To avoid ongoing confusion, scientists should complete the transition to the joule and cease using kcal in any context. PMID:18086303

  5. Care management: quelling the confusion. Case managers help clients access resources appropriate to their needs.

    PubMed

    Westhoff, L J

    1992-06-01

    The vast number of available healthcare services can be confusing to those seeking care. Care managers can resolve these issues by helping the vulnerable and their families find and receive appropriate services. Care management is not limited to the elderly: Others with special needs also benefit from care management. Care managers integrate and coordinate services, providing a continuum between the client and the providers of acute, long-term, home-based, and community-based care. The care management model that most organizations adopt at first is the brokering model. In this model care managers identify the appropriate service package from resources in the community. In the service management model, the care manager authorizes the services provided within specified financial limits. The funding source influences what services he or she can recommend. Another model is managed care. The carrier of a high-risk group of clients or a group of enrollees in a certain healthcare program prospectively pays the organization providing care management. In the acute care setting, providers find the transition to care management challenging because they have been oriented to short, episodic care. These providers must adopt new protocols to be able to work with providers and programs within their own organization or at other organizations. In community-based care, care managers' goal is to help the client and family access appropriate services so the client can function independently within his or her home. Community-based referrals are from family members or agencies and infrequently follow an acute care hospitalization. PMID:10118342

  6. A Qualitative Study of Confusing Experiences among Japanese Adult Patients with Type 1 Diabetes

    PubMed Central

    Nishio, Ikuko; Chujo, Masami; Kataoka, Hideyuki

    2016-01-01

    Background In this study, we investigated the powerlessness of patients with type 1 diabetes (T1D), and described the structure of powerlessness that these individuals experienced. In order for patients to recover from this state, we recommend that they take steps to regain their power. Methods Fifteen Japanese adults with T1D participated in this study. Data were collected from all subjects between July 2013 and March 2014 via in-depth semi-structured interviews. Qualitative data analysis was conducted according to a grounded theory approach. Finally, the core category was identified, which allowed us to build a new powerlessness structure for T1D. Results The results suggested a core category, ‘Wandering a tangled path,’ comprising four categories, eight subcategories, and twenty-six concepts. These four categories were as follows: ‘being burdened by T1D,’ ‘suffering from insulin-related troubles,’ ‘being unable to cope with difficulties in self-management,’ and ‘facing social prejudice.’ In the state of powerlessness, negative emotional experiences snowballed, with patients feeling more and more depressed until they ultimately reached ‘rock bottom.’ Conclusion We found that as negative emotional experiences related to powerlessness increased, negative feelings intensified until the patients reached rock bottom. Powerlessness is like ‘wandering a tangled path,’ a state in which T1D patients struggle to cope with reality on their own when faced with both internal and external events. ‘Wandering a tangled path’ is at the core of powerlessness. A primary characteristic of the structure of powerlessness is suffering from confusing experiences. To help patients cope with T1D without being crushed by powerlessness, nurses must pay attention to signs of powerlessness. Powerlessness is not just an emotional state, but a combination of feelings, perceptions, and thoughts; therefore, it is important to comprehensively understand patients

  7. Despite slow catalysis and confused substrate specificity, all ribulose bisphosphate carboxylases may be nearly perfectly optimized

    PubMed Central

    Tcherkez, Guillaume G. B.; Farquhar, Graham D.; Andrews, T. John

    2006-01-01

    The cornerstone of autotrophy, the CO2-fixing enzyme, d-ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco), is hamstrung by slow catalysis and confusion between CO2 and O2 as substrates, an “abominably perplexing” puzzle, in Darwin's parlance. Here we argue that these characteristics stem from difficulty in binding the featureless CO2 molecule, which forces specificity for the gaseous substrate to be determined largely or completely in the transition state. We hypothesize that natural selection for greater CO2/O2 specificity, in response to reducing atmospheric CO2:O2 ratios, has resulted in a transition state for CO2 addition in which the CO2 moiety closely resembles a carboxylate group. This maximizes the structural difference between the transition states for carboxylation and the competing oxygenation, allowing better differentiation between them. However, increasing structural similarity between the carboxylation transition state and its carboxyketone product exposes the carboxyketone to the strong binding required to stabilize the transition state and causes the carboxyketone intermediate to bind so tightly that its cleavage to products is slowed. We assert that all Rubiscos may be nearly perfectly adapted to the differing CO2, O2, and thermal conditions in their subcellular environments, optimizing this compromise between CO2/O2 specificity and the maximum rate of catalytic turnover. Our hypothesis explains the feeble rate enhancement displayed by Rubisco in processing the exogenously supplied carboxyketone intermediate, compared with its nonenzymatic hydrolysis, and the positive correlation between CO2/O2 specificity and 12C/13C fractionation. It further predicts that, because a more product-like transition state is more ordered (decreased entropy), the effectiveness of this strategy will deteriorate with increasing temperature. PMID:16641091

  8. The HI mass function in ALFALFA 70% and the role of confusion in future HI surveys

    NASA Astrophysics Data System (ADS)

    Jones, Michael G.; Papastergis, Emmanouil; Haynes, Martha P.; Giovanelli, Riccardo; ALFALFA Team

    2016-01-01

    The HI mass function represents a fundamental component of our understanding of the the gas content of galaxies. How its form varies throughout the local Universe and as a function of redshift, is key to developing a complete picture of galaxy evolution.We use the ALFALFA 70% catalog, the largest uniform catalog of extragalactic HI sources to date, to explore the environmental dependence of the HI mass function based on the projected neighbour densities in both SDSS and 2MRS. The Schechter function 'knee' mass is found to increase by approximately 0.2 dex from the lowest to highest density quartiles. However, this dependence is seen only when environment is defined by SDSS neighbours, and not with 2MRS. We interpret this as an indication of local, rather than large scale, environmental depedence. In addition, we find no evidence for any change in the faint-end slope; which is a source of tension with HI surveys of galaxy groups, and DM halo simulations.As HI surveys push deeper in an attempt to assess the HI content of the Universe towards a redshift of order unity, only the integral of the HI mass function will be measurable through stacking. We present an anaytic, and thus computationally cheap, method to estimate the contribution of HI confusion noise to these stacks and explore the design implications for upcoming SKA-precusor surveys.The ALFALFA team at Cornell is supported by NSF grants AST-0607007 and AST-1107390 to RG and MPH and by grants from the Brinson Foundation.

  9. Unraveling the confusion behind hyaluronic acid efficacy in the treatment of symptomatic knee osteoarthritis

    PubMed Central

    Miller, Larry E; Altman, Roy D; McIntyre, Louis F

    2016-01-01

    Hyaluronic acid (HA) is a commonly prescribed treatment for knee pain resulting from osteoarthritis (OA). Although numerous HA products have been approved for use by the US Food and Drug Administration, the efficacy of HA injections for knee OA remains disputed with meta-analyses and societal clinical guidelines drawing disparate conclusions. The American Academy of Orthopaedic Surgeons (AAOS) recently published a best-evidence systematic review and concluded that available data did not support the routine use of HA for knee OA. The purpose of the current article is to highlight issues that confound interpretation of meta-analyses on HA for knee OA, to provide realistic estimates of the true efficacy of HA injections in knee OA, and to provide commentary on the methods and conclusions from the AAOS systematic review. In general, the clinical benefit of HA is underestimated using conventional meta-analytic techniques. When accounting for differential control group effects in HA studies, it can be reasonably concluded that HA injections may be beneficial to an appreciable number of patients with knee OA. In addition, the systematic review methodology used by AAOS was questionable due to exclusion of numerous relevant studies and inclusion of studies that used HAs not approved for use in the US, both of which underestimated the true efficacy of HA injections. Overall, the efficacy of HA injections for knee OA is likely better than previously reported. Future clinical trials and meta-analyses should account for differential control group effects in order to avoid the continued confusion surrounding HA injection efficacy.

  10. Evaluating acellular versus cellular perfusate composition during prolonged ex vivo lung perfusion after initial cold ischaemia for 24 hours.

    PubMed

    Becker, Simon; Steinmeyer, Jasmin; Avsar, Murat; Höffler, Klaus; Salman, Jawad; Haverich, Axel; Warnecke, Gregor; Ochs, Matthias; Schnapper, Anke

    2016-01-01

    Normothermic ex vivo lung perfusion (EVLP) has developed as a powerful technique to evaluate particularly marginal donor lungs prior to transplantation. In this study, acellular and cellular perfusate compositions were compared in an identical experimental setting as no consensus has been reached on a preferred technique yet. Porcine lungs underwent EVLP for 12 h on the basis of an acellular or a cellular perfusate composition after 24 h of cold ischaemia as defined organ stress. During perfusion, haemodynamic and respiratory parameters were monitored. After EVLP, the lung condition was assessed by light and transmission electron microscopy. Aerodynamic parameters did not show significant differences between groups and remained within the in vivo range during EVLP. Mean oxygenation indices were 491 ± 39 in the acellular group and 513 ± 53 in the cellular group. Groups only differed significantly in terms of higher pulmonary artery pressure and vascular resistance in the cellular group. Lung histology and ultrastructure were largely well preserved after prolonged EVLP and showed only minor structural alterations which were similarly present in both groups. Prolonged acellular and cellular EVLP for 12 h are both feasible with lungs prechallenged by ischaemic organ stress. Physiological and ultrastructural analysis showed no superiority of either acellular or cellular perfusate composition. PMID:26264867

  11. Revival of impaired lung perfusion after sleeve lobectomy

    PubMed Central

    Shibano, Tomoki; Endo, Shunsuke; Yamamoto, Shinichi; Maki, Mitsuru

    2016-01-01

    Sleeve resection, a mainstay for centrally-located lung cancer, is a challenging procedure when the preserved lung is impaired. We herein reported a 61-year-old male who underwent right upper sleeve lobectomy for squamous cell carcinoma located at the orifice of the upper bronchus. The tumor invaded the main bronchus. A lung perfusion scan showed severe impairment, while the right middle and lower lobes were well expanded. Not only the spirogram, but also the lung perfusion in the residual lung, had markedly recovered at 2 months after the right upper extended sleeve lobectomy. The patient is currently living his normal daily life. Residual lung perfusion can be revived, even if it is impaired preoperatively. PMID:27076980

  12. New technique for retrograde cerebral perfusion during arch aneurysm repair.

    PubMed

    Bartoccioni, S; Lanzillo, G; deJong, A A; Fiaschini, P; Martinelli, G; Fedeli, C; Di Lazarro, D; Mercati, U

    1995-09-01

    Many techniques are used to reduce brain damage during surgery for dissecting aneurysms of the ascending aorta and arch. Recently, new techniques of protection were proposed, consistent with hypothermic circulatory arrest in association with retrograde cerebral perfusion via superior vena cava. We propose a simple, time-saving method, which does not require any manipulation of the heart. We use a multilumen cannula for cardioplegia (D 860-DIDECO FUNDARO') with pressure transducer. This cannula is inserted in superior vena cava by means of a simple purse-string, and linked to the arterial line with a "Y" derivation, allowing retrograde perfusion of the brain and monitoring the perfusion pressure at every moment. The superior vena cava placed downstream from the cannula is closed by a small vascular clamp, to avoid blood reflux in the right atrium. This method is time- and money-saving, is readily available, and can be prepared whenever necessary, also in the middle of the surgical procedure. PMID:7488786

  13. Complete inhibition of creatine kinase in isolated perfused rat hearts

    SciTech Connect

    Fossel, E.T.; Hoefeler, H.

    1987-01-01

    Transient exposure of an isolated isovolumic perfused rat heart to low concentrations (0.5 mM) of perfusate-born iodoacetamide resulted in complete inhibition of creatine kinase and partial inhibition of glyceraldehyde-3-phosphate dehydrogenase in the heart. At low levels of developed pressure, hearts maintained mechanical function, ATP, and creatine phosphate levels at control values. However, iodoacetamide-inhibited hearts were unable to maintain control values of end diastolic pressure or peak systolic pressure as work load increased. Global ischemia resulted in loss of all ATP without loss of creatine phosphate, indicating lack of active creatine kinase. These results indicate that isovolumic perfused rat hearts are able to maintain normal function and normal levels of high-energy phosphates without active creatine kinase at low levels of developed pressure. /sup 31/P-NMR of the heart was carried out.

  14. Testosterone biotransformation by the isolated perfused canine pancreas

    SciTech Connect

    Fernandez-del Castillo, C.; Diaz-Sanchez, V.; Varela-Fascinetto, G.; Altamirano, A.; Odor-Morales, A.; Lopez-Medrano, R.M.; Robles-Diaz, G. )

    1991-01-01

    There is strong evidence indicating that the pancreas is under the influence of sex steroid hormones, and that it may even participate in their biosynthesis and metabolism. In the present study, (3H)testosterone was perfused into the isolated canine pancreas, and measured in the effluent with several of its metabolites (5 alpha-dihydrotestosterone, androstenedione, and estradiol). Results show that testosterone is readily transformed by the canine pancreas. The main product found in the effluent is androstenedione. The testis and spleen were also perfused with (3H)testosterone and used as controls. In both cases, this hormone appeared mostly unchanged in the effluent as compared to the pancreatic perfusion (p less than 0.0001). From our data, we conclude that the canine pancreas has the capacity to transform sex steroid hormones, and could be considered an extragonadal site of sex steroid biosynthesis.

  15. Regional pulmonary perfusion following human heart-lung transplantation

    SciTech Connect

    Lisbona, R.; Hakim, T.S.; Dean, G.W.; Langleben, D.; Guerraty, A.; Levy, R.D. )

    1989-08-01

    Ventilation and perfusion scans were obtained in six subjects who had undergone heart-lung transplantation with consequent denervation of the cardiopulmonary axis. Two of the subjects had developed obliterative bronchiolitis, which is believed to be a form of chronic rejection. Their pulmonary function tests demonstrated airflow obstruction and their scintigraphic studies were abnormal. In the remaining four subjects without obstructive airways disease, ventilation and planar perfusion scans were normal. Single photon emission computed tomography imaging of pulmonary perfusion in these patients revealed a layered distribution of blood flow indistinguishable from that of normal individuals. It is concluded that neurogenic mechanisms have little influence on the pattern of local pulmonary blood flow at rest.

  16. Reversibility of hepatopulmonary syndrome evidenced by serial pulmonary perfusion scan.

    PubMed

    Shijo, H; Sasaki, H; Sakata, H; Kusuhara, H; Ueki, T; Okumura, M

    1993-02-01

    A patient with liver cirrhosis who exhibited marked hypoxemia is presented. An abnormal dilatation of intrapulmonary capillaries was evidenced by perfusion lung scan, contrast-enhanced echocardiography, and histological examinations of lungs. Serial perfusion lung scan disclosed that the radioisotope uptake by extrapulmonary organs was significantly increased and uptake by both lungs was significantly decreased during the state of severer hypoxemia. Shunt quantification method revealed that intrapulmonary right-to-left shunt ratio also paralleled the extent of hypoxemia. The pathophysiology of hepatopulmonary syndrome appeared to involve a reversible intrapulmonary vascular dilatation. The perfusion lung scan could semiquantitate the severity of intrapulmonary vascular dilatation and could offer the efficient method to follow their progress. PMID:8440418

  17. Laser-induced macular holes demonstrate impaired choroidal perfusion

    NASA Astrophysics Data System (ADS)

    Brown, Jeremiah, Jr.; Allen, Ronald D.; Zwick, Harry; Schuschereba, Steven T.; Lund, David J.; Stuck, Bruce E.

    2003-06-01

    Choroidal perfusion was evaluated following the creation of a laser induced macular hole in a nonhuman primate model. Two Rhesus monkeys underwent macular exposures delivered by a Q-switched Nd:YAG laser. The lesions were evaluated with fluorescein angiography and indocyanine green (ICG) angiography . Each lesion produced vitreous hemorrhage and progressed to a full thickness macular hole. ICG angiography revealed no perfusion of the choriocapillaris beneath the lesion centers. Histopathologic evaluation showed replacement of the choriocapillaris with fibroblasts and connective tissue. Nd:YAG, laser-induced macular holes result in long term impairment of choroidal perfusion at the base of the hole due to choroidal scarring and obliteration of the choriocapillaris.

  18. Parallel flow diffusion battery

    DOEpatents

    Yeh, H.C.; Cheng, Y.S.

    1984-01-01

    A parallel flow diffusion battery for determining the mass distribution of an aerosol has a plurality of diffusion cells mounted in parallel to an aerosol stream, each diffusion cell including a stack of mesh wire screens of different density.

  19. Parallel flow diffusion battery

    DOEpatents

    Yeh, Hsu-Chi; Cheng, Yung-Sung

    1984-08-07

    A parallel flow diffusion battery for determining the mass distribution of an aerosol has a plurality of diffusion cells mounted in parallel to an aerosol stream, each diffusion cell including a stack of mesh wire screens of different density.

  20. NIST Diffusion Data Center

    National Institute of Standards and Technology Data Gateway

    NIST Diffusion Data Center (Web, free access)   The NIST Diffusion Data Center is a collection of over 14,100 international papers, theses, and government reports on diffusion published before 1980.

  1. Characterizing potential heart agents with an isolated perfused heart system

    SciTech Connect

    Pendleton, D.B.; Sands, H.; Gallagher, B.M.; Camin, L.L.

    1984-01-01

    The authors have used an isolated perfused heart system for characterizing potential myocardial perfusion radiopharamaceuticals. Rabbit or guinea pig (GP) hearts are removed and perfused through the aorta with a blood-free buffer. Heart rate and ventricular pressure are monitored as indices of viability. Tc-99m-MAA is 96-100% retained in these hearts, and Tc-99m human serum albumin shows less than 5% extraction. Tl-201 is 30-40% extracted. It is known that in-vivo, Tc-99m(dmpe)/sub 2/Cl/sub 2//sup +/ is taken up by rabbit heart but not by GP or human heart. Analogous results are obtained with the isolated perfused heart model, where the complex is extracted well by the isolated rabbit heart (24%) but not by the GP heart (<5%). Values are unchanged if human, rabbit or GP blood is mixed and co-injected with the complex. Tc-99m)dmpe)/sub 3//sup +/ is also taken up by rabbit but not by GP hearts in-vivo. However, isolated perfused hearts of both species extract this complex well (45-52%). Heart uptake is diminished to <7% if the complex is pre-equilibrated with human blood. GP blood produces a moderate inhibition (in GP hearts only) and rabbit blood has no effect. This suggests that a human or GP blood factor may have a significant effect on heart uptake of this complex. Tc-99m(CN-t-butyl)/sub 6//sup +/ is taken up well by both rabbit and GP hearts in-vivo, and is extracted 100% by both isolated perfused hearts. Heart retention remains high (73-75%) in the presence of human blood.

  2. Preservation of Donor Hearts Using Hypothermic Oxygenated Perfusion

    PubMed Central

    Michel, Sebastian G.; La Muraglia, Glenn M.; Madariaga, Maria Lucia L.; Titus, James S.; Selig, Martin K.; Farkash, Evan A.; Allan, James S.; Anderson, Lisa M.; Madsen, Joren C.

    2015-01-01

    Background Hypothermic machine perfusion of donor hearts enables continuous aerobic metabolism and washout of toxic metabolic byproducts. We evaluated the effect of machine perfusion on cardiac myocyte integrity in hearts preserved for 4 h in a novel device that provides pulsatile oxygenated hypothermic perfusion (Paragonix Sherpa Perfusion™ Cardiac Transport System). Material/Methods Pig hearts were harvested and stored in Celsior® solution for 4 h using either conventional cold storage on ice (4-h CS, n=6) or the Sherpa device (4-h pulsatile perfusion (PP), n=6). After cold preservation, hearts were evaluated using a non-working heart Langendorff system. Controls (n=3) were reperfused immediately after organ harvest. Biopsies were taken from the apex of the left ventricle before storage, after storage, and after reperfusion to measure ATP content and endothelin-1 in the tissue. Ultrastructural analysis using electron microscopy was performed. Results Four-hour CS, 4-h PP, and control group did not show any significant differences in systolic or diastolic function (+dP/dt, −dP/dt, EDP). Four-hour PP hearts showed significantly more weight gain than 4-h CS after preservation, which shows that machine perfusion led to myocardial edema. Four-hour CS led to higher endothelin-1 levels after preservation, suggesting more endothelial dysfunction compared to 4-h PP. Electron microscopy revealed endothelial cell rupture and damaged muscle fibers in the 4-h CS group after reperfusion, but the cell structures were preserved in the 4-h PP group. Conclusions Hypothermic pulsatile perfusion of donor hearts leads to a better-preserved cell structure compared to the conventional cold storage method. This may lead to less risk of primary graft failure after orthotopic heart transplantation. PMID:25139381

  3. Evaluation of CT Perfusion Biomarkers of Tumor Hypoxia

    PubMed Central

    Qi, Qi; Yeung, Timothy Pok Chi; Lee, Ting-Yim; Bauman, Glenn; Crukley, Cathie; Morrison, Laura; Hoffman, Lisa; Yartsev, Slav

    2016-01-01

    Background Tumor hypoxia is associated with treatment resistance to cancer therapies. Hypoxia can be investigated by immunohistopathologic methods but such procedure is invasive. A non-invasive method to interrogate tumor hypoxia is an attractive option as such method can provide information before, during, and after treatment for personalized therapies. Our study evaluated the correlations between computed tomography (CT) perfusion parameters and immunohistopathologic measurement of tumor hypoxia. Methods Wistar rats, 18 controls and 19 treated with stereotactic radiosurgery (SRS), implanted with the C6 glioma tumor were imaged using CT perfusion on average every five days to monitor tumor growth. A final CT perfusion scan and the brain were obtained on average 14 days (8–22 days) after tumor implantation. Tumor hypoxia was detected immunohistopathologically with pimonidazole. The tumor, necrotic, and pimonidazole-positive areas on histology samples were measured. Percent necrotic area and percent hypoxic areas were calculated. Tumor volume (TV), blood flow (BF), blood volume (BV), and permeability-surface area product (PS) were obtained from the CT perfusion studies. Correlations between CT perfusion parameters and histological parameters were assessed by Spearman’s ρ correlation. A Bonferroni-corrected P value < 0.05 was considered significant. Results BF and BV showed significant correlations with percent hypoxic area ρ = -0.88, P < 0.001 and ρ = -0.81, P < 0.001, respectively, for control animals and ρ = -0.7, P < 0.001 and ρ = -0.6, P = 0.003, respectively, for all animals, while TV and BV were correlated (ρ = -0.64, P = 0.01 and ρ = -0.43, P = 0.043, respectively) with percent necrotic area. PS was not correlated with either percent necrotic or percent hypoxic areas. Conclusions Percent hypoxic area provided significant correlations with BF and BV, suggesting that CT perfusion parameters are potential non-invasive imaging biomarkers of tumor

  4. Influence of Thin Slice Reconstruction on CT Brain Perfusion Analysis

    PubMed Central

    Bennink, Edwin; Oosterbroek, Jaap; Horsch, Alexander D.; Dankbaar, Jan Willem; Velthuis, Birgitta K.; Viergever, Max A.; de Jong, Hugo W. A. M.

    2015-01-01

    Objectives Although CT scanners generally allow dynamic acquisition of thin slices (1 mm), thick slice (≥5 mm) reconstruction is commonly used for stroke imaging to reduce data, processing time, and noise level. Thin slice CT perfusion (CTP) reconstruction may suffer less from partial volume effects, and thus yield more accurate quantitative results with increased resolution. Before thin slice protocols are to be introduced clinically, it needs to be ensured that this does not affect overall CTP constancy. We studied the influence of thin slice reconstruction on average perfusion values by comparing it with standard thick slice reconstruction. Materials and Methods From 50 patient studies, absolute and relative hemisphere averaged estimates of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and permeability-surface area product (PS) were analyzed using 0.8, 2.4, 4.8, and 9.6 mm slice reconstructions. Specifically, the influence of Gaussian and bilateral filtering, the arterial input function (AIF), and motion correction on the perfusion values was investigated. Results Bilateral filtering gave noise levels comparable to isotropic Gaussian filtering, with less partial volume effects. Absolute CBF, CBV and PS were 22%, 14% and 46% lower with 0.8 mm than with 4.8 mm slices. If the AIF and motion correction were based on thin slices prior to reconstruction of thicker slices, these differences reduced to 3%, 4% and 3%. The effect of slice thickness on relative values was very small. Conclusions This study shows that thin slice reconstruction for CTP with unaltered acquisition protocol gives relative perfusion values without clinically relevant bias. It does however affect absolute perfusion values, of which CBF and CBV are most sensitive. Partial volume effects in large arteries and veins lead to overestimation of these values. The effects of reconstruction slice thickness should be taken into account when absolute perfusion values are

  5. FRACTIONAL PEARSON DIFFUSIONS

    PubMed Central

    Leonenko, Nikolai N.; Meerschaert, Mark M.

    2013-01-01

    Pearson diffusions are governed by diffusion equations with polynomial coefficients. Fractional Pearson diffusions are governed by the corresponding time-fractional diffusion equation. They are useful for modeling sub-diffusive phenomena, caused by particle sticking and trapping. This paper provides explicit strong solutions for fractional Pearson diffusions, using spectral methods. It also presents stochastic solutions, using a non-Markovian inverse stable time change. PMID:23626377

  6. Myocardial perfusion as an indicator of graft patency after coronary artery bypass surgery. [Thallium 201

    SciTech Connect

    Kolibash, A.J.; Call, T.D.; Bush, C.A.; Tetalman, M.R.; Lewis, R.P.

    1980-05-01

    Stress and resting myocardial perfusion were assessed in 38 patients who received 96 grafts. Stress perfusion was evaluated with thallium-201 and resting myocardial blood flow distribution with radiolabeled particles. When both stress and rest perfusion were normal, graft patency was 82% (51 of 62 grafts). Graft patency was also high (81%, 13 of 16) in areas where stress perfusion abnormalities resolved or become less apparent at rest. However, when stress perfusion defects remained unchanged at rest, the graf was likely to be occuluded (73%, 11 of 15). Maintenance of normal rest perfusion or improvement of rest perfusion postoperatively was also associated with a high graft patency rate (80%, 35 of 44), whereas the development of new rest perfusion defects postoperatively implied graft occlusion (86%, six of seven).

  7. Static and dynamic assessment of myocardial perfusion by computed tomography.

    PubMed

    Danad, Ibrahim; Szymonifka, Jackie; Schulman-Marcus, Joshua; Min, James K

    2016-08-01

    Recent developments in computed tomography (CT) technology have fulfilled the prerequisites for the clinical application of myocardial CT perfusion (CTP) imaging. The evaluation of myocardial perfusion by CT can be achieved by static or dynamic scan acquisitions. Although both approaches have proved clinically feasible, substantial barriers need to be overcome before its routine clinical application. The current review provides an outline of the current status of CTP imaging and also focuses on disparities between static and dynamic CTPs for the evaluation of myocardial blood flow. PMID:27013250

  8. Pancreas tumor model in rabbit imaged by perfusion CT scans

    NASA Astrophysics Data System (ADS)

    Gunn, Jason; Tichauer, Kenneth; Moodie, Karen; Kane, Susan; Hoopes, Jack; Stewart, Errol E.; Hadway, Jennifer; Lee, Ting-Yim; Pereira, Stephen P.; Pogue, Brian W.

    2013-03-01

    The goal of this work was to develop and validate a pancreas tumor animal model to investigate the relationship between photodynamic therapy (PDT) effectiveness and photosensitizer drug delivery. More specifically, this work lays the foundation for investigating the utility of dynamic contrast enhanced blood perfusion imaging to be used to inform subsequent PDT. A VX2 carcinoma rabbit cell line was grown in the tail of the pancreas of three New Zealand White rabbits and approximately 3-4 weeks after implantation the rabbits were imaged on a CT scanner using a contrast enhanced perfusion protocol, providing parametric maps of blood flow, blood volume, mean transit time, and vascular permeability surface area product.

  9. Perfusion Quality Improvement and the Reduction of Clinical Variability

    PubMed Central

    Stammers, Alfred H.; Trowbridge, Cody C.; Pezzuto, James; Casale, Alfred

    2009-01-01

    Abstract: The purpose of this study was to describe the development and utilization of a perfusion quality improvement program to reduce perfusion-to-perfusion variability in a large multi-center perfusion practice. Phase I of the study included the establishment of a perfusion database using standard spreadsheet format to serve multiple administrative functions including patient and procedure sequencing, predictive algorithms for yearly caseload, summary statistics, and inter-perfusionist comparison. The database used 236 separate variables, including demographic and clinical procedure-related categories. Forty of these variables are modifiable by perfusion interaction as established via protocol and algorithm. Phase II of the study used a perfusion electronic data recording system to automatically obtain patient data from physiologic monitors and the heart-lung machine. Data were transferred to a central database for perfusionist comparison. Data analysis used logical functions and macros programming, and statistical analysis used both parametric and non-parametric models within the program. Each quarter all variables underwent analysis with summary data established for the most recent 225 patients undergoing CPB. Twenty-five cases from each perfusionist (n = 9) were compared with the aggregate data of the entire staff, with reference to previous quarter’s summary statistics. The results were discussed in monthly staff meetings and methods for improving compliance were discussed. Individual variation (p < .01) varied in 17 of 40 variables (26.0 ± 8.6), with quarterly improvement (27.4 ± 2.3 vs. 24.2 ± 2.1 vs. 17.0 ± 2.1) demonstrated in seven of nine individuals. In Phase II, performance was analyzed using the same variables as in Phase I but it also included the electronically recorded data from which 27 core measures were derived. All results were discussed with the staff at monthly departmental quality improvement meetings. The perfusion quality

  10. Skin Blood Perfusion and Oxygenation Colour Affect Perceived Human Health

    PubMed Central

    Stephen, Ian D.; Coetzee, Vinet; Law Smith, Miriam; Perrett, David I.

    2009-01-01

    Skin blood perfusion and oxygenation depends upon cardiovascular, hormonal and circulatory health in humans and provides socio-sexual signals of underlying physiology, dominance and reproductive status in some primates. We allowed participants to manipulate colour calibrated facial photographs along empirically-measured oxygenated and deoxygenated blood colour axes both separately and simultaneously, to optimise healthy appearance. Participants increased skin blood colour, particularly oxygenated, above basal levels to optimise healthy appearance. We show, therefore, that skin blood perfusion and oxygenation influence perceived health in a way that may be important to mate choice. PMID:19337378

  11. Myocardial Perfusion Scintigraphy: Techniques, Interpretation, Indications and Reporting

    PubMed Central

    Fathala, Ahmed

    2011-01-01

    Myocardial perfusion single photon emission-computed tomography (MPS) has been one of the most important and common non-invasive diagnostic cardiac test. Gated MPS provides simultaneous assessment of myocardial perfusion and function with only one study. With appropriate attention to the MPS techniques, appropriate clinical utilization and effective reporting, gated MPS will remain a useful diagnostic test for many years to come. The aim of this article is to review the basic techniques of MPS, a simplified systematic approach for study interpretation, current clinical indications and reporting. After reading this article the reader should develop an understanding of the techniques, interpretation, current clinical indications and reporting of MPS studies. PMID:22048510

  12. Perfusion Electronic Record Documentation Using Epic Systems Software

    PubMed Central

    Steffens, Thomas G.; Gunser, John M.; Saviello, George M.

    2015-01-01

    Abstract: This paper describes the design and use of Epic Systems software for documentation of perfusion activities as part of the patient electronic medical record. The University of Wisconsin Hospital and Clinics adapted the Anesthesia software module and developed an integrated perfusion/anesthesia record for the documentation of cardiac and non-cardiac surgical procedures. This project involved multiple committees, approvals, and training to successfully implement. This article will describe our documentation options, concepts, design, challenges, training, and implementation during our initial experience. PMID:26834288

  13. Vascular Tissue Engineering: Building Perfusable Vasculature for Implantation

    PubMed Central

    Gui, Liqiong; Niklason, Laura E.

    2014-01-01

    Tissue and organ replacement is required when there are no alternative therapies available. Although vascular tissue engineering was originally developed to meet the clinical demands of small-diameter vascular conduits as bypass grafts, it has evolved into a highly advanced field where perfusable vasculatures are generated for implantation. Herein, we review several cutting-edge techniques that have led to implantable human blood vessels in clinical trials, the novel approaches that build complex perfusable microvascular networks in functional tissues, the use of stem cells to generate endothelial cells for vascularization, as well as the challenges in bringing vascular tissue engineering technologies into the clinics. PMID:24533306

  14. Uptake of free choline by isolated perfused rat liver.

    PubMed Central

    Zeisel, S H; Story, D L; Wurtman, R J; Brunengraber, H

    1980-01-01

    The uptake of free choline by isolated perfused rat liver was characterized. A saturable uptake mechanism [Ka = 0.17 +/- 0.07 mM (SD); Vmax = 0.84 +/- 0.16 mumol/min X g dry weight] and a nonsaturable mechanism (through which uptake is proportional to choline concentration in the perfusate) were identified. Most of the choline transported into hepatocytes was converted to betaine, phosphorylcholine, or lecithin. Free choline also accumulated within the intracellular space, suggesting that choline oxidase activity does not always limit choline's uptake by the liver. PMID:6933493

  15. High-frequency Electrocardiogram Analysis in the Ability to Predict Reversible Perfusion Defects during Adenosine Myocardial Perfusion Imaging

    NASA Technical Reports Server (NTRS)

    Tragardh, Elin; Schlegel, Todd T.; Carlsson, Marcus; Pettersson, Jonas; Nilsson, Klas; Pahlm, Olle

    2007-01-01

    Background: A previous study has shown that analysis of high-frequency QRS components (HF-QRS) is highly sensitive and reasonably specific for detecting reversible perfusion defects on myocardial perfusion imaging (MPI) scans during adenosine. The purpose of the present study was to try to reproduce those findings. Methods: 12-lead high-resolution electrocardiogram recordings were obtained from 100 patients before (baseline) and during adenosine Tc-99m-tetrofosmin MPI tests. HF-QRS were analyzed regarding morphology and changes in root mean square (RMS) voltages from before the adenosine infusion to peak infusion. Results: The best area under the curve (AUC) was found in supine patients (AUC=0.736) in a combination of morphology and RMS changes. None of the measurements, however, were statistically better than tossing a coin (AUC=0.5). Conclusion: Analysis of HF-QRS was not significantly better than tossing a coin for determining reversible perfusion defects on MPI scans.

  16. 21 CFR 876.5880 - Isolated kidney perfusion and transport system and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Isolated kidney perfusion and transport system and....5880 Isolated kidney perfusion and transport system and accessories. (a) Identification. An isolated kidney perfusion and transport system and accessories is a device that is used to support a donated or...

  17. 21 CFR 876.5880 - Isolated kidney perfusion and transport system and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Isolated kidney perfusion and transport system and....5880 Isolated kidney perfusion and transport system and accessories. (a) Identification. An isolated kidney perfusion and transport system and accesssories is a device that is used to support a donated or...

  18. 21 CFR 876.5880 - Isolated kidney perfusion and transport system and accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Isolated kidney perfusion and transport system and....5880 Isolated kidney perfusion and transport system and accessories. (a) Identification. An isolated kidney perfusion and transport system and accessories is a device that is used to support a donated or...

  19. 21 CFR 876.5880 - Isolated kidney perfusion and transport system and accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Isolated kidney perfusion and transport system and....5880 Isolated kidney perfusion and transport system and accessories. (a) Identification. An isolated kidney perfusion and transport system and accesssories is a device that is used to support a donated or...

  20. 21 CFR 876.5880 - Isolated kidney perfusion and transport system and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Isolated kidney perfusion and transport system and....5880 Isolated kidney perfusion and transport system and accessories. (a) Identification. An isolated kidney perfusion and transport system and accesssories is a device that is used to support a donated or...

  1. Procedure for Decellularization of Rat Livers in an Oscillating-pressure Perfusion Device.

    PubMed

    Hillebrandt, Karl; Polenz, Dietrich; Butter, Antje; Tang, Peter; Reutzel-Selke, Anja; Andreou, Andreas; Napierala, Hendrik; Raschzok, Nathanael; Pratschke, Johann; Sauer, Igor M; Struecker, Benjamin

    2015-01-01

    Decellularization and recellularization of parenchymal organs may enable the generation of functional organs in vitro, and several protocols for rodent liver decellularization have already been published. We aimed to improve the decellularization process by construction of a proprietary perfusion device enabling selective perfusion via the portal vein and/or the hepatic artery. Furthermore, we sought to perform perfusion under oscillating surrounding pressure conditions to improve the homogeneity of decellularization. The homogeneity of perfusion decellularization has been an underestimated factor to date. During decellularization, areas within the organ that are poorly perfused may still contain cells, whereas the extracellular matrix (ECM) in well-perfused areas may already be affected by alkaline detergents. Oscillating pressure changes can mimic the intraabdominal pressure changes that occur during respiration to optimize microperfusion inside the liver. In the study presented here, decellularized rat liver matrices were analyzed by histological staining, DNA content analysis and corrosion casting. Perfusion via the hepatic artery showed more homogenous results than portal venous perfusion did. The application of oscillating pressure conditions improved the effectiveness of perfusion decellularization. Livers perfused via the hepatic artery and under oscillating pressure conditions showed the best results. The presented techniques for liver harvesting, cannulation and perfusion using our proprietary device enable sophisticated perfusion set-ups to improve decellularization and recellularization experiments in rat livers. PMID:26327608

  2. The 154 MHz radio sky observed by the Murchison Widefield Array: noise, confusion, and first source count analyses

    NASA Astrophysics Data System (ADS)

    Franzen, T. M. O.; Jackson, C. A.; Offringa, A. R.; Ekers, R. D.; Wayth, R. B.; Bernardi, G.; Bowman, J. D.; Briggs, F.; Cappallo, R. J.; Deshpande, A. A.; Gaensler, B. M.; Greenhill, L. J.; Hazelton, B. J.; Johnston-Hollitt, M.; Kaplan, D. L.; Lonsdale, C. J.; McWhirter, S. R.; Mitchell, D. A.; Morales, M. F.; Morgan, E.; Morgan, J.; Oberoi, D.; Ord, S. M.; Prabu, T.; Seymour, N.; Shankar, N. Udaya; Srivani, K. S.; Subrahmanyan, R.; Tingay, S. J.; Trott, C. M.; Webster, R. L.; Williams, A.; Williams, C. L.

    2016-07-01

    We analyse a 154 MHz image made from a 12 h observation with the Murchison Widefield Array (MWA) to determine the noise contribution and behaviour of the source counts down to 30 mJy. The MWA image has a bandwidth of 30.72 MHz, a field-of-view within the half-power contour of the primary beam of 570 deg2, a resolution of 2.3 arcmin and contains 13 458 sources above 5σ. The rms noise in the centre of the image is 4-5 mJy beam-1. The MWA counts are in excellent agreement with counts from other instruments and are the most precise ever derived in the flux density range 30-200 mJy due to the sky area covered. Using the deepest available source count data, we find that the MWA image is affected by sidelobe confusion noise at the ≈3.5 mJy beam-1 level, due to incompletely peeled and out-of-image sources, and classical confusion becomes apparent at ≈1.7 mJy beam-1. This work highlights that (i) further improvements in ionospheric calibration and deconvolution imaging techniques would be required to probe to the classical confusion limit and (ii) the shape of low-frequency source counts, including any flattening towards lower flux densities, must be determined from deeper ≈150 MHz surveys as it cannot be directly inferred from higher frequency data.

  3. Inclusion of salt form on prescription medication labeling as a source of patient confusion: a pilot study

    PubMed Central

    McDougall, Dana J.; Hoehns, James D.; Feller, Tara T.; Kriener, Savana J.; Witry, Matthew J.

    2015-01-01

    Background: It has been estimated that 10,000 patient injuries occur in the US annually due to confusion involving drug names. An unexplored source of patient misunderstandings may be medication salt forms. Objective: The objective of this study was to assess patient knowledge and comprehension regarding the salt forms of medications as a potential source of medication errors. Methods: A 12 item questionnaire which assessed patient knowledge of medication names on prescription labels was administered to a convenience sample of patients presenting to a family practice clinic. Descriptive statistics were calculated and multivariate analyses were performed. Results: There were 308 responses. Overall, 41% of patients agreed they find their medication names confusing. Participants correctly answered to salt form questions between 12.1% and 56.9% of the time. Taking more prescription medications and higher education level were positively associated with providing more correct answers to 3 medication salt form knowledge questions, while age was negatively associated. Conclusions: Patient misconceptions about medication salt forms are common. These findings support recommendations to standardize the inclusion or exclusion of salt forms. Increasing patient education is another possible approach to reducing confusion. PMID:27011777

  4. The 154 MHz radio sky observed by the Murchison Widefield Array: noise, confusion and first source count analyses

    NASA Astrophysics Data System (ADS)

    Franzen, T. M. O.; Jackson, C. A.; Offringa, A. R.; Ekers, R. D.; Wayth, R. B.; Bernardi, G.; Bowman, J. D.; Briggs, F.; Cappallo, R. J.; Deshpande, A. A.; Gaensler, B. M.; Greenhill, L. J.; Hazelton, B. J.; Johnston-Hollitt, M.; Kaplan, D. L.; Lonsdale, C. J.; McWhirter, S. R.; Mitchell, D. A.; Morales, M. F.; Morgan, E.; Morgan, J.; Oberoi, D.; Ord, S. M.; Prabu, T.; Seymour, N.; Shankar, N. Udaya; Srivani, K. S.; Subrahmanyan, R.; Tingay, S. J.; Trott, C. M.; Webster, R. L.; Williams, A.; Williams, C. L.

    2016-04-01

    We analyse a 154 MHz image made from a 12 h observation with the Murchison Widefield Array (MWA) to determine the noise contribution and behaviour of the source counts down to 30 mJy. The MWA image has a bandwidth of 30.72 MHz, a field-of-view within the half-power contour of the primary beam of 570deg2, a resolution of 2.3 arcmin and contains 13,458 sources above 5σ. The rms noise in the centre of the image is 4 - 5mJy/beam. The MWA counts are in excellent agreement with counts from other instruments and are the most precise ever derived in the flux density range 30-200 mJy due to the sky area covered. Using the deepest available source count data, we find that the MWA image is affected by sidelobe confusion noise at the ≈3.5 mJy/beam level, due to incompletely-peeled and out-of-image sources, and classical confusion becomes apparent at ≈1.7 mJy/beam. This work highlights that (i) further improvements in ionospheric calibration and deconvolution imaging techniques would be required to probe to the classical confusion limit and (ii) the shape of low-frequency source counts, including any flattening towards lower flux densities, must be determined from deeper ≈150 MHz surveys as it cannot be directly inferred from higher frequency data.

  5. Neurofibromatosis Type 1 and the “Elephant Man's” Disease: The Confusion Persists: An Ethnographic Study

    PubMed Central

    Legendre, Claire-Marie; Charpentier-Côté, Catherine; Drouin, Régen; Bouffard, Chantal

    2011-01-01

    Background During informal interviews in the course of an ethnographic study on intergenerational dialogue between individuals with neurofibromatosis and their parents, many members of Canadian neurofibromatosis associations stated they continue to be told the condition that afflicts them or their children is the “elephant man's” disease. Today, even though well established clinical criteria make it possible to diagnose and differentiate the two diseases, the confusion between NF1 and the disease of Joseph Merrick, the “elephant man”, persists in both media representations and those of physicians. The objective of this article is to document the persistence of this confusion, to identify the factors that contribute to it, and to identify its impact on the well being of individuals with NF1. Methodology Preliminary stages of an ethnographic study. Principal Findings Our findings show that some reference sources, past medical training, and print and online news media have all contributed to the persistence of the association between NF1 and the disease of Joseph Merrick, the “elephant man”. Our observations suggest that this misconception can have negative medical, social, and psychological impacts on patients and their families and thus increase the burden of the disease. Conclusions Changes of attitude regarding medical teaching and the media could lead to definitively clearing up the confusion. PMID:21347399

  6. Role of Extracranial Carotid Duplex and Computed Tomography Perfusion Scanning in Evaluating Perfusion Status of Pericarotid Stenting

    PubMed Central

    Lin, Chih-Ming; Chang, Yu-Jun; Liu, Chi-Kuang; Yu, Cheng-Sheng

    2016-01-01

    Carotid stenting is an effective treatment of choice in terms of treating ischemic stroke patients with concomitant carotid stenosis. Though computed tomography perfusion scan has been recognized as a standard tool to monitor/follow up this group of patients, not everyone could endure due to underlying medical illness. In contrast, carotid duplex is a noninvasive assessment tool and could track patient clinical condition in real time. In this study we found that “resistance index” of the carotid ultrasound could detect flow changes before and after the stenting procedure, thus having great capacity to replace the role of computed tomography perfusion exam. PMID:27051669

  7. Correction of Gradient Nonlinearity Bias in Quantitative Diffusion Parameters of Renal Tissue with Intra Voxel Incoherent Motion

    PubMed Central

    Malyarenko, Dariya I.; Pang, Yuxi; Senegas, Julien; Ivancevic, Marko K.; Ross, Brian D.; Chenevert, Thomas L.

    2015-01-01

    Spatially non-uniform diffusion weighting bias due to gradient nonlinearity (GNL) causes substantial errors in apparent diffusion coefficient (ADC) maps for anatomical regions imaged distant from magnet isocenter. Our previously-described approach allowed effective removal of spatial ADC bias from three orthogonal DWI measurements for mono-exponential media of arbitrary anisotropy. The present work evaluates correction feasibility and performance for quantitative diffusion parameters of the two-component IVIM model for well-perfused and nearly isotropic renal tissue. Sagittal kidney DWI scans of a volunteer were performed on a clinical 3T MRI scanner near isocenter and offset superiorly. Spatially non-uniform diffusion weighting due to GNL resulted both in shift and broadening of perfusion-suppressed ADC histograms for off-center DWI relative to unbiased measurements close to isocenter. Direction-average DW-bias correctors were computed based on the known gradient design provided by vendor. The computed bias maps were empirically confirmed by coronal DWI measurements for an isotropic gel-flood phantom. Both phantom and renal tissue ADC bias for off-center measurements was effectively removed by applying pre-computed 3D correction maps. Comparable ADC accuracy was achieved for corrections of both b-maps and DWI intensities in presence of IVIM perfusion. No significant bias impact was observed for IVIM perfusion fraction. PMID:26811845

  8. Diffuse reflectance measurements using lensless CMOS imaging chip

    NASA Astrophysics Data System (ADS)

    Schelkanova, I.; Pandya, A.; Shah, D.; Lilge, L.; Douplik, A.

    2014-10-01

    To assess superficial epithelial microcirculation, a diagnostic tool should be able to detect the heterogeneity of microvasculature, and to monitor qualitative derangement of perfusion in a diseased condition. Employing a lensless CMOS imaging chip with an RGB Bayer filter, experiments were conducted with a microfluidic platform to obtain diffuse reflectance maps. Haemoglobin (Hb) solution (160 g/l) was injected in the periodic channels (grooves) of the microfluidic phantom which were covered with ~250 μm thick layer of intralipid to obtain a diffusive environment. Image processing was performed on data acquired on the surface of the phantom to evaluate the diffuse reflectance from the subsurface periodic pattern. Thickness of the microfluidic grooves, the wavelength dependent contrast between Hb and the background, and effective periodicity of the grooves were evaluated. Results demonstrate that a lens-less CMOS camera is capable of capturing images of subsurface structures with large field of view.

  9. How to Perfuse: Concepts of Cerebral Protection during Arch Replacement

    PubMed Central

    Habertheuer, Andreas; Wiedemann, Dominik; Kocher, Alfred; Laufer, Guenther; Vallabhajosyula, Prashanth

    2015-01-01

    Arch surgery remains undoubtedly among the most technically and strategically challenging endeavors in cardiovascular surgery. Surgical interventions of thoracic aneurysms involving the aortic arch require complete circulatory arrest in deep hypothermia (DHCA) or elaborate cerebral perfusion strategies with varying degrees of hypothermia to achieve satisfactory protection of the brain from ischemic insults, that is, unilateral/bilateral antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). Despite sophisticated and increasingly individualized surgical approaches for complex aortic pathologies, there remains a lack of consensus regarding the optimal method of cerebral protection and circulatory management during the time of arch exclusion. Many recent studies argue in favor of ACP with various degrees of hypothermic arrest during arch reconstruction and its advantages have been widely demonstrated. In fact ACP with more moderate degrees of hypothermia represents a paradigm shift in the cardiac surgery community and is widely adopted as an emergent strategy; however, many centers continue to report good results using other perfusion strategies. Amidst this important discussion we review currently available surgical strategies of cerebral protection management and compare the results of recent European multicenter and single-center data. PMID:26713319

  10. Ventilation-perfusion scintiscanning in tropical pulmonary eosinophilia.

    PubMed

    Ray, D; Jayachandran, C A

    1993-08-01

    We report the findings of ventilation and perfusion scintiscanning performed in three untreated patients with acute tropical pulmonary eosinophilia (TPE). In a 26-year-old man whose arterial blood gas values were normal, the lung scan showed normal radioactivity. The scintigrams of a 20-year-old woman who had hypoxemia and hypercapnea showed gross ventilation defects of both lungs that were mainly mismatched; changes in the perfusion scan were minimal. Scintiscanning in a 14-year-old girl who had moderate arterial hypoxia and mild hypocapnea, on the other hand, showed ventilation defects in both lungs, more marked in left lung; multiple matching ventilation-perfusion defects were also seen; however, the V/Q defects did not appear to be equally matched. The scintigraphic findings were compatible with arterial blood gas status of the individual patients and consistent with the notion that a disturbed ventilation-perfusion relationship may be responsible for hypoxemia in some of the patients with TPE. PMID:8339640

  11. Hypothermic Machine Perfusion Preservation of the DCD Kidney: Machine Effects

    PubMed Central

    Lindell, Susanne L.; Muir, Heather; Brassil, John; Mangino, Martin J.

    2013-01-01

    Purpose. Kidneys from DCD donors represent a significant pool, but preservation problems exist. The study objective was to test the importance of machine type for hypothermic preservation of DCD kidneys. Methods. Adult Beagle dog kidneys underwent 45 minutes of warm in situ ischemia followed by hypothermic perfusion for 24 hours (Belzer-MPS Solution) on either an ORS LifePort or a Waters RM3 using standard perfusion protocols. Kidneys were then autotransplanted, and renal function was assessed over 7 days following contralateral nephrectomy. Results. Renal vascular resistance was not different between the two pumps. After 24 hours, the oxygen partial pressure and oxygen delivery in the LifePort perfusate were significantly lower than those in the RM3 but not low enough to change lactate production. TheLifePort ran significantly colder than RM3 (2° versus 5°C). The arterial pressure waveform of the RM3 was qualitatively different from the waveform of the LifePort. Preservation injury after transplantation was not different between the devices. When the LifePort was changed to nonpulsatile flow, kidneys displayed significantly greater preservation injury compared to RM3. Conclusions. Both LifePort and RM3 can be used for hypothermic machine perfusion preservation of DCD kidneys with equal outcomes as long as the duty cycle remains pulsatile. PMID:24222842

  12. Simultaneous technetium-99m MIBI angiography and myocardial perfusion imaging

    SciTech Connect

    Baillet, G.Y.; Mena, I.G.; Kuperus, J.H.; Robertson, J.M.; French, W.J.

    1989-01-01

    Resting first-pass radionuclide angiography (FPRNA) was performed with the myocardial perfusion agent technetium-99m MIBI. In 27 patients, it was compared with technetium-99m diethylenetriamine pentaacetic acid FPRNA. A significant correlation was present in left (r = 0.93, p less than 0.001) as well as right (r = 0.92, p less than 0.001) ventricular ejection fraction measured with both radiopharmaceuticals. In 13 patients, MIBI derived segmental wall motion was compared with contrast ventriculography. A high correlation was present (p less than 0.001), and qualitative agreement was found in 38/52 segments. In 19 patients with myocardial infarction a significant correlation was present between MIBI segmental wall motion and perfusion scores (p less than 0.001). In ten patients with a history of myocardial infarction, 18 myocardial segments demonstrated diseased coronary vessels and impaired wall motion at contrast angiography. These segments were all identified by the MIBI wall motion and perfusion study. We conclude that MIBI is a promising agent for simultaneous evaluation of cardiac function and myocardial perfusion at rest.

  13. Determination of regional myocardial perfusion by x-ray fluorescence.

    PubMed

    Palmer, B M; McInerney, J J

    1990-05-01

    Validation studies were performed to demonstrate the effectiveness of an x-ray induced fluorescence system in quantitating regional myocardial perfusion in vivo. In a series of 13 open-chested canines, x-ray induced fluorescence was used to simultaneously monitor iodine concentration transients which arose in the left ventricular lumen and in the myocardium after the intravenous injection of an iodinated flow tracer. Deconvolution of the recorded transients produced a transfer function from which the mean transit time for the tracer to travel between the left ventricular lumen and the myocardium was calculated. Measurements of regional myocardial perfusion (Q) made by radioactive microspheres were compared with the reciprocals of the mean transit times (MTT-1) and gave a linear correlation (n = 38): MTT-1 = 0.033 + 0.069 Q, r = 0.71. Comparison of the percent change in perfusion (dQ) relative to a control study for each dog with the percent change in the respective reciprocals of the mean transit times (dMTT-1) produced a linear correlation coefficient of r = 0.88 for the regression line dMTT-1 = 0.46 dQ - 10.7. The x-ray induced fluorescence system may provide a minimally invasive means for monitoring iodine concentration transients and determining relative, if not absolute, measures of regional myocardial perfusion. PMID:2345078

  14. Teaching Ventilation/Perfusion Relationships in the Lung

    ERIC Educational Resources Information Center

    Glenny, Robb W.

    2008-01-01

    This brief review is meant to serve as a refresher for faculty teaching respiratory physiology to medical students. The concepts of ventilation and perfusion matching are some of the most challenging ideas to learn and teach. Some strategies to consider in teaching these concepts are, first, to build from simple to more complex by starting with a…

  15. An Appeal to Standardize CT- and MR-Perfusion.

    PubMed

    Turowski, B; Schramm, P

    2015-10-01

    Multiple treatment options and risk assessment in cerebrovascular diseases are the actual challenges in diagnostic as well as in interventional neuroradiology.Acute ischemic stroke essentially requires rapid detection of the location and extent of infarction and tissue at risk for making treatment decisions. In the acute setting, modern multiparametric perfusion imaging protocols help to determine infarct core and adjacent penumbral tissue, and they enable the estimation of collateral flow of intra- and extracranial arteries. In subacute delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) or chronic occlusive neurovascular diseases estimation of residual and collateral flow may be even more difficult.Prediction of sufficient or insufficient supply of brain tissue may be essential to balance conservative against interventional therapies. However, so far no established reliable thresholds are available for determining tissue at acute, subacute, chronic progressive, or chronic risk.Reliable and reproducible thresholds require quantitative perfusion measurements with a calibrated instrument. But the measurement instrument is not at all defined-a variety of parameter settings, different algorithms based on multiple assumptions and a wide variety of published normal and pathologic values for perfusion parameters indicate the problem. In the following text, we explain how deep the problem may be enrooted within techniques and algorithms impeding broad use of perfusion for many clinical issues. PMID:26289412

  16. Postresection bronchopleural fistula: detection by regional ventilation-perfusion studies

    SciTech Connect

    Dixon, C.; Ali, M.K.; Atallah, M.R.; Ewer, M.S.

    1983-04-01

    In three patients, bronchopleural fistula developed after right pneumonectomy for bronchogenic carcinoma. In each instance, radiologic and clinical evidence was inconclusive. Xenon 133 regional ventilation-perfusion studies confirmed the diagnosis of a bronchopleural fistula in both the immediate and late postoperative periods.

  17. Modelling Brain Temperature and Perfusion for Cerebral Cooling

    NASA Astrophysics Data System (ADS)

    Blowers, Stephen; Valluri, Prashant; Marshall, Ian; Andrews, Peter; Harris, Bridget; Thrippleton, Michael

    2015-11-01

    Brain temperature relies heavily on two aspects: i) blood perfusion and porous heat transport through tissue and ii) blood flow and heat transfer through embedded arterial and venous vasculature. Moreover brain temperature cannot be measured directly unless highly invasive surgical procedures are used. A 3D two-phase fluid-porous model for mapping flow and temperature in brain is presented with arterial and venous vessels extracted from MRI scans. Heat generation through metabolism is also included. The model is robust and reveals flow and temperature maps in unprecedented 3D detail. However, the Karmen-Kozeny parameters of the porous (tissue) phase need to be optimised for expected perfusion profiles. In order to optimise the K-K parameters a reduced order two-phase model is developed where 1D vessels are created with a tree generation algorithm embedded inside a 3D porous domain. Results reveal that blood perfusion is a strong function of the porosity distribution in the tissue. We present a qualitative comparison between the simulated perfusion maps and those obtained clinically. We also present results studying the effect of scalp cooling on core brain temperature and preliminary results agree with those observed clinically.

  18. Ex Vivo Perfusion Treatment of Infection in Human Donor Lungs.

    PubMed

    Nakajima, D; Cypel, M; Bonato, R; Machuca, T N; Iskender, I; Hashimoto, K; Linacre, V; Chen, M; Coutinho, R; Azad, S; Martinu, T; Waddell, T K; Hwang, D M; Husain, S; Liu, M; Keshavjee, S

    2016-04-01

    Ex vivo lung perfusion (EVLP) is a platform to treat infected donor lungs with antibiotic therapy before lung transplantation. Human donor lungs that were rejected for transplantation because of clinical concern regarding infection were randomly assigned to two groups. In the antibiotic group (n = 8), lungs underwent EVLP for 12 h with high-dose antibiotics (ciprofloxacin 400 mg or azithromycin 500 mg, vancomycin 15 mg/kg, and meropenem 2 g). In the control group (n = 7), lungs underwent EVLP for 12 h without antibiotics. A quantitative decrease in bacterial counts in bronchoalveolar lavage (BAL) was found in all antibiotic-treated cases but in only two control cases. Perfusate endotoxin levels at 12 h were significantly lower in the antibiotic group compared with the control group. EVLP with broad-spectrum antibiotic therapy significantly improved pulmonary oxygenation and compliance and reduced pulmonary vascular resistance. Perfusate endotoxin levels at 12 h were strongly correlated with levels of perfusates tumor necrosis factor α, IL-1β and macrophage inflammatory proteins 1α and 1β at 12 h. In conclusion, EVLP treatment of infected donor lungs with broad-spectrum antibiotics significantly reduced BAL bacterial counts and endotoxin levels and improved donor lung function. PMID:26730551

  19. Dynamic CT head phantom for perfusion and angiography studies

    NASA Astrophysics Data System (ADS)

    Russell, K.; Blazeski, A.; Dannecker, K.; Lee, Q. Y.; Holscher, C.; Donahue, C.; van Kampen, W.

    2010-03-01

    Contrast imaging is a compelling enhancement for the portable, flat panel-based brain CT scanner currently under development at Xoran. Due to the relative low temporal resolution of flat panel detectors, enabling tomographic imaging on such platform requires optimizing the imaging and injection protocols. A dynamic CT head phantom was designed to facilitate this task. The Dynamic Perfusion and Angiography Model (PAM), mimics tissue attenuation in CT images, provides physiological timing for angiography and perfusion studies, and moves fluid with properties similar to those of blood. The design consists of an arterial system, which contains bifurcating vessels that feed into perfusion chambers, mimicking blood flow through capillaries and smaller vessels, and a venous system, which is symmetrical to the arterial side and drains the perfusion chambers. The variation of geometry and flow rate in the phantom provides the physiological total time that fluid spends in the head, and the difference in material densities correlates to CT numbers for biological tissues. This paper discusses the design of Dynamic PAM and shows experimental results demonstrating its ability to realistically simulate blood flow. Results of dynamic imaging studies of the phantom are also presented.

  20. Susceptibility-Based Analysis Of Dynamic Gadolinium Bolus Perfusion MRI

    PubMed Central

    Bonekamp, David; Barker, Peter B.; Leigh, Richard; van Zijl, Peter C.M.; Li, Xu

    2014-01-01

    Purpose An algorithm is developed for the reconstruction of dynamic, gadolinium (Gd) bolus MR perfusion images of the human brain, based on quantitative susceptibility mapping (QSM). Methods The method is evaluated in 5 perfusion scans obtained from 4 different patients scanned at 3T, and compared to the conventional analysis based on changes in the transverse relaxation rate ΔR2* and to theoretical predictions. QSM images were referenced to ventricular CSF for each dynamic of the perfusion sequence. Results Images of cerebral blood flow and blood volume were successfully reconstructed from the QSM-analysis, and were comparable to those reconstructed using ΔR2*. The magnitudes of the Gd-associated susceptibility effects in gray and white matter were consistent with theoretical predictions. Conclusion QSM-based analysis may have some theoretical advantages compared to ΔR2*, including a simpler relationship between signal change and Gd concentration. However, disadvantages are its much lower contrast-to-noise ratio, artifacts due to respiration and other effects, and more complicated reconstruction methods. More work is required to optimize data acquisition protocols for QSM-based perfusion imaging. PMID:24604343