A bench evaluation of fraction of oxygen in air delivery and tidal volume accuracy in home care ventilators available for hospital use

PubMed Central

Baboi, Loredana; Subtil, Fabien

2016-01-01

Background Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT). Methods We assessed the FIO2 accuracy and the VT delivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000). For assessing FIO2 accuracy, lung model was set to mimic an obstructive lung and HCV were set in volume controlled mode (VC). They supplied with air, 3 or 15 L/min oxygen and FIO2 was measured by using a ventilator tester (Citrex H4TM). For the VT accuracy, the lung model was set in a way to mimic three adult configurations (normal, obstructive, or restrictive respiratory disorder) and one pediatric configuration. Each HCV was set in VC. Two VT (300 and 500 mL) in adult lung configuration and one 50 mL VT in pediatric lung configuration, at two positive end expiratory pressures 5 and 10 cmH2O, were tested. VT accuracy was measured as volume error (the relative difference between set and measured VT). Statistical analysis was performed by suing one-factor ANOVA with a Bonferroni correction for multiple tests. Results For Astral 150, Elisée 150, Monnal T50 and Trilogy 200, FIO2 averaged 99.2%, 93.7%, 86.3%, and 62.1%, respectively, at 15 L/min oxygen supplementation rate (P<0.001). Volume error was 0.5%±0%, −38%±0%, −9%±0%, −29%±0% and −36%±0% for pediatric lung condition (P<0.001). In adult lung configurations, Monnal T50 systematically over delivered VT and Trilogy 150 was sensitive to lung configuration when VT was set to 300 mL at either positive end-expiratory pressure (PEEP). Conclusions HCV are different in terms of FIO2 efficiency and VT delivery. PMID:28149559

Lower Monoamine Oxidase-A Total Distribution Volume in Impulsive and Violent Male Offenders with Antisocial Personality Disorder and High Psychopathic Traits: An [11C] Harmine Positron Emission Tomography Study

PubMed Central

Kolla, Nathan J; Matthews, Brittany; Wilson, Alan A; Houle, Sylvain; Michael Bagby, R; Links, Paul; Simpson, Alexander I; Hussain, Amina; Meyer, Jeffrey H

2015-01-01

Antisocial personality disorder (ASPD) often presents with highly impulsive, violent behavior, and pathological changes in the orbitofrontal cortex (OFC) and ventral striatum (VS) are implicated. Several compelling reasons support a relationship between low monoamine oxidase-A (MAO-A), an enzyme that regulates neurotransmitters, and ASPD. These include MAO-A knockout models in rodents evidencing impulsive aggression and positron emission tomography (PET) studies of healthy subjects reporting associations between low brain MAO-A levels and greater impulsivity or aggression. However, a fundamental gap in the literature is that it is unknown whether brain MAO-A levels are low in more severe, clinical disorders of impulsivity, such as ASPD. To address this issue, we applied [11C] harmine PET to measure MAO-A total distribution volume (MAO-A VT), an index of MAO-A density, in 18 male ASPD participants and 18 age- and sex-matched controls. OFC and VS MAO-A VT were lower in ASPD compared with controls (multivariate analysis of variance (MANOVA): F2,33=6.8, P=0.003; OFC and VS MAO-A VT each lower by 19%). Similar effects were observed in other brain regions: prefrontal cortex, anterior cingulate cortex, dorsal putamen, thalamus, hippocampus, and midbrain (MANOVA: F7,28=2.7, P=0.029). In ASPD, VS MAO-A VT was consistently negatively correlated with self-report and behavioral measures of impulsivity (r=−0.50 to −0.52, all P-values<0.05). This study is the first to demonstrate lower brain MAO-A levels in ASPD. Our results support an important extension of preclinical models of impulsive aggression into a human disorder marked by pathological aggression and impulsivity. PMID:26081301

Lower Monoamine Oxidase-A Total Distribution Volume in Impulsive and Violent Male Offenders with Antisocial Personality Disorder and High Psychopathic Traits: An [(11)C] Harmine Positron Emission Tomography Study.

PubMed

Kolla, Nathan J; Matthews, Brittany; Wilson, Alan A; Houle, Sylvain; Bagby, R Michael; Links, Paul; Simpson, Alexander I; Hussain, Amina; Meyer, Jeffrey H

2015-10-01

Antisocial personality disorder (ASPD) often presents with highly impulsive, violent behavior, and pathological changes in the orbitofrontal cortex (OFC) and ventral striatum (VS) are implicated. Several compelling reasons support a relationship between low monoamine oxidase-A (MAO-A), an enzyme that regulates neurotransmitters, and ASPD. These include MAO-A knockout models in rodents evidencing impulsive aggression and positron emission tomography (PET) studies of healthy subjects reporting associations between low brain MAO-A levels and greater impulsivity or aggression. However, a fundamental gap in the literature is that it is unknown whether brain MAO-A levels are low in more severe, clinical disorders of impulsivity, such as ASPD. To address this issue, we applied [(11)C] harmine PET to measure MAO-A total distribution volume (MAO-A VT), an index of MAO-A density, in 18 male ASPD participants and 18 age- and sex-matched controls. OFC and VS MAO-A VT were lower in ASPD compared with controls (multivariate analysis of variance (MANOVA): F2,33=6.8, P=0.003; OFC and VS MAO-A VT each lower by 19%). Similar effects were observed in other brain regions: prefrontal cortex, anterior cingulate cortex, dorsal putamen, thalamus, hippocampus, and midbrain (MANOVA: F7,28=2.7, P=0.029). In ASPD, VS MAO-A VT was consistently negatively correlated with self-report and behavioral measures of impulsivity (r=-0.50 to -0.52, all P-values<0.05). This study is the first to demonstrate lower brain MAO-A levels in ASPD. Our results support an important extension of preclinical models of impulsive aggression into a human disorder marked by pathological aggression and impulsivity.

Effects of inspired CO2, hyperventilation, and time on VA/Q inequality in the dog

NASA Technical Reports Server (NTRS)

Tsukimoto, K.; Arcos, J. P.; Schaffartzik, W.; Wagner, P. D.; West, J. B.

1992-01-01

In a recent study by Tsukimoto et al. (J. Appl. Physiol. 68: 2488-2493, 1990), CO2 inhalation appeared to reduce the size of the high ventilation-perfusion ratio (VA/Q) mode commonly observed in anesthetized mechanically air-ventilated dogs. In that study, large tidal volumes (VT) were used during CO2 inhalation to preserve normocapnia. To separate the influences of CO2 and high VT on the VA/Q distribution in the present study, we examined the effect of inspired CO2 on the high VA/Q mode using eight mechanically ventilated dogs (4 given CO2, 4 controls). The VA/Q distribution was measured first with normal VT and then with increased VT. In the CO2 group at high VT, data were collected before, during, and after CO2 inhalation. With normal VT, there was no difference in the size of the high VA/Q mode between groups [10.5 +/- 3.5% (SE) of ventilation in the CO2 group, 11.8 +/- 5.2% in the control group]. Unexpectedly, the size of the high VA/Q mode decreased similarly in both groups over time, independently of the inspired PCO2, at a rate similar to the fall in cardiac output over time. The reduction in the high VA/Q mode together with a simultaneous increase in alveolar dead space (estimated by the difference between inert gas dead space and Fowler dead space) suggests that poorly perfused high VA/Q areas became unperfused over time. A possible mechanism is that elevated alveolar pressure and decreased cardiac output eliminate blood flow from corner vessels in nondependent high VA/Q regions.

Effect of hyperinflation on inspiratory function of the diaphragm.

PubMed

Minh, V D; Dolan, G F; Konopka, R F; Moser, K M

1976-01-01

The inspiratory efficiency of the diaphragm during unilateral and bilateral phrenic stimulation (UEPS and BEPS) with constant stimulus was studied in seven dogs from FRC to 120% TLC. Alveolar pressures (PAl) were recorded during relaxation, BEPS and UEPS at each lung volume in the closed respiratory system. From the PAl-lung volume curves, tidal volume (VT), and pressure developed by the diaphragm (Pmus) were derived. Results are summarized below. a) Hyperinflation impaired the inspiratory efficiency of the diaphragm which behaved as an expiratory muscle beyond the lung volume of 103.7% TLC (Vinef). b) The diaphragm during UEPS became expiratory at the same Vinef as during (BEPS. C) The VT-lung volume relationship was linear during BEPS, allowing simple quantitation of VT loss with hyperinflation and prediction of Vinef. d) With only one phrenic nerve stimulated, the functional loss is less pronounced in VT than in Pmus, as compared to BEPS, indicating that the respiratory system was more compliant during UEPS than BEPS. This compliance difference from UEPS to BEPS diminished with severe hyperinflation.

Efficacy of the clinical agent VT-1161 against fluconazole-sensitive and -resistant Candida albicans in a murine model of vaginal candidiasis.

PubMed

Garvey, E P; Hoekstra, W J; Schotzinger, R J; Sobel, J D; Lilly, E A; Fidel, P L

2015-09-01

Vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC) remain major health problems for women. VT-1161, a novel fungal CYP51 inhibitor which has potent antifungal activity against fluconazole-sensitive Candida albicans, retained its in vitro potency (MIC50 of ≤0.015 and MIC90 of 0.12 μg/ml) against 10 clinical isolates from VVC or RVVC patients resistant to fluconazole (MIC50 of 8 and MIC90 of 64 μg/ml). VT-1161 pharmacokinetics in mice displayed a high volume of distribution (1.4 liters/kg), high oral absorption (73%), and a long half-life (>48 h) and showed rapid penetration into vaginal tissue. In a murine model of vaginal candidiasis using fluconazole-sensitive yeast, oral doses as low as 4 mg/kg VT-1161 significantly reduced the fungal burden 1 and 4 days posttreatment (P < 0.0001). Similar VT-1161 efficacy was measured when an isolate highly resistant to fluconazole (MIC of 64 μg/ml) but fully sensitive in vitro to VT-1161 was used. When an isolate partially sensitive to VT-1161 (MIC of 0.12 μg/ml) and moderately resistant to fluconazole (MIC of 8 μg/ml) was used, VT-1161 remained efficacious, whereas fluconazole was efficacious on day 1 but did not sustain efficacy 4 days posttreatment. Both agents were inactive in treating an infection with an isolate that demonstrated weaker potency (MICs of 2 and 64 μg/ml for VT-1161 and fluconazole, respectively). Finally, the plasma concentrations of free VT-1161 were predictive of efficacy when in excess of the in vitro MIC values. These data support the clinical development of VT-1161 as a potentially more efficacious treatment for VVC and RVVC. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

CT volumetry can potentially predict the local stage for gastric cancer after chemotherapy

PubMed Central

Wang, Zhi-Cong; Wang, Chen; Ding, Ying; Ji, Yuan; Zeng, Meng-Su; Rao, Sheng-Xiang

2017-01-01

PURPOSE We aimed to evaluate the value of CT tumor volumetry for predicting T and N stages of gastric cancer after chemotherapy, with pathologic results as the reference standard. METHODS This study retrospectively evaluated 42 patients diagnosed with gastric cancer, who underwent chemotherapy followed by surgery. Pre- and post-treatment CT tumor volumes (VT) were measured in portal venous phase and volume reduction ratios were calculated. Correlations between pre- and post-treatment VT, reduction ratio, and pathologic stages were analyzed. Receiver operator characteristic (ROC) analyses were also performed to assess diagnostic performance for prediction of downstaging to T0–2 stage and N0 stage. RESULTS Pretreatment VT, post-treatment VT, and VT reduction ratio were significantly correlated with T stage (rs=0.329, rs=0.546, rs= −0.422, respectively). Post-treatment VT and VT reduction ratio were significantly correlated with N stage (rs=0.442 and rs= −0.376, respectively). Pretreatment VT, post-treatment VT, and VT reduction ratio were significantly different between T0–2 and T3,4 stage tumors (P = 0.05, P < 0.001, and P = 0.002, respectively). The differences between N0 and ≥N1 groups were also statistically significant (P = 0.005 for post-treatment VT, P = 0.016 for VT reduction ratio, respectively). The area under the ROC curve (AUC) for identification of T0–2 groups was 0.70 for pretreatment VT, 0.88 for post-treatment VT, and 0.82 for VT reduction ratio, respectively. AUC was 0.78 for post-treatment VT and 0.74 for VT reduction ratio for identification of N0 groups. CONCLUSION CT tumor volumetry, particularly post-treatment measurement of VT, is potentially valuable for predicting histopathologic T and N stages after chemotherapy in patients with gastric cancer. PMID:28703101

Influence of forward leaning and incentive spirometry on inspired volumes and inspiratory electromyographic activity during breathing exercises in healthy subjects.

PubMed

Santos, Thalita Vilaboim; Ruas, Gualberto; Sande de Souza, Luciane Aparecida Pascucci; Volpe, Marcia Souza

2012-12-01

Breathing exercises (BE), incentive spirometry and positioning are considered treatment modalities to achieve lung re-expansion. This study evaluated the influence of incentive spirometry and forward leaning on inspired tidal volumes (V(T)) and electromyographic activity of inspiratory muscles during BE. Four modalities of exercises were investigated: deep breathing, spirometry using both flow and volume-oriented devices, and volume-oriented spirometry after modified verbal instruction. Twelve healthy subjects aged 22.7 ± 2.1 years were studied. Surface electromyography activity of diaphragm, external intercostals, sternocleidomastoid and scalenes was recorded. Comparisons among the three types of exercises, without considering spirometry after modified instruction, showed that electromyographic activity and V(T) were lower during volume-oriented spirometry (p = 0.000, p = 0.054, respectively). Forward leaning resulted in a lower V(T) when compared to upright sitting (p = 0.000), but electromyographic activity was not different (p = 0.606). Inspired V(T) and electromyographic activity were higher during volume-oriented spirometry performed after modified instruction when compared with the flow-oriented device (p = 0.027, p = 0.052, respectively). In conclusion BE using volume-oriented spirometry before modified instruction resulted in a lower work of breathing as a result of a lower V(T) and was not a consequence of the device type used. Forward leaning might not be assumed by healthy subjects during situations of augmented respiratory demand. Copyright © 2012 Elsevier Ltd. All rights reserved.

Benchmarking the ERG valve tip and MRI Interventions Smart Flow neurocatheter convection-enhanced delivery system's performance in a gel model of the brain: employing infusion protocols proposed for gene therapy for Parkinson's disease

NASA Astrophysics Data System (ADS)

Sillay, Karl; Schomberg, Dominic; Hinchman, Angelica; Kumbier, Lauren; Ross, Chris; Kubota, Ken; Brodsky, Ethan; Miranpuri, Gurwattan

2012-04-01

Convection-enhanced delivery (CED) is an advanced infusion technique used to deliver therapeutic agents into the brain. CED has shown promise in recent clinical trials. Independent verification of published parameters is warranted with benchmark testing of published parameters in applicable models such as gel phantoms, ex vivo tissue and in vivo non-human animal models to effectively inform planned and future clinical therapies. In the current study, specific performance characteristics of two CED infusion catheter systems, such as backflow, infusion cloud morphology, volume of distribution (mm3) versus the infused volume (mm3) (Vd/Vi) ratios, rate of infusion (µl min-1) and pressure (mmHg), were examined to ensure published performance standards for the ERG valve-tip (VT) catheter. We tested the hypothesis that the ERG VT catheter with an infusion protocol of a steady 1 µl min-1 functionality is comparable to the newly FDA approved MRI Interventions Smart Flow (SF) catheter with the UCSF infusion protocol in an agarose gel model. In the gel phantom models, no significant difference was found in performance parameters between the VT and SF catheter. We report, for the first time, such benchmark characteristics in CED between these two otherwise similar single-end port VT with stylet and end-port non-stylet infusion systems. Results of the current study in agarose gel models suggest that the performance of the VT catheter is comparable to the SF catheter and warrants further investigation as a tool in the armamentarium of CED techniques for eventual clinical use and application.

A new graphic plot analysis for determination of neuroreceptor binding in positron emission tomography studies.

PubMed

Ito, Hiroshi; Yokoi, Takashi; Ikoma, Yoko; Shidahara, Miho; Seki, Chie; Naganawa, Mika; Takahashi, Hidehiko; Takano, Harumasa; Kimura, Yuichi; Ichise, Masanori; Suhara, Tetsuya

2010-01-01

In positron emission tomography (PET) studies with radioligands for neuroreceptors, tracer kinetics have been described by the standard two-tissue compartment model that includes the compartments of nondisplaceable binding and specific binding to receptors. In the present study, we have developed a new graphic plot analysis to determine the total distribution volume (V(T)) and nondisplaceable distribution volume (V(ND)) independently, and therefore the binding potential (BP(ND)). In this plot, Y(t) is the ratio of brain tissue activity to time-integrated arterial input function, and X(t) is the ratio of time-integrated brain tissue activity to time-integrated arterial input function. The x-intercept of linear regression of the plots for early phase represents V(ND), and the x-intercept of linear regression of the plots for delayed phase after the equilibrium time represents V(T). BP(ND) can be calculated by BP(ND)=V(T)/V(ND)-1. Dynamic PET scanning with measurement of arterial input function was performed on six healthy men after intravenous rapid bolus injection of [(11)C]FLB457. The plot yielded a curve in regions with specific binding while it yielded a straight line through all plot data in regions with no specific binding. V(ND), V(T), and BP(ND) values calculated by the present method were in good agreement with those by conventional non-linear least-squares fitting procedure. This method can be used to distinguish graphically whether the radioligand binding includes specific binding or not.

Low tidal volume and high positive end-expiratory pressure mechanical ventilation results in increased inflammation and ventilator-associated lung injury in normal lungs.

PubMed

Hong, Caron M; Xu, Da-Zhong; Lu, Qi; Cheng, Yunhui; Pisarenko, Vadim; Doucet, Danielle; Brown, Margaret; Aisner, Seena; Zhang, Chunxiang; Deitch, Edwin A; Delphin, Ellise

2010-06-01

Protective mechanical ventilation with low tidal volume (Vt) and low plateau pressure reduces mortality and decreases the length of mechanical ventilation in patients with acute respiratory distress syndrome. Mechanical ventilation that will protect normal lungs during major surgical procedures of long duration may improve postoperative outcomes. We performed an animal study comparing 3 ventilation strategies used in the operating room in normal lungs. We compared the effects on pulmonary mechanics, inflammatory mediators, and lung tissue injury. Female pigs were randomized into 3 groups. Group H-Vt/3 (n = 6) was ventilated with a Vt of 15 mL/kg predicted body weight (PBW)/positive end-expiratory pressure (PEEP) of 3 cm H(2)O, group L-Vt/3 (n = 6) with a Vt of 6 mL/kg PBW/PEEP of 3 cm H(2)O, and group L-Vt/10 (n = 6) with a Vt of 6 mL/kg PBW/PEEP of 10 cm H(2)O, for 8 hours. Hemodynamics, airway mechanics, arterial blood gases, and inflammatory markers were monitored. Bronchoalveolar lavage (BAL) was analyzed for inflammatory markers and protein concentration. The right lower lobe was assayed for mRNA of specific cytokines. The right lower lobe and right upper lobe were evaluated histologically. In contrast to groups H-Vt/3 and L-Vt/3, group L-Vt/10 exhibited a 6-fold increase in inflammatory mediators in BAL (P < 0.001). Cytokines in BAL were similar in groups H-Vt/3 and L-Vt/3. Group H-Vt/3 had a significantly lower lung injury score than groups L-Vt/3 and L-Vt/10. Comparing intraoperative strategies, ventilation with high PEEP resulted in increased production of inflammatory markers. Low PEEP resulted in lower levels of inflammatory markers. High Vt/low PEEP resulted in less histologic lung injury.

Work of breathing during lung-protective ventilation in patients with acute lung injury and acute respiratory distress syndrome: a comparison between volume and pressure-regulated breathing modes.

PubMed

Kallet, Richard H; Campbell, Andre R; Dicker, Rochelle A; Katz, Jeffrey A; Mackersie, Robert C

2005-12-01

Pressure-control ventilation (PCV) and pressure-regulated volume-control (PRVC) ventilation are used during lung-protective ventilation because the high, variable, peak inspiratory flow rate (V (I)) may reduce patient work of breathing (WOB) more than the fixed V (I) of volume-control ventilation (VCV). Patient-triggered breaths during PCV and PRVC may result in excessive tidal volume (V(T)) delivery unless the inspiratory pressure is reduced, which in turn may decrease the peak V (I). We tested whether PCV and PRVC reduce WOB better than VCV with a high, fixed peak V (I) (75 L/min) while also maintaining a low V(T) target. Fourteen nonconsecutive patients with acute lung injury or acute respiratory distress syndrome were studied prospectively, using a random presentation of ventilator modes in a crossover, repeated-measures design. A target V(T) of 6.4 + 0.5 mL/kg was set during VCV and PRVC. During PCV the inspiratory pressure was set to achieve the same V(T). WOB and other variables were measured with a pulmonary mechanics monitor (Bicore CP-100). There was a nonsignificant trend toward higher WOB (in J/L) during PCV (1.27 + 0.58 J/L) and PRVC (1.35 + 0.60 J/L), compared to VCV (1.09 + 0.59 J/L). While mean V(T) was not statistically different between modes, in 40% of patients, V(T) markedly exceeded the lung-protective ventilation target during PRVC and PCV. During lung-protective ventilation, PCV and PRVC offer no advantage in reducing WOB, compared to VCV with a high flow rate, and in some patients did not allow control of V(T) to be as precise.

Kinetic modeling of the monoamine oxidase B radioligand [¹¹C]SL25.1188 in human brain with high-resolution positron emission tomography.

PubMed

Rusjan, Pablo M; Wilson, Alan A; Miler, Laura; Fan, Ian; Mizrahi, Romina; Houle, Sylvain; Vasdev, Neil; Meyer, Jeffrey H

2014-05-01

This article describes the kinetic modeling of [(11)C]SL25.1188 ([(S)-5-methoxymethyl-3-[6-(4,4,4-trifluorobutoxy)-benzo[d]isoxazol-3-yl]-oxazolidin-2-[(11)C]one]) binding to monoamine oxidase B (MAO-B) in the human brain using high-resolution positron emission tomography (PET). Seven healthy subjects underwent two separate 90- minute PET scans after an intravenous injection of [(11)C]SL25.1188. Complementary arterial blood sampling was acquired. Radioactivity was quickly eliminated from plasma with 80% of parent compound remaining at 90 minutes. Metabolites were more polar than the parent compound. Time-activity curves showed high brain uptake, early peak and washout rate consistent with known regional MAO-B concentration. A two-tissue compartment model (2-TCM) provided better fits to the data than a 1-TCM. Measurement of total distribution volume (VT) showed very good identifiability (based on coefficient of variation (COV)) for all regions of interest (ROIs) (COV(VT)<8%), low between-subject variability (∼20%), and quick temporal convergence (within 5% of final value at 45 minutes). Logan graphical method produces very good estimation of VT. Regional VT highly correlated with previous postmortem report of MAO-B level (r(2)= ≥ 0.9). Specific binding would account from 70% to 90% of VT. Hence, VT measurement of [(11)C]SL25.1(1)88 PET is an excellent estimation of MAO-B concentration.

Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease.

PubMed

Pinheiro de Oliveira, Roselaine; Hetzel, Marcio Pereira; dos Anjos Silva, Mauro; Dallegrave, Daniele; Friedman, Gilberto

2010-01-01

Mechanical ventilation (MV) with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy, on systemic and lung production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in patients without lung disease. Patients without lung disease and submitted to mechanical ventilation admitted to one trauma and one general adult intensive care unit of two different university hospitals were enrolled in a prospective randomized-control study. Patients were randomized to receive MV either with tidal volume (VT) of 10 to 12 ml/kg predicted body weight (high VT group) (n = 10) or with VT of 5 to 7 ml/kg predicted body weight (low VT group) (n = 10) with an oxygen inspiratory fraction (FIO2) enough to keep arterial oxygen saturation >90% with positive end-expiratory pressure (PEEP) of 5 cmH2O during 12 hours after admission to the study. TNF-alpha and IL-8 concentrations were measured in the serum and in the bronchoalveolar lavage fluid (BALF) at admission and after 12 hours of study observation time. Twenty patients were enrolled and analyzed. At admission or after 12 hours there were no differences in serum TNF-alpha and IL-8 between the two groups. While initial analysis did not reveal significant differences, standardization against urea of logarithmic transformed data revealed that TNF-alpha and IL-8 levels in bronchoalveolar lavage (BAL) fluid were stable in the low VT group but increased in the high VT group (P = 0.04 and P = 0.03). After 12 hours, BALF TNF-alpha (P = 0.03) and BALF IL-8 concentrations (P = 0.03) were higher in the high VT group than in the low VT group. The use of lower tidal volumes may limit pulmonary inflammation in mechanically ventilated patients even without lung injury. NCT00935896.

Increased ventilatory variability and complexity in patients with hyperventilation disorder.

PubMed

Bokov, Plamen; Fiamma, Marie-Noëlle; Chevalier-Bidaud, Brigitte; Chenivesse, Cécile; Straus, Christian; Similowski, Thomas; Delclaux, Christophe

2016-05-15

It has been hypothesized that hyperventilation disorders could be characterized by an abnormal ventilatory control leading to enhanced variability of resting ventilation. The variability of tidal volume (VT) often depicts a nonnormal distribution that can be described by the negative slope characterizing augmented breaths formed by the relationship between the probability density distribution of VT and VT on a log-log scale. The objectives of this study were to describe the variability of resting ventilation [coefficient of variation (CV) of VT and slope], the stability in respiratory control (loop, controller and plant gains characterizing ventilatory-chemoresponsiveness interactions) and the chaotic-like dynamics (embedding dimension, Kappa values characterizing complexity) of resting ventilation in patients with a well-defined dysfunctional breathing pattern characterized by air hunger and constantly decreased PaCO2 during a cardiopulmonary exercise test. Compared with 14 healthy subjects with similar anthropometrics, 23 patients with hyperventilation were characterized by increased variability of resting tidal ventilation (CV of VT median [interquartile]: 26% [19-35] vs. 36% [28-48], P = 0.020; slope: -6.63 [-7.65; -5.36] vs. -3.88 [-5.91; -2.66], P = 0.004) that was not related to increased chemical drive (loop gain: 0.051 [0.039-0.221] vs. 0.044 [0.012-0.087], P = 0.149) but that was related to an increased ventilatory complexity (Kappa values, P < 0.05). Plant gain was decreased in patients and correlated with complexity (with Kappa 5 - degree 5: Rho = -0.48, P = 0.006). In conclusion, well-defined patients suffering from hyperventilation disorder are characterized by increased variability of their resting ventilation due to increased ventilatory complexity with stable ventilatory-chemoresponsiveness interactions. Copyright © 2016 the American Physiological Society.

Volume-controlled Ventilation Does Not Prevent Injurious Inflation during Spontaneous Effort.

PubMed

Yoshida, Takeshi; Nakahashi, Susumu; Nakamura, Maria Aparecida Miyuki; Koyama, Yukiko; Roldan, Rollin; Torsani, Vinicius; De Santis, Roberta R; Gomes, Susimeire; Uchiyama, Akinori; Amato, Marcelo B P; Kavanagh, Brian P; Fujino, Yuji

2017-09-01

Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and Vt, and worsens lung injury. Intuitively, controlling Vt and transpulmonary pressure might limit injury caused by added spontaneous effort. To test the hypothesis that, during spontaneous effort in injured lungs, limitation of Vt and transpulmonary pressure by volume-controlled ventilation results in less injurious patterns of inflation. Dynamic computed tomography was used to determine patterns of regional inflation in rabbits with injured lungs during volume-controlled or pressure-controlled ventilation. Transpulmonary pressure was estimated by using esophageal balloon manometry [Pl(es)] with and without spontaneous effort. Local dependent lung stress was estimated as the swing (inspiratory change) in transpulmonary pressure measured by intrapleural manometry in dependent lung and was compared with the swing in Pl(es). Electrical impedance tomography was performed to evaluate the inflation pattern in a larger animal (pig) and in a patient with acute respiratory distress syndrome. Spontaneous breathing in injured lungs increased Pl(es) during pressure-controlled (but not volume-controlled) ventilation, but the pattern of dependent lung inflation was the same in both modes. In volume-controlled ventilation, spontaneous effort caused greater inflation and tidal recruitment of dorsal regions (greater than twofold) compared with during muscle paralysis, despite the same Vt and Pl(es). This was caused by higher local dependent lung stress (measured by intrapleural manometry). In injured lungs, esophageal manometry underestimated local dependent pleural pressure changes during spontaneous effort. Limitation of Vt and Pl(es) by volume-controlled ventilation could not eliminate harm caused by spontaneous breathing unless the level of spontaneous effort was lowered and local dependent lung stress was reduced.

Unilateral empyema impacts the assessment of regional lung ventilation by electrical impedance tomography.

PubMed

Bläser, D; Pulletz, S; Becher, T; Schädler, D; Elke, G; Weiler, N; Frerichs, I

2014-06-01

Several studies have shown the ability of electrical impedance tomography (EIT) to assess regional ventilation distribution in human lungs. Fluid accumulation in the pleural space as in empyema, typically occurring on one chest side, may influence the distribution of ventilation and the corresponding EIT findings. The aim of our study was to examine this effect on the assessment of regional ventilation by EIT. Six patients suffering from unilateral empyema and intubated with a double-lumen endotracheal tube were studied. EIT data were acquired during volume-controlled ventilation with bilateral (tidal volume (V(T)): 800 ml) and unilateral ventilation (V(T): 400 ml) of the right and left lungs. Mean tidal amplitudes of the EIT signal were calculated in all image pixels. The sums of these values, expressed as relative impedance change (rel. ΔZ), were then determined in whole images and functionally defined regions-of-interest (ROI). The sums of rel. ΔZ calculated during the two cases of one-lung ventilation either on the affected or unaffected side were significantly smaller than during bilateral ventilation. However, in contrast to previous findings in patients with no pleural pathology, very low values of rel. ΔZ were found when the lung on the affected side was ventilated. ROI-based analysis rendered higher values than the whole-image analysis in this case, nonetheless, the values were significantly smaller than when the unaffected side was ventilated in spite of identical VT. In conclusion, our results indicate that the presence of empyema may affect the quantitative evaluation of regional lung ventilation by EIT.

Detection and quantification of large-vessel inflammation with 11C-(R)-PK11195 PET/CT.

PubMed

Lamare, Frederic; Hinz, Rainer; Gaemperli, Oliver; Pugliese, Francesca; Mason, Justin C; Spinks, Terence; Camici, Paolo G; Rimoldi, Ornella E

2011-01-01

We investigated whether PET/CT angiography using 11C-(R)-PK11195, a selective ligand for the translocator protein (18 kDa) expressed in activated macrophages, could allow imaging and quantification of arterial wall inflammation in patients with large-vessel vasculitis. Seven patients with systemic inflammatory disorders (3 symptomatic patients with clinical suspicion of active vasculitis and 4 asymptomatic patients) underwent PET with 11C-(R)-PK11195 and CT angiography to colocalize arterial wall uptake of 11C-(R)-PK11195. Tissue regions of interest were defined in bone marrow, lung parenchyma, wall of the ascending aorta, aortic arch, and descending aorta. Blood-derived and image-derived input functions (IFs) were generated. A reversible 1-tissue compartment with 2 kinetic rate constants and a fractional blood volume term were used to fit the time-activity curves to calculate total volume of distribution (VT). The correlation between VT and standardized uptake values was assessed. VT was significantly higher in symptomatic than in asymptomatic patients using both image-derived total plasma IF (0.55±0.15 vs. 0.27±0.12, P=0.009) and image-derived parent plasma IF (1.40±0.50 vs. 0.58±0.25, P=0.018). A good correlation was observed between VT and standardized uptake value (R=0.79; P=0.03). 11C-(R)-PK11195 imaging allows visualization of macrophage infiltration in inflamed arterial walls. Tracer uptake can be quantified with image-derived IF without the need for metabolite corrections and evaluated semiquantitatively with standardized uptake values.

Role of bronchodilation and pattern of breathing in increasing tidal expiratory flow with progressive induced hypercapnia in chronic obstructive pulmonary disease.

PubMed

Finucane, Kevin E; Singh, Bhajan

2018-01-01

Hypercapnia (HC) in vitro relaxes airway smooth muscle; in vivo, it increases respiratory effort, tidal expiratory flows (V̇ exp ), and, by decreasing inspiratory duration (Ti), increases elastic recoil pressure (Pel) via lung viscoelasticity; however, its effect on airway resistance is uncertain. We examined the contributions of bronchodilation, Ti, and expiratory effort to increasing V̇ exp with progressive HC in 10 subjects with chronic obstructive pulmonary disease (COPD): mean forced expiratory volume in 1 s (FEV 1 ) 53% predicted. Lung volumes (Vl), V̇ exp , esophageal pressure (Pes), Ti, and end-tidal Pco 2 ([Formula: see text]) were measured during six tidal breaths followed by an inspiratory capacity (IC), breathing air, and at three levels of HC. V̇ exp and V̇ with submaximal forced vital capacities breathing air (V̇ sFVC ) were compared. Pulmonary resistance ( Rl) was measured from the Pes-V̇ relationship. V̇ exp and Pes at end-expiratory lung volume (EELV) + 0.3 tidal volume [V̇ (0.3Vt) and Pes (0.3Vt) , respectively], Ti, and Rl correlated with [Formula: see text] ( P < 0.001 for all) and were independent of tiotropium. [Formula: see text], Ti, and Pes (0.3Vt) predicted the increasing V̇ (0.3Vt) /V̇ sFVC(0.3Vt) [multiple regression analysis (MRA): P = 0.001, 0.004, and 0.025, respectively]. At [Formula: see text] ≥ 50 Torr, V̇ (0.3Vt) /V̇ sFVC(0.3Vt) exceeded unity in 30 of 36 measurements and was predicted by [Formula: see text] and Pes (0.3Vt) (MRA: P = 0.02 and 0.025, respectively). Rl decreased at [Formula: see text] 45 Torr ( P < 0.05) and did not change with further HC. IC and Vl (0.3Vt) did not change with HC. We conclude that in COPD HC increases V̇ exp due to bronchodilation, increased Pel secondary to decreasing Ti, and increased expiratory effort, all promoting lung emptying and a stable EELV. NEW & NOTEWORTHY The response of airways to intrapulmonary hypercapnia (HC) is uncertain. In chronic obstructive pulmonary disease (COPD), progressive HC increases tidal expiratory flows by inducing bronchodilation and via an increased rate of inspiration and lung viscoelasticity, a probable increase in lung elastic recoil pressure, both changes increasing expiratory flows, promoting lung emptying and a stable end-expiratory volume. Bronchodilation with HC occurred despite optimal standard bronchodilator therapy, suggesting that in COPD further bronchodilation is possible.

[Study of setting of ventilator volume tidal and airway pressure alarm threshold with continuous extra-sternum heart compression in cardiopulmonary resuscitation].

PubMed

Luo, Jian-yu; Wang, Xiao-yuan; Cai, Tian-bin; Jiang, Wen-fang

2013-02-01

To investigate the setting of ventilator volume tidal (VT) and airway pressure alarm threshold during cardiopulmonary resuscitation (CPR) by continuous extra-sternum heart compression. Forty cases with respiration and cardiac arrest in the department of critical care medicine were randomly divided into low VT ventilation group and conventional VT group. Both groups were given the volume control mode. In the low VT ventilation group, VT was set on 6 - 7 ml/kg, and high pressure alarm threshold was adjusted to 60 cm H2O by the conventional 40 cm H2O during CPR. In the conventional VT group, VT and high pressure alarm threshold were set at 8 - 12 ml/kg and 40 cm H2O, respectively. Real-time actual VT, peak inspiratory pressure (PIP), and arterial blood gas test, blood lactic acid at 10 minutes and 30 minutes after CPR were observed. At 10 minutes after CPR, in the low VT ventilation group, arterial blood pH, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3(-), arterial oxygen saturation (SaO2) and blood lactic acid were better as compared with those in the conventional VT ventilation group (pH: 7.21±0.09 vs. 7.13±0.07, PaO2: 45.35±5.92 mm Hg vs. 40.70±4.70 mm Hg, PaCO2: 57.10±7.59 mm Hg vs. 61.60±5.47 mm Hg, HCO3(-): 18.50±3.50 mmol/L vs. 14.75±2.65 mmol/L, SaO2: 0.796±0.069 vs. 0.699±0.066, blood lactic acid: 7.07±1.60 mmol/L vs. 8.13±1.56 mmol/L, all P<0.05). The success rate of resuscitation in the low VT ventilation group was higher than that of the conventional VT ventilation group (45% vs. 15%, P<0.05), and PIP (cm H2O) of low VT ventilation group was lower than that of the conventional VT group (37.25±7.99 cm H2O vs. 42.70±7.40 cm H2O, P<0.05). In all the patients in both groups barotrauma did not occur. The strategy of low ventilator VT (6 - 7 ml/kg) with appropriate elevation of airway pressure alarm threshold was better than that of conventional ventilation setting, with no increase in incidence of barotraumas during CPR.

Does core mobility of lumbar total disc arthroplasty influence sagittal and frontal intervertebral displacement? Radiologic comparison with fixed-core prosthesis

PubMed Central

Delécrin, Joël; Allain, Jérôme; Beaurain, Jacques; Steib, Jean-Paul; Chataigner, Hervé; Aubourg, Lucie; Huppert, Jean; Ameil, Marc; Nguyen, Jean-Michel

2009-01-01

Background An artificial disc prosthesis is thought to restore segmental motion in the lumbar spine. However, it is reported that disc prosthesis can increase the intervertebral translation (VT). The concept of the mobile-core prosthesis is to mimic the kinematic effects of the migration of the natural nucleus and therefore core mobility should minimize the VT. This study explored the hypothesis that core translation should influence VT and that a mobile core prosthesis may facilitate physiological motion. Methods Vertebral translation (measured with a new method presented here), core translation, range of motion (ROM), and distribution of flexion-extension were measured on flexion-extension, neutral standing, and lateral bending films in 89 patients (63 mobile-core [M]; 33 fixed-core [F]). Results At L4-5 levels the VT with M was lower than with F and similar to the VT of untreated levels. At L5-S1 levels the VT with M was lower than with F but was significantly different compared to untreated levels. At M levels a strong correlation was found between VT and core translation; the VT decreases as the core translation increases. At F levels the VT increases as the ROM increases. No significant difference was found between the ROM of untreated levels and levels implanted with either M or F. Regarding the mobility distribution with M and F we observed a deficit in extension at L5-S1 levels and a similar distribution at L4-5 levels compared to untreated levels. Conclusion The intervertebral mobility was different between M and F. The M at L4-5 levels succeeded to replicate mobility similar to L4-5 untreated levels. The M at L5-S1 succeeded in ROM, but failed regarding VT and mobility distribution. Nevertheless M minimized VT at L5-S1 levels. The F increased VT at both L4-5 and L5-S1. Clinical Relevance This study validates the concept that the core translation of an artificial lumbar disc prosthesis minimizes the VT. PMID:25802632

Volume Transmission in Central Dopamine and Noradrenaline Neurons and Its Astroglial Targets.

PubMed

Fuxe, Kjell; Agnati, Luigi F; Marcoli, Manuela; Borroto-Escuela, Dasiel O

2015-12-01

Already in the 1960s the architecture and pharmacology of the brainstem dopamine (DA) and noradrenaline (NA) neurons with formation of vast numbers of DA and NA terminal plexa of the central nervous system (CNS) indicated that they may not only communicate via synaptic transmission. In the 1980s the theory of volume transmission (VT) was introduced as a major communication together with synaptic transmission in the CNS. VT is an extracellular and cerebrospinal fluid transmission of chemical signals like transmitters, modulators etc. moving along energy gradients making diffusion and flow of VT signals possible. VT interacts with synaptic transmission mainly through direct receptor-receptor interactions in synaptic and extrasynaptic heteroreceptor complexes and their signaling cascades. The DA and NA neurons are specialized for extrasynaptic VT at the soma-dendrtitic and terminal level. The catecholamines released target multiple DA and adrenergic subtypes on nerve cells, astroglia and microglia which are the major cell components of the trophic units building up the neural-glial networks of the CNS. DA and NA VT can modulate not only the strength of synaptic transmission but also the VT signaling of the astroglia and microglia of high relevance for neuron-glia interactions. The catecholamine VT targeting astroglia can modulate the fundamental functions of astroglia observed in neuroenergetics, in the Glymphatic system, in the central renin-angiotensin system and in the production of long-distance calcium waves. Also the astrocytic and microglial DA and adrenergic receptor subtypes mediating DA and NA VT can be significant drug targets in neurological and psychiatric disease.

Separation of β-amyloid binding and white matter uptake of 18F-flutemetamol using spectral analysis

PubMed Central

Heurling, Kerstin; Buckley, Christopher; Vandenberghe, Rik; Laere, Koen Van; Lubberink, Mark

2015-01-01

The kinetic components of the β-amyloid ligand 18F-flutemetamol binding in grey and white matter were investigated through spectral analysis, and a method developed for creation of parametric images separating grey and white matter uptake. Tracer uptake in grey and white matter and cerebellar cortex was analyzed through spectral analysis in six subjects, with (n=4) or without (n=2) apparent β-amyloid deposition, having undergone dynamic 18F-flutemetamol scanning with arterial blood sampling. The spectra were divided into three components: slow, intermediate and fast basis function rates. The contribution of each of the components to total volume of distribution (VT) was assessed for different tissue types. The slow component dominated in white matter (average 90%), had a higher contribution to grey matter VT in subjects with β-amyloid deposition (average 44%) than without (average 6%) and was absent in cerebellar cortex, attributing the slow component of 18F-flutemetamol uptake in grey matter to β-amyloid binding. Parametric images of voxel-based spectral analysis were created for VT, the slow component and images segmented based on the slow component contribution; confirming that grey matter and white matter uptake can be discriminated on voxel-level using a threshold for the contribution from the slow component to VT. PMID:26550542

Longitudinal dispersion in model of central airways during high-frequency ventilation.

PubMed

van der Kooij, A M; Luijendijk, S C

1991-04-01

We have measured the longitudinal dispersion of boluses of helium, acetylene and sulphur hexafluoride in a plastic model of the human airways--generations zero through six--during high frequency ventilation (HFV). HFV was maintained by a piston pump. Frequency f and tidal volume VT ranged from 2.5 to 25 Hz and from 5 to 20 ml, respectively. Boluses were injected near the entrance of the zeroth generation (trachea), and the dispersion curves were measured by mass spectrometry at the end of the sixth airway generation. The shapes of the bolus dispersion curves could be well described with Gaussian distribution functions. With the exception of the HFV-conditions with VT = 5 ml, the effective dispersion coefficient DDISP appeared to be independent of the molecular diffusion coefficient. This independency was also found by other investigators in studies with dogs and human subjects. The measured results for DDISP for different f and VT could be satisfactorily described with the empirical equation DDISP = 0.0617 f0.8VT1.38 [cm2S-1]. Application of this equation to f and VT values normally applied in man resulted in DDISP values which should be considered to be too small for maintaining eucapnic ventilation in vivo. On the basis of this result we believe that during HFV in intubated subjects gas transport by longitudinal dispersion will be limited to the instrumental dead space--the endotracheal tube inclusive--and a few generations of large bronchi.

Performance of Portable Ventilators at Altitude

DTIC Science & Technology

2015-03-30

collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT...Deploying ventilators that can maintain a consistent tidal volume (VT) delivery at various altitudes is imperative for lung protection when...performance of mechanical ventilators calibrated for operation at sea level. Deploying ventilators that can maintain a consistent tidal volume (VT) delivery

Comparative evaluation of two glycine transporter 1 radiotracers [11C]GSK931145 and [18F]MK-6577 in baboons.

PubMed

Zheng, Ming-Qiang; Lin, Shu-Fei; Holden, Daniel; Naganawa, Mika; Ropchan, Jim R; Najafzaden, Soheila; Kapinos, Michael; Tabriz, Mike; Carson, Richard E; Hamill, Terence G; Huang, Yiyun

2016-03-01

Glycine transporter type-1 (GlyT1) has been proposed as a target for drug development for schizophrenia. PET imaging with a GlyT1 specific radiotracer will allow for the measurement of target occupancy of GlyT1 inhibitors, and for in vivo investigation of GlyT1 alterations in schizophrenia. We conducted a comparative evaluation of two GlyT1 radiotracers, [(11) C]GSK931145, and [(18) F]MK-6577, in baboons. Two baboons were imaged with [(11) C]GSK931145 and [(18) F]MK-6577. Blocking studies with GSK931145 (0.3 or 0.2 mg/kg) were conducted to determine the level of tracer specific binding. [(11) C]GSK931145 and [(18) F]MK-6577 were synthesized in good yield and high specific activity. Moderately fast metabolism was observed for both tracers, with ∼ 30% of parent at 30 min post-injection. In the brain, both radiotracers showed good uptake and distribution profiles consistent with regional GlyT1 densities. [(18) F]MK-6577 displayed higher uptake and faster kinetics than [(11) C]GSK931145. Time activity curves were well described by the two-tissue compartment model. Regional volume of distribution (VT ) values were higher for [(18) F]MK-6577 than [(11) C]GSK931145. Pretreatment with GSK931145 reduced tracer uptake to a homogeneous level throughout the brain, indicating in vivo binding specificity and lack of a reference region for both radiotracers. Linear regression analysis of VT estimates between tracers indicated higher specific binding for [(18) F]MK-6577 than [(11) C]GSK931145, consistent with higher regional binding potential (BPND ) values of [(18) F]MK-6577 calculated using VT from the baseline scans and non-displaceable distribution volume (VND ) derived from blocking studies. [(18) F]MK-6577 appears to be a superior radiotracer with higher brain uptake, faster kinetics, and higher specific binding signals than [(11) C]GSK931145. © 2016 Wiley Periodicals, Inc.

Reduced Brain Cannabinoid Receptor Availability In Schizophrenia

PubMed Central

Ranganathan, Mohini; Cortes, Jose; Radhakrishnan, Rajiv; Thurnauer, Halle; Planeta, Beata; Skosnik, Patrick; Gao, Hong; Labaree, David; Neumeister, Alexander; Pittman, Brian; Surti, Toral; Huang, Yiyun; Carson, Richard E.; D’Souza, Deepak Cyril

2015-01-01

BACKGROUND Several lines of evidence suggest the presence of abnormalities in the endocannabinoid (eCB) system in schizophrenia (SCZ). However, there are limited in vivo measures of the eCB system in SCZ. METHODS Twenty five male SCZ subjects (SCZs), 18 antipsychotic treated [SCZ-MED] and 7 antipsychotic free [SCZ-UNMED]) were compared to 18 age- matched male healthy control subjects (HCs). Subjects underwent one Positron Emission Tomography (PET) scan each with the cannabinoid receptor-1 (CB1R) selective radiotracer [11C]OMAR on the High Resolution Research Tomography (HRRT) scanner. Regional volume of distribution (VT) values were determined using kinetic modeling of PET data as a measure of CB1R availability. Group differences in mean composite [11C]OMAR VT values were compared between SCZs and HCs. Exploratory comparisons of CB1R availability within 15 brain regions were also conducted. All analyses were covaried for age and body mass index. RESULTS SCZs showed significantly (p =0.02) lower composite [11C]OMAR VT relative to HCs (~12% difference, effect size d= 0.73). [11C]OMAR VT was significantly (all ps <0.05) lower in SCZs in the amygdala, caudate, posterior cingulate cortex, hippocampus, hypothalamus and insula. Composite [11C]OMAR VT was greater in HCs> SCZ-MED>SCZ-UNMED. Furthermore, composite [11C]OMAR VT was greater in HCs> SCZ smokers (n=11) > SCZ non-smokers (n=14). CONCLUSIONS CB1R availability is lower in males SCZs compared to HCs. Furthermore, antipsychotics and tobacco use may increase CB1R availability in this population. The findings of the study provide further evidence supporting the hypothesis that alterations in the eCB system might contribute to the pathophysiology of SCZ. PMID:26432420

Delivery of tidal volume from four anaesthesia ventilators during volume-controlled ventilation: a bench study.

PubMed

Wallon, G; Bonnet, A; Guérin, C

2013-06-01

Tidal volume (V(T)) must be accurately delivered by anaesthesia ventilators in the volume-controlled ventilation mode in order for lung protective ventilation to be effective. However, the impact of fresh gas flow (FGF) and lung mechanics on delivery of V(T) by the newest anaesthesia ventilators has not been reported. We measured delivered V(T) (V(TI)) from four anaesthesia ventilators (Aisys™, Flow-i™, Primus™, and Zeus™) on a pneumatic test lung set with three combinations of lung compliance (C, ml cm H2O(-1)) and resistance (R, cm H2O litre(-1) s(-2)): C60R5, C30R5, C60R20. For each CR, three FGF rates (0.5, 3, 10 litre min(-1)) were investigated at three set V(T)s (300, 500, 800 ml) and two values of PEEP (0 and 10 cm H2O). The volume error = [(V(TI) - V(Tset))/V(Tset)] ×100 was computed in body temperature and pressure-saturated conditions and compared using analysis of variance. For each CR and each set V(T), the absolute value of the volume error significantly declined from Aisys™ to Flow-i™, Zeus™, and Primus™. For C60R5, these values were 12.5% for Aisys™, 5% for Flow-i™ and Zeus™, and 0% for Primus™. With an increase in FGF, absolute values of the volume error increased only for Aisys™ and Zeus™. However, in C30R5, the volume error was minimal at mid-FGF for Aisys™. The results were similar at PEEP 10 cm H2O. Under experimental conditions, the volume error differed significantly between the four new anaesthesia ventilators tested and was influenced by FGF, although this effect may not be clinically relevant.

Volcano-tectonic earthquakes: A new tool for estimating intrusive volumes and forecasting eruptions

NASA Astrophysics Data System (ADS)

White, Randall; McCausland, Wendy

2016-01-01

We present data on 136 high-frequency earthquakes and swarms, termed volcano-tectonic (VT) seismicity, which preceded 111 eruptions at 83 volcanoes, plus data on VT swarms that preceded intrusions at 21 other volcanoes. We find that VT seismicity is usually the earliest reported seismic precursor for eruptions at volcanoes that have been dormant for decades or more, and precedes eruptions of all magma types from basaltic to rhyolitic and all explosivities from VEI 0 to ultraplinian VEI 6 at such previously long-dormant volcanoes. Because large eruptions occur most commonly during resumption of activity at long-dormant volcanoes, VT seismicity is an important precursor for the Earth's most dangerous eruptions. VT seismicity precedes all explosive eruptions of VEI ≥ 5 and most if not all VEI 4 eruptions in our data set. Surprisingly we find that the VT seismicity originates at distal locations on tectonic fault structures at distances of one or two to tens of kilometers laterally from the site of the eventual eruption, and rarely if ever starts beneath the eruption site itself. The distal VT swarms generally occur at depths almost equal to the horizontal distance of the swarm from the summit out to about 15 km distance, beyond which hypocenter depths level out. We summarize several important characteristics of this distal VT seismicity including: swarm-like nature, onset days to years prior to the beginning of magmatic eruptions, peaking of activity at the time of the initial eruption whether phreatic or magmatic, and large non-double couple component to focal mechanisms. Most importantly we show that the intruded magma volume can be simply estimated from the cumulative seismic moment of the VT seismicity from: Log10 V = 0.77 Log ΣMoment - 5.32, with volume, V, in cubic meters and seismic moment in Newton meters. Because the cumulative seismic moment can be approximated from the size of just the few largest events, and is quite insensitive to precise locations, the intruded magma volume can be quickly and easily estimated with few short-period seismic stations. Notable cases in which distal VT events preceded eruptions at long-dormant volcanoes include: Nevado del Ruiz (1984-1985), Pinatubo (1991), Unzen (1989-1995), Soufriere Hills (1995), Shishaldin (1989-1999), Tacana' (1985-1986), Pacaya (1980-1984), Rabaul (1994), and Cotopaxi (2001). Additional cases are recognized at frequently active volcanoes including Popocateptl (2001-2003) and Mauna Loa (1984). We present four case studies (Pinatubo, Soufriere Hills, Unzen, and Tacana') in which we demonstrate the above mentioned VT characteristics prior to eruptions. Using regional data recorded by NEIC, we recognized in near-real time that a huge distal VT swarm was occurring, deduced that a proportionately huge magmatic intrusion was taking place beneath the long dormant Sulu Range, New Britain Island, Papua New Guinea, that it was likely to lead to eruptive activity, and warned Rabaul Volcano Observatory days before a phreatic eruption occurred. This confirms the value of this technique for eruption forecasting. We also present a counter-example where we deduced that a VT swarm at Volcan Cosiguina, Nicaragua, indicated a small intrusion, insufficient to reach the surface and erupt. Finally, we discuss limitations of the method and propose a mechanism by which this distal VT seismicity is triggered by magmatic intrusion.

Effects of breathing pattern and inspired air conditions on breath condensate volume, pH, nitrite, and protein concentrations.

PubMed

McCafferty, J B; Bradshaw, T A; Tate, S; Greening, A P; Innes, J A

2004-08-01

The effects of breathing pattern and inspired air conditions on the volume and content of exhaled breath condensate (EBC) were investigated. Total exhaled water (TEW), EBC volume, pH, nitrite and protein concentrations were measured in three groups of 10 healthy subjects breathing into a condenser at different target minute ventilations (Vm), tidal volumes (Vt), and inspired air conditions. The volumes of both TEW and EBC increased significantly with Vm. For Vm 7.5, 15 and 22.5 l/min, mean (SD) EBC was 627 (258) microl, 1019 (313) microl, and 1358 (364) microl, respectively (p<0.001) and TEW was 1879 (378) microl, 2986 (496) microl, and 4679 (700) microl, respectively (p<0.001). TEW was significantly higher than EBC, reflecting a condenser efficiency of 40% at a target Vm of 7.5 l/min which reduced to 29% at Vm 22.5 l/min. Lower Vt gave less TEW than higher Vt (26.6 v 30.7 microl/l, mean difference 4.1 (95% CI 2.6 to 5.6), p<0.001) and a smaller EBC volume (4.3 v 7.6 microl/l, mean difference 3.4 (95% CI 2.3 to 4.5), p<0.001). Cooler and drier inspired air yielded less water vapour and less breath condensate than standard conditions (p<0.05). Changes in the breathing pattern had no effect on EBC protein and nitrite concentrations and pH. These results show that condensate volume can be increased by using high Vt and increased Vm without compromising the dilution of the sample.

Accuracy of tidal volume delivered by home mechanical ventilation during mouthpiece ventilation

PubMed Central

Prigent, Helene; Falaize, Line; Leroux, Karl; Santos, Dante; Vaugier, Isabelle; Orlikowski, David; Lofaso, Frederic

2016-01-01

The aim of our study was to evaluate efficacy and reliability of currently available ventilators for mouthpiece ventilation (MPV). Five life-support home ventilators were assessed in a bench test using different settings simulating the specificities of MPV, such as intermittent circuit disconnection and presence of continuous leaks. The intermittent disconnection of the circuit caused relevant swings in the delivered tidal volume (VT), showing a VT overshoot during the disconnection periods and a VT decrease when the interface was reconnected to the test lung. The five ventilators showed substantial differences in the number of respiratory cycles necessary to reach a stable VT in the volume-controlled setting, ranging from 1.3 ± 0.6 to 7.3 ± 1.2 cycles. These differences were less accentuated in the volume-assisted setting (MPV-dedicated mode, when available). Our data show large differences in the capacity of the different ventilators to deal with the rapidly changing respiratory load features that characterize MPV, which can be further accentuated according to the used ventilator setting. The dedicated MPV modes allow improvement in the performance of ventilators only in some defined situations. This has practical consequences for the choice of the ventilator to be used for MPV in a specific patient. PMID:27146811

Volume guarantee ventilation during surgical closure of patent ductus arteriosus.

PubMed

Keszler, Martin; Abubakar, Kabir

2015-01-01

Surgical closure of patent ductus arteriosus (PDA) is associated with adverse outcomes. Surgical exposure requires retraction of the lung, resulting in decreased aeration and compliance. Optimal respiratory support for PDA surgery is unknown. Experience with volume guarantee (VG) ventilation at our institution led us to hypothesize that surgery would be better tolerated with automatic adjustment of pressure by VG to maintain tidal volume (VT) during retraction. The objective of this study was to describe ventilator support, VT, and oxygenation of infants supported with VG during PDA surgery. Ventilator variables, oxygen saturation, and heart rate were recorded during PDA surgery in a convenience sample of infants during PDA closure on VG. Pressure limit increased 11% and set VT was 26% lower during lung retraction. Fentanyl and pancuronium/vecuronium were used for anesthesia/muscle relaxation. Longitudinal data were analyzed by analysis of variance for repeated measures. Seven infants, 25.4 ± 1.5 weeks and 723 ± 141 g, underwent closure of PDA on VG at a mean age 29.9 days. No air leak, bradycardia, or death occurred. Target VT was maintained with a modest increase in inflation pressure. Oxygenation remained adequate. VG avoided hypoxemia and maintained adequate VT with only a modest increase in peak inflation pressure and thus may be a useful mode during PDA surgery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

High tidal volume ventilation in infant mice.

PubMed

Cannizzaro, Vincenzo; Zosky, Graeme R; Hantos, Zoltán; Turner, Debra J; Sly, Peter D

2008-06-30

Infant mice were ventilated with either high tidal volume (V(T)) with zero end-expiratory pressure (HVZ), high V(T) with positive end-expiratory pressure (PEEP) (HVP), or low V(T) with PEEP. Thoracic gas volume (TGV) was determined plethysmographically and low-frequency forced oscillations were used to measure the input impedance of the respiratory system. Inflammatory cells, total protein, and cytokines in bronchoalveolar lavage fluid (BALF) and interleukin-6 (IL-6) in serum were measured as markers of pulmonary and systemic inflammatory response, respectively. Coefficients of tissue damping and tissue elastance increased in all ventilated mice, with the largest rise seen in the HVZ group where TGV rapidly decreased. BALF protein levels increased in the HVP group, whereas serum IL-6 rose in the HVZ group. PEEP keeps the lungs open, but provides high volumes to the entire lungs and induces lung injury. Compared to studies in adult and non-neonatal rodents, infant mice demonstrate a different response to similar ventilation strategies underscoring the need for age-specific animal models.

Breath stacking in children with neuromuscular disorders.

PubMed

Jenkins, H M; Stocki, A; Kriellaars, D; Pasterkamp, H

2014-06-01

Respiratory muscle weakness in neuromuscular disorders (NMD) can lead to shallow breathing and respiratory insufficiency over time. Children with NMD often cannot perform maneuvers to recruit lung volume. In adults, breath stacking with a mask and one-way valve can achieve significantly increased lung volumes. To evaluate involuntary breath stacking (IBS) in NMD, we studied 23 children of whom 15 were cognitively aware and able to communicate verbally. For IBS, a one-way valve and pneumotachograph were attached to a face mask. Tidal volumes (Vt) and minute ventilation (VE ) were calculated from airflow over 30 sec before and after 15 sec of expiratory valve closure. Six cooperative male subjects with Duchenne muscular dystrophy (DMD) participated in a subsequent comparison of IBS with voluntary breath stacking (VBS) and supported breath stacking (SBS). The average Vt in those studied with IBS was 277 ml (range 29-598 ml). The average increase in volume by stacking was 599 ml (range -140 to 2,916 ml) above Vt . The average number of stacked breaths was 4.5 (range 0-17). VE increased on average by 18% after stacking (P < 0.05, paired t-test). Oxygen saturation did not change after stacking. Four of the 23 children did not breath stack. Compared to IBS, VBS achieved similar volumes in the six subjects with DMD but SBS was more successful in those with greatest muscle weakness. IBS may achieve breath volumes of approximately three times Vt and may be particularly useful in non-cooperative subjects with milder degrees of respiratory muscle weakness. © 2013 Wiley Periodicals, Inc.

Effects of breathing pattern and inspired air conditions on breath condensate volume, pH, nitrite, and protein concentrations

PubMed Central

McCafferty, J; Bradshaw, T; Tate, S; Greening, A; Innes, J

2004-01-01

Background: The effects of breathing pattern and inspired air conditions on the volume and content of exhaled breath condensate (EBC) were investigated. Methods: Total exhaled water (TEW), EBC volume, pH, nitrite and protein concentrations were measured in three groups of 10 healthy subjects breathing into a condenser at different target minute ventilations (Vm), tidal volumes (Vt), and inspired air conditions. Results: The volumes of both TEW and EBC increased significantly with Vm. For Vm 7.5, 15 and 22.5 l/min, mean (SD) EBC was 627 (258) µl, 1019 (313) µl, and 1358 (364) µl, respectively (p<0.001) and TEW was 1879 (378) µl, 2986 (496) µl, and 4679 (700) µl, respectively (p<0.001). TEW was significantly higher than EBC, reflecting a condenser efficiency of 40% at a target Vm of 7.5 l/min which reduced to 29% at Vm 22.5 l/min. Lower Vt gave less TEW than higher Vt (26.6 v 30.7 µl/l, mean difference 4.1 (95% CI 2.6 to 5.6), p<0.001) and a smaller EBC volume (4.3 v 7.6 µl/l, mean difference 3.4 (95% CI 2.3 to 4.5), p<0.001). Cooler and drier inspired air yielded less water vapour and less breath condensate than standard conditions (p<0.05). Changes in the breathing pattern had no effect on EBC protein and nitrite concentrations and pH. Conclusion: These results show that condensate volume can be increased by using high Vt and increased Vm without compromising the dilution of the sample. PMID:15282391

Effect of leak and breathing pattern on the accuracy of tidal volume estimation by commercial home ventilators: a bench study.

PubMed

Luján, Manel; Sogo, Ana; Pomares, Xavier; Monsó, Eduard; Sales, Bernat; Blanch, Lluís

2013-05-01

New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (VT) is a key point in the assessment of the efficacy of home mechanical ventilation. To assess the reliability of the VT provided by 5 ventilators in a bench test. Five commercial ventilators from 4 different manufacturers were tested in pressure support mode with the help of a breathing simulator under different conditions of mechanical respiratory pattern, inflation pressure, and intentional leakage. Values provided by the built-in software of each ventilator were compared breath to breath with the VT monitored through an external pneumotachograph. Ten breaths for each condition were compared for every tested situation. All tested ventilators underestimated VT (ranges of -21.7 mL to -83.5 mL, which corresponded to -3.6% to -14.7% of the externally measured VT). A direct relationship between leak and underestimation was found in 4 ventilators, with higher underestimations of the VT when the leakage increased, ranging between -2.27% and -5.42% for each 10 L/min increase in the leakage. A ventilator that included an algorithm that computes the pressure loss through the tube as a function of the flow exiting the ventilator had the minimal effect of leaks on the estimation of VT (0.3%). In 3 ventilators the underestimation was also influenced by mechanical pattern (lower underestimation with restrictive, and higher with obstructive). The inclusion of algorithms that calculate the pressure loss as a function of the flow exiting the ventilator in commercial models may increase the reliability of VT estimation.

Adaptive support ventilation may deliver unwanted respiratory rate-tidal volume combinations in patients with acute lung injury ventilated according to an open lung concept.

PubMed

Dongelmans, Dave A; Paulus, Frederique; Veelo, Denise P; Binnekade, Jan M; Vroom, Margreeth B; Schultz, Marcus J

2011-05-01

With adaptive support ventilation, respiratory rate and tidal volume (V(T)) are a function of the Otis least work of breathing formula. We hypothesized that adaptive support ventilation in an open lung ventilator strategy would deliver higher V(T)s to patients with acute lung injury. Patients with acute lung injury were ventilated according to a local guideline advising the use of lower V(T) (6-8 ml/kg predicted body weight), high concentrations of positive end-expiratory pressure, and recruitment maneuvers. Ventilation parameters were recorded when the ventilator was switched to adaptive support ventilation, and after recruitment maneuvers. If V(T) increased more than 8 ml/kg predicted body weight, airway pressure was limited to correct for the rise of V(T). Ten patients with a mean (±SD) Pao(2)/Fio(2) of 171 ± 86 mmHg were included. After a switch from pressure-controlled ventilation to adaptive support ventilation, respiratory rate declined (from 31 ± 5 to 21 ± 6 breaths/min; difference = 10 breaths/min, 95% CI 3-17 breaths/min, P = 0.008) and V(T) increased (from 6.5 ± 0.8 to 9.0 ± 1.6 ml/kg predicted body weight; difference = 2.5 ml, 95% CI 0.4-4.6 ml/kg predicted body weight, P = 0.02). Pressure limitation corrected for the rise of V(T), but minute ventilation declined, forcing the user to switch back to pressure-controlled ventilation. Adaptive support ventilation, compared with pressure-controlled ventilation in an open lung strategy setting, delivers a lower respiratory rate-higher V(T) combination. Pressure limitation does correct for the rise of V(T), but leads to a decline in minute ventilation.

Lung and chest wall impedances in the dog in normal range of breathing: effects of pulmonary edema.

PubMed

Barnas, G M; Stamenović, D; Lutchen, K R

1992-09-01

We evaluated the effect of pulmonary edema on the frequency (f) and tidal volume (VT) dependences of respiratory system mechanical properties in the normal ranges of breathing. We measured resistance and elastance of the lungs (RL and EL) and chest wall of four anesthetized-paralyzed dogs during sinusoidal volume oscillations at the trachea (50-300 ml, 0.2-2 Hz), delivered at a constant mean airway pressure. Measurements were made before and after severe pulmonary edema was produced by injection of 0.06 ml/kg oleic acid into the right atrium. Chest wall properties were not changed by the injection. Before oleic acid, EL increased slightly with increasing f in each dog but was independent of VT. RL decreased slightly and was independent of VT from 0.2 to 0.4 Hz, but above 0.4 Hz it tended to increase with increasing flow, presumably due to the airway contribution. After oleic acid injection, EL and RL increased greatly. Large negative dependences of EL on VT and of RL on f were also evident, so that EL and RL after oleic acid changed two- and fivefold, respectively, within the ranges of f and VT studied. We conclude that severe pulmonary edema changes lung properties so as to make behavior VT dependent (i.e., nonlinear) and very frequency dependent in the normal range of breathing.

Noninvasive measurement of mean alveolar carbon dioxide tension and Bohr's dead space during tidal breathing.

PubMed

Koulouris, N G; Latsi, P; Dimitroulis, J; Jordanoglou, B; Gaga, M; Jordanoglou, J

2001-06-01

The lack of methodology for measuring the alveolar carbon dioxide tension (PA,CO2) has forced investigators to make several assumptions, such as that PA,CO2 is equal to end-tidal (PET,CO2) and arterial CO2 tension (Pa,CO2). The present study measured the mean PA,CO2 and Bohr's dead space ratio (Bohr's dead space/tidal volume (VD,Bohr/VT)) during tidal breathing. The method used is a new, simple and noninvasive technique, based on the analysis of the expired CO2 volume per breath (VCO2) versus the exhaled VT. This curve was analysed in 21 normal, healthy subjects and 35 chronic obstructive pulmonary disease (COPD) patients breathing tidally through a mouthpiece apparatus in the sitting position. It is shown that: 1) PA,CO2 is similar to Pa,CO2 in normal subjects, whilst it is significantly lower than Pa,CO2 in COPD patients; 2) PA,CO2 is significantly higher than PET,CO2 in all subjects, especially in COPD patients; 3) VD,Bohr/VT is increased in COPD patients as compared to normal subjects; and 4) VD,Bohr/VT is lower than the "physiological" dead space ratio (VD,phys/VT) in COPD patients. It is concluded that the expired carbon dioxide versus tidal volume curve is a useful tool for research and clinical work, because it permits the noninvasive and accurate measurement of Bohr's dead space and mean alveolar carbon dioxide tension accurately during spontaneous breathing.

Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model.

PubMed

Erranz, Benjamín; Díaz, Franco; Donoso, Alejandro; Salomón, Tatiana; Carvajal, Cristóbal; Torres, María Fernanda; Cruces, Pablo

2015-01-01

Preload dynamic tests, pulse pressure variation (PPV) and stroke volume variation (SVV) have emerged as powerful tools to predict response to fluid administration. The influence of factors other than preload in dynamic preload test is currently poorly understood in pediatrics. The aim of our study was to assess the effect of tidal volume (VT) on PPV and SVV in the context of normal and reduced lung compliance in a piglet model. Twenty large-white piglets (5.2±0.4kg) were anesthetized, paralyzed and monitored with pulse contour analysis. PPV and SVV were recorded during mechanical ventilation with a VT of 6 and 12mL/kg (low and high VT, respectively), both before and after tracheal instillation of polysorbate 20. Before acute lung injury (ALI) induction, modifications of VT did not significantly change PPV and SVV readings. After ALI, PPV and SVV were significantly greater during ventilation with a high VT compared to a low VT (PPV increased from 8.9±1.2 to 12.4±1.1%, and SVV from 8.5±1.0 to 12.7±1.2%, both P<0.01). This study found that a high VT and reduced lung compliance due to ALI increase preload dynamic tests, with a greater influence of the latter. In subjects with ALI, lung compliance should be considered when interpreting the preload dynamic tests. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Cognitive correlates of α4β2 nicotinic acetylcholine receptors in mild Alzheimer's dementia.

PubMed

Sabri, Osama; Meyer, Philipp M; Gräf, Susanne; Hesse, Swen; Wilke, Stephan; Becker, Georg-Alexander; Rullmann, Michael; Patt, Marianne; Luthardt, Julia; Wagenknecht, Gudrun; Hoepping, Alexander; Smits, Rene; Franke, Annegret; Sattler, Bernhard; Tiepolt, Solveig; Fischer, Steffen; Deuther-Conrad, Winnie; Hegerl, Ulrich; Barthel, Henryk; Schönknecht, Peter; Brust, Peter

2018-06-01

In early Alzheimer's dementia, there is a need for PET biomarkers of disease progression with close associations to cognitive dysfunction that may aid to predict further cognitive decline and neurodegeneration. Amyloid biomarkers are not suitable for that purpose. The α4β2 nicotinic acetylcholine receptors (α4β2-nAChRs) are widely abundant in the human brain. As neuromodulators they play an important role in cognitive functions such as attention, learning and memory. Post-mortem studies reported lower expression of α4β2-nAChRs in more advanced Alzheimer's dementia. However, there is ongoing controversy whether α4β2-nAChRs are reduced in early Alzheimer's dementia. Therefore, using the recently developed α4β2-nAChR-specific radioligand (-)-18F-flubatine and PET, we aimed to quantify the α4β2-nAChR availability and its relationship to specific cognitive dysfunction in mild Alzheimer's dementia. Fourteen non-smoking patients with mild Alzheimer's dementia, drug-naïve for cholinesterase therapy, were compared with 15 non-smoking healthy controls matched for age, sex and education by applying (-)-18F-flubatine PET together with a neuropsychological test battery. The one-tissue compartment model and Logan plot method with arterial input function were used for kinetic analysis to obtain the total distribution volume (VT) as the primary, and the specific binding part of the distribution volume (VS) as the secondary quantitative outcome measure of α4β2-nAChR availability. VS was determined by using a pseudo-reference region. Correlations between VT within relevant brain regions and Z-scores of five cognitive functions (episodic memory, executive function/working memory, attention, language, visuospatial function) were calculated. VT (and VS) were applied for between-group comparisons. Volume of interest and statistical parametric mapping analyses were carried out. Analyses revealed that in patients with mild Alzheimer's dementia compared to healthy controls, there was significantly lower VT, especially within the hippocampus, fronto-temporal cortices, and basal forebrain, which was similar to comparisons of VS. VT decline in Alzheimer's dementia was associated with distinct domains of impaired cognitive functioning, especially episodic memory and executive function/working memory. Using (-)-18F-flubatine PET in patients with mild Alzheimer's dementia, we show for the first time a cholinergic α4β2-nAChR deficiency mainly present within the basal forebrain-cortical and septohippocampal cholinergic projections and a relationship between lower α4β2-nAChR availability and impairment of distinct cognitive domains, notably episodic memory and executive function/working memory. This shows the potential of (-)-18F-flubatine as PET biomarker of cholinergic α4β2-nAChR dysfunction and specific cognitive decline. Thus, if validated by longitudinal PET studies, (-)-18F-flubatine might become a PET biomarker of progression of neurodegeneration in Alzheimer's dementia.

Respiratory system loop gain in normal men and women measured with proportional-assist ventilation.

PubMed

Wellman, Andrew; Malhotra, Atul; Fogel, Robert B; Edwards, Jill K; Schory, Karen; White, David P

2003-01-01

We hypothesized that increased chemical control instability (CCI) in men could partially explain the male predominance in obstructive sleep apnea (OSA). CCI was assessed by sequentially increasing respiratory control system loop gain (LG) with proportional-assist ventilation (PAV) in 10 men (age 24-48 yr) and 9 women (age 22-36 yr) until periodic breathing or awakening occurred. Women were studied in both the follicular and luteal phases of the menstrual cycle. The amount by which PAV amplified LG was quantified from the tidal volume amplification factor [(VtAF) assisted tidal volume/unassisted tidal volume]. LG was calculated as the inverse of the VtAF occurring at the assist level immediately preceding the emergence of periodic breathing (when LG x VtAF = 1). Only 1 of 10 men and 2 of 9 women developed periodic breathing with PAV. The rest were resistant to periodic breathing despite moderately high levels of PAV amplification. We conclude that LG is low in the majority of normal men and women and that higher volume amplification factors are needed to determine whether gender differences exist in this low range.

Quantification of metabotropic glutamate subtype 5 receptors in the brain by an equilibrium method using 18F-SP203.

PubMed

Kimura, Yasuyuki; Siméon, Fabrice G; Zoghbi, Sami S; Zhang, Yi; Hatazawa, Jun; Pike, Victor W; Innis, Robert B; Fujita, Masahiro

2012-02-01

A new PET ligand, 3-fluoro-5-(2-(2-(18)F-(fluoromethyl)-thiazol-4-yl)ethynyl)benzonitrile (18F-SP203) can quantify metabotropic glutamate subtype 5 receptors (mGluR5) in human brain by a bolus injection and kinetic modeling. As an alternative approach to a bolus injection, binding can simply be measured as a ratio of tissue to metabolite-corrected plasma at a single time point under equilibrium conditions achieved by administering the radioligand with a bolus injection followed by a constant infusion. The purpose of this study was to validate the equilibrium method as an alternative to the standard kinetic method for measuring 18F-SP203 binding in the brain. Nine healthy subjects were injected with 18F-SP203 using a bolus plus constant infusion for 300 min. A single ratio of bolus-to-constant infusion (the activity of bolus equaled to that of infusion over 219 min) was applied to all subjects to achieve equilibrium in approximately 120 min. As a measure of ligand binding, we compared total distribution volume (VT) calculated by the equilibrium and kinetic methods in each scan. The equilibrium method calculated VT by the ratio of radioactivity in the brain to the concentration of 18F-SP203 in arterial plasma at 120 min, and the kinetic method calculated VT by a two-tissue compartment model using brain and plasma dynamic data from 0 to 120 min. VT obtained via the equilibrium method was highly correlated with VT obtained via kinetic modeling. Inter-subject variability of VT obtained via the equilibrium method was slightly smaller than VT obtained via the kinetic method. VT obtained via the equilibrium method was ~10% higher than VT obtained via the kinetic method, indicating a small difference between the measurements. Taken together, the results of this study show that using the equilibrium method is an acceptable alternative to the standard kinetic method when using 18F-SP203 to measure mGluR5. Although small differences in the measurements obtained via the equilibrium and kinetic methods exist, both methods consistently measured mGluR5 as indicated by the highly correlated VT values; the equilibrium method was slightly more precise, as indirectly measured by the smaller coefficient of variability across subjects. In addition, when using 18F-SP203, the equilibrium method is more efficient because it requires much less data. Copyright © 2011. Published by Elsevier Inc.

Effects of tidal volume and methacholine on low-frequency total respiratory impedance in dogs.

PubMed

Lutchen, K R; Jackson, A C

1990-05-01

The frequency dependence of respiratory impedance (Zrs) from 0.125 to 4 Hz (Hantos et al., J. Appl. Physiol. 60: 123-132, 1986) may reflect inhomogeneous parallel time constants or the inherent viscoelastic properties of the respiratory tissues. However, studies on the lung alone or chest wall alone indicate that their impedance features are also dependent on the tidal volumes (VT) of the forced oscillations. The goals of this study were 1) to identify how total Zrs at lower frequencies measured with random noise (RN) compared with that measure with larger VT, 2) to identify how Zrs measured with RN is affected by bronchoconstriction, and 3) to identify the impact of using linear models for analyzing such data. We measured Zrs in six healthy dogs by use of a RN technique from 0.125 to 4 Hz or with a ventilator from 0.125 to 0.75 Hz with VT from 50 to 250 ml. Then methacholine was administered and the RN was repeated. Two linear models were fit to each separate set of data. Both models assume uniform airways leading to viscoelastic tissues. For healthy dogs, the respiratory resistance (Rrs) decreased with frequency, with most of the decrease occurring from 0.125 to 0.375 Hz. Significant VT dependence of Rrs was seen only at these lower frequencies, with Rrs higher as VT decreased. The respiratory compliance (Crs) was dependent on VT in a similar fashion at all frequencies, with Crs decreasing as VT decreased. Both linear models fit the data well at all VT, but the viscoelastic parameters of each model were very sensitive to VT. After methacholine, the minimum Rrs increased as did the total drop with frequency. Nevertheless the same models fit the data well, and both the airways and tissue parameters were altered after methacholine. We conclude that inferences based only on low-frequency Zrs data are problematic because of the effects of VT on such data (and subsequent linear modeling of it) and the apparent inability of such data to differentiate parallel inhomogeneities from normal viscoelastic properties of the respiratory tissues.

In Vivo Measurement of GABA Transmission in Healthy Subjects and Schizophrenia Patients

PubMed Central

Frankle, W. Gordon; Cho, Raymond Y.; Prasad, Konasale M.; Mason, N. Scott; Paris, Jennifer; Himes, Michael L.; Walker, Christopher; Lewis, David A.; Narendran, Rajesh

2016-01-01

Objective Postmortem studies in schizophrenia reveal alterations in gene products that regulate the release and extracellular persistence of GABA. However, results of in vivo studies of schizophrenia measuring total tissue GABA with magnetic resonance spectroscopy (MRS) have been inconsistent. Neither the postmortem nor the MRS studies directly address the physiological properties of GABA neurotransmission. The present study addresses this question through an innovative positron emission tomography (PET) paradigm. Method The binding of [11C]flumazenil, a benzodiazepine-specific PET radiotracer, was measured before and after administration of tiagabine (0.2 mg/kg of body weight), a GABA membrane transporter (GAT1) blocker, in 17 off-medication patients with schizophrenia and 22 healthy comparison subjects. Increased extracellular GABA, through GAT1 blockade, enhances the affinity of GABAA receptors for benzodiazepine ligands, detected as an increase in [11C]flumazenil tissue distribution volume (VT). Results [11C]Flumazenil VT was significantly increased across all cortical brain regions in the healthy comparison group but not in the schizophrenia group. This lack of effect was most prominent in the antipsychotic-naive schizophrenia group. In this subgroup, [11C]flumazenil ΔVT in the medial temporal lobe was correlated with positive symptoms, and baseline [11C] flumazenil VT in the medial temporal lobe was negatively correlated with visual learning. In the healthy comparison group but not the schizophrenia group, [11C]flumazenil ΔVT was positively associated with gamma-band oscillation power. Conclusions This study demonstrates, for the first time, an in vivo impairment in GABA transmission in schizophrenia, most prominent in antipsychotic-naive individuals. The impairment in GABA transmission appears to be linked to clinical symptoms, disturbances in cortical oscillations, and cognition. PMID:26133962

In vivo measurement of GABA transmission in healthy subjects and schizophrenia patients.

PubMed

Frankle, W Gordon; Cho, Raymond Y; Prasad, Konasale M; Mason, N Scott; Paris, Jennifer; Himes, Michael L; Walker, Christopher; Lewis, David A; Narendran, Rajesh

2015-11-01

Postmortem studies in schizophrenia reveal alterations in gene products that regulate the release and extracellular persistence of GABA. However, results of in vivo studies of schizophrenia measuring total tissue GABA with magnetic resonance spectroscopy (MRS) have been inconsistent. Neither the postmortem nor the MRS studies directly address the physiological properties of GABA neurotransmission. The present study addresses this question through an innovative positron emission tomography (PET) paradigm. The binding of [(11)C]flumazenil, a benzodiazepine-specific PET radiotracer, was measured before and after administration of tiagabine (0.2 mg/kg of body weight), a GABA membrane transporter (GAT1) blocker, in 17 off-medication patients with schizophrenia and 22 healthy comparison subjects. Increased extracellular GABA, through GAT1 blockade, enhances the affinity of GABAA receptors for benzodiazepine ligands, detected as an increase in [(11)C]flumazenil tissue distribution volume (VT). [(11)C]Flumazenil VT was significantly increased across all cortical brain regions in the healthy comparison group but not in the schizophrenia group. This lack of effect was most prominent in the antipsychotic-naive schizophrenia group. In this subgroup, [(11)C]flumazenil ΔVT in the medial temporal lobe was correlated with positive symptoms, and baseline [(11)C]flumazenil VT in the medial temporal lobe was negatively correlated with visual learning. In the healthy comparison group but not the schizophrenia group, [(11)C]flumazenil ΔVT was positively associated with gamma-band oscillation power. This study demonstrates, for the first time, an in vivo impairment in GABA transmission in schizophrenia, most prominent in antipsychotic-naive individuals. The impairment in GABA transmission appears to be linked to clinical symptoms, disturbances in cortical oscillations, and cognition.

Comparative evaluation of hemodynamic and respiratory parameters during mechanical ventilation with two tidal volumes calculated by demi-span based height and measured height in normal lungs

PubMed Central

Seresht, L. Mousavi; Golparvar, Mohammad; Yaraghi, Ahmad

2014-01-01

Background: Appropriate determination of tidal volume (VT) is important for preventing ventilation induced lung injury. We compared hemodynamic and respiratory parameters in two conditions of receiving VTs calculated by using body weight (BW), which was estimated by measured height (HBW) or demi-span based body weight (DBW). Materials and Methods: This controlled-trial was conducted in St. Alzahra Hospital in 2009 on American Society of Anesthesiologists (ASA) I and II, 18-65-years-old patients. Standing height and weight were measured and then height was calculated using demi-span method. BW and VT were calculated with acute respiratory distress syndrome-net formula. Patients were randomized and then crossed to receive ventilation with both calculated VTs for 20 min. Hemodynamic and respiratory parameters were analyzed with SPSS version 20.0 using univariate and multivariate analyses. Results: Forty nine patients were studied. Demi-span based body weight and thus VT (DTV) were lower than Height based body weight and VT (HTV) (P = 0.028), in male patients (P = 0.005). Difference was observed in peak airway pressure (PAP) and airway resistance (AR) changes with higher PAP and AR at 20 min after receiving HTV compared with DTV. Conclusions: Estimated VT based on measured height is higher than that based on demi-span and this difference exists only in females, and this higher VT results higher airway pressures during mechanical ventilation. PMID:24627845

Comparative evaluation of hemodynamic and respiratory parameters during mechanical ventilation with two tidal volumes calculated by demi-span based height and measured height in normal lungs.

PubMed

Seresht, L Mousavi; Golparvar, Mohammad; Yaraghi, Ahmad

2014-01-01

Appropriate determination of tidal volume (VT) is important for preventing ventilation induced lung injury. We compared hemodynamic and respiratory parameters in two conditions of receiving VTs calculated by using body weight (BW), which was estimated by measured height (HBW) or demi-span based body weight (DBW). This controlled-trial was conducted in St. Alzahra Hospital in 2009 on American Society of Anesthesiologists (ASA) I and II, 18-65-years-old patients. Standing height and weight were measured and then height was calculated using demi-span method. BW and VT were calculated with acute respiratory distress syndrome-net formula. Patients were randomized and then crossed to receive ventilation with both calculated VTs for 20 min. Hemodynamic and respiratory parameters were analyzed with SPSS version 20.0 using univariate and multivariate analyses. Forty nine patients were studied. Demi-span based body weight and thus VT (DTV) were lower than Height based body weight and VT (HTV) (P = 0.028), in male patients (P = 0.005). Difference was observed in peak airway pressure (PAP) and airway resistance (AR) changes with higher PAP and AR at 20 min after receiving HTV compared with DTV. Estimated VT based on measured height is higher than that based on demi-span and this difference exists only in females, and this higher VT results higher airway pressures during mechanical ventilation.

Respiratory system mechanics in acute respiratory distress syndrome.

PubMed

Kallet, Richard H; Katz, Jeffrey A

2003-09-01

Respiratory mechanics research is important to the advancement of ARDS management. Twenty-eight years ago, research on the effects of PEEP and VT indicated that the lungs of ARDS patients did not behave in a manner consistent with homogenously distributed lung injury. Both Suter and colleagues] and Katz and colleagues reported that oxygenation continued to improve as PEEP increased (suggesting lung recruitment), even though static Crs decreased and dead-space ventilation increased (suggesting concurrent lung overdistension). This research strongly suggested that without VT reduction, the favorable effects of PEEP on lung recruitment are offset by lung overdistension at end-inspiration. The implications of these studies were not fully appreciated at that time, in part because the concept of ventilator-associated lung injury was in its nascent state. Ten years later. Gattinoni and colleagues compared measurements of static pressure-volume curves with FRC and CT scans of the chest in ARDS. They found that although PEEP recruits collapsed (primarily dorsal) lung segments, it simultaneously causes overdistension of non-dependent, inflated lung regions. Furthermore, the specific compliance of the aerated, residually healthy lung tissue is essentially normal. The main implication of these findings is that traditional mechanical ventilation practice was injecting excessive volumes of gas into functionally small lungs. Therefore, the emblematic low static Crs measured in ARDS reflects not only surface tension phenomena and recruitment of collapsed airspaces but also overdistension of the remaining healthy lung. The studies reviewed in this article support the concept that lung injury in ARDS is heterogeneously distributed, with resulting disparate mechanical stresses, and indicate the additional complexity from alterations in chest wall mechanics. Most of these studies, however, were published before lung-protective ventilation. Therefore, further studies are needed to refine the understanding of the mechanical effects of lung-protective ventilation. Although low-VT ventilation is becoming a standard of care for ARDS patients, many issues remain unresolved; among them are the role of PEEP and recruitment maneuvers in either preventing or promoting lung injury and the effects of respiratory rate and graded VT reduction on mechanical stress in the lungs. The authors believe that advances in mechanical ventilation that may further improve patient outcomes are likely to come from more sophisticated monitoring capabilities (ie, the ability to measure P1 or perhaps Cslice) than from the creation of new modes of ventilatory support.

Distribution of the Vasotocin Subtype Four Receptor (VT4R) in the Anterior Pituitary Gland of the Chicken, Gallus gallus, and its Possible Role in the Avian Stress Response.

PubMed

Selvam, R; Jurkevich, A; Kang, S W; Mikhailova, M V; Cornett, L E; Kuenzel, W J

2013-01-01

The neurohormone arginine vasotocin (AVT) in non mammalian vertebrates is homologous to arginine vasopressin (AVP) in mammals. Its actions are mediated via G protein-coupled receptors that belong to the vasotocin/mesotocin family. Because of the known regulatory effects of nonapeptide hormones on anterior pituitary functions, receptor subtypes in that family have been proposed to be located in anterior pituitary cells. Recently, an avian vasotocin receptor subtype designated VT4R has been cloned, which shares 69% sequence homology with a human vasopressin receptor, the V1aR. In the present study, a polyclonal antibody to the VT4R was developed and validated to confirm its specificity to the VT4R. The antibody was used to test the hypothesis that the VT4R is present in the avian anterior pituitary and is specifically associated with certain cell types, where its expression is modulated by acute stress. Western blotting of membrane protein extracts from pituitary tissue, the use of HeLa cells transfected with the VT4R and peptide competition assays all confirmed the specificity of the antibody to the VT4R. Dual-labelling immunofluorescence microscopy was utilised to identify pituitary cell types that contained immunoreactive VT4R. The receptor was found to be widely distributed throughout the cephalic lobe but not in the caudal lobe of the anterior pituitary. Immunoreactive VT4R was associated with corticotrophs. Approximately 89% of immunolabelled corticotrophs were shown to contain the VT4R. The immunoreactive VT4R was not found in gonadotrophs, somatotrophs or lactotrophs. To determine a possible functional role of the VT4R and previously characterised VT2R, gene expression levels in the anterior pituitary were determined after acute immobilisation stress by quantitative reverse transcriptase-polymerase chain reaction. The results showed a significant increase in plasma corticosterone levels (three- to four-fold), a significant reduction of VT4R mRNA and an increase of VT2R mRNA (P < 0.05) in acutely immobilised chicks compared to controls. The data suggest a role of the VT4R in the avian stress response. © 2012 British Society for Neuroendocrinology.

Highly symmetric D-brane-anti-D-brane effective actions

NASA Astrophysics Data System (ADS)

Hatefi, Ehsan

2017-09-01

The entire S-matrix elements of four, five and six point functions of D-brane-anti D-brane system are explored. To deal with symmetries of string amplitudes as well as their all order α ' corrections we first address a four point function of one closed string Ramond-Ramond (RR) and two real tachyons on the world volume of brane-anti brane system. We then focus on symmetries of string theory as well as universal tachyon expansion to achieve both string and effective field theory of an RR and three tachyons where the complete algebraic analysis for the whole S-matrix < {V}_{C^{-1}}{V}_{T^{-1}}{V}_{T^0}{V}_{T^0}> was also revealed. Lastly, we employ all the conformal field theory techniques to < {V}_{C^{-1}}{V}_{T^{-1}}{V}_{T^0}{V}_{T^0}{V}_{T^0}> , working out with symmetries of theory and find out the expansion for the amplitude to be able to precisely discover all order singularity structures of D-brane-anti-D-brane effective actions of string theory. Various remarks about the so called generalized Veneziano amplitude and new string couplings are elaborated as well.

Single-sample method for the estimation of glomerular filtration rate in children

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tauxe, W.N.; Bagchi, A.; Tepe, P.G.

1987-03-01

A method for the determination of the glomerular filtration rate (GFR) in children which involves the use of a single-plasma sample (SPS) after the injection of a radioactive indicator such as radioiodine labeled diatrizoate (Hypaque) has been developed. This is analogous to previously published SPS techniques of effective renal plasma flow (ERPF) in adults and children and GFR SPS techniques in adults. As a reference standard, GFR has been calculated from compartment analysis of injected radiopharmaceuticals (Sapirstein Method). Theoretical volumes of distribution were calculated at various times after injection (Vt) by dividing the total injected counts (I) by the plasmamore » concentration (Ct) expressed in liters, determined by counting an aliquot of plasma in a well type scintillation counter. Errors of predicting GFR from the various Vt values were determined as the standard error of estimate (Sy.x) in ml/min. They were found to be relatively high early after injection and to fall to a nadir of 3.9 ml/min at 91 min. The Sy.x Vt relationship was examined in linear, quadratic, and exponential form, but the simpler linear relationship was found to yield the lowest error. Other data calculated from the compartment analysis of the reference plasma disappearance curves are presented, but at this time have apparently little clinical relevance.« less

SELECTED CHARACTERISTICS OF OCCUPATIONS (PHYSICAL DEMANDS, WORKING CONDITIONS, TRAINING TIME), A SUPPLEMENT TO THE DICTIONARY OF OCCUPATIONAL TITLES.

ERIC Educational Resources Information Center

Bureau of Employment Security (DOL), Washington, DC.

THIS SUPPLEMENT LISTS INDIVIDUAL PHYSICAL DEMANDS, WORKING CONDITIONS, AND TRAINING TIME DATA FOR EACH JOB DEFINED IN VOLUMES 1 AND 2 (VT 003 654 AND VT 003 655). IT WAS PUBLISHED IN RESPONSE TO THE SPECIAL NEEDS OF ORGANIZATIONS AND INDIVIDUALS CONCERNED WITH MANPOWER UTILIZATION WHO REQUIRE MORE SPECIFIC OCCUPATIONAL CHARACTERISTICS DATA THAN…

Response of Volume Transport through the Taiwan and Tsushima Straits to the Wind Fields in the East China Sea

NASA Astrophysics Data System (ADS)

Matsuno, T.; Liu, C. T.; Fukudome, K.; Chen, H. W.; Ichikawa, K.; Doong, D. J.; Senjyu, T.

2016-02-01

Circulation in the shelf region of the East China Sea is strongly controlled by the volume transport (VT) through the Taiwan Strait (TwS). It is well known that the VT through TwS has a significant seasonal variation, large in summer and small in winter. Based on a time series of the current field obtained by ADCP installed on a ferry boat crossing the TwS, from Keelung to Matsu Island in Taiwan, it had been investigated that the seasonal variations have a good correlation with the local wind around the TwS. The VT through the TwS had been compared with that through Tsushima Strait (TsS), and the results using the data from 2009 to 2012 were presented in the last OSM. In this study the monitoring data were extended further to 2014 and the difference of VTs between TwS and TsS was compared with wind fields and Ekman transport for not only seasonal variation but also shorter time scale variations. Ekman transport across the shelf break with time scales shorter than one month has a good correlation with the difference of VTs between TwS and TsS, that is, net transport across the shelf break of the East China Sea. The correlation is much better with VT through TwS rather than through TsS. Onshoreward net transport due to the Ekman transport may decrease the VT through TwS, which means that the VT through TwS is not only related to the local wind but also wind field over the East China Sea.

Retest imaging of [11C]NOP-1A binding to nociceptin/orphanin FQ peptide (NOP) receptors in the brain of healthy humans.

PubMed

Lohith, Talakad G; Zoghbi, Sami S; Morse, Cheryl L; Araneta, Maria D Ferraris; Barth, Vanessa N; Goebl, Nancy A; Tauscher, Johannes T; Pike, Victor W; Innis, Robert B; Fujita, Masahiro

2014-02-15

[(11)C]NOP-1A is a novel high-affinity PET ligand for imaging nociceptin/orphanin FQ peptide (NOP) receptors. Here, we report reproducibility and reliability measures of binding parameter estimates for [(11)C]NOP-1A binding in the brain of healthy humans. After intravenous injection of [(11)C]NOP-1A, PET scans were conducted twice on eleven healthy volunteers on the same (10/11 subjects) or different (1/11 subjects) days. Subjects underwent serial sampling of radial arterial blood to measure parent radioligand concentrations. Distribution volume (VT; a measure of receptor density) was determined by compartmental (one- and two-tissue) modeling in large regions and by simpler regression methods (graphical Logan and bilinear MA1) in both large regions and voxel data. Retest variability and intraclass correlation coefficient (ICC) of VT were determined as measures of reproducibility and reliability respectively. Regional [(11)C]NOP-1A uptake in the brain was high, with a peak radioactivity concentration of 4-7 SUV (standardized uptake value) and a rank order of putamen>cingulate cortex>cerebellum. Brain time-activity curves fitted well in 10 of 11 subjects by unconstrained two-tissue compartmental model. The retest variability of VT was moderately good across brain regions except cerebellum, and was similar across different modeling methods, averaging 12% for large regions and 14% for voxel-based methods. The retest reliability of VT was also moderately good in most brain regions, except thalamus and cerebellum, and was similar across different modeling methods averaging 0.46 for large regions and 0.48 for voxels having gray matter probability >20%. The lowest retest variability and highest retest reliability of VT were achieved by compartmental modeling for large regions, and by the parametric Logan method for voxel-based methods. Moderately good reproducibility and reliability measures of VT for [(11)C]NOP-1A make it a useful PET ligand for comparing NOP receptor binding between different subject groups or under different conditions in the same subject. Copyright © 2013. Published by Elsevier Inc.

Estimation of gas and tissue lung volumes by MRI: functional approach of lung imaging.

PubMed

Qanadli, S D; Orvoen-Frija, E; Lacombe, P; Di Paola, R; Bittoun, J; Frija, G

1999-01-01

The purpose of this work was to assess the accuracy of MRI for the determination of lung gas and tissue volumes. Fifteen healthy subjects underwent MRI of the thorax and pulmonary function tests [vital capacity (VC) and total lung capacity (TLC)] in the supine position. MR examinations were performed at inspiration and expiration. Lung volumes were measured by a previously validated technique on phantoms. Both individual and total lung volumes and capacities were calculated. MRI total vital capacity (VC(MRI)) was compared with spirometric vital capacity (VC(SP)). Capacities were correlated to lung volumes. Tissue volume (V(T)) was estimated as the difference between the total lung volume at full inspiration and the TLC. No significant difference was seen between VC(MRI) and VC(SP). Individual capacities were well correlated (r = 0.9) to static volume at full inspiration. The V(T) was estimated to be 836+/-393 ml. This preliminary study demonstrates that MRI can accurately estimate lung gas and tissue volumes. The proposed approach appears well suited for functional imaging of the lung.

In vitro and in vivo evaluation of 11C-SD5024, a novel PET radioligand for human brain imaging of cannabinoid CB1 receptors

PubMed Central

Tsujikawa, Tetsuya; Zoghbi, Sami S.; Hong, Jinsoo; Donohue, Sean R.; Jenko, Kimberly J.; Gladding, Robert L.; Halldin, Christer; Pike, Victor W.; Innis, Robert B.; Fujita, Masahiro

2013-01-01

We recently developed a novel cannabinoid subtype-1 (CB1) receptor radioligand 11C-SD5024 for brain imaging. This study aimed to evaluate 11C-SD5024 both in vitro and in vivo and compare it with the other CB1 receptor ligands previously used in humans, i.e., 11C-MePPEP, 11C-OMAR, 18F-MK-9470, and 18F-FMPEP-d2. In vitro experiments were performed to measure dissociation constant (Ki) in human brain and to measure the lipophilicity of five CB1 receptor ligands listed above. In vivo specific binding in monkeys was measured by comparing total distribution volume (VT) at baseline and after full receptor blockade. The kinetics of 11C-SD5024 in humans were evaluated in seven healthy subjects with compartmental modeling. SD5024 showed Ki=0.47 nM, which was at an intermediate level among the five CB1 receptor ligands. Lipophilicity (LogD7.4) was 3.79, which is appropriate for brain imaging. Monkey scans showed high proportion of specific binding: ~80% of VT. In humans, 11C-SD5024 showed peak brain uptake of 1.5–3 standardized uptake value, which was slightly higher than those of 11C-OMAR and 18F-MK-9470. One-compartment model showed good fitting, consistent with the vast majority of brain uptake being specific binding found in the monkey. Regional VT values were consistent with known distribution of CB1 receptors. VT calculated from 80 and 120 min of scan data were strongly correlated (R2=0.97), indicating that 80 min provided adequate information for quantitation and that the influence of radiometabolites was low. Intersubject variability for VT of 11C-SD5024 was 22%, which was low among the five radioligands and indicated precise measurement. In conclusion, 11C-SD5024 has appropriate affinity and lipophilicity, high specific binding, moderate brain uptake, and provides good precision to measure the binding. The results suggest that 11C-SD5024 is slightly better than or equivalent to 11C-OMAR and that both are suitable for clinical studies, especially those that involve two scans in one day. PMID:24076222

Imaging for metabotropic glutamate receptor subtype 1 in rat and monkey brains using PET with [18F]FITM.

PubMed

Yamasaki, Tomoteru; Fujinaga, Masayuki; Maeda, Jun; Kawamura, Kazunori; Yui, Joji; Hatori, Akiko; Yoshida, Yuichiro; Nagai, Yuji; Tokunaga, Masaki; Higuchi, Makoto; Suhara, Tetsuya; Fukumura, Toshimitsu; Zhang, Ming-Rong

2012-04-01

In this study, we evaluate the utility of 4-[(18)F]fluoro-N-[4-[6-(isopropylamino)pyrimidin-4-yl]-1,3-thiazol-2-yl]-N-methylbenzamide ([(18)F]FITM) as a positron emission tomography (PET) ligand for imaging of the metabotropic glutamate receptor subtype 1 (mGluR1) in rat and monkey brains. In vivo distribution of [(18)F]FITM in brains was evaluated by PET scans with or without the mGluR1-selective antagonist (JNJ16259685). Kinetic parameters of monkey PET data were obtained using the two-tissue compartment model with arterial blood sampling. In PET studies in rat and monkey brains, the highest uptake of radioactivity was in the cerebellum, followed by moderate uptake in the thalamus, hippocampus and striatum. The lowest uptake of radioactivity was detected in the pons. These uptakes in all brain regions were dramatically decreased by pre-administration of JNJ16259685. In kinetic analysis of monkey PET, the highest volume of distribution (V(T)) was detected in the cerebellum (V(T) = 11.5). [(18)F]FITM has an excellent profile as a PET ligand for mGluR1 imaging. PET with [(18)F]FITM may prove useful for determining the regional distribution and density of mGluR1 and the mGluR1 occupancy of drugs in human brains.

First-in-human PET quantification study of cerebral α4β2* nicotinic acetylcholine receptors using the novel specific radioligand (-)-[(18)F]Flubatine.

PubMed

Sabri, Osama; Becker, Georg-Alexander; Meyer, Philipp M; Hesse, Swen; Wilke, Stephan; Graef, Susanne; Patt, Marianne; Luthardt, Julia; Wagenknecht, Gudrun; Hoepping, Alexander; Smits, René; Franke, Annegret; Sattler, Bernhard; Habermann, Bernd; Neuhaus, Petra; Fischer, Steffen; Tiepolt, Solveig; Deuther-Conrad, Winnie; Barthel, Henryk; Schönknecht, Peter; Brust, Peter

2015-09-01

α4β2* nicotinic receptors (α4β2* nAChRs) could provide a biomarker in neuropsychiatric disorders (e.g., Alzheimer's and Parkinson's diseases, depressive disorders, and nicotine addiction). However, there is a lack of α4β2* nAChR specific PET radioligands with kinetics fast enough to enable quantification of nAChR within a reasonable time frame. Following on from promising preclinical results, the aim of the present study was to evaluate for the first time in humans the novel PET radioligand (-)-[(18)F]Flubatine, formerly known as (-)-[(18)F]NCFHEB, as a tool for α4β2* nAChR imaging and in vivo quantification. Dynamic PET emission recordings lasting 270min were acquired on an ECAT EXACT HR+ scanner in 12 healthy male non-smoking subjects (71.0±5.0years) following the intravenous injection of 353.7±9.4MBq of (-)-[(18)F]Flubatine. Individual magnetic resonance imaging (MRI) was performed for co-registration. PET frames were motion-corrected, before the kinetics in 29 brain regions were characterized using 1- and 2-tissue compartment models (1TCM, 2TCM). Given the low amounts of metabolite present in plasma, we tested arterial input functions with and without metabolite corrections. In addition, pixel-based graphical analysis (Logan plot) was used. The model's goodness of fit, with and without metabolite correction was assessed by Akaike's information criterion. Model parameters of interest were the total distribution volume VT (mL/cm(3)), and the binding potential BPND relative to the corpus callosum, which served as a reference region. The tracer proved to have high stability in vivo, with 90% of the plasma radioactivity remaining as untransformed parent compound at 90min, fast brain kinetics with rapid uptake and equilibration between free and receptor-bound tracer. Adequate fits of brain TACs were obtained with the 1TCM. VT could be reliably estimated within 90min for all regions investigated, and within 30min for low-binding regions such as the cerebral cortex. The rank order of VT by region corresponded well with the known distribution of α4β2* receptors (VT [thalamus] 27.4±3.8, VT [putamen] 12.7±0.9, VT [frontal cortex] 10.0±0.8, and VT [corpus callosum] 6.3±0.8). The BPND, which is a parameter of α4β2* nAChR availability, was 3.41±0.79 for the thalamus, 1.04±0.25 for the putamen and 0.61±0.23 for the frontal cortex, indicating high specific tracer binding. Use of the arterial input function without metabolite correction resulted in a 10% underestimation in VT, and was without important biasing effects on BPND. Altogether, kinetics and imaging properties of (-)-[(18)F]Flubatine appear favorable and suggest that (-)-[(18)F]Flubatine is a very suitable and clinically applicable PET tracer for in vivo imaging of α4β2* nAChRs in neuropsychiatric disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Agricultural Handling and Processing Industries; Data Pertinent to an Evaluation of Overtime Exemptions Available under the Fair Labor Standards Act. Volume II, Appendices.

ERIC Educational Resources Information Center

Wage and Labor Standards Administration (DOL), Washington, DC.

Definitions of terms used in the Fair Labor Standards Act and statistical tables compiled from a survey of agricultural processing firms comprise this appendix, which is the second volume of a two volume report. Volume I is available as VT 012 247. (BH)

Validating Lung Models Using the ASL 5000 Breathing Simulator.

PubMed

Dexter, Amanda; McNinch, Neil; Kaznoch, Destiny; Volsko, Teresa A

2018-04-01

This study sought to validate pediatric models with normal and altered pulmonary mechanics. PubMed and CINAHL databases were searched for studies directly measuring pulmonary mechanics of healthy infants and children, infants with severe bronchopulmonary dysplasia and neuromuscular disease. The ASL 5000 was used to construct models using tidal volume (VT), inspiratory time (TI), respiratory rate, resistance, compliance, and esophageal pressure gleaned from literature. Data were collected for a 1-minute period and repeated three times for each model. t tests compared modeled data with data abstracted from the literature. Repeated measures analyses evaluated model performance over multiple iterations. Statistical significance was established at a P value of less than 0.05. Maximum differences of means (experimental iteration mean - clinical standard mean) for TI and VT are the following: term infant without lung disease (TI = 0.09 s, VT = 0.29 mL), severe bronchopulmonary dysplasia (TI = 0.08 s, VT = 0.17 mL), child without lung disease (TI = 0.10 s, VT = 0.17 mL), and child with neuromuscular disease (TI = 0.09 s, VT = 0.57 mL). One-sample testing demonstrated statistically significant differences between clinical controls and VT and TI values produced by the ASL 5000 for each iteration and model (P < 0.01). The greatest magnitude of differences was negligible (VT < 1.6%, TI = 18%) and not clinically relevant. Inconsistencies occurred with the models constructed on the ASL 5000. It was deemed accurate for the study purposes. It is therefore essential to test models and evaluate magnitude of differences before use.

DICTIONARY OF OCCUPATIONAL TITLES, 1965. VOLUME II, OCCUPATIONAL CLASSIFICATION AND INDUSTRY INDEX.

ERIC Educational Resources Information Center

Bureau of Employment Security (DOL), Washington, DC.

VOLUME 2 COMPLEMENTS VOLUME 1 (VT 003 654) BY PROVIDING A CLASSIFICATION STRUCTURE WHICH GROUPS JOBS HAVING THE SAME BASIC OCCUPATIONAL, INDUSTRIAL, OR WORKER CHARACTERISTICS. THE SECTIONS ARE (1) THE OCCUPATIONAL CATEGORIES, DIVISIONS, AND GROUPS, (2) AN ALPHABETIC ARRANGEMENT OF OCCUPATIONAL DIVISIONS AND GROUPS, (3) THE OCCUPATIONAL GROUP…

Hypercapnic acidosis modulates inflammation, lung mechanics, and edema in the isolated perfused lung.

PubMed

De Smet, Hilde R; Bersten, Andrew D; Barr, Heather A; Doyle, Ian R

2007-12-01

Low tidal volume (V(T)) ventilation strategies may be associated with permissive hypercapnia, which has been shown by ex vivo and in vivo studies to have protective effects. We hypothesized that hypercapnic acidosis may be synergistic with low V(T) ventilation; therefore, we studied the effects of hypercapnia and V(T) on unstimulated and lipopolysaccharide-stimulated isolated perfused lungs. Isolated perfused rat lungs were ventilated for 2 hours with low (7 mL/kg) or moderately high (20 mL/kg) V(T) and 5% or 20% CO(2), with lipopolysaccharide or saline added to the perfusate. Hypercapnia resulted in reduced pulmonary edema, lung stiffness, tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) in the lavage and perfusate. The moderately high V(T) did not cause lung injury but increased lavage IL-6 and perfusate IL-6 as well as TNF-alpha. Pulmonary edema and respiratory mechanics improved, possibly as a result of a stretch-induced increase in surfactant turnover. Lipopolysaccharide did not induce significant lung injury. We conclude that hypercapnia exerts a protective effect by modulating inflammation, lung mechanics, and edema. The moderately high V(T) used in this study stimulated inflammation but paradoxically improved edema and lung mechanics with an associated increase in surfactant release.

Archaeal community structure in leachate and solid waste is correlated to methane generation and volume reduction during biodegradation of municipal solid waste.

PubMed

Fei, Xunchang; Zekkos, Dimitrios; Raskin, Lutgarde

2015-02-01

Duplicate carefully-characterized municipal solid waste (MSW) specimens were reconstituted with waste constituents obtained from a MSW landfill and biodegraded in large-scale landfill simulators for about a year. Repeatability and relationships between changes in physical, chemical, and microbial characteristics taking place during the biodegradation process were evaluated. Parameters such as rate of change of soluble chemical oxygen demand in the leachate (rsCOD), rate of methane generation (rCH4), rate of specimen volume reduction (rVt), DNA concentration in the leachate, and archaeal community structures in the leachate and solid waste were monitored during operation. The DNA concentration in the leachate was correlated to rCH4 and rVt. The rCH4 was related to rsCOD and rVt when waste biodegradation was intensive. The structures of archaeal communities in the leachate and solid waste of both simulators were very similar and Methanobacteriaceae were the dominant archaeal family throughout the testing period. Monitoring the chemical and microbial characteristics of the leachate was informative of the biodegradation process and volume reduction in the simulators, suggesting that leachate monitoring could be informative of the extent of biodegradation in a full-scale landfill. Copyright © 2014 Elsevier Ltd. All rights reserved.

Defining a Ventilation Strategy for Flexible Bronchoscopy on Mechanically Ventilated Patients in the Medical Intensive Care Unit.

PubMed

Greenstein, Yonatan Y; Shakespeare, Eric; Doelken, Peter; Mayo, Paul H

2017-07-01

Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. We studied 16 subjects who were intubated on mechanical ventilation and required FB. Changes in EELV were measured by respiratory inductance plethysmography. Ventilator mechanics, EELV, and arterial blood gases, were measured. FB insertions decreased EELV in 64% of cases (-325±371 mL) and increased it in 32% of cases (65±59 mL). Suctioning decreased EELV in 76% of cases (-120±104 mL) and increased it in 16% of cases (29±33 mL). Respiratory mechanics were unchanged. Pre-FB and post-FB, PaO2 decreased by 61±96 mm Hg and PaCO2 increased by 15±7 mm Hg. There was no clinically significant increase in EELV in any subject during FB. Decreases in EELV coincided with FB-suctioning maneuvers. Peak pressure limiting ventilation protected the subject against hyperinflation with a consequent, well-tolerated reduction in VT, and hypercapnea. Suctioning should be limited, especially in patients vulnerable to derecruitment effect.

Imaging of cerebral α4β2* nicotinic acetylcholine receptors with (−)-[18F]Flubatine PET: Implementation of bolus plus constant infusion and sensitivity to acetylcholine in human brain☆

PubMed Central

Hillmer, A.T.; Esterlis, I.; Gallezot, J.D.; Bois, F.; Zheng, M.Q.; Nabulsi, N.; Lin, S.F.; Papke, R.L.; Huang, Y.; Sabri, O.; Carson, R.E.; Cosgrove, K.P.

2016-01-01

The positron emission tomography (PET) radioligand (−)-[18F]flubatine is specific to α4β2∗ nicotinic acetylcholine receptors (nAChRs) and has promise for future investigation of the acetylcholine system in neuropathologies such as Alzheimer's disease, schizophrenia, and substance use disorders. The two goals of this work were to develop a simplified method for α4β2∗ nAChR quantification with bolus plus constant infusion (B/I) (−)-[18F]flubatine administration, and to assess the radioligand's sensitivity to acetylcholine fluctuations in humans. Healthy human subjects were imaged following either bolus injection (n = 8) or B/I (n = 4) administration of (−)-[18F]flubatine. The metabolite-corrected input function in arterial blood was measured. Free-fraction corrected distribution volumes (VT/fP) were estimated with modeling and graphical analysis techniques. Next, sensitivity to acetylcholine was assessed in two ways: 1. A bolus injection paradigm with two scans (n = 6), baseline (scan 1) and physostigmine challenge (scan 2; 1.5 mg over 60 min beginning 5 min prior to radiotracer injection); 2. A single scan B/I paradigm (n = 7) lasting up to 240 min with 1.5 mg physostigmine administered over 60 min beginning at 125 min of radiotracer infusion. Changes in VT/fP were measured. Baseline VT/fP values were 33.8 ± 3.3 mL/cm3 in thalamus, 12.9 ± 1.6 mL/cm3 in cerebellum, and ranged from 9.8 to 12.5 mL/cm3 in other gray matter regions. The B/I paradigm with equilibrium analysis at 120 min yielded comparable VT/fP values with compartment modeling analysis of bolus data in extrathalamic gray matter regions (regional means <4% different). Changes in VT/fP following physostigmine administration were small and most pronounced in cortical regions, ranging from 0.8 to 4.6% in the two-scan paradigm and 2.8 to 6.5% with the B/I paradigm. These results demonstrate the use of B/I administration for accurate quantification of (−)-[18F]flubatine VT/fP in 120 min, and suggest possible sensitivity of (−)-[18F]flubatine binding to physostigmine-induced changes in acetylcholine levels. PMID:27426839

Imaging of cerebral α4β2* nicotinic acetylcholine receptors with (-)-[(18)F]Flubatine PET: Implementation of bolus plus constant infusion and sensitivity to acetylcholine in human brain.

PubMed

Hillmer, A T; Esterlis, I; Gallezot, J D; Bois, F; Zheng, M Q; Nabulsi, N; Lin, S F; Papke, R L; Huang, Y; Sabri, O; Carson, R E; Cosgrove, K P

2016-11-01

The positron emission tomography (PET) radioligand (-)-[(18)F]flubatine is specific to α4β2(⁎) nicotinic acetylcholine receptors (nAChRs) and has promise for future investigation of the acetylcholine system in neuropathologies such as Alzheimer's disease, schizophrenia, and substance use disorders. The two goals of this work were to develop a simplified method for α4β2(⁎) nAChR quantification with bolus plus constant infusion (B/I) (-)-[(18)F]flubatine administration, and to assess the radioligand's sensitivity to acetylcholine fluctuations in humans. Healthy human subjects were imaged following either bolus injection (n=8) or B/I (n=4) administration of (-)-[(18)F]flubatine. The metabolite-corrected input function in arterial blood was measured. Free-fraction corrected distribution volumes (VT/fP) were estimated with modeling and graphical analysis techniques. Next, sensitivity to acetylcholine was assessed in two ways: 1. A bolus injection paradigm with two scans (n=6), baseline (scan 1) and physostigmine challenge (scan 2; 1.5mg over 60min beginning 5min prior to radiotracer injection); 2. A single scan B/I paradigm (n=7) lasting up to 240min with 1.5mg physostigmine administered over 60min beginning at 125min of radiotracer infusion. Changes in VT/fP were measured. Baseline VT/fP values were 33.8±3.3mL/cm(3) in thalamus, 12.9±1.6mL/cm(3) in cerebellum, and ranged from 9.8 to 12.5mL/cm(3) in other gray matter regions. The B/I paradigm with equilibrium analysis at 120min yielded comparable VT/fP values with compartment modeling analysis of bolus data in extrathalamic gray matter regions (regional means <4% different). Changes in VT/fP following physostigmine administration were small and most pronounced in cortical regions, ranging from 0.8 to 4.6% in the two-scan paradigm and 2.8 to 6.5% with the B/I paradigm. These results demonstrate the use of B/I administration for accurate quantification of (-)-[(18)F]flubatine VT/fP in 120min, and suggest possible sensitivity of (-)-[(18)F]flubatine binding to physostigmine-induced changes in acetylcholine levels. Copyright © 2016 Elsevier Inc. All rights reserved.

Spectral analysis of 87-lead body surface signal-averaged ECGs in patients with previous anterior myocardial infarction as a marker of ventricular tachycardia.

PubMed

Hosoya, Y; Kubota, I; Shibata, T; Yamaki, M; Ikeda, K; Tomoike, H

1992-06-01

There were few studies on the relation between the body surface distribution of high- and low-frequency components within the QRS complex and ventricular tachycardia (VT). Eighty-seven signal-averaged ECGs were obtained from 30 normal subjects (N group) and 30 patients with previous anterior myocardial infarction (MI) with VT (MI-VT[+] group, n = 10) or without VT (MI-VT[-] group, n = 20). The onset and offset of the QRS complex were determined from 87-lead root mean square values computed from the averaged (but not filtered) ECG waveforms. Fast Fourier transform analysis was performed on signal-averaged ECG. The resulting Fourier coefficients were attenuated by use of the transfer function, and then inverse transform was done with five frequency ranges (0-25, 25-40, 40-80, 80-150, and 150-250 Hz). From the QRS onset to the QRS offset, the time integration of the absolute value of reconstructed waveforms was calculated for each of the five frequency ranges. The body surface distributions of these areas were expressed as QRS area maps. The maximal values of QRS area maps were compared among the three groups. In the frequency ranges of 0-25 and 150-250 Hz, there were no significant differences in the maximal values among these three groups. Both MI groups had significantly smaller maximal values of QRS area maps in the frequency ranges of 25-40 and 40-80 Hz compared with the N group. The MI-VT(+) group had significantly smaller maximal values in the frequency ranges of 40-80 and 80-150 Hz than the MI-VT(-) group. These three groups were clearly differentiated by the maximal values of the 40-80-Hz QRS area map. It was suggested that the maximal value of the 40-80-Hz QRS area map was a new marker for VT after anterior MI.

First-time imaging of effects of inspired oxygen concentration on regional lung volumes and breathing pattern during hypergravity.

PubMed

Borges, João Batista; Hedenstierna, Göran; Bergman, Jakob S; Amato, Marcelo B P; Avenel, Jacques; Montmerle-Borgdorff, Stéphanie

2015-02-01

Aeroatelectasis can develop in aircrew flying the latest generation high-performance aircraft. Causes alleged are relative hyperoxia, increased gravity in the head-to-foot direction (+Gz), and compression of legs and stomach by anti-G trousers (AGT). We aimed to assess, in real time, the effects of hyperoxia, +Gz accelerations and AGT inflation on changes in regional lung volumes and breathing pattern evaluated in an axial plane by electrical impedance tomography (EIT). The protocol mimicked a routine peacetime flight in combat aircraft. Eight subjects wearing AGT were studied in a human centrifuge during 1 h 15 min exposure of +1 to +3.5Gz. They performed this sequence three times, breathing AIR, 44.5 % O2 or 100 % O2. Continuous recording of functional EIT enabled uninterrupted assessment of regional lung volumes at the 5th intercostal level. Breathing pattern was also monitored. EIT data showed that +3.5Gz, compared with any moment without hypergravity, caused an abrupt decrease in regional tidal volume (VT) and regional end-expiratory lung volume (EELV) measured in the EIT slice, independently of inspired oxygen concentration. Breathing AIR or 44.5 % O2, sub-regional EELV measured in the EIT slice decreased similarly in dorsal and ventral regions, but sub-regional VT measured in the EIT slice decreased significantly more dorsally than ventrally. Breathing 100 % O2, EELV and VT decreased similarly in both regions. Inspired tidal volume increased in hyperoxia, whereas breathing frequency increased in hypergravity and hyperoxia. Our findings suggest that hypergravity and AGT inflation cause airway closure and air trapping in gravity-dependent lung regions, facilitating absorption atelectasis formation, in particular during hyperoxia.

Lung volumes during sustained microgravity on Spacelab SLS-1.

PubMed

Elliott, A R; Prisk, G K; Guy, H J; West, J B

1994-10-01

Gravity is known to influence the mechanical behavior of the lung and chest wall. However, the effect of sustained microgravity (mu G) on lung volumes has not been reported. Pulmonary function tests were performed by four subjects before, during, and after 9 days of mu G exposure. Ground measurements were made in standing and supine postures. Tests were performed using a bag-in-box-and-flowmeter system and a respiratory mass spectrometer. Measurements included functional residual capacity (FRC), expiratory reserve volume (ERV), residual volume (RV), inspiratory and expiratory vital capacities (IVC and EVC), and tidal volume (VT). Total lung capacity (TLC) was derived from the measured EVC and RV values. With preflight standing values as a comparison, FRC was significantly reduced by 15% (approximately 500 ml) in mu G and 32% in the supine posture. ERV was reduced by 10-20% in mu G and decreased by 64% in the supine posture. RV was significantly reduced by 18% (310 ml) in mu G but did not significantly change in the supine posture compared with standing. IVC and EVC were slightly reduced during the first 24 h of mu G but returned to 1-G standing values within 72 h of mu G exposure. IVC and EVC in the supine posture were significantly reduced by 12% compared with standing. During mu G, VT decreased by 15% (approximately 90 ml), but supine VT was unchanged compared with preflight standing values. TLC decreased by approximately 8% during mu G and in the supine posture compared with preflight standing. The reductions in FRC, ERV, and RV during mu G are probably due to the cranial shift of the diaphragm, an increase in intrathoracic blood volume, and more uniform alveolar expansion.

Quantification of 18F-JNJ-42259152, a novel phosphodiesterase 10A PET tracer: kinetic modeling and test-retest study in human brain.

PubMed

Van Laere, Koen; Ahmad, Rawaha U; Hudyana, Hendra; Dubois, Kristof; Schmidt, Mark E; Celen, Sofie; Bormans, Guy; Koole, Michel

2013-08-01

Phosphodiesterase 10A (PDE10A) plays a central role in striatal signaling and is implicated in several neuropsychiatric disorders, such as movement disorders and schizophrenia. We performed initial brain kinetic modeling of the novel PDE10A tracer (18)F-JNJ-42259152 (2-[[4-[1-(2-(18)F-fluoroethyl)-4-(4-pyridinyl)-1H-pyrazol-3-yl]phenoxy]methyl]-3,5-dimethyl-pyridine) and studied test-retest reproducibility in healthy volunteers. Twelve healthy volunteers (5 men, 7 women; age range, 42-77 y) were scanned dynamically up to 135 min after bolus injection of 172.5 ± 10.3 MBq of (18)F-JNJ42259152. Four volunteers (2 men, 2 women) underwent retest scanning, with a mean interscan interval of 37 d. Input functions and tracer parent fractions were determined using arterial sampling and high-performance liquid chromatography analysis. Volumes of interest for the putamen, caudate nucleus, ventral striatum, substantia nigra, thalamus, frontal cortex, and cerebellum were delineated using individual volumetric T1 MR imaging scans. One-tissue (1T) and 2-tissue (2T) models were evaluated to calculate total distribution volume (VT). Simplified models were also tested to calculate binding potential (BPND), including the simplified reference tissue model (SRTM) and multilinear reference tissue model, using the frontal cortex as the optimal reference tissue. The stability of VT and BPND was assessed down to a 60-min scan time. The average intact tracer half-life in blood was 90 min. The 2T model VT values for the putamen, caudate nucleus, ventral striatum, substantia nigra, thalamus, frontal cortex, and cerebellum were 1.54 ± 0.37, 0.90 ± 0.24, 0.64 ± 0.18, 0.42 ± 0.09, 0.35 ± 0.09, 0.30 ± 0.07, and 0.36 ± 0.12, respectively. The 1T model provided significantly lower VT values, which were well correlated to the 2T VT. SRTM BPND values referenced to the frontal cortex were 3.45 ± 0.43, 1.78 ± 0.35, 1.10 ± 0.31, and 0.44 ± 0.09 for the respective target regions putamen, caudate nucleus, ventral striatum, and substantia nigra, with similar values for the multilinear reference tissue model. Good correlations were found for the target regions putamen, caudate nucleus, ventral striatum, and substantia nigra between the 2T-compartment model BPND and the SRTM BPND (r = 0.57, 0.82, 0.70, and 0.64, respectively). SRTM BPND using a 90- and 60-min acquisition interval showed low bias. Test-retest variability was 5%-19% for 2T VT and 5%-12% for BPND SRTM. Kinetic modeling of (18)F-JNJ-42259152 shows that PDE10A activity can be reliably quantified and simplified using a reference tissue model with the frontal cortex as reference and a 60-min acquisition period.

Hand volume estimates based on a geometric algorithm in comparison to water displacement.

PubMed

Mayrovitz, H N; Sims, N; Hill, C J; Hernandez, T; Greenshner, A; Diep, H

2006-06-01

Assessing changes in upper extremity limb volume during lymphedema therapy is important for determining treatment efficacy and documenting outcomes. Although arm volumes may be determined by tape measure, the suitability of circumference measurements to estimate hand volumes is questionable because of the deviation in circularity of hand shape. Our aim was to develop an alternative measurement procedure and algorithm for routine use to estimate hand volumes. A caliper was used to measure hand width and depth in 33 subjects (66 hands) and volumes (VE) were calculated using an elliptical frustum model. Using regression analysis and limits of agreement (LOA), VE was compared to volumes determined by water displacement (VW), to volumes calculated from tape-measure determined circumferences (VC), and to a trapezoidal model (VT). VW and VE (mean +/- SD) were similar (363 +/- 98 vs. 362 +/-100 ml) and highly correlated; VE = 1.01VW -3.1 ml, r=0.986, p<0.001, with LOA of +/- 33.5 ml and +/- 9.9 %. In contrast, VC (480 +/- 138 ml) and VT (432 +/- 122 ml) significantly overestimated volume (p<0.0001). These results indicate that the elliptical algorithm can be a useful alternative to water displacement when hand volumes are needed and the water displacement method is contra-indicated, impractical to implement, too time consuming or not available.

Genetics of Venous Thrombosis: Insights from a New Genome Wide Association Study

PubMed Central

Germain, Marine; Saut, Noémie; Greliche, Nicolas; Dina, Christian; Lambert, Jean-Charles; Perret, Claire; Cohen, William; Oudot-Mellakh, Tiphaine; Antoni, Guillemette; Alessi, Marie-Christine; Zelenika, Diana; Cambien, François; Tiret, Laurence; Bertrand, Marion; Dupuy, Anne-Marie; Letenneur, Luc; Lathrop, Mark; Emmerich, Joseph; Amouyel, Philippe; Trégouët, David-Alexandre; Morange, Pierre-Emmanuel

2011-01-01

Background Venous Thrombosis (VT) is a common multifactorial disease associated with a major public health burden. Genetics factors are known to contribute to the susceptibility of the disease but how many genes are involved and their contribution to VT risk still remain obscure. We aimed to identify genetic variants associated with VT risk. Methodology/Principal Findings We conducted a genome-wide association study (GWAS) based on 551,141 SNPs genotyped in 1,542 cases and 1,110 controls. Twelve SNPs reached the genome-wide significance level of 2.0×10−8 and encompassed four known VT-associated loci, ABO, F5, F11 and FGG. By means of haplotype analyses, we also provided novel arguments in favor of a role of HIVEP1, PROCR and STAB2, three loci recently hypothesized to participate in the susceptibility to VT. However, no novel VT-associated loci came out of our GWAS. Using a recently proposed statistical methodology, we also showed that common variants could explain about 35% of the genetic variance underlying VT susceptibility among which 3% could be attributable to the main identified VT loci. This analysis additionally suggested that the common variants left to be identified are not uniformly distributed across the genome and that chromosome 20, itself, could contribute to ∼7% of the total genetic variance. Conclusions/Significance This study might also provide a valuable source of information to expand our understanding of biological mechanisms regulating quantitative biomarkers for VT. PMID:21980494

Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis.

PubMed

Serpa Neto, Ary; Hemmes, Sabrine N T; Barbas, Carmen S V; Beiderlinden, Martin; Biehl, Michelle; Binnekade, Jan M; Canet, Jaume; Fernandez-Bustamante, Ana; Futier, Emmanuel; Gajic, Ognjen; Hedenstierna, Göran; Hollmann, Markus W; Jaber, Samir; Kozian, Alf; Licker, Marc; Lin, Wen-Qian; Maslow, Andrew D; Memtsoudis, Stavros G; Reis Miranda, Dinis; Moine, Pierre; Ng, Thomas; Paparella, Domenico; Putensen, Christian; Ranieri, Marco; Scavonetto, Federica; Schilling, Thomas; Schmid, Werner; Selmo, Gabriele; Severgnini, Paolo; Sprung, Juraj; Sundar, Sugantha; Talmor, Daniel; Treschan, Tanja; Unzueta, Carmen; Weingarten, Toby N; Wolthuis, Esther K; Wrigge, Hermann; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

2015-07-01

Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Randomized controlled trials comparing protective ventilation (low VT with or without high levels of PEEP) and conventional ventilation (high VT with low PEEP) in patients undergoing general surgery. The primary outcome was development of PPC. Predefined prognostic factors were tested using multivariate logistic regression. Fifteen randomized controlled trials were included (2,127 patients). There were 97 cases of PPC in 1,118 patients (8.7%) assigned to protective ventilation and 148 cases in 1,009 patients (14.7%) assigned to conventional ventilation (adjusted relative risk, 0.64; 95% CI, 0.46 to 0.88; P < 0.01). There were 85 cases of PPC in 957 patients (8.9%) assigned to ventilation with low VT and high PEEP levels and 63 cases in 525 patients (12%) assigned to ventilation with low VT and low PEEP levels (adjusted relative risk, 0.93; 95% CI, 0.64 to 1.37; P = 0.72). A dose-response relationship was found between the appearance of PPC and VT size (R2 = 0.39) but not between the appearance of PPC and PEEP level (R2 = 0.08). These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.

Impact of Different Ventilation Strategies on Driving Pressure, Mechanical Power, and Biological Markers During Open Abdominal Surgery in Rats.

PubMed

Maia, Lígia de A; Samary, Cynthia S; Oliveira, Milena V; Santos, Cintia L; Huhle, Robert; Capelozzi, Vera L; Morales, Marcelo M; Schultz, Marcus J; Abreu, Marcelo G; Pelosi, Paolo; Silva, Pedro L; Rocco, Patricia Rieken Macedo

2017-10-01

Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery. Thirty-five Wistar rats were used, of which 28 were anesthetized, and a laparotomy was performed with standardized bowel manipulation. Postoperatively, animals (n = 7/group) were randomly assigned to 4 hours of ventilation with: (1) tidal volume (VT) = 7 mL/kg and positive end-expiratory pressure (PEEP) = 1 cm H2O without recruitment maneuvers (RMs) (low VT/low PEEP/RM-), mimicking the low-VT/low-PEEP strategy of PROVHILO; (2) VT = 7 mL/kg and PEEP = 3 cm H2O with RMs before laparotomy and hourly thereafter (low VT/moderate PEEP/4 RM+), mimicking the protective ventilation strategy of IMPROVE; (3) VT = 7 mL/kg and PEEP = 6 cm H2O with RMs only before laparotomy (low VT/high PEEP/1 RM+), mimicking the strategy used after intubation and before extubation in PROVHILO; or (4) VT = 14 mL/kg and PEEP = 1 cm H2O without RMs (high VT/low PEEP/RM-), mimicking conventional ventilation used in IMPROVE. Seven rats were not tracheotomized, operated, or mechanically ventilated, and constituted the healthy nonoperated and nonventilated controls. Low VT/moderate PEEP/4 RM+ and low VT/high PEEP/1 RM+, compared to low VT/low PEEP/RM- and high VT/low PEEP/RM-, resulted in lower ΔPRS (7.1 ± 0.8 and 10.2 ± 2.1 cm H2O vs 13.9 ± 0.9 and 16.9 ± 0.8 cm H2O, respectively; P< .001) and less mechanical power (63 ± 7 and 79 ± 20 J/min vs 110 ± 10 and 120 ± 20 J/min, respectively; P = .007). Low VT/high PEEP/1 RM+ was associated with less alveolar collapse than low VT/low PEEP/RM- (P = .03). E-cadherin expression was higher in low VT/moderate PEEP/4 RM+ than in low VT/low PEEP/RM- (P = .013) or high VT/low PEEP/RM- (P = .014). The extent of alveolar collapse, E-cadherin expression, and tumor necrosis factor-alpha correlated with ΔPRS (r = 0.54 [P = .02], r = -0.48 [P = .05], and r = 0.59 [P = .09], respectively) and mechanical power (r = 0.57 [P = .02], r = -0.54 [P = .02], and r = 0.48 [P = .04], respectively). In this model of open abdominal surgery based on the mechanical ventilation strategies used in IMPROVE and PROVHILO trials, lower mechanical power and its surrogate ΔPRS were associated with reduced lung damage.

INDUSTRIAL RADIOGRAPHY COURSE, INSTRUCTORS' GUIDE. VOLUME 2.

ERIC Educational Resources Information Center

Texas A and M Univ., College Station. Engineering Extension Service.

INFORMATION RELATIVE TO THE LESSON PLANS IN "INDUSTRIAL RADIOGRAPHY COURSE, INSTRUCTOR'S GUIDE, VOLUME I" (VT 003 565) IS PRESENTED ON 52 INFORMATION SHEETS INCLUDING THE SUBJECTS SHIELDING EQUATIONS AND LOGARITHMS, METAL PROPERTIES, FIELD TRIP INSTRUCTIONS FOR STUDENTS, WELDING SYMBOLS AND SIZES, SAMPLE REPORT FORMS, AND TYPICAL SHIPPING…

How absolute EIT reflects the dependence of unilateral lung aeration on hyper-gravity and weightlessness?

PubMed

Hahn, G; Just, A; Hellige, G; Dittmar, J; Quintel, M

2013-09-01

We studied the influence of three gravity levels (0, 1 and 1.8 g) on unilateral lung aeration in a left lateral position by the application of absolute electrical impedance tomography. The electrical resistivity of the lung tissue was considered to be a meaningful indicator for lung aeration since changes in resistivity have already been validated in other studies to be proportional to changes in lung volume. Twenty-two healthy volunteers were studied during parabolic flights with three phases of different gravity, each lasting ∼20-22 s. Spontaneous breathing at normal tidal volume VT and at increased VT was performed. During transition to hyper-gravity mean expiratory resistivities (±SD in Ωm) increased at normal VT in the upper (right) lung from 7.6 ± 1.5 to 8.0 ± 1.7 and decreased from 5.8 ± 1.2 to 5.7 ± 1.2 in the lower (left) lung. Inspiratory resistivity values are 8.3 ± 1.6 to 8.8 ± 1.8 (right) and 6.3 ± 1.3 to 6.0 ± 1.3 (left). At increased VT, the changes in resistivities at end-expiration were 7.7 ± 1.5 to 8.0 ± 1.7 (right) and 5.8 ± 1.2 to 5.7 ± 1.2 (left). Corresponding end-inspiratory values are 9.9 ± 1.9 to 10.0 ± 2.0 (right) and 8.6 ± 2.1 to 7.9 ± 2.0 (left). During weightlessness, the distortion in the lungs disappeared and both lungs showed a nearly identical aeration, which was between the levels displayed at normal gravity. The small increase in resistivity for the upper lung during transition to hyper-gravity from 1 to 1.8 g at increased VT suggests that the degressive part of the pressure-volume curve has already been reached at end-inspiration. The results for a left lateral position are in agreement with West's lung model which has been introduced for cranio-caudal gravity dependence in the lungs.

Central and peripheral effects of the non-neural substances on respiration before and after vagotomy.

PubMed

Sahin, G; Oruç, T; Simşek, G; Güner, I

1997-08-01

The central effects of capsaicin, veratrine, histamine and bradykinin were studied by injecting them directly into the oerebrospinal fluid and their peripheral effects were examined by injecting into femoral vein. Our experiments were performed in Na-pentobarbital-anaesthetized dogs. Tidal volume (VT), respiratory frequency (f/min), systemic arterial pressure (BP) were recorded. A significant increase in f, and an initial apnea or hypoventilation followed by a significant increase in VT were observed with central and peripheral capsaicin. Vagotomy removed the peripheral VT response, but not the central one. While central capsaicin administration increased BP, peripheral administration decreased. After vagotomy, a significant increase was observed in BP for both administrations. Respiratory responses to central and peripheral administrations of veratrine were similar to those of capsaicin. Significant increases were observed in f and VT of the intact group in response to central and peripheral administration of histamine. Response to peripheral administration disappeared after vagotomy. While central and peripheral bradykinin increased VT significantly, there was no significant change in f. Vagotomy only removed the increase in VT in response to peripheral administration. In conclusion, respiratory responses to central administration of capsaicin and veratrine are due to direct effects of these substances on respiratory neurons. In peripheral administration, disappearance of the responses after vagotomy indicate that the responses are brought about by stimulation of the lung receptors.

The effect of helium on ventilator performance: study of five ventilators and a bedside Pitot tube spirometer.

PubMed

Oppenheim-Eden, A; Cohen, Y; Weissman, C; Pizov, R

2001-08-01

To assess in vitro the performance of five mechanical ventilators-Siemens 300 and 900C (Siemens-Elma; Solna, Sweden), Puritan Bennett 7200 (Nellcor Puritan Bennett; Pleasanton, CA), Evita 4 (Dragerwerk; Lubeck, Germany), and Bear 1000 (Bear Medical Systems; Riverside CA)-and a bedside sidestream spirometer (Datex CS3 Respiratory Module; Datex-Ohmeda; Helsinki, Finland) during ventilation with helium-oxygen mixtures. In vitro study. ICUs of two university-affiliated hospitals. Each ventilator was connected to 100% helium through compressed air inlets and then tested at three to six different tidal volume (VT) settings using various helium-oxygen concentrations (fraction of inspired oxygen [FIO(2)] of 0.2 to 1.0). FIO(2) and VT were measured with the Datex CS3 spirometer, and VT was validated with a water-displacement spirometer. The Puritan Bennett 7200 ventilator did not function with helium. With the other four ventilators, delivered FIO(2) was lower than the set FIO(2). For the Siemens 300 and 900C ventilators, this difference could be explained by the lack of 21% oxygen when helium was connected to the air supply port, while for the other two ventilators, a nonlinear relation was found. The VT of the Siemens 300 ventilator was independent of helium concentration, while for the other three ventilators, delivered VT was greater than the set VT and was dependent on helium concentration. During ventilation with 80% helium and 20% oxygen, VT increased to 125% of set VT for the Siemens 900C ventilator, and more than doubled for the Evita 4 and Bear 1000 ventilators. Under the same conditions, the Datex CS3 spirometer underestimated the delivered VT by about 33%. At present, no mechanical ventilator is calibrated for use with helium. This investigation offers correction factors for four ventilators for ventilation with helium.

OCCUPATIONAL EDUCATION--PLANNING AND PROGRAMMING. VOLUME TWO.

ERIC Educational Resources Information Center

KOTZ, ARNOLD

ADDITIONAL POSITION PAPERS BASED ON INFORMATION GATHERED IN THE RECONNAISSANCE SURVEYS OF PLANNING AND PROGRAMING IN OCCUPATIONAL EDUCATION, REPORTED IN VOLUME ONE (VT 005 041), ARE PRESENTED. PART IV, CONCERNED WITH PROGRAM STRUCTURE AND BUDGETING AND THEIR RELATION TO THE PLANNING PROCESS, INCLUDES THE PAPERS--(1) "CURRENT POLICIES AND…

PARAVT: Parallel Voronoi tessellation code

NASA Astrophysics Data System (ADS)

González, R. E.

2016-10-01

In this study, we present a new open source code for massive parallel computation of Voronoi tessellations (VT hereafter) in large data sets. The code is focused for astrophysical purposes where VT densities and neighbors are widely used. There are several serial Voronoi tessellation codes, however no open source and parallel implementations are available to handle the large number of particles/galaxies in current N-body simulations and sky surveys. Parallelization is implemented under MPI and VT using Qhull library. Domain decomposition takes into account consistent boundary computation between tasks, and includes periodic conditions. In addition, the code computes neighbors list, Voronoi density, Voronoi cell volume, density gradient for each particle, and densities on a regular grid. Code implementation and user guide are publicly available at https://github.com/regonzar/paravt.

Dead space and slope indices from the expiratory carbon dioxide tension-volume curve.

PubMed

Kars, A H; Bogaard, J M; Stijnen, T; de Vries, J; Verbraak, A F; Hilvering, C

1997-08-01

The slope of phase 3 and three noninvasively determined dead space estimates derived from the expiratory carbon dioxide tension (PCO2) versus volume curve, including the Bohr dead space (VD,Bohr), the Fowler dead space (VD,Fowler) and pre-interface expirate (PIE), were investigated in 28 healthy control subjects, 12 asthma and 29 emphysema patients (20 severely obstructed and nine moderately obstructed) with the aim to establish diagnostic value. Because breath volume and frequency are closely related to CO2 elimination, the recording procedures included varying breath volumes in all subjects during self-chosen/natural breathing frequency, and fixed frequencies of 10, 15 and 20 breaths x min(-1) with varying breath volumes only in the healthy controls. From the relationships of the variables with tidal volume (VT), the values at 1 L were estimated to compare the groups. The slopes of phase 3 and VD,Bohr at 1 L VT showed the most significant difference between controls and patients with asthma or emphysema, compared to the other two dead space estimates, and were related to the degree of airways obstruction. Discrimination between no-emphysema (asthma and controls) and emphysema patients was possible on the basis of a plot of intercept and slope of the relationship between VD,Bohr and VT. A combination of both the slope of phase 3 and VD,Bohr of a breath of 1 L was equally discriminating. The influence of fixed frequencies in the controls did not change the results. The conclusion is that Bohr dead space in relation to tidal volume seems to have diagnostic properties separating patients with asthma from patients with emphysema with the same degree of airways obstruction. Equally discriminating was a combination of both phase 3 and Bohr dead space of a breath of 1 L. The different pathophysiological mechanisms in asthma and emphysema leading to airways obstruction are probably responsible for these results.

Contemporary ventilator management in patients with and at risk of ALI/ARDS.

PubMed

Chang, Steven Y; Dabbagh, Ousama; Gajic, Ognen; Patrawalla, Amee; Elie, Marie-Carmelle; Talmor, Daniel S; Malhotra, Atul; Adesanya, Adebola; Anderson, Harry L; Blum, James M; Park, Pauline K; Gong, Michelle Ng

2013-04-01

Ventilator practices in patients at risk for acute lung injury (ALI) and ARDS are unclear. We examined factors associated with choice of set tidal volumes (VT), and whether VT < 8 mL/kg predicted body weight (PBW) relates to the development of ALI/ARDS. We performed a secondary analysis of a multicenter cohort of adult subjects at risk of lung injury with and without ALI/ARDS at onset of invasive ventilation. Descriptive statistics were used to describe ventilator practices in specific settings and ALI/ARDS risk groups. Logistic regression analysis was used to determine the factors associated with the use of VT < 8 mL/kg PBW and the relationship of VT to ALI/ARDS development and outcome. Of 829 mechanically ventilated patients, 107 met the criteria for ALI/ARDS at time of intubation, and 161 developed ALI/ARDS after intubation (post-intubation ALI/ARDS). There was significant intercenter variability in initial ventilator settings, and in the incidence of ALI/ARDS and post-intubation ALI/ARDS. The median VT was 7.96 (IQR 7.14-8.94) mL/kg PBW in ALI/ARDS subjects, and 8.45 (IQR 7.50-9.55) mL/kg PBW in subjects without ALI/ARDS (P = .004). VT decreased from 8.40 (IQR 7.38-9.37) mL/kg PBW to 7.97 (IQR 6.90-9.23) mL/kg PBW (P < .001) in those developing post-intubation ALI/ARDS. Among subjects without ALI/ARDS, VT ≥ 8 mL/kg PBW was associated with shorter height and higher body mass index, while subjects with pneumonia were less likely to get ≥ 8 mL/kg PBW. Initial VT ≥ 8 mL/kg PBW was not associated with the post-intubation ALI/ARDS (adjusted odds ratio 1.30, 95% CI 0.74-2.29) or worse outcomes. Post-intubation ALI/ARDS subjects had mortality similar to subjects intubated with ALI/ARDS. Clinicians seem to respond to ALI/ARDS with lower initial VT. Initial VT, however, was not associated with the development of post-intubation ALI/ARDS or other outcomes.

Are tidal volume measurements in neonatal pressure-controlled ventilation accurate?

PubMed

Chow, Lily C; Vanderhal, Andre; Raber, Jorge; Sola, Augusto

2002-09-01

Bedside pulmonary mechanics monitors (PMM) have become useful in ventilatory management in neonates. These monitors are used more frequently due to recent improvements in data-processing capabilities. PMM devices are often part of the ventilator or are separate units. The accuracy and reliability of these systems have not been carefully evaluated. We compared a single ventilatory parameter, tidal volume (V(t)), as measured by several systems. We looked at two freestanding PMMs: the Ventrak Respiratory Monitoring System (Novametrix, Wallingford, CT) and the Bicore CP-100 Neonatal Pulmonary Monitor (Allied Health Care Products, Riverside, CA), and three ventilators with built-in PMM: the VIP Bird Ventilator (Bird Products Corp., Palm Springs, CA), Siemens Servo 300A (Siemens-Elema AB, Solna, Sweden), and Drager Babylog 8000 (Drager, Inc., Chantilly, VA). A calibrated syringe (Hans Rudolph, Inc., Kansas City, MO) was used to deliver tidal volumes of 4, 10, and 20 mL to each ventilator system coupled with a freestanding PMM. After achieving steady state, six consecutive V(t) readings were taken simultaneously from the freestanding PMM and each ventilator. In a second portion of the bench study, we used pressure-control ventilation and measured exhaled tidal volume (V(te)) while ventilating a Bear Test Lung with the same three ventilators. We adjusted peak inspiratory pressure (PIP) under controlled conditions to achieve the three different targeted tidal volumes on the paired freestanding PMM. Again, six V(te) measurements were recorded for each tidal volume. Means and standard deviations were calculated.The percentage difference in measurement of V(t) delivered by calibrated syringe varied greatly, with the greatest discrepancy seen in the smallest tidal volumes, by up to 28%. In pressure control mode, V(te) as measured by the Siemens was significantly overestimated by 20-95%, with the biggest discrepancy at the smallest V(te), particularly when paired with the Bicore PMM. V(te), as measured by the VIP Bird and Drager paired with the Ventrak PMM, had a tendency to underestimate V(t) by up to 25% at the smallest V(te). However, when paired with the Bicore PMM, these same two ventilators read over target by up to 18%. Under controlled laboratory conditions, we demonstrated that true delivered V(te), as measured by the three ventilators and two freestanding PMM, differed markedly. In general, decreasing dynamic compliance of the tubing was not associated with greater inaccuracy in V(te) measurements. Copyright 2002 Wiley-Liss, Inc.

Meningiomas: A Comparative Study of 68Ga-DOTATOC, 68Ga-DOTANOC and 68Ga-DOTATATE for Molecular Imaging in Mice

PubMed Central

Soto-Montenegro, María Luisa; Peña-Zalbidea, Santiago; Mateos-Pérez, Jose María; Oteo, Marta; Romero, Eduardo; Morcillo, Miguel Ángel; Desco, Manuel

2014-01-01

Purpose The goal of this study was to compare the tumor uptake kinetics and diagnostic value of three 68Ga-DOTA-labeled somatostatin analogues (68Ga-DOTATOC, 68Ga-DOTANOC, and 68Ga-DOTATATE) using PET/CT in a murine model with subcutaneous meningioma xenografts. Methods The experiment was performed with 16 male NUDE NU/NU mice bearing xenografts of a human meningioma cell line (CH-157MN). 68Ga-DOTATOC, 68Ga-DOTANOC, and 68Ga-DOTATATE were produced in a FASTLab automated platform. Imaging was performed on an Argus small-animal PET/CT scanner. The SUVmax of the liver and muscle, and the tumor-to-liver (T/L) and tumor-to-muscle (T/M) SUV ratios were computed. Kinetic analysis was performed using Logan graphical analysis for a two-tissue reversible compartmental model, and the volume of distribution (Vt) was determined. Results Hepatic SUVmax and Vt were significantly higher with 68Ga-DOTANOC than with 68Ga-DOTATOC and 68Ga-DOTATATE. No significant differences between tracers were found for SUVmax in tumor or muscle. No differences were found in the T/L SUV ratio between 68Ga-DOTATATE and 68Ga-DOTATOC, both of which had a higher fraction than 68Ga-DOTANOC. The T/M SUV ratio was significantly higher with 68Ga-DOTATATE than with 68Ga-DOTATOC and 68Ga-DOTANOC. The Vt for tumor was higher with 68Ga-DOTATATE than with 68Ga-DOTANOC and relatively similar to that of 68Ga-DOTATOC. Conclusions This study demonstrates, for the first time, the ability of the three radiolabeled somatostatin analogues tested to image a human meningioma cell line. Although Vt was relatively similar with 68Ga-DOTATATE and 68Ga-DOTATOC, uptake was higher with 68Ga-DOTATATE in the tumor than with 68Ga-DOTANOC and 68Ga-DOTATOC, suggesting a higher diagnostic value of 68Ga-DOTATATE for detecting meningiomas. PMID:25369268

Evaluation of the sensitivity of the novel α4β2* nicotinic acetylcholine receptor PET radioligand 18F-(-)-NCFHEB to increases in synaptic acetylcholine levels in rhesus monkeys.

PubMed

Gallezot, Jean-Dominique; Esterlis, Irina; Bois, Frederic; Zheng, Ming-Qiang; Lin, Shu-Fei; Kloczynski, Tracy; Krystal, John H; Huang, Yiyun; Sabri, Osama; Carson, Richard E; Cosgrove, Kelly P

2014-11-01

18F-(-)-NCFHEB (also known as 18F-(-)-Flubatine) is a new radioligand to image α4β2* nicotinic acetylcholine receptors in vivo with positron emission tomography (PET), with faster kinetics than previous radioligands such as 18F-2-F-A85380. The goal of this study was to assess the sensitivity of 18F-(-)-NCFHEB-PET to increases in synaptic acetylcholine concentration induced by acetylcholinesterase inhibitors. Two rhesus monkeys were scanned four times each on a Focus 220 scanner: first at baseline, then during two bolus plus infusions of physostigmine (0.06-0.28 mg/kg), and finally following a bolus injection of donepezil (0.25 mg/kg). The arterial input function and the plasma free fraction fP were measured. 18F-(-)-NCFHEB volume of distribution VT was estimated using the multilinear analysis MA1 and then normalized by plasma free fraction fP . 18F-(-)-NCFHEB fP was 0.89±0.04. At baseline, 18F-(-)-NCFHEB VT /fP ranged from 7.9±1.3 mL plasma/cm3 tissue in the cerebellum to 34.3±8.4 mL plasma/cm3 tissue in the thalamus. Physostigmine induced a dose-dependent reduction of 18F-(-)-NCFHEB VT /fP of 34±9% in the putamen, 32±8% in the thalamus, 25±8% in the cortex, and 23±10% in the hippocampus. With donepezil, 18F-(-)-NCFHEB VT /fP was reduced by 24±2%, 14+3% and 14±5%, 10±6% in the same regions. 18F-(-)-NCFHEB can be used to detect changes in synaptic acetylcholine concentration and is a promising tracer to study acetylcholine dynamics with shorter scan durations than previous radioligands. © 2014 Wiley Periodicals, Inc.

Driving pressure and survival in the acute respiratory distress syndrome.

PubMed

Amato, Marcelo B P; Meade, Maureen O; Slutsky, Arthur S; Brochard, Laurent; Costa, Eduardo L V; Schoenfeld, David A; Stewart, Thomas E; Briel, Matthias; Talmor, Daniel; Mercat, Alain; Richard, Jean-Christophe M; Carvalho, Carlos R R; Brower, Roy G

2015-02-19

Mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, lower tidal volumes (VT), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS), but the relative importance of each of these components is uncertain. Because respiratory-system compliance (CRS) is strongly related to the volume of aerated remaining functional lung during disease (termed functional lung size), we hypothesized that driving pressure (ΔP=VT/CRS), in which VT is intrinsically normalized to functional lung size (instead of predicted lung size in healthy persons), would be an index more strongly associated with survival than VT or PEEP in patients who are not actively breathing. Using a statistical tool known as multilevel mediation analysis to analyze individual data from 3562 patients with ARDS enrolled in nine previously reported randomized trials, we examined ΔP as an independent variable associated with survival. In the mediation analysis, we estimated the isolated effects of changes in ΔP resulting from randomized ventilator settings while minimizing confounding due to the baseline severity of lung disease. Among ventilation variables, ΔP was most strongly associated with survival. A 1-SD increment in ΔP (approximately 7 cm of water) was associated with increased mortality (relative risk, 1.41; 95% confidence interval [CI], 1.31 to 1.51; P<0.001), even in patients receiving "protective" plateau pressures and VT (relative risk, 1.36; 95% CI, 1.17 to 1.58; P<0.001). Individual changes in VT or PEEP after randomization were not independently associated with survival; they were associated only if they were among the changes that led to reductions in ΔP (mediation effects of ΔP, P=0.004 and P=0.001, respectively). We found that ΔP was the ventilation variable that best stratified risk. Decreases in ΔP owing to changes in ventilator settings were strongly associated with increased survival. (Funded by Fundação de Amparo e Pesquisa do Estado de São Paulo and others.).

Functional differences in bi-level pressure preset ventilators.

PubMed

Highcock, M P; Shneerson, J M; Smith, I E

2001-02-01

The performance of four bilevel positive pressure preset ventilators was compared. The ventilators tested were; BiPAP ST30 (Respironics); Nippy2 (B + D Electrical); Quantum PSV (Healthdyne); and Sullivan VPAP H ST (Resmed). A patient simulator was used to determine the sensitivity of the triggering mechanisms and the responses to a leak within the patient circuit, and to changes in patient effort. Significant differences (p <0.05) between the devices were seen in the trigger delay time and inspiratory trigger pressure. When a leak was introduced into the patient circuit, the fall in tidal volume (VT) was less than ten per cent for each ventilator. The addition of patient effort produced a number of changes in the ventilation delivered. Patient efforts of 0.25 s induced a variable fall in VT. An increase in VT was seen with some ventilators with patient efforts of 1 s but the effect was variable. Trigger failures and subsequent falls in minute volume were seen with the BiPAP and the Nippy2 at the highest respiratory frequency. Differences in the responses of the ventilators are demonstrated that may influence the selection of a ventilator, particularly in the treatment of breathless patients with ventilatory failure.

Evaluation in Monkey of Two Candidate PET Radioligands, [11C]RX-1 and [18F]RX-2, for Imaging Brain 5-HT4 Receptors

PubMed Central

LOHITH, TALAKAD G.; XU, RONG; TSUJIKAWA, TETSUYA; MORSE, CHERYL L.; ANDERSON, KACEY B.; GLADDING, ROBERT L.; ZOGHBI, SAMI S.; FUJITA, MASAHIRO; INNIS, ROBERT B.; PIKE, VICTOR W.

2014-01-01

The serotonin subtype-4 (5-HT4) receptor, which is known to be involved physiologically in learning and memory, and pathologically in Alzheimer’s disease, anxiety and other neuropsychiatric disorders – has few radioligands readily available for imaging in vivo. We have previously reported two novel 5-HT4 receptor radioligands, namely [methoxy-11C](1-butylpiperidin-4-yl)methyl 4-amino-3-methoxybenzoate; [11C]RX-1) and the [18F]3-fluoromethoxy analog ([18F]RX-2), and in this study we evaluated them by PET in rhesus monkey. Brain scans were performed at baseline, receptor preblock or displacement conditions using SB 207710, a 5-HT4 receptor antagonist, on the same day for [11C]RX-1 and on different days for [18F]RX-2. Specific-to-nondisplaceable ratio (BPND) was measured with the simplified reference tissue model from all baseline scans. To determine specific binding, total distribution volume (VT) was also measured in some monkeys by radiometabolite-corrected arterial input function after ex vivo inhibition of esterases from baseline and blocked scans. Both radioligands showed moderate to high peak brain uptake of radioactivity (2–6 SUV). Regional BPND values were in the rank order of known 5-HT4 receptor distribution with a trend for higher BPND values from [18F]RX-2. One-tissue compartmental model provided good fits with well identified VT values for both radioligands. In the highest 5-HT4 receptor density region, striatum, 50–60% of total binding was specific. The VT in receptor-poor cerebellum reached stable values by about 60 min for both radioligands indicating little influence of radiometabolites on brain signal. In conclusion, both [11C]RX-1 and [18F]RX-2 showed positive attributes for PET imaging of brain 5-HT4 receptors, validating the radioligand design strategy. PMID:25088028

Volcano-tectonic earthquakes: A new tool for estimating intrusive volumes and forecasting eruptions

USGS Publications Warehouse

White, Randall A.; McCausland, Wendy

2016-01-01

Notable cases in which distal VT events preceded eruptions at long-dormant volcanoes include: Nevado del Ruiz (1984–1985), Pinatubo (1991), Unzen (1989–1995), Soufriere Hills (1995), Shishaldin (1989–1999), Tacana' (1985–1986), Pacaya (1980–1984), Rabaul (1994), and Cotopaxi (2001). Additional cases are recognized at frequently active volcanoes including Popocateptl (2001–2003) and Mauna Loa (1984). We present four case studies (Pinatubo, Soufriere Hills, Unzen, and Tacana') in which we demonstrate the above mentioned VT characteristics prior to eruptions. Using regional data recorded by NEIC, we recognized in near-real time that a huge distal VT swarm was occurring, deduced that a proportionately huge magmatic intrusion was taking place beneath the long dormant Sulu Range, New Britain Island, Papua New Guinea, that it was likely to lead to eruptive activity, and warned Rabaul Volcano Observatory days before a phreatic eruption occurred. This confirms the value of this technique for eruption forecasting. We also present a counter-example where we deduced that a VT swarm at Volcan Cosiguina, Nicaragua, indicated a small intrusion, insufficient to reach the surface and erupt. Finally, we discuss limitations of the method and propose a mechanism by which this distal VT seismicity is triggered by magmatic intrusion.

ONR Far East Scientific Bulletin. Volume 11, Number 2.

DTIC Science & Technology

1986-06-01

the following subjects: the consequences of increasing CO 2 in the atmosphere, the exchange rate of chemical substances between the ocean and the...characteristics for emitter-common at 77 K is shown. The current amplication factor Bof 3.8 was obtained. This is expected to increase further by reduction of the...mS/V mm. The gate sustaining voltage (-BVGD) is seen to decrease as the n’ dose is increased . ’ ith L =0.8 um devices, Gm=250 mS/mm, VT=O.l V and aVT

Influence of Training Load and Altitude on HRV Fatigue Patterns in Elite Nordic Skiers.

PubMed

Schmitt, Laurent; Regnard, Jacques; Coulmy, Nicolas; Millet, Gregoire P

2018-06-14

We aimed to analyse the relationship between training load/intensity and different heart rate variability (HRV) fatigue patterns in 57 elite Nordic-skiers. 1063 HRV tests were performed during 5 years. R-R intervals were recorded in resting supine (SU) and standing (ST) positions. Heart rate, low (LF), high (HF) frequency powers of HRV were determined. Training volume, training load (TL, a.u.) according to ventilatory threshold 1 (VT1) and VT2 were measured in zones I≤VT1; VT1VT2, IV for strength. TL was performed at 81.6±3.5% in zone I, 0.9±0.9% in zone II, 5.0±3.6% in zone III, 11.6±6.3% in zone IV. 172 HRV tests matched a fatigue state and four HRV fatigue patterns (F) were statistically characterized as F(HF-LF-)SU_ST for 121 tests, F(LF+SULF-ST) for 18 tests, F(HF-SUHF+ST) for 26 tests and F(HF+SU) for 7 tests. The occurrence of fatigue states increased substantially with the part of altitude training time (r2=0.52, p<0.001). This study evidenced that there is no causal relationship between training load/intensity and HRV fatigue patterns. Four fatigue-shifted HRV patterns were sorted. Altitude training periods appeared critical as they are likely to increase the overreaching risks. © Georg Thieme Verlag KG Stuttgart · New York.

PITTSBURGH TECHNICAL HEALTH TRAINING INSTITUTE DEMONSTRATION PROJECT. FINAL REPORT, VOLUME II.

ERIC Educational Resources Information Center

KISHKUNAS, LOUIS J.

APPENDIXES TO THE "FINAL REPORT," VOLUME I (VT 005 511), ARE INCLUDED--(1) A SCHEMATIC REPRESENTATION OF CURRICULUM DEVELOPMENT, (2) TECHNICAL BEHAVIOR CHECKLISTS, (3) PERFORMANCE INVENTORY FORMS USED IN ON-THE-JOB OBSERVATIONS, (4) REPORT FORM FOR TYPICAL JOB BEHAVIOR OF EMPLOYEE, (5) COOPERATING AREA HEALTH INSTITUTIONS, (6) TABLES OF Z SCORES…

Application of dead space fraction to titrate optimal positive end-expiratory pressure in an ARDS swine model.

PubMed

Bian, Weishuai; Chen, Wei; Chao, Yangong; Wang, Lan; Li, Liming; Guan, Jian; Zang, Xuefeng; Zhen, Jie; Sheng, Bo; Zhu, Xi

2017-04-01

This study aimed to apply the dead space fraction [ratio of dead space to tidal volume (VD/VT)] to titrate the optimal positive end-expiratory pressure (PEEP) in a swine model of acute respiratory distress syndrome (ARDS). Twelve swine models of ARDS were constructed. A lung recruitment maneuver was then conducted and the PEEP was set at 20 cm H 2 O. The PEEP was reduced by 2 cm H 2 O every 10 min until 0 cm H 2 O was reached, and VD/VT was measured after each decrement step. VD/VT was measured using single-breath analysis of CO 2 , and calculated from arterial CO 2 partial pressure (PaCO 2 ) and mixed expired CO 2 (PeCO 2 ) using the following formula: VD/VT = (PaCO 2 - PeCO 2 )/PaCO 2 . The optimal PEEP was identified by the lowest VD/VT method. Respiration and hemodynamic parameters were recorded during the periods of pre-injury and injury, and at 4 and 2 cm H 2 O below and above the optimal PEEP (Po). The optimal PEEP in this study was found to be 13.25±1.36 cm H 2 O. During the Po period, VD/VT decreased to a lower value (0.44±0.08) compared with that during the injury period (0.68±0.10) (P<0.05), while the intrapulmonary shunt fraction reached its lowest value. In addition, a significant change of dynamic tidal respiratory compliance and oxygenation index was induced by PEEP titration. These results indicate that minimal VD/VT can be used for PEEP titration in ARDS.

Mechanical ventilatory constraints during incremental cycle exercise in human pregnancy: implications for respiratory sensation

PubMed Central

Jensen, Dennis; Webb, Katherine A; Davies, Gregory A L; O'Donnell, Denis E

2008-01-01

The aim of this study was to identify the physiological mechanisms of exertional respiratory discomfort (breathlessness) in pregnancy by comparing ventilatory (breathing pattern, airway function, operating lung volumes, oesophageal pressure (Poes)-derived indices of respiratory mechanics) and perceptual (breathlessness intensity) responses to incremental cycle exercise in 15 young, healthy women in the third trimester (TM3; between 34 and 38 weeks gestation) and again 4–5 months postpartum (PP). During pregnancy, resting inspiratory capacity (IC) increased (P < 0.01) and end-expiratory lung volume decreased (P < 0.001), with no associated change in total lung capacity (TLC) or static respiratory muscle strength. This permitted greater tidal volume (VT) expansion throughout exercise in TM3, while preserving the relationship between contractile respiratory muscle effort (tidal Poes swing expressed as a percentage of maximum inspiratory pressure (PImax)) and thoracic volume displacement (VT expressed as a percentage of vital capacity) and between breathlessness and ventilation (V̇E). At the highest equivalent work rate (HEWR = 128 ± 5 W) in TM3 compared with PP: V̇E, tidal Poes/PImax and breathlessness intensity ratings increased by 10.2 l min−1 (P < 0.001), 8.8%PImax (P < 0.05) and 0.9 Borg units (P < 0.05), respectively. Pulmonary resistance was not increased at rest or during exercise at the HEWR in TM3, despite marked increases in mean tidal inspiratory and expiratory flow rates, suggesting increased bronchodilatation. Dynamic mechanical constraints on VT expansion (P < 0.05) with associated increased breathlessness intensity ratings (P < 0.05) were observed near peak exercise in TM3 compared with PP. In conclusion: (1) pregnancy-induced increases in exertional breathlessness reflected the normal awareness of increased V̇E and contractile respiratory muscle effort; (2) mechanical adaptations of the respiratory system, including recruitment of resting IC and increased bronchodilatation, accommodated the increased VT while preserving effort–displacement and breathlessness–V̇E relationships; and (3) dynamic mechanical ventilatory constraints contributed to respiratory discomfort near the limits of tolerance in late gestation. PMID:18687714

Susceptibility to ventilator induced lung injury is increased in senescent rats

PubMed Central

2013-01-01

Introduction The principal mechanisms of ventilator induced lung injury (VILI) have been investigated in numerous animal studies. However, prospective data on the effect of old age on VILI are limited. Under the hypothesis that susceptibility to VILI is increased in old age, we investigated the pulmonary and extrapulmonary effects of mechanical ventilation with high tidal volume (VT) in old compared to young adult animals. Interventions Old (19.1 ± 3.0 months) and young adult (4.4 ± 1.3 months) male Wistar rats were anesthetized and mechanically ventilated (positive end-expiratory pressure 5 cmH2O, fraction of inspired oxygen 0.4, respiratory rate 40/minute) with a tidal volume (VT) of either 8, 16 or 24 ml/kg for four hours. Respiratory and hemodynamic variables, including cardiac output, and markers of systemic inflammation were recorded throughout the ventilation period. Lung histology and wet-to-dry weight ratio, injury markers in lung lavage and respiratory system pressure-volume curves were assessed post mortem. Basic pulmonary characteristics were assessed in non-ventilated animals. Results Compared to young adult animals, high VT (24 ml/kg body weight) caused more lung injury in old animals as indicated by decreased oxygenation (arterial oxygen tension (PaO2): 208 ± 3 vs. 131 ± 20 mmHg; P <0.05), increased lung wet-to-dry-weight ratio (5.61 ± 0.29 vs. 7.52 ± 0.27; P <0.05), lung lavage protein (206 ± 52 mg/l vs. 1,432 ± 101; P <0.05) and cytokine (IL-6: 856 ± 448 vs. 3,283 ± 943 pg/ml; P <0.05) concentration. In addition, old animals ventilated with high VT had more systemic inflammation than young animals (IL-1β: 149 ± 44 vs. 272 ± 36 pg/ml; P <0.05 - young vs. old, respectively). Conclusions Ventilation with unphysiologically large tidal volumes is associated with more lung injury in old compared to young rats. Aggravated pulmonary and systemic inflammation is a key finding in old animals developing VILI. PMID:23710684

Variable tidal volumes improve lung protective ventilation strategies in experimental lung injury.

PubMed

Spieth, Peter M; Carvalho, Alysson R; Pelosi, Paolo; Hoehn, Catharina; Meissner, Christoph; Kasper, Michael; Hübler, Matthias; von Neindorff, Matthias; Dassow, Constanze; Barrenschee, Martina; Uhlig, Stefan; Koch, Thea; de Abreu, Marcelo Gama

2009-04-15

Noisy ventilation with variable Vt may improve respiratory function in acute lung injury. To determine the impact of noisy ventilation on respiratory function and its biological effects on lung parenchyma compared with conventional protective mechanical ventilation strategies. In a porcine surfactant depletion model of lung injury, we randomly combined noisy ventilation with the ARDS Network protocol or the open lung approach (n = 9 per group). Respiratory mechanics, gas exchange, and distribution of pulmonary blood flow were measured at intervals over a 6-hour period. Postmortem, lung tissue was analyzed to determine histological damage, mechanical stress, and inflammation. We found that, at comparable minute ventilation, noisy ventilation (1) improved arterial oxygenation and reduced mean inspiratory peak airway pressure and elastance of the respiratory system compared with the ARDS Network protocol and the open lung approach, (2) redistributed pulmonary blood flow to caudal zones compared with the ARDS Network protocol and to peripheral ones compared with the open lung approach, (3) reduced histological damage in comparison to both protective ventilation strategies, and (4) did not increase lung inflammation or mechanical stress. Noisy ventilation with variable Vt and fixed respiratory frequency improves respiratory function and reduces histological damage compared with standard protective ventilation strategies.

Open lung approach versus standard protective strategies: Effects on driving pressure and ventilatory efficiency during anesthesia - A pilot, randomized controlled trial.

PubMed

Ferrando, Carlos; Suarez-Sipmann, Fernando; Tusman, Gerardo; León, Irene; Romero, Esther; Gracia, Estefania; Mugarra, Ana; Arocas, Blanca; Pozo, Natividad; Soro, Marina; Belda, Francisco J

2017-01-01

Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia. Consecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1) and standard PEEP of 5 cmH2O (pre-RM, n = 36). After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18) or to an individualized open-lung PEEP (OL-PEEP) (Open Lung Approach, OLA group, n = 18) defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography. OL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002). VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035). Lung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery. ClinicalTrials.gov NCT02798133.

Pulmonary atelectasis during low stretch ventilation: "open lung" versus "lung rest" strategy.

PubMed

Fanelli, Vito; Mascia, Luciana; Puntorieri, Valeria; Assenzio, Barbara; Elia, Vincenzo; Fornaro, Giancarlo; Martin, Erica L; Bosco, Martino; Delsedime, Luisa; Fiore, Tommaso; Grasso, Salvatore; Ranieri, V Marco

2009-03-01

Limiting tidal volume (VT) may minimize ventilator-induced lung injury (VILI). However, atelectasis induced by low VT ventilation may cause ultrastructural evidence of cell disruption. Apoptosis seems to be involved as protective mechanisms from VILI through the involvement of mitogen-activated protein kinases (MAPKs). We examined the hypothesis that atelectasis may influence the response to protective ventilation through MAPKs. Prospective randomized study. University animal laboratory. Adult male 129/Sv mice. Isolated, nonperfused lungs were randomized to VILI: VT of 20 mL/kg and positive end-expiratory pressure (PEEP) zero; low stretch/lung rest: VT of 6 mL/kg and 8-10 cm H2O of PEEP; low stretch/open lung: VT of 6 mL/kg, two recruitment maneuvers and 14-16 cm H2O of PEEP. Ventilator settings were adjusted using the stress index. Both low stretch strategies equally blunted the VILI-induced derangement of respiratory mechanics (static volume-pressure curve), lung histology (hematoxylin and eosin), and inflammatory mediators (interleukin-6, macrophage inflammatory protein-2 [enzyme-linked immunosorbent assay], and inhibitor of nuclear factor-kB[Western blot]). VILI caused nuclear swelling and membrane disruption of pulmonary cells (electron microscopy). Few pulmonary cells with chromatin condensation and fragmentation were seen during both low stretch strategies. However, although cell thickness during low stretch/open lung was uniform, low stretch/lung rest demonstrated thickening of epithelial cells and plasma membrane bleb formation. Compared with the low stretch/open lung, low stretch/lung rest caused a significant decrease in apoptotic cells (terminal deoxynucleotidyl transferase mediated deoxyuridine-triphosphatase nick end-labeling) and tissue expression of caspase-3 (Western blot). Both low stretch strategies attenuated the activation of MAPKs. Such reduction was larger during low stretch/open lung than during low stretch/lung rest (p < 0.001). Low stretch strategies provide similar attenuation of VILI. However, low stretch/lung rest strategy is associated to less apoptosis and more ultrastructural evidence of cell damage possibly through MAPKs-mediated pathway.

Non-lobar atelectasis generates inflammation and structural alveolar injury in the surrounding healthy tissue during mechanical ventilation.

PubMed

Retamal, Jaime; Bergamini, Bruno Curty; Carvalho, Alysson R; Bozza, Fernando A; Borzone, Gisella; Borges, João Batista; Larsson, Anders; Hedenstierna, Göran; Bugedo, Guillermo; Bruhn, Alejandro

2014-09-09

When alveoli collapse the traction forces exerted on their walls by adjacent expanded units may increase and concentrate. These forces may promote its re-expansion at the expense of potentially injurious stresses at the interface between the collapsed and the expanded units. We developed an experimental model to test the hypothesis that a local non-lobar atelectasis can act as a stress concentrator, contributing to inflammation and structural alveolar injury in the surrounding healthy lung tissue during mechanical ventilation. A total of 35 rats were anesthetized, paralyzed and mechanically ventilated. Atelectasis was induced by bronchial blocking: after five minutes of stabilization and pre-oxygenation with FIO2 = 1.0, a silicon cylinder blocker was wedged in the terminal bronchial tree. Afterwards, the animals were randomized between two groups: 1) Tidal volume (VT) = 10 ml/kg and positive end-expiratory pressure (PEEP) = 3 cmH2O (VT10/PEEP3); and 2) VT = 20 ml/kg and PEEP = 0 cmH2O (VT20/zero end-expiratory pressure (ZEEP)). The animals were then ventilated during 180 minutes. Three series of experiments were performed: histological (n = 12); tissue cytokines (n = 12); and micro-computed tomography (microCT; n = 2). An additional six, non-ventilated, healthy animals were used as controls. Atelectasis was successfully induced in the basal region of the lung of 26 out of 29 animals. The microCT of two animals revealed that the volume of the atelectasis was 0.12 and 0.21 cm3. There were more alveolar disruption and neutrophilic infiltration in the peri-atelectasis region than the corresponding contralateral lung (control) in both groups. Edema was higher in the peri-atelectasis region than the corresponding contralateral lung (control) in the VT20/ZEEP than VT10/PEEP3 group. The volume-to-surface ratio was higher in the peri-atelectasis region than the corresponding contralateral lung (control) in both groups. We did not find statistical difference in tissue interleukin-1β and cytokine-induced neutrophil chemoattractant-1 between regions. The present findings suggest that a local non-lobar atelectasis acts as a stress concentrator, generating structural alveolar injury and inflammation in the surrounding lung tissue.

AN INVESTIGATION OF THE TRAINING AND SKILL REQUIREMENTS OF INDUSTRIAL MACHINERY MAINTENANCE WORKERS. VOLUME II. FINAL REPORT.

ERIC Educational Resources Information Center

LYNN, FRANK

THE APPENDIXES FOR "AN INVESTIGATION OF THE TRAINING AND SKILL REQUIREMENTS OF INDUSTRIAL MACHINERY MAINTENANCE WORKERS, FINAL REPORT, VOLUME I" (VT 004 006) INCLUDE (1) TWO LETTERS FROM PLANT ENGINEERS STRESSING THE IMPORTANCE OF TRAINING MACHINERY MAINTENANCE WORKERS, (2) A DESCRIPTION OF THE MAINTENANCE TRAINING SURVEY, A SAMPLE QUESTIONNAIRE,…

Volume-translated cubic EoS and PC-SAFT density models and a free volume-based viscosity model for hydrocarbons at extreme temperature and pressure conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burgess, Ward A.; Tapriyal, Deepak; Morreale, Bryan D.

2013-12-01

This research focuses on providing the petroleum reservoir engineering community with robust models of hydrocarbon density and viscosity at the extreme temperature and pressure conditions (up to 533 K and 276 MPa, respectively) characteristic of ultra-deep reservoirs, such as those associated with the deepwater wells in the Gulf of Mexico. Our strategy is to base the volume-translated (VT) Peng–Robinson (PR) and Soave–Redlich–Kwong (SRK) cubic equations of state (EoSs) and perturbed-chain, statistical associating fluid theory (PC-SAFT) on an extensive data base of high temperature (278–533 K), high pressure (6.9–276 MPa) density rather than fitting the models to low pressure saturated liquidmore » density data. This high-temperature, high-pressure (HTHP) data base consists of literature data for hydrocarbons ranging from methane to C{sub 40}. The three new models developed in this work, HTHP VT-PR EoS, HTHP VT-SRK EoS, and hybrid PC-SAFT, yield mean absolute percent deviation values (MAPD) for HTHP hydrocarbon density of ~2.0%, ~1.5%, and <1.0%, respectively. An effort was also made to provide accurate hydrocarbon viscosity models based on literature data. Viscosity values are estimated with the frictional theory (f-theory) and free volume (FV) theory of viscosity. The best results were obtained when the PC-SAFT equation was used to obtain both the attractive and repulsive pressure inputs to f-theory, and the density input to FV theory. Both viscosity models provide accurate results at pressures to 100 MPa but experimental and model results can deviate by more than 25% at pressures above 200 MPa.« less

FLOW-i ventilator performance in the presence of a circle system leak.

PubMed

Lucangelo, Umberto; Ajčević, Miloš; Accardo, Agostino; Borelli, Massimo; Peratoner, Alberto; Comuzzi, Lucia; Zin, Walter A

2017-04-01

Recently, the FLOW-i anaesthesia ventilator was developed based on the SERVO-i intensive care ventilator. The aim of this study was to test the FLOW-i's tidal volume delivery in the presence of a leak in the breathing circuit. We ventilated a test lung model in volume-, pressure-, and pressure-regulated volume-controlled modes (VC, PC, and PRVC, respectively) with a FLOW-i. First, the circuit remained airtight and the ventilator was tested with fresh gas flows of 6, 1, and 0.3 L/min in VC, PC, and PRVC modes and facing 4 combinations of different resistive and elastic loads. Second, a fixed leak in the breathing circuit was introduced and the measurements repeated. In the airtight system, FLOW-i maintained tidal volume (VT) and circuit pressure at approximately the set values, independently of respiratory mode, load, or fresh gas flow. In the leaking circuit, set VT = 500 mL, FLOW-i delivered higher VTs in PC (about 460 mL) than in VC and PRVC, where VTs were substantially less than 500 mL. Interestingly, VT did not differ appreciably from 6 to 0.3 L/min of fresh air flow among the 3 ventilatory modes. In the absence of leakage, peak inspiratory pressures were similar, while they were 35-45 % smaller in PRVC and VC than in PC mode in the presence of leaks. In conclusion, FLOW-i maintained VT (down to fresh gas flows of 0.3 L/min) to 90 % of its preset value in PC mode, which was 4-5 times greater than in VC or PRVC modes.

Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome.

PubMed

Fanelli, Vito; Ranieri, Marco V; Mancebo, Jordi; Moerer, Onnen; Quintel, Michael; Morley, Scott; Moran, Indalecio; Parrilla, Francisco; Costamagna, Andrea; Gaudiosi, Marco; Combes, Alain

2016-02-10

Mechanical ventilation with a tidal volume (VT) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (Pplat) lower than 30 cmH2O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low VT combined with extracorporeal carbon dioxide removal (ECCO2R). In fifteen patients with moderate ARDS, VT was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure--(Pplat) between 23 and 25 cmH2O. Low-flow ECCO2R was initiated when respiratory acidosis developed (pH < 7.25, PaCO2 > 60 mmHg). Ventilation parameters (VT, respiratory rate, PEEP), respiratory compliance (CRS), driving pressure (DeltaP = VT/CRS), arterial blood gases, and ECCO2R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO2R when PaO2/FiO2 was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO2R were also collected. During the 2 h run in phase, VT reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH < 7.25) in all fifteen patients. At steady state, ECCO2R with an average blood flow of 435 mL/min and sweep gas flow of 10 L/min was effective at correcting pH and PaCO2 to within 10 % of baseline values. PEEP values tended to increase at VT of 4 mL/kg from 12.2 to 14.5 cmH2O, but this change was not statistically significant. Driving pressure was significantly reduced during the first two days compared to baseline (from 13.9 to 11.6 cmH2O; p < 0.05) and there were no significant differences in the values of respiratory system compliance. Rescue therapies for life threatening hypoxemia such as prone position and ECMO were necessary in four and two patients, respectively. Only two study-related adverse events were observed (intravascular hemolysis and femoral catheter kinking). The low-flow ECCO2R system safely facilitates a low volume, low pressure ultra-protective mechanical ventilation strategy in patients with moderate ARDS.

Ventilatory effects of gap junction blockade in the RTN in awake rats.

PubMed

Hewitt, Amy; Barrie, Rachel; Graham, Michael; Bogus, Kara; Leiter, J C; Erlichman, Joseph S

2004-12-01

We tested the hypothesis that carbenoxolone, a pharmacological inhibitor of gap junctions, would reduce the ventilatory response to CO(2) when focally perfused within the retrotrapezoid nucleus (RTN). We tested this hypothesis by measuring minute ventilation (V(E)), tidal volume (V(T)), and respiratory frequency (F(R)) responses to increasing concentrations of inspired CO(2) (Fi(CO(2)) = 0-8%) in rats during wakefulness. We confirmed that the RTN was chemosensitive by perfusing the RTN unilaterally with either acetazolamide (AZ; 10 microM) or hypercapnic artificial cerebrospinal fluid equilibrated with 50% CO(2) (pH approximately 6.5). Focal perfusion of AZ or hypercapnic aCSF increased V(E), V(T), and F(R) during exposure to room air. Carbenoxolone (300 microM) focally perfused into the RTN decreased V(E) and V(T) in animals <11 wk of age, but V(E) and V(T) were increased in animals >12 wk of age. Glyzyrrhizic acid, a congener of carbenoxolone, did not change V(E), V(T), or F(R) when focally perfused into the RTN. Carbenoxolone binds to the mineralocorticoid receptor, but spironolactone (10 microM) did not block the disinhibition of V(E) or V(T) in older animals when combined with carbenoxolone. Thus the RTN is a CO(2) chemosensory site in all ages tested, but the function of gap junctions in the chemosensory process varies substantially among animals of different ages: gap junctions amplify the ventilatory response to CO(2) in younger animals, but appear to inhibit the ventilatory response to CO(2) in older animals.

Quantification of [(11)C]yohimbine binding to α2 adrenoceptors in rat brain in vivo.

PubMed

Phan, Jenny-Ann; Landau, Anne M; Wong, Dean F; Jakobsen, Steen; Nahimi, Adjmal; Doudet, Doris J; Gjedde, Albert

2015-03-01

We quantified the binding potentials (BPND) of [(11)C]yohimbine binding in rat brain to alpha-2 adrenoceptors to evaluate [(11)C]yohimbine as an in vivo marker of noradrenergic neurotransmission and to examine its sensitivity to the level of noradrenaline. Dual [(11)C]yohimbine dynamic positron emission tomography (PET) recordings were applied to five Sprague Dawley rats at baseline, followed by acute amphetamine administration (2 mg/kg) to induce elevation of the endogenous level of noradrenaline. The volume of distribution (VT) of [(11)C]yohimbine was obtained using Logan plot with arterial plasma input. Because alpha-2 adrenoceptors are distributed throughout the brain, the estimation of the BPND is complicated by the absence of an anatomic region of no displaceable binding. We used the Inhibition plot to acquire the reference volume, VND, from which we calculated the BPND. Acute pharmacological challenge with amphetamine induced a significant decline of [(11)C]yohimbine BPND of ~38% in all volumes of interest. The BPND was greatest in the thalamus and striatum, followed in descending order by, frontal cortex, pons, and cerebellum. The experimental data demonstrate that [(11)C]yohimbine binding is sensitive to a challenge known to increase the extracellular level of noradrenaline, which can benefit future PET investigations of pathologic conditions related to disrupted noradrenergic neurotransmission.

Cold in-place recycled bituminous pavement Dorset-Danby, VT.

DOT National Transportation Integrated Search

2015-01-01

The report documents the long-term performance and cost effectiveness of four rehabilitation : treatments in a mostly homogenous environment. The underlying subbase and subgrade soils, traffic : volume, existing pavement structure and ambient conditi...

Federal Logistics Information Systems. FLIS Procedures Manual. Document Identifier Code Input/Output Formats (Variable Length). Volume 9.

DTIC Science & Technology

1997-04-01

DATA COLLABORATORS 0001N B NQ 8380 NUMBER OF DATA RECEIVERS 0001N B NQ 2533 AUTHORIZED ITEM IDENTIFICATION DATA COLLABORATOR CODE 0002 ,X B 03 18 TD...01 NC 8268 DATA ELEMENT TERMINATOR CODE 000iX VT 9505 TYPE OF SCREENING CODE 0001A 01 NC 8268 DATA ELEMENT TERMINATOR CODE 000iX VT 4690 OUTPUT DATA... 9505 TYPE OF SCREENING CODE 0001A 2 89 2910 REFERENCE NUMBER CATEGORY CODE (RNCC) 0001X 2 89 4780 REFERENCE NUMBER VARIATION CODE (RNVC) 0001 N 2 89

Feasibility and safety of low-flow extracorporeal CO2 removal managed with a renal replacement platform to enhance lung-protective ventilation of patients with mild-to-moderate ARDS.

PubMed

Schmidt, Matthieu; Jaber, Samir; Zogheib, Elie; Godet, Thomas; Capellier, Gilles; Combes, Alain

2018-05-10

Extracorporeal carbon-dioxide removal (ECCO 2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (P plat ) (< 30 cmH 2 O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO 2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS). Twenty patients with mild (n = 8) or moderate (n = 12) ARDS were included. VT was gradually lowered from 6 to 5, 4.5, and 4 ml/kg, and PEEP adjusted to reach 23 ≤ P plat  ≤ 25 cmH 2 O. Standalone ECCO 2 R (no hemofilter associated with the RRT platform) was initiated when arterial PaCO 2 increased by > 20% from its initial value. Ventilation parameters (VT, respiratory rate, PEEP), respiratory system compliance, P plat and driving pressure, arterial blood gases, and ECCO 2 R-system operational characteristics were collected during at least 24 h of very low tidal volume ventilation. Complications, day-28 mortality, need for adjuvant therapies, and data on weaning off ECCO 2 R and mechanical ventilation were also recorded. While VT was reduced from 6 to 4 ml/kg and P plat kept < 25 cmH 2 O, PEEP was significantly increased from 13.4 ± 3.6 cmH 2 O at baseline to 15.0 ± 3.4 cmH 2 O, and the driving pressure was significantly reduced from 13.0 ± 4.8 to 7.9 ± 3.2 cmH 2 O (both p < 0.05). The PaO 2 /FiO 2 ratio and respiratory-system compliance were not modified after VT reduction. Mild respiratory acidosis occurred, with mean PaCO 2 increasing from 43 ± 8 to 53 ± 9 mmHg and mean pH decreasing from 7.39 ± 0.1 to 7.32 ± 0.10 from baseline to 4 ml/kg VT, while the respiratory rate was not altered. Mean extracorporeal blood flow, sweep-gas flow, and CO 2 removal were 421 ± 40 ml/min, 10 ± 0.3 L/min, and 51 ± 26 ml/min, respectively. Mean treatment duration was 31 ± 22 h. Day-28 mortality was 15%. A low-flow ECCO 2 R device managed with an RRT platform easily and safely enabled very low tidal volume ventilation with moderate increase in PaCO 2 in patients with mild-to-moderate ARDS. ClinicalTrials.gov, NCT02606240. Registered on 17 November 2015.

Price-volume multifractal analysis and its application in Chinese stock markets

NASA Astrophysics Data System (ADS)

Yuan, Ying; Zhuang, Xin-tian; Liu, Zhi-ying

2012-06-01

An empirical research on Chinese stock markets is conducted using statistical tools. First, the multifractality of stock price return series, ri(ri=ln(Pt+1)-ln(Pt)) and trading volume variation series, vi(vi=ln(Vt+1)-ln(Vt)) is confirmed using multifractal detrended fluctuation analysis. Furthermore, a multifractal detrended cross-correlation analysis between stock price return and trading volume variation in Chinese stock markets is also conducted. It is shown that the cross relationship between them is also found to be multifractal. Second, the cross-correlation between stock price Pi and trading volume Vi is empirically studied using cross-correlation function and detrended cross-correlation analysis. It is found that both Shanghai stock market and Shenzhen stock market show pronounced long-range cross-correlations between stock price and trading volume. Third, a composite index R based on price and trading volume is introduced. Compared with stock price return series ri and trading volume variation series vi, R variation series not only remain the characteristics of original series but also demonstrate the relative correlation between stock price and trading volume. Finally, we analyze the multifractal characteristics of R variation series before and after three financial events in China (namely, Price Limits, Reform of Non-tradable Shares and financial crisis in 2008) in the whole period of sample to study the changes of stock market fluctuation and financial risk. It is found that the empirical results verified the validity of R.

Tennis Play Intensity Distribution and Relation with Aerobic Fitness in Competitive Players

PubMed Central

Baiget, Ernest; Fernández-Fernández, Jaime; Iglesias, Xavier; Rodríguez, Ferran A.

2015-01-01

The aims of this study were (i) to describe the relative intensity of simulated tennis play based on the cumulative time spent in three metabolic intensity zones, and (ii) to determine the relationships between this play intensity distribution and the aerobic fitness of a group of competitive players. 20 male players of advanced to elite level (ITN) performed an incremental on-court specific endurance tennis test to exhaustion to determine maximal oxygen uptake (VO2max) and the first and second ventilatory thresholds (VT1, VT2). Ventilatory and gas exchange parameters were monitored using a telemetric portable gas analyser (K4 b2, Cosmed, Rome, Italy). Two weeks later the participants played a simulated tennis set against an opponent of similar level. Intensity zones (1: low, 2: moderate, and 3: high) were delimited by the individual VO2 values corresponding to VT1 and VT2, and expressed as percentage of maximum VO2 and heart rate. When expressed relative to VO2max, percentage of playing time in zone 1 (77 ± 25%) was significantly higher (p < 0.001) than in zone 2 (20 ± 21%) and zone 3 (3 ± 5%). Moderate to high positive correlations were found between VT1, VT2 and VO2max, and the percentage of playing time spent in zone 1 (r = 0.68–0.75), as well as low to high inverse correlations between the metabolic variables and the percentage of time spent in zone 2 and 3 (r = -0.49–0.75). Players with better aerobic fitness play at relatively lower intensities. We conclude that players spent more than 75% of the time in their low-intensity zone, with less than 25% of the time spent at moderate to high intensities. Aerobic fitness appears to determine the metabolic intensity that players can sustain throughout the game. PMID:26098638

Lower tidal volume strategy (≈3 ml/kg) combined with extracorporeal CO2 removal versus 'conventional' protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study.

PubMed

Bein, Thomas; Weber-Carstens, Steffen; Goldmann, Anton; Müller, Thomas; Staudinger, Thomas; Brederlau, Jörg; Muellenbach, Ralf; Dembinski, Rolf; Graf, Bernhard M; Wewalka, Marlene; Philipp, Alois; Wernecke, Klaus-Dieter; Lubnow, Matthias; Slutsky, Arthur S

2013-05-01

Acute respiratory distress syndrome is characterized by damage to the lung caused by various insults, including ventilation itself, and tidal hyperinflation can lead to ventilator induced lung injury (VILI). We investigated the effects of a low tidal volume (V(T)) strategy (V(T) ≈ 3 ml/kg/predicted body weight [PBW]) using pumpless extracorporeal lung assist in established ARDS. Seventy-nine patients were enrolled after a 'stabilization period' (24 h with optimized therapy and high PEEP). They were randomly assigned to receive a low V(T) ventilation (≈3 ml/kg) combined with extracorporeal CO2 elimination, or to a ARDSNet strategy (≈6 ml/kg) without the extracorporeal device. The primary outcome was the 28-days and 60-days ventilator-free days (VFD). Secondary outcome parameters were respiratory mechanics, gas exchange, analgesic/sedation use, complications and hospital mortality. Ventilation with very low V(T)'s was easy to implement with extracorporeal CO2-removal. VFD's within 60 days were not different between the study group (33.2 ± 20) and the control group (29.2 ± 21, p = 0.469), but in more hypoxemic patients (PaO2/FIO2 ≤150) a post hoc analysis demonstrated significant improved VFD-60 in study patients (40.9 ± 12.8) compared to control (28.2 ± 16.4, p = 0.033). The mortality rate was low (16.5%) and did not differ between groups. The use of very low V(T) combined with extracorporeal CO2 removal has the potential to further reduce VILI compared with a 'normal' lung protective management. Whether this strategy will improve survival in ARDS patients remains to be determined (Clinical trials NCT 00538928).

Comparison of flow and gas washout characteristics between pressure control and high-frequency percussive ventilation using a test lung

PubMed Central

Dutta, Rabijit; Xing, Tao; Swanson, Craig; Heltborg, Jeff; Murdoch, Gordon K

2018-01-01

Objective A comparison between flow and gas washout data for high-frequency percussive ventilation (HFPV) and pressure control ventilation (PCV) under similar conditions is currently not available. This bench study aims to compare and describe the flow and gas washout behavior of HFPV and PCV in a newly designed experimental setup and establish a framework for future clinical and animal studies. Approach We studied gas washout behavior using a newly designed experimental setup that is motivated by the multi-breath nitrogen washout measurements. In this procedure, a test lung was filled with nitrogen gas before it was connected to a ventilator. Pressure, volume, and oxygen concentrations were recorded under different compliance and resistance conditions. PCV was compared with two settings of HFPV, namely, HFPV-High and HFPV-Low, to simulate the different variations in its clinical application. In the HFPV-Low mode, the peak pressures and drive pressures of HFPV and PCV are matched, whereas in the HFPV-High mode, the mean airway pressures (MAP) are matched. Main results HFPV-Low mode delivers smaller tidal volume (VT) as compared to PCV under all lung conditions, whereas HFPV-High delivers a larger VT. HFPV-High provides rapid washout as compared to PCV under all lung conditions. HFPV-Low takes a longer time to wash out nitrogen except at a low compliance, where it expedites washout at a smaller VT and MAP compared to PCV washout. Significance Various flow parameters for HFPV and PCV are mathematically defined. A shorter washout time at a small VT in low compliant test lungs for HFPV could be regarded as a hypothesis for lung protective ventilation for animal or human lungs. PMID:29369819

First-in-Human Assessment of the Novel PDE2A PET Radiotracer 18F-PF-05270430

PubMed Central

Waterhouse, Rikki N.; Nabulsi, Nabeel; Lin, Shu-Fei; Labaree, David; Ropchan, Jim; Tarabar, Sanela; DeMartinis, Nicholas; Ogden, Adam; Banerjee, Anindita; Huang, Yiyun; Carson, Richard E.

2016-01-01

This was a first-in-human study of the novel phosphodiesterase-2A (PDE2A) PET ligand 18F-PF-05270430. The primary goals were to determine the appropriate tracer kinetic model to quantify brain uptake and to examine the within-subject test–retest variability. Methods: In advance of human studies, radiation dosimetry was determined in nonhuman primates. Six healthy male subjects participated in a test–retest protocol with dynamic scans and metabolite-corrected input functions. Nine brain regions of interest were studied, including the striatum, white matter, neocortical regions, and cerebellum. Multiple modeling methods were applied to calculate volume of distribution (VT) and binding potentials relative to the nondisplaceable tracer in tissue (BPND), concentration of tracer in plasma (BPP), and free tracer in tissue (BPF). The cerebellum was selected as a reference region to calculate binding potentials. Results: The dosimetry study provided an effective dose of less than 0.30 mSv/MBq, with the gallbladder as the critical organ; the human target dose was 185 MBq. There were no adverse events or clinically detectable pharmacologic effects reported. Tracer uptake was highest in the striatum, followed by neocortical regions and white matter, and lowest in the cerebellum. Regional time–activity curves were well fit by multilinear analysis-1, and a 70-min scan duration was sufficient to quantify VT and the binding potentials. BPND, with mean values ranging from 0.3 to 0.8, showed the best intrasubject and intersubject variability and reliability. Test–retest variability in the whole brain (excluding the cerebellum) of VT, BPND, and BPP were 8%, 16%, and 17%, respectively. Conclusion: 18F-PF-05270430 shows promise as a PDE2A PET ligand, albeit with low binding potential values. PMID:27103022

Nicotinic Acetylcholine Receptor Availability in Cigarette Smokers: Effect of Heavy Caffeine or Marijuana Use

PubMed Central

Brody, Arthur L.; Hubert, Robert; Mamoun, Michael S.; Enoki, Ryutaro; Garcia, Lizette Y.; Abraham, Paul; Young, Paulina; Mandelkern, Mark A.

2016-01-01

Rationale Upregulation of α4β2* nicotinic acetylcholine receptors (nAChRs) is one of the most well-established effects of chronic cigarette smoking on the brain. Prior research by our group gave a preliminary indication that cigarette smokers with concomitant use of caffeine or marijuana have altered nAChR availability. Objective We sought to determine if smokers with heavy caffeine or marijuana use have different levels of α4β2* nAChRs than smokers without these drug usages. Methods One hundred and one positron emission tomography (PET) scans, using the radiotracer 2-FA (a ligand for β2*-containing nAChRs), were obtained from 4 groups of males: non-smokers without heavy caffeine or marijuana use, smokers without heavy caffeine or marijuana use, smokers with heavy caffeine use (mean 4 coffee cups per day), and smokers with heavy marijuana use (mean 22 days of use per month). Total distribution volume (Vt/fp) was determined for the brainstem, prefrontal cortex, and thalamus, as a measure of nAChR availability. Results A significant between-group effect was found, resulting from the heavy caffeine and marijuana groups having the highest Vt/fp values (especially for the brainstem and prefrontal cortex), followed by smokers without such use, followed by non-smokers. Direct between-group comparisons revealed significant differences for Vt/fp values between the smoker groups with and without heavy caffeine or marijuana use. Conclusions Smokers with heavy caffeine or marijuana use have higher α4β2* nAChR availability than smokers without these drug usages. These findings are likely due to increased nicotine exposure, but could also be due to an interaction on a cellular/molecular level. PMID:27370018

Elevated Brain Cannabinoid CB1 Receptor Availability in Posttraumatic Stress Disorder: A Positron Emission Tomography Study

PubMed Central

Neumeister, Alexander; Normandin, Marc D.; Pietrzak, Robert H.; Piomelli, Daniele; Zheng, Ming-Qiang; Gujarro-Anton, Ana; Potenza, Marc N.; Bailey, Christopher R.; Lin, Shu-fei; Najafzadeh, Soheila; Ropchan, Jim; Henry, Shannan; Corsi-Travali, Stefani; Carson, Richard E.; Huang, Yiyun

2013-01-01

Endocannabinoids and their attending cannabinoid type 1 receptor (CB1) have been implicated in animal models of posttraumatic stress disorder (PTSD). However, their specific role has not been studied in people with PTSD. Herein, we present an in vivo imaging study using positron emission tomography (PET) and the CB1-selective radioligand [11C]OMAR in individuals with PTSD, and healthy controls with lifetime histories of trauma (trauma controls [TC]) and those without such histories (healthy controls [HC]). Untreated individuals with PTSD (N=25) with non-combat trauma histories, and TC (N=12) and HC (N=23) participated in a magnetic resonance (MR) imaging scan and a resting PET scan with the CB1 receptor antagonist radiotracer [11C]OMAR, which measures volume of distribution (VT) linearly related to CB1 receptor availability. Peripheral levels of anandamide, 2-arachidonoylglycerol (2-AG), oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and cortisol were also assessed. In the PTSD group, relative to the HC and TC groups, we found elevated brain-wide [11C]OMAR VT values (F(2,53)=7.96, p=.001; 19.5% and 14.5% higher, respectively) which were most pronounced in women (F(1,53)=5.52, p=.023). Anandamide concentrations were reduced in the PTSD relative to the TC (53.1% lower) and HC (58.2% lower) groups. Cortisol levels were lower in the PTSD and TC groups relative to the HC group. Three biomarkers examined collectively—OMAR VT, anandamide, and cortisol—correctly classified nearly 85% of PTSD cases. These results suggest that abnormal CB1 receptor-mediated anandamide signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder. PMID:23670490

Nicotinic acetylcholine receptor availability in cigarette smokers: effect of heavy caffeine or marijuana use.

PubMed

Brody, Arthur L; Hubert, Robert; Mamoun, Michael S; Enoki, Ryutaro; Garcia, Lizette Y; Abraham, Paul; Young, Paulina; Mandelkern, Mark A

2016-09-01

Upregulation of α4β2* nicotinic acetylcholine receptors (nAChRs) is one of the most well-established effects of chronic cigarette smoking on the brain. Prior research by our group gave a preliminary indication that cigarette smokers with concomitant use of caffeine or marijuana have altered nAChR availability. We sought to determine if smokers with heavy caffeine or marijuana use have different levels of α4β2* nAChRs than smokers without these drug usages. One hundred and one positron emission tomography (PET) scans, using the radiotracer 2-FA (a ligand for β2*-containing nAChRs), were obtained from four groups of males: non-smokers without heavy caffeine or marijuana use, smokers without heavy caffeine or marijuana use, smokers with heavy caffeine use (mean four coffee cups per day), and smokers with heavy marijuana use (mean 22 days of use per month). Total distribution volume (Vt/fp) was determined for the brainstem, prefrontal cortex, and thalamus, as a measure of nAChR availability. A significant between-group effect was found, resulting from the heavy caffeine and marijuana groups having the highest Vt/fp values (especially for the brainstem and prefrontal cortex), followed by smokers without such use, followed by non-smokers. Direct between-group comparisons revealed significant differences for Vt/fp values between the smoker groups with and without heavy caffeine or marijuana use. Smokers with heavy caffeine or marijuana use have higher α4β2* nAChR availability than smokers without these drug usages. These findings are likely due to increased nicotine exposure but could also be due to an interaction on a cellular/molecular level.

Reduced Brain Cannabinoid Receptor Availability in Schizophrenia.

PubMed

Ranganathan, Mohini; Cortes-Briones, Jose; Radhakrishnan, Rajiv; Thurnauer, Halle; Planeta, Beata; Skosnik, Patrick; Gao, Hong; Labaree, David; Neumeister, Alexander; Pittman, Brian; Surti, Toral; Huang, Yiyun; Carson, Richard E; D'Souza, Deepak Cyril

2016-06-15

Several lines of evidence suggest the presence of abnormalities in the endocannabinoid (eCB) system in schizophrenia (SCZ). However, there are limited in vivo measures of the eCB system in SCZ. Twenty five male SCZ subjects (SCZs) (18 antipsychotic treated and 7 antipsychotic free) were compared with 18 age-matched male healthy control subjects (HCs). Subjects underwent one positron emission tomography scan each with the cannabinoid receptor-1 (CB1R) selective radiotracer [(11)C]OMAR on the high resolution research tomography scanner. Regional volume of distribution (VT) values were determined using kinetic modeling of positron emission tomography data as a measure of CB1R availability. Group differences in mean composite [(11)C]OMAR VT values were compared between SCZs and HCs. Exploratory comparisons of CB1R availability within 15 brain regions were also conducted. All analyses were covaried for age and body mass index. SCZs showed significantly (p = .02) lower composite [(11)C]OMAR VT relative to HCs (~12% difference, effect size d = .73). [(11)C]OMAR VT was significantly (all ps < .05) lower in SCZs in the amygdala, caudate, posterior cingulate cortex, hippocampus, hypothalamus, and insula. Composite [11]OMAR VT was HCs > antipsychotic treated SZCs > antipsychotic free SZCs. Furthermore, composite [(11)C]OMAR VT was greater in HCs than SCZ smokers (n = 11) and SCZ nonsmokers (n = 14). CB1R availability is lower in male SCZ subjects compared with HCs. Furthermore, antipsychotics and tobacco use may increase CB1R availability in this population. The findings of the study provide further evidence supporting the hypothesis that alterations in the eCB system might contribute to the pathophysiology of SCZ. Published by Elsevier Inc.

Determination of the critical micelle concentration in simulations of surfactant systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santos, Andrew P.; Panagiotopoulos, Athanassios Z., E-mail: azp@princeton.edu

Alternative methods for determining the critical micelle concentration (cmc) are investigated using canonical and grand canonical Monte Carlo simulations of a lattice surfactant model. A common measure of the cmc is the “free” (unassociated) surfactant concentration in the presence of micellar aggregates. Many prior simulations of micellizing systems have observed a decrease in the free surfactant concentration with overall surfactant loading for both ionic and nonionic surfactants, contrary to theoretical expectations from mass-action models of aggregation. In the present study, we investigate a simple lattice nonionic surfactant model in implicit solvent, for which highly reproducible simulations are possible in bothmore » the canonical (NVT) and grand canonical (μVT) ensembles. We confirm the previously observed decrease of free surfactant concentration at higher overall loadings and propose an algorithm for the precise calculation of the excluded volume and effective concentration of unassociated surfactant molecules in the accessible volume of the solution. We find that the cmc can be obtained by correcting the free surfactant concentration for volume exclusion effects resulting from the presence of micellar aggregates. We also develop an improved method for determination of the cmc based on the maximum in curvature for the osmotic pressure curve determined from μVT simulations. Excellent agreement in cmc and other micellar properties between NVT and μVT simulations of different system sizes is observed. The methodological developments in this work are broadly applicable to simulations of aggregating systems using any type of surfactant model (atomistic/coarse grained) or solvent description (explicit/implicit)« less

Ventilation changes associated with hatching and maturation of an endothermic phenotype in the Pekin duck, Anas platyrhynchos domestica.

PubMed

Sirsat, Tushar S; Dzialowski, Edward M

2016-04-15

Precocial birds begin embryonic life with an ectothermic metabolic phenotype and rapidly develop an endothermic phenotype after hatching. Switching to a high-energy, endothermic phenotype requires high-functioning respiratory and cardiovascular systems to deliver sufficient environmental oxygen to the tissues. We measured tidal volume (VT), breathing frequency (ƒ), minute ventilation (V̇e), and whole-animal oxygen consumption (V̇o2) in response to gradual cooling from 37.5°C (externally pipped paranates, EP) or 35°C (hatchlings) to 20°C along with response to hypercapnia during developmental transition from an ectothermic, EP paranate to endothermic hatchling. To examine potential eggshell constraints on EP ventilation, we repeated these experiments in artificially hatched early and late EP paranates. Hatchlings and artificially hatched late EP paranates were able to increase V̇o2significantly in response to cooling. EP paranates had high ƒ that decreased with cooling, coupled with an unchanging low VT and did not respond to hypercapnia. Hatchlings had significantly lower ƒ and higher VT and V̇e that increased with cooling and hypercapnia. In response to artificial hatching, all ventilation values quickly reached those of hatchlings and responded to hypercapnia. The timing of artificial hatching influenced the temperature response, with only artificially hatched late EP animals, exhibiting the hatchling ventilation response to cooling. We suggest one potential constraint on ventilatory responses of EP paranates is the rigid eggshell, limiting air sac expansion during inhalation and constraining VT Upon natural or artificial hatching, the VT limitation is removed and the animal is able to increase VT, V̇e, and thus V̇o2, and exhibit an endothermic phenotype. Copyright © 2016 the American Physiological Society.

Ventilation changes associated with hatching and maturation of an endothermic phenotype in the Pekin duck, Anas platyrhynchos domestica

PubMed Central

Sirsat, Tushar S.

2016-01-01

Precocial birds begin embryonic life with an ectothermic metabolic phenotype and rapidly develop an endothermic phenotype after hatching. Switching to a high-energy, endothermic phenotype requires high-functioning respiratory and cardiovascular systems to deliver sufficient environmental oxygen to the tissues. We measured tidal volume (VT), breathing frequency (ƒ), minute ventilation (V̇e), and whole-animal oxygen consumption (V̇o2) in response to gradual cooling from 37.5°C (externally pipped paranates, EP) or 35°C (hatchlings) to 20°C along with response to hypercapnia during developmental transition from an ectothermic, EP paranate to endothermic hatchling. To examine potential eggshell constraints on EP ventilation, we repeated these experiments in artificially hatched early and late EP paranates. Hatchlings and artificially hatched late EP paranates were able to increase V̇o2 significantly in response to cooling. EP paranates had high ƒ that decreased with cooling, coupled with an unchanging low VT and did not respond to hypercapnia. Hatchlings had significantly lower ƒ and higher VT and V̇e that increased with cooling and hypercapnia. In response to artificial hatching, all ventilation values quickly reached those of hatchlings and responded to hypercapnia. The timing of artificial hatching influenced the temperature response, with only artificially hatched late EP animals, exhibiting the hatchling ventilation response to cooling. We suggest one potential constraint on ventilatory responses of EP paranates is the rigid eggshell, limiting air sac expansion during inhalation and constraining VT. Upon natural or artificial hatching, the VT limitation is removed and the animal is able to increase VT, V̇e, and thus V̇o2, and exhibit an endothermic phenotype. PMID:26818053

Streptococcus pyogenes strains containing emm12 and emm55 possess a novel gene coding for distantly related SIC protein.

PubMed

Hartas, J; Sriprakash, K S

1999-01-01

Streptococcus pyogenes infection and acute glomerulonephritis (AGN), a non-suppurtave disease, are endemic in the Aboriginal people of the Northern Territory (NT) of Australia. Vir typing, a locus-specific polymerase chain reaction (PCR)-based typing method [Gardiner, Hartas, Currie et al PCR Meth Appl 1995 4: 288-93], has revealed high divergence among the NT streptococcal strains. A total of 76 Vir types (VTs) representing about 95% of the NT isolates were screened for sic, a gene for streptococcal inhibitor of complement function, by PCR and hybridization. This revealed that seven VTs are positive for sic, and there are two classes of the gene: those closely related to sic (CRS) originally described by Akesson, Sjoholm & Bjorck [ J. Biol. Chem. 1996 271: 1081-8] and those distantly related to sic (DRS). Among the CRS-positive VTs, VT16, VT78 and VT91 have emm (gene for M protein) encoding type 1 M protein or related specificity, and VT8 and VT101 contain emm57 or related alleles. Chromosomal location of CRS in emm57 is different from that in emm1 or related strains. The DRS-positive VT18 and VT52 contained emm55 and emm12 respectively, which are phylogenetically related. Strains of S. pyogenes types 1, 12, 55 and 57 are known to be associated with AGN. Restricted distribution of CRS and DRS among the M types historically associated with AGN suggests that these sic alleles may have a role in AGN pathogenesis. Copyright 1999 Academic Press.

Electrical impedance tomography compared to positron emission tomography for the measurement of regional lung ventilation: an experimental study

PubMed Central

Richard, JC; Pouzot, C; Gros, A; Tourevieille, C; Lebars, D; Lavenne, F; Frerichs, I; Guérin, C

2009-01-01

Introduction Electrical impedance tomography (EIT), which can assess regional lung ventilation at the bedside, has never been compared with positron-emission tomography (PET), a gold-standard to quantify regional ventilation. This experiment systematically compared both techniques in injured and non-injured lungs. Methods The study was performed in six mechanically ventilated female piglets. In normal lungs, tidal volume (VT) was randomly changed to 6, 8, 10 and 15 ml/kg on zero end-expiratory pressure (ZEEP), then, at VT 10 ml/kg, positive end-expiratory pressure (PEEP) was randomly changed to 5, 10 and 15 cmH2O. Afterwards, acute lung injury (ALI) was subsequently created in three animals by injecting 3 ml/kg hydrochloric acid into the trachea. Then at PEEP 5 cmH2O, VT was randomly changed to 8 and 12 ml/kg and PEEP of 10 and 15 cmH2O applied at VT 10 ml/kg. EIT and PET examinations were performed simultaneously. EIT ventilation (VTEIT) and lung volume (VL) were measured in the anterior and posterior area of each lung. On the same regions of interest, ventilation (VPET) and aerated lung volume (VAatten) were determined with PET. Results On ZEEP, VTEIT and VPET significantly correlated for global (VTEIT = VPET - 2E-13, R2 = 0.95, P < 0.001) and regional (VTEIT = 0.81VPET+7.65, R2 = 0.63, P < 0.001) ventilation over both conditions. For ALI condition, corresponding R2 were 0.91 and 0.73 (P < 0.01). Bias was = 0 and limits of agreement were -37.42 and +37.42 ml/min for global ventilation over both conditions. These values were 0.04 and -29.01 and +29.08 ml/min, respectively, for regional ventilation. Significant correlations were also found between VL and VAatten for global (VL = VAatten+1E-12, R2 = 0.93, P < 0.0001) and regional (VL = 0.99VAatten+0.92, R2 = 0.65, P < 0.001) volume. For ALI condition, corresponding R2 were 0.94 (P < 0.001) and 0.54 (P < 0.05). Bias was = 0 and limits of agreement ranged -38.16 and +38.16 ml for global ventilation over both conditions. These values were -0.24 and -31.96 to +31.48 ml, respectively, for regional ventilation. Conclusions Regional lung ventilation and volume were accurately measured with EIT in healthy and injured lungs and validated by simultaneous PET imaging. PMID:19480694

Arterial input function derived from pairwise correlations between PET-image voxels.

PubMed

Schain, Martin; Benjaminsson, Simon; Varnäs, Katarina; Forsberg, Anton; Halldin, Christer; Lansner, Anders; Farde, Lars; Varrone, Andrea

2013-07-01

A metabolite corrected arterial input function is a prerequisite for quantification of positron emission tomography (PET) data by compartmental analysis. This quantitative approach is also necessary for radioligands without suitable reference regions in brain. The measurement is laborious and requires cannulation of a peripheral artery, a procedure that can be associated with patient discomfort and potential adverse events. A non invasive procedure for obtaining the arterial input function is thus preferable. In this study, we present a novel method to obtain image-derived input functions (IDIFs). The method is based on calculation of the Pearson correlation coefficient between the time-activity curves of voxel pairs in the PET image to localize voxels displaying blood-like behavior. The method was evaluated using data obtained in human studies with the radioligands [(11)C]flumazenil and [(11)C]AZ10419369, and its performance was compared with three previously published methods. The distribution volumes (VT) obtained using IDIFs were compared with those obtained using traditional arterial measurements. Overall, the agreement in VT was good (∼3% difference) for input functions obtained using the pairwise correlation approach. This approach performed similarly or even better than the other methods, and could be considered in applied clinical studies. Applications to other radioligands are needed for further verification.

Initial evaluation of 18F-GE-179, a putative PET Tracer for activated N-methyl D-aspartate receptors.

PubMed

McGinnity, Colm J; Hammers, Alexander; Riaño Barros, Daniela A; Luthra, Sajinder K; Jones, Paul A; Trigg, William; Micallef, Caroline; Symms, Mark R; Brooks, David J; Koepp, Matthias J; Duncan, John S

2014-03-01

N-methyl D-aspartate (NMDA) ion channels play a key role in a wide range of physiologic (e.g., memory and learning tasks) and pathologic processes (e.g., excitotoxicity). To date, suitable PET markers of NMDA ion channel activity have not been available. (18)F-GE-179 is a novel radioligand that selectively binds to the open/active state of the NMDA receptor ion channel, displacing the binding of (3)H-tenocyclidine from the intrachannel binding site with an affinity of 2.4 nM. No significant binding was observed with 10 nM GE-179 at 60 other neuroreceptors, channels, or transporters. We describe the kinetic behavior of the radioligand in vivo in humans. Nine healthy participants (6 men, 3 women; median age, 37 y) each underwent a 90-min PET scan after an intravenous injection of (18)F-GE-179. Continuous arterial blood sampling over the first 15 min was followed by discrete blood sampling over the duration of the scan. Brain radioactivity (KBq/mL) was measured in summation images created from the attenuation- and motion-corrected dynamic images. Metabolite-corrected parent plasma input functions were generated. We assessed the abilities of 1-, 2-, and 3-compartment models to kinetically describe cerebral time-activity curves using 6 bilateral regions of interest. Parametric volume-of-distribution (V(T)) images were generated by voxelwise rank-shaping regularization of exponential spectral analysis (RS-ESA). A 2-brain-compartment, 4-rate-constant model best described the radioligand's kinetics in normal gray matter of subjects at rest. At 30 min after injection, 37% of plasma radioactivity represented unmetabolized (18)F-GE-179. The highest mean levels of gray matter radioactivity were seen in the putamina and peaked at 7.5 min. A significant positive correlation was observed between K1 and V(T) (Spearman ρ = 0.398; P = 0.003). Between-subject coefficients of variation of V(T) ranged between 12% and 16%. Voxelwise RS-ESA yielded similar V(T)s and coefficients of variation. (18)F-GE-179 exhibits high and rapid brain extraction, with a relatively homogeneous distribution in gray matter and acceptable between-subject variability. Despite its rapid peripheral metabolism, quantification of (18)F-GE-179 VT is feasible both within regions of interest and at the voxel level. The specificity of (18)F-GE-179 binding, however, requires further characterization with in vivo studies using activation and disease models.

Positron Emission Tomography studies with [11C]PBR28 in the Healthy Rodent Brain: Validating SUV as an Outcome Measure of Neuroinflammation.

PubMed

Tóth, Miklós; Doorduin, Janine; Häggkvist, Jenny; Varrone, Andrea; Amini, Nahid; Halldin, Christer; Gulyás, Balázs

2015-01-01

Molecular imaging of the 18 kD Translocator protein (TSPO) with positron emission tomography (PET) is of great value for studying neuroinflammation in rodents longitudinally. Quantification of the TSPO in rodents is, however, quite challenging. There is no suitable reference region and the use of plasma-derived input is not an option for longitudinal studies. The aim of this study was therefore to evaluate the use of the standardized uptake value (SUV) as an outcome measure for TSPO imaging in rodent brain PET studies, using [11C]PBR28. In the first part of the study, healthy male Wistar rats (n = 4) were used to determine the correlation between the distribution volume (VT, calculated with Logan graphical analysis) and the SUV. In the second part, healthy male Wistar rats (n = 4) and healthy male C57BL/6J mice (n = 4), were used to determine the test-retest variability of the SUV, with a 7-day interval between measurements. Dynamic PET scans of 63 minutes were acquired with a nanoScan PET/MRI and nanoScan PET/CT. An MRI scan was made for anatomical reference with each measurement. The whole brain VT of [11C]PBR28 in rats was 42.9 ± 1.7. A statistically significant correlation (r2 = 0.96; p < 0.01) was found between the VT and the SUV. The test-retest variability in 8 brain region ranged from 8 to 20% in rats and from 7 to 23% in mice. The interclass correlation coefficient (ICC) was acceptable to excellent for rats, but poor to acceptable for mice. The SUV of [11C]PBR28 showed a high correlation with VT as well as good test-retest variability. For future longitudinal small animal PET studies the SUV can thus be used to describe [11C]PBR28 uptake in healthy brain tissue. Based on the present observations, further studies are needed to explore the applicability of this approach in small animal disease models, with special regard to neuroinflammatory models.

Feasibility study of TSPO quantification with [18F]FEPPA using population-based input function.

PubMed

Mabrouk, Rostom; Strafella, Antonio P; Knezevic, Dunja; Ghadery, Christine; Mizrahi, Romina; Gharehgazlou, Avideh; Koshimori, Yuko; Houle, Sylvain; Rusjan, Pablo

2017-01-01

The input function (IF) is a core element in the quantification of Translocator protein 18 kDa with positron emission tomography (PET), as no suitable reference region with negligible binding has been identified. Arterial blood sampling is indeed needed to create the IF (ASIF). In the present manuscript we study individualization of a population based input function (PBIF) with a single arterial manual sample to estimate total distribution volume (VT) for [18F]FEPPA and to replicate previously published clinical studies in which the ASIF was used. The data of 3 previous [18F]FEPPA studies (39 of healthy controls (HC), 16 patients with Parkinson's disease (PD) and 18 with Alzheimer's disease (AD)) was reanalyzed with the new approach. PBIF was used with the Logan graphical analysis (GA) neglecting the vascular contribution to estimate VT. Time of linearization of the GA was determined with the maximum error criteria. The optimal calibration of the PBIF was determined based on the area under the curve (AUC) of the IF and the agreement range of VT between methods. The shape of the IF between groups was studied while taking into account genotyping of the polymorphism (rs6971). PBIF scaled with a single value of activity due to unmetabolized radioligand in arterial plasma, calculated as the average of a sample taken at 60 min and a sample taken at 90 min post-injection, yielded a good interval of agreement between methods and optimized the area under the curve of IF. In HC, gray matter VTs estimated by PBIF highly correlated with those using the standard method (r2 = 0.82, p = 0.0001). Bland-Altman plots revealed PBIF slightly underestimates (~1 mL/cm3) VT calculated by ASIF (including a vascular contribution). It was verified that the AUC of the ASIF were independent of genotype and disease (HC, PD, and AD). Previous clinical results were replicated using PBIF but with lower statistical power. A single arterial blood sample taken 75 minute post-injection contains enough information to individualize the IF in the groups of subjects studied; however, the higher variability produced requires an increase in sample size to reach the same effect size.

40 CFR Appendix B to Subpart E of... - Federal Guidelines-User Charges for Operation and Maintenance of Publicly Owned Treatment Works

Code of Federal Regulations, 2010 CFR

2010-07-01

... characteristics; i.e., levels of biochemical oxygen demand, suspended solids, etc. Each class is then assigned its... works. Factors such as strength, volume, and delivery flow rate characteristics shall be considered and... user charges can be developed on a volume basis in accordance with the model below: Cu = CT/VT(Vu) (2...

Instrument development in the measurement of unsupported arm exercise endurance in normal adult subjects.

PubMed

Breslin, E H; Adams, E; Lutz, A; Roy, C

1993-06-01

Many daily activities, from basic grooming to employment tasks, require adequate unsupported arm endurance (UAE). We developed an electromechanical device to measure UAE endurance. The purpose of this study was to standardize the instrument for two rates of arm motion, moderate and slow, in 18 normal adult subjects (FEVI = 3.7L +/- .78, FVC = 4.2L +/- .74, FEV1/FVC = 1.1 +/- .08). Exercise endurance limits, and the following metabolic, ventilatory, and sensation responses were determined at rest prior to exercise and at end-exercise limits for both rates of UAE:minute ventilation (Ve), tidal volume (VT), respiratory rate (RR), duty cycle (Ti/Ttot), oxygen uptake (VO2), carbon dioxide production (VCO2), inspiratory flow (VT/Ti), heart rate (HR), and visual analog scale measurements (VAS) of dyspnea (D), respiratory effort (RE), and arm fatigue (AF). Significance increases from baseline rest were shown at the endurance limits for both rates of UAE in: VO2, VCO2, Ve, VT, RR, VT/Ti, HR, VAS-D, VAS-RE, and VAS-AF. There were no changes in Ti/Ttot and SaO2 with UAE. Peak VO2, RR, Ve, VT/Ti, and VAS-D with moderate exercise were significantly greater than slow UAE; and there was a trend increase in peak HR for moderate as opposed to slow rate UAE. Despite these differences, the endurance time between the two rates of UAE were similar. These data provide standards against which UAE in COPD can be evaluated.

Distribution of intravenously administered acetylcholinesterase inhibitor and acetylcholinesterase activity in the adrenal gland: 11C-donepezil PET study in the normal rat.

PubMed

Watabe, Tadashi; Naka, Sadahiro; Ikeda, Hayato; Horitsugi, Genki; Kanai, Yasukazu; Isohashi, Kayako; Ishibashi, Mana; Kato, Hiroki; Shimosegawa, Eku; Watabe, Hiroshi; Hatazawa, Jun

2014-01-01

Acetylcholinesterase (AChE) inhibitors have been used for patients with Alzheimer's disease. However, its pharmacokinetics in non-target organs other than the brain has not been clarified yet. The purpose of this study was to evaluate the relationship between the whole-body distribution of intravenously administered (11)C-Donepezil (DNP) and the AChE activity in the normal rat, with special focus on the adrenal glands. The distribution of (11)C-DNP was investigated by PET/CT in 6 normal male Wistar rats (8 weeks old, body weight  = 220 ± 8.9 g). A 30-min dynamic scan was started simultaneously with an intravenous bolus injection of (11)C-DNP (45.0 ± 10.7 MBq). The whole-body distribution of the (11)C-DNP PET was evaluated based on the Vt (total distribution volume) by Logan-plot analysis. A fluorometric assay was performed to quantify the AChE activity in homogenized tissue solutions of the major organs. The PET analysis using Vt showed that the adrenal glands had the 2nd highest level of (11)C-DNP in the body (following the liver) (13.33 ± 1.08 and 19.43 ± 1.29 ml/cm(3), respectively), indicating that the distribution of (11)C-DNP was the highest in the adrenal glands, except for that in the excretory organs. The AChE activity was the third highest in the adrenal glands (following the small intestine and the stomach) (24.9 ± 1.6, 83.1 ± 3.0, and 38.5 ± 8.1 mU/mg, respectively), indicating high activity of AChE in the adrenal glands. We demonstrated the whole-body distribution of (11)C-DNP by PET and the AChE activity in the major organs by fluorometric assay in the normal rat. High accumulation of (11)C-DNP was observed in the adrenal glands, which suggested the risk of enhanced cholinergic synaptic transmission by the use of AChE inhibitors.

Impact of the right ventricular lead position on clinical outcome and on the incidence of ventricular tachyarrhythmias in patients with CRT-D.

PubMed

Kutyifa, Valentina; Bloch Thomsen, Poul Erik; Huang, David T; Rosero, Spencer; Tompkins, Christine; Jons, Christian; McNitt, Scott; Polonsky, Bronislava; Shah, Amil; Merkely, Bela; Solomon, Scott D; Moss, Arthur J; Zareba, Wojciech; Klein, Helmut U

2013-12-01

Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited. To evaluate the impact of different RV lead locations on clinical outcome in CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy trial. We investigated 742 of 1089 CRT-D patients (68%) with adjudicated RV lead location enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy trial to evaluate the impact of RV lead location on cardiac events. The primary end point was heart failure or death; secondary end points included ventricular tachycardia (VT), ventricular fibrillation (VF), or death and VT or VF alone. Eighty-six patients had the RV lead positioned at the RV septal or right ventricular outflow tract region, combined as nonapical RV group, and 656 patients had apical RV lead location. There was no difference in the primary end point in patients with nonapical RV lead location versus those with apical RV lead location (hazard ratio [HR] 0.98; 95% confidence interval [CI] 0.54-1.80; P = .983). Echocardiographic response to CRT-D was comparable across RV lead location groups (P > .05 for left ventricular end-diastolic volume, left ventricular end-systolic volume, and left atrial volume percent change). However, nonapical RV lead location was associated with significantly higher risk of VT/VF/death (HR 2.45; 95% CI 1.36-4.41; P = .003) and VT/VF alone (HR 2.52; 95% CI 1.36-4.65; P = .002), predominantly in the first year after device implantation. Results were consistent in patients with left bundle branch block. In CRT-D patients, there is no benefit of nonapical RV lead location in clinical outcome or echocardiographic response. Moreover, nonapical RV lead location is associated with an increased risk of ventricular tachyarrhythmias, particularly in the first year after device implantation. Published by Elsevier Inc.

PET brain kinetics studies of 11C-ITMM and 11C-ITDM,radioprobes for metabotropic glutamate receptor type 1, in a nonhuman primate

PubMed Central

Yamasaki, Tomoteru; Maeda, Jun; Fujinaga, Masayuki; Nagai, Yuji; Hatori, Akiko; Yui, Joji; Xie, Lin; Nengaki, Nobuki; Zhang, Ming-Rong

2014-01-01

The metabotropic glutamate receptor type 1 (mGluR1) is a novel target protein for the development of new drugs against central nervous system disorders. Recently, we have developed 11C-labeled PET probes 11C-ITMM and 11C-ITDM, which demonstrate similar profiles, for imaging of mGluR1. In the present study, we compared 11C-ITMM and 11C-ITDM PET imaging and quantitative analysis in the monkey brain. Respective PET images showed similar distribution of uptake in the cerebellum, thalamus, and cingulate cortex. Slightly higher uptake was detected with 11C-ITDM than with 11C-ITMM. For the kinetic analysis using the two-tissue compartment model (2-TCM), the distribution volume (VT) in the cerebellum, an mGluR1-rich region in the brain, was 2.5 mL∙cm-3 for 11C-ITMM and 3.6 mL∙cm-3 for 11C-ITDM. By contrast, the VT in the pons, a region with negligible mGluR1 expression, was similarly low for both radiopharmaceuticals. Based on these results, we performed noninvasive PET quantitative analysis with general reference tissue models using the time-activity curve of the pons as a reference region. We confirmed the relationship and differences between the reference tissue models and 2-TCM using correlational scatter plots and Bland-Altman plots analyses. Although the scattergrams of both radiopharmaceuticals showed over- or underestimations of reference tissue model-based the binding potentials against 2-TCM, there were no significant differences between the two kinetic analysis models. In conclusion, we first demonstrated the potentials of 11C-ITMM and 11C-ITDM for noninvasive PET quantitative analysis using reference tissue models. In addition, our findings suggest that 11C-ITDM may be superior to 11C-ITMM as a PET probe for imaging of mGluR1, because regional VT values in PET with 11C-ITDM were higher than those of 11C-ITMM. Clinical studies of 11C-ITDM in humans will be necessary in the future. PMID:24795840

PET brain kinetics studies of (11)C-ITMM and (11)C-ITDM,radioprobes for metabotropic glutamate receptor type 1, in a nonhuman primate.

PubMed

Yamasaki, Tomoteru; Maeda, Jun; Fujinaga, Masayuki; Nagai, Yuji; Hatori, Akiko; Yui, Joji; Xie, Lin; Nengaki, Nobuki; Zhang, Ming-Rong

2014-01-01

The metabotropic glutamate receptor type 1 (mGluR1) is a novel target protein for the development of new drugs against central nervous system disorders. Recently, we have developed (11)C-labeled PET probes (11)C-ITMM and (11)C-ITDM, which demonstrate similar profiles, for imaging of mGluR1. In the present study, we compared (11)C-ITMM and (11)C-ITDM PET imaging and quantitative analysis in the monkey brain. Respective PET images showed similar distribution of uptake in the cerebellum, thalamus, and cingulate cortex. Slightly higher uptake was detected with (11)C-ITDM than with (11)C-ITMM. For the kinetic analysis using the two-tissue compartment model (2-TCM), the distribution volume (VT) in the cerebellum, an mGluR1-rich region in the brain, was 2.5 mL∙cm(-3) for (11)C-ITMM and 3.6 mL∙cm(-3) for (11)C-ITDM. By contrast, the VT in the pons, a region with negligible mGluR1 expression, was similarly low for both radiopharmaceuticals. Based on these results, we performed noninvasive PET quantitative analysis with general reference tissue models using the time-activity curve of the pons as a reference region. We confirmed the relationship and differences between the reference tissue models and 2-TCM using correlational scatter plots and Bland-Altman plots analyses. Although the scattergrams of both radiopharmaceuticals showed over- or underestimations of reference tissue model-based the binding potentials against 2-TCM, there were no significant differences between the two kinetic analysis models. In conclusion, we first demonstrated the potentials of (11)C-ITMM and (11)C-ITDM for noninvasive PET quantitative analysis using reference tissue models. In addition, our findings suggest that (11)C-ITDM may be superior to (11)C-ITMM as a PET probe for imaging of mGluR1, because regional VT values in PET with (11)C-ITDM were higher than those of (11)C-ITMM. Clinical studies of (11)C-ITDM in humans will be necessary in the future.

[Evolution of breathing pattern and ventilation at maximal exercise during growth. Definition of reference values].

PubMed

Prioux, J; Mercier, J; Ramonatxo, M; Granier, P; Mercier, B; Prefaut, C

1995-01-01

The aim of the study was to define the changes of parameters of breathing pattern and ventilation (VE) as a function of age during maximal exercise in children. A multi-longitudinal survey was conducted in forty four untrained schoolboys, divided in three groups with initial age of 11.2 years for group I, 12.9 years for group II, and 14.9 for group III. These children were subsequently followed three years ago at the same period. The range age was thus 11.2 to 16.9 years. This study showed that, during growth, ventilation (VE max), tidal volume (VT max) and mean inspiratory flow (VT/TI max) increased significantly with age, that inspiratory frequency (f max) decreased, that inspiratory, expiratory and total time of the respiratory cycle (TI max, TE max, TTOT max) increased slightly and that the inspiration fraction (TI/TTOT max) was identical at 11 and 17 years. Furthermore we observed that the peak height velocity and peak tidal volume velocity took place at the same age, i.e., 14 years and that those of weight and VT/TI at the same age of 15 years. In conclusion, this study allowed us to define reference values for breathing pattern at maximal exercise in sedentary boys and to specify the relation between growth and parameters of breathing pattern in these children.

Quantification of [11C]yohimbine binding to α2 adrenoceptors in rat brain in vivo

PubMed Central

Phan, Jenny-Ann; Landau, Anne M; Wong, Dean F; Jakobsen, Steen; Nahimi, Adjmal; Doudet, Doris J; Gjedde, Albert

2015-01-01

We quantified the binding potentials (BPND) of [11C]yohimbine binding in rat brain to alpha-2 adrenoceptors to evaluate [11C]yohimbine as an in vivo marker of noradrenergic neurotransmission and to examine its sensitivity to the level of noradrenaline. Dual [11C]yohimbine dynamic positron emission tomography (PET) recordings were applied to five Sprague Dawley rats at baseline, followed by acute amphetamine administration (2 mg/kg) to induce elevation of the endogenous level of noradrenaline. The volume of distribution (VT) of [11C]yohimbine was obtained using Logan plot with arterial plasma input. Because alpha-2 adrenoceptors are distributed throughout the brain, the estimation of the BPND is complicated by the absence of an anatomic region of no displaceable binding. We used the Inhibition plot to acquire the reference volume, VND, from which we calculated the BPND. Acute pharmacological challenge with amphetamine induced a significant decline of [11C]yohimbine BPND of ~38% in all volumes of interest. The BPND was greatest in the thalamus and striatum, followed in descending order by, frontal cortex, pons, and cerebellum. The experimental data demonstrate that [11C]yohimbine binding is sensitive to a challenge known to increase the extracellular level of noradrenaline, which can benefit future PET investigations of pathologic conditions related to disrupted noradrenergic neurotransmission. PMID:25564241

REDUCTION IN INSPIRATORY FLOW ATTENUATES IL-8 RELEASE AND MAPK ACTIVATION OF LUNG OVERSTRETCH

EPA Science Inventory

Lung overstretch involves mechanical factors, including large tidal volumes (VT), which induce inflammatory responses. The current authors hypothesised that inspiratory flow contributes to ventilator-induced inflammation. Buffer-perfused rabbit lungs were ventilated for 2 h with ...

The implantable cardioverter defibrillator: technology, indications, and impact on cardiovascular survival.

PubMed

Bhatia, Atul; Cooley, Ryan; Berger, Marcie; Blanck, Zalmen; Dhala, Anwer; Sra, Jasbir; Axtell-Mcbride, Kathleen; Vandervort, Cheryl; Akhtar, Masood

2004-06-01

Since the introduction of the implantable cardioverter defibrillator (ICD) for the management of patients with high risk of arrhythmic SCD, there has been increasing use of this device. Its basic promise to effectively terminate ventricular tachycardia (VT)-ventricular fibrillation (VF) has been repeatedly met. In several randomized trials, the ICD has been shown to be superior to conventional anti-arrhythmic therapy, both in patients with documented VT-VF (secondary prevention) and those with high risk such as left ventricular ejection fraction and no prior sustained VT-VF (primary prevention). In both groups, the ICD showed overall and cardiac mortality reduction. The device now can more accurately detect VT-VF and differentiate these from other arrhythmias through a series of algorithms and direct-chamber sensing. Therapy options include painless antitachycardia pacing, low-energy cardioversion, and high-energy defibrillation. The technique implant is now simple as a pacemaker with one lead attached to an active (hot) can functioning as the other electrode. Among other improvements is its weight, volume, multiprogrammability, and storage of information,dual-chamber pacing and sensing, dual-chamber defibrillation, and addition of biventricular pacing for cardiac synchronization. It is anticipated that further improvement in ICD technology will take place and the list of indications will grow.

Short-term volcano-tectonic earthquake forecasts based on a moving mean recurrence time algorithm: the El Hierro seismo-volcanic crisis experience

NASA Astrophysics Data System (ADS)

García, Alicia; De la Cruz-Reyna, Servando; Marrero, José M.; Ortiz, Ramón

2016-05-01

Under certain conditions, volcano-tectonic (VT) earthquakes may pose significant hazards to people living in or near active volcanic regions, especially on volcanic islands; however, hazard arising from VT activity caused by localized volcanic sources is rarely addressed in the literature. The evolution of VT earthquakes resulting from a magmatic intrusion shows some orderly behaviour that may allow the occurrence and magnitude of major events to be forecast. Thus governmental decision makers can be supplied with warnings of the increased probability of larger-magnitude earthquakes on the short-term timescale. We present here a methodology for forecasting the occurrence of large-magnitude VT events during volcanic crises; it is based on a mean recurrence time (MRT) algorithm that translates the Gutenberg-Richter distribution parameter fluctuations into time windows of increased probability of a major VT earthquake. The MRT forecasting algorithm was developed after observing a repetitive pattern in the seismic swarm episodes occurring between July and November 2011 at El Hierro (Canary Islands). From then on, this methodology has been applied to the consecutive seismic crises registered at El Hierro, achieving a high success rate in the real-time forecasting, within 10-day time windows, of volcano-tectonic earthquakes.

Effects of temperature on metabolism, ventilation, and oxygen extraction in the southern brown bandicoot Isoodon obesulus (Marsupialia: Peramelidae).

PubMed

Larcombe, Alexander

2002-01-01

The effects of ambient temperatures (T(a)) from 10 degrees to 35 degrees C on metabolism, ventilation, and oxygen extraction were examined for the southern brown bandicoot (Isoodon obesulus). Oxygen consumption (VO2) followed the pattern typical for endotherms, decreasing with increasing T(a) from 10 degrees to 25 degrees C. It did not significantly change between Ta=25 degrees and 35 degrees C (the thermoneutral zone). VO2 was approximately 2.4 times higher at Ta=10 degrees C (0.967 mL O(2) g(-1) h(-1)) compared with basal (0.410 mL O(2) g(-1) h(-1)) at Ta=30 degrees C. While the metabolic rates of the bandicoots were basal at Ta=30 degrees C, respiratory frequency (f(R)) was 24.6 breaths min(-1), tidal volume (V(T)) was 7.79 mL, minute volume (V(I)) was 191.3 mL min(-1), and oxygen extraction efficiency (EO2) was 26.8%. Increased VO2 at Ta< or =25 degrees C was associated with a large increase in V(I) due to increases in V(T) and f(R). A greater proportion of the change was due to the increase in tidal volume. EO2 was constant at approximately 26% for all T(a) up to and including 30 degrees C. At Ta=35 degrees C, EO2 decreased to 17.7%, f(R) increased to 35.6 breaths min(-1), and V(T) decreased to 7.22 mL. The metabolic and ventilatory physiology of the southern brown bandicoot are typical of an unspecialized medium-sized marsupial.

Evaluation of manual resuscitators used in ICUs in Brazil*

PubMed Central

Ortiz, Tatiana de Arruda; Forti, Germano; Volpe, Márcia Souza; Beraldo, Marcelo do Amaral; Amato, Marcelo Britto Passos; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2013-01-01

OBJECTIVE: To evaluate the performance of manual resuscitators (MRs) used in Brazil in accordance with international standards. METHODS: Using a respiratory system simulator, four volunteer physiotherapists employed eight MRs (five produced in Brazil and three produced abroad), which were tested for inspiratory and expiratory resistance of the patient valve; functioning of the pressure-limiting valve; and tidal volume (VT) generated when the one-handed and two-handed techniques were used. The tests were performed and analyzed in accordance with the American Society for Testing and Materials (ASTM) F920-93 criteria. RESULTS: Expiratory resistance was greater than 6 cmH2O . L−1 . s−1 in only one MR. The pressure-limiting valve, a feature of five of the MRs, opened at low pressures (< 17 cmH2O), and the maximal pressure was 32.0-55.9 cmH2O. Mean VT varied greatly among the MRs tested. The mean VT values generated with the one-handed technique were lower than the 600 mL recommended by the ASTM. In the situations studied, mean VT was generally lower from the Brazilian-made MRs that had a pressure-limiting valve. CONCLUSIONS: The resistances imposed by the patient valve met the ASTM criteria in all but one of the MRs tested. The pressure-limiting valves of the Brazilian-made MRs usually opened at low pressures, providing lower VT values in the situations studied, especially when the one-handed technique was used, suggesting that both hands should be used and that the pressure-limiting valve should be closed whenever possible. PMID:24310633

Predicting the response of the injured lung to the mechanical breath profile

PubMed Central

Smith, Bradford J.; Lundblad, Lennart K. A.; Kollisch-Singule, Michaela; Satalin, Joshua; Nieman, Gary; Habashi, Nader

2015-01-01

Mechanical ventilation is a crucial component of the supportive care provided to patients with acute respiratory distress syndrome. Current practice stipulates the use of a low tidal volume (Vt) of 6 ml/kg ideal body weight, the presumptive notion being that this limits overdistension of the tissues and thus reduces volutrauma. We have recently found, however, that airway pressure release ventilation (APRV) is efficacious at preventing ventilator-induced lung injury, yet APRV has a very different mechanical breath profile compared with conventional low-Vt ventilation. To gain insight into the relative merits of these two ventilation modes, we measured lung mechanics and derecruitability in rats before and following Tween lavage. We fit to these lung mechanics measurements a computational model of the lung that accounts for both the degree of tissue distension of the open lung and the amount of lung derecruitment that takes place as a function of time. Using this model, we predicted how tissue distension, open lung fraction, and intratidal recruitment vary as a function of ventilator settings both for conventional low-Vt ventilation and for APRV. Our predictions indicate that APRV is more effective at recruiting the lung than low-Vt ventilation, but without causing more overdistension of the tissues. On the other hand, low-Vt ventilation generally produces less intratidal recruitment than APRV. Predictions such as these may be useful for deciding on the relative benefits of different ventilation modes and thus may serve as a means for determining how to ventilate a given lung in the least injurious fashion. PMID:25635004

Whole-Body High-Intensity Interval Training Induce Similar Cardiorespiratory Adaptations Compared With Traditional High-Intensity Interval Training and Moderate-Intensity Continuous Training in Healthy Men.

PubMed

Schaun, Gustavo Z; Pinto, Stephanie S; Silva, Mariana R; Dolinski, Davi B; Alberton, Cristine L

2018-05-07

Schaun, GZ, Pinto, SS, Silva, MR, Dolinski, DB, and Alberton, CL. Sixteen weeks of whole-body high-intensity interval training induce similar cardiorespiratory responses compared with traditional high-intensity interval training and moderate-intensity continuous training in healthy men. J Strength Cond Res XX(X): 000-000, 2018-Low-volume high-intensity interval training (HIIT) protocols that use the body weight as resistance could be an interesting and inexpensive alternative to traditional ergometer-based high-intensity interval training (HIIT-T) and moderate-intensity continuous training (MICT). Therefore, our aim was to compare the effects of 16 weeks of whole-body HIIT (HIIT-WB), HIIT-T, and MICT on maximal oxygen uptake (V[Combining Dot Above]O2max), second ventilatory threshold (VT2), and running economy (RE) outcomes. Fifty-five healthy men (23.7 ± 0.7 years, 1.79 ± 0.01 m, 78.5 ± 1.7 kg) were randomized into 3 training groups (HIIT-T = 17; HIIT-WB = 19; MICT = 19) for 16 weeks (3× per week). The HIIT-T group performed eight 20-second bouts at 130% of the velocity associated to V[Combining Dot Above]O2max (vV[Combining Dot Above]O2max) interspersed by 10-second passive recovery on a treadmill, whereas HIIT-WB group performed the same protocol but used calisthenics exercises at an all-out intensity instead of treadmill running. Finally, MICT group exercised for 30 minutes at 90-95% of the heart rate (HR) associated to VT2. After the intervention, all groups improved V[Combining Dot Above]O2max, vV[Combining Dot Above]O2max, time to exhaustion (Tmax), VT2, velocity associated with VT2 (vVT2), and time to reach VT2 (tVT2) significantly (p < 0.05). Moreover, Tmax, vVT2, and tVT2 were greater after HIIT-T compared with HIIT-WB (p < 0.05), whereas oxygen uptake increased and HR decreased during the RE test in all groups (p < 0.05). Our results demonstrate that HIIT-WB can be as effective as traditional HIIT while also being time-efficient compared with MICT to improve health-related outcomes after 16 weeks of training. However, HIIT-T and MICT seem preferable to enhance performance-related outcomes compared with HIIT-WB.

Changes in sitting posture induce multiplanar changes in chest wall shape and motion with breathing.

PubMed

Lee, Linda-Joy; Chang, Angela T; Coppieters, Michel W; Hodges, Paul W

2010-03-31

This study examined the effect of sitting posture on regional chest wall shape in three dimensions, chest wall motion (measured with electromagnetic motion analysis system), and relative contributions of the ribcage and abdomen to tidal volume (%RC/V(t)) (measured with inductance plethysmography) in 7 healthy volunteers. In seven seated postures, increased dead space breathing automatically increased V(t) (to 1.5 V(t)) to match volume between conditions and study the effects of posture independent of volume changes. %RC/V(t) (p<0.05), chest wall shape (p<0.05) and motion during breathing differed between postures. Compared to a reference posture, movement at the 9th rib lateral diameter increased in the thoracolumbar extension posture (p<0.008). In slumped posture movement at the AP diameters at T1 and axilla increased (p<0.00001). Rotation postures decreased movement in the lateral diameter at the axilla (p<0.0007). The data show that single plane changes in sitting posture alter three-dimensional ribcage configuration and chest wall kinematics during breathing, while maintaining constant respiratory function. Copyright 2010 Elsevier B.V. All rights reserved.

[Effect of airway humidification on lung injury induced by mechanical ventilation].

PubMed

Song, Junjie; Jiang, Min; Qi, Guiyan; Xie, Yuying; Wang, Huaiquan; Tian, Yonggang; Qu, Jingdong; Zhang, Xiaoming; Li, Haibo

2014-12-01

To explore the effect of airway humidification on lung injury as a result of mechanical ventilation with different tidal volume (VT). Twenty-four male Japanese white rabbits were randomly divided into four groups: low VT with airway humidification group, high VT with airway humidification group, low VT and high VT group without humidification, with 6 rabbits in each group. Mechanical ventilation was started after intubation and lasted for 6 hours. Low VT denoted 8 mL/kg, while high VT was 16 mL/kg, fraction of inspired oxygen (FiO₂) denoted 0.40, positive end-expiratory pressure (PEEP) was 0. Temperature at Y piece of circuit in airway humidification groups was monitored and controlled at 40 centigrade. Arterial blood gas analysis, including pH value, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), lung mechanics indexes, including peak airway pressure (P(peak)) and airway resistance (Raw), and lung compliance was measured at 0, 2, 4, 6 hours of mechanical ventilation. The levels of tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) in plasma and bronchoalveolar lavage fluid (BALF) were determined by enzyme linked immunosorbent assay (ELISA). The animals were sacrificed at the end of mechanical ventilation. The wet to dry (W/D) ratio of lung tissues was calculated. Histopathologic changes in the lung tissueies were observed with microscope, and lung injury score was calculated. Scanning and transmission electron microscopies were used to examine the integrity of the airway cilia and the tracheal epithelium. Compared with low V(T) group, pH value in high V(T) group was significantly increased, PaCO₂was significantly lowered, and no difference in PaO₂was found. P(peak), Raw, and lung compliance were significantly increased during mechanical ventilation. There were no significant differences in blood gas analysis and lung mechanics indexes between low V(T) with airway humidification group and low V(T) group. Compared with high V(T) group, PaCO₂in high V(T) with airway humidification group was significantly decreased, Ppeak raised obviously, and no difference in pH value, PaO₂, Raw and pulmonary compliance was found. Compared with low V(T) with airway humidification group, no difference in blood gas analysis (PaCO2, mmHg, 1 mmHg=0.133 kPa) was found, but Ppeak (cmH₂O, 1 cmH₂O=0.098 kPa), Raw (cmH₂O), and lung compliance (mL/cmH₂O) were increased significantly in high V(T) with airway humidification group (PaCO₂at 2 hours: 27.96 ± 4.64 vs. 36.08 ± 2.11, 4 hours: 28.62 ± 2.93 vs. 34.55 ± 5.50, 6 hours: 29.33 ± 2.14 vs. 35.01 ± 5.53; Ppeak at 0 hour: 14.34 ± 1.97 vs. 8.84 ± 1.32, 2 hours: 17.33 ± 0.52 vs. 11.17 ± 2.14, 4 hours: 17.83 ± 0.98 vs. 12.67 ± 2.06, 6 hours: 18.67 ± 1.22 vs. 13.50 ± 2.16; Raw at 0 hour: 37.36 ± 5.14 vs. 27.0 5 ± 2.93, 2 hours: 43.94 ± 6.58 vs. 31.95 ± 3.56, 4 hours: 48.04 ± 6.07 vs. 35.24 ± 3.50, 6 hours: 50.33 ± 6.34 vs. 36.66 ± 3.64; pulmonary compliance at 6 hours: 2.28 ± 0.18 vs. 1.86 ± 0.37, all P<0.05). The lung W/D ratio in high VT group was significantly higher than that of the low V(T) group (6.17 ± 2.14 vs. 3.50 ± 1.52, P<0.05). W/D in high V(T) with airway humidification group was higher than that of low V(T) with airway humidification group but without statistically significant difference (5.17 ± 2.14 vs. 3.00 ± 1.10, P>0.05). Microscopic observation showed that cilia were partially detached, adhered and sparse in low V(T) group, while cilia in high V(T) group showed serious detachment and lodging. Remaining cilia were sparse, with lodging, and cellular structure was damaged. Lung tissue pathological injury score in the high V(T) group was significantly higher than that of low V(T) group (6.17 ± 2.14 vs. 3.50 ± 1.52, P<0.05). Cilia density and cellularity were normal in low V(T) with airway humidification group, and no difference in lung tissue pathological injury score was found compared with low V(T) group (3.00 ± 1.10 vs. 3.50 ± 1.52, P>0.05). Cilia were severely detached, adhered and lodging, and cellularity were not obvious in high V(T) with airway humidification group, and lung tissue pathological injury score was elevated significantly than that of the low V(T) with airway humidification group but without statistically significant difference (5.17 ± 2.14 vs. 3.00 ± 1.10, P>0.05). TNF-α and IL-8 concentrations showed no change in plasma and BALF in all groups during ventilation, and no significant difference was found among the groups. Airway humidification can alleviate pathological lung injury, damage of cilia and cellular structure in trachea caused by mechanical ventilation with low and high V(T). High V(T) with humidification can result in serious pulmonary edema.

Synthesis and Preclinical Evaluation of 11C-UCB-J as a PET Tracer for Imaging the Synaptic Vesicle Glycoprotein 2A in the Brain.

PubMed

Nabulsi, Nabeel B; Mercier, Joël; Holden, Daniel; Carré, Stephane; Najafzadeh, Soheila; Vandergeten, Marie-Christine; Lin, Shu-Fei; Deo, Anand; Price, Nathalie; Wood, Martyn; Lara-Jaime, Teresa; Montel, Florian; Laruelle, Marc; Carson, Richard E; Hannestad, Jonas; Huang, Yiyun

2016-05-01

The synaptic vesicle glycoprotein 2A (SV2A) is found in secretory vesicles in neurons and endocrine cells. PET with a selective SV2A radiotracer will allow characterization of drugs that modulate SV2A (e.g., antiepileptic drugs) and potentially could be a biomarker of synaptic density (e.g., in neurodegenerative disorders). Here we describe the synthesis and characterization of the SV2A PET radiotracer (11)C-UCB-J ((R)-1-((3-((11)C-methyl-(11)C)pyridin-4-yl)methyl)-4-(3,4,5-trifluorophenyl)pyrrolidin-2-one) in nonhuman primates, including whole-body biodistribution. (11)C-UCB-J was prepared by C-(11)C-methylation of the 3-pyridyl trifluoroborate precursor with (11)C-methyl iodide via the Suzuki-Miyaura cross-coupling method. Rhesus macaques underwent multiple scans including coinjection with unlabeled UCB-J (17, 50, and 150 μg/kg) or preblocking with the antiepileptic drug levetiracetam at 10 and 30 mg/kg. Scans were acquired for 2 h with arterial sampling and metabolite analysis to measure the input function. Regional volume of distribution (VT) was estimated using the 1-tissue-compartment model. Target occupancy was assessed using the occupancy plot; the dissociation constant (Kd) was determined by fitting self-blocking occupancies to a 1-site model, and the maximum number of receptor binding sites (Bmax) values were derived from baseline VT and from the estimated Kd and the nondisplaceable distribution volume (VND). (11)C-UCB-J was synthesized with greater than 98% purity. (11)C-UCB-J exhibited high free fraction (0.46 ± 0.02) and metabolized at a moderate rate (39% ± 5% and 24% ± 3% parent remaining at 30 and 90 min) in plasma. In the monkey brain, (11)C-UCB-J displayed high uptake and fast kinetics. VT was high (∼25-55 mL/cm(3)) in all gray matter regions, consistent with the ubiquitous expression of SV2A. Preblocking with 10 and 30 mg/kg of levetiracetam resulted in approximately 60% and 90% occupancy, respectively. Analysis of the self-blocking scans yielded a Kd estimate of 3.4 nM and Bmax of 125-350 nM, in good agreement with the in vitro inhibition constant (Ki) of 6.3 nM and regional Bmax in humans. Whole-body biodistribution revealed that the liver and the brain are the dose-limiting organs for males and females, respectively. (11)C-UCB-J exhibited excellent characteristics as an SV2A PET radiotracer in nonhuman primates. The radiotracer is currently undergoing first-in-human evaluation. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Protective ventilation in experimental acute respiratory distress syndrome after ventilator-induced lung injury: a randomized controlled trial.

PubMed

Uttman, L; Bitzén, U; De Robertis, E; Enoksson, J; Johansson, L; Jonson, B

2012-10-01

Low tidal volume (V(T)), PEEP, and low plateau pressure (P(PLAT)) are lung protective during acute respiratory distress syndrome (ARDS). This study tested the hypothesis that the aspiration of dead space (ASPIDS) together with computer simulation can help maintain gas exchange at these settings, thus promoting protection of the lungs. ARDS was induced in pigs using surfactant perturbation plus an injurious ventilation strategy. One group then underwent 24 h protective ventilation, while control groups were ventilated using a conventional ventilation strategy at either high or low pressure. Pressure-volume curves (P(el)/V), blood gases, and haemodynamics were studied at 0, 4, 8, 16, and 24 h after the induction of ARDS and lung histology was evaluated. The P(el)/V curves showed improvements in the protective strategy group and deterioration in both control groups. In the protective group, when respiratory rate (RR) was ≈ 60 bpm, better oxygenation and reduced shunt were found. Histological damage was significantly more severe in the high-pressure group. There were no differences in venous oxygen saturation and pulmonary vascular resistance between the groups. The protective ventilation strategy of adequate pH or PaCO2 with minimal V(T), and high/safe P(PLAT) resulting in high PEEP was based on the avoidance of known lung-damaging phenomena. The approach is based upon the optimization of V(T), RR, PEEP, I/E, and dead space. This study does not lend itself to conclusions about the independent role of each of these features. However, dead space reduction is fundamental for achieving minimal V(T) at high RR. Classical physiology is applicable at high RR. Computer simulation optimizes ventilation and limiting of dead space using ASPIDS. Inspiratory P(el)/V curves recorded from PEEP or, even better, expiratory P(el)/V curves allow monitoring in ARDS.

In vitro validation of an ultrasonic flowmeter in order to measure the functional residual capacity in newborns.

PubMed

Wauer, Juliane; Leier, Tim U; Henschen, Matthias; Wauer, Roland R; Schmalisch, Gerd

2003-05-01

Ultrasonic transit-time airflow meters (UFM) allow simultaneous measurements of volume flow V'(t) and molar mass MM(t) of the breathing gas in the mainstream. Consequently, by using a suitable tracer gas the functional residual capacity (FRC) of the lungs can be measured by a gas wash-in/wash-out technique. The aim of this study was to investigate the in vitro accuracy of a multiple-breath wash-in/wash-out technique for FRC measurements using 4% sulphur hexafluoride (SF6) in air. V'(t) and MM(t) were measured with a Spiroson SCIENTIFIC flowmeter (ECO Medics, CH) with 1.3 ml dead space. Linearity of airflow and MM were tested using different tidal volumes (V(T)) and breathing gases with different O2 and SF6 concentrations. To determine the accuracy of FRC measurements SF6 wash-in and wash-out curves from four mechanical lung models (FRC of 22, 53, 102 and 153 ml) were evaluated by the Spiroson. For each model five measurements were performed with a physiological V(T)/FRC ratio of 0.3 and constant respiratory rate of 30 min(-1). The error of measured V(T) (range 4-60 ml) was <2.5%. There was a strong correlation between the measured and calculated MM of different breathing gases (r = 0.989), and the measuring accuracy was better than 1%. The measured FRC of the four models were 20.3, 49.7, 104.3 and 153.4 ml with a coefficient of variation of 16.5%, 4.5%, 4.9% and 3%. Accordingly, for FRC <100 ml the in vitro accuracy was better than 8% and for FRC >100 ml better than 2.5%. The determination of FRC by MM measurements using the UFM is a simple and cost-effective alternative to conventionally used gas analysers with an acceptable accuracy for many clinical purposes.

Non-RVD mutations that enhance the dynamics of the TAL repeat array along the superhelical axis improve TALEN genome editing efficacy

PubMed Central

Tochio, Naoya; Umehara, Kohei; Uewaki, Jun-ichi; Flechsig, Holger; Kondo, Masaharu; Dewa, Takehisa; Sakuma, Tetsushi; Yamamoto, Takashi; Saitoh, Takashi; Togashi, Yuichi; Tate, Shin-ichi

2016-01-01

Transcription activator-like effector (TALE) nuclease (TALEN) is widely used as a tool in genome editing. The DNA binding part of TALEN consists of a tandem array of TAL-repeats that form a right-handed superhelix. Each TAL-repeat recognises a specific base by the repeat variable diresidue (RVD) at positions 12 and 13. TALEN comprising the TAL-repeats with periodic mutations to residues at positions 4 and 32 (non-RVD sites) in each repeat (VT-TALE) exhibits increased efficacy in genome editing compared with a counterpart without the mutations (CT-TALE). The molecular basis for the elevated efficacy is unknown. In this report, comparison of the physicochemical properties between CT- and VT-TALEs revealed that VT-TALE has a larger amplitude motion along the superhelical axis (superhelical motion) compared with CT-TALE. The greater superhelical motion in VT-TALE enabled more TAL-repeats to engage in the target sequence recognition compared with CT-TALE. The extended sequence recognition by the TAL-repeats improves site specificity with limiting the spatial distribution of FokI domains to facilitate their dimerization at the desired site. Molecular dynamics simulations revealed that the non-RVD mutations alter inter-repeat hydrogen bonding to amplify the superhelical motion of VT-TALE. The TALEN activity is associated with the inter-repeat hydrogen bonding among the TAL repeats. PMID:27883072

Characteristics and circadian distribution of cardiac arrhythmias in patients with heart failure and sleep-disordered breathing.

PubMed

Omran, Hazem; Bitter, Thomas; Horstkotte, Dieter; Oldenburg, Olaf; Fox, Henrik

2018-05-08

Cardiac arrhythmias and sleep-disordered breathing (SDB) are common comorbidities in heart failure with reduced ejection fraction (HFrEF). However, understanding of the association between arrhythmias and SDB is poor. This study assessed the occurrence and circadian distribution of ventricular arrhythmias in HFrEF patients with and without SDB. This retrospective analysis included HFrEF patients admitted for unattended overnight cardiorespiratory polygraphy and 24-h Holter-ECG recording. Holter-ECG data (events/h) were categorized by time of day: morning, 06:00-13:59; afternoon, 14:00-21:59; nighttime, 22:00-05:59. Respiratory events were expressed using the apnea-hypopnea index (AHI) and an AHI ≥ 15/h was categorized as moderate to severe SDB. 167 patients were included (82% male, age 65 ± 10.4 years, left ventricular ejection fraction 30.9 ± 7.9%); SDB was predominantly central sleep apnea (CSA) in 45.5%, obstructive sleep apnea (OSA) in 23.9% or none/mild (nmSDB) in 17.4%. Morning premature ventricular contractions (PVCs) were detected significantly more frequently in CSA versus nmSDB patients (44.4/h versus 1.8/h; p = 0.02). Non-sustained VT was more frequent in patients with CSA versus versus OSA or nmSDB (17.9 versus 3.2 or 3.2%/h; p = 0.003 and p = 0.005, respectively). There was no significant variation in VT occurrence by time of day in HFrEF patients with CSA (p = 0.3). CSA was an independent predictor of VT occurrence in HFrEF in multivariate logistic regression analysis (odds ratio 4.1, 95% confidence interval 1.5-11.4, p = 0.007). CSA was associated with VT occurrence irrespective of sleep/wake status in HFrEF patients, and independently predicted the occurrence of VT. This association may contribute to chances by which CSA increases sudden death risk in HFrEF patients.

THE PREPARATION OF CURRICULUM MATERIALS AND THE DEVELOPMENT OF TEACHERS FOR AN EXPERIMENTAL APPLICATION OF THE CLUSTER CONCEPT OF VOCATIONAL EDUCATION AT THE SECONDARY SCHOOL LEVEL. VOLUME II, INSTRUCTIONAL PLANS FOR THE CONSTRUCTION CLUSTER.

ERIC Educational Resources Information Center

MALEY, DONALD

DESIGNED FOR USE WITH 11TH AND 12TH GRADE STUDENTS, THIS CURRICULUM GUIDE FOR THE OCCUPATIONAL CLUSTER IN CONSTRUCTION WAS DEVELOPED BY PARTICIPATING TEACHERS FROM RESULTS OF THE RESEARCH PROCEDURES DESCRIBED IN VOLUME I (VT 004 162). THE COURSE DESCRIPTION, NEED FOR THE COURSE, COURSE OBJECTIVES, PROCEDURE, AND INSTRUCTIONAL PLAN ARE DISCUSSED…

Open Architecture Framework for Improved Early Stage Submarine Design

DTIC Science & Technology

2010-06-01

Figure 12 Data Structure Example – VPH ..................................................................................... 41 Figure 13 SUBSTART Data...in the MIT SMM (e.g. – VPH -VB, pressure hull volume without volume of the in-hull variable ballast). Tables 4 and 5 list the variables by module...MUD1frac FFsurf θ(x,t) V(t) VPH ∆ff VCGLEADs BTf MUDfwd GMt R(x) Vambt VPHguess ∆mbt VCGnsc BTops OBambt ηa tenvsurf Vaux VPH -VB ∆nsc VCGVL

HISTORY OF EMPLOYMENT AND MANPOWER POLICY IN THE UNITED STATES. PARTS I AND II, DEPRESSION EXPERIENCE, PROPOSALS, AND PROGRAMS. SELECTED READINGS IN EMPLOYMENT AND MANPOWER, VOLUME 5.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Public Welfare.

THE SELECTED READINGS WERE COMPILED TO PROVIDE SUBCOMMITTEE MEMBERS WITH A BROAD BACKGROUND OF DEVELOPMENTS LEADING TO THE EMPLOYMENT ACT OF 1946 AND WITH APPRAISALS OF ITS ADEQUACY AND EFFECTIVENESS. MATERIAL IN THIS VOLUME SPANS THE LATE 1920'S AND THE GREAT DEPRESSION. PARTS III AND IV (VT 004 820) CONTINUE THE HISTORICAL BACKGROUND AND REVIEW.…

Lung-protective mechanical ventilation does not protect against acute kidney injury in patients without lung injury at onset of mechanical ventilation.

PubMed

Cortjens, Bart; Royakkers, Annick A N M; Determann, Rogier M; van Suijlen, Jeroen D E; Kamphuis, Stephan S; Foppen, Jannetje; de Boer, Anita; Wieland, Cathrien W; Spronk, Peter E; Schultz, Marcus J; Bouman, Catherine S C

2012-06-01

Preclinical and clinical studies suggest that mechanical ventilation contributes to the development of acute kidney injury (AKI), particularly in the setting of lung-injurious ventilator strategies. To determine whether ventilator settings in critically ill patients without acute lung injury (ALI) at onset of mechanical ventilation affect the development of AKI. Secondary analysis of a randomized controlled trial (N = 150), comparing conventional tidal volume (V(T), 10 mL/kg) with low tidal volume (V(T), 6 mL/kg) mechanical ventilation in critically ill patients without ALI at randomization. During the first 5 days of mechanical ventilation, the RIFLE class was determined daily, whereas neutrophil gelatinase-associated lipocalin and cystatin C levels were measured in plasma collected on days 0, 2, and 4. Eighty-six patients had no AKI at inclusion, and 18 patients (21%) subsequently developed AKI, but without significant difference between ventilation strategies. (Cumulative hazard, 0.26 vs 0.23; P = .88.) The courses of neutrophil gelatinase-associated lipocalin and cystatin C plasma levels did not differ significantly between randomization groups. In the present study in critically patients without ALI at onset of mechanical ventilation, lower tidal volume ventilation did not reduce the development or worsening of AKI compared with conventional tidal volume ventilation. Copyright © 2012 Elsevier Inc. All rights reserved.

Heat and moisture exchangers and heated humidifiers in acute lung injury/acute respiratory distress syndrome patients. Effects on respiratory mechanics and gas exchange.

PubMed

Morán, Indalecio; Bellapart, Judith; Vari, Alessandra; Mancebo, Jordi

2006-04-01

To compare, in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) patients, the short-term effects of heat and moisture exchangers (HME) and heated humidifiers (HH) on gas exchange, and also on respiratory system mechanics when isocapnic conditions are met. Prospective open clinical study. Intensive Care Service. Seventeen invasively ventilated ALI/ARDS patients. The study was performed in three phases: (1) determinations were made during basal ventilatory settings with HME; (2) basal ventilatory settings were maintained and HME was replaced by an HH; (3) using the same HH, tidal volume (Vt) was decreased until basal PaCO2 levels were reached. FiO2, respiratory rate and PEEP were kept unchanged. Respiratory mechanics, Vdphys, gas exchange and hemodynamic parameters were obtained at each phase. By using HH instead of HME and without changing Vt, PaCO2 decreased from 46+/-9 to 40+/-8 mmHg (p<0.001) and Vdphys decreased from 352+/-63 to 310+/-74 ml (p<0.001). Comparing the first phase with the third, Vt decreased from 521+/-106 to 440+/-118 ml (p<0.001) without significant changes in PaCO2, Vd/Vt decreased from 0.69+/-0.11 to 0.62+/-0.12 (p<0.001), plateau airway pressure decreased from 25+/-6 to 21+/-6 cmH2O (p<0.001) and respiratory system compliance improved from 35+/-12 to 42+/-15 ml/cmH2O (p<0.001). PaO2 remained unchanged in the three phases. Reducing dead space with the use of HH decreases PaCO2 and more importantly, if isocapnic conditions are maintained by reducing Vt, this strategy improves respiratory system compliance and reduces plateau airway pressure.

Catheter ablation of ventricular tachycardias using remote magnetic navigation: a consecutive case-control study.

PubMed

Szili-Torok, Tamas; Schwagten, Bruno; Akca, Ferdi; Bauernfeind, Tamas; Abkenari, Lara Dabiri; Haitsma, David; Van Belle, Yves; Groot, Natasja D E; Jordaens, Luc

2012-09-01

Remote Magnetic Navigation for VT Ablation. This study aimed to compare acute and late outcomes of VT ablation using the magnetic navigation system (MNS) to manual techniques (MAN) in patients with (SHD) and without (NSHD) structural heart disease. Ablation data of 113 consecutive patients (43 SHD, 70 NSHD) with ventricular tachycardia treated with catheter ablation at our center were analyzed. Success rate, complications, procedure, fluoroscopy, and ablation times, and recurrence rates were systematically recorded for all patients. A total of 72 patients were included in the MNS group and 41 patients were included in the MAN group. Patient age, gender, and right ventricular and left ventricular VT were equally distributed. Acute success was achieved in 59 patients in the MNS group (82%) versus 27 (66%) patients in the MAN group (P = 0.046). Overall procedural time (177 ± 79 vs 232 ± 99 minutes, P < 0.01) and mean patient fluoroscopy time (27 ± 19 vs 56 ± 32 minutes, P < 0.001) were all significantly lower using MNS. In NSHD pts, higher acute success was achieved with MNS (83,7% vs 61.9%, P = 0.049), with shorter procedure times (151 ± 57 vs 210 ± 96, P = 0.011), whereas in SHD-VT these were not significantly different. No major complications occurred in the MNS group (0%) versus 1 cardiac tamponade and 1 significantly damaged ICD lead in the MAN group (4.9%, NS). After follow-up (20 ± 11 vs 20 ± 10 months, NS), VT recurred in 14 pts (23.7%) in the MNS group versus 12 pts (44.4%) in the MAN group (P = 0.047). The use of MNS offers advantages for ablation of NSHD-VT, while it offers similar efficacy for SHD-VT. (J Cardiovasc Electrophysiol, Vol. 23, pp. 948-954, September 2012). © 2012 Wiley Periodicals, Inc.

Structure-dependent Pseudoreceptor Intracellular Traffic of Adamantyl Globotriaosyl Ceramide Mimics*

PubMed Central

Saito, Mitsumasa; Mylvaganum, Murugespillai; Tam, Patty; Novak, Anton; Binnington, Beth; Lingwood, Clifford

2012-01-01

The verotoxin (VT) (Shiga toxin) receptor globotriaosyl ceramide (Gb3), mediates VT1/VT2 retrograde transport to the endoplasmic reticulum (ER) for cytosolic A subunit access to inhibit protein synthesis. Adamantyl Gb3 is an amphipathic competitive inhibitor of VT1/VT2 Gb3 binding. However, Gb3-negative VT-resistant CHO/Jurkat cells incorporate adaGb3 to become VT1/VT2-sensitive. CarboxyadaGb3, urea-adaGb3, and hydroxyethyl adaGb3, preferentially bound by VT2, also mediate VT1/VT2 cytotoxicity. VT1/VT2 internalize to early endosomes but not to Golgi/ER. AdabisGb3 (two deacyl Gb3s linked to adamantane) protects against VT1/VT2 more effectively than adaGb3 without incorporating into Gb3-negative cells. AdaGb3 (but not hydroxyethyl adaGb3) incorporation into Gb3-positive Vero cells rendered punctate cell surface VT1/VT2 binding uniform and subverted subsequent Gb3-dependent retrograde transport to Golgi/ER to render cytotoxicity (reduced for VT1 but not VT2) brefeldin A-resistant. VT2-induced vacuolation was maintained in adaGb3-treated Vero cells, but vacuolar membrane VT2 was lost. AdaGb3 destabilized membrane cholesterol and reduced Gb3 cholesterol stabilization in phospholipid liposomes. Cholera toxin GM1-mediated Golgi/ER targeting was unaffected by adaGb3. We demonstrate the novel, lipid-dependent, pseudoreceptor function of Gb3 mimics and their structure-dependent modulation of endogenous intracellular Gb3 vesicular traffic. PMID:22418442

Image-derived input function in PET brain studies: blood-based methods are resistant to motion artifacts.

PubMed

Zanotti-Fregonara, Paolo; Liow, Jeih-San; Comtat, Claude; Zoghbi, Sami S; Zhang, Yi; Pike, Victor W; Fujita, Masahiro; Innis, Robert B

2012-09-01

Image-derived input function (IDIF) from carotid arteries is an elegant alternative to full arterial blood sampling for brain PET studies. However, a recent study using blood-free IDIFs found that this method is particularly vulnerable to patient motion. The present study used both simulated and clinical [11C](R)-rolipram data to assess the robustness of a blood-based IDIF method (a method that is ultimately normalized with blood samples) with regard to motion artifacts. The impact of motion on the accuracy of IDIF was first assessed with an analytical simulation of a high-resolution research tomograph using a numerical phantom of the human brain, equipped with internal carotids. Different degrees of translational (from 1 to 20 mm) and rotational (from 1 to 15°) motions were tested. The impact of motion was then tested on the high-resolution research tomograph dynamic scans of three healthy volunteers, reconstructed with and without an online motion correction system. IDIFs and Logan-distribution volume (VT) values derived from simulated and clinical scans with motion were compared with those obtained from the scans with motion correction. In the phantom scans, the difference in the area under the curve (AUC) for the carotid time-activity curves was up to 19% for rotations and up to 66% for translations compared with the motionless simulation. However, for the final IDIFs, which were fitted to blood samples, the AUC difference was 11% for rotations and 8% for translations. Logan-VT errors were always less than 10%, except for the maximum translation of 20 mm, in which the error was 18%. Errors in the clinical scans without motion correction appeared to be minor, with differences in AUC and Logan-VT always less than 10% compared with scans with motion correction. When a blood-based IDIF method is used for neurological PET studies, the motion of the patient affects IDIF estimation and kinetic modeling only minimally.

Role of high-resolution image integration to visualize left phrenic nerve and coronary arteries during epicardial ventricular tachycardia ablation.

PubMed

Yamashita, Seigo; Sacher, Frédéric; Mahida, Saagar; Berte, Benjamin; Lim, Han S; Komatsu, Yuki; Amraoui, Sana; Denis, Arnaud; Derval, Nicolas; Laurent, François; Montaudon, Michel; Hocini, Mélèze; Haïssaguerre, Michel; Jaïs, Pierre; Cochet, Hubert

2015-04-01

Epicardial ventricular tachycardia (VT) ablation is associated with risks of coronary artery (CA) and phrenic nerve (PN) injury. We investigated the role of multidetector computed tomography in visualizing CA and PN during VT ablation. Ninety-five consecutive patients (86 men; age, 57 ± 15) with VT underwent cardiac multidetector computed tomography. The PN detection rate and anatomic variability were analyzed. In 49 patients undergoing epicardial mapping, real-time multidetector computed tomographic integration was used to display CAs/PN locations in 3-dimensional mapping systems. Elimination of local abnormal ventricular activities (LAVAs) was used as ablation end point. The distribution of CAs/PN with respect to LAVA was analyzed and compared between VT etiologies. Multidetector computed tomography detected PN in 81 patients (85%). Epicardial LAVAs were observed in 44 of 49 patients (15 ischemic cardiomyopathy, 15 nonischemic cardiomyopathy, and 14 arrhythmogenic right ventricular cardiomyopathy) with a mean of 35 ± 37 LAVA points/patient. LAVAs were located within 1 cm from CAs and PN in 35 (80%) and 18 (37%) patients, respectively. The prevalence of LAVA adjacent to CAs was higher in nonischemic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy than in ischemic cardiomyopathy (100% versus 86% versus 53%; P < 0.01). The prevalence of LAVAs adjacent to PN was higher in nonischemic cardiomyopathy than in ischemic cardiomyopathy (93% versus 27%; P < 0.001). Epicardial ablation was performed in 37 patients (76%). Epicardial LAVAs could not be eliminated because of the proximity to CAs or PN in 8 patients (18%). The epicardial electrophysiological VT substrate is often close to CAs and PN in patients with nonischemic cardiomyopathy. High-resolution image integration is potentially useful to minimize risks of PN and CA injury during epicardial VT ablation. © 2015 American Heart Association, Inc.

Electrical Substrate Elimination in 135 Consecutive Patients With Brugada Syndrome.

PubMed

Pappone, Carlo; Brugada, Josep; Vicedomini, Gabriele; Ciconte, Giuseppe; Manguso, Francesco; Saviano, Massimo; Vitale, Raffaele; Cuko, Amarild; Giannelli, Luigi; Calovic, Zarko; Conti, Manuel; Pozzi, Paolo; Natalizia, Andrea; Crisà, Simonetta; Borrelli, Valeria; Brugada, Ramon; Sarquella-Brugada, Georgia; Guazzi, Marco; Frigiola, Alessandro; Menicanti, Lorenzo; Santinelli, Vincenzo

2017-05-01

There is emerging evidence that localization and elimination of abnormal electric activity in the epicardial right ventricular outflow tract may be beneficial in patients with Brugada syndrome. A total of 135 symptomatic Brugada syndrome patients having implantable cardiac defibrillator were enrolled: 63 (group 1) having documented ventricular tachycardia (VT)/ventricular fibrillation (VF) and Brugada syndrome-related symptoms, and 72 (group 2) having inducible VT/VF without ECG documentation at the time of symptoms. About 27 patients of group 1 experienced multiple implantable cardiac defibrillator shocks for recurrent VT/VF episodes. Three-dimensional maps before and after ajmaline determined the arrhythmogenic electrophysiological substrate (AES) as characterized by prolonged fragmented ventricular potentials. Primary end point was identification and elimination of AES leading to ECG pattern normalization and VT/VF noninducibility. Extensive areas of AES were found in the right ventricle epicardium, which were wider in group 1 ( P =0.007). AES increased after ajmaline in both groups ( P <0.001) and was larger in men ( P =0.008). The increase of type-1 ST-segment elevation correlated with AES expansion ( r =0.682, P <0.001). Radiofrequency ablation eliminated AES leading to ECG normalization and VT/VF noninducibility in all patients. During a median follow-up of 10 months, the ECG remained normal even after ajmaline in all except 2 patients who underwent a repeated effective procedure for recurrent VF. In Brugada syndrome, AES is commonly located in the right ventricle epicardium and ajmaline exposes its extent and distribution, which is correlated with the degree of coved ST-elevation. AES elimination by radiofrequency ablation results in ECG normalization and VT/VF noninducibility. Substrate-based ablation is effective in potentially eliminating the arrhythmic consequences of this genetic disease. URL: https://clinicaltrials.gov. Unique identifier: NCT02641431. © 2017 American Heart Association, Inc.

THE PREPARATION OF CURRICULUM MATERIALS AND THE DEVELOPMENT OF TEACHERS FOR AN EXPERIMENTAL APPLICATION OF THE CLUSTER CONCEPT OF VOCATIONAL EDUCATION AT THE SECONDARY SCHOOL LEVEL. VOLUME III, INSTRUCTIONAL PLANS FOR THE METAL FORMING AND FABRICATION CLUSTER.

ERIC Educational Resources Information Center

MALEY, DONALD

DESIGNED FOR USE WITH 11TH AND 12TH GRADE STUDENTS, THIS CURRICULUM GUIDE FOR THE OCCUPATIONAL CLUSTER IN METAL FORMING AND FABRICATION WAS DEVELOPED BY PARTICIPATING TEACHERS FROM RESULTS OF THE RESEARCH PROCEDURES DESCRIBED IN VOLUME I (VT 004 162). THE COURSE DESCRIPTION, NEED FOR THE COURSE, COURSE OBJECTIVES, PROCEDURES AND INSTRUCTIONAL PLAN…

THE PREPARATION OF CURRICULUM MATERIALS AND THE DEVELOPMENT OF TEACHERS FOR AN EXPERIMENTAL APPLICATION OF THE CLUSTER CONCEPT OF VOCATIONAL EDUCATION AT THE SECONDARY SCHOOL LEVEL. VOLUME IV, INSTRUCTIONAL PLANS FOR THE ELECTRO-MECHANICAL CLUSTER.

ERIC Educational Resources Information Center

MALEY, DONALD

DESIGNED FOR USE WITH 11TH AND 12TH GRADE STUDENTS, THIS CURRICULUM GUIDE FOR THE OCCUPATIONAL CLUSTER IN ELECTRO-MECHANICAL INSTALLATION AND REPAIR WAS DEVELOPED BY PARTICIPATING TEACHERS FROM RESULTS OF THE RESEARCH PROCEDURES DESCRIBED IN VOLUME I (VT 004 162). THE COURSE DESCRIPTIONS, NEED FOR THE COURSE, COURSE OBJECTIVES, PROCEDURES, AND…

Command History. 1969. Volume 1. Sanitized

DTIC Science & Technology

1969-01-01

as sugar, meat, milk , eggs and fish sauce were scarce. This scarcity was reflected in prices on both the free and black markets foodstuffs cost up to...front Artiy Reserve and- National Guard ortdntoS0"-t iA RVf were i-- atsseubled ino their original nifts in RV&.Vt nt oete oe to t%* tratistorstatenit

Breathing mechanics during exercise with added dead space reflect mechanisms of ventilatory control.

PubMed

Wood, Helen E; Mitchell, Gordon S; Babb, Tony G

2009-09-30

Small increases in external dead space (V(D)) augment the exercise ventilatory response via a neural mechanism known as short-term modulation (STM). We hypothesized that breathing mechanics would differ during exercise, increased V(D) and STM. Men were studied at rest and during cycle exercise (10-50W) without (Control) and with added V(D) (200-600ml). With added V(D), V(T) increased via increased end-inspiratory lung volume (EILV), with no change in end-expiratory lung volume (EELV), indicating recruitment of inspiratory muscles only. With exercise, V(T) increased via both decreased EELV and increased EILV, indicating recruitment of both expiratory and inspiratory muscles. A significant interaction between the effects of exercise and V(D) on mean inspiratory flow indicated that the augmented exercise ventilatory response with added V(D) (i.e. STM) resulted from increased drive to the inspiratory muscles. These results reveal different patterns of respiratory muscle recruitment among experimental conditions. Hence, we conclude that fundamental differences exist in the neural control of ventilatory responses during exercise, increased V(D) and STM.

Physiological intensity profile, exercise load and performance predictors of a 65-km mountain ultra-marathon.

PubMed

Fornasiero, Alessandro; Savoldelli, Aldo; Fruet, Damiano; Boccia, Gennaro; Pellegrini, Barbara; Schena, Federico

2018-06-01

The aims of the study were to describe the physiological profile of a 65-km (4000-m cumulative elevation gain) running mountain ultra-marathon (MUM) and to identify predictors of MUM performance. Twenty-three amateur trail-runners performed anthropometric evaluations and an uphill graded exercise test (GXT) for VO 2max, ventilatory thresholds (VTs), power outputs (PMax, PVTs) and heart rate response (HRmax, HR@VTs). Heart rate (HR) was monitored during the race and intensity was expressed as: Zone I (VT2) for exercise load calculation (training impulse, TRIMP). Mean race intensity was 77.1%±4.4% of HRmax distributed as: 85.7%±19.4% Zone I, 13.9%±18.6% Zone II, 0.4%±0.9% Zone III. Exercise load was 766±110 TRIMP units. Race time (11.8±1.6h) was negatively correlated with VO 2max (r = -0.66, P <0.001) and PMax (r = -0.73, P <0.001), resulting these variables determinant in predicting MUM performance, whereas exercise thresholds did not improve performance prediction. Laboratory variables explained only 59% of race time variance, underlining the multi-factorial character of MUM performance. Our results support the idea that VT1 represents a boundary of tolerable intensity in this kind of events, where exercise load is extremely high. This information can be helpful in identifying optimal pacing strategies to complete such extremely demanding MUMs.

Identification of verotoxin type 2 variant B subunit genes in Escherichia coli by the polymerase chain reaction and restriction fragment length polymorphism analysis.

PubMed Central

Tyler, S D; Johnson, W M; Lior, H; Wang, G; Rozee, K R

1991-01-01

A set of synthetic oligonucleotide primers was designed for use in a polymerase chain reaction protocol to specifically detect the B subunit genes in vtx2ha and vtx2hb, which code for the production of the VT2 (Shiga-like toxin II) variant cytotoxins VT2v-a and VT2v-b, respectively. An additional set of primers amplified a fragment common to the B subunits of the VT2 and the VT2 variant genes. Subsequent restriction endonuclease digestion of this amplicon permitted prediction of specific VT2 and variant genotypes on the basis of predetermined restriction fragment length polymorphisms. Genotypes of 21 VT2-producing strains of Escherichia coli were determined using this polymerase chain reaction-restriction fragment length polymorphism procedure. Four strains contained B subunit target sequences only for VT2 genes, 9 strains contained sequences only for VT2v-a genes, and 3 strains contained sequences only for VT2v-b. For genes in combination, one strain contained B subunit genes for both VT2 and VT2v-a and two strains contained B subunit genes for VT2 and VT2v-b. Two strains of E. coli O91:H21 contained both VT2v-a and VT2v-b B subunit genes. The VT2 reference strain of E. coli, E32511, was found to contain the targeted sequences from both VT2 and VT2v-a genes, whereas the recombinant E. coli, pEB1, possessed only that of the VT2 gene. The specific activities of extracellular VT2 determined in HeLa cells ranged from 0.3 to 41.7 TCD50 per microgram of protein in strains carrying the VT2 gene target and from 0 to 50.0 TCD50 per microgram of protein in strains carrying only the VT2 variant target (TCD50 is the tissue culture dose by which 50% of the cells were affected), suggesting that phenotypic expression does not correlate with genotype. Images PMID:1679436

Employing an Incentive Spirometer to Calibrate Tidal Volumes Estimated from a Smartphone Camera.

PubMed

Reyes, Bersain A; Reljin, Natasa; Kong, Youngsun; Nam, Yunyoung; Ha, Sangho; Chon, Ki H

2016-03-18

A smartphone-based tidal volume (V(T)) estimator was recently introduced by our research group, where an Android application provides a chest movement signal whose peak-to-peak amplitude is highly correlated with reference V(T) measured by a spirometer. We found a Normalized Root Mean Squared Error (NRMSE) of 14.998% ± 5.171% (mean ± SD) when the smartphone measures were calibrated using spirometer data. However, the availability of a spirometer device for calibration is not realistic outside clinical or research environments. In order to be used by the general population on a daily basis, a simple calibration procedure not relying on specialized devices is required. In this study, we propose taking advantage of the linear correlation between smartphone measurements and V(T) to obtain a calibration model using information computed while the subject breathes through a commercially-available incentive spirometer (IS). Experiments were performed on twelve (N = 12) healthy subjects. In addition to corroborating findings from our previous study using a spirometer for calibration, we found that the calibration procedure using an IS resulted in a fixed bias of -0.051 L and a RMSE of 0.189 ± 0.074 L corresponding to 18.559% ± 6.579% when normalized. Although it has a small underestimation and slightly increased error, the proposed calibration procedure using an IS has the advantages of being simple, fast, and affordable. This study supports the feasibility of developing a portable smartphone-based breathing status monitor that provides information about breathing depth, in addition to the more commonly estimated respiratory rate, on a daily basis.

Employing an Incentive Spirometer to Calibrate Tidal Volumes Estimated from a Smartphone Camera

PubMed Central

Reyes, Bersain A.; Reljin, Natasa; Kong, Youngsun; Nam, Yunyoung; Ha, Sangho; Chon, Ki H.

2016-01-01

A smartphone-based tidal volume (VT) estimator was recently introduced by our research group, where an Android application provides a chest movement signal whose peak-to-peak amplitude is highly correlated with reference VT measured by a spirometer. We found a Normalized Root Mean Squared Error (NRMSE) of 14.998% ± 5.171% (mean ± SD) when the smartphone measures were calibrated using spirometer data. However, the availability of a spirometer device for calibration is not realistic outside clinical or research environments. In order to be used by the general population on a daily basis, a simple calibration procedure not relying on specialized devices is required. In this study, we propose taking advantage of the linear correlation between smartphone measurements and VT to obtain a calibration model using information computed while the subject breathes through a commercially-available incentive spirometer (IS). Experiments were performed on twelve (N = 12) healthy subjects. In addition to corroborating findings from our previous study using a spirometer for calibration, we found that the calibration procedure using an IS resulted in a fixed bias of −0.051 L and a RMSE of 0.189 ± 0.074 L corresponding to 18.559% ± 6.579% when normalized. Although it has a small underestimation and slightly increased error, the proposed calibration procedure using an IS has the advantages of being simple, fast, and affordable. This study supports the feasibility of developing a portable smartphone-based breathing status monitor that provides information about breathing depth, in addition to the more commonly estimated respiratory rate, on a daily basis. PMID:26999152

Quantitative head ultrasound measurements to determine thresholds for preterm neonates requiring interventional therapies following intraventricular hemorrhage

NASA Astrophysics Data System (ADS)

Kishimoto, Jessica; Fenster, Aaron; Salehi, Fateme; Romano, Walter; Lee, David S. C.; de Ribaupierre, Sandrine

2016-04-01

Dilation of the cerebral ventricles is a common condition in preterm neonates with intraventricular hemorrhage (IVH). This post hemorrhagic ventricle dilation (PHVD) can lead to lifelong neurological impairment through ischemic injury due to increased intracranial pressure and without treatment, can lead to death. Clinically, 2D ultrasound (US) through the fontanelles ('soft spots') of the patients are serially acquired to monitor the progression of the ventricle dilation. These images are used to determine when interventional therapies such as needle aspiration of the built up cerebrospinal fluid (CSF) ('ventricle tap', VT) might be indicated for a patient; however, quantitative measurements of the growth of the ventricles are often not performed. There is no consensus on when a neonate with PHVD should have an intervention and often interventions are performed after the potential for brain damage is quite high. Previously we have developed and validated a 3D US system to monitor the progression of ventricle volumes (VV) in IVH patients. We will describe the potential utility of quantitative 2D and 3D US to monitor and manage PHVD in neonates. Specifically, we will look to determine image-based measurement thresholds for patients who will require VT in comparison to patients with PHVD who resolve without intervention. Additionally, since many patients who have an initial VT will require subsequent interventions, we look at the potential for US to determine which PHVD patients will require additional VT after the initial one has been performed.

Positioning of electrode plane systematically influences EIT imaging.

PubMed

Krueger-Ziolek, Sabine; Schullcke, Benjamin; Kretschmer, Jörn; Müller-Lisse, Ullrich; Möller, Knut; Zhao, Zhanqi

2015-06-01

Up to now, the impact of electrode positioning on electrical impedance tomography (EIT) had not been systematically analyzed due to the lack of a reference method. The aim of the study was to determine the impact of electrode positioning on EIT imaging in spontaneously breathing subjects at different ventilation levels with our novel lung function measurement setup combining EIT and body plethysmography. EIT measurements were conducted in three transverse planes between the 3rd and 4th intercostal space (ICS), at the 5th ICS and between the 6th and 7th ICS (named as cranial, middle and caudal) on 12 healthy subjects. Pulmonary function tests were performed simultaneously by body plethysmography to determine functional residual capacity (FRC), vital capacity (VC), tidal volume (VT), expiratory reserve volume (ERV), and inspiratory reserve volume (IRV). Ratios of impedance changes and body plethysmographic volumes were calculated for every thorax plane (ΔIERV/ERV, ΔIVT/VT and ΔIIRV/IRV). In all measurements of a subject, FRC values and VC values differed ≤5%, which confirmed that subjects were breathing at comparable end-expiratory levels and with similar efforts. In the cranial thorax plane the normalized ΔIERV/ERV ratio in all subjects was significantly higher than the normalized ΔIIRV/IRV ratio whereas the opposite was found in the caudal chest plane. No significant difference between the two normalized ratios was found in the middle thoracic plane. Depending on electrode positioning, impedance to volume ratios may either increase or decrease in the same lung condition, which may lead to opposite clinical decisions.

In vivo TSPO imaging in patients with multiple sclerosis: a brain PET study with [18F]FEDAA1106.

PubMed

Takano, Akihiro; Piehl, Fredrik; Hillert, Jan; Varrone, Andrea; Nag, Sangram; Gulyás, Balázs; Stenkrona, Per; Villemagne, Victor L; Rowe, Christopher C; Macdonell, Richard; Tawil, Nabil Al; Kucinski, Thomas; Zimmermann, Torsten; Schultze-Mosgau, Marcus; Thiele, Andrea; Hoffmann, Anja; Halldin, Christer

2013-04-24

The activation of microglia, in general, and the upregulation of the translocator protein (18 kDa) (TSPO) system, in particular, are key features of neuroinflammation, of which the in vivo visualization and quantitative assessment are still challenging due to the lack of appropriate molecular imaging biomarkers. Recent positron emission tomography (PET) studies using TSPO radioligands such as [11C]PK11195 and [11C]PBR28 have indicated the usefulness of these PET biomarkers in patients with neuroinflammatory diseases, including multiple sclerosis (MS). [18F]FEDAA1106 is a recently developed PET radioligand for the in vivo quantification of TSPO. In the present study, we aimed at investigating the diagnostic usefulness of [18F]FEDAA1106 in patients with MS. Nine patients (three on the interferon beta therapy and six without immunomodulatory therapy; seven females/two males; age 34.2 ± 9.1 years old) with relapsing-remitting MS in acute relapse and with gadolinium (Gd)-enhancing lesion(s) in the magnetic resonance imaging (MRI) scans and five healthy controls (four females/one male, age 38.0 ± 9.7 years old) were investigated in this study. Genetic information about the TSPO binding could not be obtained because knowledge about the importance of genetic background for TSPO binding was not available at the time the study was performed. Dynamic PET measurements were performed using an ECAT EXACT HR system (CTI/Siemens, Knoxville, TN, USA) for a total of 150 min, with a 30-min break after the injection of 153.4 ± 10.2 MBq of [18F]FEDAA1106. Metabolite-corrected arterial plasma samples were used to calculate the input function. PET data were analyzed in the following ways: (1) region-of-interest analysis for cortical and subcortical regions was performed using a two-tissue compartment kinetic model in order to estimate binding potentials (BPND) and distribution volume (VT), (2) the feasibility of the estimation of BPND and VT was investigated for MS lesions, and (3) VT parametric images by a Logan plot and standard uptake value (SUV) images were visually compared with the corresponding MRI, focusing on MRI-identified MS lesions. There were no significant differences in the BPND or VT values between patients with MS and healthy controls. Robust BPND and VT values could not be obtained for most MS lesions due to noisy time-activity curves. Visual inspection of VT and SUV images in all nine patients did not reveal high uptake of the radioligand inside and beyond MRI-identified active MS lesions with the exception of one Gd-enhanced MS lesion in the whole patient population. In our study, [18F]FEDAA1106 as a PET radioligand could neither differentiate patients with MS from healthy controls nor detect active plaques in the brain of MS patients. Stratification with respect to genetics and binder status might help to uncover the differences between the groups, which could not be detected here. ClinicalTrials.gov, NCT01031199.

SU-E-T-429: Uncertainties of Cell Surviving Fractions Derived From Tumor-Volume Variation Curves

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chvetsov, A

2014-06-01

Purpose: To evaluate uncertainties of cell surviving fraction reconstructed from tumor-volume variation curves during radiation therapy using sensitivity analysis based on linear perturbation theory. Methods: The time dependent tumor-volume functions V(t) have been calculated using a twolevel cell population model which is based on the separation of entire tumor cell population in two subpopulations: oxygenated viable and lethally damaged cells. The sensitivity function is defined as S(t)=[δV(t)/V(t)]/[δx/x] where δV(t)/V(t) is the time dependent relative variation of the volume V(t) and δx/x is the relative variation of the radiobiological parameter x. The sensitivity analysis was performed using direct perturbation method wheremore » the radiobiological parameter x was changed by a certain error and the tumor-volume was recalculated to evaluate the corresponding tumor-volume variation. Tumor volume variation curves and sensitivity functions have been computed for different values of cell surviving fractions from the practically important interval S{sub 2}=0.1-0.7 using the two-level cell population model. Results: The sensitivity functions of tumor-volume to cell surviving fractions achieved a relatively large value of 2.7 for S{sub 2}=0.7 and then approached zero as S{sub 2} is approaching zero Assuming a systematic error of 3-4% we obtain that the relative error in S{sub 2} is less that 20% in the range S2=0.4-0.7. This Resultis important because the large values of S{sub 2} are associated with poor treatment outcome should be measured with relatively small uncertainties. For the very small values of S2<0.3, the relative error can be larger than 20%; however, the absolute error does not increase significantly. Conclusion: Tumor-volume curves measured during radiotherapy can be used for evaluation of cell surviving fractions usually observed in radiation therapy with conventional fractionation.« less

Acute effects of volume-oriented incentive spirometry on chest wall volumes in patients after a stroke.

PubMed

Lima, Illia Ndf; Fregonezi, Guilherme Af; Melo, Rodrigo; Cabral, Elis Ea; Aliverti, Andrea; Campos, Tânia F; Ferreira, Gardênia Mh

2014-07-01

The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. Twenty poststroke patients and 20 age-matched healthy subjects were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), during incentive spirometry, and during the recovery period after incentive spirometry. Incentive spirometry was associated with an increased chest wall volume measured at the pulmonary rib cage, abdominal rib cage and abdominal compartment (P = .001) and under 3 conditions (P < .001). Compared with healthy control subjects, the tidal volume (VT) of the subjects with stroke was 24.7, 18.0, and 14.7% lower during QB, incentive spirometry, and postincentive spirometry, respectively. Under all 3 conditions, the contribution of the abdominal compartment to VT was greater in the stroke subjects (54.1, 43.2, and 48.9%) than in the control subjects (43.7, 40.8, and 46.1%, P = .039). In the vast majority of subjects (13/20 and 18/20 during QB and incentive spirometry, respectively), abdominal expansion precedes rib cage expansion during inspiration. Greater asymmetry between the right and left hemithoracic expansions occurred in stroke subjects compared with control subjects, but it decreased during QB (62.5%, P = .002), during incentive spirometry (19.7%), and postincentive spirometry (67.6%, P = .14). Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation. Copyright © 2014 by Daedalus Enterprises.

Thermal analysis of the vortex tube based thermocycler for fast DNA amplification: Experimental and two-dimensional numerical results

NASA Astrophysics Data System (ADS)

Raghavan, V.; Whitney, Scott E.; Ebmeier, Ryan J.; Padhye, Nisha V.; Nelson, Michael; Viljoen, Hendrik J.; Gogos, George

2006-09-01

In this article, experimental and numerical analyses to investigate the thermal control of an innovative vortex tube based polymerase chain reaction (VT-PCR) thermocycler are described. VT-PCR is capable of rapid DNA amplification and real-time optical detection. The device rapidly cycles six 20μl 96bp λ-DNA samples between the PCR stages (denaturation, annealing, and elongation) for 30cycles in approximately 6min. Two-dimensional numerical simulations have been carried out using computational fluid dynamics (CFD) software FLUENT v.6.2.16. Experiments and CFD simulations have been carried out to measure/predict the temperature variation between the samples and within each sample. Heat transfer rate (primarily dictated by the temperature differences between the samples and the external air heating or cooling them) governs the temperature distribution between and within the samples. Temperature variation between and within the samples during the denaturation stage has been quite uniform (maximum variation around ±0.5 and 1.6°C, respectively). During cooling, by adjusting the cold release valves in the VT-PCR during some stage of cooling, the heat transfer rate has been controlled. Improved thermal control, which increases the efficiency of the PCR process, has been obtained both experimentally and numerically by slightly decreasing the rate of cooling. Thus, almost uniform temperature distribution between and within the samples (within 1°C) has been attained for the annealing stage as well. It is shown that the VT-PCR is a fully functional PCR machine capable of amplifying specific DNA target sequences in less time than conventional PCR devices.

Air compressor battery duration with mechanical ventilation in a field anesthesia machine.

PubMed

Szpisjak, Dale F; Giberman, Anthony A

2015-05-01

Compressed air to power field anesthesia machine ventilators may be supplied by air compressor with battery backup. This study determined the battery duration when the compPAC ventilator's air compressor was powered by NiCd battery to ventilate the Vent Aid Training Test Lung modeling high (HC = 0.100 L/cm H2O) and low (LC = 0.020 L/cm H2O) pulmonary compliance. Target tidal volumes (VT) were 500, 750, and 1,000 mL. Respiratory rate = 10 bpm, inspiratory-to-expiratory time ratio = 1:2, and fresh gas flow = 1 L/min air. N = 5 in each group. Control limits were determined from the first 150 minutes of battery power for each run and lower control limit = mean VT - 3SD. Battery depletion occurred when VT was below the lower control limit. Battery duration ranged from 185.8 (±3.2) minutes in the LC-1000 group to 233.3 (±3.6) minutes in the HC-750 group. Battery duration of the LC-1000 group was less than all others (p = 0.027). The differences among the non-LC-1000 groups were not clinically significant. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Information Processing Techniques Program. Volume I. Packet Speech Systems Technology

DTIC Science & Technology

1980-09-30

Itindsign has litt-rn vt-tntit-r aliti sill dI- ditiibuted trrni cparat- tintr aisa ithnnin ITtc-i A. Packet Vttice Terminal As Iprt- iouisik rtrtteti tin...September 1980. FO1M 1473 EDITION OF I NOV 65 IS OBSOLETEDD I JAN 73 UNCLA.SSI F[IF ) SECURITY CLASSIFICATION OF THIS PAGE (Ibmn Data fntew-d)

ONR Tokyo Scientific Bulletin. Volume 2, Number 2. April-June 1977,

DTIC Science & Technology

1977-01-01

authors were l)r. I lideshige lmai , Albany Medical (‘ollege , Albany, New York: I)rs. Albert I I . Sub way and V . Subramanyam , Northeastern...and already iu ~ operatio n . It occupies 245 hee t ares ( abou t 600 acres) of the n e w town. By Japanese s tamidards such a camu ipu s vt

Rationale, study design and analysis plan of the lung imaging morphology for ventilator settings in acute respiratory distress syndrome study (LIVE study): Study protocol for a randomised controlled trial.

PubMed

Jabaudon, Matthieu; Godet, Thomas; Futier, Emmanuel; Bazin, Jean-Étienne; Sapin, Vincent; Roszyk, Laurence; Pereira, Bruno; Constantin, Jean-Michel

2017-10-01

Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study). Patients will be enrolled within the first 12hours of ARDS onset. In both groups, volume-controlled ventilation with low tidal-volumes (Vt) will be used to target a plateau pressure≤30 cmH 2 O. In the control group, the PEEP level and inspired fraction of oxygen (FiO 2 ) will be set using the ARDSNet table; a Vt of 6 mL/kg of predicted body weight (PBW) will be set and prone position (PP) will be applied. In the intervention arm, the ventilator will be set according to lung morphology (focal/non-focal) that will be assessed according to CT-scan±chest x-ray+lung echography. For focal ARDS patients, a Vt of 8 mL/kg PBW will be used along with low PEEP and PP. For non-focal ARDS patients, a Vt of 6 mL/kg PBW will be used with RM and PEEP to reach a plateau pressure≤30 cmH 2 O. The primary outcome is all-cause 90-day mortality and the secondary outcomes are: in-hospital mortality, mortality at day 28, 60, 180 and 365; ventilator-free days at day 30, quality of life at one year; ventilator-associated pneumonia rate; barotrauma; ICU and hospital length of stay. This RCT is registered on Clinicaltrials.gov under identifier NCT02149589. Copyright © 2017 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Mechanisms of Coupled Vibrational Relaxation and Dissociation in Carbon Dioxide.

PubMed

Armenise, Iole; Kustova, Elena

2018-05-21

A complete vibrational state-specific kinetic scheme describing dissociating carbon dioxide mixtures is proposed. CO 2 symmetric, bending and asymmetric vibrations and dissociation-recombination are strongly coupled through inter-mode vibrational energy transfers. Comparative study of state-resolved rate coefficients is carried out; the effect of different transitions may vary considerably with temperature. A non-equilibrium 1-D boundary layer flow typical to hypersonic planetary entry is studied in the state-to-state approach. To assess the sensitivity of fluid-dynamic variables and heat transfer to various vibrational transitions and chemical reactions, corresponding processes are successively included to the kinetic scheme. It is shown that vibrational-translational (VT) transitions in the symmetric and asymmetric modes do not alter the flow and can be neglected whereas the VT 2 exchange in the bending mode is the main channel of vibrational relaxation. Inter-mode vibrational exchanges affect the flow implicitly, through energy redistribution enhancing VT relaxation; the dominating role belongs to near-resonant transitions between symmetric and bending modes as well as between CO molecules and CO 2 asymmetric mode. Strong coupling between VT 2 relaxation and chemical reactions is emphasized. While vibrational distributions and average vibrational energy show strong dependence on the kinetic scheme, the heat flux is more sensitive to chemical reactions.

Fungal CYP51 Inhibitors VT-1161 and VT-1129 Exhibit Strong In Vitro Activity against Candida glabrata and C. krusei Isolates Clinically Resistant to Azole and Echinocandin Antifungal Compounds.

PubMed

Schell, W A; Jones, A M; Garvey, E P; Hoekstra, W J; Schotzinger, R J; Alexander, B D

2017-03-01

The in vitro activities of fungal CYP51 inhibitors VT-1161 and VT-1129 were determined for Candida glabrata ( n = 34) and C. krusei ( n = 50). C. glabrata isolates were screened for FKS gene mutations. All isolates were resistant clinically and/or in vitro to at least one standard antifungal compound. VT-1161 and VT-1129 MICs for all isolates were at least 5-fold below achievable human plasma levels for VT-1161. VT-1161 and VT-1129 are promising for the treatment of resistant C. glabrata and C. krusei infections. Copyright © 2017 American Society for Microbiology.

Memory formation and evolution of the vortex configuration associated with random organization

NASA Astrophysics Data System (ADS)

Dobroka, M.; Kawamura, Y.; Ienaga, K.; Kaneko, S.; Okuma, S.

2017-05-01

We study the general phenomenon of random organization using a vortex system. When a periodic shear with a small shear amplitude d inp is applied to many-particle (vortex) assemblies with a random distribution, the particles (vortices) gradually self-organize to avoid future collisions and transform into an organized configuration. This is detected from the time-evolution of the voltage V(t) (average velocity) that increases towards a steady-state value. From the subsequent readout measurements of V(t) using various shear amplitudes, we find that the information of the input shear amplitude d inp is memorized in the configuration of the vortex distributions in the transient as well as the steady state, and that it is readable. We also find that the transient vortex configuration formed during random organization is not microscopically homogeneous but consists of disordered and organized regions.

Effect of CO₂ on the ventilatory sensitivity to rising body temperature during exercise.

PubMed

Hayashi, Keiji; Honda, Yasushi; Miyakawa, Natsuki; Fujii, Naoto; Ichinose, Masashi; Koga, Shunsaku; Kondo, Narihiko; Nishiyasu, Takeshi

2011-05-01

We examined the degree to which ventilatory sensitivity to rising body temperature (the slope of the regression line relating ventilation and body temperature) is altered by restoration of arterial PCO(2) to the eucapnic level during prolonged exercise in the heat. Thirteen subjects exercised for ~60 min on a cycle ergometer at 50% of peak O(2) uptake with and without inhalation of CO(2)-enriched air. Subjects began breathing CO(2)-enriched air at the point that end-tidal Pco(2) started to decline. Esophageal temperature (T(es)), minute ventilation (V(E)), tidal volume (V(T)), respiratory frequency (f(R)), respiratory gases, middle cerebral artery blood velocity, and arterial blood pressure were recorded continuously. When V(E), V(T), f(R), and ventilatory equivalents for O(2) uptake (V(E)/VO(2)) and CO(2) output (V(E)/VCO(2)) were plotted against changes in T(es) from the start of the CO(2)-enriched air inhalation (ΔT(es)), the slopes of the regression lines relating V(E), V(T), V(E)/VO(2), and V(E)/VCO(2) to ΔT(es) (ventilatory sensitivity to rising body temperature) were significantly greater when subjects breathed CO(2)-enriched air than when they breathed room air (V(E): 19.8 ± 10.3 vs. 8.9 ± 6.7 l·min(-1)·°C(-1), V(T): 18 ± 120 vs. -81 ± 92 ml/°C; V(E)/VO(2): 7.4 ± 5.5 vs. 2.6 ± 2.3 units/°C, and V(E)/VCO(2): 7.6 ± 6.6 vs. 3.4 ± 2.8 units/°C). The increase in Ve was accompanied by increases in V(T) and f(R). These results suggest that restoration of arterial PCO(2) to nearly eucapnic levels increases ventilatory sensitivity to rising body temperature by around threefold.

High flow through a nasal cannula and CPAP effect in a simulated infant model.

PubMed

Volsko, Teresa A; Fedor, Kathy; Amadei, Jason; Chatburn, Robert L

2011-12-01

Limited data are available to describe the CPAP effects that can be expected when using high flow with a traditional nasal cannula. To describe the relationship between the pressure generated at the airway opening and flow through a nasal cannula using a simulated infant model. We hypothesized that positive pressure generated by a standard cannula at flows > 2 L/min would be minimal and clinically unimportant. Nares were simulated with holes drilled in a plastic fixture. A nares template for CPAP prongs served as a sizing template for the holes. Small, medium, and large nares fixtures were constructed and connected to a lung simulator that simulated spontaneous breathing. Respiratory muscle pressure was simulated by setting a waveform and adjusting the amplitude to deliver a range of tidal volumes (V(T)) from 3 mL to 12 mL. Lung compliance and resistance were set at 0.5 mL/cm H(2)O and 125 cm H(2)O/L/s, respectively. Nasal cannulas were inserted in the model nares. We assured that the prong occlusion of the nares did not exceed 50%. Cannula flow was adjusted from 2-6 L/min in 1-L/min increments. Data were averaged over 20 breaths. Mean airway pressure and percent change in V(T) were recorded. The greatest effect on V(T) (mean ± SD 0.16 ± 0.10 mL) and pressure change (mean ± SD 0.7 ± 0.5 cm H(2)O) occurred with the premature cannula. The least effect on pressure (mean ± SD 0.3 ± 0.22 cm H(2)O) and V(T) change (mean ± SD 0.01 ± 0.02 mL) occurred with the infant cannula. Clinically important pressures were not generated by high flows with a standard nasal cannula. The differences in spontaneous V(T) across all flows were negligible.

Volumetric capnography curves as lung function test to confirm bronchoconstriction after carbachol challenge in sedated dogs.

PubMed

Scheffzek, S; Mosing, M; Hirt, R; Iff, I; Moens, Y

2012-12-01

This study investigated volumetric capnography (VC) in detecting airway responsiveness following airway challenge using carbachol in seven sedated dogs via face mask. Nebulised saline was administered, followed by increasing concentrations of nebulised carbachol until airflow limitation occurred (EP). Dead space (DS) variables and shape indices of the VC curve were calculated automatically after entering arterial carbon dioxide tension. Airway DS, airway DS to tidal volume (VT) ratio and the intercept of slope 2 of the VC curve decreased significantly at EP by 10%, 13% and 16%, respectively, minute ventilation, VT and alveolar DS increased significantly at EP by 49%, 22% and 200%, respectively. We conclude that VC and derived indices may be used to verify a reaction to airway challenge caused by carbachol in sedated dogs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Habituation of the cold shock response may include a significant perceptual component.

PubMed

Barwood, Martin J; Corbett, Jo; Wagstaff, Christopher R D

2014-02-01

Accidental immersion in cold water is a risk factor for many occupations. Habituation to cold-water immersion (CWI) is one practical means of reducing the cold shock response (CSR) on immersion. We investigated whether repeated thermoneutral water immersion (TWI) induced a perceptual habituation (i.e., could lessen perceived threat and anxiety) and consequently reduce the CSR on subsequent CWI. There were 12 subjects who completed seven 7-min head-out immersions. Immersions one and seven were CWls [15.0 (0.1) degrees C], and immersions two to six were TWI [34.9 (0.10) degrees C]. Anxiety 120-cm visual analogue scale) and the cardiorespiratory responses [heart rate (f(C)), respiratory frequency (f(R)), tidal volume (V(T)), and minute ventilation (V(E))] to immersion were measured throughout. Data were compared within subject between conditions using ANOVA to an alpha level of 0.05. Acute anxiety was significantly reduced after repeated exposure to the immersion scenario (i.e., TWI): CWI-1: 6.3 (4.4) cm; and CWI-2: 4.5 (4.0) cm [condition mean (SD)]. These differences did not influence the peak in the CSR. The f(C), f(R), and V(E) responses were similar between CWI-1 and CWI-2. V(T) response was significantly lower in CWI-2; mean (SD) across the immersion: CWI-1 1.27 (0.17) vs. CWI-2 1.11 0.21 L. Repeated TWI lessened the anxiety associated with CWI (perceptual habituation). This had a negligible effect on the primary components of the CSR, but did lower VT, which may reduce the volume of any aspirated water in an emergency situation. Reducing the threat appraisal of an environmental stressor may be a useful biproduct of survival training, thereby minimizing psychophysiological strain.

Ultrasound assessment of diaphragmatic function in patients with amyotrophic lateral sclerosis.

PubMed

Fantini, Riccardo; Mandrioli, Jessica; Zona, Stefano; Antenora, Federico; Iattoni, Andrea; Monelli, Marco; Fini, Nicola; Tonelli, Roberto; Clini, Enrico; Marchioni, Alessandro

2016-07-01

Evaluation of diaphragm function in Amyotrophic Lateral Sclerosis (ALS) is critical in determining when to commence non-invasive mechanical ventilation (NIV). Currently, forced vital capacity (FVC) and sniff nasal inspiratory pressure (SNIP) are volitional measures for this evaluation, but require collaboration and are poorly specific. The primary aim of this study was to assess whether diaphragmatic thickness measured by ultrasound (US) correlates with lung function impairment in ALS patients. The secondary aim was then to compare US diaphragm thickness index (ΔTdi) with a new parameter (ΔTmax index). 41 patients with ALS and 30 healthy subjects were enrolled in the study. All subjects underwent spirometry, SNIP and diaphragm US evaluation, while arterial blood gases were measured in some patients only. US assessed diaphragm thickness (Tdi) at tidal volume (Vt) or total lung capacity (TLC), and their ratio (ΔTmax) were recorded. Changes (Δ) in Tdi indices during tidal volume (ΔTdiVt) and maximal inspiration (ΔTdiTLC) were also assessed. ΔTdiTLC (p <0.001) and ΔTmax (p = 0.007), but not ΔTdiVt, differed between patients and controls. Significant correlation (p < 0.05) was found between ΔTdiTLC, ΔTmax and FVC. The ROC curve analysis for comparison of individual testing showed better accuracy with Δtmax than with ΔtdiTLC for FVC (AUC 0.76 and 0.27) and SNIP (AUC 0.71 and 0.25). Diaphragm thickness assessed by ultrasound significantly correlates with global respiratory alterations in patients with ALS. ΔTmax represents a new US index of early diaphragmatic dysfunction, better related with the routinely performed lung function tests. © 2016 Asian Pacific Society of Respirology.

Characterization of Inclusion Populations in Mn-Si Deoxidized Steel

NASA Astrophysics Data System (ADS)

García-Carbajal, Alfonso; Herrera-Trejo, Martín; Castro-Cedeño, Edgar-Ivan; Castro-Román, Manuel; Martinez-Enriquez, Arturo-Isaias

2017-12-01

Four plant heats of Mn-Si deoxidized steel were conducted to follow the evolution of the inclusion population through ladle furnace (LF) treatment and subsequent vacuum treatment (VT). The liquid steel was sampled, and the chemical composition and size distribution of the inclusion populations were characterized. The Gumbel generalized extreme-value (GEV) and generalized Pareto (GP) distributions were used for the statistical analysis of the inclusion size distributions. The inclusions found at the beginning of the LF treatment were mostly fully liquid SiO2-Al2O3-MnO inclusions, which then evolved into fully liquid SiO2-Al2O3-CaO-MgO and partly liquid SiO2-CaO-MgO-(Al2O3-MgO) inclusions detected at the end of the VT. The final fully liquid inclusions had a desirable chemical composition for plastic behavior in subsequent metallurgical operations. The GP distribution was found to be undesirable for statistical analysis. The GEV distribution approach led to shape parameter values different from the zero value hypothesized from the Gumbel distribution. According to the GEV approach, some of the final inclusion size distributions had statistically significant differences, whereas the Gumbel approach predicted no statistically significant differences. The heats were organized according to indicators of inclusion cleanliness and a statistical comparison of the size distributions.

Ventilatory Patterning in a Mouse Model of Stroke

PubMed Central

Koo, Brian B; Strohl, Kingman P; Gillombardo, Carl B; Jacono, Frank J

2010-01-01

Cheyne-Stokes respiration (CSR) is a breathing pattern characterized by waxing and waning of breath volume and frequency, and is often recognized following stroke, when causal pathways are often obscure. We used an animal model to address the hypothesis that cerebral infarction is a mechanism for producing breathing instability. Fourteen male A/J mice underwent either stroke (n=7) or sham (n=7) procedure. Ventilation was measured using whole body plethysmography. Respiratory rate (RR), tidal volume (VT) and minute ventilation (Ve) mean values and coefficient of variation were computed for ventilation and oscillatory behavior. In addition, the ventilatory data were computationally fit to models to quantify autocorrelation, mutual information, sample entropy and a nonlinear complexity index. At the same time post procedure, stroke when compared to sham animal breathing consisted of a lower RR and autocorrelation, higher coefficient of variation for VT and higher coefficient of variation for Ve. Mutual information and the nonlinear complexity index were higher in breathing following stroke which also demonstrated a waxing/waning pattern. The absence of stroke in the sham animals was verified anatomically. We conclude that ventilatory pattern following cerebral infarction demonstrated increased variability with increased nonlinear patterning and a waxing/waning pattern, consistent with CSR. PMID:20472101

Lung reflexes in rabbits during pulmonary stretch receptor block by sulphur dioxide.

PubMed

Davies, A; Dixon, M; Callanan, D; Huszczuk, A; Widdicombe, J G; Wise, J C

1978-07-01

Anaesthetized rabbits were given 200 ppm sulphur dioxide to breathe for 10 min. This abolished activity in 23 of 26 pulmonary stretch receptors, while leaving that of lung irritant receptors unimpaired. The Breuer-Hering reflex was abolished and breathing became deeper and slower. Inspiratory time (tI) was increased and expiratory time (tE) decreased. Subsequent vagotomy increased tidal volume (VT), tI and tE. In animals with stretch receptors blocked, injections of phenyl diguanide and histamine still increased breathing frequency and decreased VT, indicating that reflexes from lung irritant and J-receptors were intact. Inhalation of 8% CO2 caused a bigger increase in frequency and tidal volume in rabbits with stretch receptor block compared with controls or those after vagotomy. Induction of pneumothorax with stretch receptor block transiently prolonged tI and shortened tE; removal of the pneumothorax also transiently shortened tE and usually also decreased tI. The results suggest that lung irritant receptors reflexly shorten tE in all our experimental conditions, but have various effects on tI which may depend on the timing of the irritant receptor discharge and refractoriness of the inspiratory response.

Graphics Software For VT Terminals

NASA Technical Reports Server (NTRS)

Wang, Caroline

1991-01-01

VTGRAPH graphics software tool for DEC/VT computer terminal or terminals compatible with it, widely used by government and industry. Callable in FORTRAN or C language, library program enabling user to cope with many computer environments in which VT terminals used for window management and graphic systems. Provides PLOT10-like package plus color or shade capability for VT240, VT241, and VT300 terminals. User can easily design more-friendly user-interface programs and design PLOT10 programs on VT terminals with different computer systems. Requires ReGis graphics set terminal and FORTRAN compiler.

Prediction and prognosis of ventricular tachycardia recurrence after catheter ablation with remote magnetic navigation for electrical storm in patients with ischemic cardiomyopathy.

PubMed

Jin, Qi; Jacobsen, Peter Karl; Pehrson, Steen; Chen, Xu

2017-11-01

Ventricular tachycardia (VT) recurrence after catheter ablation for electrical storm is commonly seen in patients with ischemic cardiomyopathy (ICM). We hypothesized that VT recurrence can be predicted and be related to the all-cause death after VT storm ablation guided by remote magnetic navigation (RMN) in patients with ICM. A total of 54 ICM patients (87% male; mean age, 65 ± 7.1 years) presenting with VT storm undergoing acute ablation using RMN were enrolled. Acute complete ablation success was defined as noninducibility of any sustained monomorphic VT at the end of the procedure. Early VT recurrence was defined as the occurrence of sustained VT within 1 month after the first ablation. After a mean follow-up of 17.1 months, 27 patients (50%) had freedom from VT recurrence. Sustained VT recurred in 12 patients (22%) within 1 month following the first ablation. In univariate analysis, VT recurrence was associated with incomplete procedural success (hazard ratio [HR]: 6.25, 95% confidence interval [CI]: 1.20-32.47, P = 0.029), lack of amiodarone usage before ablation (HR: 4.71, 95% CI: 1.12-19.7, P = 0.034), and a longer procedural time (HR: 1.023, 95% CI: 1.00-1.05, P = 0.05). The mortality of patients with early VT recurrence was higher than that of patients without recurrence (P < 0.01). Inducibility of any VT at the end of procedure for VT storm guided by RMN is the strongest predictor of VT recurrence. ICM patients who have early recurrences after VT storm ablation are at high risk of all-cause death. © 2017 Wiley Periodicals, Inc.

Histopathology of tympanic membranes from patients with ventilation tubes.

PubMed

Oktay, Mehmet Faruk; Tansuker, Hasan Deniz; Fukushima, Hisaki; Paparella, Michael M; Schachern, Patricia A; Cureoglu, Sebahattin

2018-06-01

To evaluate the histopathologic changes in tympanic membranes (TMs) with ventilation tubes (VTs). In this retrospective human temporal bone study our overall study group included 4 subgroups of TMs from deceased donors as follows: 24 with a history of VT insertion for chronic otitis media with effusion (COME-VT); 5 with a history of VT insertion for Meniere's disease (MD-VT); 33 without a history of VT insertion for chronic otitis media with effusion (COME); and 14 without a history of VT insertion for Meniere's disease (MD). We classified the extent of migration of the outer keratinized squamous epithelium onto the inner surface of TM perforations and noted the presence and location of tympanosclerosis, of atrophy, of perforation, and/or of cholesteatoma formation. Tympanosclerosis occurred in 14/24 TMs in the COME-VT subgroup; 2/5, MD-VT; 7/33, COME; and 0/14, MD. The VT insertion site was mostly in the anteroinferior (63%) quadrant of the TM; tympanosclerosis occurred more frequently in the posteroinferior (42%) and posterosuperior (33%) quadrants. We found no significant correlation between the location of tympanosclerosis and the VT insertion site (P>0.05). Atrophy occurred in 7/24 TMs in the COME-VT subgroup; 3/5, MD-VT; 8/33, COME; and 2/14, MD. We found no significant correlation between the location of atrophy and the VT insertion site; however, atrophy was located mostly in the anteroinferior quadrant (one of the most common VT insertion sites) of the TM. Regarding the ingrowth of keratinized epithelium, the mucocutanous junction was detected at any point at the inner surface of the TM in 50% of the specimens. We observed intratympanic cholesteatoma formation in 2/24 TMs in the COME-VT subgroup. TM changes due to VT insertion are more common than previously realized. Meticulous otomicroscopic evaluation of the TM is necessary during tympanomastoidectomies in order to prevent the intratympanic inclusion pearls and squamous epithelial ingrowth to prevent any further cholesteatoma formation. Copyright © 2017. Published by Elsevier B.V.

Beyond the Storm: Comparison of Clinical Factors, Arrhythmogenic Substrate, and Catheter Ablation Outcomes in Structural Heart Disease Patients With versus Those Without a History of Ventricular Tachycardia Storm.

PubMed

Kumar, Saurabh; Fujii, Akira; Kapur, Sunil; Romero, Jorge; Mehta, Nishaki K; Tanigawa, Shinichi; Epstein, Laurence M; Koplan, Bruce A; Michaud, Gregory F; John, Roy M; Stevenson, William G; Tedrow, Usha B

2017-01-01

Catheter ablation can be lifesaving in ventricular tachycardia (VT) storm, but the underlying substrate in patients with storm is not well characterized. We sought to compare the clinical factors, substrate, and outcomes differences in patients with sustained monomorphic VT who present for catheter ablation with VT storm versus those with a nonstorm presentation. Consecutive ischemic (ICM; n = 554) or nonischemic cardiomyopathy patients (NICM; n = 369) with a storm versus nonstorm presentation were studied (ICM storm 186; NICM storm 101). In ICM, storm compared with nonstorm patients had significantly lower left ventricular (LV) ejection fraction (EF), greater number of antiarrhythmic drug (AAD) failures, slower VTs, greater number of scarred LV segments, higher incidence of anterior, septal, and apical endocardial LV scar (all P < 0.05). However, outcomes in follow-up were similar (12-month ventricular arrhythmia [VA]-free survival: 51% vs. 52%, P = 0.6; survival free of death/transplant 75% vs. 87%, P = 0.7). In addition to the above differences, NICM storm patients were also older; however, the extent and distribution of scar was similar except for a higher incidence of lateral endocardial scar in storm patients (P = 0.05). VA-free survival (36% vs. 47%, P = 0.004) and survival free of death/transplant, however, were worse in NICM storm than nonstorm patients (72% vs. 88%, P = 0.001). NICM storm patients had worse VA-free survival than ICM storm patients. There are differences in clinical factors and scar patterns in patients undergoing VT ablation who present with VT storm versus those with a nonstorm presentation. Clinical outcomes are worse in NICM storm patients. © 2016 Wiley Periodicals, Inc.

Yolk proteins during ovary and egg development of mature female freshwater crayfish (Cherax quadricarinatus).

PubMed

Serrano-Pinto, Vania; Vazquez-Boucard, Celia; Villarreal-Colmenares, Humberto

2003-01-01

Vitellins from ovaries and eggs at different stages of development in freshwater crayfish (Cherax quadricarinatus) were examined by chromatography, PAGE and SDS-PAGE. With these methods, two forms of vitellin (Vt1 and Vt2) were observed in ovaries and eggs (stages I and V). In ovaries in secondary vitellogenesis, native molecular mass was 470 (Vt1) and 440 (Vt2) kDa. The electrophoretic pattern of the eggs proved to be more complex. The protein molecular mass depend on the development stage of the egg: stage I, 650 kDa (Vt1) and 440 kDa (Vt2); stage V, 390 kDa (Vt1) and 340 kDa (Vt2). The identified vitellins appear to be lipo-glycocarotenoprotein. A similar vitellin polypeptide composition was observed in the two forms of vitellin from ovaries and eggs in stage V. In ovaries the SDS-PAGE analysis showed four subunits with molecular weights of approximately 180, 120, 95 and 80 kDa (Vt1 and Vt2). The polypeptide composition in the two forms of vitellins in stage I and stage III eggs were different at 195, 190, 130 and 110 kDa (Vt1) and 116 and 107 kDa (Vt2). On the other hand, in stage V eggs, 110, 95, 87 and 75 kDa (Vt1 and Vt2) were identified. Two antibodies (Ab1 and Ab2) were prepared against the purified proteins of stage V eggs and their specificity was demonstrated by radial immunoprecipitation, and Western blotting analysis. Two forms of vitellins were also found in stage V eggs after chromatography on Sepharose CL-2B column and hydroxylapatite and polyacrylamide gel electrophoresis.

VT-1161 protects mice against oropharyngeal candidiasis caused by fluconazole-susceptible and -resistant Candida albicans

PubMed Central

Break, Timothy J; Desai, Jigar V; Ferre, Elise M N; Henderson, Christina; Zelazny, Adrian M; Siebenlist, Ulrich; Hoekstra, William J; Schotzinger, Robert J; Garvey, Edward P; Lionakis, Michail S

2018-01-01

Abstract Background Candida albicans, the most common human fungal pathogen, causes chronic mucosal infections in patients with inborn errors of IL-17 immunity that rely heavily on chronic, often lifelong, azole antifungal agents for treatment. However, a rise in azole resistance has predicated a need for developing new antifungal drugs. Objectives To test the in vitro and in vivo efficacy of VT-1161 and VT-1129 in the treatment of oropharyngeal candidiasis with azole-susceptible or -resistant C. albicans strains. Methods MICs of VT-1161, VT-1129 and nine licensed antifungal drugs were determined for 31 Candida clinical isolates. The drug concentrations in mouse serum and tongues were measured following oral administration. IL-17-signalling-deficient Act1−/− mice were infected with fluconazole-susceptible or fluconazole-resistant C. albicans strains, and the amount of mucosal fungal burden was determined after fluconazole or VT-1161 treatment. Results Fourteen isolates (45%) were not fluconazole susceptible (MIC ≥4 mg/L). VT-1161 and VT-1129 showed significant in vitro activity against the majority of the 31 mucosal clinical isolates (MIC50 0.03 and 0.06 mg/L, respectively), including Candida glabrata (MIC50, 0.125 and 0.25 mg/L, respectively). After oral doses, VT-1161 and VT-1129 concentrations in mouse serum and tongues were well above their MIC50 values. VT-1161 was highly effective as treatment of both fluconazole-susceptible and -resistant oropharyngeal candidiasis in Act1−/− mice. Conclusions VT-1129 and VT-1161 exhibit significant in vitro activity against Candida strains, including fluconazole-resistant C. albicans and C. glabrata. VT-1161 administration in mice results in significant mucosal drug accumulation and eradicates infection caused by fluconazole-susceptible and -resistant Candida strains. PMID:29040636

Changes in ventilatory threshold with exercise training in a sedentary population: the HERITAGE Family Study.

PubMed

Gaskill, S E; Walker, A J; Serfass, R A; Bouchard, C; Gagnon, J; Rao, D C; Skinner, J S; Wilmore, J H; Leon, A S

2001-11-01

The purpose of this study was to evaluate the effect of exercise training intensity relative to the ventilatory threshold (VT) on changes in work (watts) and VO2 at the ventilatory threshold and at maximal exercise in previously sedentary participants in the HERITAGE Family Study. We hypothesized that those who exercised below their VT would improve less in VO2 at the ventilatory threshold (VO2vt) and VO2max than those who trained at an intensity greater than their VT. Supervised cycle ergometer training was performed at the 4 participating clinical centers, 3 times a week for 20 weeks. Exercise training progressed from the HR corresponding to 55% VO2max for 30 minutes to the HR associated with 75% VO2max for 50 minutes for the final 6 weeks. VT was determined at baseline and after exercise training using standardized methods. 432 sedentary white and black men (n = 224) and women (n = 208), aged 17 to 65 years, were retrospectively divided into groups based on whether exercise training was initiated below, at, or above VT. 1) Training intensity (relative to VT) accounting for about 26% of the improvement in VO2vt (R2 = 0.26, p < 0.0001). 2) The absolute intensity of training in watts (W) accounted for approximately 56% of the training effect at VT (R2 = 0.56, p < 0.0001) with post-training watts at VT (VT(watts)) being not significantly different than W during training (p > 0.70). 3) Training intensity (relative to VT) had no effect on DeltaVO2max. These data clearly show that as a result of aerobic training both the VO2 and W associated with VT respond and become similar to the absolute intensity of sustained (3 x /week for 50 min) aerobic exercise training. Higher intensities of exercise, relative to VT, result in larger gains in VO2vt but not in VO2max.

Mechanism-specific effects of adenosine on ventricular tachycardia.

PubMed

Lerman, Bruce B; Ip, James E; Shah, Bindi K; Thomas, George; Liu, Christopher F; Ciaccio, Edward J; Wit, Andrew L; Cheung, Jim W; Markowitz, Steven M

2014-12-01

There is no universally accepted method by which to diagnose clinical ventricular tachycardia (VT) due to cAMP-mediated triggered activity. Based on cellular and clinical data, adenosine termination of VT is thought to be consistent with a diagnosis of triggered activity. However, a major gap in evidence mitigates the validity of this proposal, namely, defining the specificity of adenosine response in well-delineated reentrant VT circuits. To this end, we systematically studied the effects of adenosine in a model of canine reentrant VT and in human reentrant VT, confirmed by 3-dimensional, pace- and substrate mapping. Adenosine (12 mg [IQR 12-24]) failed to terminate VT in 31 of 31 patients with reentrant VT due to structural heart disease, and had no effect on VT cycle length (age, 67 years [IQR 53-74]); ejection fraction, 35% [IQR 20-55]). In contrast, adenosine terminated VT in 45 of 50 (90%) patients with sustained focal right or left outflow tract tachycardia. The sensitivity of adenosine for identifying VT due to triggered activity was 90% (95% CI, 0.78-0.97) and its specificity was 100% (95% CI, 0.89-1.0). Additionally, reentrant circuits were mapped in the epicardial border zone of 4-day-old infarcts in mongrel dogs. Adenosine (300-400 μg/kg) did not terminate sustained VT or have any effect on VT cycle length. These data support the concept that adenosine's effects on ventricular myocardium are mechanism specific, such that termination of VT in response to adenosine is diagnostic of cAMP-mediated triggered activity. © 2014 Wiley Periodicals, Inc.

Optimization of furfural production from D-xylose with formic acid as catalyst in a reactive extraction system.

PubMed

Yang, Wandian; Li, Pingli; Bo, Dechen; Chang, Heying; Wang, Xiaowei; Zhu, Tao

2013-04-01

Furfural is one of the most promising platform chemicals derived from biomass. In this study, response surface methodology (RSM) was utilized to determine four important parameters including reaction temperature (170-210°C), formic acid concentration (5-25 g/L), o-nitrotoluene volume percentage (20-80 vt.%), and residence time (40-200 min). The maximum furfural yield of 74% and selectivity of 86% were achieved at 190°C for 20 g/L formic acid concentration and 75 vt.% o-nitrotoluene by 75 min. The high boiling solvent, o-nitrotoluene, was recommended as extraction solvent in a reactive extraction system to obtain high furfural yield and reduce furfural-solvent separation costs. Although the addition of halides to the xylose solutions enhanced the furfural yield and selectivity, the concentration of halides was not an important factor on the furfural yield and selectivity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Characterisation of the contribution of the GABA-benzodiazepine α1 receptor subtype to [11C]Ro15-4513 PET images

PubMed Central

Myers, James FM; Rosso, Lula; Watson, Ben J; Wilson, Sue J; Kalk, Nicola J; Clementi, Nicoletta; Brooks, David J; Nutt, David J; Turkheimer, Federico E; Lingford-Hughes, Anne R

2012-01-01

This positron emission tomography (PET) study aimed to further define selectivity of [11C]Ro15-4513 binding to the GABARα5 relative to the GABARα1 benzodiazepine receptor subtype. The impact of zolpidem, a GABARα1-selective agonist, on [11C]Ro15-4513, which shows selectivity for GABARα5, and the nonselective benzodiazepine ligand [11C]flumazenil binding was assessed in humans. Compartmental modelling of the kinetics of [11C]Ro15-4513 time-activity curves was used to describe distribution volume (VT) differences in regions populated by different GABA receptor subtypes. Those with low α5 were best fitted by one-tissue compartment models; and those with high α5 required a more complex model. The heterogeneity between brain regions suggested spectral analysis as a more appropriate method to quantify binding as it does not a priori specify compartments. Spectral analysis revealed that zolpidem caused a significant VT decrease (∼10%) in [11C]flumazenil, but no decrease in [11C]Ro15-4513 binding. Further analysis of [11C]Ro15-4513 kinetics revealed additional frequency components present in regions containing both α1 and α5 subtypes compared with those containing only α1. Zolpidem reduced one component (mean±s.d.: 71%±41%), presumed to reflect α1-subtype binding, but not another (13%±22%), presumed to reflect α5. The proposed method for [11C]Ro15-4513 analysis may allow more accurate selective binding assays and estimation of drug occupancy for other nonselective ligands. PMID:22214903

Biased distribution of IS629 among strains in different lineages of enterohemorrhagic Escherichia coli serovar O157.

PubMed

Yokoyama, Eiji; Hashimoto, Ruiko; Etoh, Yoshiki; Ichihara, Sachiko; Horikawa, Kazumi; Uchimura, Masako

2011-01-01

The distribution of insertion sequence (IS) 629 among strains of enterohemorrhagic Escherichia coli serovar O157 (O157) was investigated and compared with the strain lineages defined by lineage specific polymorphism assay-6 (LSPA-6) to demonstrate the effectiveness of IS629 analysis for population genetics analysis. Using pulsed-field gel electrophoresis and variable-number tandem repeat typing, 140 strains producing both VT1 and VT2 and 98 strains producing only VT2 were selected from a total of 592 strains isolated from patients and asymptomatic carriers in Chiba Prefecture, Japan, during 2003-2008. By LSPA-6 analysis, six strains had atypical amplicon sizes in their Z5935 loci and five strains had atypical amplicon sizes in their arp-iclR intergenic regions. Sequence analyses of PCR amplified DNAs showed that five of the six loci used for LSPA-6 analysis had tandem repeats and the allele changes were due to changes in the number of tandem repeats. Subculturing and long-term incubation was found to have no detectable effect on the lineages defined by LSPA-6 analysis, demonstrating the robustness of LSPA-6 analysis. Minimum spanning tree analysis reconstruction revealed that strains in lineage I, I/II, and II clustered on separate branches, indicating that the distribution of IS629 was biased among O157 strains in different lineages. Strains with LSPA-6 codes 231111, 211113, and 211114 had atypical amplicon sizes and were clustered in lineage I/II branch, and strains with LSPA-6 codes 212114, 221123, 221223, 222123, 222224, 242123, 252123, and 242222 had atypical amplicon sizes and clustered in lineage II branches. Linkage disequilibrium was observed in strains in every lineage when the standardized index of association was calculated using IS629 distribution data. Therefore, the distribution analysis of IS629 may be effective for population genetics analysis of O157 due to the biased IS629 distribution among strains in the three O157 lineages. Copyright © 2010 Elsevier B.V. All rights reserved.

Very Preterm Infants Failing CPAP Show Signs of Fatigue Immediately after Birth

PubMed Central

Siew, Melissa L.; van Vonderen, Jeroen J.; Hooper, Stuart B.; te Pas, Arjan B.

2015-01-01

Objective To investigate the differences in breathing pattern and effort in infants at birth who failed or succeeded on continuous positive airway pressure (CPAP) during the first 48 hours after birth. Methods Respiratory function recordings of 32 preterm infants were reviewed of which 15 infants with a gestational age of 28.6 (0.7) weeks failed CPAP and 17 infants with a GA of 30.1 (0.4) weeks did not fail CPAP. Frequency, duration and tidal volumes (VT) of expiratory holds (EHs), peak inspiratory flows, CPAP-level and FiO2-levels were analysed. Results EH incidence increased <6 minutes after birth and remained stable thereafter. EH peak inspiratory flows and VT were similar between CPAP-fail and CPAP-success infants. At 9-12 minutes, CPAP-fail infants more frequently used smaller VTs, 0-9 ml/kg and required higher peak inspiratory flows. However, CPAP-success infants often used large VTs (>9 ml/kg) with higher peak inspiratory flows than CPAP-fail infants (71.8 ± 15.8 vs. 15.5 ± 5.2 ml/kg.s, p <0.05). CPAP-fail infants required higher FiO2 (0.31 ± 0.03 vs. 0.21 ± 0.01), higher CPAP pressures (6.62 ± 0.3 vs. 5.67 ± 0.26 cmH2O) and more positive pressure-delivered breaths (45 ± 12 vs. 19 ± 9%) (p <0.05) Conclusion At 9-12 minutes after birth, CPAP-fail infants more commonly used lower VTs and required higher peak inspiratory flow rates while receiving greater respiratory support. VT was less variable and larger VT was infrequently used reflecting early signs of fatigue. PMID:26052947

Effect of tracheostomy tube on work of breathing: Comparison of pre- and post-decannulation.

PubMed

Villalba, Darío; Feld, Viviana; Leiva, Valeria; Scrigna, Mariana; Distéfano, Eduardo; Pratto, Romina; Rodriguez, Matías; Collins, Jesica; Rocco, Ana; Matesa, Amelia; Rossi, Damián; Areas, Laura; Virgilio, Sacha; Golfarini, Nicolás; Gil-Rosetti, Gregorio; Diaz-Ballve, Pablo; Planells, Fernando

2016-01-01

To describe and compare the work of breathing (WOB) during spontaneous breathing under four conditions: (1) breathing through a tracheostomy tube with an inflated cuff, (2) breathing through the upper airway (UA) with a deflated cuff and occluded tube, (3) breathing through the UA with an occluded cuffless tube, and (4) postdecannulation. Patients who tolerated an occluded cuffless tube were included. Ventilatory variables and esophageal pressure were recorded. The pressure-time product (PTP), PTP/min, and PTP/min/tidal volume (PTP/min/VT) were measured. Each condition was measured for 5 min with a 15 min time interval between evaluations. Quantitative data are expressed as mean ± standard deviation. Single-factor analysis of variance was used, and the Games-Howell test was used for post hoc analysis of comparisons between group means ( P ≤ 0.05). Eight patients were studied under each of the four conditions described above. Statistically significant differences were found for PTP, PTP/min, and PTP/min/VT. In the post hoc analysis for PTP, significant differences among all conditions were found. For PTP/min, there was no significant difference between Conditions 2 and 4 ( P = 0.138), and for PTP/min/VT, there was no significant difference between Conditions 1 and 2 ( P = 0.072) or between Conditions 2 and 3 ( P = 0.106). A trend toward a higher PTP, PTP/min, and PTP/min/VT was observed when breathing through a cuffless tracheostomy tube. The four conditions differed with respect to WOB. Cuff inflation could result in a reduced WOB because there is less dead space. Cuffless tracheostomy tubes generate increased WOB, perhaps due to the material deformity caused by body temperature.

Monitoring of noninvasive ventilation by built-in software of home bilevel ventilators: a bench study.

PubMed

Contal, Olivier; Vignaux, Laurence; Combescure, Christophe; Pepin, Jean-Louis; Jolliet, Philippe; Janssens, Jean-Paul

2012-02-01

Current bilevel positive-pressure ventilators for home noninvasive ventilation (NIV) provide physicians with software that records items important for patient monitoring, such as compliance, tidal volume (Vt), and leaks. However, to our knowledge, the validity of this information has not yet been independently assessed. Testing was done for seven home ventilators on a bench model adapted to simulate NIV and generate unintentional leaks (ie, other than of the mask exhalation valve). Five levels of leaks were simulated using a computer-driven solenoid valve (0-60 L/min) at different levels of inspiratory pressure (15 and 25 cm H(2)O) and at a fixed expiratory pressure (5 cm H(2)O), for a total of 10 conditions. Bench data were compared with results retrieved from ventilator software for leaks and Vt. For assessing leaks, three of the devices tested were highly reliable, with a small bias (0.3-0.9 L/min), narrow limits of agreement (LA), and high correlations (R(2), 0.993-0.997) when comparing ventilator software and bench results; conversely, for four ventilators, bias ranged from -6.0 L/min to -25.9 L/min, exceeding -10 L/min for two devices, with wide LA and lower correlations (R(2), 0.70-0.98). Bias for leaks increased markedly with the importance of leaks in three devices. Vt was underestimated by all devices, and bias (range, 66-236 mL) increased with higher insufflation pressures. Only two devices had a bias < 100 mL, with all testing conditions considered. Physicians monitoring patients who use home ventilation must be aware of differences in the estimation of leaks and Vt by ventilator software. Also, leaks are reported in different ways according to the device used.

Very Preterm Infants Failing CPAP Show Signs of Fatigue Immediately after Birth.

PubMed

Siew, Melissa L; van Vonderen, Jeroen J; Hooper, Stuart B; te Pas, Arjan B

2015-01-01

To investigate the differences in breathing pattern and effort in infants at birth who failed or succeeded on continuous positive airway pressure (CPAP) during the first 48 hours after birth. Respiratory function recordings of 32 preterm infants were reviewed of which 15 infants with a gestational age of 28.6 (0.7) weeks failed CPAP and 17 infants with a GA of 30.1 (0.4) weeks did not fail CPAP. Frequency, duration and tidal volumes (VT) of expiratory holds (EHs), peak inspiratory flows, CPAP-level and FiO2-levels were analysed. EH incidence increased <6 minutes after birth and remained stable thereafter. EH peak inspiratory flows and VT were similar between CPAP-fail and CPAP-success infants. At 9-12 minutes, CPAP-fail infants more frequently used smaller VTs, 0-9 ml/kg and required higher peak inspiratory flows. However, CPAP-success infants often used large VTs (>9 ml/kg) with higher peak inspiratory flows than CPAP-fail infants (71.8 ± 15.8 vs. 15.5 ± 5.2 ml/kg.s, p <0.05). CPAP-fail infants required higher FiO2 (0.31 ± 0.03 vs. 0.21 ± 0.01), higher CPAP pressures (6.62 ± 0.3 vs. 5.67 ± 0.26 cmH2O) and more positive pressure-delivered breaths (45 ± 12 vs. 19 ± 9%) (p <0.05). At 9-12 minutes after birth, CPAP-fail infants more commonly used lower VTs and required higher peak inspiratory flow rates while receiving greater respiratory support. VT was less variable and larger VT was infrequently used reflecting early signs of fatigue.

Hyperadditive Ventilatory Response Arising from Interaction between the Carotid Chemoreflex and the Muscle Mechanoreflex in Healthy Humans.

PubMed

Silva, Talita M; Aranda, Liliane C; Paula-Ribeiro, Marcelle; Oliveira, Diogo M; Medeiros, Wladimir Musetti; Vianna, Lauro C; Nery, Luiz E; Silva, Bruno M

2018-03-22

Physical exercise potentiates the carotid chemoreflex control of ventilation (VE). Hyperadditive neural interactions may partially mediate the potentiation. However, some neural interactions remain incompletely explored. As the potentiation occurs even during low-intensity exercise, we tested the hypothesis that the carotid chemoreflex and the muscle mechanoreflex could interact in a hyperadditive fashion. Fourteen young healthy subjects inhaled, randomly, in separate visits, 12% O 2 to stimulate the carotid chemoreflex, and 21% O 2 as control. A rebreathing circuit maintained isocapnia. During gases administration, subjects either remained at rest (i.e., normoxic and hypoxic rest) or the muscle mechanoreflex was stimulated, via passive knee movement (i.e., normoxic and hypoxic movement). Surface muscle electrical activity did not increase during the passive movement, confirming the absence of active contractions. Hypoxic rest and normoxic movement similarly increased VE [change (mean {plus minus} SEM) = 1.24 {plus minus} 0.72 vs. 0.73 {plus minus} 0.43 L/min, respectively; P = 0.46], but hypoxic rest only increased tidal volume (Vt) and normoxic movement only increased breathing frequency (BF). Hypoxic movement induced greater VE and mean inspiratory flow (Vt/Ti) increase than the sum of hypoxic rest and normoxic movement isolated responses (VE change: hypoxic movement = 3.72 {plus minus} 0.81 vs. sum = 1.96 {plus minus} 0.83 L/min, P = 0.01; Vt/Ti change: hypoxic movement = 0.13 {plus minus} 0.03 vs. sum = 0.06 {plus minus} 0.03 L/s, P = 0.02). Moreover, hypoxic movement increased both Vt and BF. Collectively, the results indicate the carotid chemoreflex and the muscle mechanoreflex interacted mediating a hyperadditive ventilatory response in healthy humans.

Why do dentists struggle with removable partial denture design? An assessment of financial and educational issues.

PubMed

Lynch, C D; Allen, P F

2006-03-11

Published studies in the international dental literature illustrate that the quality of prescription and fabrication of cobalt-chromium removable partial dentures (CCRPDs) by general dental practitioners frequently fail to comply with ethical and legal requirements. The reasons cited for this in the past have broadly related to either financial or educational issues. The aim of this investigation is to determine the effect of financial and educational factors on the quality of CCRPD design and fabrication by general dental practitioners. This investigation was completed in two parts. (1) A pre-piloted pro-forma was distributed to a number of dental laboratories throughout the UK and Ireland. These sought information relating to the quality of written instructions for CCRPDs received by these laboratories, and details of the remunerative scheme under which they were being provided. Three categories of remunerative scheme were considered, private CCRPDs in Ireland, private CCRPDs in the UK, and CCRPDs being provided by salaried NHS practitioners. (2) A pre-piloted questionnaire was distributed to vocational dental practitioners in the UK and Ireland. This sought information relating to their attitudes, opinions, and educational and clinical experiences of CCRPD design and fabrication. (1) Three hundred completed pro-formas were returned from dental laboratories, 100 of which related to each of the three remunerative schemes. Poor or no written instructions were provided in 47% (n = 47) of CCRPD cases funded privately in the UK, 46% (n = 46) of CCRPD cases funded privately in Ireland, and 50% (n = 50) of CCRPDs being provided by salaried NHS practitioners. (2) One hundred and seven completed questionnaires were returned from vocational trainees. Vocational dental practitioners had completed fewer CCRPDs during VT than in dental school (dental school: median = 4, inter-quartile range = 3 to 5; VT: median = 2, inter-quartile range = 1 to 4). One-fifth of respondents (n = 22) had not completed any CCRPDs during VT. Nine per cent of VT practices (n = 10) had a surveyor on their premises. Only 15% (n = 16) of respondents felt the time they had spent in VT had increased their confidence in the design of CCRPDs. Financial factors did not have as significant an effect on the quality of prescription and fabrication of CCRPDs as did educational factors. Serious deficiencies in the teaching of CCRPDs during vocational training were identified.

Arrhythmogenic Mechanisms in a Mouse Model of Catecholaminergic Polymorphic Ventricular Tachycardia

PubMed Central

Cerrone, Marina; Noujaim, Sami F.; Tolkacheva, Elena G.; Talkachou, Arkadzi; O’Connell, Ryan; Berenfeld, Omer; Anumonwo, Justus; Pandit, Sandeep V.; Vikstrom, Karen; Napolitano, Carlo; Priori, Silvia G.; Jalife, José

2008-01-01

Catecholaminergic polymorphic ventricular tachycardia (VT) is a lethal familial disease characterized by bidirectional VT, polymorphic VT, and ventricular fibrillation. Catecholaminergic polymorphic VT is caused by enhanced Ca2+ release through defective ryanodine receptor (RyR2) channels. We used epicardial and endocardial optical mapping, chemical subendocardial ablation with Lugol’s solution, and patch clamping in a knockin (RyR2/RyR2R4496C) mouse model to investigate the arrhythmogenic mechanisms in catecholaminergic polymorphic VT. In isolated hearts, spontaneous ventricular arrhythmias occurred in 54% of 13 RyR2/RyR2R4496C and in 9% of 11 wild-type (P=0.03) littermates perfused with Ca2+ and isoproterenol; 66% of 12 RyR2/RyR2R4496C and 20% of 10 wild-type hearts perfused with caffeine and epinephrine showed arrhythmias (P=0.04). Epicardial mapping showed that monomorphic VT, bidirectional VT, and polymorphic VT manifested as concentric epicardial breakthrough patterns, suggesting a focal origin in the His–Purkinje networks of either or both ventricles. Monomorphic VT was clearly unifocal, whereas bidirectional VT was bifocal. Polymorphic VT was initially multifocal but eventually became reentrant and degenerated into ventricular fibrillation. Endocardial mapping confirmed the Purkinje fiber origin of the focal arrhythmias. Chemical ablation of the right ventricular endocardial cavity with Lugol’s solution induced complete right bundle branch block and converted the bidirectional VT into monomorphic VT in 4 anesthetized RyR2/RyR2R4496C mice. Under current clamp, single Purkinje cells from RyR2/RyR2R4496C mouse hearts generated delayed afterdepolarization–induced triggered activity at lower frequencies and level of adrenergic stimulation than wild-type. Overall, the data demonstrate that the His–Purkinje system is an important source of focal arrhythmias in catecholaminergic polymorphic VT. PMID:17872467

Blood Accessibility to Fibrin in Venous Thrombosis is Thrombus Age-Dependent and Predicts Fibrinolytic Efficacy: An In Vivo Fibrin Molecular Imaging Study

PubMed Central

Stein-Merlob, Ashley F.; Kessinger, Chase W.; Erdem, S. Sibel; Zelada, Henry; Hilderbrand, Scott A.; Lin, Charles P.; Tearney, Guillermo J.; Jaff, Michael R.; Reed, Guy L.; Henke, Peter K.; McCarthy, Jason R.; Jaffer, Farouc A.

2015-01-01

Fibrinolytic therapy of venous thromboembolism (VTE) is increasingly utilized, yet limited knowledge is available regarding in vivo mechanisms that govern fibrinolytic efficacy. In particular, it is unknown how age-dependent thrombus organization limits direct blood contact with fibrin, the target of blood-based fibrinolytic agents. Utilizing high-resolution in vivo optical molecular imaging with FTP11, a near-infrared fluorescence (NIRF) fibrin-specific reporter, here we investigated the in vivo interrelationships of blood accessibility to fibrin, thrombus age, thrombus neoendothelialization, and fibrinolysis in murine venous thrombosis (VT). In both stasis VT and non-stasis VT, NIRF microscopy showed that FTP11 fibrin binding was thrombus age-dependent. FTP11 localized to the luminal surface of early-stage VT, but only minimally to subacute VT (p<0.001). Transmission electron microscopy of early stage VT revealed direct blood cell contact with luminal fibrin-rich surfaces. In contrast, subacute VT exhibited an encasing CD31+ neoendothelial layer that limited blood cell contact with thrombus fibrin in both VT models. Next we developed a theranostic strategy to predict fibrinolytic efficacy based on the in vivo fibrin accessibility to blood NIRF signal. Mice with variably aged VT underwent FTP11 injection and intravital microscopy (IVM), followed by tissue plasminogen activator infusion to induce VT fibrinolysis. Fibrin molecular IVM revealed that early stage VT, but not subacute VT, bound FTP11 (p<0.05), and experienced higher rates of fibrinolysis and total fibrinolysis (p<0.05 vs. subacute VT). Before fibrinolysis, the baseline FTP11 NIRF signal predicted the net fibrinolysis at 60 minutes (p<0.001). Taken together, these data provide novel insights into the temporal evolution of VT and its susceptibility to therapeutic fibrinolysis. Fibrin molecular imaging may provide a theranostic strategy to identify venous thrombi amenable to fibrinolytic therapies. PMID:26516370

Avoidance of Timeout from Response-Independent Food: Effects of Delivery Rate and Quality

ERIC Educational Resources Information Center

Richardson, Joseph V.; Baron, Alan

2008-01-01

In three experiments, a rat's lever presses could postpone timeouts from food pellets delivered on response-independent schedules. In Experiment 1, the pellets were delivered at variable-time (VT) rates ranging from VT 0.5 to VT 8 min. Experiment 2 replicated the VT 1 min and VT 8 min conditions of Experiment 1 with new subjects. Finally, subjects…

Influence of humic acid on adsorption of Hg(II) by vermiculite.

PubMed

do Nascimento, Fernando Henrique; Masini, Jorge Cesar

2014-10-01

Geochemical mobility of Hg(II) species is strongly affected by the interactions of these compounds with naturally occurring adsorbents such as humic acids, clay minerals, oxides, etc. Interactions among these sorbents affect their affinity for Hg(II) and a full understanding of these processes is still lacking. The present work describes the influence of a humic acid (HA) sample on the adsorption of Hg(II) by vermiculite (VT). Adsorption isotherms were constructed to evaluate the affinity of Hg(II) by VT, HA, VT modified with humic acid (VT-HA), and VT-HA in presence of soluble humic acid (VT-HA + HA). All experiments were made at pH 6.0 ± 0.1 in 0.02 M NaNO3 and 25.0 ± 0.5 °C for initial Hg(II) concentrations from 1.0 to 100 μM. Determinations of Hg(II) were made by square wave voltammetry automated by sequential injection analysis, an approach that enables the determination of the free plus labile fractions of Hg(II) in HA suspensions without the need for laborious separation steps. The adsorption isotherms were fitted to Langmuir and Freundlich equations, showing that HA was the material with the higher adsorption capacity (537 ± 30 μmol g(-1)) in comparison with VT and VT-HA (44 ± 3 and 51 ± 11 μmol g(-1), respectively). Adsorption order was HA > VT-HA + HA > VT = VT-HA. At pH 6.0 the interaction of HA with VT is weak and only 14% of C initially added to the suspension was effectively retained by the mineral. Desorption of Hg(II) in acidic medium (0.05 M HCl) was higher in binary (VT-HA) and ternary (VT-HA + HA) systems in comparison with that of VT and HA alone, suggesting that interactions between VT and HA are facilitated in acidic medium, weakening the binding to Hg(II). Copyright © 2014 Elsevier Ltd. All rights reserved.

The association of statin therapy with the risk of recurrent venous thrombosis.

PubMed

Smith, N L; Harrington, L B; Blondon, M; Wiggins, K L; Floyd, J S; Sitlani, C M; McKnight, B; Larson, E B; Rosendaal, F R; Heckbert, S R; Psaty, B M

2016-07-01

Essentials A lowered risk of recurrent venous thrombosis (VT) with statin treatment is controversial. Among observational inception cohort of 2,798 adults with incident VT, 457 had recurrent VT. Time-to-event models with time-varying statin use and adjustment for potential confounders was used for analysis. Compared to nonuse, current statin use was associated with 26% lower risk of recurrent VT. Click to hear Prof. Büller's perspective on Anticoagulant Therapy in the Treatment of Venous Thromboembolism Background Meta-analyses of randomized controlled trials suggest that treatment with hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) lowers the risk of incident venous thrombosis (VT), particularly among those without prevalent clinical cardiovascular disease (CVD). Whether this is true for the prevention of recurrent VT is debated. We used an observational inception cohort to estimate the association of current statin use with the risk of recurrent VT. Methods and Results The study setting was a large healthcare organization with detailed medical record and pharmacy information at cohort entry and throughout follow-up. We followed 2798 subjects 18-89 years of age who experienced a validated incident VT between January 1, 2002, and December 31, 2010, for a first recurrent VT, validated by medical record review. During follow-up, 457 (16%) developed a first recurrent VT. In time-to-event models incorporating time-varying statin use and adjusting for potential confounders, current statin use was associated with a 26% lower risk of recurrent VT: hazard ratio 0.74, 95% confidence interval 0.59-0.94. Among cohort members free of CVD (n = 2134), current statin use was also associated with a lower risk (38%) of recurrent VT: hazard ratio 0.62, 95% confidence interval 0.45-0.85. We found similar results when restricting to new users of statins and in subgroups of different statin types and doses. Conclusions In a population-based cohort of subjects who had experienced an incident VT, statin use, compared with nonuse, was associated with a clinically relevant lower risk of recurrent VT. These findings suggest a potential secondary benefit of statins among patients who have experienced an incident VT. © 2016 International Society on Thrombosis and Haemostasis.

Diagnosis and ablation of multiform fascicular tachycardia.

PubMed

Sung, Raphael K; Kim, Albert M; Tseng, Zian H; Han, Frederick; Inada, Keiichi; Tedrow, Usha B; Viswanathan, Mohan N; Badhwar, Nitish; Varosy, Paul D; Tanel, Ronn; Olgin, Jeffrey E; Stephenson, William G; Scheinman, Melvin

2013-03-01

Fascicular tachycardia (FT) is an uncommon cause of monomorphic sustained ventricular tachycardia (VT). We describe 6 cases of FT with multiform QRS morphologies. Six of 823 consecutive VT cases were retrospectively analyzed and found attributable to FT with multiform QRS patterns, with 3 cases exhibiting narrow QRS VT as well. All underwent electrophysiology study including fascicular potential mapping, entrainment pacing, and electroanatomic mapping. The first 3 cases describe similar multiform VT patterns with successful ablation in the upper mid septum. Initially, a right bundle branch block (RBBB) VT with superior axis was induced. Radiofrequency catheter ablation (RFCA) targeting the left posterior fascicle (LPF) resulted in a second VT with RBBB inferior axis. RFCA in the upper septum just apical to the LBB potential abolished VT in all cases. Cases 4 and 5 showed RBBB VT with alternating fascicular block compatible with upper septal dependent VT, resulting in bundle branch reentrant VT (BBRT) after ablation of LPF and left anterior fascicle (LAF). Finally, Cases 5 and 6 demonstrated spontaneous shift in QRS morphology during VT, implicating participation of a third fascicle. In Case 6, successful ablation was achieved over the proximal LAF, likely representing insertion of the auxiliary fascicle near the proximal LAF. Multiform FTs show a reentrant mechanism using multiple fascicular branches. We hypothesize that retrograde conduction over the septal fascicle produces alternate fascicular patterns as well as narrow VT forms. Ablation of the respective fascicle was successful in abolishing FT but does not preclude development of BBRT unless septal fascicle is targeted and ablated. © 2012 Wiley Periodicals, Inc.

Thoracic Epidural Anesthesia Can Be Effective for the Short-Term Management of Ventricular Tachycardia Storm.

PubMed

Do, Duc H; Bradfield, Jason; Ajijola, Olujimi A; Vaseghi, Marmar; Le, John; Rahman, Siamak; Mahajan, Aman; Nogami, Akihiko; Boyle, Noel G; Shivkumar, Kalyanam

2017-10-27

Novel therapies aimed at modulating the autonomic nervous system, including thoracic epidural anesthesia (TEA), have been shown in small case series to be beneficial in treating medically refractory ventricular tachycardia (VT) storm. However, it is not clear when these options should be considered. We reviewed a multicenter experience with TEA in the management of VT storm to determine its optimal therapeutic use. Data for 11 patients in whom TEA was instituted for VT storm between July 2005 and March 2016 were reviewed to determine the clinical characteristics, outcomes, and role in management. The clinical presentation was incessant VT in 7 (64%), with polymorphic VT in 3 (27%) and monomorphic VT in 8 (73%). The underlying conditions were nonischemic cardiomyopathy in 5 (45%), ischemic cardiomyopathy in 3 (27%), and hypertrophic cardiomyopathy, Brugada syndrome, and cardiac lipoma in 1 (9%) each. Five (45%) had a complete and 1 (9%) had a partial response to TEA; 4 of the complete responders had incessant VT. All 4 patients with a documented response to deep sedation demonstrated a complete response to TEA. More than half of the patients with VT storm in our series responded to TEA. TEA may be effective and should be considered as a therapeutic option in patients with VT storm, especially incessant VT, who are refractory to initial management. Improvement in VT burden with deep sedation may suggest that sympathoexcitation plays a key role in perpetuating VT and predict a positive response to TEA. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Angiotensin II effects on ischemic focal ventricular tachycardia are predominantly mediated through myocardial AT(2) receptor.

PubMed

Gopinathannair, Rakesh; Chaudhary, Ashok K; Xing, Dezhi; Ely, Debra; Zheng, Wei; Martins, James B

2009-11-01

Ischemic focal ventricular tachycardia (VT) occurs in animals and humans. Angiotensin-converting enzyme inhibitors and receptor blockers reduce sudden death in patients with ischemic heart disease. In our dog model of coronary artery occlusion (CAO), we tested the hypothesis that angiotensin II (AGII) will selectively promote focal VT and that the specific AT(2) blocker PD-123319 (PD), or AT(1) blocker losartan, will affect this VT. Anesthetized dogs (n = 90) underwent CAO, followed by three-dimensional activation mapping of inducible VT. Dogs without VT in 1-3 h after CAO received AGII, and those with VT received either PD or losartan. Focal endocardium excised from ischemic sites was studied in vitro with standard microelectrode. Of 33 dogs with no inducible VT, AGII infusion resulted in sustained VT of only focal Purkinje origin in 13 (39%) compared with 0 of 20 dogs with saline. Of 26 dogs with inducible VT at baseline, given PD, reinduction was blocked in 8 of 10 (P < 0.05) focal VT, but only 1 of 15 with reentry. In contrast, of 11 dogs given losartan, reinduction of either mechanism was not blocked. In vitro triggered activity in Purkinje was blocked by PD in 13 of 19 (P < 0.05), but not by losartan in 8. Also, triggered activity was promoted by AGII, losartan, or the combination in 9 of 12 tissues. AGII promotes only focal, mainly Purkinje ischemic VT. PD, but not losartan, preferentially blocked focal VT, which is likely due to triggered activity due to delayed afterdepolarizations in Purkinje.

Improving ovarian tissue cryopreservation for oncologic patients: slow freezing versus vitrification, effect of different procedures and devices.

PubMed

Herraiz, Sonia; Novella-Maestre, Edurne; Rodríguez, Beatriz; Díaz, César; Sánchez-Serrano, María; Mirabet, Vicente; Pellicer, Antonio

2014-03-01

To compare slow freezing (SF) with four vitrification techniques (VT) for cryopreservation of ovarian tissue (OT) and to evaluate the best protocol for human OT in a xenograft model. Experimental study. University hospital. Patients undergoing fertility preservation. Ovariectomized nude mice. Cryopreservation of bovine OT after SF and four VTs (VT1, VT2, VT3, and VT4) by combining two cryoprotectant vitrification solutions (VS1 and VS2) and two devices (metallic grid and ethyl vinyl acetate bag), after which the cryopreservation of human OT by SF and VT1 and xenograft into nude mice. Follicular densities, proliferation, vascularization, fibrosis, apoptosis, tissue viability. The in vitro study in bovine OT showed a lower percentage of quiescent follicles in the SF group but not in the vitrification groups (VT1-VT4). Apoptosis increased and cell proliferation decreased in all the experimental groups except VT1 (20% ethylene glycol, 20% dimethyl sulfoxide, 0.5 M sucrose, and 20% synthetic serum substitute in HEPES-buffered M199 culture media with Cryotissue metallic grids). Tissue viability was diminished in VT3, and the SF-xenografted human samples showed reduced primordial and secondary densities and unbalanced follicular populations when compared with fresh and VT1 tissue. VT1 offers similar conditions to fresh tissue for follicular density, proliferation, viability, and cell death and preserves a larger population of quiescent follicles than SF after transplantation, thus ensuring the maintenance of graft potential fertility. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Usefulness of a mobile phone with video telephony in identifying the correct landmark for performing needle thoracocentesis.

PubMed

You, J S; Park, S; Chung, S P; Park, J W

2009-03-01

A needle thoracocentesis should be performed with maximal safety and optimal efficacy in mind. Mobile video telephony (VT) could be used to facilitate instructions for the accurate performance of needle thoracocentesis in an emergency setting. This new communication method will increase the accuracy of identifying the relevant anatomical site during the decompression technique. A prospective randomised manikin study was performed to investigate the effectiveness of using VT as a method of instruction for the identification of anatomical landmarks during the performance of needle thoracocentesis. The overall success rate was significantly higher in the VT group which performed needle thoracocentesis under the guidance of VT than in the non-VT group who performed the procedure without VT-aided instruction. The instrument difficulty score and procedure satisfaction score were significantly lower in the VT group than in the non-VT group. Identification of the correct anatomical landmark for needle thoracocentesis can be performed with instructions provided via VT because a dispatcher can monitor every step and provide correct instructions. This new technology will improve critical care medicine.

No effect of elevated operating lung volumes on airway function during variable workrate exercise in asthmatic humans.

PubMed

Klansky, Andrew; Irvin, Charlie; Morrison-Taylor, Adriane; Ahlstrand, Sarah; Labrie, Danielle; Haverkamp, Hans Christian

2016-07-01

In asthmatic adults, airway caliber fluctuates during variable intensity exercise such that bronchodilation (BD) occurs with increased workrate whereas bronchoconstriction (BC) occurs with decreased workrate. We hypothesized that increased lung mechanical stretch would prevent BC during such variable workrate exercise. Ten asthmatic and ten nonasthmatic subjects completed two exercise trials on a cycle ergometer. Both trials included a 28-min exercise bout consisting of alternating four min periods at workloads equal to 40 % (Low) and 70% (High) peak power output. During one trial, subjects breathed spontaneously throughout exercise (SVT), such that tidal volume (VT) and end-inspiratory lung volume (EILV) were increased by 0.5 and 0.6 liters during the high compared with the low workload in nonasthmatic and asthmatic subjects, respectively. During the second trial (MVT), VT and EILV were maintained constant when transitioning from the high to the low workload. Forced exhalations from total lung capacity were performed during each exercise workload. In asthmatic subjects, forced expiratory volume 1.0 s (FEV1.0) increased and decreased with the increases and decreases in workrate during both SVT (Low, 3.3 ± 0.3 liters; High, 3.6 ± 0.2 liters; P < 0.05) and MVT (Low, 3.3 ± 0.3 liters; High, 3.5 ± 0.2 liters; P < 0.05). Thus increased lung stretch during MVT did not prevent decreases in airway caliber when workload was reduced. We conclude that neural factors controlling airway smooth muscle (ASM) contractile activity during whole body exercise are more robust determinants of airway caliber than the ability of lung stretch to alter ASM actin-myosin binding and contraction. Copyright © 2016 the American Physiological Society.

Science Library of Test Items. Volume Twelve. Mastery Testing Programme. [Mastery Tests Series 4.] Tests M39-M50.

ERIC Educational Resources Information Center

New South Wales Dept. of Education, Sydney (Australia).

As part of a series of tests to measure mastery of specific skills in the natural sciences, copies of tests 39 through 50 include: (39) using a code; (40) naming the parts of a microscope; (41) calculating density and predicting flotation; (42) estimating metric length; (43) using SI symbols; (44) using s=vt; (45) applying a novel theory; (46)…

Remarks on non-BPS string amplitudes and their all order α' contact interactions in IIB, IIA

NASA Astrophysics Data System (ADS)

Hatefi, Ehsan

2017-03-01

We explore the entire form of S-Matrix elements of a potential C n-1 Ramond-Ramond (RR) form field, a tachyon and two transverse scalar fields on both world volume and transverse directions of type IIB and IIA superstring theories. Apart from < {V}_{C^{-2}}{V}_{φ^0}{V}_{φ^0}{V}_{T^0}\\rangle the other scattering amplitude, namely < {V}_{C^{-1}}{V}_{φ^{-1}}{V}_{φ^0}{V}_{T^0}\\rangle is also revealed. We then start to compare all singularity structures of symmetric and asymmetric analysis, generating all infinite singularity structures as well as all order α' contact interactions on the whole directions. This leads to deriving various new contact terms and several new restricted Bianchi identities in both type IIB and IIA. It is also shown that just some of the new couplings of type IIB (IIA) string theory can be re-verified in an Effective Field Theory (EFT) by pull-back of branes. To construct the rest of S-matrix elements one needs to first derive restricted world volume (or bulk) Bianchi identities and then discover new EFT couplings in both type IIB and IIA. Finally the presence of commutator of scalar fields inside the exponential of Wess-Zumino action for non-BPS branes has been confirmed as well.

Ventilatory thresholds determined from HRV: comparison of 2 methods in obese adolescents.

PubMed

Quinart, S; Mourot, L; Nègre, V; Simon-Rigaud, M-L; Nicolet-Guénat, M; Bertrand, A-M; Meneveau, N; Mougin, F

2014-03-01

The development of personalised training programmes is crucial in the management of obesity. We evaluated the ability of 2 heart rate variability analyses to determine ventilatory thresholds (VT) in obese adolescents. 20 adolescents (mean age 14.3±1.6 years and body mass index z-score 4.2±0.1) performed an incremental test to exhaustion before and after a 9-month multidisciplinary management programme. The first (VT1) and second (VT2) ventilatory thresholds were identified by the reference method (gas exchanges). We recorded RR intervals to estimate VT1 and VT2 from heart rate variability using time-domain analysis and time-varying spectral-domain analysis. The coefficient correlations between thresholds were higher with spectral-domain analysis compared to time-domain analysis: Heart rate at VT1: r=0.91 vs. =0.66 and VT2: r=0.91 vs. =0.66; power at VT1: r=0.91 vs. =0.74 and VT2: r=0.93 vs. =0.78; spectral-domain vs. time-domain analysis respectively). No systematic bias in heart rate at VT1 and VT2 with standard deviations <6 bpm were found, confirming that spectral-domain analysis could replace the reference method for the detection of ventilatory thresholds. Furthermore, this technique is sensitive to rehabilitation and re-training, which underlines its utility in clinical practice. This inexpensive and non-invasive tool is promising for prescribing physical activity programs in obese adolescents. © Georg Thieme Verlag KG Stuttgart · New York.

Triggers of sustained monomorphic ventricular tachycardia differ among patients with varying etiologies of left ventricular dysfunction.

PubMed

Rosman, Jonathan; Hanon, Sam; Shapiro, Michael; Evans, Steven J; Schweitzer, Paul

2006-04-01

The mechanisms underlying the initiation of sustained ventricular tachycardia (VT) have not been fully elucidated. The extent to which reentry, abnormal automaticity, and triggered activity play a role in VT differs depending on the etiology of left ventricular dysfunction. By analyzing electrograms from implantable cardioverter defibrillator (ICD), we sought to determine whether there were differences in VT initiation patterns between patients with ischemic and nonischemic cardiomyopathy. We analyzed ICD electrograms in patients with ejection fractions < 40% who had sustained VT over a 27-month period. The trigger for VT onset was classified as a ventricular premature beat (VPB), supraventricular tachycardia, or of "sudden onset." The baseline cycle length, VT cycle length, coupling interval, and prematurity ratio were recorded for each event. The prematurity ratio was calculated as the coupling interval of the VT initiator divided by the baseline cycle length. Sixty-three VT events in 14 patients met the inclusion criteria. A VPB initiated the VT in 58 episodes (92%), 1 episode (2%) was initiated by a supraventricular tachycardia, and 4 episodes (6%) were sudden onset. The prematurity ratio was significantly higher (P < 0.05) in patients with ischemic cardiomyopathy (0.751 +/- 0.068) as compared to patients with nonischemic cardiomyopathy (0.604 +/- 0.139). VPBs initiated most sustained VT episodes. A significantly higher prematurity ratio was observed in the ischemic heart disease group. This may represent different mechanisms of VT initiation in patients with ischemic versus nonischemic heart disease.

Moderate concentrations of supplemental oxygen worsen hypercapnia in obesity hypoventilation syndrome: a randomised crossover study.

PubMed

Hollier, Carly Ann; Harmer, Alison Rosemary; Maxwell, Lyndal Jane; Menadue, Collette; Willson, Grant Neville; Unger, Gunnar; Flunt, Daniel; Black, Deborah Ann; Piper, Amanda Jane

2014-04-01

In people with obesity hypoventilation syndrome (OHS), breathing 100% oxygen increases carbon dioxide (PCO2), but its effect on pH is unknown. This study investigated the effects of moderate concentrations of supplemental oxygen on PCO2, pH, minute ventilation (VE) and physiological dead space to tidal volume ratio (VD/VT) among people with stable untreated OHS, with comparison to healthy controls. In a double-blind randomised crossover study, participants breathed oxygen concentrations (FiO2) 0.28 and 0.50, each for 20 min, separated by a 45 min washout period. Arterialised-venous PCO2 (PavCO2) and pH, VE and VD/VT were measured at baseline, then every 5 min. Data were analysed using general linear model analysis. 28 participants were recruited (14 OHS, 14 controls). Among OHS participants (mean ± SD arterial PCO2 6.7 ± 0.5 kPa; arterial oxygen 8.9 ± 1.4 kPa) FiO2 0.28 and 0.50 maintained oxygen saturation 98-100%. After 20 min of FiO2 0.28, PavCO2 change (ΔPavCO2) was 0.3 ± 0.2 kPa (p = 0.013), with minimal change in VE and rises in VD/VT of 1 ± 5% (p = 0.012). FiO2 0.50 increased PavCO2 by 0.5 ± 0.4 kPa (p = 0.012), induced acidaemia and increased VD/VT by 3 ± 3% (p = 0.012). VE fell by 1.2 ± 2.1 L/min within 5 min then recovered individually to varying degrees. A negative correlation between ΔVE and ΔPavCO2 (r = -0.60, p = 0.024) suggested that ventilatory responses were the key determinant of PavCO2 rises. Among controls, FiO2 0.28 and 0.50 did not change PavCO2 or pH, but FiO2 0.50 significantly increased VE and VD/VT. Commonly used oxygen concentrations caused hypoventilation, PavCO2 rises and acidaemia among people with stable OHS. This highlights the potential dangers of this common intervention in this group.

Double Tunneling Injection Quantum Dot Lasers for High Speed Operation

DTIC Science & Technology

2017-10-23

Double Tunneling-Injection Quantum Dot Lasers for High -Speed Operation The views, opinions and/or findings contained in this report are those of...SECURITY CLASSIFICATION OF: 1. REPORT DATE (DD-MM-YYYY) 4. TITLE AND SUBTITLE 13. SUPPLEMENTARY NOTES 12. DISTRIBUTION AVAILIBILITY STATEMENT 6...State University Title: Double Tunneling-Injection Quantum Dot Lasers for High -Speed Operation Report Term: 0-Other Email: asryan@vt.edu Distribution

Long-Term Outcome With Catheter Ablation of Ventricular Tachycardia in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy.

PubMed

Santangeli, Pasquale; Zado, Erica S; Supple, Gregory E; Haqqani, Haris M; Garcia, Fermin C; Tschabrunn, Cory M; Callans, David J; Lin, David; Dixit, Sanjay; Hutchinson, Mathew D; Riley, Michael P; Marchlinski, Francis E

2015-12-01

Catheter ablation of ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy improves short-term VT-free survival. We sought to determine the long-term outcomes of VT control and need for antiarrhythmic drug therapy after endocardial (ENDO) and adjuvant epicardial (EPI) substrate modification in patients with arrhythmogenic right ventricular cardiomyopathy. We examined 62 consecutive patients with Task Force criteria for arrhythmogenic right ventricular cardiomyopathy referred for VT ablation with a minimum follow-up of 1 year. Catheter ablation was guided by activation/entrainment mapping for tolerated VT and pacemapping/targeting of abnormal substrate for unmappable VT. Adjuvant EPI ablation was performed when recurrent VT or persistent inducibility after ENDO-only ablation. Endocardial plus adjuvant EPI ablation was performed in 39 (63%) patients, including 13 who crossed over to ENDO-EPI after VT recurrence during follow-up, after ENDO-only ablation. Before ablation, 54 of 62 patients failed a mean of 2.4 antiarrhythmic drugs, including amiodarone in 29 (47%) patients. During follow-up of 56±44 months after the last ablation, VT-free survival was 71% with only a single VT episode in additional 9 patients (15%). At last follow-up, 39 (64%) patients were only on β-blockers or no treatment, 21 were on class 1 or 3 antiarrhythmic drugs (11 for atrial arrhythmias), and 2 were on amiodarone as a bridge to heart transplantation. The long-term outcome after ENDO and adjuvant EPI substrate ablation of VT in arrhythmogenic right ventricular cardiomyopathy is good. Most patients have complete VT control without amiodarone therapy and limited need for antiarrhythmic drugs. © 2015 American Heart Association, Inc.

MAGNETIC VT study: a prospective, multicenter, post-market randomized controlled trial comparing VT ablation outcomes using remote magnetic navigation-guided substrate mapping and ablation versus manual approach in a low LVEF population.

PubMed

Di Biase, Luigi; Tung, Roderick; Szili-Torok, Tamás; Burkhardt, J David; Weiss, Peter; Tavernier, Rene; Berman, Adam E; Wissner, Erik; Spear, William; Chen, Xu; Neužil, Petr; Skoda, Jan; Lakkireddy, Dhanunjaya; Schwagten, Bruno; Lock, Ken; Natale, Andrea

2017-04-01

Patients with ischemic cardiomyopathy (ICM) are prone to scar-related ventricular tachycardia (VT). The success of VT ablation depends on accurate arrhythmogenic substrate localization, followed by optimal delivery of energy provided by constant electrode-tissue contact. Current manual and remote magnetic navigation (RMN)-guided ablation strategies aim to identify a reentry circuit and to target a critical isthmus through activation and entrainment mapping during ongoing tachycardia. The MAGNETIC VT trial will assess if VT ablation using the Niobe™ ES magnetic navigation system results in superior outcomes compared to a manual approach in subjects with ischemic scar VT and low ejection fraction. This is a randomized, single-blind, prospective, multicenter post-market study. A total of 386 subjects (193 per group) will be enrolled and randomized 1:1 between treatment with the Niobe ES system and treatment via a manual procedure at up to 20 sites. The study population will consist of patients with ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) of ≤35% and implantable cardioverter defibrillator (ICD) who have sustained monomorphic VT. The primary study endpoint is freedom from any recurrence of VT through 12 months. The secondary endpoints are acute success; freedom from any VT at 1 year in a large-scar subpopulation; procedure-related major adverse events; and mortality rate through 12-month follow-up. Follow-up will consist of visits at 3, 6, 9, and 12 months, all of which will include ICD interrogation. The MAGNETIC VT trial will help determine whether substrate-based ablation of VT with RMN has clinical advantages over manual catheter manipulation. Clinicaltrials.gov identifier: NCT02637947.

Long-Term Outcomes of Catheter Ablation of Ventricular Tachycardia in Patients With Cardiac Sarcoidosis.

PubMed

Muser, Daniele; Santangeli, Pasquale; Pathak, Rajeev K; Castro, Simon A; Liang, Jackson J; Magnani, Silvia; Hayashi, Tatsuya; Garcia, Fermin C; Hutchinson, Mathew D; Supple, Gregory E; Frankel, David S; Riley, Michael P; Lin, David; Schaller, Robert D; Desjardins, Benoit; Dixit, Sanjay; Callans, David J; Zado, Erica S; Marchlinski, Francis E

2016-08-01

Catheter ablation (CA) of ventricular tachycardia (VT) in patients with cardiac sarcoidosis can be challenging because of the complex underlying substrate. We sought to determine the long-term outcome of CA of VT in patients with cardiac sarcoidosis. We enrolled 31 patients (age, 55±10 years) with diagnosis of cardiac sarcoidosis based on Heart Rhythm Society criteria and VT who underwent CA. In 23 (74%) patients, preprocedure cardiac magnetic resonance imaging and positron emission tomographic (PET) evaluation were performed. Preprocedure magnetic resonance imaging was positive for late gadolinium enhancement in 21 of 23 (91%) patients, whereas abnormal 18-fluorodeoxyglucose uptake was found in 15 of 23 (65%) cases. In 14 of 15 patients with positive PET at baseline, PET was repeated after 6.1±3.7-month follow-up. After a median follow-up of 2.5 (range, 0-10.5) years, 1 (3%) patient died and 4 (13%) underwent heart transplant. Overall VT-free survival was 55% at 2-year follow-up. Among the 16 (52%) patients with VT recurrences, CA resulted in a significant reduction of VT burden, with 8 (50%) having only isolated (1-3) VT episodes and only 1 patient with recurrent VT storm. The presence of late gadolinium enhancement at magnetic resonance imaging, a positive PET at baseline, and lack of PET improvement over follow-up were associated with increased risk of recurrent VT. In patients with cardiac sarcoidosis and VT, CA is effective in achieving long-term freedom from VT or improvement in VT burden in the majority of patients. The presence of late gadolinium enhancement at magnetic resonance imaging, a positive PET scan at baseline, or lack of improvement at repeat PET over follow-up predict worse arrhythmia-free survival. © 2016 American Heart Association, Inc.

Pre-Clinical Model to Study Recurrent Venous Thrombosis in the Inferior Vena Cava.

PubMed

Andraska, Elizabeth A; Luke, Catherine E; Elfline, Megan A; Henke, Samuel P; Madapoosi, Siddharth S; Metz, Allan K; Hoinville, Megan E; Wakefield, Thomas W; Henke, Peter K; Diaz, Jose A

2018-06-01

 Patients undergoing deep vein thrombosis (VT) have over 30% recurrence, directly increasing their risk of post-thrombotic syndrome. Current murine models of inferior vena cava (IVC) VT model host one thrombosis event.  We aimed to develop a murine model to study IVC recurrent VT in mice.  An initial VT was induced using the electrolytic IVC model (EIM) with constant blood flow. This approach takes advantage of the restored vein lumen 21 days after a single VT event in the EIM demonstrated by ultrasound. We then induced a second VT 21 days later, using either EIM or an IVC ligation model for comparison. The control groups were a sham surgery and, 21 days later, either EIM or IVC ligation. IVC wall and thrombus were harvested 2 days after the second insult and analysed for IVC and thrombus size, gene expression of fibrotic markers, histology for collagen and Western blot for citrullinated histone 3 (Cit-H3) and fibrin.  Ultrasound confirmed the first VT and its progressive resolution with an anatomical channel allowing room for the second thrombus by day 21. As compared with a primary VT, recurrent VT has heavier walls with significant up-regulation of transforming growth factor-β (TGF-β), elastin, interleukin (IL)-6, matrix metallopeptidase 9 (MMP9), MMP2 and a thrombus with high citrullinated histone-3 and fibrin content.  Experimental recurrent thrombi are structurally and compositionally different from the primary VT, with a greater pro-fibrotic remodelling vein wall profile. This work provides a VT recurrence IVC model that will help to improve the current understanding of the biological mechanisms and directed treatment of recurrent VT. Schattauer GmbH Stuttgart.

VTGRAPH - GRAPHIC SOFTWARE TOOL FOR VT TERMINALS

NASA Technical Reports Server (NTRS)

Wang, C.

1994-01-01

VTGRAPH is a graphics software tool for DEC/VT or VT compatible terminals which are widely used by government and industry. It is a FORTRAN or C-language callable library designed to allow the user to deal with many computer environments which use VT terminals for window management and graphic systems. It also provides a PLOT10-like package plus color or shade capability for VT240, VT241, and VT300 terminals. The program is transportable to many different computers which use VT terminals. With this graphics package, the user can easily design more friendly user interface programs and design PLOT10 programs on VT terminals with different computer systems. VTGRAPH was developed using the ReGis Graphics set which provides a full range of graphics capabilities. The basic VTGRAPH capabilities are as follows: window management, PLOT10 compatible drawing, generic program routines for two and three dimensional plotting, and color graphics or shaded graphics capability. The program was developed in VAX FORTRAN in 1988. VTGRAPH requires a ReGis graphics set terminal and a FORTRAN compiler. The program has been run on a DEC MicroVAX 3600 series computer operating under VMS 5.0, and has a virtual memory requirement of 5KB.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dale, R.; Sáez, D., E-mail: rdale@umh.es, E-mail: diego.saez@uv.es

The vector-tensor (VT) theory of gravitation revisited in this article was studied in previous papers, where it was proved that VT works and deserves attention. New observational data and numerical codes have motivated further development which is presented here. New research has been planed with the essential aim of proving that current cosmological observations, including Planck data, baryon acoustic oscillations (BAO), and so on, may be explained with VT, a theory which accounts for a kind of dark energy which has the same equation of state as vacuum. New versions of the codes CAMB and COSMOMC have been designed formore » applications to VT, and the resulting versions have been used to get the cosmological parameters of the VT model at suitable confidence levels. The parameters to be estimated are the same as in general relativity (GR), plus a new parameter D . For D = 0, VT linear cosmological perturbations reduces to those of GR, but the VT background may explain dark energy. The fits between observations and VT predictions lead to non vanishing | D | upper limits at the 1σ confidence level. The value D = 0 is admissible at this level, but this value is not that of the best fit in any case. Results strongly suggest that VT may explain current observations, at least, as well as GR; with the advantage that, as it is proved in this paper, VT has an additional parameter which facilitates adjustments to current observational data.« less

Outcome of Radiofrequency Catheter Ablation as a non-pharmacological therapy for idiopathic Ventricular Tachycardia.

PubMed

Samore, Naseer Ahmed; Imran Majeed, Syed Muhammad; Kayani, Azhar Mahmud; Bhalli, Muhammad Asif; Shabbir, Muhammad

2009-09-01

To determine the outcome of Radiofrequency Catheter Ablation (RFCA) as a non-pharmacological curative therapy for idiopathic Ventricular Tachycardia (VT) and to identify procedure-related complications. Descriptive study. The Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, from February 2001 to October 2008. Ninety eight consecutive patients with idiopathic VT, resistant to drug therapy, who underwent Electrophysiology Studies (EPS) radiofrequency catheter ablation were enrolled. Clinical and electrophysiological variables were recorded and a descriptive analysis was done. Out of the 98 patients, 79 were males (80.6%). The mean age was 33.29+11.93 years. Modes of presentation were sustained VT, Repetitive Monomorphic VT (RMVT), Non-sustained VT (NSVT) and Ventricular Premature Beats (VPBs). Right Ventricular Outflow Tract (RVOT) VT was found in 37 patients, 37 had Idiopathic Left Ventricular Tachycardia (ILVT), 20 had Left Ventricular Outflow Tract (LVOT) VT, and Inflow Right Ventricular Tachycardia (IRVT) was found in 7 patients. Other sites of origin of VT were infrequent. Eight patients had dual morphologies of VT. Atrioventricular Nodal Re-entry Tachycardia (AVNRT) was found in 8 patients. RFCA was successful in abolishing inducible VT in 88 patients. One patient developed complete AV block requiring a permanent pacemaker. Results of this study confirm a high degree of success and safety of radiofrequency catheter ablation as curative therapy for idiopathic ventricular tachycardia.

Hypoxia attenuates the respiratory response to injection of substance P into the nucleus of the solitary tract of the rat.

PubMed

Mazzone, S B; Hinrichsen, C F; Geraghty, D P

1998-10-30

Prolonged or repetitive bouts of hypoxia may desensitize the brain stem respiratory centres leading to reduced stimulation of ventilation. We investigated the possible involvement of changes in the sensitivity of the commissural nucleus of the solitary tract (cNTS) to the tachykinin peptide, substance P (SP). Urethane-anaesthetised rats were allowed to breath room air (normoxic) or subjected to four, 30 s bouts of hypoxia (10% O2/90% N2) prior to the injection of SP (750 pmol) into the cNTS. In normoxic rats (n = 5), SP produced a fall in frequency (f, 88+/-4% control) after 4 min and a maximum rise in tidal volume (VT) after 6 min (138+/-10% control) leading to an overall increase in minute ventilation (VE, maximum, 127+/-12% control after 2 min). In rats (n = 5) exposed to four bouts of hypoxia and allowed to recover for 10 min, injection of SP produced a similar fall in f but a delayed and significantly (P < 0.001) reduced VT (maximum after 10 min, 110+/-1% control) and hence, VE response (104+/-3% control). Sixty min after hypoxia, the f, VT and VE responses to SP were identical to those of normoxic rats. These data suggest that hypoxia desensitizes SP receptors in the cNTS and this may partly explain why the respiratory response to hypoxia declines over time.

Sudden cardiac arrest in people with epilepsy in the community

PubMed Central

Lamberts, Robert J.; Blom, Marieke T.; Wassenaar, Merel; Bardai, Abdennasser; Leijten, Frans S.; de Haan, Gerrit-Jan; Sander, Josemir W.; Thijs, Roland D.

2015-01-01

Objective: To ascertain whether characteristics of ventricular tachycardia/fibrillation (VT/VF) differed between people with epilepsy and those without and which individuals with epilepsy were at highest risk. Methods: We ascertained 18 people with active epilepsy identified in a community-based registry of sudden cardiac arrest (SCA) with ECG-confirmed VT/VF (cases). We compared them with 470 individuals with VT/VF without epilepsy (VT/VF controls) and 54 individuals with epilepsy without VT/VF (epilepsy controls). Data on comorbidity, epilepsy severity, and medication use were collected and entered into (conditional) logistic regression models to identify determinants of VT/VF in epilepsy. Results: In most cases, there was an obvious (10/18) or presumed cardiovascular cause (5/18) in view of preexisting heart disease. In 2 of the 3 remaining events, near–sudden unexpected death in epilepsy (SUDEP) was established after successful resuscitation. Cases had a higher prevalence of congenital/inherited heart disease (17% vs 1%, p = 0.002), and experienced VT/VF at younger age (57 vs 64 years, p = 0.023) than VT/VF controls. VT/VF in cases occurred more frequently at/near home (89% vs 58%, p = 0.009), and was less frequently witnessed (72% vs 89%, p = 0.048) than in VT/VF controls. Cases more frequently had clinically relevant heart disease (50% vs 15%, p = 0.005) and intellectual disability (28% vs 1%, p < 0.001) than epilepsy controls. Conclusion: Cardiovascular disease rather than epilepsy characteristics is the main determinant of VT/VF in people with epilepsy in the community. SCA and SUDEP are partially overlapping disease entities. PMID:26092917

VT_50m_Wind

Science.gov Websites

Vermont at a 50 meter height. Purpose: Provide information on the wind resource development potential , alter, enhance and distribute this data for any purpose whatsoever, provided that this entire notice FOR A PARTICULAR PURPOSE ARE DISCLAIMED. IN NO EVENT SHALL DOE/NREL BE LIABLE FOR ANY SPECIAL

Large-Scale Operations Management Test of Use of the White Amur for Control of Problem Aquatic Plants. Report 3. Second Year Poststocking Results. Volume VI. The Water and Sediment Quality of Lake Conway, Florida.

DTIC Science & Technology

1982-08-01

AD-A-11 701 ORANGE COUNTY POLLUTION CONTROL DEPT ORLANDO FL F/0 6/6 LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF THE WHITE AMUR--ETC(U) AUG 82 H...8217 OPERATIONS MANAGEMENT TEST OF USE OF THE WHITE AMUR FOR CONTROL -OF PROBLEM AQ.UATIC PLANTS SECOND YEAR POSTSTOCKING RESULTS Volume, Vt The Water...and Subetie) S. TYPE OF REPORT & PERIOD COVERED LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF Report 3 of a series THE WHITE AMUR FOR CONTROL OF

Effect of mask dead space and occlusion of mask holes on delivery of nebulized albuterol.

PubMed

Berlinski, Ariel

2014-08-01

Infants and children with respiratory conditions are often prescribed bronchodilators. Face masks are used to facilitate the administration of nebulized therapy in patients unable to use a mouthpiece. Masks incorporate holes into their design, and their occlusion during aerosol delivery has been a common practice. Masks are available in different sizes and different dead volumes. The aim of this study was to compare the effect of different degrees of occlusion of the mask holes and different mask dead space on the amount of nebulized albuterol available at the mouth opening in a model of a spontaneously breathing child. A breathing simulator mimicking infant (tidal volume [VT] = 50 mL, breathing frequency = 30 breaths/min, inspiratory-expiratory ratio [I:E] = 1:3), child (VT = 155 mL, breathing frequency = 25 breaths/min, I:E = 1:2), and adult (VT = 500 mL, breathing frequency = 15 breaths/min, I:E = 1:2) breathing patterns was connected to a collection filter hidden behind a face plate. A pediatric size mask and an adult size mask connected to a continuous output jet nebulizer were sealed to the face plate. Three nebulizers were loaded with albuterol sulfate (2.5 mg/3 mL) and operated with 6 L/min compressed air for 5 min. Experiments were repeated with different degrees of occlusion (0%, 50%, and 90%). Albuterol was extracted from the filter and measured with a spectrophotometer at 276 nm. Occlusion of the holes in the large mask did not increase the amount of albuterol in any of the breathing patterns. The amount of albuterol captured at the mouth opening did not change when the small mask was switched to the large mask, except with the breathing pattern of a child, and when the holes in the mask were 50% occluded (P = .02). Neither decreasing the dead space of the mask nor occluding the mask holes increased the amount of nebulized albuterol captured at the mouth opening.

Prone position improves lung mechanical behavior and enhances gas exchange efficiency in mechanically ventilated chronic obstructive pulmonary disease patients.

PubMed

Mentzelopoulos, Spyros D; Zakynthinos, Spyros G; Roussos, Charris; Tzoufi, Maria J; Michalopoulos, Argyris S

2003-06-01

Pronation might favorably affect respiratory system (rs) mechanics and function in volume-controlled, mode-ventilated chronic obstructive pulmonary disease (COPD) patients. We studied 10 COPD patients, initially positioned supine (baseline supine [supine(BAS)]) and then randomly and consecutively changed to protocol supine (supine(PROT)), semirecumbent, and prone positions. Rs mechanics and inspiratory work (W(I)) were assessed at baseline (0.6 L) (all postures) and sigh (1.2 L) (supine(BAS) excluded) tidal volume (V(T)) with rapid airway occlusion during constant-flow inflation. Hemodynamics and gas exchange were assessed in all postures. There were no complications. Prone positioning resulted in (a) increased dynamic-static chest wall (cw) elastance (at both V(Ts)) and improved oxygenation versus supine(BAS), supine(PROT), and semirecumbent, (b) decreased additional lung (L) resistance-elastance versus supine(PROT) and semirecumbent at sigh V(T), (c) decreased L-static elastance (at both V(Ts)) and improved CO(2) elimination versus supine(BAS) and supine(PROT), and (d) improved oxygenation versus all other postures. Semirecumbent positioning increased mainly additional cw-resistance versus supine(BAS) and supine(PROT) at baseline. V(T) W(I)-sub-component changes were consistent with changes in rs, cw, and L mechanical properties. Total rs-W(I) and hemodynamics were unaffected by posture change. After pronation, five patients were repositioned supine (supine(POSTPRO)). In supine(POSTPRO), static rs-L elastance were lower, and oxygenation was still improved versus supine(BAS). Pronation of mechanically ventilated COPD patients exhibits applicability and effectiveness and improves oxygenation and sigh-L mechanics versus semirecumbent ("gold standard") positioning. By assessing respiratory mechanics, inspiratory work, hemodynamics, and gas exchange, we showed that prone positioning of mechanically ventilated chronic obstructed pulmonary disease patients improves oxygenation and lung mechanics during sigh versus semirecumbent positioning. Furthermore, certain pronation-related benefits versus preprone-supine positioning (reduced lung elastance and improved oxygenation) are maintained in the postprone supine position.

Increased sensitivity to radiochemotherapy in IDH1 mutant glioblastoma as demonstrated by serial quantitative MR volumetry

PubMed Central

Tran, Anh N.; Lai, Albert; Li, Sichen; Pope, Whitney B.; Teixeira, Stephanie; Harris, Robert J.; Woodworth, Davis C.; Nghiemphu, Phioanh L.; Cloughesy, Timothy F.; Ellingson, Benjamin M.

2014-01-01

Background Isocitrate dehydrogenase 1 (IDH1) mutations have been linked to favorable outcomes in patients with glioblastoma multiforme (GBM). Recent in vitro experiments suggest that IDH1 mutation sensitizes tumors to radiation damage. We hypothesized that radiographic treatment response would be significantly different between IDH1 mutant versus wild-type GBMs after radiotherapy (RT) and concurrent temozolomide (TMZ). Methods A total of 39 newly diagnosed GBM patients with known IDH1 mutational status (10 IDH1 mutants), who followed standard therapy and had regular post-contrast T1W (T1+C) and T2W/ fluid-attenuated inversion recovery (FLAIR) images in the 6-month period after starting RT, were enrolled. The volume of contrast-enhancing and FLAIR hyperintensity were calculated from each scan. Linear and polynomial regression techniques were used to estimate the rate of change and temporal patterns in tumor volumes. Results IDH1 mutant GBMs demonstrated a favorable response to RT/TMZ in the study period, as demonstrated by 10 of 10 mutants showing radiographic response (decreasing VT1+C), compared with 13 of 29 wild-types (P < .001). During the study period, VT1+C and VFLAIR changed at −3.6% per week and +0.6% per week in IDH1 mutant tumors, respectively, as compared with +0.8% per week and +5.2% per week in IDH1 wild-type tumors (P = .0076 and P = .0118, respectively). Amongst the radiographic responders, IDH1 mutant GBMs still demonstrated significant progression-free and overall survival benefit. Aggregated tumor kinetics by group showed significant lower rate in IDH1 mutant GBMs in specific periods: >105 days for VFLAIR and 95–120 and >150 days for VT1+C from starting RT/TMZ. Conclusions The current study supports the hypothesis that IDH1 mutant GBMs are more sensitive to radiochemotherapy than IDH1 wild-type GBMs. PMID:24305712

Tilt recorded by a portable broadband seismograph: The 2003 eruption of Anatahan Volcano, Mariana Islands

USGS Publications Warehouse

Wiens, D.A.; Pozgay, S.H.; Shore, P.J.; Sauter, A.W.; White, R.A.

2005-01-01

The horizontal components of broadband seismographs are highly sensitive to tilt, suggesting that commonly deployed portable broadband seismic sensors may record important tilt information associated with volcanic eruptions. We report on a tilt episode that coincides with the first historical eruption of Anatahan volcano on May 10, 2003. The tilt was recorded by a Strekheisen STS-2 seismograph deployed in an underground insulated chamber 7 km west of the active vent. An ultra-long period signal with a dominant period of several hours was recorded on the E-W component beginning at 06:20 GMT on May 10, which coincides with the onset of continuous volcano-tectonic (VT) seismicity and is one hour prior to the eruption time estimated by the Volcanic Ash Advisory Center. The signal is much smaller on the N-S component and absent on the vertical component, suggesting it results from tilt that is approximately radial with respect to the active vent. An estimate of tilt as a function of time is recovered by deconvolving the record to acceleration and dividing by the acceleration of gravity. The record indicates an initial episode of tilt downward away from the volcanic center from 06:20-09:30 GMT, which we interpret as inflation of the shallow volcanic source. The tilt reverses, recording deflation, from 09:30 until 17:50, after which the tilt signal becomes insignificant. The inflation corresponds to a period of numerous VT events, whereas fewer events were recorded during the deflation episode, and the VT events subsequently resumed after the end of the deflationary tilt. The maximum tilt of 2 microradians can be used to estimate the volume of the source inflation (???2 million in m3), assuming a simple Mogi source model. These calculations are consistent with other estimates of source volume if reasonable source depths are assumed. Examination of broadband records of other eruptions may disclose further previously unrecognized tilt signals. Copyright 2005 by the American Geophysical Union.

USAF Summer Research Program - 1993 Graduate Student Research Program Final Reports, Volume 6, AEDC, FJSRL and WHMC

DTIC Science & Technology

1993-12-01

Mechanical Engineering Associate, PhD Laboratory: PL/VT Division Engineering University of Texas, San Anton Vol-Page No: 3-26 San Antonio, TX 7824-9065...parameters. The modules can be primitive or compound. Primitive modules represent the elementary computation units and define their interfaces. The... linear under varying conditions for the range of processor numbers. Discussion Performance: Our evaluation of the performance measurement results is the

Structures to Resist the Effects of Accidential Explosions. Volume 4. Reinforced Concrete Design

DTIC Science & Technology

1987-04-01

menus , however, references are given defining similar procedures for, one-way elements. Procedure: Step 1. Establish design parameters: a. Blast loads...Torsional capacity. 2.4 Kfc )112 t1.v2 1/2 (eq. 4-146) [1 +( u tu A -80 V. 2.4 x (4,000)S~~~~~~~VtC ........... 1 /2 tI 1.2 x 235.2) ] 82.5 142.6 psi

Causes of distal volcano-tectonic seismicity inferred from hydrothermal modeling

NASA Astrophysics Data System (ADS)

Coulon, C. A.; Hsieh, P. A.; White, R.; Lowenstern, J. B.; Ingebritsen, S. E.

2017-10-01

Distal volcano-tectonic (dVT) seismicity typically precedes eruption at long-dormant volcanoes by days to years. Precursory dVT seismicity may reflect magma-induced fluid-pressure pulses that intersect critically stressed faults. We explored this hypothesis using an open-source magmatic-hydrothermal code that simulates multiphase fluid and heat transport over the temperature range 0 to 1200 °C. We calculated fluid-pressure changes caused by a small (0.04 km3) intrusion and explored the effects of flow geometry (channelized vs. radial flow), magma devolatilization rates (0-15 kg/s), and intrusion depths (5 and 7.5 km, above and below the brittle-ductile transition). Magma and host-rock permeabilities were key controlling parameters and we tested a wide range of permeability (k) and permeability anisotropies (kh/kv), including k constant, k(z), k(T), and k(z, T, P) distributions, examining a total of 1600 realizations to explore the relevant parameter space. Propagation of potentially causal pressure changes (ΔP ≥ 0.1 bars) to the mean dVT location (6 km lateral distance, 6 km depth) was favored by channelized fluid flow, high devolatilization rates, and permeabilities similar to those found in geothermal reservoirs (k 10- 16 to 10- 13 m2). For channelized flow, magma-induced thermal pressurization alone can generate cases of Δ P ≥ 0.1 bars for all permeabilities in the range 10- 16 to 10- 13 m2, whereas in radial flow regimes thermal pressurization causes Δ P < 0.1 bars for all permeabilities. Changes in distal fluid pressure occurred before proximal pressure changes given modest anisotropies (kh/kv 10-100). Invoking k(z,T,P) and high, sustained devolatilization rates caused large dynamic fluctuations in k and P in the near-magma environment but had little effect on pressure changes at the distal dVT location. Intrusion below the brittle-ductile transition damps but does not prevent pressure transmission to the dVT site.

Verocytotoxin-induced apoptosis of human microvascular endothelial cells.

PubMed

Pijpers, A H; van Setten, P A; van den Heuvel, L P; Assmann, K J; Dijkman, H B; Pennings, A H; Monnens, L A; van Hinsbergh, V W

2001-04-01

The pathogenesis of the epidemic form of hemolytic uremic syndrome is characterized by endothelial cell damage. In this study, the role of apoptosis in verocytotoxin (VT)-mediated endothelial cell death in human glomerular microvascular endothelial cells (GMVEC), human umbilical vein endothelial cells, and foreskin microvascular endothelial cells (FMVEC) was investigated. VT induced apoptosis in GMVEC and human umbilical vein endothelial cells when the cells were prestimulated with the inflammatory mediator tumor necrosis factor-alpha (TNF-alpha). FMVEC displayed strong binding of VT and high susceptibility to VT under basal conditions, which made them suitable for the study of VT-induced apoptosis without TNF-alpha interference. On the basis of functional (flow cytometry and immunofluorescence microscopy using FITC-conjugated annexin V and propidium iodide), morphologic (transmission electron microscopy), and molecular (agarose gel electrophoresis of cellular DNA fragments) criteria, it was documented that VT induced programmed cell death in microvascular endothelial cells in a dose- and time-dependent manner. Furthermore, whereas partial inhibition of protein synthesis by VT was associated with a considerable number of apoptotic cells, comparable inhibition of protein synthesis by cycloheximide was not. This suggests that additional pathways, independent of protein synthesis inhibition, may be involved in VT-mediated apoptosis in microvascular endothelial cells. Specific inhibition of caspases by Ac-Asp-Glu-Val-Asp-CHO, but not by Ac-Tyr-Val-Ala-Asp-CHO, was accompanied by inhibition of VT-induced apoptosis in FMVEC and TNF-alpha-treated GMVEC. These data indicate that VT can induce apoptosis in human microvascular endothelial cells.

Interaction of Viscotoxins A3 and B with Membrane Model Systems: Implications to Their Mechanism of Action

PubMed Central

Giudici, Marcela; Pascual, Roberto; de la Canal, Laura; Pfüller, Karola; Pfüller, Uwe; Villalaín, José

2003-01-01

Viscotoxins are small proteins that are thought to interact with biomembranes, displaying different toxic activities against a varied number of cell types, being viscotoxin A3 (VtA3) the most cytotoxic whereas viscotoxin B (VtB) is the less potent. By using infrared and fluorescence spectroscopies, we have studied the interaction of VtA3 and VtB, both wild and reduced ones, with model membranes containing negatively charged phospholipids. Both VtA3 and VtB present a high conformational stability, and a similar conformation both in solution and when bound to membranes. In solution, the infrared spectra of the reduced proteins show an increase in bandwidth compared to the nonreduced ones indicating a greater flexibility. VtA3 and VtB bind with high affinity to membranes containing negatively charged phospholipids and are motional restricted, their binding being dependent on phospholipid composition. Whereas nonreduced proteins maintain their structure when bound to membranes, reduced ones aggregate. Furthermore, leakage experiments show that wild proteins were capable of disrupting membranes whereas reduced proteins were not. The effect of VtA3 and VtB on membranes having different phospholipid composition is diverse, affecting the cooperativity and fluidity of the membranes. Viscotoxins interact with membranes in a complex way, most likely organizing themselves at the surface inducing the appearance of defects that lead to the destabilization and disruption of the membrane bilayer. PMID:12885644

Image-derived input function with factor analysis and a-priori information.

PubMed

Simončič, Urban; Zanotti-Fregonara, Paolo

2015-02-01

Quantitative PET studies often require the cumbersome and invasive procedure of arterial cannulation to measure the input function. This study sought to minimize the number of necessary blood samples by developing a factor-analysis-based image-derived input function (IDIF) methodology for dynamic PET brain studies. IDIF estimation was performed as follows: (a) carotid and background regions were segmented manually on an early PET time frame; (b) blood-weighted and tissue-weighted time-activity curves (TACs) were extracted with factor analysis; (c) factor analysis results were denoised and scaled using the voxels with the highest blood signal; (d) using population data and one blood sample at 40 min, whole-blood TAC was estimated from postprocessed factor analysis results; and (e) the parent concentration was finally estimated by correcting the whole-blood curve with measured radiometabolite concentrations. The methodology was tested using data from 10 healthy individuals imaged with [(11)C](R)-rolipram. The accuracy of IDIFs was assessed against full arterial sampling by comparing the area under the curve of the input functions and by calculating the total distribution volume (VT). The shape of the image-derived whole-blood TAC matched the reference arterial curves well, and the whole-blood area under the curves were accurately estimated (mean error 1.0±4.3%). The relative Logan-V(T) error was -4.1±6.4%. Compartmental modeling and spectral analysis gave less accurate V(T) results compared with Logan. A factor-analysis-based IDIF for [(11)C](R)-rolipram brain PET studies that relies on a single blood sample and population data can be used for accurate quantification of Logan-V(T) values.

Quantitative graphical analysis of simultaneous dynamic PET/MRI for assessment of prostate cancer.

PubMed

Rosenkrantz, Andrew B; Koesters, Thomas; Vahle, Anne-Kristin; Friedman, Kent; Bartlett, Rachel M; Taneja, Samir S; Ding, Yu-Shin; Logan, Jean

2015-04-01

Dynamic FDG imaging for prostate cancer characterization is limited by generally small size and low uptake in prostate tumors. Our aim in this pilot study was to explore feasibility of simultaneous PET/MRI to guide localization of prostate lesions for dynamic FDG analysis using a graphical approach. Three patients with biopsy-proven prostate cancer underwent simultaneous FDG PET/MRI, incorporating dynamic prostate imaging. Histology and multiparametric MRI findings were used to localize tumors, which in turn guided identification of tumors on FDG images. Regions of interest were manually placed on tumor and benign prostate tissue. Blood activity was extracted from a region of interest placed on the femoral artery on PET images. FDG data were analyzed by graphical analysis using the influx constant Ki (Patlak analysis) when FDG binding seemed irreversible and distribution volume VT (reversible graphical analysis) when FDG binding seemed reversible given the presence of washout. Given inherent coregistration, simultaneous acquisition facilitated use of MRI data to localize small lesions on PET and subsequent graphical analysis in all cases. In 2 cases with irreversible binding, tumor had higher Ki than benign using Patlak analysis (0.023 vs 0.006 and 0.019 vs 0.008 mL/cm3 per minute). In 1 case appearing reversible, tumor had higher VT than benign using reversible graphical analysis (0.68 vs 0.52 mL/cm3). Simultaneous PET/MRI allows localization of small prostate tumors for dynamic PET analysis. By taking advantage of inclusion of the femoral arteries in the FOV, we applied advanced PET data analysis methods beyond conventional static measures and without blood sampling.

Medullary serotonergic neurones modulate the ventilatory response to hypercapnia, but not hypoxia in conscious rats.

PubMed

Taylor, Natalie C; Li, Aihua; Nattie, Eugene E

2005-07-15

Serotonergic neurones in the mammalian medullary raphe region (MRR) have been implicated in central chemoreception and the modulation of the ventilatory response to hypercapnia, and may also be involved in the ventilatory response to hypoxia. In this study, we ask whether ventilatory responses across arousal states are affected when the 5-hydroxytryptamine 1A receptor (5-HT1A) agonist (R)-(+)-8-hydroxy-2(di-n-propylamino)tetralin (DPAT) is microdialysed into the MRR of the unanaesthetized adult rat. Microdialysis of 1, 10 and 30 mM DPAT into the MRR significantly decreased absolute ventilation values(VE) during 7% CO2 breathing by 21%, 19% and 30%, respectively, in wakefulness compared to artificial cerebrospinal fluid (aCSF) microdialysis, due to decreases in tidal volume (VT) and not in frequency (f), similar to what occurred during non-rapid eye movement (NREM) sleep. The concentration-dependence of the hypercapnic ventilatory effect might be due to differences in tissue distribution of DPAT. DPAT (30 mM) changed room air breathing pattern by increasing f and decreasing VT. As evidenced by a sham control group, repeated experimentation and microdialysis of aCSF alone had no effect on the ventilatory response to 7% CO2 during wakefulness or sleep. Unlike during hypercapnia, microdialysis of 30 mM DPAT into the MRR did not change the ventilatory response to 10% O2. Additionally, 10 and 30 mM DPAT MRR microdialysis decreased body temperature, and 30 mM DPAT increased the percentage of experimental time in wakefulness. We conclude that serotonergic activity in the MRR plays a role in the ventilatory response to hypercapnia, but not to hypoxia, and that MRR 5-HT1A receptors are also involved in thermoregulation and arousal.

Long-term outcome of catheter ablation for left posterior fascicular ventricular tachycardia with the development of left posterior fascicular block and characteristics of repeat procedures.

PubMed

Luo, Bin; Zhou, Gongbu; Guo, Xiaogang; Liu, Xu; Yang, Jiandu; Sun, Qi; Ma, Jian; Zhang, Shu

2017-06-01

The present study aimed to retrospectively investigate long-term clinical outcomes of patients undergoing catheter ablation of left posterior fascicular ventricular tachycardia (LPF-VT) with the development of left posterior fascicular block (LPF block) and characteristics of repeat procedures. A total of 195 patients (mean age 29.76±1.03years, 16.4% females) who underwent catheter ablation for LPF-VT were consecutively enrolled. The earliest ventricular potential with a single fused Purkinje potential (PP) during VT and the PP located in the inferior-apical or mid-apical septum during SR were targeted for linear ablation. The endpoint of the procedure was noninducible VT and development of new-onset LPF block. Follow-up with clinic visits or telephonic interviews, electrocardiogram (ECG), or Holter monitoring was performed after the procedure. With a median follow-up of 85 (18,181) months, 20 patients were censored and 152 of 175 (86.86%) patients had long-term freedom from VT after a single procedure. No statistical difference in the outcome of catheter ablation of LPF-VT was found between inducible and non-inducible groups (P=0.89). Twenty-three patients exhibited recurrent LPF-VT. Seven of 23 patients developed new-onset left upper septal ventricular tachycardia that was successfully ablated. All the patients undergoing repeat procedures had freedom from VT. No procedural complications occurred. Ablation of LPF-VT using the development of LPF block as the endpoint is associated with a high procedural success rate. No difference in freedom from LPF-VT was found between inducible and non-inducible patients. New-onset LPF block recovery and non-early PP-QRS interval can be the predictors of LPF-VT repeat procedure. Copyright © 2017 Elsevier B.V. All rights reserved.

The association of ventricular tachycardia and endothelial dysfunction in the setting of acute myocardial infarction with ST elevation

PubMed Central

Škerk, Vedrana; Markotić, Alemka; Brkljačić, Diana Delić; Manola, Šime; Krčmar, Tomislav; Gabrić, Ivo Darko; Štajminger, Gordana; Pintarić, Hrvoje

2013-01-01

Background Ventricular tachycardia (VT) is frequently seen in ischemic settings like acute myocardial infarction with ST segment elevation (STEMI). Endothelial dysfunction (ED) represents inflammation and the loss of all protective features of the endothelium. We aimed to examine the association between VT and ED in patients with STEMI. Material/Methods The study included 90 subjects (30 with VT and acute STEMI, 30 with STEMI without VT, and 30 controls). Sera of all subjects were tested on ED markers by enzyme immunoassay: sICAM-1 (intracellular adhesive molecule-1), sVCAM-1 (vascular adhesive molecule-1), P- and E-selectins, and VEGF (vascular endothelial growth factor). In addition, CRP (C-reactive protein) was detected. Results Significantly increased values of low-density lipoprotein, triglycerides, leukocytes, creatinine, and the number of cigarettes smoked were observed among patients with VT+STEMI in comparison to controls. The levels of E-selectin were significantly lower in the VT+STEMI group than in the other groups, while the levels of VCAM-1 were significantly higher in the groups with STEMI and VT+STEMI compared to the controls. Lower levels of VEGF were recorded in STEMI and VT+STEMI groups compared to the control group. A significant correlation between CRP and VCAM-1 in patients with VT +STEMI was demonstrated. Conclusions We showed that ED may have a role in the immunopathogenesis of VT in patients with STEMI. The role of sE-selectin and correlation of sVCAM-1 with CRP as possible ED predictive markers in patients with VT+STEMI should be further investigated in a large cohort of patients. PMID:24253420

The Association of Statin Therapy with the Risk of Recurrent Venous Thrombosis

PubMed Central

Smith, Nicholas L.; Harrington, Laura B.; Blondon, Marc; Wiggins, Kerri L.; Floyd, James S.; Sitlani, Colleen M.; McKnight, Barbara; Larson, Eric B.; Rosendaal, Frits R.; Heckbert, Susan R.; Psaty, Bruce M.

2016-01-01

Background Meta-analyses of randomized controlled trials suggest that treatment with HMG-CoA reductase inhibitors (statins) lowers the risk of incident venous thrombosis (VT), particularly among those without prevalent clinical cardiovascular disease (CVD). Whether this is true for the prevention of recurrent VT is debated. We used an observational inception cohort to estimate the association of current statin use with the risk of recurrent VT. Methods and Results The study setting was a large healthcare organization with detailed medical record and pharmacy information at cohort entry and throughout follow-up. We followed 2,798 subjects 18–89 years of age who experienced a validated incident VT between January 1, 2002 and December 31, 2010, for a first recurrent VT, validated by medical record review. During follow-up, 457 (16%) developed a first recurrent VT. In time-to-event models incorporating time-varying statin use and adjusting for potential confounders, current statin use was associated with a 26% lower risk of recurrent VT: HR=0.74; 95%CI: 0.59–0.94. Among cohort members free of CVD (n=2,134), current statin use was also associated with a lower risk (38%) of recurrent VT: HR=0.62; 95%CI: 0.45–0.85. We found similar results when restricting to new users of statins and in subgroups of different statin types and doses. Conclusions In a population-based cohort of subjects who had experienced an incident VT, statin use, compared with non-use, was associated with a clinically-relevant lower risk of recurrent VT. These findings suggest a potential secondary benefit of statins among patients who have experienced an incident VT. PMID:27061794

Predictors of new malignant ventricular arrhythmias after coronary surgery: a case-control study.

PubMed

Ascione, Raimondo; Reeves, Barnaby C; Santo, Kirkpatrick; Khan, Nouman; Angelini, Gianni D

2004-05-05

We sought to investigate the relationship between perioperative factors and the occurrence of ventricular tachycardia (VT) and ventricular fibrillation (VF), as well as the impact of VT/VF on early and late mortality. Both VT and VF are rare but serious complications after coronary artery bypass graft surgery (CABG), and their etiology and implications remain uncertain. Data on 4,411 consecutive patients undergoing CABG (1,154 [25.8%] had off-pump surgery) between April 1996 and September 2001 were extracted from a prospective database and analyzed. Odds ratios (ORs) describing associations between possible risk factors and VT/VF were estimated separately. Factors observed to be significantly associated with VT/VF were further investigated using multivariate logistic regression. Sixty-nine patients suffered VT/VF (1.6%). There were 61 (1.4%) in-hospital/30-day deaths, 15 among patients who had postoperative VT/VF (21.7%). Patient factors independently associated with an increase in the odds of VT/VF included age <65 years, female gender, body mass index <25 kg/m(2), unstable angina, moderate or poor ejection fraction, and the need for inotropes and an intra-aortic balloon pump (OR 1.72 to 4.47, p < 0.05). After adjustment, off-pump surgery was associated with a substantial but nonsignificant protective effect against VT/VF (OR 0.53, 95% confidence interval [CI] 0.25 to 1.13; p = 0.10). Actuarial survival at two years was 98.2% among patients who had VT/VF and who survived to discharge/30 days, compared with 97.0% for the control group (adjusted hazard ratio 0.96 (95% CI 0.40 to 2.31, p = 0.92). The incidence of VT/VF is low in patients undergoing coronary surgery but is associated with high in-hospital mortality. The late survival of the discharged VT/VF patients compares favorably with that of controls.

Comparison of affective responses during and after low volume high-intensity interval exercise, continuous moderate- and continuous high-intensity exercise in active, untrained, healthy males.

PubMed

Niven, Ailsa; Thow, Jacqueline; Holroyd, Jack; Turner, Anthony P; Phillips, Shaun M

2018-09-01

This study compared affective responses to low volume high-intensity interval exercise (HIIE), moderate-intensity continuous exercise (MICE) and high-intensity continuous exercise (HICE). Twelve untrained males ([Formula: see text] 48.2 ± 6.7 ml·kg -1 ·min -1 ) completed MICE (30 min cycle at 85% of ventilatory threshold (VT)), HICE (cycle at 105% of VT matched with MICE for total work), and HIIE (10 x 6 s cycle sprints with 60 s recovery). Affective valence and perceived activation were measured before exercise, post warm-up, every 20% of exercise time, and 1, 5, 10, and 15 min post-exercise. Affective valence during exercise declined by 1.75 ± 2.42, 1.17 ± 1.99, and 0.42 ± 1.38 units in HICE, HIIE, and MICE, respectively, but was not statistically influenced by trial (P = 0.35), time (P = 0.06), or interaction effect (P = 0.08). Affective valence during HICE and HIIE was consistently less positive than MICE. Affective valence post-exercise was not statistically influenced by trial (P = 0.10) and at 5 min post-exercise exceeded end-exercise values (P = 0.048). Circumplex profiles showed no negative affect in any trial. Affective responses to low volume HIIE are similar to HICE but remain positive and rebound rapidly, suggesting it may be a potential alternative exercise prescription.

Metabolic and ventilatory responses to submaximal and maximal exercise using different breathing assemblies.

PubMed

Evans, B W; Potteiger, J A

1995-06-01

This study compared ventilatory and metabolic responses during exercise using three breathing assemblies: mouthpiece/noseclip (BV); mouth/face mask (MM); and facemask (FM). Ten male runners completed three maximal treadmill tests with breathing assembly randomly assigned. Metabolic and ventilatory data were recorded every 15s, and heart rate (HR) and rating of perceived exertion (RPE) each min. No significant differences were found for treadmill run time, HRmax, respiratory exchange ratio (RER), and RPE, indicating similar efforts on all trials. No significant differences were found at maximal exercise for VO2 minute ventilation (VE), tidal volume (VT), and breathing frequency (f). At ventilatory threshold (TVENT), VO2, VE, and f were not significantly different. However, peak flow (PF) was significantly higher for BV than FM, and VT was significantly higher for BV than MM and FM. Results indicate alterations in ventilatory mechanics occur at TVENT, but type of breathing assembly does not significantly affect maximal values.

Altered respiratory response to substance P and reduced NK1 receptor binding in the nucleus of the solitary tract of aged rats.

PubMed

Mazzone, S B; Geraghty, D P

1999-04-24

The respiratory response to microinjection of substance P (SP) into the commissural nucleus of the solitary tract (cNTS) and binding of [125I]-Bolton-Hunter SP ([125I]-BHSP) to brain stem NK1 receptors were compared in young and aged rats. Injection of SP (750 pmol) into the cNTS of young rats (2 months) increased tidal volume (VT) but had no effect on respiratory rate (f). In aged rats (19-21 months), injection of SP had no significant effect on f or VT. The NTS of aged rats displayed significantly lower specific [125I]-BHSP binding than young rats, indicating a reduction in the number in NK1 receptors. These findings show that the respiratory response to microinjection of SP into the cNTS of aged rats is severely blunted and that this phenomenon may be due to a decrease in the number of NK1 receptors in the NTS. Copyright 1999 Elsevier Science B.V.

Adjusting tidal volume to stress index in an open lung condition optimizes ventilation and prevents overdistension in an experimental model of lung injury and reduced chest wall compliance.

PubMed

Ferrando, Carlos; Suárez-Sipmann, Fernando; Gutierrez, Andrea; Tusman, Gerardo; Carbonell, Jose; García, Marisa; Piqueras, Laura; Compañ, Desamparados; Flores, Susanie; Soro, Marina; Llombart, Alicia; Belda, Francisco Javier

2015-01-13

The stress index (SI), a parameter derived from the shape of the pressure-time curve, can identify injurious mechanical ventilation. We tested the hypothesis that adjusting tidal volume (VT) to a non-injurious SI in an open lung condition avoids hypoventilation while preventing overdistension in an experimental model of combined lung injury and low chest-wall compliance (Ccw). Lung injury was induced by repeated lung lavages using warm saline solution, and Ccw was reduced by controlled intra-abdominal air-insufflation in 22 anesthetized, paralyzed and mechanically ventilated pigs. After injury animals were recruited and submitted to a positive end-expiratory pressure (PEEP) titration trial to find the PEEP level resulting in maximum compliance. During a subsequent four hours of mechanical ventilation, VT was adjusted to keep a plateau pressure (Pplat) of 30 cmH2O (Pplat-group, n = 11) or to a SI between 0.95 and 1.05 (SI-group, n = 11). Respiratory rate was adjusted to maintain a 'normal' PaCO2 (35 to 65 mmHg). SI, lung mechanics, arterial-blood gases haemodynamics pro-inflammatory cytokines and histopathology were analyzed. In addition Computed Tomography (CT) data were acquired at end expiration and end inspiration in six animals. PaCO2 was significantly higher in the Pplat-group (82 versus 53 mmHg, P = 0.01), with a resulting lower pH (7.19 versus 7.34, P = 0.01). We observed significant differences in VT (7.3 versus 5.4 mlKg(-1), P = 0.002) and Pplat values (30 versus 35 cmH2O, P = 0.001) between the Pplat-group and SI-group respectively. SI (1.03 versus 0.99, P = 0.42) and end-inspiratory transpulmonary pressure (PTP) (17 versus 18 cmH2O, P = 0.42) were similar in the Pplat- and SI-groups respectively, without differences in overinflated lung areas at end- inspiration in both groups. Cytokines and histopathology showed no differences. Setting tidal volume to a non-injurious stress index in an open lung condition improves alveolar ventilation and prevents overdistension without increasing lung injury. This is in comparison with limited Pplat protective ventilation in a model of lung injury with low chest-wall compliance.

Breath-stacking and incentive spirometry in Parkinson's disease: Randomized crossover clinical trial.

PubMed

Ribeiro, Rhayssa; Brandão, Daniella; Noronha, Jéssica; Lima, Cibelle; Fregonezi, Guilherme; Resqueti, Vanessa; Dornelas de Andrade, Arméle

2018-05-01

Patients with Parkinson's disease often exhibit respiratory disorders and there are no Respiratory Therapy protocols which are suggested as interventions in Parkinson's patients. The aim of this study is to evaluate the effects of Breathing-Stacking (BS) and incentive spirometer (IS) techniques in volume variations of the chest wall in patients with Parkinson's Disease (PD). 14 patients with mild-moderate PD were included in this randomized cross-over study. Volume variations of the chest wall were assessed before, immediately after, then 15 and 30 min after BS and IS performance by optoelectronic plethysmography. Tidal volume (VT) and minute ventilation (MV) significantly increased after BS and IS techniques (p < 0.05). There was greater involvement of pulmonary and abdominal compartments after IS. The results suggest that these re-expansion techniques can be performed to immediately improve volume. Copyright © 2018 Elsevier B.V. All rights reserved.

Modulation of nitric oxide, hydrogen peroxide and cytokine production in a clonal macrophage model by the trichothecene vomitoxin (deoxynivalenol).

PubMed

Ji, G E; Park, S Y; Wong, S S; Pestka, J J

1998-02-06

Characterization of how vomitoxin (VT) and other trichothecenes affect macrophage regulatory and effector function may contribute to improved understanding of mechanisms by which these mycotoxins impact the immune system. The RAW 264.7 murine cell line was used as a macrophage model to assess effects of the VT on proliferation and the production of nitric oxide (NO), hydrogen peroxide (H2O2) and cytokines. Using the MTT cleavage assay, VT at concentrations of 50 ng/ml or higher was found to significantly decrease proliferation and viability of RAW 264.7 cells without stimulation or with stimulation by lipopolysaccharide (LPS) or interferon (IFN)-gamma. In the absence of an activation agent, VT (25-250 ng/ml) had negligible effects on the production of NO, H2O2, and cytokines. Upon activation with LPS at concentrations of 10 to 100 ng/ml, VT at 25-100 ng/ml markedly enhanced production of H2O2 but was inhibitory at 250 ng/ml. VT enhancement of H2O2 production was observed as early as 12 h after LPS stimulation. When IFN-gamma was used as the stimulant, VT (25-250 ng/ml) delayed peak H2O2 production. VT (25-250 ng/ml) also markedly decreased NO production in cells activated with LPS or IFN-gamma. Interestingly, VT superinduced TNF-alpha and IL-6 production in LPS-stimulated cells and also elevated TNF-alpha in IFN-gamma stimulated cells. These results suggest that VT can selectively and concurrently upregulate or downregulate critical functions associated with activated macrophages.

Clinical and Electrocardiographic Characteristics of Electrical Storms Due to Monomorphic Ventricular Tachycardia Refractory to Intravenous Amiodarone.

PubMed

Murata, Hiroshige; Miyauchi, Yasushi; Hayashi, Meiso; Iwasaki, Yu-Ki; Yodogawa, Kenji; Ueno, Akira; Hayashi, Hiroshi; Tsuboi, Ippei; Uetake, Shunsuke; Takahashi, Kenta; Yamamoto, Teppei; Maruyama, Mitsunori; Akutsu, Koichi; Yamamoto, Takeshi; Kobayashi, Yoshinori; Tanaka, Keiji; Atarashi, Hirotsugu; Katoh, Takao; Shimizu, Wataru

2015-01-01

Few reports are available on the characteristics of electrical storms of ventricular tachycardia (VT storm) refractory to intravenous (IV) amiodarone. IV-amiodarone was administered to 60 patients with ventricular tachyarrhythmia between 2007 and 2012. VT storms, defined as 3 or more episodes of VT within 24 h, occurred in 30 patients (68±12 years, 7 female), with 12 having ischemic and 18 non-ischemic heart disease. We compared the clinical and electrocardiographic characteristics of the patients with VT storms suppressed by IV-amiodarone (Effective group) to those of patients not affected by the treatment (Refractory group). IV-amiodarone could not control recurrence of VT in 9 patients (30%). The Refractory group comprised 5 patients with acute myocardial infarctions. Although there was no difference in the VT cycle length, the QRS duration of both the VT and premature ventricular contractions (PVCs) followed by VT was narrower in the Refractory group than in the Effective group (140±30 vs. 178±25 ms, P<0.01; 121±14 vs. 179±22 ms, P<0.01). In the Refractory group, additional administration of IV-mexiletine and/or Purkinje potential-guided catheter ablation was effective. IV-amiodarone-refractory VT exhibited a relatively narrow QRS tachycardia. The narrow triggering PVCs, suggesting a Purkinje fiber origin, may be treated by additional IV-mexiletine and endocardial catheter ablation.

Vantage Theory and Linguistic Relativity

ERIC Educational Resources Information Center

Allan, Keith

2010-01-01

Rob MacLaury's Vantage Theory, VT, models the way in which a cognizer constructs, recalls, uses, and modifies a category in terms of point of view or vantage. Alongside of VT, there is place for the kind of semantic specification found in the lexicon. VT2 [Allan, Keith, 2002. "Vantage theory, VT2, and number." "Language Sciences" 24(5-6), 679-703…

Spectroscopic analysis of electron trapping levels in pentacene field-effect transistors

NASA Astrophysics Data System (ADS)

Park, Chang Bum

2014-08-01

Electron trapping phenomena have been investigated with respect to the energy levels of localized trap states and bias-induced device instability effects in pentacene field-effect transistors. The mechanism of the photoinduced threshold voltage shift (ΔVT) is presented by providing a ΔVT model governed by the electron trapping. The trap-and-release behaviour functionalized by photo-irradiation also shows that the trap state for electrons is associated with the energy levels in different positions in the forbidden gap of pentacene. Spectroscopic analysis identifies two kinds of electron trap states distributed above and below the energy of 2.5 eV in the band gap of the pentacene crystal. The study of photocurrent spectra shows the specific trap levels of electrons in energy space that play a substantial role in causing device instability. The shallow and deep trapping states are distributed at two centroidal energy levels of ˜1.8 and ˜2.67 eV in the pentacene band gap. Moreover, we present a systematic energy profile of electron trap states in the pentacene crystal for the first time.

Lack of sensitivity of measurements of Vd/Vt at rest and during exercise in detection of hemodynamically significant pulmonary vascular abnormalities in collagen vascular disease.

PubMed

Mohsenifar, Z; Tashkin, D P; Levy, S E; Bjerke, R D; Clements, P J; Furst, D

1981-05-01

Wasted ventilation fraction (Vd/Vt) normally declines substantially during exercise in persons without lung disease. Failure of Vd/Vt to decrease during exercise has been reported to be one of the earliest abnormalities in patients with dyspnea caused by pulmonary vaso-occlusive disease, suggesting that measurement of Vd/Vt at rest and during exercise are useful in the diagnosis of pulmonary vascular disorders. We studied pulmonary hemodynamic and Vd/Vt responses to exercise in 11 patients in the supine position with suspected pulmonary vascular involvement caused by progressive systemic sclerosis, systemic lupus erythematosus, or recurrent pulmonary emboli, 10 of whom had dyspnea at rest and/or on exertion. In contrast to previous reports of no change or an increase in Vd/Vt during exercise in patients with pulmonary vascular disease, we found Vd/Vt to decrease significantly during exercise in 8 of 9 patients in whom mean pulmonary artery pressures were abnormally elevated at rest and/or during exercise. Our findings suggest that normal responses of Vd/Vt to exercise do not exclude hemodynamically significant pulmonary vaso-occlusive disease.

Control of cardiorespiratory function in response to hypoxia in an air-breathing fish, the African sharptooth catfish, Clarias gariepinus.

PubMed

Belão, T C; Zeraik, V M; Florindo, L H; Kalinin, A L; Leite, C A C; Rantin, F T

2015-09-01

We evaluated the role of the first pair of gill arches in the control of cardiorespiratory responses to normoxia and hypoxia in the air-breathing catfish, Clarias gariepinus. An intact group (IG) and an experimental group (EG, bilateral excision of first gill arch) were submitted to graded hypoxia, with and without access to air. The first pair of gill arches ablations reduced respiratory surface area and removed innervation by cranial nerve IX. In graded hypoxia without access to air, both groups displayed bradycardia and increased ventilatory stroke volume (VT), and the IG showed a significant increase in breathing frequency (fR). The EG exhibited very high fR in normoxia that did not increase further in hypoxia, this was linked to reduced O2 extraction from the ventilatory current (EO2) and a significantly higher critical O2 tension (PcO2) than the IG. In hypoxia with access to air, only the IG showed increased air-breathing, indicating that the first pair of gill arches excision severely attenuated air-breathing responses. Both groups exhibited bradycardia before and tachycardia after air-breaths. The fH and gill ventilation amplitude (VAMP) in the EG were overall higher than the IG. External and internal NaCN injections revealed that O2 chemoreceptors mediating ventilatory hypoxic responses (fR and VT) are internally oriented. The NaCN injections indicated that fR responses were mediated by receptors predominantly in the first pair of gill arches but VT responses by receptors on all gill arches. Receptors eliciting cardiac responses were both internally and externally oriented and distributed on all gill arches or extra-branchially. Air-breathing responses were predominantly mediated by receptors in the first pair of gill arches. In conclusion, the role of the first pair of gill arches is related to: (a) an elevated EO2 providing an adequate O2 uptake to maintain the aerobic metabolism during normoxia; (b) a significant bradycardia and increased fAB elicited by externally oriented O2 chemoreceptors; (c) increase in the ventilatory variables (fR and VAMP) stimulated by internally oriented O2 chemoreceptors. Copyright © 2015 Elsevier Inc. All rights reserved.

KA-111, Phase C, M-1 Propellant Tests: Deflagration in Partial Confinement.

DTIC Science & Technology

1991-07-01

DNA Test Director and Mr. R. !. Flory, Washington Research Center, was Program Coordinator. The DDESB, NDCS , and SSO Technical Monitors for Phase C...to simulate the chamber and access tunnel proportions of the Shallow Underground Tunnel /Chamber Explosion Test conducted at China Lake, CA, in 1988...The chamber and access tunnel at China Lake had the following dimensions (volume, cross-sectional area and length): Chamber: V. - 331.2 m 3 Tunnel : Vt

Performance of portable ventilators at altitude

DTIC Science & Technology

2015-04-20

currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 20 Apr 2015 2. REPORT TYPE Journal...consistent tidal volume (VT) delivery at various altitudes is imperative for lung protection when transporting wounded war fighters to each echelon...of care. Three ventilators (Impact 731, Hamilton T1, and CareFusion Revel) were tested at pediatric (50 and 100 mL) and adult (250Y750 mL) tidal VTs

Optimisation of a simple and reliable method based on headspace solid-phase microextraction for the determination of volatile phenols in beer.

PubMed

Pizarro, C; Pérez-del-Notario, N; González-Sáiz, J M

2010-09-24

A simple, accurate and sensitive method based on headspace solid-phase microextraction (HS-SPME) coupled to gas chromatography-tandem mass spectrometry (GC-MS/MS) was developed for the analysis of 4-ethylguaiacol, 4-ethylphenol, 4-vinylguaiacol and 4-vinylphenol in beer. The effect of the presence of CO2 in the sample on the extraction of analytes was examined. The influence on extraction efficiency of different fibre coatings, of salt addition and stirring was also evaluated. Divinylbenzene/carboxen/polydimethylsiloxane was selected as extraction fibre and was used to evaluate the influence of exposure time, extraction temperature and sample volume/total volume ratio (Vs/Vt) by means of a central composite design (CCD). The optimal conditions identified were 80 degrees C for extraction temperature, 55 min for extraction time and 6 mL of beer (Vs/Vt 0.30). Under optimal conditions, the proposed method showed satisfactory linearity (correlation coefficients between 0.993 and 0.999), precision (between 6.3% and 9.7%) and detection limits (lower than those previously reported for volatile phenols in beers). The method was applied successfully to the analysis of beer samples. To our knowledge, this is the first time that a HS-SPME based method has been developed to determine simultaneously these four volatile phenols in beers. Copyright 2010 Elsevier B.V. All rights reserved.

Long-Term Outcomes of Catheter Ablation of Electrical Storm in Nonischemic Dilated Cardiomyopathy Compared With Ischemic Cardiomyopathy.

PubMed

Muser, Daniele; Liang, Jackson J; Pathak, Rajeev K; Magnani, Silvia; Castro, Simon A; Hayashi, Tatsuya; Garcia, Fermin C; Supple, Gregory E; Riley, Michael P; Lin, David; Dixit, Sanjay; Zado, Erica S; Frankel, David S; Callans, David J; Marchlinski, Francis E; Santangeli, Pasquale

2017-07-01

The goal of this study was to determine the long-term outcomes of catheter ablation (CA) of electrical storm in patients with nonischemic dilated cardiomyopathy (NIDCM) compared with patients with ischemic cardiomyopathy (ICM). CA of ventricular tachycardia (VT) electrical storm has been shown to improve VT-free survival in patients with ICM. Data on the outcomes of CA of electrical storm in patients with NIDCM are insufficient. The study included 267 consecutive patients with NIDCM (n = 71; ejection fraction 32 ± 14%) and ICM (n = 196; ejection fraction 28 ± 12%). Endo-epicardial CA was performed in 59 (22%) patients. CA was guided by activation and entrainment mapping for tolerated VT and pacemapping/targeting of abnormal substrate for unmappable VT. After a median follow-up of 45 (25th to 75th percentile: 9 to 71) months and 1 (25th to 75th percentile: 1 to 8) procedures, 76 (29%) patients died, 25 (9%) underwent heart transplantation, 87 (33%) experienced VT recurrence, and 13 (5%) had recurrence of electrical storm. Overall VT-free survival was 54% at 60 months (48% in NIDCM and 54% in ICM; p = 0.128). Patients with VT recurrence experienced a median of 2 (1 to 10) VT episodes in the 5 (1 to 14) months after the procedure. Death/transplantation-free survival was 62% at 60 months (53% in NIDCM and 64% in ICM; p = 0.067). Persistent inducibility of any VT with cycle length ≥250 ms at programmed stimulation at the end of the procedure was the only independent predictor of VT recurrence. Low ejection fraction, New York Heart Association functional class, and VT recurrence over follow-up independently predicted death/transplantation. CA of electrical storm was similarly effective in patients with NIDCM compared with patients with ICM, with elimination of electrical storm in 95% of cases and achievement of complete VT control at long-term follow-up in most patients. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Vibration therapy in patients with cerebral palsy: a systematic review

PubMed Central

Ritzmann, Ramona; Stark, Christina; Krause, Anne

2018-01-01

The neurological disorder cerebral palsy (CP) is caused by unprogressive lesions of the immature brain and affects movement, posture, and the musculoskeletal system. Vibration therapy (VT) is increasingly used to reduce the signs and symptoms associated with this developmental disability. The purpose of this narrative review was systematically to appraise published research regarding acute and long-term effects of VT on functional, neuromuscular, and structural parameters. Systematic searches of three electronic databases identified 28 studies that fulfilled the inclusion criteria. Studies were analyzed to determine participant characteristics, VT-treatment protocols, effect on gross motor function (GMF), strength, gait, posture, mobility, spasticity, reflex excitability, muscle tone, mass, and bone strength within this population, and outcome measures used to evaluate effects. The results revealed that one acute session of VT reduces reflex excitability, spasticity, and coordination deficits. Subsequently, VT has a positive effect on the ability to move, manifested for GMF, strength, gait, and mobility in patients with CP. Effects persist up to 30 minutes after VT. Long-term effects of VT manifest as reduced muscle tone and spasticity occurring concomitantly with improved movement ability in regard to GMF, strength, gait, and mobility, as well as increased muscle mass and bone-mineral density. Posture control remained unaffected by VT. In conclusion, the acute and chronic application of VT as a nonpharmacological approach has the potential to ameliorate CP symptoms, achieving functional and structural adaptations associated with significant improvements in daily living. Even though further studies including adult populations validating the neuromuscular mechanisms underlying the aforementioned adaptations should be fostered, growing scientific evidence supports the effectiveness of VT in regard to supplementing conventional treatments (physiotherapy and drugs). Therefore, VT could reduce CP-associated physical disability and sensorimotor handicaps. Goals for patients and their caregivers referring to greater independence and improved safety may be achieved more easily and time efficiently.

Systematic Review of the Indirect Effect of Pneumococcal Conjugate Vaccine Dosing Schedules on Pneumococcal Disease and Colonization

PubMed Central

2014-01-01

Background: To aid decision making for pneumococcal conjugate vaccine (PCV) use in infant national immunization programs, we summarized the indirect effects of PCV on clinical outcomes among nontargeted age groups. Methods: We systematically reviewed the English literature on infant PCV dosing schedules published from 1994 to 2010 (with ad hoc addition of 2011 articles) for outcomes on children >5 years of age and adults including vaccine-type nasopharyngeal carriage (VT-NP), vaccine-type invasive pneumococcal disease (VT-IPD) and syndromic pneumonia. Results: Of 12,980 citations reviewed, we identified 21 VT-IPD, 6 VT-NP and 9 pneumonia studies. Of these 36, 21 (58%) included 3 primary doses plus PCV or pneumococcal polysaccharide vaccine (PPV23) booster schedule (3+1 or 3+PPV23), 5 (14%) 3+0, 9 (25%) 2+1 and 1 (3%) 2+0. Most (95%) were PCV7 studies. Among observational VT-IPD studies, all schedules (2+1, 3+0 and 3+1) demonstrated reductions in incidence among young adult groups. Among syndromic pneumonia observational studies (2+1, 3+0 and 3+1), only 3+1 schedules showed significant indirect impact. Of 2 VT-NP controlled trials (3+0 and 3+1) and 3 VT-NP observational studies (2+1, 3+1 and 3+PPV23), 3+1 and 3+PPV23 schedules showed significant indirect effect. The 1 study to directly compare between schedules was a VT-NP study (2+0 vs. 2+1), which found no indirect effect on older siblings and parents of vaccinated children with either schedule. Conclusions: Indirect benefit of a 3+1 infant PCV dosing schedule has been demonstrated for VT-IPD, VT-NP and syndromic pneumonia; 2+1 and 3+0 schedules have demonstrated indirect effect only for VT-IPD. The choice of optimal infant PCV schedule is limited by data paucity on indirect effects, especially a lack of head-to-head studies and studies of PCV10 and PCV13. PMID:24336058

Comparison of efficacies of bovine immune colostral antibody and each immunoglobulin class against verotoxin 2, flagellum and somatic cells of Escherichia coli O157:H7 in mice.

PubMed

Seita, Tetsurou; Kuribayashi, Takashi; Honjo, Toshio; Yamamoto, Shizuo

2013-04-01

The efficacy of bovine immune colostral (colostral) antibodies against verotoxin (VT) 2, flagellum and somatic cells of Escherichia coli (E. coli) O157:H7 in mice was determined. Three major immunoglobulin (Ig) classes were isolated from the colostral antibody against VT2 by affinity chromatography and were used for estimation. Mice inoculated with VT2 were administered each Ig class from the colostral antibody, colostral antibody (colostral whey containing antibody) or serum antibody against VT2 at 1 hour after VT2 inoculation. All control mice (20/20) died after administration of sterilized saline instead of the colostral antibody. The survival rate was 93.3% (14/15) after administration of S-IgA or IgM antibody, or colostral antibody. Survival rates for IgG antibody and serum antibody administration were 80% (12/15) and 60% (9/15), respectively. Serum concentrations of VT2, which was absorbed from the small intestine in mice after administration of VT2 and colostral antibody, were measured by fluorescence enzyme immunoassay (FEIA). Serum concentrations of VT2 after administration of colostral antibody were lower than those after administration of sterilized saline. Mice inoculated with VT2-producing E. coli 157:H7 were administered anti-flagellum or anti-somatic colostral antibodies. Survival rates for E. coli O157:H7-infected mice administered the anti-flagellum and anti-somatic colostral antibodies were 52.4% (11/21) and 22.2% (4/18), respectively. Furthermore, survival rates increased to 89.5% (17/19) with combined administration of anti-flagellum and anti-VT2 colostral antibodies. These results suggest that colostral antibodies against VT2, flagellum and somatic cells are effective against E. coli O157:H7 infection. Copyright © 2012. Published by Elsevier B.V.

Failure of third-generation implantable cardioverter defibrillators to abort shock therapy for nonsustained ventricular tachycardia due to shortcomings of the VF confirmation algorithm.

PubMed

Grimm, W; Menz, V; Hoffmann, J; Maisch, B

1998-04-01

Unnecessary shocks by ICDs for rhythms other than sustained VT or VF have been described as the most frequent adverse event in ICD patients. To avoid unnecessary shocks for self-terminating arrhythmias, the third-generation Jewel PCD defibrillators 7202, 7219, and 7220 Plus use a specially designed VF confirmation algorithm after charge end. The purpose of this study was to determine the ability of this VF confirmation algorithm to recognize nonsustained VT, and to analyze the reasons for failure of the PCD device to abort shock therapy for nonsustained VT despite use of this VF confirmation algorithm. Analysis of stored electrograms of electrical events triggering high voltage capacitor charging in the programmed VF zone of the device showed 36 spontaneous episodes of nonsustained VT (227 +/- 21 beats/min) during 18 +/- 7 months follow-up in 15 patients who had a Jewel PCD implanted at our hospital. Intracardiac electrogram recordings and simultaneously retrieved marker channels demonstrated that the ICD shock was appropriately aborted according to the VF confirmation algorithm in 24 (67%) of 36 episodes of nonsustained VT. Twelve episodes (33%) of nonsustained VT, however, were followed by spontaneous ICD shock in 6 (40%) of the 15 study patients. The only reason for all 12 shocks for sustained VT was the inability of the device to recognize the absence of VT after charge end due to shortcomings of the VF confirmation algorithm: 11 of the 12 shocks for nonsustained VT were triggered by the occurrence of paced beats during the VF confirmation period and 1 shock for nonsustained VT was triggered by the occurrence of 2 premature beats after charge end. Thus, better VF confirmation algorithms need to be incorporated in future PCD devices to avoid unnecessary shocks for nonsustained VT.

Rhythms and outcomes of adult in-hospital cardiac arrest.

PubMed

Meaney, Peter A; Nadkarni, Vinay M; Kern, Karl B; Indik, Julia H; Halperin, Henry R; Berg, Robert A

2010-01-01

To determine the relationship of electrocardiographic rhythm during cardiac arrest with survival outcomes. Prospective, observational study. Total of 411 hospitals in the National Registry of Cardiopulmonary Resuscitation. Total of 51,919 adult patients with pulseless cardiac arrests from April 1999 to July 2005. Registry data collected included first documented rhythm, patient demographics, pre-event data, event data, and survival and neurologic outcome data. Of 51,919 indexed cardiac arrests, first documented pulseless rhythm was ventricular tachycardia (VT) in 3810 (7%), ventricular fibrillation (VF) in 8718 (17%), pulseless electrical activity (PEA) in 19,262 (37%) and asystole 20,129 (39%). Subsequent VT/VF (that is, VT or VF occurring during resuscitation for PEA or asystole) occurred in 5154 (27%), with first documented rhythm of PEA and 4988 (25%) with asystole. Survival to hospital discharge rate was not different between those with first documented VF and VT (37% each, adjusted odds ratio [OR]) 1.08; 95% confidence interval [CI] 0.95-1.23). Survival to hospital discharge was slightly more likely after PEA than asystole (12% vs. 11%, adjusted OR 1.1; 95% CI 1.00-1.18), Survival to discharge was substantially more likely after first documented VT/VF than PEA/asystole (adjusted OR 1.68; 95% CI 1.55-1.82). Survival to discharge was also more likely after PEA/asystole without subsequent VT/VF compared with PEA/asystole with subsequent VT/VF (14% vs. 7% for PEA without vs. with subsequent VT/VF; 12% vs. 8% for asystole without vs. with subsequent VT/VF; adjusted OR 1.60; 95% CI, 1.44-1.80). Survival to hospital discharge was substantially more likely when the first documented rhythm was shockable rather than nonshockable, and slightly more likely after PEA than asystole. Survival to hospital discharge was less likely following PEA/asystole with subsequent VT/VF compared to PEA/asystole without subsequent VT/VF.

Correlations between the circadian patterns of body temperature, metabolism and breathing in rats.

PubMed

Mortola, Jacopo P

2007-02-15

It had been demonstrated previously that the circadian patterns of activity and state of arousal are not essential for the manifestation of the daily patterns of pulmonary ventilation (V(E)), tidal volume (V(T)) and breathing frequency (f). In this study we investigated the extent of the linkage between the circadian pattern of breathing and those of body temperature (T(b)) and metabolic rate (oxygen consumption, V(O2), and carbon dioxide production, V(CO2)). Rats were instrumented for measurements of T(b) (by telemetry), and placed in a chamber for continuous 13-day period of measurement of breathing (by a modification of the barometric methodology), and of V(O2) and V(CO2) (by an open flow method). After the first 4 days in control conditions under a 12 h light:12 h dark (L:D) cycle, a perturbation was introduced on day 4, with an L-phase prolongation of 12 h, and on day 9, with an D-phase prolongation of 12 h. During the control days 1-4, all variables had daily oscillations (higher values in D), in phase with each other. During the perturbations (days 4-13), changes in T(b), V(O2) and V(CO2), averaged over the whole period, correlated significantly better with f than with V(T). Day-by-day X-Y loops indicated that V (E), V(T) and f could lead significantly the changes of T(b), V(O2) and V(CO2), and that these relations changed throughout the perturbation period. In addition, f and V(T) did not change necessarily in phase with each other. It is concluded that neither the oscillation in T(b) nor that in metabolism can be considered the direct cause of the daily oscillation of breathing. Presumably, the circadian pattern of breathing reflects the interplay of the daily patterns of many variables, none acting as the primary guide of the breathing daily rhythm.

Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

PubMed

Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

2015-07-01

Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, P<0.001). The percentage of the ideal curve (concomitantly evaluating the pressurization speed and the levels of pressure reached) also differed significantly (range 57-86% for invasive PSV, P=0.04; and 60-90% for non-invasive PSV, P<0.001). Non-invasive ventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Capsaicin and regulation of respiration: interaction with central substance P mechanisms.

PubMed

Hedner, J; Hedner, T; Jonason, J

1985-01-01

The neuropharmacological effects of capsaicin (CAPS) (8-methyl-N-vanillyl-6-nonenamide) have been closely linked to the peptide neurotransmitter substance P (SP). In order to elucidate SP mechanisms in peripheral and central control of breathing we have studied the respiratory effects of CAPS and SP administration to neonatal and adult rats using a whole body plethysmographic method. CAPS (3 and 30 micrograms) induced an immediate apnea after intravenous injection. This effect could be reduced by vagotomy but not further changed by combined vagotomy and glossopharyngectomy. The apnoic periods were followed by periods of tachypnea. Intracerebroventricular (i.c.v.) administration of CAPS resulted in an increased tidal volume (VT) and a decreased respiratory frequency (f), i.e. a respiratory response similar to that seen after i.c.v. SP. No apnoic episodes were seen after i.c.v. injection. The respiratory pattern after acute i.c.v. CAPS administration was not significantly changed by neonatal CAPS pretreatment. However, while saline pretreated control animals responded to an i.c.v. injection of SP with an increase in VT and inspiratory drive (VT/TI), animals pretreated with CAPS responded with a shortening of inspiratory and expiratory time in combination with an increase in VT. Similar changes have been observed in vagotomized animals after SP administration. It is concluded that CAPS elicits apnea via mechanisms located outside the CNS, which cannot be fully deafferented by combined vagotomy and glossopharyngectomy. Furthermore, CAPS i.c.v. induces a stimulation of respiration by a central mechanism of action, possibly due to a release of SP. Neonatal pretreatment with CAPS modifies the respiratory response to i.c.v. SP. This effect might be due to an impairment in tonical afferent SP mechanisms to the central respiratory regulating system and possibly also to an impairment of central SP mechanisms involved in respiration.

Early Ventricular Tachycardia or Fibrillation in Patients With ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention and Impact on Mortality and Stent Thrombosis (from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction Trial).

PubMed

Kosmidou, Ioanna; Embacher, Monica; McAndrew, Thomas; Dizon, José M; Mehran, Roxana; Ben-Yehuda, Ori; Mintz, Gary S; Stone, Gregg W

2017-11-15

The prevalence and impact of early ventricular arrhythmias (ventricular tachycardia [VT]/ventricular fibrillation [VF]) occurring before mechanical revascularization for acute ST segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention are poorly understood. We sought to investigate the association between early VT/VF and long-term clinical outcomes using data from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial. Among 3,602 patients with STEMI, 108 patients (3.0%) had early VT/VF. Baseline clinical characteristics were similar in patients with versus without early VT/VF. Patients with early VT/VF had shorter symptom-to-balloon times and lower left ventricular ejection fraction and underwent more frequent thrombectomy compared with patients without early VT/VF. Adjusted 3-year rates of all-cause death (15.7% vs 6.5%; adjusted hazard ratio 2.62, 95% confidence interval 1.48 to 4.61, p <0.001) and stent thrombosis (13.7% vs 5.7%; adjusted hazard ratio 2.74, 95% confidence interval 1.52 to 4.93, p <0.001) were significantly higher in patients with early VT/VF compared with patients without early VT/VF. In conclusion, in the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial, VT/VF occurring before coronary angiography and revascularization in patients with STEMI was strongly associated with increased 3-year rates of death and stent thrombosis. Further investigation into the mechanisms underlying the increased risk of early stent thrombosis in patients with early VT/VF is required. Copyright © 2017 Elsevier Inc. All rights reserved.

The risk of venous thrombosis in women over 50 years old using oral contraception or postmenopausal hormone therapy.

PubMed

Roach, R E J; Lijfering, W M; Helmerhorst, F M; Cannegieter, S C; Rosendaal, F R; van Hylckama Vlieg, A

2013-01-01

Oral contraception (OC) and postmenopausal hormone therapy (HT) can be used to alleviate menopausal symptoms. However, the risk of venous thrombosis (VT) associated with OC use in women over 50 years old has never been assessed and the two preparations have not been directly compared. To determine and compare the risk of VT associated with OC and HT use. From a large case-control study, 2550 women aged over 50 years old, 1082 patients with a first VT and 1468 controls, were included. Odds ratios (ORs) and 95% confidence intervals for VT were calculated for OC-users (164 patients and 54 controls) and HT-users (88 patients and 102 controls) compared with non-hormone users (823 patients and 1304 controls). OC-users had a 6.3-fold (4.6-9.8) increased risk of VT. This ranged from 5.4 (3.3-8.9) for preparations containing levonorgestrel to 10.2 (4.8-21.7) for desogestrel. The VT-risk associated with oral HT use was 4.0 (1.8-8.2) for conjugated equine estrogen combined with medroxyprogesterone acetate and 3.9 (1.5-10.7) for micronized estradiol combined with norethisterone acetate. Non-oral HT did not increase the risk of VT: OR 1.1 (0.6-1.8). Relative risk estimates were further increased in hormone users with factor V Leiden, prothrombin G20210A or blood group non-O and hormone users with a family history of VT. In this study, non-oral HT seemed to be the safest hormonal preparation in women over 50 years old. OC use increased the VT risk the most, especially in women with inherited thrombophilia or a family history of VT. © 2012 International Society on Thrombosis and Haemostasis.

Impact of gas emboli and hyperbaric treatment on respiratory function of loggerhead sea turtles (Caretta caretta)

PubMed Central

Portugues, Cyril; Crespo-Picazo, Jose Luis; García-Párraga, Daniel; Altimiras, Jordi; Lorenzo, Teresa; Borque-Espinosa, Alicia

2018-01-01

Abstract Fisheries interactions are the most serious threats for sea turtle populations. Despite the existence of some rescue centres providing post-traumatic care and rehabilitation, adequate treatment is hampered by the lack of understanding of the problems incurred while turtles remain entrapped in fishing gears. Recently it was shown that bycaught loggerhead sea turtles (Caretta caretta) could experience formation of gas emboli (GE) and develop decompression sickness (DCS) after trawl and gillnet interaction. This condition could be reversed by hyperbaric O2 treatment (HBOT). The goal of this study was to assess how GE alters respiratory function in bycaught turtles before recompression therapy and measure the improvement after this treatment. Specifically, we assessed the effect of DCS on breath duration, expiratory and inspiratory flow and tidal volume (VT), and the effectiveness of HBOT to improve these parameters. HBOT significantly increased respiratory flows by 32–45% while VT increased by 33–35% immediately after HBOT. Repeated lung function testing indicated a temporal increase in both respiratory flow and VT for all bycaught turtles, but the changes were smaller than those seen immediately following HBOT. The current study suggests that respiratory function is significantly compromised in bycaught turtles with GE and that HBOT effectively restores lung function. Lung function testing may provide a novel means to help diagnose the presence of GE, be used to assess treatment efficacy, and contribute to sea turtle conservation efforts. PMID:29340152

DNA Inversion on Conjugative Plasmid pVT745

PubMed Central

Chen, Jinbiao; Leblanc, Donald J.; Galli, Dominique M.

2002-01-01

Plasmid pVT745 from Actinobacillus actinomycetemcomitans strain VT745 can be transferred to other A. actinomycetemcomitans strains at a frequency of 10−6. Screening of transconjugants revealed that the DNA of pDMG21A, a pVT745 derivative containing a kanamycin resistance gene, displayed a structural rearrangement after transfer. A 9-kb segment on the plasmid had switched orientation. The inversion was independent of RecA and required the activity of the pVT745-encoded site-specific recombinase. This recombinase, termed Inv, was highly homologous to invertases of the Din family. Two recombination sites of 22 bp, which are arranged in opposite orientation and which function as DNA crossover sequences, were identified on pVT745. One of the sites was located adjacent to the 5′ end of the invertase gene, inv. Inversion of the 9-kb segment on pVT745 derivatives has been observed in all A. actinomycetemcomitans strains tested except for the original host, VT745. This would suggest that a host factor that is either inactive or absent in VT745 is required for efficient recombination. Inactivation of the invertase in the donor strain resulted in a 1,000-fold increase in the number of transconjugants upon plasmid transfer. It is proposed that an activated invertase causes the immediate loss of the plasmid in most recipient cells after mating. No biological role has been associated with the invertase as of yet. PMID:12374826

Purification of vitellin and dynamics of vitellogenesis in the parthenogenetic tick Haemaphysalis longicornis (Acari: Ixodidae).

PubMed

Yang, Xiaolong; Yu, Zhijun; He, Yanjie; Xu, Xiaoli; Gao, Zhihua; Wang, Hui; Chen, Jie; Liu, Jingze

2015-03-01

Vitellin (Vt) was purified from eggs of parthenogenetic bush tick Haemaphysalis longicornis by gel filtration and ion exchange chromatography. Our results revealed that only one single Vt existed in parthenogenetic bush tick, and the purified Vt was proved to be a hemoglycolipoprotein consisting of nine polypeptides with molecular weights of 203, 147, 126, 82, 74, 70, 61, 47 and 31 kDa, respectively. Polyclonal antibody and monoclonal antibody against Vt were produced using the purified Vt. The change in vitellogenin (Vg) and Vt levels over time of the parthenogenetic H. longicornis was established, and the Vg content in haemolymph and Vt in ovary at different feeding or engorgement statuses was also determined using a double antibody sandwich enzyme-linked immunosorbent assay. The Vg level in haemolymph was distinctly increased on the day of engorgement (1.785 mg/mL) and continued to increase until 2nd day post-engorgement (5.611 mg/mL). There was a slight decrease in Vg level after 4 days of engorgement, and a second peak was observed on day 2 post-oviposition (10.774 mg/mL). Subsequently, Vg content continuously decreased and reached a low level on the 10th day post-oviposition. The Vt content in ovary continuously increased once the female reached its critical weight (0.024 mg per female), and reached the maximum level on day 2 post-oviposition (1.942 mg per female). Afterwards, Vt content rapidly decreased.

Occurrence of verotoxin-producing Escherichia coli in dairy heifers grazing an irrigated pasture.

PubMed

Thran, B H; Hussein, H S; Hall, M R; Khaiboullina, S F

2001-02-28

Verotoxin-producing Escherichia coli (VTEC) produce one or two toxins known as VT1 and VT2. These toxins have been associated with several human illnesses. Dairy cattle harboring VTEC represent a potential health hazard because they enter the food chain as ground beef. The objective of this study was to assess the occurrence of VTEC in dairy heifers. A total of 91 fecal samples were rectally collected during four periods (spring, summer, fall, and winter of 1999) from 23 heifers. A random sample (n=530) of potential VTEC isolates were tested for verotoxicity and were screened by the polymerase chain reaction (PCR) for presence or absence of VT1 and/or VT2 genes. Thirteen isolates from two heifers (from the winter collection) were verotoxic and were confirmed as E. coli. VTEC were only detected during winter with an occurrence rate of 9.5%. Using PCR, five isolates had the VT1 gene while the remaining eight had the VT2 gene. The sequence and expression of VT1 and VT2 genes were confirmed. No E. coli O157:H7 was detected, but serotyping revealed that the five VT1-positive isolates were O26:NM (a non-motile strain of O26). The remaining eight isolates were untypeable. Identification of VTEC-positive cattle before slaughter is a critical step in any on-farm strategy to minimize the risk of beef contamination with such pathogens.

Consequences of an Immense Hadean-Archean Heat Flux that Results from Virial Theorem Constraints on the Earth's Initial Axial Spin

NASA Astrophysics Data System (ADS)

Hofmeister, A. M.; Criss, R. E.

2016-12-01

Early Earth conditions were largely erased, but the powerful Virial Theorem (VT) constrains Earth's post-accretion state, which largely dictates subsequent thermal and dynamical evolution. Proposals of huge initial inventories of primordial heat are based on Kelvin's disproven theory of starlight. Rather, the VT requires that gravitational potential of the Solar nebula was converted to rotational energy in a conservative, bound accretionary system, which is confirmed by planetary orbit characteristics. In addition, the VT relates axial spin to gravitational self-potential (Ug,self) of each body [2016 Can. J. Phys. p. 380]. From the VT, ½Ug,self binds the body and is unavailable, but spin energy (SE), also equal to ½Ug,self, degrades while gradually evolving heat via friction. The VT likewise restricts primordial heat of core formation, and is consistent with entropy reduction due to ordering and volume restriction [2015 J. Earth Sci., p. 124]. High initial Virial spin is confirmed by (1) data on young stars, (2) independent projections of Earth's initial spin as 2-17 hrs (from fossils and the current rate of spin loss: Lathe 2006), and (3) current SE for all planets defining a power-law trend with Ug,self, which further requires a universal cause for spin loss [2012 Planet. Space Sci. p. 111]. Spin loss is caused by tidal friction and differential rotation of layers. Dissipation is concentrated in the upper layers and especially in the brittle zone, which are much weaker than the highly compressed, essentially hydrostatic interior. With friction, neither mechanical energy nor angular momentum are conserved. Earth's frictional dissipation is immense. Uniform release over time would provide 300-700 TW. This source dominated heat generation for 2 Ga, whereas radiogenic heat dominates today. Exponential spin down suggests 100x more heat production during the Hadean than now, which obliterated early rocks while promoting outgassing and differentiation. Reduction to 10x present levels in the Archean permitted formation of a thin lithosphere and stabilized an ocean and atmosphere. Frictional heat from spin loss helps explain why oceanic heat flux today resembles that of continents which store all the chondritic U and Th. Topside frictional and radiogenic heat production prohibits lower mantle convection.

Effect of Wheelchair Frame Material on Users' Mechanical Work and Transmitted Vibration

PubMed Central

Aissaoui, Rachid

2014-01-01

Wheelchair propulsion exposes the user to a high risk of shoulder injury and to whole-body vibration that exceeds recommendations of ISO 2631-1:1997. Reducing the mechanical work required to travel a given distance (WN-WPM, weight-normalized work-per-meter) can help reduce the risk of shoulder injury, while reducing the vibration transmissibility (VT) of the wheelchair frame can reduce whole-body vibration. New materials such as titanium and carbon are used in today's wheelchairs and are advertised to improve both parameters, but current knowledge on this matter is limited. In this study, WN-WPM and VT were measured simultaneously and compared between six folding wheelchairs (1 titanium, 1 carbon, and 4 aluminium). Ten able-bodied users propelled the six wheelchairs on three ground surfaces. Although no significant difference of WN-WPM was found between wheelchairs (P < 0.1), significant differences of VT were found (P < 0.05). The carbon wheelchair had the lowest VT. Contrarily to current belief, the titanium wheelchair VT was similar to aluminium wheelchairs. A negative correlation between VT and WN-WPM was found, which means that reducing VT may be at the expense of increasing WN-WPM. Based on our results, use of carbon in wheelchair construction seems promising to reduce VT without increasing WN-WPM. PMID:25276802

Anti-Inflammatory Effects of Vitis thunbergii var. taiwaniana on Knee Damage Associated with Arthritis

PubMed Central

Tsai, Ching-Fent; Wang, Kun-Teng; Chen, Lih-Geeng; Lee, Chia-Jung; Tseng, Sung-Hui

2014-01-01

Abstract Vitis thunbergii Sieb. et Zucc. var. taiwaniana Lu (VT) is an indigenous plant in Taiwan that is traditionally used for promoting joint health. In this study, we used in vitro primary human chondrocytes (PHCs) and two in vivo animal models to evaluate the anti-inflammatory effects of VT on arthritis. Results showed that the water extract of the stems and roots from VT (VT-SR) was rich in flavones and phenols with 1.1 mg/g of resveratrol, 6.7 mg/g of hopeaphenol, and 5.1 mg/g of (+)-ɛ-viniferin. VT-SR significantly scavenged DPPH radicals and inhibited prostaglandin E2 (PGE2) production in lipopolysaccharide (LPS)-induced PHCs without exhibiting significant cytotoxicity. In in vivo models, the VT-SR (500 mg/kg) significantly decreased serum PGE2 and knee 2-18F-fluoro-2-deoxy-D-glucose (18F-FDG) levels in LPS-induced acute inflammatory arthritis in rabbits. In addition, dietary supplementation with VT-SR for 28 days significantly alleviated type II collagenase-induced rat osteoarthritis with improvements in weight bearing and range of motion tests. In conclusion, our results suggest that the VT-SR is a good candidate for developing dietary supplements to prevent joint deterioration and inhibit inflammation. PMID:24720858

The endophyte Verticillium Vt305 protects cauliflower against Verticillium wilt.

PubMed

Tyvaert, L; França, S C; Debode, J; Höfte, M

2014-06-01

To investigate the interaction between cauliflower and the isolate VerticilliumVt305, obtained from a field suppressive to Verticillium wilt of cauliflower, and to evaluate the ability of VerticilliumVt305 to control Verticillium wilt of cauliflower caused by V. longisporum. Single and combined inoculations of VerticilliumVt305 and V. longisporum were performed on cauliflower seedlings. Symptom development was evaluated, and fungal colonization was measured in the roots, hypocotyl and stem with real-time PCR. No symptoms were observed after single inoculation of VerticilliumVt305, although it colonized the plant tissues. Pre-inoculation of VerticilliumVt305 reduced symptom development and colonization of plant tissues by V. longisporum. VerticilliumVt305 is an endophyte on cauliflower plants and showed effective biological control of V. longisporum in controlled conditions. This work can contribute to the development of a sustainable control measure of V. longisporum in Brassicaceae hosts, which is currently not available. Additionally, this study provides evidence for the different roles of Verticillium species present in the agro-ecosystem. © 2014 The Society for Applied Microbiology.

Prevalence and prognosis of ventricular tachycardia/ventricular fibrillation in patients with post-infarction left ventricular aneurysm: Analysis of 575 cases.

PubMed

Ning, Xiaohui; Ye, Xuerui; Si, Yanhua; Yang, Zihe; Zhao, Yunzi; Sun, Qi; Chen, Ruohan; Tang, Min; Chen, Keping; Zhang, Xiaoli; Zhang, Shu

2018-03-21

We investigated the prevalence of ventricular tachycardia/ventricular fibrillation (VT/VF) in Post-infarction left ventricular aneurysm (PI-LVA) patients and analyze clinical outcomes in patients presenting with VT/VF. 575 PI-LVA patients were enrolled and investigated by logistic regression analysis. Patients with VT/VF were followed up, the composite primary endpoint was cardiac death and appropriate ICD/external shocks. The incidence of sustained VT/VF was 11%. Logistical regression analysis showed male gender, enlarged LV end diastolic diameter (LVEDD) and higher NYHA class were correlated with VT/VF development. During follow up of 46 ± 15 months, 19 out of 62(31%) patients reached study end point. Multivariate Cox regression analysis revealed that enlarged LVEDD and moderate/severe mitral regurgitation (MR) were independently predictive of clinical outcome. Male gender, enlarged LVEDD and higher NYHA class associated with risk of sustained VT/VF in PI-LVA patients. Among VT/VF positive patients, enlarged LVEDD and moderate/severe MR independently predicted poor clinical prognosis. Copyright © 2018. Published by Elsevier Inc.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Riss P. J.; Fowler J.; Riss, P.J.

N-(4-fluorobut-2-yn-1-yl)-2{beta}-carbomethoxy-3{beta}-(4{prime}-tolyl)nortropane (PR04.MZ, 1) is a PET radioligand for the non-invasive exploration of the function of the cerebral dopamine transporter (DAT). A reliable automated process for routine production of the carbon-11 labelled analogue [{sup 11}C]PR04.MZ ([{sup 11}C]-1) has been developed using GMP compliant equipment. An adult female Papioanubis baboon was studied using a test-retest protocol with [{sup 11}C]-1 in order to assess test-retest reliability, metabolism and CNS distribution profile of the tracer in non-human primates. Blood sampling was performed throughout the studies for determination of the free fraction in plasma (fP), plasma input functions and metabolic degradation of the radiotracer [{supmore » 11}C]-1. Time-activity curves were derived for the putamen, the caudate nucleus, the ventral striatum, the midbrain and the cerebellum. Distribution volumes (VT) and non-displaceable binding potentials (BPND) for various brain regions and the blood were obtained from kinetic modelling. [{sup 11}C]-1 shows promising results as aselective marker of the presynaptic dopamine transporter. With the reliable visualisation of the extra-striatal dopaminergic neurons and no indication on labelled metabolites, the tracer provides excellent potential for translation into man.« less

Hemodynamic deterioration precedes onset of ventricular tachyarrhythmia after Heartmate II implantation.

PubMed

Yaksh, Ameeta; Kik, Charles; Knops, Paul; Zwiers, Korinne; van Ettinger, Maarten J B; Manintveld, Olivier C; de Wijs, Marcel C J; van der Kemp, Peter; Bogers, Ad J J C; de Groot, Natasja M S

2016-07-08

Early postoperative ventricular tachyarrhythmia (PoVT) after left ventricular assist device (LVAD) implantation are common and associated with higher mortality-rates. At present, there is no data on initiation of these PoVT and the role of alterations in cardiac hemodynamics. A LVAD was implanted in a patient with end-stage heart failure due to a ischemic cardiomyopathy. Alterations in cardiac rhythm and hemodynamics preceding PoVT-episodes during the first five postoperative days were examined by using continuous recordings of cardiac rhythm and various hemodynamic parameters. All PoVT (N=120) were monomorphic, most often preceded by short-long-short-sequences or regular SR and initiated by ventricular runs. Prior to PoVT, mean arterial pressure decreased; heart rate and ST-segments deviations increased. PoVT are caused by different underlying electrophysiological mechanisms. Yet, they are all monomorphic and preceded by hemodynamic deterioration due to myocardial ischemia.

Relationship among eye and muzzle temperatures measured using digital infrared thermal imaging and vaginal and rectal temperatures in hair sheep and cattle.

PubMed

George, W D; Godfrey, R W; Ketring, R C; Vinson, M C; Willard, S T

2014-11-01

Digital infrared thermal imaging (DITI) using a thermal camera has potential to be a useful tool for the production animal industry. Thermography has been used in both humans and a wide range of animal species to measure body temperature as a method to detect injury or inflammation. The objective of these experiments was to compare the temperature of the eye (EYE) or muzzle (MUZ) measured using DITI to vaginal (VT) and rectal temperature (RT) as measures of core body temperature in hair sheep and beef cattle. In Exp.1 EYE, VT and RT were measured in lactating, multiparous hair sheep ewes (St. Croix White, n = 10, and Dorper × St. Croix White, n = 10) in a non-febrile state 5 times over a 48-h period. Data loggers were used to measure VT and a digital veterinary thermometer was used to measure RT. There was a high correlation (P < 0.001) between VT and RT (r = 0.95), EYE and RT (r = 0.76) and EYE and VT (r = 0.77). In Exp. 2 EYE, MUZ, VT and RT were measured in multiparous, lactating ewes (St. Croix White, n = 2, and Barbados Blackbelly, n = 12) at -12, -1, 0, 1, 2, 3, 4, 6, 12, 24, 36, and 48 h after being administered lipopolysaccharide (LPS; n = 7; 0.2 µg/kg BW, i.v.) or saline (n = 7; 0.5 mL, i.v.). Data loggers were used to measure VT and a digital veterinary thermometer was used to measure RT. When data were combined across treatments (LPS and saline) there was a high correlation (P < 0.001) between VT and RT (r = 0.96), EYE and RT (r = 0.82), MUZ and RT (r = 0.72), and EYE and VT (r = 0.93). In Exp. 3 EYE, MUZ, VT and RT were measured in multiparous, non-lactating, pregnant Senepol cattle (n = 44) between 0900 and 1200 h on a single day. A digital veterinary thermometer was used to measure both VT and RT. There was a high correlation (P < 0.001) between VT and RT (r = 0.78), a moderate correlation (P < 0.001) between VT and EYE (r = 0.52), RT and EYE (r = 0.58) and EYE and MUZ (r = 0.48). There was no correlation (P > 0.10) between RT or VT and MUZ. The findings of these three studies indicate that temperature of the eye, measured using DITI, can be used as an indicator of core body temperature in hair sheep and beef cattle as an alternative to using vaginal or rectal temperature.

Preparation of nanodispersions by solvent displacement using the Venturi tube.

PubMed

García-Salazar, Gilberto; de la Luz Zambrano-Zaragoza, María; Quintanar-Guerrero, David

2018-05-02

The Venturi tube (VT) is an apparatus that produces turbulence which is taken advantage of to produce nanoparticles (NP) by solvent displacement. The objective of this study was to evaluate the potential of this device for preparing NP of poly-ε-caprolactone. Response Surface Methodology was used to determine the effect of the operating conditions and optimization. The NP produced by VT were characterized by Dynamic Light-Scattering to determine their particle size distribution (PS) and polydispersity index (PDI). Results showed that the Reynolds number (Re) has a strong effect on both PS and process yield (PY).The turbulence regime is key to the efficient formation of NP. The optimal conditions for obtaining NP were a polymer concentration of 1.6 w/v, a recirculation rate of 4.8 L/min, and a stabilizer concentration of 1.1 w/v. The predicted response of the PY was 99.7%, with a PS of 333 nm, and a PDI of 0.2. Maintaining the same preparation conditions will make it possible to obtain NP using other polymers with similar properties. Our results show that VT is a reproducible and versatile method for manufacturing NP, and so may be a feasible method for industrial-scale nanoprecipitation production. Copyright © 2018 Elsevier B.V. All rights reserved.

Contemporary Tools and Techniques for Substrate Ablation of Ventricular Tachycardia in Structural Heart Disease.

PubMed

Hutchinson, Mathew D; Garza, Hyon-He K

2018-02-24

As we have witnessed in other arenas of catheter-based therapeutics, ventricular tachycardia (VT) ablation has become increasingly anatomical in its execution. Multi-modality imaging provides anatomical detail in substrate characterization, which is often complex in nonischemic cardiomyopathy patients. Patients with intramural, intraseptal, and epicardial substrates provide challenges in delivering effective ablation to the critical arrhythmia substrate due to the depth of origin or the presence of adjacent critical structures. Novel ablation techniques such as simultaneous unipolar or bipolar ablation can be useful to achieve greater lesion depth, though at the expense of increasing collateral damage. Disruptive technologies like stereotactic radioablation may provide a tailored approach to these complex patients while minimizing procedural risk. Substrate ablation is a cornerstone of the contemporary VT ablation procedure, and recent data suggest that it is as effective and more efficient that conventional activation guided ablation. A number of specific targets and techniques for substrate ablation have been described, and all have shown a fairly high success in achieving their acute procedural endpoint. Substrate ablation also provides a novel and reproducible procedural endpoint, which may add predictive value for VT recurrence beyond conventional programmed stimulation. Extrapolation of outcome data to nonischemic phenotypes requires caution given both the variability in substrate nonischemic distribution and the underrepresentation of these patients in previous trials.

Short-term moderate intensive high volume training program provides aerobic endurance benefit in wheelchair basketball players.

PubMed

Skucas, Kestutis; Pokvytyte, Vaida

2017-04-01

The aim of this paper was to investigate the effect of short-term period, moderate intensity and high volume endurance training on physiological variables in elite wheelchair basketball players. Eight wheelchair basketball players were examined. The subjects participated in a two-week intervention program of mainly two training types: wheelchair basketball and wheelchair driving endurance training. The subjects performed the continuously increasing cycling exercise (CCE) at the constant 60 rpm arm cranking speed at the beginning of the program and after two weeks of the program. The initial workload was 20 W, then the workload was increased by 2 W every 5 seconds until fatigue. The post training of the wheelchair basketball group in the study showed a significant improvement in the peak oxygen uptake (VO2peak) and the peak power output (POpeak). VO2peak increased by 9% from 2.32±0.16 L/min to 2.53±0.2 L/min (P<0.05). POpeak increased by 28% from 141.75±14.23 W, to 181.63±26.3 W (P<0.05). The pre-training and post training test power output (PO [w]), relative power output (PO [w/kg]) increased significantly in all zones of energy production. In conclusion, this study indicated that the wheelchair basketball squad had relatively high levels of aerobic fitness prior to participating in the endurance training program. Nevertheless, the high-volume, moderate-intensity, short-term training program, which evolved over the two-weeks period, resulted in the improvement of the athlete's aerobic endurance. The ventilatory threshold (VT) and the second ventilatory threshold (VT2) are good markers for aerobic capacity of wheelchair athletes.

Mobilization and Defense Management Technical Reports Series. Mobilization Studies Program Report: Coordinated Policy for the Aircraft Industry.

DTIC Science & Technology

1983-05-01

THE ARMED FORCES AREA 6 WORK UNIT NUMBERS -. FORT LESLEY J. MC NAIR WASHINGTON, DC 20319 11. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE "Vt...yearly dollar volume and lead directly to cost- effective 𔃾.- national security. Such business generates research funding that can have important military...Mbreover, there is no central focus for these policies and no foru to discuss their effect on national security and international catetiiveness. The

HISTORY OF EMPLOYMENT AND MANPOWER POLICY IN THE UNITED STATES. PARTS III AND IV, LOOKING AHEAD TO THE POSTWAR ECONOMY AND THE CONCEPT OF FULL EMPLOYMENT IN CONGRESS. SELECTED READINGS IN EMPLOYMENT AND MANPOWER, VOLUME 6.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Public Welfare.

THE SELECTED READINGS WERE COMPILED TO PROVIDE SUBCOMMITTEE MEMBERS WITH A BROAD BACKGROUND OF DEVELOPMENTS LEADING TO THE EMPLOYMENT ACT OF 1946 AND ARE CONCERNED WITH THE FORMULATION OF U.S. EMPLOYMENT POLICIES FOLLOWING WORLD WAR II. PARTS I AND II (VT 004 819) PROVIDE THE HISTORICAL BACKGROUND FROM THE LATE 1920'S THROUGH THE GREAT DEPRESSION.…

A Pilot Study for Gainful Employment in Home Economics. Final Report. Volume IV, A Suggested Curriculum Guide for Preparing Food Service Workers for Entry Level Jobs.

ERIC Educational Resources Information Center

Cozine, June; And Others

Curriculum guidelines for teacher use in organizing and teaching a course to prepare 11th and 12th grade students for entry level food service occupations were developed as part of a pilot study which is reported in VT 006 870. The 1-year program requires 2 hours daily plus 10 hours per week on-the-job work experience. Content areas are: (1)…

A Pilot Study for Gainful Employment in Home Economics. Final Report. Volume III, A Suggested Curriculum Guide for Preparing Clothing Service Workers for Entry Level Jobs.

ERIC Educational Resources Information Center

Cozine, June; And Others

Curriculum guidelines for teacher use in organizing and teaching a course to prepare 11th and 12th grade students for entry level clothing service occupations were developed as part of a pilot study which is reported in VT 006 870. The 1-year program requires 2 hours daily; a 1-hour lab experience or on-the-job work experience is suggested for the…

Biaxial flexural strength of bilayered zirconia using various veneering ceramics

PubMed Central

Chantranikul, Natravee

2015-01-01

PURPOSE The aim of this study was to evaluate the biaxial flexural strength (BFS) of one zirconia-based ceramic used with various veneering ceramics. MATERIALS AND METHODS Zirconia core material (Katana) and five veneering ceramics (Cerabien ZR; CZR, Lava Ceram; LV, Cercon Ceram Kiss; CC, IPS e.max Ceram; EM and VITA VM9; VT) were selected. Using the powder/liquid layering technique, bilayered disk specimens (diameter: 12.50 mm, thickness: 1.50 mm) were prepared to follow ISO standard 6872:2008 into five groups according to veneering ceramics as follows; Katana zirconia veneering with CZR (K/CZR), Katana zirconia veneering with LV (K/LV), Katana zirconia veneering with CC (K/CC), Katana zirconia veneering with EM (K/EM) and Katana zirconia veneering with VT (K/VT). After 20,000 thermocycling, load tests were conducted using a universal testing machine (Instron). The BFS were calculated and analyzed with one-way ANOVA and Tukey HSD (α=0.05). The Weibull analysis was performed for reliability of strength. The mode of fracture and fractured surface were observed by SEM. RESULTS It showed that K/CC had significantly the highest BFS, followed by K/LV. BFS of K/CZR, K/EM and K/VT were not significantly different from each other, but were significantly lower than the other two groups. Weibull distribution reported the same trend of reliability as the BFS results. CONCLUSION From the result of this study, the BFS of the bilayered zirconia/veneer composite did not only depend on the Young's modulus value of the materials. Further studies regarding interfacial strength and sintering factors are necessary to achieve the optimal strength. PMID:26576251

Oxygen consumption and heart rate responses to isolated ballet exercise sets.

PubMed

Rodrigues-Krause, Josianne; Dos Santos Cunha, Giovani; Alberton, Cristine Lima; Follmer, Bruno; Krause, Mauricio; Reischak-Oliveira, Alvaro

2014-01-01

Ballet stage performances are associated with higher cardiorespiratory demand than rehearsals and classes. Hence, new interest is emerging to create periodized training that enhances dancers' fitness while minimizing delayed exercise-induced fatigue and possible injuries. Finding out in what zones of intensity dancers work during different ballet movements may support the use of supplemental training adjusted to the needs of the individual dancer. Therefore, the main purpose of this study was to describe dancers' oxygen consumption (VO2) and heart rate (HR) responses during the performance of nine isolated ballet exercise sets, as correlated with their first and second ventilatory thresholds (VT1 and VT2). Twelve female ballet dancers volunteered for the study. Their maximum oxygen consumption (VO2max), VT1, and VT2 were determined by use of an incremental treadmill test. Nine sets of ballet movements were assessed: pliés, tendus, jetés, rond de jambes, fondus, grand adage (adage), grand battements, temps levés, and sautés. The sets were randomly executed and separated by 5 minute rest periods. ANOVA for repeated measurements followed by the Bonferroni Post-hoc test were applied (p < 0.05). VO2 responses were as follows: pliés (17.6 ± 1.6 ml·kg(-1)·min(-1)); tendus and adage were not significantly greater than VT1; rond de jambes (21.8 ± 3.1 ml·kg(-1) ·min(-1)); fondus and jetés were higher than VT1 and the previous exercises; grand battements (25.8 ± 2.9 ml·kg(-1)·min(-1)) was greater than all the other exercises and VT1; and VT2 was significantly higher than all ballet sets. This stratification followed closely, but not exactly, the variation in HR. For example, rond de jambes (156.8 ± 19 b·min(-1)) did not show any significant difference from all the other ballet sets, nor VT1 or VT2. It is concluded that the workloads of isolated ballet sets, based on VO2 responses, vary between low and moderate aerobic intensity in relation to dancers' VT1 and VT2. However, ballet set workloads may be higher when based on HR responses, due to the intermittent and isometric components of dance.

Pharmacological Tie2 activation in kidney transplantation.

PubMed

Thamm, Kristina; Njau, Florence; Van Slyke, Paul; Dumont, Daniel J; Park, Joon-Keun; Haller, Hermann; David, Sascha

2016-09-24

To investigate the therapeutic potential of vasculotide (VT) - a Tie2 activating therapeutic - in kidney transplantation. We performed a murine MHC-mismatched renal transplant model (C57Bl/6 male into Balb/c female) with 60 min cold and 30 min warm ischemia time. 500 ng VT was administered i.p. to donor mice 1 h before organ removal. In addition, recipients received 500 ng VT i.p. directly and 3 d after surgery. Survival was monitored and remaining animals were sacrificed 28 d after transplantation. In this model, we analyzed: (1) organ function; (2) Kaplan-Meier survival; (3) organ damage (periodic acid Schiff staining) via semi-quantitative scoring [0-4 (0 = no injury/inflammation to 4 = very severe injury/inflammation)]; (4) expression of renal endothelial adhesion molecules (ICAM-1) via immunofluorescence (IF) staining, immunoblotting and qPCR; (5) infiltration of inflammatory cells (IF Gr-1, F4/80); and (6) fibrosis via staining of α-smooth muscle actin (αSMA), Sirius red staining and immunoblotting of SMAD3 activation. Exogenous activation of Tie2 with VT resulted in diminished expression of peritubular and glomerular endothelial adhesion molecules. Consequently, infiltration of inflammatory cells (analyzed as ICAM-1, Gr-1 and F4/80 positive cells) was reduced in VT-treated mice compared to controls. Additionally, VT was protective against fibrogenesis after kidney transplantation. Trends towards lower serum creatinine (vehicle: 142 ± 17 μmol/L vs VT: 94 ± 23 μmol/L), urea (vehicle: 76 ± 5 mmol/L vs VT: 60 ± 8 mmol/L) and lactate dehydrogenase (vehicle: 1288 ± 383 iU vs VT: 870 ± 275 iU) were observed on day 6 after transplantation. Kaplan-Meier survival analysis showed improved survival rates in the VT-treated mice that did not reach statistical significance (27% vs 54%, P = 0.24, n = 11 per group). Exogenous activation of Tie2 via VT might reduce infiltration of inflammatory cells into renal tissue thereby protecting the transplant from early graft dysfunction potentially affecting long-term function. Protection of the endothelial microvasculature via the Tie2 axis in the early transplant setting might hold promise as a therapeutic target.

Validity of electromyographic fatigue threshold as a noninvasive method for tracking changes in ventilatory threshold in college-aged men.

PubMed

Kendall, Kristina L; Smith, Abbie E; Graef, Jennifer L; Walter, Ashley A; Moon, Jordan R; Lockwood, Christopher M; Beck, Travis W; Cramer, Joel T; Stout, Jeffrey R

2010-01-01

The submaximal electromyographic fatigue threshold test (EMG(FT)) has been shown to be highly correlated to ventilatory threshold (VT) as determined from maximal graded exercise tests (GXTs). Recently, a prediction equation was developed using the EMG(FT) value to predict VT. The aim of this study, therefore, was to determine if this new equation could accurately track changes in VT after high-intensity interval training (HIIT). Eighteen recreationally trained men (mean +/- SD; age 22.4 +/- 3.2 years) performed a GXT to determine maximal oxygen consumption rate (V(O2)peak) and VT using breath-by-breath spirometry. Participants also completed a discontinuous incremental cycle ergometer test to determine their EMGFT value. A total of four 2-minute work bouts were completed to obtain 15-second averages of the electromyographic amplitude. The resulting slopes from each successive work bout were used to calculate EMG(FT). The EMG(FT) value from each participant was used to estimate VT from the recently developed equation. All participants trained 3 days a week for 6 weeks. Training consisted of 5 sets of 2-minute work bouts with 1 minute of rest in between. Repeated-measures analysis of variance indicated no significant difference between actual and predicted VT values after 3 weeks of training. However, there was a significant difference between the actual and predicted VT values after 6 weeks of training. These findings suggest that the EMG(FT) may be useful when tracking changes in VT after 3 weeks of HIIT in recreationally trained individuals. However, the use of EMG(FT) to predict VT does not seem to be valid for tracking changes after 6 weeks of HIIT. At this time, it is not recommended that EMG(FT) be used to predict and track changes in VT.

Reasons for recurrent ventricular tachycardia after catheter ablation of post-infarction ventricular tachycardia.

PubMed

Yokokawa, Miki; Desjardins, Benoit; Crawford, Thomas; Good, Eric; Morady, Fred; Bogun, Frank

2013-01-08

The purpose of this study was to assess the determinants of ventricular tachycardia (VT) recurrence in patients who underwent VT ablation for post-infarction VT. The factors that predict recurrence of VT after catheter ablation in patients with prior infarctions are not well described. Catheter ablation was performed in 98 consecutive patients (88 males [90%]; mean age 67 ± 10 years; ejection fraction 27 ± 13%) with post-infarction VT. Electrograms from the implantable cardioverter-defibrillator were analyzed, and VTs were classified as clinical, nonclinical, or new clinical. A total of 725 VTs were induced during the ablation procedure. All VTs were targeted. In 76 patients, 105 clinical VTs were inducible. Critical sites were identified with entrainment mapping and pace-mapping (≥10 of 12 matching leads) for 75 of 105 clinical VTs (71%) and for 278 of 620 nonclinical VTs (45%). Post-ablation, the clinical VT was not inducible in any patient, and all VTs were rendered noninducible in 63% of the patients. Over a mean follow-up period of 35 ± 23 months, 65 of 98 patients (66%) had no recurrent VTs and 33 (34%) had VT recurrence. A new VT occurred in 26 of 33 patients (79%), and a prior clinical VT recurred in 7 patients (21%). Patients with recurrent VT had a larger scar area as assessed by electroanatomic mapping compared with patients without recurrent VTs (93 ± 40 cm(2) vs. 69 ± 30 cm(2); p = 0.002). In patients with repeat procedures, the majority of inducible VTs for which a critical area could be identified were at a distance of 6 ± 3 mm to the prior ablation lesions. Patients with recurrent VTs have a larger scar as assessed by electroanatomic mapping. Most recurrent VTs were new, and the majority of these VTs were mapped to the vicinity of prior ablation lesions in patients with repeat procedures. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Causes of distal volcano-tectonic seismicity inferred from hydrothermal modeling

USGS Publications Warehouse

Coulon, Cecile A.; Hsieh, Paul A.; White, Randall A.; Lowenstern, Jacob B.; Ingebritsen, Steven E.

2017-01-01

Distal volcano-tectonic (dVT) seismicity typically precedes eruption at long-dormant volcanoes by days to years. Precursory dVT seismicity may reflect magma-induced fluid-pressure pulses that intersect critically stressed faults. We explored this hypothesis using an open-source magmatic-hydrothermal code that simulates multiphase fluid and heat transport over the temperature range 0 to 1200 °C. We calculated fluid-pressure changes caused by a small (0.04 km3) intrusion and explored the effects of flow geometry (channelized vs. radial flow), magma devolatilization rates (0–15 kg/s), and intrusion depths (5 and 7.5 km, above and below the brittle-ductile transition). Magma and host-rock permeabilities were key controlling parameters and we tested a wide range of permeability (k) and permeability anisotropies (kh/kv), including k constant, k(z), k(T), and k(z, T, P) distributions, examining a total of ~ 1600 realizations to explore the relevant parameter space. Propagation of potentially causal pressure changes (ΔP ≥ 0.1 bars) to the mean dVT location (6 km lateral distance, 6 km depth) was favored by channelized fluid flow, high devolatilization rates, and permeabilities similar to those found in geothermal reservoirs (k ~ 10− 16 to 10− 13 m2). For channelized flow, magma-induced thermal pressurization alone can generate cases of ∆ P ≥ 0.1 bars for all permeabilities in the range 10− 16 to 10− 13 m2, whereas in radial flow regimes thermal pressurization causes ∆ P < 0.1 bars for all permeabilities. Changes in distal fluid pressure occurred before proximal pressure changes given modest anisotropies (kh/kv ~ 10–100). Invoking k(z,T,P) and high, sustained devolatilization rates caused large dynamic fluctuations in k and P in the near-magma environment but had little effect on pressure changes at the distal dVT location. Intrusion below the brittle-ductile transition damps but does not prevent pressure transmission to the dVT site.

Scar Homogenization Versus Limited-Substrate Ablation in Patients With Nonischemic Cardiomyopathy and Ventricular Tachycardia.

PubMed

Gökoğlan, Yalçın; Mohanty, Sanghamitra; Gianni, Carola; Santangeli, Pasquale; Trivedi, Chintan; Güneş, Mahmut F; Bai, Rong; Al-Ahmad, Amin; Gallinghouse, G Joseph; Horton, Rodney; Hranitzky, Patrick M; Sanchez, Javier E; Beheiry, Salwa; Hongo, Richard; Lakkireddy, Dhanunjaya; Reddy, Madhu; Schweikert, Robert A; Dello Russo, Antonio; Casella, Michela; Tondo, Claudio; Burkhardt, J David; Themistoclakis, Sakis; Di Biase, Luigi; Natale, Andrea

2016-11-01

Scar homogenization improves long-term ventricular arrhythmia-free survival compared with standard limited-substrate ablation in patients with post-infarction ventricular tachycardia (VT). Whether such benefit extends to patients with nonischemic cardiomyopathy and scar-related VT is unclear. The aim of this study was to assess the long-term efficacy of an endoepicardial scar homogenization approach compared with standard ablation in this population. Consecutive patients with dilated nonischemic cardiomyopathy (n = 93), scar-related VTs, and evidence of low-voltage regions on the basis of pre-defined criteria on electroanatomic mapping (i.e., bipolar voltage <1.5 mV) underwent either standard VT ablation (group 1 [n = 57]) or endoepicardial ablation of all abnormal potentials within the electroanatomic scar (group 2 [n = 36]). Acute procedural success was defined as noninducibility of any VT at the end of the procedure; long-term success was defined as freedom from any ventricular arrhythmia at follow-up. Acute procedural success rates were 69.4% and 42.1% after scar homogenization and standard ablation, respectively (p = 0.01). During a mean follow-up period of 14 ± 2 months, single-procedure success rates were 63.9% after scar homogenization and 38.6% after standard ablation (p = 0.031). After multivariate analysis, scar homogenization and left ventricular ejection fraction were predictors of long-term success. During follow-up, the rehospitalization rate was significantly lower in the scar homogenization group (p = 0.035). In patients with dilated nonischemic cardiomyopathy, scar-related VT, and evidence of low-voltage regions on electroanatomic mapping, endoepicardial homogenization of the scar significantly increased freedom from any recurrent ventricular arrhythmia compared with a standard limited-substrate ablation. However, the success rate with this approach appeared to be lower than previously reported with ischemic cardiomyopathy, presumably because of the septal and midmyocardial distribution of the scar in some patients. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The Virtual Teacher (VT) Paradigm: Learning New Patterns of Interpersonal Coordination Using the Human Dynamic Clamp

PubMed Central

2015-01-01

The Virtual Teacher paradigm, a version of the Human Dynamic Clamp (HDC), is introduced into studies of learning patterns of inter-personal coordination. Combining mathematical modeling and experimentation, we investigate how the HDC may be used as a Virtual Teacher (VT) to help humans co-produce and internalize new inter-personal coordination pattern(s). Human learners produced rhythmic finger movements whilst observing a computer-driven avatar, animated by dynamic equations stemming from the well-established Haken-Kelso-Bunz (1985) and Schöner-Kelso (1988) models of coordination. We demonstrate that the VT is successful in shifting the pattern co-produced by the VT-human system toward any value (Experiment 1) and that the VT can help humans learn unstable relative phasing patterns (Experiment 2). Using transfer entropy, we find that information flow from one partner to the other increases when VT-human coordination loses stability. This suggests that variable joint performance may actually facilitate interaction, and in the long run learning. VT appears to be a promising tool for exploring basic learning processes involved in social interaction, unraveling the dynamics of information flow between interacting partners, and providing possible rehabilitation opportunities. PMID:26569608

Ventricular arrhythmias and changes in heart rate preceding ventricular tachycardia in patients with an implantable cardioverter defibrillator.

PubMed

Lerma, Claudia; Wessel, Niels; Schirdewan, Alexander; Kurths, Jürgen; Glass, Leon

2008-07-01

The objective was to determine the characteristics of heart rate variability and ventricular arrhythmias prior to the onset of ventricular tachycardia (VT) in patients with an implantable cardioverter defibrillator (ICD). Sixty-eight beat-to-beat time series from 13 patients with an ICD were analyzed to quantify heart rate variability and ventricular arrhythmias. The episodes of VT were classified in one of two groups depending on whether the sinus rate in the 1 min preceding the VT was greater or less than 90 beats per minute. In a subset of patients, increased heart rate and reduced heart rate variability was often observed up to 20 min prior to the VT. There was a non-significant trend to higher incidence of premature ventricular complexes (PVCs) before VT compared to control recordings. The patterns of the ventricular arrhythmias were highly heterogeneous among different patients and even within the same patient. Analysis of the changes of heart rate and heart rate variability may have predictive value about the onset of VT in selected patients. The patterns of ventricular arrhythmia could not be used to predict onset of VT in this group of patients.

The Virtual Teacher (VT) Paradigm: Learning New Patterns of Interpersonal Coordination Using the Human Dynamic Clamp.

PubMed

Kostrubiec, Viviane; Dumas, Guillaume; Zanone, Pier-Giorgio; Kelso, J A Scott

2015-01-01

The Virtual Teacher paradigm, a version of the Human Dynamic Clamp (HDC), is introduced into studies of learning patterns of inter-personal coordination. Combining mathematical modeling and experimentation, we investigate how the HDC may be used as a Virtual Teacher (VT) to help humans co-produce and internalize new inter-personal coordination pattern(s). Human learners produced rhythmic finger movements whilst observing a computer-driven avatar, animated by dynamic equations stemming from the well-established Haken-Kelso-Bunz (1985) and Schöner-Kelso (1988) models of coordination. We demonstrate that the VT is successful in shifting the pattern co-produced by the VT-human system toward any value (Experiment 1) and that the VT can help humans learn unstable relative phasing patterns (Experiment 2). Using transfer entropy, we find that information flow from one partner to the other increases when VT-human coordination loses stability. This suggests that variable joint performance may actually facilitate interaction, and in the long run learning. VT appears to be a promising tool for exploring basic learning processes involved in social interaction, unraveling the dynamics of information flow between interacting partners, and providing possible rehabilitation opportunities.

An electrocardiographic scoring system for distinguishing right ventricular outflow tract arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia.

PubMed

Hoffmayer, Kurt S; Bhave, Prashant D; Marcus, Gregory M; James, Cynthia A; Tichnell, Crystal; Chopra, Nagesh; Moxey, Laura; Krahn, Andrew D; Dixit, Sanjay; Stevenson, William; Calkins, Hugh; Badhwar, Nitish; Gerstenfeld, Edward P; Scheinman, Melvin M

2013-04-01

Ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and idiopathic ventricular tachycardia (VT) can share a left bundle branch block/inferior axis morphology. We previously reported electrocardiogram characteristics during outflow tract ventricular arrhythmias that helped distinguish VT related to ARVD/C from idiopathic VT. To prospectively validate these criteria. We created a risk score by using a derivation cohort. Two experienced electrophysiologists blinded to the diagnosis prospectively scored patients with VT/premature ventricular contractions (PVCs) with left bundle branch block/inferior axis pattern in a validation cohort of 37 ARVD/C tracings and 49 idiopathic VT tracings. All patients with ARVD/C had their diagnosis confirmed based on the revised task force criteria. Patients with idiopathic VT were selected based on structurally normal hearts with documented right ventricular outflow tract VT successfully treated with ablation. The scoring system provides 3 points for sinus rhythm anterior T-wave inversions in leads V1-V3 and during ventricular arrhythmia: 2 points for QRS duration in lead I≥120 ms, 2 points for QRS notching, and 1 point for precordial transition at lead V5 or later. A score of 5 or greater was able to correctly distinguish ARVD/C from idiopathic VT 93% of the time, with a sensitivity of 84%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 91%. We describe a simple scoring algorithm that uses 12-lead electrocardiogram characteristics to effectively distinguish right ventricular outflow tract arrhythmias originating from patients with ARVD/C versus patients with idiopathic VT. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Out-of-hospital defibrillation with automated external defibrillators: postshock analysis should be delayed.

PubMed

Blouin, D; Topping, C; Moore, S; Stiell, I; Afilalo, M

2001-09-01

The American Heart Association protocols for use of automated external defibrillators (AEDs) recommend that a rhythm analysis be done immediately after each defibrillation attempt. However, shock is often followed by electrical silence or marginally organized electrical activity before ventricular fibrillation (VF) or ventricular tachycardia (VT) recurs. The optimal timing of postshock analysis for identification of recurrent VF/VT is unknown. This study examines the time to recurrence of VF/VT after a defibrillation attempt with AED. Over an 18-month period, all tapes from patients with out-of-hospital cardiac arrest who received shocks at least once with an AED were screened for recurrent VF/VT. All cases come from a single emergency medical services system providing basic life support, defibrillation with AED, and intubation with an esophageal-tracheal twin-lumen airway device (Combitube) for a population of 633,511 individuals. Pediatric and traumatic cases were excluded. When VF/VT recurred within 3 minutes of the defibrillation attempt, rhythm strips were printed and included in the study. Two cardiology fellows, blinded to the study objectives, measured the time from defibrillation to recurrent VF/VT for each strip. Over the study period, 222 tapes from 96 patients met the inclusion criteria. Only 44 (20%) occurrences of VF/VT had recurred within 6 seconds of defibrillation, 162 (73%) at 60 seconds, and 200 (90%) at 90 seconds. Eighty percent of VF/VT recurred more than 6 seconds after defibrillation and were missed when using current American Heart Association AED protocols. Subsequent analysis should be postponed until at least 30 seconds after defibrillation. Performing 30 seconds of chest compressions after defibrillation before subsequent AED rhythm analysis would increase AED identification of VF/VT to 52%.

Re-entry using anatomically determined isthmuses: a curable ventricular tachycardia in repaired congenital heart disease.

PubMed

Kapel, Gijsbert F L; Reichlin, Tobias; Wijnmaalen, Adrianus P; Piers, Sebastiaan R D; Holman, Eduard R; Tedrow, Usha B; Schalij, Martin J; Stevenson, William G; Zeppenfeld, Katja

2015-02-01

Ventricular tachycardia (VT) is an important cause of late morbidity and mortality in repaired congenital heart disease. The substrate often includes anatomic isthmuses that can be transected by radiofrequency catheter ablation similar to isthmus block for atrial flutter. This study evaluates the long-term efficacy of isthmus block for treatment of re-entry VT in adults with repaired congenital heart disease. Thirty-four patients (49±13 years; 74% male) with repaired congenital heart disease who underwent radiofrequency catheter ablation of VT in 2 centers were included. Twenty-two (65%) had a preserved left and right ventricular function. Patients were inducible for 1 (interquartile range, 1-2) VT, median cycle length: 295 ms (interquartile range, 242-346). Ablation aimed to transect anatomic isthmuses containing VT re-entry circuit isthmuses. Procedural success was defined as noninducibility of any VT and transection of the anatomic isthmus and was achieved in 25 (74%) patients. During long-term follow-up (46±29 months), all patients with procedural success (18/25 with internal cardiac defibrillators) were free of VT recurrence but 7 of 18 experienced internal cardiac defibrillator-related complications. One patient with procedural success and depressed cardiac function received an internal cardiac defibrillator shock for ventricular fibrillation. None of the 18 patients (12/18 with internal cardiac defibrillators) with complete success and preserved cardiac function experienced any ventricular arrhythmia. In contrast, VT recurred in 4 of 9 patients without procedural success. Four patients died from nonarrhythmic causes. In patients with repaired congenital heart disease with preserved ventricular function and isthmus-dependent re-entry, VT isthmus ablation can be curative. © 2014 American Heart Association, Inc.

A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation.

PubMed

Turagam, Mohit K; Atkins, Donita; Tung, Roderick; Mansour, Moussa; Ruskin, Jeremy; Cheng, Jie; Di Biase, Luigi; Natale, Andrea; Lakkireddy, Dhanunjaya

2017-09-01

There are limited studies on the safety and efficacy of remote magnetic navigation (RMN) versus manual navigation (MAN) in ventricular tachycardia (VT) ablation. A comprehensive literature search was performed using the keywords VT ablation, stereotaxis, RMN and MAN in Pubmed, Ebsco, Web of Science, Cochrane, and Google scholar databases. The analysis included seven studies (one randomized, three prospective observational, and three retrospective) including 779 patients [both structural heart disease (SHD) and idiopathic VT] comparing RMN (N = 433) and MAN (N = 339) in VT ablation. The primary end point of long-term VT recurrence was significantly lower with RMN (OR 0.61, 95% CI 0.44-0.85, p = 0.003) compared with MAN. Other end points of acute procedural success (OR 2.13, 95% CI 1.40-3.23, p = 0.0004) was significantly higher with RMN compared with MAN. Fluoroscopy [mean difference -10.42, 95% CI -12.7 to -8.1, p < 0.0001], procedural time [mean difference -9.79, 95% CI -19.27 to -0.3, p = 0.04] and complications (OR 0.35, 95% CI 0.17-0.74, p = 0.0006) were also significantly lower in RMN when compared with MAN. In a subgroup analysis SHD, there was no significant difference in VT recurrence or acute procedural success with RMN vs. MAN. In idiopathic VT, RMN significantly increased acute procedural success with no difference in VT recurrence. The results demonstrate that RMN is safe and effective when compared with MAN in patients with both SHD and idiopathic VT undergoing catheter ablation. Further prospective studies are needed to further verify the safety and efficacy of RMN.

New Substrate-Guided Method of Predicting Slow Conducting Isthmuses of Ventricular Tachycardia: Preliminary Analysis to the Combined Use of Voltage Limit Adjustment and Fast-Fourier Transform Analysis.

PubMed

Kuroki, Kenji; Nogami, Akihiko; Igarashi, Miyako; Masuda, Keita; Kowase, Shinya; Kurosaki, Kenji; Komatsu, Yuki; Naruse, Yoshihisa; Machino, Takeshi; Yamasaki, Hiro; Xu, Dongzhu; Murakoshi, Nobuyuki; Sekiguchi, Yukio; Aonuma, Kazutaka

2018-04-01

Several conducting channels of ventricular tachycardia (VT) can be identified using voltage limit adjustment (VLA) of substrate mapping. However, the sensitivity or specificity to predict a VT isthmus is not high by using VLA alone. This study aimed to evaluate the efficacy of the combined use of VLA and fast-Fourier transform analysis to predict VT isthmuses. VLA and fast-Fourier transform analyses of local ventricular bipolar electrograms during sinus rhythm were performed in 9 postinfarction patients who underwent catheter ablation for a total of 13 monomorphic VTs. Relatively higher voltage areas on an electroanatomical map were defined as high voltage channels (HVCs), and relatively higher fast-Fourier transform areas were defined as high-frequency channels (HFCs). HVCs were classified into full or partial HVCs (the entire or >30% of HVC can be detectable, respectively). Twelve full HVCs were identified in 7 of 9 patients. HFCs were located on 7 of 12 full HVCs. Five VT isthmuses (71%) were included in the 7 full HVC+/HFC+ sites, whereas no VT isthmus was found in the 5 full HVC+/HFC- sites. HFCs were identical to 9 of 16 partial HVCs. Eight VT isthmuses (89%) were included in the 9 partial HVC+/HFC+ sites, whereas no VT isthmus was found in the 7 partial HVC+/HFC- sites. All HVC+/HFC+ sites predicted VT isthmus with a sensitivity of 100% and a specificity of 80%. Combined use of VLA and fast-Fourier transform analysis may be a useful method to detect VT isthmuses. © 2018 American Heart Association, Inc.

High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition.

PubMed

Fan, Shengxian; Ni, Xiaodong; Wang, Jian; Zhang, Yongliang; Tao, Shen; Kong, Wencheng; Li, Yousheng; Li, Jieshou

2017-04-01

Previous studies have noticed the high incidence of suboptimal vitamin D (VtD) status and bone loss in short bowel syndrome (SBS) with parenteral nutrition (PN) dependence. However, limited data have focused on adult SBS without PN dependence. Therefore, our objective was to investigate the incidence and risk factors of suboptimal VtD status and bone loss in adult SBS even after weaning off PN. We performed a prospective study of 60 adult patients with SBS. Serum 25-hydroxyvitamin D (25-OHD) was measured by radioimmunoassay. Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry (DEXA). Medical records and various laboratory parameters were collected in all participants. Suboptimal VtD status was identified in all individuals, including 3 (5.0%) with VtD insufficiency and 57 (95.0%) with VtD deficiency. Residual small bowel length (B, 0.072, P = .001) and duration of SBS (B, -0.066, P = .020) were both significantly correlated with suboptimal VtD levels. Overall, only 2 patients presented a normal BMD; osteopenia and osteoporosis were noted in 41 (68.3%) and 17 (28.3%) individuals, respectively. Low 25-OHD concentration was associated with a decreased BMD (B, 0.065, P = .029). There were no other demographic characteristics or clinical examinations associated with suboptimal VtD levels and bone loss. Suboptimal VtD status and bone loss were common in adult SBS even after weaning off PN. Despite routine oral VtD supplementation, most patients did not achieve satisfactory status. This emphasizes the critical importance of routine surveillance of 25-OHD and BMD, as well as consideration of alternative methods of supplementation after weaning off PN.

Effects of fresh gas flow, tidal volume, and charcoal filters on the washout of sevoflurane from the Datex Ohmeda (GE) Aisys, Aestiva/5, and Excel 210 SE Anesthesia Workstations.

PubMed

Sabouri, A Sassan; Lerman, Jerrold; Heard, Christopher

2014-10-01

We investigated the effects of tidal volume (VT), fresh gas flow (FGF), and a charcoal filter in the inspiratory limb on the washout of sevoflurane from the following Datex Ohmeda (GE) Anesthesia Workstations (AWSs): Aisys, Aestiva/5, and Excel 210SE. After equilibrating the AWSs with 2% sevoflurane, the anesthetic was discontinued, and the absorbent anesthesia breathing circuit (ABC), reservoir bag, and test lung were changed. The lung was ventilated with 350 or 200 mL·breath(-1), 15 breaths·min(-1), and a FGF of 10 L·min(-1) while the washout of sevoflurane was performed in triplicate using a calibrated Datex Ohmeda Capnomac Ultima™ and a calibrated MIRAN SapphIRe XL ambient air analyzer until the concentration was ≤ 10 parts per million (ppm). The effects of decreasing the FGF to 5 and 2 L·min(-1) after the initial washout and of a charcoal filter in the ABC were recorded separately. The median washout times with the Aisys AWS (14 min, P < 0.01) and the Aestiva/5 (17 min, P < 0.001) with VT 350 mL·breath(-1) were significantly less than that with the Excel 210SE (32 min). The mean (95% confidence interval) washout time with the Aisys increased to 23.5 (21.5 to 25.5) min with VT 200 mL·breath(-1) (P < 0.01). Decreasing the FGF from 10 to 5 and 2 L·min(-1) with the Aisys caused a rebound in sevoflurane concentration to ≥ 50 ppm. Placement of a charcoal filter in the inspiratory limb reduced the sevoflurane concentration to < 2 ppm in the Aisys and Aestiva/5 AWSs within two minutes. The GE AWSs should be purged with large FGFs and VTs ~350 mL·breath(-1) for ~25 min to achieve 10 ppm sevoflurane. The FGF should be maintained to avoid a rebound in anesthetic concentration. Charcoal filters rapidly decrease the anesthetic concentration to < 2 ppm.

Pulmonary Gas Exchange Abnormalities in Mild Chronic Obstructive Pulmonary Disease. Implications for Dyspnea and Exercise Intolerance.

PubMed

Elbehairy, Amany F; Ciavaglia, Casey E; Webb, Katherine A; Guenette, Jordan A; Jensen, Dennis; Mourad, Sahar M; Neder, J Alberto; O'Donnell, Denis E

2015-06-15

Several studies in mild chronic obstructive pulmonary disease (COPD) have shown a higher than normal ventilatory equivalent for carbon dioxide ([Formula: see text]e/[Formula: see text]co2) during exercise. Our objective was to examine pulmonary gas exchange abnormalities and the mechanisms of high [Formula: see text]e/[Formula: see text]co2 in mild COPD and its impact on dyspnea and exercise intolerance. Twenty-two subjects (11 patients with GOLD [Global Initiative for Chronic Obstructive Lung Disease] grade 1B COPD, 11 age-matched healthy control subjects) undertook physiological testing and a symptom-limited incremental cycle exercise test with arterial blood gas collection. Patients (post-bronchodilator FEV1: 94 ± 10% predicted; mean ± SD) had evidence of peripheral airway dysfunction and reduced peak oxygen uptake compared with control subjects (80 ± 18 vs. 113 ± 24% predicted; P<0.05). Arterial blood gases were within the normal range and effective alveolar ventilation was not significantly different from control subjects throughout exercise. The alveolar-arterial O2 tension gradient was elevated at rest and throughout exercise in COPD (P<0.05). [Formula: see text]e/[Formula: see text]co2, dead space to tidal volume ratio (Vd/Vt), and arterial to end-tidal CO2 difference were all higher (P<0.05) in patients with COPD than in control subjects during exercise. In patients with COPD versus control subjects, there was significant dynamic hyperinflation and greater tidal volume constraints (P<0.05). Standardized dyspnea intensity ratings were also higher (P<0.05) in patients with COPD versus control subjects in association with higher ventilatory requirements. Within all subjects, Vd/Vt correlated with the [Formula: see text]e/[Formula: see text]co2 ratio during submaximal exercise (r=0.780, P<0.001). High Vd/Vt was the most consistent gas exchange abnormality in smokers with only mild spirometric abnormalities. Compensatory increases in minute ventilation during exercise maintained alveolar ventilation and arterial blood gas homeostasis but at the expense of earlier dynamic mechanical constraints, greater dyspnea, and exercise intolerance in mild COPD.

Experimental intra-abdominal hypertension influences airway pressure limits for lung protective mechanical ventilation.

PubMed

Cortes-Puentes, Gustavo A; Cortes-Puentes, Luis A; Adams, Alexander B; Anderson, Christopher P; Marini, John J; Dries, David J

2013-06-01

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may complicate monitoring of pulmonary mechanics owing to their impact on the respiratory system. However, recommendations for mechanical ventilation of patients with IAH/ACS and the interpretation of thoracoabdominal interactions remain unclear. Our study aimed to characterize the influence of elevated intra-abdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on airway plateau pressure (PPLAT) and bladder pressure (PBLAD). Nine deeply anesthetized swine were mechanically ventilated via tracheostomy: volume-controlled mode at tidal volume (VT) of 10 mL/kg, frequency of 15, inspiratory-expiratory ratio of 1:2, and PEEP of 1 and 10 cm H2O (PEEP1 and PEEP10, respectively). A tracheostomy tube was placed in the peritoneal cavity, and IAP levels of 5, 10, 15, 20, and 25 mm Hg were applied, using a continuous positive airway pressure system. At each IAP level, PBLAD and airway pressure measurements were performed during both PEEP1 and PEEP10. PBLAD increased as experimental IAP rose (y = 0.83x + 0.5; R = 0.98; p < 0.001 at PEEP1). Minimal underestimation of IAP by PBLAD was observed (-2.5 ± 0.8 mm Hg at an IAP of 10-25 mm Hg). Applying PEEP10 did not significantly affect the correlation between experimental IAP and PBLAD. Approximately 50% of the PBLAD (in cm H2O) was reflected by changes in PPLAT, regardless of the PEEP level applied. Increasing IAP did not influence hemodynamics at any level of IAP generated. With minimal underestimation, PBLAD measurements closely correlated with experimentally regulated IAP, independent of the PEEP level applied. For each PEEP level applied, a constant proportion (approximately 50%) of measured PBLAD (in cm H2O) was reflected in PPLAT. A higher safety threshold for PPLAT should be considered in the setting of IAH/ACS as the clinician considers changes in VT. A strategy of reducing VT to cap PPLAT at widely recommended values may not be warranted in the setting of increased IAP.

Saline as a vehicle control does not alter ventilation in male CD-1 mice.

PubMed

Receno, Candace N; Glausen, Taylor G; DeRuisseau, Lara R

2018-05-01

Saline (0.9% NaCl) is used in clinical and research settings as a vehicle for intravenous drug administration. While saline is a standard control in mouse studies, there are reports of hyperchloremic metabolic acidosis in high doses. It remains unknown if metabolic acidosis occurs in mice and/or if compensatory increases in breathing frequency and tidal volume accompany saline administration. It was hypothesized that saline administration alters blood pH and the pattern of breathing in conscious CD-1 male mice exposed to air or hypoxia (10% O 2 , balanced N 2 ). Unrestrained barometric plethysmography was used to quantify breathing frequency (breaths/min; bpm), tidal volume (VT; mL/breath/10 g body weight (BW)), and minute ventilation (VE; mL/min/10 g BW) in two designs: (1) 11-week-old mice with no saline exposure (n = 11) compared to mice with 7 days of 0.9% saline administration (intraperitoneal, i.p.; 10 mL/kg body mass; n = 6). and (2) 17-week-old mice tested before (PRE) and after 1 day (POST1, n = 6) or 7 days (POST7, n = 5) of saline (i.p.; 10 mL/kg body mass). There were no differences when comparing frequency, VT, or VE between groups for either design with room air or hypoxia exposures. Hypoxia increased frequency, VT, and VE compared to room air. Moreover, conscious blood sampling showed no differences in pH, p a CO 2 , p aO2 , or HCO3- in mice without or with 7 days of saline. These findings reveal no differences in ventilation following 1 and/or 7 days of saline administration in mice. Therefore, the use of 0.9% saline as a control is supported for studies evaluating the control of breathing in mice. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Pharmacokinetics of ketamine and its metabolite norketamine administered at a sub-anesthetic dose together with xylazine to calves prior to castration.

PubMed

Gehring, R; Coetzee, J F; Tarus-Sang, J; Apley, M D

2009-04-01

The objective of this study was to evaluate the plasma pharmacokinetics of ketamine and its active metabolite norketamine administered intravenously at a dose of 0.1 mg/kg together with xylazine (0.05 mg/kg) to control the pain associated with castration in calves. A two-compartment model with an additional metabolite compartment linked to the central compartment was used to simultaneously describe the time-concentration profiles of both ketamine and its major metabolite norketamine. Parameter values estimated from the time-concentration profiles observed in this study were volume of the central compartment (V(c) = 132.82 +/- 68.23 mL/kg), distribution clearance (CL(D) = 15.49 +/- 2.56 mL/min/kg), volume of the peripheral compartment (V(T) = 257.05 +/- 41.65 mL/kg), ketamine clearance by the formation of the norketamine metabolite (CL(2M) = 8.56 +/- 7.37 mL/kg/min) and ketamine clearance by other routes (CL(o) = 16.41 +/- 3.42 mL/kg/min). Previously published data from rats suggest that the metabolite norketamine contributes to the analgesic effect of ketamine, with a potency that is one-third of the parent drug. An understanding of the time-concentration relationships and the disposition of the parent drug and its metabolite is therefore important for a better understanding of the analgesic potential of ketamine in cattle.

Correlation of proton irradiation induced threshold voltage shifts to deep level traps in AlGaN/GaN heterostructures

NASA Astrophysics Data System (ADS)

Zhang, Z.; Cardwell, D.; Sasikumar, A.; Kyle, E. C. H.; Chen, J.; Zhang, E. X.; Fleetwood, D. M.; Schrimpf, R. D.; Speck, J. S.; Arehart, A. R.; Ringel, S. A.

2016-04-01

The impact of proton irradiation on the threshold voltage (VT) of AlGaN/GaN heterostructures is systematically investigated to enhance the understanding of a primary component of the degradation of irradiated high electron mobility transistors. The value of VT was found to increase monotonically as a function of 1.8 MeV proton fluence in a sub-linear manner reaching 0.63 V at a fluence of 1 × 1014 cm-2. Silvaco Atlas simulations of VT shifts caused by GaN buffer traps using experimentally measured introduction rates, and energy levels closely match the experimental results. Different buffer designs lead to different VT dependences on proton irradiation, confirming that deep, acceptor-like defects in the GaN buffer are primarily responsible for the observed VT shifts. The proton irradiation induced VT shifts are found to depend on the barrier thickness in a linear fashion; thus, scaling the barrier thickness could be an effective way to reduce such degradation.

Assessment of vasoreactivity using videodensitometry coronary angiography.

PubMed

Molloi, Sabee; Berenji, Gholam R; Dang, Trien T; Kassab, Ghassan

2003-08-01

Previous studies demonstrated that the dysfunction of vasomotor tone (VT) is closely linked to the development of atherosclerosis and it is considered important in the very early stages of atherogenesis. Currently, the evaluation of VT relies on lumen changes in response to vasoactive stimuli using quantitative coronary angiography (QCA) based on geometric edge detection (ED). However, using ED for measuring lumen diameters is inherently associated with large uncertainties. Videodensitometry (VD) methods have important advantages over ED for QCA. The objective of this study was to investigate the reliability of VD and ED techniques in determining the effect of nitroglycerin (NTG) on cross-sectional area (CSA) and volume changes in a swine animal model for evaluating coronary vasoreactivity. Coronary angiography was performed on four anesthetized swine. CSA and volume were measured in the left anterior descending (LAD) coronary artery using VD before and after intracoronary injection of 0.3 mg of NTG. CSA was also calculated using standard QCA based on ED. The average CSA changes in the proximal, middle and distal branches measured using VD were 23.83% (+/-10.76%), 30.78% (+/-18.39%), and 27.34% (+/-36.53%), respectively. Similarly, the average CSA changes in the proximal, middle, and distal branches measured using ED were 15.02% (+/-36.38%), 22.02% (+/-26.12), and 38.00% (+/-48.31%), respectively. The average lumen volume change measured using VD was 29.79% (+/-14.79%). In order to evaluate the relative reliability of the techniques. the significance of deviation (SOD) was calculated, which is the ratio of the change after NTG and the measurement error. The average SOD for CSA for all the branches based on VD and ED were 1.86 and 0.69, respectively. The SOD for volume measurement was 2.78. Lumen changes measured by VD showed substantial improvement in reliability when compared to the ED. Moreover, VD can be used to measure substantially smaller changes in lumen dimension in response to vasoactive stimuli than the standard QCA based on ED. Finally, VD allows the measurement of arterial volume, which is not possible with ED.

A scale-free network with limiting on vertices

NASA Astrophysics Data System (ADS)

Tang, Lian; Wang, Bin

2010-05-01

We propose and analyze a random graph model which explains a phenomena in the economic company network in which company may not expand its business at some time due to the limiting of money and capacity. The random graph process is defined as follows: at any time-step t, (i) with probability α(k) and independently of other time-step, each vertex vi (i≤t-1) is inactive which means it cannot be connected by more edges, where k is the degree of vi at the time-step t; (ii) a new vertex vt is added along with m edges incident with vt at one time and its neighbors are chosen in the manner of preferential attachment. We prove that the degree distribution P(k) of this random graph process satisfies P(k)∝C1k if α(ṡ) is a constant α0; and P(k)∝C2k-3 if α(ℓ)↓0 as ℓ↑∞, where C1,C2 are two positive constants. The analytical result is found to be in good agreement with that obtained by numerical simulations. Furthermore, we get the degree distributions in this model with m-varying functions by simulation.

Consensus-Based Attributes for Identifying Patients With Spasmodic Dysphonia and Other Voice Disorders.

PubMed

Ludlow, Christy L; Domangue, Rickie; Sharma, Dinesh; Jinnah, H A; Perlmutter, Joel S; Berke, Gerald; Sapienza, Christine; Smith, Marshall E; Blumin, Joel H; Kalata, Carrie E; Blindauer, Karen; Johns, Michael; Hapner, Edie; Harmon, Archie; Paniello, Randal; Adler, Charles H; Crujido, Lisa; Lott, David G; Bansberg, Stephen F; Barone, Nicholas; Drulia, Teresa; Stebbins, Glenn

2018-06-21

A roadblock for research on adductor spasmodic dysphonia (ADSD), abductor SD (ABSD), voice tremor (VT), and muscular tension dysphonia (MTD) is the lack of criteria for selecting patients with these disorders. To determine the agreement among experts not using standard guidelines to classify patients with ABSD, ADSD, VT, and MTD, and develop expert consensus attributes for classifying patients for research. From 2011 to 2016, a multicenter observational study examined agreement among blinded experts when classifying patients with ADSD, ABSD, VT or MTD (first study). Subsequently, a 4-stage Delphi method study used reiterative stages of review by an expert panel and 46 community experts to develop consensus on attributes to be used for classifying patients with the 4 disorders (second study). The study used a convenience sample of 178 patients clinically diagnosed with ADSD, ABSD, VT MTD, vocal fold paresis/paralysis, psychogenic voice disorders, or hypophonia secondary to Parkinson disease. Participants were aged 18 years or older, without laryngeal structural disease or surgery for ADSD and underwent speech and nasolaryngoscopy video recordings following a standard protocol. Speech and nasolaryngoscopy video recordings following a standard protocol. Specialists at 4 sites classified 178 patients into 11 categories. Four international experts independently classified 75 patients using the same categories without guidelines after viewing speech and nasolaryngoscopy video recordings. Each member from the 4 sites also classified 50 patients from other sites after viewing video clips of voice/laryngeal tasks. Interrater κ less than 0.40 indicated poor classification agreement among rater pairs and across recruiting sites. Consequently, a Delphi panel of 13 experts identified and ranked speech and laryngeal movement attributes for classifying ADSD, ABSD, VT, and MTD, which were reviewed by 46 community specialists. Based on the median attribute rankings, a final attribute list was created for each disorder. When classifying patients without guidelines, raters differed in their classification distributions (likelihood ratio, χ2 = 107.66), had poor interrater agreement, and poor agreement with site categories. For 11 categories, the highest agreement was 34%, with no κ values greater than 0.26. In external rater pairs, the highest κ was 0.23 and the highest agreement was 38.5%. Using 6 categories, the highest percent agreement was 73.3% and the highest κ was 0.40. The Delphi method yielded 18 attributes for classifying disorders from speech and nasolaryngoscopic examinations. Specialists without guidelines had poor agreement when classifying patients for research, leading to a Delphi-based development of the Spasmodic Dysphonia Attributes Inventory for classifying patients with ADSD, ABSD, VT, and MTD for research.

Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

2016-01-01

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

Prevalences and pregnancy outcome of vanishing twin pregnancies achieved by in vitro fertilization versus natural conception.

PubMed

Márton, Virág; Zádori, János; Kozinszky, Zoltan; Keresztúri, Attila

2016-11-01

To evaluate whether vanishing twin (VT) pregnancies achieved by in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) had a more adverse perinatal outcome than those after natural conception. Longitudinal, retrospective cohort study. Tertiary university hospital. Three hundred and six (78 after IVF-ICSI and 228 after natural conception) VT pregnancies over a 22-year period, with VT cases matched to primarily singleton controls. None. Obstetric and neonatal outcome data. The incidence of VT was statistically significantly higher after natural conception (18.2% of twins) than after IVF-ICSI (12.6% of twins). The odds of VT in pregnancies complicated with pregestational or gestational diabetes were disproportionally higher in IVF-ICSI cases than in spontaneously conceived VT pregnancies (adjusted odds ratio [AOR]: 0.80 vs. 3.10 and 1.00 vs. 1.07, respectively). Previous induced abortion (AOR 1.34) or second-trimester fetal loss (AOR 3.3) increased the risk of VT pregnancies after spontaneous conception. Gestational diabetes mellitus in both the previous (AOR 5.41) and the present (AOR 2.3) pregnancy as well as chronic maternal diseases (AOR 3.5) and placentation anomalies all represented independent risk factors for VT after IVF-ICSI. Vanishing twin pregnancies had a lower prevalence and a worse perinatal outcome after IVF-ICSI as compared with those of their spontaneously conceived counterparts. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

An open-label study of sodium oxybate (Xyrem®) in spasmodic dysphonia

PubMed Central

Rumbach, Anna F.; Blitzer, Andrew; Frucht, Steven J.; Simonyan, Kristina

2016-01-01

Objective Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. Study Design and Methods We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem®), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration. Results Sodium oxybate significantly improved voice symptoms (p = 0.001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (p = 0.03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug’s effects were observed approximately 30–40 min after its intake and lasted about 3.5–4 hours. Conclusion Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol and as such sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients. PMID:27808415

Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

PubMed Central

Ng, Shamay S. M.; Cheng, Yoyo T. Y.; Yu, Esther Y. T.; Chow, Gary C. C.; Chak, Yvonne T. C.; Chan, Ivy K. Y.; Zhang, Joni; Macfarlane, Duncan

2016-01-01

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020

A model for the magmatic-hydrothermal system at Mount Rainier, Washington, from seismic and geochemical observations

USGS Publications Warehouse

Moran, S.C.; Zimbelman, D.R.; Malone, S.D.

2000-01-01

Mount Rainier is one of the most seismically active volcanoes in the Cascade Range, with an average of one to two high-frequency volcano-tectonic (or VT) earthquakes occurring directly beneath the summit in a given month. Despite this level of seismicity, little is known about its cause. The VT earthquakes occur at a steady rate in several clusters below the inferred base of the Quaternary volcanic edifice. More than half of 18 focal mechanisms determined for these events are normal, and most stress axes deviate significantly from the regional stress field. We argue that these characteristics are most consistent with earthquakes in response to processes associated with circulation of fluids and magmatic gases within and below the base of the edifice. Circulation of these fluids and gases has weakened rock and reduced effective stress to the point that gravity-induced brittle fracture, due to the weight of the overlying edifice, can occur. Results from seismic tomography and rock, water, and gas geochemistry studies support this interpretation. We combine constraints from these studies into a model for the magmatic system that includes a large volume of hot rock (temperatures greater than the brittle-ductile transition) with small pockets of melt and/or hot fluids at depths of 8-18 km below the summit. We infer that fluids and heat from this volume reach the edifice via a narrow conduit, resulting in fumarolic activity at the summit, hydrothermal alteration of the edifice, and seismicity.

The effect of mouth leak and humidification during nasal non-invasive ventilation.

PubMed

Tuggey, Justin M; Delmastro, Monica; Elliott, Mark W

2007-09-01

Poor mask fit and mouth leak are associated with nasal symptoms and poor sleep quality in patients receiving domiciliary non-invasive ventilation (NIV) through a nasal mask. Normal subjects receiving continuous positive airways pressure demonstrate increased nasal resistance following periods of mouth leak. This study explores the effect of mouth leak during pressure-targeted nasal NIV, and whether this results in increased nasal resistance and consequently a reduction in effective ventilatory support. A randomised crossover study of 16 normal subjects was performed on separate days. Comparison was made of the effect of 5 min of mouth leak during daytime nasal NIV with and without heated humidification. Expired tidal volume (V(T)), nasal resistance (R(N)), and patient comfort were measured. Mean change (Delta) in V(T) and R(N) were significantly less following mouth leak with heated humidification compared to the without (DeltaV(T) -36+/-65 ml vs. -88+/-50 ml, p<0.001; DeltaR(N) +0.9+/-0.4 vs. +2.0+/-0.7 cm H(2)O l s(-1), p<0.001). Baseline comfort was worse without humidification (5.3+/-0.4 vs. 6.2+/-0.4, p<0.01), and only deteriorated following mouth leak without humidification. In normal subjects, heated humidification during nasal NIV attenuates the adverse effects of mouth leak on effective tidal volume, nasal resistance and improves overall comfort. Heated humidification should be considered as part of an approach to patients who are troubled with nasal symptoms, once leak has been minimised.

Thermophysical Properties and Temperature of the Start of Titanium Recrystallization in Different Structural States

NASA Astrophysics Data System (ADS)

Pavlenko, D. V.; Tkach, D. V.; Danilova-Tret'yak, S. M.; Evseeva, L. E.

2017-05-01

The results of measurements of the thermal diffusivity, thermal conductivity, and heat capacity of VT1-0-grade titanium samples in as-cast, deformed submicrocrystalline, and sintered states are presented. It has been established that the decrease in the thermal conductivity and thermal diffusivity of titanium in the submicrocrystalline and sintered states is associated with the increase in the quantity of defects in the material volume, whereas the increase in the temperature of polymorphic transformation of titanium is connected with the dissolution of oxygen in its lattice. The results of investigation of the coefficient of thermal linear expansion of titanium in the macrocrystalline and submicrocrystalline states are presented. The decrease in the coefficient of thermal linear expansion of titanium of submicrocrystalline structure has been established, which may point to the decrease in its melting temperature. It is shown that annealing of samples in a submicrocrystalline state leads to the growth of the temperature coefficient of linear expansion, bringing its value closer to the temperature coefficient of linear expansion of titanium in the equilibrium state. Studies by the method of back reflection photography in a KROS chamber made it possible to estimate the temperature of the start of VT1-0-grade titanium recrystallization after intense plastic deformation by the twist extrusion method. The decrease in the temperature of the start of recrystallization for titanium in the deformed submicrocrystalline state has been established. Based on the trends revealed, optimum regimes of thermal treatment of VT1-0-grade titanium for removing internal stresses and preserving the submicrocrystalline structure have been established.

Pulmonary rehabilitation improves cardiovascular response to exercise in COPD.

PubMed

Ramponi, Sara; Tzani, Panagiota; Aiello, Marina; Marangio, Emilio; Clini, Enrico; Chetta, Alfredo

2013-01-01

Pulmonary rehabilitation (PR) has emerged as a recommended standard of care in symptomatic COPD. We now studied whether PR may affect cardiovascular response to exercise in these patients. Twenty-seven patients (9 females aged 69 ± 8 years) with moderate-to-severe airflow obstruction admitted to a 9-week PR course performed a pre-to-post evaluation of lung function test and symptom-limited cardiopulmonary exercise test (CPET). Oxygen uptake (VO2), tidal volume (V(T)), dyspnea and leg fatigue scores were measured during CPET. Cardiovas-cular response was assessed by means of oxygen pulse (O2Pulse), the oxygen uptake efficiency slope and heart rate recovery at the 1st min. A significant increase in peak VO2 and in all cardiovascular parameters (p < 0.05) was found following PR when compared to baseline. Leg fatigue (p < 0.05), but not dyspnea, was significantly reduced after PR. When assessed at metabolic and ventilatory iso levels [% VCO2max and % minute ventilation (VEmax)], O2Pulse and V(T) were significantly higher (p < 0.05) at submaximal exercise (75 and 50% of VCO2max and VEmax) after PR when compared to baseline. V(T) percent changes at 75% VCO2max and 75% VEmax after PR significantly correlated with corresponding changes in O2Pulse (p < 0.01). In COPD patients, a PR training program improved the cardiovascular response during exercise at submaximal exercise independent of the external workload. This change was associated with an enhanced ventilatory function during exercise. Copyright © 2013 S. Karger AG, Basel.

The effect of low level laser therapy on ventilator-induced lung injury in mice (Conference Presentation)

NASA Astrophysics Data System (ADS)

Szabari, Margit V.; Miller, Alyssa J.; Hariri, Lida P.; Hamblin, Michael R.; Musch, Guido; Stroh, Helene; Suter, Melissa J.

2016-03-01

Although mechanical ventilation (MV) is necessary to support gas exchange in critically ill patients, it can contribute to the development of lung injury and multiple organ dysfunction. It is known that high tidal volume (Vt) MV can cause ventilator-induced lung injury (VILI) in healthy lungs and increase the mortality of patients with Acute Respiratory Distress Syndrome. Low level laser therapy (LLLT) has demonstrated to have anti-inflammatory effects. We investigated whether LLLT could alleviate inflammation from injurious MV in mice. Adult mice were assigned to 2 groups: VILI+LLLT group (3 h of injurious MV: Vt=25-30 ml/kg, respiratory rate (RR)=50/min, positive end-expiratory pressure (PEEP)=0 cmH20, followed by 3 h of protective MV: Vt=9 ml/kg, RR=140/min, PEEP=2 cmH20) and VILI+no LLLT group. LLLT was applied during the first 30 min of the MV (810 nm LED system, 5 J/cm2, 1 cm above the chest). Respiratory impedance was measured in vivo with forced oscillation technique and lung mechanics were calculated by fitting the constant phase model. At the end of the MV, bronchoalveolar lavage (BAL) was performed and inflammatory cells counted. Lungs were removed en-bloc and fixed for histological evaluation. We hypothesize that LLLT can reduce lung injury and inflammation from VILI. This therapy could be translated into clinical practice, where it can potentially improve outcomes in patients requiring mechanical ventilation in the operating room or in the intensive care units.

Chronotropic and pressor effects of water ingestion at rest and in response to incremental dynamic exercise.

PubMed

Mendonca, Goncalo V; Teixeira, Micael S; Heffernan, Kevin S; Fernhall, Bo

2013-06-01

Ingestion of water attenuates the chronotropic response to submaximal exercise. However, it is not known whether this effect is equally manifested during dynamic exercise below and above the ventilatory threshold (VT). We explored the effects of water ingestion on the heart rate response to an incremental cycle-ergometer protocol. In a randomized fashion, 19 healthy adults (10 men and nine women, age 20.9 ± 1.8 years) ingested 50 and 500 ml of water before completing a cycle-ergometer protocol on two separate days. The heart rate and oxygen uptake ( ) responses to water ingestion were analysed both at rest and during exercise performed below and above the VT. The effects of water intake on brachial blood pressure were measured only at rest. Resting mean arterial pressure increased and resting heart rate decreased, but only after 500 ml of water (P < 0.05). Compared with that seen after 50 ml of water, the 500 ml volume elicited an overall decrease in submaximal heart rate (P < 0.05). In contrast, drinking 500 ml of water did not affect submaximal . The participants' maximal heart rate, maximal and VT were similar between conditions. Our results therefore indicate that, owing to its effects on submaximal heart rate over a broad spectrum of intensities, the drinking of water should be recognized as a potential confounder in cardiovascular exercise studies. However, by showing no differences between conditions for submaximal , they also suggest that the magnitude of heart rate reduction after drinking 500 ml of water may be of minimal physiological significance for exercise cardiorespiratory capacity.

Unique Distribution of Aromatase in the Human Brain: In Vivo Studies With PET and [N-Methyl-11C]Vorozole

DOE Office of Scientific and Technical Information (OSTI.GOV)

Biegon, A.; Biegon, A.; Kim, S.W.

Aromatase catalyzes the last step in estrogen biosynthesis. Brain aromatase is involved in diverse neurophysiological and behavioral functions including sexual behavior, aggression, cognition, and neuroprotection. Using positron emission tomography (PET) with the radiolabeled aromatase inhibitor [N-methyl-{sup 11}C]vorozole, we characterized the tracer distribution and kinetics in the living human brain. Six young, healthy subjects, three men and three women, were administered the radiotracer alone on two separate occasions. Women were scanned in distinct phases of the menstrual cycle. Specificity was confirmed by pretreatment with a pharmacological (2.5 mg) dose of the aromatase inhibitor letrozole. PET data were acquired over a 90-minmore » period and regions of interest placed over selected brain regions. Brain and plasma time activity curves, corrected for metabolites, were used to derive kinetic parameters. Distribution volume (V{sub T}) values in both men and women followed the following rank order: thalamus > amygdala = preoptic area > medulla (inferior olive) > accumbens, pons, occipital and temporal cortex, putamen, cerebellum, and white matter. Pretreatment with letrozole reduced VT in all regions, though the size of the reduction was region-dependent, ranging from {approx}70% blocking in thalamus andpreoptic area to {approx}10% in cerebellum. The high levels of aromatase in thalamus and medulla (inferior olive) appear to be unique to humans. These studies set the stage for the noninvasive assessment of aromatase involvement in various physiological and pathological processes affecting the human brain.« less

A Vowel-Based Method for Vocal Tract Control in Clarinet Pedagogy

ERIC Educational Resources Information Center

González, Darleny; Payri, Blas

2017-01-01

Our review of scientific literature shows that the activity inside the clarinetist's vocal tract (VT) affects pitch and timbre, while also facilitating technical exercises. Clarinetists adapt their VT intuitively and, in some cases, may compensate an inadequate VT configuration through unnecessary pressure, resulting in technical blockage,…

Complete genome analysis of jasmine virus T from Jasminum sambac in China.

PubMed

Tang, Yajun; Gao, Fangluan; Yang, Zhen; Wu, Zujian; Yang, Liang

2016-07-01

The genome of a potyvirus (isolate JaVT_FZ) recovered from jasmine (Jasminum sambac L.) showing yellow ringspot symptoms in Fuzhou, China, was sequenced. JaVT_FZ is closely related to seven other potyviruses with completely sequenced genomes, with which it shares 66-70 % nucleotide and 52-56 % amino acid sequence identity. However, the coat protein (CP) gene shares 82-92 % nucleotide and 90-97 % amino acid sequence identity with those of two partially sequenced potyviruses, named jasmine potyvirus T (JaVT-jasmine) and jasmine yellow mosaic potyvirus (JaYMV-India), respectively. This suggests that JaVT_FZ, JaVT-jasmine and JaYMV-India should be regarded as members of a single potyvirus species, for which the name "Jasmine virus T" has priority.

Improving trend in ventricular fibrillation/pulseless ventricular tachycardia out-of-hospital cardiac arrest in Rochester, Minnesota: A 26-year observational study from 1991 to 2016.

PubMed

Okubo, Masashi; Atkinson, Elizabeth J; Hess, Erik P; White, Roger D

2017-11-01

Mortality from out-of-hospital cardiac arrest (OHCA) is characterized by substantial regional variation. The Institute of Medicine (IOM) recently recommended enhancing the capabilities of EMS systems to improve outcome. In this study, we analyzed the trend in outcome from ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) OHCA in Rochester, MN. Survival from these forms of arrest is commonly employed as a benchmark of Emergency Medical Services (EMS) system performance. Using a population-based Utstein-style registry in Rochester, MN where a first responder early defibrillation system is utilized, we evaluated outcome from all EMS-treated VF/pVT arrests and the subgroup of bystander-witnessed VF/pVT from 1991 to 2016. Outcome measurement was neurologically intact survival to discharge, defined as Cerebral Performance Category (CPC) 1 or 2. We divided the 26-year study into three periods: 1991-1997, 1998-2008, and 2009-2016, based on initiation of the first responder system of police officers in 1991 and fire-rescue personnel in 1998, and the latter period for comparison with our previous report in 2009. We observed 355 all VF/pVT arrests and 292 bystander-witnessed VF/pVT arrests between 1991 and 2016. In 2009-2016, neurologically intact survival to discharge from overall VF/pVT and bystander-witnessed VF/pVT increased to 53.7% and 65.2%, respectively, compared with 39.5% and 43.4% in 1991-1997. Using multivariable analysis, survival significantly increased in 2009-2016 among all VF/pVT arrests (adjusted OR, 3.10; 95% CI, 1.54-6.40) and bystander-witnessed VF/pVT (adjusted OR, 4.28; 95% CI, 2.01-9.50), compared with those in 1991-1997. We observed a significant improving secular trend in neurologically intact survival from VF/pVT cardiac arrests with a relatively high recent survival rate in this EMS System. Copyright © 2017 Elsevier B.V. All rights reserved.

Civilian casualties of terror-related explosions: The impact of vascular trauma on treatment and prognosis.

PubMed

Heldenberg, Eitan; Givon, Adi; Simon, Daniel; Bass, Arie; Almogy, Gidon; Peleg, Kobi

2016-09-01

A high prevalence (10%) of vascular trauma (VT) was previously described in terror-related trauma as compared with non-terror-related trauma (1%), in a civilian setting. No data regarding outcome of VT casualties of improvised explosive device (IED) explosions, in civilian settings, are available. The aim of the current study is to present the prognosis of civilian casualties of IED explosions with and without VT. A retrospective analysis of the Israeli National Trauma Registry was performed. All patients in the registry from September 2000 to December 2005 who were victims of explosions were included. These patients were subdivided into patients with VT (n = 109) and non-VT (NVT) (n = 1,152). Both groups were analyzed according to mechanism of trauma, type and severity of injury, and treatment. Of 1,261 explosion casualties, there were 109 VT victims (8.6%). Patients with VT tended to be more complex, with a higher injury severity score (ISS): 17.4% with ISS 16 to 24 as compared with only 10.5%. In the group of critically injured patients (ISS, 25-75), 51.4% had VT compared with only 15.5% of the NVT patients. As such, a heavy share of hospitals' resources were used-trauma bay admission (62.4%), operating rooms (91.7%), and intensive care unit beds (55.1%). The percentage of VT patients who were admitted for more than 15 days was 2.3 times higher than that observed among the NVT patients. Lower-extremity VT injuries were the most prevalent. Although many resources are being invested in treating this group of patients, their mortality rate is approximately five times more than NVT (22.9% vs. 4.9%). Vascular trauma casualties of IED explosions are more complex and have poorer prognosis. Their higher ISS markedly increases the hospital's resource utilization, and as such, it should be taken into consideration either upon the primary evacuation from the scene or when secondary modulation is needed in order to reduce the burden of the hospitals receiving the casualties. Prognostic/epidemiologic study, level V.

An open-label study of sodium oxybate in Spasmodic dysphonia.

PubMed

Rumbach, Anna F; Blitzer, Andrew; Frucht, Steven J; Simonyan, Kristina

2017-06-01

Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. Open-label study. We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration. Sodium oxybate significantly improved voice symptoms (P = .001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (P = .03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug's effects were observed approximately 30 to 40 minutes after its intake and lasted about 3.5 to 4 hours. Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol, and as such, sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients. 4 Laryngoscope, 127:1402-1407, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Potential role for IL-5 and IL-6 in enhanced IgA secretion by Peyer's patch cells isolated from mice acutely exposed to vomitoxin.

PubMed

Yan, D; Zhou, H R; Brooks, K H; Pestka, J J

1997-09-26

Dietary exposure to vomitoxin (VT) results in hyperelevated serum IgA and IgA nephropathy in mice. To assess the possible role of cytokines in this IgA dysregulation, the effects of a single oral exposure in B6C3F1 male mice to 0, 5 or 25 mg/kg BW VT on production of IgA and cytokines in Peyer's patch (PP) and spleen cell cultures were evaluated. IgA levels were increased significantly in PP cell cultures prepared from mice at 2 or 24 h after oral exposure to VT and subsequently stimulated with phorbol myristate acetate (PMA) and ionomycin (ION) or with lipopolysaccharide (LPS). Significant effects on IgA production were not observed in spleen cell cultures. Since cytokines such as IL-2, IL-4, IL-5 and IL-6 have been shown to promote IgA production, the effect of the same VT exposure regimen on secretion of these mediators was determined in PP and spleen cultures. Supernatant IL-2 and IL-4 levels were unaffected by the prior treatment of animals with VT. In contrast, IL-5 levels were increased significantly in 7-day PP cell cultures obtained 2 h after VT exposure both with and without PMA + ION exposure but not in other cultures. IL-6 levels were increased significantly in LPS-treated cultures prepared from PP at 2 and 24 h following exposure to VT. IL-6 levels were also elevated significantly in both PMA + ION or LPS treated cultures from spleen isolated at 2 h but not 24 h post VT exposure. To determine whether IL-5 or IL-6 play a role in IgA hyperelevation in vitro, PP and spleen cells from mice obtained 2 h after exposure to 25 mg/kg VT were cultured in the presence of neutralizing cytokine antibodies (Abs) and IgA production was monitored. Consistent with IL-5's previously documented role in IgA production, anti-IL-5 decreased IgA levels to background in cultures of both control and VT-exposed PP or spleen cells in the presence of either PMA + ION or LPS. Similar results were seen with addition of anti-IL-6. IgA levels were decreased to a lesser extent in PP cells cultured with LPS and in spleen cells cultured with PMA + ION from VT-exposed mice to which anti-IL-2 Ab was added. Thus, the potential for enhanced IgA production exists in lymphocytes as early as 2 h and as late as 24 h after a single oral exposure to VT and this may be related to the increased capacity to secrete helper cytokines of T cell and macrophage origin. Taken together, the results suggest that the superinduction of cytokine expression may, in part, be responsible for upregulation of IgA secretion in mice exposed orally to VT.

Combination of a pressure source and block movement for ground deformation analysis at Merapi volcano prior to the eruptions in 2006 and 2010

NASA Astrophysics Data System (ADS)

Aisyah, Nurnaning; Iguchi, Masato; Subandriyo; Budisantoso, Agus; Hotta, Kohei; Sumarti, Sri

2018-05-01

We analyzed ground deformation prior to the eruptions in 2006 and 2010 at Merapi volcano, Central Java, Indonesia. Ground deformation was monitored by electronic distance measurement (EDM) by measuring the slope distance toward 12 reflectors installed near the summit from five benchmarks on flanks every day. A large change of slope distance (CSD) was detected on the southeast and south baselines and a minor CSD was detected on the north and northwest baselines during the pre-eruptive stages of both the 2006 and 2010 eruptions. We applied a block movement model to the south and southeast baselines and a spherical pressure source model to the CSDs on the north and northwest baselines using the finite element method (FEM). The rates of block movement southward and the volume change of the pressure source increased on April 7, 2006 and continued at constant rates until the appearance of a new lava dome on April 26. Prior to the eruption in 2010, the block movement southeastward and the volume increase of the pressure source accelerated in the middle of October, and acceleration continued until the first outburst on October 26, 2010. Temporal patterns of the block movement and the increase in the volume of the pressure source correlate well with the increase in seismicity of VT and MP earthquakes. The pressure sources were obtained at a depth of 2 ± 0.5 km below the summit, and this position corresponds to the aseismic zone of VT earthquakes. Magma injection at the shallow part of this region causes an increase in the volume of the pressure source, and inflation of the ground of the summit triggered gravitational slip southeastward or southward of the ground surface. The volumes increases of the pressure sources were 9.7 ± 1 M m3 and 17.6 ± 0.8 M m3 in 2006 and 2010, respectively. The volume increase is related to the scale and type of the eruption. The effusive eruption in 2006 had a volcanic explosivity index (VEI) of 2 and the explosive eruption in 2010 had a VEI of 4. The directions and amounts of the block movement are strongly related to topography, hydrothermally weak zone and underground gap near the summit between West and East Domes.

Safety of varenicline tartrate and counseling versus counseling alone for smoking cessation: a randomized controlled trial for inpatients (STOP study).

PubMed

Carson, Kristin Veronica; Smith, Brian James; Brinn, Malcolm Philip; Peters, Matthew J; Fitridge, Robert; Koblar, Simon A; Jannes, Jim; Singh, Kuljit; Veale, Antony J; Goldsworthy, Sharon; Litt, John; Edwards, David; Hnin, Khin Moe; Esterman, Adrian Jeffrey

2014-11-01

Inpatient medical settings offer an opportunistic environment for initiating smoking cessation interventions to patients reflecting on their health. Current evidence has shown the superior efficacy of varenicline tartrate (VT) for smoking cessation compared with other tobacco cessation therapies; however, recent evidence also has highlighted concerns about the safety and tolerability of VT. Given these apprehensions, we aimed to evaluate the safety and effectiveness of VT plus quitline-counseling compared to quitline-counseling alone in the inpatient medical setting. Adult patients (n = 392, 20-75 years) admitted with a smoking-related illnesses to 3 hospitals were randomized to receive either 12 weeks of varenicline tartrate (titrated from 0.5mg daily to 1mg twice daily) plus quitline-counseling (VT+C), (n = 196) or quitline-counseling alone (n = 196). VT was well tolerated in the inpatient setting among subjects admitted with acute smoking-related illnesses (mean age 52.8±2.89 and 53.7±2.77 years in the VT+C and counseling alone groups, respectively). The most common self-reported adverse event during the 12-week treatment phase was nausea (16.3% in the VT+C group compared with 1.5% in the counseling alone group). Thirteen deaths occurred during the study period (n = 6 were in the VT+C arm compared with n = 7 in the counseling alone arm). All of these subjects had known comorbidities or developed underlying comorbidities. VT appears to be a safe and well-tolerated opportunistic treatment for inpatient smokers who have related chronic disease. Based on the proven efficacy of varenicline from outpatient studies and our recent inpatient evidence, we suggest it be considered as part of standard care in the hospital setting. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluation of the Variable Reluctance Transducer/Carrier Amplifier Method of Measuring Low Pneumatic Pressures in Aerodynamic and Propulsion Testing.

DTIC Science & Technology

1983-02-01

in ZT position, adjust Rx and VT to give the following conditions simul taneously: a) Vc to be specifiied value * RMS Volts. b) VRX Vz. 3. Record: RX...conditions simultaneously: a) V to be specified value as before.c b) VRX Vc. 2. Record: Rx = Q_ ; VT = ; VR =Vc (Volts). C. CALCULATE VOLTAGE AND...2 _V2 cos 8 = cos (180-,) = VRX V2 . VT 2VRX* V Z =R (cos + isino) = Rz + JWTLZ (OHMS) VT x10 (MILLIAMPERES) E(Rx+Rz)2 + LZ2 󈧏 2 • =TLz COIL "Q

The effects of locomotor-respiratory coupling on the pattern of breathing in horses.

PubMed Central

Lafortuna, C L; Reinach, E; Saibene, F

1996-01-01

1. To investigate the effect of locomotor activity on the pattern of breathing in quadrupeds, ventilatory response was studied in four healthy horses during horizontal and inclined (7%) treadmill exercise at different velocities (1.4-6.9 m s(-1)) and during chemical stimulation with a rebreathing method. Stride frequency (f(s)) and locomotor-respiratory coupling (LRC) were also simultaneously determined by means of video recordings synchronized with respiratory events. 2. Tidal volume (V(T)) was positively correlated with pulmonary ventilation (V(E)) but significantly different linear regression equations were found between the experimental conditions (P < 0.0001), since the chemical hyperventilation was mainly due to increases in V(T), whereas the major contribution to exercise hyperpnoea came from changes in respiratory frequency (f(R)). 3. The average f(R) at each exercise level was not significantly different from f(S), although there was not always a tight 1:1 LRC. At constant speeds, f(S) was independent of the treadmill slope and hence the greater V(E) during inclined exercise was due to increased V(T). 4. At any ventilatory level, the differences in breathing patterns between locomotion and rebreathing or locomotion at different slopes derived from different set points of the inspiratory off-switch mechanism. 5. The percentage of single breaths entrained with locomotor rhythm rose progressively and significantly with treadmill speed (P < 0.0001) up to a 1:1 LRC and was significantly affected by treadmill slope (P < 0.001). 6. A LRC of 1:1 was systematically observed at canter (10 out of 10 trials) and sometimes at trot (5 out of 14) and it entailed (i) a 4- to 5-fold reduction in both V(T) and f(R) variability, and (ii) a gait-specific phase locking of inspiratory onset during the locomotor cycle. 7. It is concluded that different patterns of breathing are employed during locomotion and rebreathing due to the interference between locomotor and respiratory functions, which may play a role in the optimization and control of exercise ventilation in horses. PMID:9019552

Feasibility of Protective Ventilation During Elective Supratentorial Neurosurgery: A Randomized, Crossover, Clinical Trial.

PubMed

Ruggieri, Francesco; Beretta, Luigi; Corno, Laura; Testa, Valentina; Martino, Enrico A; Gemma, Marco

2017-06-30

Traditional ventilation approaches, providing high tidal volumes (Vt), produce excessive alveolar distention and lung injury. Protective ventilation, employing lower Vt and positive end-expiratory pressure (PEEP), is an attractive alternative also for neuroanesthesia, when prolonged mechanical ventilation is needed. Nevertheless, protective ventilation during intracranial surgery may exert dangerous effects on intracranial pressure (ICP). We tested the feasibility of a protective ventilation strategy in neurosurgery. Our monocentric, double-blind, 1:1 randomized, 2×2 crossover study aimed at studying the effect size and variability of ICP in patients undergoing elective supratentorial brain tumor removal and alternatively ventilated with Vt 9 mL/kg-PEEP 0 mm Hg and Vt 7 mL/kg-PEEP 5 mm Hg. Respiratory rate was adjusted to maintain comparable end-tidal carbon dioxide between ventilation modes. ICP was measured through a subdural catheter inserted before dural opening. Forty patients were enrolled; 8 (15%) were excluded after enrollment. ICP did not differ between traditional and protective ventilation (11.28±5.37, 11 [7 to 14.5] vs. 11.90±5.86, 11 [8 to 15] mm Hg; P=0.541). End-tidal carbon dioxide (28.91±2.28, 29 [28 to 30] vs. 28.00±2.17, 28 [27 to 29] mm Hg; P<0.001). Peak airway pressure (17.25±1.97, 17 [16 to 18.5] vs. 15.81±2.87, 15.5 [14 to 17] mm Hg; P<0.001) and plateau airway pressure (16.06±2.30, 16 [14.5 to 17] vs. 14.19±2.82, 14 [12.5 to 16] mm Hg; P<0.001) were higher during protective ventilation. Blood pressure, heart rate, and body temperature did not differ between ventilation modes. Dural tension was "acceptable for surgery" in all cases. ICP differences between ventilation modes were not affected by ICP values under traditional ventilation (coefficient=0.067; 95% confidence interval, -0.278 to 0.144; P=0.523). Protective ventilation is a feasible alternative to traditional ventilation during elective neurosurgery.

Evaluating the effects of protective ventilation on organ-specific cytokine production in porcine experimental postoperative sepsis.

PubMed

Sperber, Jesper; Lipcsey, Miklós; Larsson, Anders; Larsson, Anders; Sjölin, Jan; Castegren, Markus

2015-05-10

Protective ventilation with lower tidal volume (VT) and higher positive end-expiratory pressure (PEEP) reduces the negative additive effects of mechanical ventilation during systemic inflammatory response syndrome. We hypothesised that protective ventilation during surgery would affect the organ-specific immune response in an experimental animal model of endotoxin-induced sepsis-like syndrome. 30 pigs were laparotomised for 2 hours (h), after which a continuous endotoxin infusion was started at 0.25 micrograms × kg(-1) × h(-1) for 5 h. Catheters were placed in the carotid artery, hepatic vein, portal vein and jugular bulb. Animals were randomised to two protective ventilation groups (n = 10 each): one group was ventilated with VT 6 mL × kg(-1) during the whole experiment while the other group was ventilated during the surgical phase with VT of 10 mL × kg(-1). In both groups PEEP was 5 cmH2O during surgery and increased to 10 cmH2O at the start of endotoxin infusion. A control group (n = 10) was ventilated with VT of 10 mL × kg(-1) and PEEP 5 cm H20 throughout the experiment. In four sample locations we a) simultaneously compared cytokine levels, b) studied the effect of protective ventilation initiated before and during endotoxemia and c) evaluated protective ventilation on organ-specific cytokine levels. TNF-alpha levels were highest in the hepatic vein, IL-6 levels highest in the artery and jugular bulb and IL-10 levels lowest in the artery. Protective ventilation initiated before and during endotoxemia did not differ in organ-specific cytokine levels. Protective ventilation led to lower levels of TNF-alpha in the hepatic vein compared with the control group, whereas no significant differences were seen in the artery, portal vein or jugular bulb. Variation between organs in cytokine output was observed during experimental sepsis. We see no implication from cytokine levels for initiating protective ventilation before endotoxemia. However, during endotoxemia protective ventilation attenuates hepatic inflammatory cytokine output contributing to a reduced total inflammatory burden.

Oxygen consumption of a pneumatically controlled ventilator in a field anesthesia machine.

PubMed

Szpisjak, Dale F; Javernick, Elizabeth N; Kyle, Richard R; Austin, Paul N

2008-12-01

Field anesthesia machines (FAM) have been developed for remote locations where reliable supplies of compressed medical gases or electricity may be absent. In place of electricity, pneumatically controlled ventilators use compressed gas to power timing circuitry and actuate valves. We sought to determine the total O(2) consumption and ventilator gas consumption (drive gas [DG] plus pneumatic control [PC] gas) of a FAM's pneumatically controlled ventilator in mechanical models of high (HC) and low (LC) total thoracic compliance. The amount of total O(2) consumed by the Magellan-2200 (Oceanic Medical Products, Atchison, KS) FAM with pneumatically controlled ventilator was calculated using the ideal gas law and the measured mass of O(2) consumed from E cylinders. DG to the bellows canister assembly was measured with the Wright Respirometer Mk 8 (Ferraris Respiratory Europe, Hertford, UK). PC gas consumption was calculated by subtracting DG and fresh gas flow (FGF) from the total O(2) consumed from the E cylinder. The delivered tidal volume (V(T)) was measured with a pneumotach (Hans Rudolph, KS City, MO). Three different V(T) were tested (500, 750, and 1000 mL) with two lung models (HC and LC) using the Vent Aid Training Test Lung (MI Instruments, Grand Rapids, MI). Respiratory variables included an I:E of 1:2, FGF of 1 L/min, and respiratory rate of 10 breaths/min. Total O(2) consumption was directly proportional to V(T) and inversely proportional to compliance. The smallest total O(2) consumption rate (including FGF) was 9.3 +/- 0.4 L/min in the HC-500 model and the largest was 15.9 +/- 0.5 L/min in the LC-1000 model (P < 0.001). The mean PC circuitry consumption was 3.9 +/- 0.24 L/min or 390 mL +/- 24 mL/breath. To prepare for loss of central DG supply, patient safety will be improved by estimating cylinder duration for low total thoracic compliance. Using data from the smaller compliance and greatest V(T) model (LC-1000), a full O(2) E cylinder would be depleted in <42 min, whereas a full H cylinder would last approximately 433 min.

Application of mid-frequency ventilation in an animal model of lung injury: a pilot study.

PubMed

Mireles-Cabodevila, Eduardo; Chatburn, Robert L; Thurman, Tracy L; Zabala, Luis M; Holt, Shirley J; Swearingen, Christopher J; Heulitt, Mark J

2014-11-01

Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. Our hypothesis was that MFV can maximize ventilation at higher frequencies without adverse consequences. We compared ventilation and hemodynamic outcomes between conventional ventilation and MFV. This was a prospective study of 6 live Yorkshire pigs (10 ± 0.5 kg). The animals were subjected to lung injury induced by saline lavage and injurious conventional mechanical ventilation. Baseline conventional pressure control continuous mandatory ventilation was applied with V(T) = 6 mL/kg and PEEP determined using a decremental PEEP trial. A manual decision support algorithm was used to implement MFV using the same conventional ventilator. We measured P(aCO2), P(aO2), end-tidal carbon dioxide, cardiac output, arterial and venous blood oxygen saturation, pulmonary and systemic vascular pressures, and lactic acid. The MFV algorithm produced the same minute ventilation as conventional ventilation but with lower V(T) (-1 ± 0.7 mL/kg) and higher frequency (32.1 ± 6.8 vs 55.7 ± 15.8 breaths/min, P < .002). There were no differences between conventional ventilation and MFV for mean airway pressures (16.1 ± 1.3 vs 16.4 ± 2 cm H2O, P = .75) even when auto-PEEP was higher (0.6 ± 0.9 vs 2.4 ± 1.1 cm H2O, P = .02). There were no significant differences in any hemodynamic measurements, although heart rate was higher during MFV. In this pilot study, we demonstrate that MFV allows the use of higher breathing frequencies and lower V(T) than conventional ventilation to maximize alveolar ventilation. We describe the ventilatory or hemodynamic effects of MFV. We also demonstrate that the application of a decision support algorithm to manage MFV is feasible. Copyright © 2014 by Daedalus Enterprises.

77 FR 75837 - Amendment of Time of Designation for Restricted Area R-6501B; Underhill, VT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... R-6501B; Underhill, VT AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: This action amends the time of designation for restricted area R-6501B, Underhill, VT by adding a... INFORMATION: Background The current time of designation of restricted area R-6501B reads [[Page 75838...

33 CFR 110.8 - Lake Champlain, N.Y. and Vt.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Lake Champlain, N.Y. and Vt. 110... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.8 Lake Champlain, N.Y. and Vt. (a) Ticonderoga, N.Y. An area shoreward of a line bearing 312° from Ticonderoga Light to the southeast corner of the...

Kinetic modeling and long-term test-retest reproducibility of the mGluR5 PET tracer 18F-FPEB in human brain.

PubMed

Leurquin-Sterk, Gil; Postnov, Andrey; de Laat, Bart; Casteels, Cindy; Celen, Sofie; Crunelle, Cleo L; Bormans, Guy; Koole, Michel; Van Laere, Koen

2016-04-01

(18)F-FPEB is a promising PET tracer for studying the metabotropic glutamate subtype 5 receptor (mGluR5) expression in neuropsychiatric disorders. To assess the potential of (18)F-FPEB for longitudinal mGluR5 evaluation in patient studies, we evaluated the long-term test-retest reproducibility using various kinetic models in the human brain. Nine healthy volunteers underwent consecutive scans separated by a 6-month period. Dynamic PET was combined with arterial sampling and radiometabolite analysis. Total distribution volume (V(T)) and nondisplaceable binding potential (BP(ND)) were derived from a two-tissue compartment model without constraints (2TCM) and with constraining the K(1)/k(2) ratio to the value of either cerebellum (2TCM-CBL) or pons (2TCM-PONS). The effect of fitting different functions to the tracer parent fractions and reducing scan duration were assessed. Regional absolute test-retest variability (aTRV), coefficient of repeatability (CR) and intraclass correlation coefficient (ICC) were computed. The 2TCM-CBL showed best fits. The mean 6-month aTRV of V(T) ranged from 8 to 13% (CR < 25%) with ICC > 0.6 for all kinetic models. BPND from 2TCM-CBL with a sigmoid fit for the parent fractions showed the best reproducibility, with aTRV ≤ 7% (CR < 16%) and ICC > 0.9 in most regions. Reducing the scan duration from 90 to 60 min did not affect reproducibility. These results demonstrate for the first time that (18)F-FPEB brain PET has good long-term reproducibility, therefore validating its use to monitor mGluR5 expression in longitudinal clinical studies. We suggest a 2TCM-CBL with fitting a sigmoid function to the parent fractions to be optimal for this tracer. © 2016 Wiley Periodicals, Inc.

The Effects of a Duathlon Simulation on Ventilatory Threshold and Running Economy

PubMed Central

Berry, Nathaniel T.; Wideman, Laurie; Shields, Edgar W.; Battaglini, Claudio L.

2016-01-01

Multisport events continue to grow in popularity among recreational, amateur, and professional athletes around the world. This study aimed to determine the compounding effects of the initial run and cycling legs of an International Triathlon Union (ITU) Duathlon simulation on maximal oxygen uptake (VO2max), ventilatory threshold (VT) and running economy (RE) within a thermoneutral, laboratory controlled setting. Seven highly trained multisport athletes completed three trials; Trial-1 consisted of a speed only VO2max treadmill protocol (SOVO2max) to determine VO2max, VT, and RE during a single-bout run; Trial-2 consisted of a 10 km run at 98% of VT followed by an incremental VO2max test on the cycle ergometer; Trial-3 consisted of a 10 km run and 30 km cycling bout at 98% of VT followed by a speed only treadmill test to determine the compounding effects of the initial legs of a duathlon on VO2max, VT, and RE. A repeated measures ANOVA was performed to determine differences between variables across trials. No difference in VO2max, VT (%VO2max), maximal HR, or maximal RPE was observed across trials. Oxygen consumption at VT was significantly lower during Trial-3 compared to Trial-1 (p = 0.01). This decrease was coupled with a significant reduction in running speed at VT (p = 0.015). A significant interaction between trial and running speed indicate that RE was significantly altered during Trial-3 compared to Trial-1 (p < 0.001). The first two legs of a laboratory based duathlon simulation negatively impact VT and RE. Our findings may provide a useful method to evaluate multisport athletes since a single-bout incremental treadmill test fails to reveal important alterations in physiological thresholds. Key points Decrease in relative oxygen uptake at VT (ml·kg-1·min-1) during the final leg of a duathlon simulation, compared to a single-bout maximal run. We observed a decrease in running speed at VT during the final leg of a duathlon simulation; resulting in an increase of more than 2 minutes to complete a 5 km run. During our study, highly trained athletes were unable to complete the final 5 km run at the same intensity that they completed the initial 10 km run (in a laboratory setting). A better understanding, and determination, of training loads during multisport training may help to better periodize training programs; additional research is required. PMID:27274661

Performance and technological feasibility of rocket powered HTHL-SSTO with take-off assist (aerospace plane/ekranoplane)

NASA Astrophysics Data System (ADS)

Tomita, Nobuyuki; Nebylov, Alexander V.; Sokolov, Victor V.; Ohkami, Yoshiaki

It might be said that it is common understanding that rocket-powered single stage to orbit (SSTO) aerospace planes will become feasible with near-term technology as described in [1] (Koelle, D. E. Survey and comparison of winged launch vehicle options, ISTS 94-g-11 V 1994) and [2] (Bekey, I. Why SSTO rocket launch vehicles are now feasible and practical, IAF-94-V.1.524 1994). Among two methods of launching aerospace planes into orbit, vertical take-off (VT) and horizontal take-off (HT), it seems that VT takes the lead from HT [1, 2]. The decision for the X-33 program by NASA, also, seems to favor VT. In retrospect, almost all of the launch vehicles in the past have been VT, mainly because VT solved the problem of exit from atmosphere to space. However, broadening the range of requirements for space transportation systems from military to commercial and unmanned to manned seems to favor the need for HT. In this paper, the authors are going to prove that aerospace plane/ekranoplane system, which is a reusable launch vehicle system based on the HT concept, with ekranoplane as a take-off and possibly, landing assist, could be competitive with the VT concept from both technological and economical view points. Ekranoplane is a wing-in-ground-effect craft (WIG), which moves at a speed of approximately 0.5 M, carrying heavy loads above the sea surface. Combination of high initial velocity and high performance tri-propellant engine for aerospace plane makes it possible to configure an aerospace plane which is competitive with VT. Other specific features of HT in comparison with VT are discussed.

Electrocardiographic characteristics of left ventricular outflow tract tachycardia.

PubMed

Hachiya, H; Aonuma, K; Yamauchi, Y; Harada, T; Igawa, M; Nogami, A; Iesaka, Y; Hiroe, M; Marumo, F

2000-11-01

Catheter ablation of idiopathic left ventricular outflow tract tachycardia (LVOT-VT) is rare because a safe ablation technique at this site has not been described, and serious complications may occur. This study compared the QRS morphology of LVOT-VT with that of idiopathic right ventricular outflow tract tachycardia. A comparison was made between the electrocardiographic characteristics of LVOT-VT originating from the supravalvular region of a coronary cusp (Supra-Ao group) with those of LVOT-VT originating from the infravalvular endocardial region of a coronary cusp of the aortic valve within the LV (Infra-Ao group). After precise mapping of the right ventricle, left ventricle, pulmonary artery, coronary cusps, and proximal portion of the anterior interventricular vein, there were 17 patients in whom VT was thought to be located at the LVOT by both activation and pace mapping. They were divided between a Supra-Ao group (n = 8), and an Infra-Ao group (n = 9). Analysis of the 12-lead electrocardiogram (ECG) revealed an S wave in lead I in all 17 patients. A precordial R wave transition was also observed at V1 or V2 in 16 patients (94%). In 7 of 8 patients (88%) with Supra-Ao LVOT-VT, no S wave was observed in either V5 or V6. In contrast, an Rs pattern was observed in both V5 and V6, or in V6 only, in 100% of the patients with Infra-Ao LVOT-VT. A LVOT-VT should be suspected when the ECG shows an S wave in lead I and an R/S ratio greater than 1 in lead V1 or V2, versus a coronary cusp location if there is no S wave in either lead V5 or V6.

Evaluation of a turbine flow meter (Ventilometer Mark 2) in the measurement of ventilation.

PubMed

Cooper, C B; Harris, N D; Howard, P

1990-01-01

We have evaluated a turbine flow meter (Ventilometer Mark 2, PK Morgan, Kent, UK) at low flow rates and levels of ventilation which are likely to be encountered during exercise in patients with chronic respiratory disease. Pulsatile flows were generated from a volume-cycled mechanical ventilator, the flow wave-form was modified by damping to simulate a human breathing pattern. Comparative measurements of ventilation were made whilst varying tidal volume (VT) from 0.22 to 1.131 and respiratory rate (fR) from 10 to 35 min-1. At lower levels of ventilation the instrument tended to underread especially with increasing fR. The calibration factor must be adjusted to match the level of ventilation if the measurement errors are to be within 5%.

New findings on venous thrombogenesis

PubMed Central

Byrnes, James R.; Wolberg, Alisa S.

2017-01-01

Summary Venous thrombosis (VT) is the third most common cause of cardiovascular death worldwide. Complications from VT and pulmonary embolism are the leading cause of lost disability-adjusted life years. Risks include genetic (e.g., non-O blood group, activated protein C resistance, hyperprothrombinemia) and acquired (e.g., age, surgery, cancer, pregnancy, immobilisation, female hormone use) factors. Pathophysiologic mechanisms that promote VT are incompletely understood, but involve abnormalities in blood coagulability, vessel function, and flow (so-called Virchow’s Triad). Epidemiologic studies of humans, animal models, and biochemical and biophysical investigations have revealed contributions from extrinsic, intrinsic, and common pathways of coagulation, endothelial cells, leukocytes, red blood cells, platelets, cell-derived microvesicles, stasis-induced changes in vascular cells, and blood rheology. Knowledge of these mechanisms may yield new therapeutic targets. Characterisation of mechanisms that mediate VT formation and stability, particularly in aging, are needed to advance understanding of VT. PMID:27878206

Idiopathic ventricular tachycardia and fibrillation.

PubMed

Belhassen, B; Viskin, S

1993-06-01

Important data have recently been added to our understanding of sustained ventricular tachyarrhythmias occurring in the absence of demonstrable heart disease. Idiopathic ventricular tachycardia (VT) is usually of monomorphic configuration and can be classified according to its site of origin as either right monomorphic (70% of all idiopathic VTs) or left monomorphic VT. Several physiopathological types of monomorphic VT can be presently individualized, according to their mode of presentation, their relationship to adrenergic stress, or their response to various drugs. The long-term prognosis is usually good. Idiopathic polymorphic VT is a much rarer type of arrhythmia with a less favorable prognosis. Idiopathic ventricular fibrillation may represent an underestimated cause of sudden cardiac death in ostensibly healty patients. A high incidence of inducibility of sustained polymorphic VT with programmed ventricular stimulation has been found by our group, but not by others. Long-term prognosis on Class IA antiarrhythmic medications that are highly effective at electrophysiologic study appears excellent.

Trends and Issues in Vocational Training in the Republic of China on Taiwan.

ERIC Educational Resources Information Center

Lee, Lung-Sheng

Vocational training (VT) in Taiwan is categorized into public training (PT) and enterprise training (ET). PT is provided primarily by 13 PT centers, and ET is provided in various ways. A review of the state of VT in Taiwan established that VT policies and practices are being influenced by increasing emphasis on the knowledge-based economy and…

Vasculotide reduces endothelial permeability and tumor cell extravasation in the absence of binding to or agonistic activation of Tie2

PubMed Central

Wu, Florence TH; Lee, Christina R; Bogdanovic, Elena; Prodeus, Aaron; Gariépy, Jean; Kerbel, Robert S

2015-01-01

Angiopoietin-1 (Ang1) activation of Tie2 receptors on endothelial cells (ECs) reduces adhesion by tumor cells (TCs) and limits junctional permeability to TC diapedesis. We hypothesized that systemic therapy with Vasculotide (VT)—a purported Ang1 mimetic, Tie2 agonist—can reduce the extravasation of potentially metastatic circulating TCs by similarly stabilizing the host vasculature. In vitro, VT and Ang1 treatments impeded endothelial hypermeability and the transendothelial migration of MDA-MB-231•LM2-4 (breast), HT29 (colon), or SN12 (renal) cancer cells to varying degrees. In mice, VT treatment inhibited the transit of TCs through the pulmonary endothelium, but not the hepatic or lymphatic endothelium. In the in vivo LM2-4 model, VT monotherapy had no effect on primary tumors, but significantly delayed distant metastatic dissemination to the lungs. In the post-surgical adjuvant treatment setting, VT therapeutically complemented sunitinib therapy, an anti-angiogenic tyrosine kinase inhibitor which limited the local growth of residual disease. Unexpectedly, detailed investigations into the putative mechanism of action of VT revealed no evidence of Tie2 agonism or Tie2 binding; alternative mechanisms have yet to be determined. PMID:25851538

Temporal and spectral characteristics of seismicity observed at Popocatepetl volcano, central Mexico

USGS Publications Warehouse

Arciniega-Ceballos, A.; Valdes-Gonzalez, C.; Dawson, P.

2000-01-01

Popocatepetl volcano entered an eruptive phase from December 21, 1994 to March 30, 1995, which was characterized by ash and fumarolic emissions. During this eruptive episode, the observed seismicity consisted of volcano-tectonic (VT) events, long-period (LP) events and sustained tremor. Before the initial eruption on December 21, VT seismicity exhibited no increase in number until a swarm of VT earthquakes was observed at 01:31 hours local time. Visual observations of the eruption occurred at dawn the next morning. LP activity increased from an average of 7 events a day in October 1994 to 22 events per day in December 1994. At the onset of the eruption, LP activity peaked at 49 events per day. LP activity declined until mid-January 1995 when no events were observed. Tremor was first observed about one day after the initial eruption and averaged 10 h per episode. By late February 1995, tremor episodes became more intermittent, lasting less than 5 min, and the number of LP events returned to pre-eruption levels (7 events per day). Using a spectral ratio technique, low-frequency oceanic microseismic noise with a predominant peak around 7 s was removed from the broadband seismic signal of tremor and LP events. Stacks of corrected tremor episodes and LP events show that both tremor and LP events contain similar frequency features with major peaks around 1.4 Hz. Frequency analyses of LP events and tremor suggest a shallow extended source with similar radiation pattern characteristics. The distribution of VT events (between 2.5 and 10 km) also points to a shallow source of the tremor and LP events located in the first 2500 m beneath the crater. Under the assumption that the frequency characteristics of the signals are representative of an oscillator we used a fluid-filled-crack model to infer the length of the resonator.

Patterns of seismicity in a complex volcanic crisis at Brava, Cabo Verde

NASA Astrophysics Data System (ADS)

Faria, B. V. E.; Day, S. J.

2017-12-01

Brava is the smallest inhabited island of the Cape Verde archipelago, with an area of 62.5 km2 and a population of 6000. Geologically recent volcanism on Brava has produced lava (including carbonatite) flows, phonolite lava domes, pyroclastic density current deposits, and many phreatomagmatic craters in central Brava (where most of the population lives). Recent geological studies indicate that last eruptive period is about 1000 years old. Brava has experienced recurrent seismic swarms and felt earthquakes. The first permanent seismic station was installed in 1999, and a small network in 2011. From then until 2015 the seismic rate was near constant with sporadic peaks. Most seismic events were located offshore and associated with submarine volcanoes. However, the pattern of activity has been very different since 25th September 2015, when a M4 earthquake occurred in the submarine slopes of Brava. Subsequently, the seismicity became very complex with frequent volcano-tectonic (VT) earthquake swarms beneath Brava itself, with a few offshore events in some months. In addition, long-period, hybrid and hydrothermal events and likely very weak volcanic tremor episodes have been recorded. These non-VT events support the hypothesis that magma emplacement beneath Brava is at the origin of the abnormal seismic activity. The VT swarms indicate deformation around the magma body and possible dike intrusions, and there are indications of perturbation of a shallow hydrothermal system. The largest swarm occurred on the 1st and 2nd August 2016, with almost 1000 shallow events, including a M3.7 VT earthquake, medium-frequency events and weak volcanic tremor. An alert for a possible eruption was issued and a village (about 300 people) was evacuated as a precaution. Distributions of the cumulative number of events with depth in the main swarms suggest that the hypocenters are becoming shallower with time. Thus a possible eruption in the near future cannot be ruled out.

Using domiciliary non-invasive ventilator data downloads to inform clinical decision-making to optimise ventilation delivery and patient compliance

PubMed Central

Mansell, Stephanie K; Cutts, Steven; Hackney, Isobel; Wood, Martin J; Hawksworth, Kevin; Creer, Dean D; Kilbride, Cherry; Mandal, Swapna

2018-01-01

Introduction Ventilation parameter data from patients receiving home mechanical ventilation can be collected via secure data cards and modem technology. This can then be reviewed by clinicians and ventilator prescriptions adjusted. Typically available measures include tidal volume (VT), leak, respiratory rate, minute ventilation, patient triggered breaths, achieved pressures and patient compliance. This study aimed to assess the potential impact of ventilator data downloads on management of patients requiring home non-invasive ventilation (NIV). Methods A longitudinal within-group design with repeated measurements was used. Baseline ventilator data were downloaded, reviewed and adjustments made to optimise ventilation. Leak, VT and compliance data were collected for comparison at the first review and 3–7 weeks later. Ventilator data were monitored and amended remotely via a modem by a consultant physiotherapist between the first review and second appointment. Results Analysis of data from 52 patients showed increased patient compliance (% days used >4 hours) from 90% to 96% (p=0.007), increased usage from 6.53 to 6.94 hours (p=0.211) and a change in VT(9.4 vs 8.7 mL/kg/ideal body weight, p=0.022). There was no change in leak following review of NIV prescriptions (mean (SD): 43 (23.4) L/min vs 45 (19.9)L/min, p=0.272). Conclusion Ventilator data downloads, via early remote assessment, can help optimise patient ventilation through identification of modifiable factors, in particular interface leak and ventilator prescriptions. However, a prospective study is required to assess whether using ventilator data downloads provides value in terms of patient outcomes and cost-effectiveness. The presented data will help to inform the design of such a study. PMID:29531743

Physiologic response to varying levels of pressure support and neurally adjusted ventilatory assist in patients with acute respiratory failure.

PubMed

Colombo, Davide; Cammarota, Gianmaria; Bergamaschi, Valentina; De Lucia, Marta; Corte, Francesco Della; Navalesi, Paolo

2008-11-01

Neurally adjusted ventilatory assist (NAVA) is a new mode wherein the assistance is provided in proportion to diaphragm electrical activity (EAdi). We assessed the physiologic response to varying levels of NAVA and pressure support ventilation (PSV). ICU of a University Hospital. Fourteen intubated and mechanically ventilated patients. DESIGN AND PROTOCOL: Cross-over, prospective, randomized controlled trial. PSV was set to obtain a VT/kg of 6-8 ml/kg with an active inspiration. NAVA was matched with a dedicated software. The assistance was decreased and increased by 50% with both modes. The six assist levels were randomly applied. Arterial blood gases (ABGs), tidal volume (VT/kg), peak EAdi, airway pressure (Paw), neural and flow-based timing. Asynchrony was calculated using the asynchrony index (AI). There was no difference in ABGs regardless of mode and assist level. The differences in breathing pattern, ventilator assistance, and respiratory drive and timing between PSV and NAVA were overall small at the two lower assist levels. At the highest assist level, however, we found greater VT/kg (9.1 +/- 2.2 vs. 7.1 +/- 2 ml/kg, P < 0.001), and lower breathing frequency (12 +/- 6 vs. 18 +/- 8.2, P < 0.001) and peak EAdi (8.6 +/- 10.5 vs. 12.3 +/- 9.0, P < 0.002) in PSV than in NAVA; we found mismatch between neural and flow-based timing in PSV, but not in NAVA. AI exceeded 10% in five (36%) and no (0%) patients with PSV and NAVA, respectively (P < 0.05). Compared to PSV, NAVA averted the risk of over-assistance, avoided patient-ventilator asynchrony, and improved patient-ventilator interaction.

The time-course of cortico-limbic neural responses to air hunger.

PubMed

Binks, Andrew P; Evans, Karleyton C; Reed, Jeffrey D; Moosavi, Shakeeb H; Banzett, Robert B

2014-12-01

Several studies have mapped brain regions associated with acute dyspnea perception. However, the time-course of brain activity during sustained dyspnea is unknown. Our objective was to determine the time-course of neural activity when dyspnea is sustained. Eight healthy subjects underwent brain blood oxygen level dependent functional magnetic imaging (BOLD-fMRI) during mechanical ventilation with constant mild hypercapnia (∼ 45 mm Hg). Subjects rated dyspnea (air hunger) via visual analog scale (VAS). Tidal volume (V(T)) was alternated every 90 s between high VT (0.96 ± 0.23 L) that provided respiratory comfort (12 ± 6% full scale) and low V(T) (0.48 ± 0.08 L) which evoked air hunger (56 ± 11% full scale). BOLD signal was extracted from a priori brain regions and combined with VAS data to determine air hunger related neural time-course. Air hunger onset was associated with BOLD signal increases that followed two distinct temporal profiles within sub-regions of the anterior insula, anterior cingulate and prefrontal cortices (cortico-limbic circuitry): (1) fast, BOLD signal peak <30s and (2) slow, BOLD signal peak >40s. BOLD signal during air hunger offset followed fast and slow temporal profiles symmetrical, but inverse (signal decreases) to the time-courses of air hunger onset. We conclude that differential cortico-limbic circuit elements have unique contributions to dyspnea sensation over time. We suggest that previously unidentified sub-regions are responsible for either the acute awareness or maintenance of dyspnea. These data enhance interpretation of previous studies and inform hypotheses for future dyspnea research. Copyright © 2014 Elsevier B.V. All rights reserved.

Protective lung ventilation in operating room: a systematic review.

PubMed

Futier, E; Constantin, J M; Jaber, S

2014-06-01

Postoperative pulmonary and extrapulmonary complications adversely affect clinical outcomes and healthcare utilization, so that prevention has become a measure of the quality of perioperative care. Mechanical ventilation is an essential support therapy to maintain adequate gas exchange during general anesthesia for surgery. Mechanical ventilation using high tidal volume (VT) (between 10 and 15 mL/kg) has been historically encouraged to prevent hypoxemia and atelectasis formation in anesthetized patients undergoing abdominal and thoracic surgery. However, there is accumulating evidence from both experimental and clinical studies that mechanical ventilation, especially the use of high VT and plateau pressure, may potentially aggravate or even initiate lung injury. Ventilator-associated lung injury can result from cyclic alveolar overdistension of non-dependent lung tissue, and repetitive opening and closing of dependent lung tissue resulting in ultrastructural damage at the junction of closed and open alveoli. Lung-protective ventilation, which refers to the use of lower VT and limited plateau pressure to minimize overdistension, and positive end-expiratory pressure to prevent alveolar collapse at end-expiration, was shown to improve outcome in critically ill patients with acute respiratory distress syndrome (ARDS). It has been recently suggested that this approach might also be beneficial in a broader population, especially in critically ill patients without ARDS at the onset of mechanical ventilation. There is, however, little evidence regarding a potential beneficial effect of lung protective ventilation during surgery, especially in patients with healthy lungs. Although surgical patients are frequently exposed to much shorter periods of mechanical ventilation, this is an important gap in knowledge given the number of patients receiving mechanical ventilation in the operating room. This review developed the benefits of lung protective ventilation during surgery and general anesthesia and offers some recommendations for mechanical ventilation in the surgical context.

Protective ventilation of preterm lambs exposed to acute chorioamnionitis does not reduce ventilation-induced lung or brain injury.

PubMed

Barton, Samantha K; Moss, Timothy J M; Hooper, Stuart B; Crossley, Kelly J; Gill, Andrew W; Kluckow, Martin; Zahra, Valerie; Wong, Flora Y; Pichler, Gerhard; Galinsky, Robert; Miller, Suzanne L; Tolcos, Mary; Polglase, Graeme R

2014-01-01

The onset of mechanical ventilation is a critical time for the initiation of cerebral white matter (WM) injury in preterm neonates, particularly if they are inadvertently exposed to high tidal volumes (VT) in the delivery room. Protective ventilation strategies at birth reduce ventilation-induced lung and brain inflammation and injury, however its efficacy in a compromised newborn is not known. Chorioamnionitis is a common antecedent of preterm birth, and increases the risk and severity of WM injury. We investigated the effects of high VT ventilation, after chorioamnionitis, on preterm lung and WM inflammation and injury, and whether a protective ventilation strategy could mitigate the response. Pregnant ewes (n = 18) received intra-amniotic lipopolysaccharide (LPS) 2 days before delivery, instrumentation and ventilation at 127±1 days gestation. Lambs were either immediately euthanased and used as unventilated controls (LPSUVC; n = 6), or were ventilated using an injurious high VT strategy (LPSINJ; n = 5) or a protective ventilation strategy (LPSPROT; n = 7) for a total of 90 min. Mean arterial pressure, heart rate and cerebral haemodynamics and oxygenation were measured continuously. Lungs and brains underwent molecular and histological assessment of inflammation and injury. LPSINJ lambs had poorer oxygenation than LPSPROT lambs. Ventilation requirements and cardiopulmonary and systemic haemodynamics were not different between ventilation strategies. Compared to unventilated lambs, LPSINJ and LPSPROT lambs had increases in pro-inflammatory cytokine expression within the lungs and brain, and increased astrogliosis (p<0.02) and cell death (p<0.05) in the WM, which were equivalent in magnitude between groups. Ventilation after acute chorioamnionitis, irrespective of strategy used, increases haemodynamic instability and lung and cerebral inflammation and injury. Mechanical ventilation is a potential contributor to WM injury in infants exposed to chorioamnionitis.

Effects of assisted and variable mechanical ventilation on cardiorespiratory interactions in anesthetized pigs.

PubMed

Beda, Alessandro; Güldner, Andreas; Simpson, David M; Carvalho, Nadja C; Franke, Susanne; Uhlig, Christopher; Koch, Thea; Pelosi, Paolo; de Abreu, Marcelo Gama

2012-03-01

The physiological importance of respiratory sinus arrhythmia (RSA) and cardioventilatory coupling (CVC) has not yet been fully elucidated, but these phenomena might contribute to improve ventilation/perfusion matching, with beneficial effects on gas exchange. Furthermore, decreased RSA amplitude has been suggested as an indicator of impaired autonomic control and poor clinical outcome, also during positive-pressure mechanical ventilation (MV). However, it is currently unknown how different modes of MV, including variable tidal volumes (V(T)), affect RSA and CVC during anesthesia. We compared the effects of pressure controlled (PCV) versus pressure assisted (PSV) ventilation, and of random variable versus constant V(T), on RSA and CVC in eight anesthetized pigs. At comparable depth of anesthesia, global hemodynamics, and ventilation, RSA amplitude increased from 20 ms in PCV to 50 ms in PSV (p < 0.05). CVC was detected (using proportional Shannon entropy of the interval between each inspiration onset and the previous R-peak in ECG) in two animals in PCV and seven animals in PSV. Variable V(T) did not significantly influence these phenomena. Furthermore, heart period and systolic arterial pressure oscillations were in phase during PCV but in counter-phase during PSV. At the same depth of anesthesia in pigs, PSV increases RSA amplitude and CVC compared to PCV. Our data suggest that the central respiratory drive, but not the baroreflex or the mechano-electric feedback in the heart, is the main mechanism behind the RSA increase. Hence, differences in RSA and CVC between mechanically ventilated patients might reflect the difference in ventilation mode rather than autonomic impairment. Also, since gas exchange did not increase from PCV to PSV, it is questionable whether RSA has any significance in improving ventilation/perfusion matching during MV.

Change in VO2max and time trial performance in response to high-intensity interval training prescribed using ventilatory threshold.

PubMed

Astorino, Todd A; deRevere, Jamie; Anderson, Theodore; Kellogg, Erin; Holstrom, Patrick; Ring, Sebastian; Ghaseb, Nicholas

2018-06-19

Completion of high-intensity interval training (HIIT) leads to significant increases in maximal oxygen uptake (VO 2max ) and oxidative capacity. However, individual responses to HIIT have been identified as approximately 20-40% of individuals show no change in VO 2max , which may be due to the relatively homogeneous approach to implementing HIIT. This study tested the effects of HIIT prescribed using ventilatory threshold (VT) on changes in VO 2max and cycling performance. Fourteen active men and women (age and VO 2max  = 27 ± 8 year and 38 ± 4 mL/kg/min) underwent nine sessions of HIIT, and 14 additional men and women (age and VO 2max  = 22 ± 3 year and 40 ± 5 mL/kg/min) served as controls. Training was performed on a cycle ergometer at a work rate equal to 130%VT and consisted of eight to ten 1 min bouts interspersed with 75 s of recovery. At baseline and post-testing, they completed progressive cycling to exhaustion to determine VO 2max , and on a separate day, a 5 mile cycling time trial. Compared to the control group, HIIT led to significant increases in VO 2max (6%, p = 0.007), cycling performance (2.5%, p = 0.003), and absolute VT (9 W, p = 0.005). However, only 57% of participants revealed meaningful increases in VO 2max and cycling performance in response to training, and two showed no change in either outcome. A greater volume of HIIT may be needed to maximize the training response for all individuals.

Convection Enhanced Delivery: A Comparison of infusion characteristics in ex vivo and in vivo non-human primate brain tissue.

PubMed

Miranpuri, Gurwattan; Hinchman, Angelica; Wang, Anyi; Schomberg, Dominic; Kubota, Ken; Brady, Martin; Raghavan, Raghu; Bruner, Kevin; Brodsky, Ethan; Block, Walter; Grabow, Ben; Raschke, Jim; Alexander, Andrew; Ross, Chris; Simmons, Heather; Sillay, Karl

2013-07-01

Convection enhanced delivery (CED) is emerging as a promising infusion toolto facilitate delivery of therapeutic agents into the brain via mechanically controlled pumps. Infusion protocols and catheter design have an important impact on delivery. CED is a valid alternative for systemic administration of agents in clinical trials for cell and gene therapies. Where gel and ex vivo models are not sufficient in modeling the disease, in vivo models allow researchers to better understand the underlying mechanisms of neuron degeneration, which is helpful in finding novel approaches to control the process or reverse the progression. Determining the risks, benefits, and efficacy of new gene therapies introduced via CED will pave a way to enter human clinical trial. The objective of this study is to compare volume distribution (Vd)/ volume infused (Vi) ratios and backflow measurements following CED infusions in ex vivo versus in vivo non-human primate brain tissue, based on infusion protocols developed in vitro. In ex vivo infusions, the first brain received 2 infusions using a balloon catheter at rates of 1 μL/min and 2 μL/min for 30 minutes. The second and third brains received infusions using a valve-tip (VT) catheter at 1 μL/min for 30 minutes. The fourth brain received a total of 45 μL infused at a rate of 1 μL/min for 15 minutes followed by 2 μL/min for 15 minutes. Imaging was performed (SPGR FA34) every 3 minutes. In the in vivo group, 4 subjects received a total of 8 infusions of 50 μL. Subjects 1 and 2 received infusions at 1.0 μL/min using a VT catheter in the left hemisphere and a smart-flow (SF) catheter in the right hemisphere. Subjects 3 and 4 each received 1 infusion in the left and right hemisphere at 1.0 μL/min. MRI calculations of Vd/Vi did not significantly differ from those obtained on post-mortem pathology. The mean measured Vd/Vi of in vivo (5.23 + /-1.67) compared to ex vivo (2.17 + /-1.39) demonstrated a significantly larger Vd/Vi for in vivo by 2.4 times (p = 0.0017). We detected higher ratios in the in vivo subjects than in ex vivo. This difference could be explained by the extra cellular space volume fraction. Studies evaluating backflow and morphology use in vivo tissue as a medium are recommended. Further investigation is warranted to evaluate the role blood pressure and heart rate may play in human CED clinical trials.

High-frequency percussive ventilation attenuates lung injury in a rabbit model of gastric juice aspiration.

PubMed

Allardet-Servent, Jérôme; Bregeon, Fabienne; Delpierre, Stéphane; Steinberg, Jean-Guillaume; Payan, Marie-José; Ravailhe, Sylvie; Papazian, Laurent

2008-01-01

To test the effects of high-frequency percussive ventilation (HFPV) compared with high-frequency oscillatory ventilation (HFOV) and low-volume conventional mechanical ventilation (LVCMV), on lung injury course in a gastric juice aspiration model. Prospective, randomized, controlled, in-vivo animal study. University animal research laboratory. Forty-three New Zealand rabbits. Lung injury was induced by intratracheal instillation of human gastric juice in order to achieve profound hypoxaemia (PaO2/FIO2< or =50). Animals were ventilated for 4h after randomization in one of the following four groups: HFPV (median pressure 15cmH2O); LVCMV (VT 6mlkg(-1) and PEEP set to reach 15cmH2O plateau pressure); HFOV (mean pressure 15cmH2O); and a high-volume control group HVCMV (VT 12ml kg(-1) and ZEEP). Static respiratory compliance increased after the ventilation period in the HFPV, LVMCV and HFOV groups, in contrast with the HVCMV group. PaO2/FIO2 improved similarly in the HFPV, LVCMV and HFOV groups, and remained lower in the HVCMV group than in the three others. Lung oedema, myeloperoxidase and histological lung injury score were higher in the HVCMV group, but not different among all others. Arterial lactate markedly increased after 4h of ventilation in the HVCMV group, while lower but similar levels were observed in the three other groups. HFPV, like HFOV and protective CMV, improves respiratory mechanics and oxygenation, and attenuates lung damage. The HFPV provides attractive lung protection, but further studies should confirm these results before introducing HFPV into the clinical arena.

A Special Ingredient (VtR) Containing Oligostilbenes Isolated from Vitis thunbergii Prevents Bone Loss in Ovariectomized Mice: In Vitro and In Vivo Study

PubMed Central

Huang, Yu-Ling; Liu, Yen-Wenn; Huang, Yu-Jou; Chiou, Wen-Fei

2013-01-01

Vitis thunbergii is used in Taiwan as a botanical supplement for inflammatory bone diseases. This study aims to examine its direct effect on bone metabolism. Three-month-old female mice were randomly divided into ovariectomized control (OVX), sham operated (SHAM), and ovariectomy treated with either 17β-estradiol or a special ingredient (VtR) fractionated from an ethanol extract of V. thunbergii started two weeks after ovariectomy. VtR treatment for 8 weeks significantly ameliorated the deterioration of bone mineral density and reversed all the ovariectomy-induced changes in  μ-CT parameters. The antiosteoporotic effect of VtR accompanied decrease in serum levels of C-terminal telopeptides of type I collagen (CTx), interleukin-7, and ration of RANKL/osteoprotegerin (OPG) but rise in osteocalcin concentration. Sparse calcified microarchitecture and less alkaline-phosphatase- (ALP-) positive cells were observed at the femur and vertebral sites in OVX mice while VtR remarkably restored such variation. HPLC analysis showed (+)-vitisin-A, (−)-vitisin-B, and ampelopsin C predominated in VtR. Both (−)-vitisin B and ampelopsin C increased ALP activity and bone nodule formation in cultured osteoblasts. Instead of stimulating osteoblastogenesis, (+)-vitisin A dramatically repressed osteoclasts differentiation and bone resorption. The results suggested VtR composed of diverse components to reciprocally drive osteoblastogenesis and interdict osteoclastogenesis may serve as a potential botanic drug for osteoporosis therapy. PMID:23662133

Trace metals in fugitive dust from unsurfaced roads in the Viburnum Trend resource mining District of Missouri--implementation of a direct-suspension sampling methodology.

PubMed

Witt, Emitt C; Wronkiewicz, David J; Pavlowsky, Robert T; Shi, Honglan

2013-09-01

Fugitive dust from 18 unsurfaced roadways in Missouri were sampled using a novel cyclonic fugitive dust collector that was designed to obtain suspended bulk samples for analysis. The samples were analyzed for trace metals, Fe and Al, particle sizes, and mineralogy to characterize the similarities and differences between roadways. Thirteen roads were located in the Viburnum Trend (VT) mining district, where there has been a history of contaminant metal loading of local soils; while the remaining five roads were located southwest of the VT district in a similar rural setting, but without any mining or industrial process that might contribute to trace metal enrichment. Comparison of these two groups shows that trace metal concentration is higher for dusts collected in the VT district. Lead is the dominant trace metal found in VT district dusts representing on average 79% of the total trace metal concentration, and was found moderately to strongly enriched relative to unsurfaced roads in the non-VT area. Fugitive road dust concentrations calculated for the VT area substantially exceed the 2008 Federal ambient air standard of 0.15μgm(-3) for Pb. The pattern of trace metal contamination in fugitive dust from VT district roads is similar to trace metal concentrations patterns observed for soils measured more than 40years ago indicating that Pb contamination in the region is persistent as a long-term soil contaminant. Published by Elsevier Ltd.

Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC).

PubMed

Abdullah, B J J; Mohammad, N; Sangkar, J V; Abd Aziz, Y F; Gan, G G; Goh, K Y; Benedict, I

2005-07-01

The objective of this study was to prospectively determine the incidence of venous thrombosis (VT) in the upper limbs in patients with peripherally inserted central catheters (PICC). We prospectively investigated the incidence of VT in the upper limbs of 26 patients who had PICC inserted. The inclusion criteria were all patients who had a PICC inserted, whilst the exclusion criterion was the inability to perform a venogram (allergies, previous contrast medium reaction and inability of gaining venous access). Both valved and non-valved catheters were evaluated. Prior to removal of the PICC, an upper limb venogram was performed. The number of segments involved with VT were determined. The duration of central venous catheterization was classified as; less than 6 days, between 6 days and 14 days and more than 14 days. VT was confirmed in 38.5% (10/26) of the patients. The majority 85.7% (12/14) were complete occlusive thrombi and the majority of VT only involved one segment. There was no statistical correlation between the site of insertion of the PICC and the location of VT. Neither was there any observed correlation between the occurrence of VT with the patient's history of hypertension, hypercholesterolaemia, coronary artery disease, diabetes mellitus, cardiac insufficiency, smoking or cancer. There was also no statistical correlation with the size of the catheter. In conclusion, PICCs are associated with a significant risk of upper extremity deep vein thrombosis (UEVT).

Volcano-Tectonic Activity at Deception Island Volcano Following a Seismic Swarm in the Bransfield Rift (2014-2015)

NASA Astrophysics Data System (ADS)

Almendros, J.; Carmona, E.; Jiménez, V.; Díaz-Moreno, A.; Lorenzo, F.

2018-05-01

In September 2014 there was a sharp increase in the seismic activity of the Bransfield Strait, Antarctica. More than 9,000 earthquakes with magnitudes up to 4.6 located SE of Livingston Island were detected over a period of 8 months. A few months after the series onset, local seismicity at the nearby (˜35 km) Deception Island volcano increased, displaying enhanced long-period seismicity and several outbursts of volcano-tectonic (VT) earthquakes. Before February 2015, VT earthquakes occurred mainly at 5-20 km SW of Deception Island. In mid-February the numbers and sizes of VT earthquakes escalated, and their locations encompassed the whole volcanic edifice, suggesting a situation of generalized unrest. The activity continued in anomalously high levels at least until May 2015. Given the spatial and temporal coincidence, it is unlikely that the Livingston series and the Deception VT swarm were unrelated. We propose that the Livingston series may have produced a triggering effect on Deception Island volcano. Dynamic stresses associated to the seismic swarm may have induced overpressure in the unstable volcanic system, leading to a magmatic intrusion that may in turn have triggered the VT swarm. Alternatively, both the Livingston earthquakes and the VT swarm could be consequences of a magmatic intrusion at Deception Island. The Livingston series would be an example of precursory distal VT swarm, which seems to be a common feature preceding volcanic eruptions and magma intrusions in long-dormant volcanoes.

Patterning of physiological and affective responses in older active adults during a maximal graded exercise test and self-selected exercise.

PubMed

Smith, Ashleigh E; Eston, Roger; Tempest, Gavin D; Norton, Belinda; Parfitt, Gaynor

2015-09-01

The American College of Sports Medicine has highlighted the importance of considering the physiological and affective responses to exercise when setting exercise intensity. Here, we examined the relationship between exercise intensity and physiological and affective responses in active older adults. Eighteen participants (60-74 years; 64.4 ± 3.9; 8 women) completed a maximal graded exercise test (GXT) on a treadmill. Since time to exhaustion in the GXT differed between participants, heart rate (HR), oxygen consumption (VO2), affective valence (affect) and rating of perceived exertion (RPE) were expressed relative to the individually determined ventilatory threshold (%atVT). During the GXT, VO2, HR and RPE increased linearly (all P < 0.01). Affect declined initially (but remained positive) (P = 0.03), stabilised around VT (still positive) (P > 0.05) and became negative towards the end of the test (P < 0.01). In a subsequent session, participants completed a 20-min bout of self-selected exercise (at a preferred intensity). Initially, participants chose to exercise below VT (88.2 ± 17.4 %VO2atVT); however, the intensity was adjusted to work at, or above VT (107.7 ± 19.9 %VO2atVT) after 10 min (P < 0.001), whilst affect remained positive. Together, these findings indicate that exercise around VT, whether administered during an exercise test, or self-selected by the participant, is likely to result in positive affective responses in older adults.

An Analysis of Hardware-Assisted Virtual Machine Based Rootkits

DTIC Science & Technology

2014-06-01

certain aspects of TPM implementation just to name a few. HyperWall is an architecture proposed by Szefer and Lee to protect guest VMs from...DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) The use of virtual machine (VM) technology has expanded rapidly since AMD and Intel implemented ...Intel VT-x implementations of Blue Pill to identify commonalities in the respective versions’ attack methodologies from both a functional and technical

Diversity and distribution of Listeria monocytogenes in meat processing plants.

PubMed

Martín, Belén; Perich, Adriana; Gómez, Diego; Yangüela, Javier; Rodríguez, Alicia; Garriga, Margarita; Aymerich, Teresa

2014-12-01

Listeria monocytogenes is a major concern for the meat processing industry because many listeriosis outbreaks have been linked to meat product consumption. The aim of this study was to elucidate L. monocytogenes diversity and distribution across different Spanish meat processing plants. L. monocytogenes isolates (N = 106) collected from food contact surfaces of meat processing plants and meat products were serotyped and then characterised by multilocus sequence typing (MLST). The isolates were serotyped as 1/2a (36.8%), 1/2c (34%), 1/2b (17.9%) and 4b (11.3%). MLST identified ST9 as the most predominant allelic profile (33% of isolates) followed by ST121 (16%), both of which were detected from several processing plants and meat products sampled in different years, suggesting that those STs are highly adapted to the meat processing environment. Food contact surfaces during processing were established as an important source of L. monocytogenes in meat products because the same STs were obtained in isolates recovered from surfaces and products. L. monocytogenes was recovered after cleaning and disinfection procedures in two processing plants, highlighting the importance of thorough cleaning and disinfection procedures. Epidemic clone (EC) marker ECI was identified in 8.5%, ECIII was identified in 2.8%, and ECV was identified in 7.5% of the 106 isolates. Furthermore, a selection of presumably unrelated ST9 isolates was analysed by multi-virulence-locus sequence typing (MVLST). Most ST9 isolates had the same virulence type (VT11), confirming the clonal origin of ST9 isolates; however, one ST9 isolate was assigned to a new VT (VT95). Consequently, MLST is a reliable tool for identification of contamination routes and niches in processing plants, and MVLST clearly differentiates EC strains, which both contribute to the improvement of L. monocytogenes control programs in the meat industry. Copyright © 2014 Elsevier Ltd. All rights reserved.

Protective mechanical ventilation, why use it?

PubMed

Seiberlich, Emerson; Santana, Jonas Alves; Chaves, Renata de Andrade; Seiberlich, Raquel Carvalho

2011-01-01

Mechanical ventilation (MV) strategies have been modified over the last decades with a tendency for increasingly lower tidal volumes (VT). However, in patients without acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) the use of high VTs is still very common. Retrospective studies suggest that this practice can be related to mechanical ventilation-associated ALI. The objective of this review is to search for evidence to guide protective MV in patients with healthy lungs and to suggest strategies to properly ventilate lungs with ALI/ARDS. A review based on the main articles that focus on the use of strategies of mechanical ventilation was performed. Consistent studies to determine which would be the best way to ventilate a patient with healthy lungs are lacking. Expert recommendations and current evidence presented in this article indicate that the use of a VT lower than 10 mL.kg(-1), associated with positive end-expiratory pressure (PEEP) ≥ 5 cmH(2)O without exceeding a pressure plateau of 15 to 20 cmH(2)O could minimize alveolar stretching at the end of inspiration and avoid possible inflammation or alveolar collapse. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

Breathing pattern and breathlessness in idiopathic pulmonary fibrosis: An observational study.

PubMed

Olukogbon, Kasope L; Thomas, Paul; Colasanti, Ricardo; Hope-Gill, Ben; Williams, Edgar Mark

2016-02-01

Idiopathic pulmonary fibrosis (IPF) is characterized by progressive decline in lung function and increasing dyspnoea. The aim of this study was to investigate the relationship among IPF, pulmonary function, resting tidal breathing patterns and level of breathlessness. Thirty-one participants with IPF and 17 matched healthy controls underwent lung function testing, followed by a 2-min period of resting tidal breathing. The IPF cohort was stratified according to disease severity, based on their forced vital capacity and diffusion capacity for carbon monoxide. In comparison to the healthy controls, the IPF cohort showed a higher tidal volume, VT , of 0.22 L (P = 0.026) and a raised minute ventilation in the severest IPF group, while no differences in the timing of inspiration or expiration were observed. In the IPF cohort, the ratio of VT to forced vital capacity was around 15% higher. These changes corresponded with an increase in the self-reported sensation of breathlessness. Those with IPF increased their depth of breathing with worsening disease severity, with IPF-induced changes in pulmonary function and breathlessness associated with an altered tidal breathing pattern. © 2015 Asian Pacific Society of Respirology.

Ventilatory threshold may be a more specific measure of aerobic capacity than peak oxygen consumption rate in persons with stroke.

PubMed

Boyne, Pierce; Reisman, Darcy; Brian, Michael; Barney, Brian; Franke, Ava; Carl, Daniel; Khoury, Jane; Dunning, Kari

2017-03-01

After stroke, aerobic deconditioning can have a profound impact on daily activities. This is usually measured by the peak oxygen consumption rate achieved during exercise testing (VO2-peak). However, VO2-peak may be distorted by motor function. The oxygen uptake efficiency slope (OUES) and VO2 at the ventilatory threshold (VO2-VT) could more specifically assess aerobic capacity after stroke, but this has not been tested. To assess the differential influence of motor function on three measures of aerobic capacity (VO2-peak, OUES, and VO2-VT) and to evaluate the inter-rater reliability of VO2-VT determination post-stroke. Among 59 persons with chronic stroke, cross-sectional correlations with motor function (comfortable gait speed [CGS] and lower extremity Fugl-Meyer [LEFM]) were compared between the different aerobic capacity measures, after adjustment for covariates, in order to isolate any distorting effect of motor function. Reliability of VO2-VT determination between three raters was assessed with intra-class correlation (ICC). CGS was moderately correlated with VO2-peak (r = 0.52, p < 0.0001) and weakly correlated with OUES (r = 0.41, p = 0.002) and VO2-VT (r = 0.37, p = 0.01). LEFM was weakly correlated with VO2-peak (r = 0.26, p = 0.055) and very weakly correlated with OUES (r = 0.19, p = 0.17) and VO2-VT (r = 0.14, p = 0.31). Compared to VO2-peak, VO2-VT was significantly less correlated with CGS (r difference = -0.16, p = 0.02). Inter-rater reliability of VO2-VT determination was high (ICC: 0.93, 95% CI: 0.89-0.96). Motor dysfunction appears to artificially lower measured aerobic capacity. VO2-VT seemed to be less distorted than VO2-peak and had good inter-rater reliability, so it may provide more specific assessment of aerobic capacity post-stroke.

Performance of Digital Communications over Selective Fading Channels.

DTIC Science & Technology

1983-09-01

and we assume that the "" receiver has compensated for the mean path delay td . Equivalently, we let d - : - 0 in order to establish a time reference...Pv dl g(V v( 4bd 2G2 E 211v/T2 (3.37) N0 4’. .4 which implies that iv is the key parameter in determining the signal-to-noise ratio for single-pulse...in (4.8) are defined by R-77 7777 7777,077 7-7.7 70 jnht(-b )/ Td Kv(h,bi,:) = , v(t) v(t-4) e h i dt (4.10a) and R=hbit v(t) v(t+T-4) e•j uh t (1- b

Ventricular tachycardia storm originating from interventricular septum successfully treated with surgical cryoablation with electroanatomic and electrophysiological mapping before dual valve replacement.

PubMed

Kawamura, Iwanari; Fukamizu, Seiji; Miyazawa, Satoshi; Hojo, Rintaro; Ito, Fusahiko; Watanabe, Masazumi; Nishizaki, Mitsuhiro; Sakurada, Harumizu; Hiraoka, Masayasu

2018-02-01

A 58-year-old man with dilated cardiomyopathy was admitted with heart failure. He had a history of two catheter ablation procedures for ventricular tachycardia (VT) originating from the intraventricular septum (IVS). Before dual valve replacement (DVR), he suffered a VT storm. An electrophysiological study revealed an extended low-voltage area at the IVS with the exit of the induced VT at the anterior side. Radiofrequency application was performed at the VT exit as a landmark for surgical cryoablation (SA). During the DVR, SA was performed at the IVS using this landmark. After SA, the patient had no ventricular tachyarrhythmia.

Arrhythmogenic substrate at the interventricular septum as a target site for radiofrequency catheter ablation of recurrent ventricular tachycardia in left dominant arrhythmogenic cardiomyopathy.

PubMed

Havranek, Stepan; Palecek, Tomas; Kovarnik, Tomas; Vitkova, Ivana; Psenicka, Miroslav; Linhart, Ales; Wichterle, Dan

2015-03-10

Left dominant arrhythmogenic cardiomyopathy (LDAC) is a rare condition characterised by progressive fibrofatty replacement of the myocardium of the left ventricle (LV) in combination with ventricular arrhythmias of LV origin. A thirty-five-year-old male was referred for evaluation of recurrent sustained monomorphic ventricular tachycardia (VT) of 200 bpm and right bundle branch block (RBBB) morphology. Cardiac magnetic resonance imaging showed late gadolinium enhancement distributed circumferentially in the epicardial layer of the LV free wall myocardium including the rightward portion of the interventricular septum (IVS). The clinical RBBB VT was reproduced during the EP study. Ablation at an LV septum site with absence of abnormal electrograms and a suboptimum pacemap rendered the VT of clinical morphology noninducible. Three other VTs, all of left bundle branch block (LBBB) pattern, were induced by programmed electrical stimulation. The regions corresponding to abnormal electrograms were identified and ablated at the mid-to-apical RV septum and the anteroseptal portion of the right ventricular outflow tract. No abnormalities were found at the RV free wall including the inferolateral peritricuspid annulus region. Histological examination confirmed the presence of abnormal fibrous and adipose tissue with myocyte reduction in endomyocardial samples taken from both the left and right aspects of the IVS. LDAC rarely manifests with sustained monomorphic ventricular tachycardia. In this case, several VTs of both RBBB and LBBB morphology were amenable to endocardial radiofrequency catheter ablation.

Better GGA and meta-GGA Functionals: VT84, meta-VMT, meta-VT84

NASA Astrophysics Data System (ADS)

Vela, Alberto; Martin Del Campo, J.; Gazquez, J. L.; Trickey, S. B.

2011-03-01

The goal of fast DFT calculations on large families of highly complicated systems (e.g. large clusters, biomolecules) implicitly conflicts with the heavy emphasis of recent years on inclusion of exact exchange. In response we have worked on improving non-empirical GGA X functionals. Here we report extension of our VMT GGA functional (J. Chem. Phys. 130 244103 (2009)) to satisfy a relevant asymptotic constraint, yielding the VT{84} X functional. With the PBE C functional, VT{84} gives about 10% improvement over VMT in energetics on the G3 223 molecule set. At the meta-GGA level of complexity, we have both meta-VMT and meta-{84}. The former is about 10% better on the G3 set than the TPSS meta-GGA, while meta-VT{84} gives roughly 10% further improvement over meta-VMT. Details of these assessments, including improvements in chemical shifts, will be presented. SBT acknowledges US DOE Grant DE-SC0002139.

Ventricular tachycardia in post-myocardial infarction patients. Results of surgical therapy.

PubMed

Viganò, M; Martinelli, L; Salerno, J A; Minzioni, G; Chimienti, M; Graffigna, A; Goggi, C; Klersy, C; Montemartini, C

1986-05-01

This report addresses the problems related to surgical treatment of post-infarction ventricular tachycardia (VT) and is based on a 5 year experience of 36 consecutive patients. In every case the arrhythmia was unresponsive to pharmacological therapy. All patients were operated on after the completion of a diagnostic protocol including preoperative endocardial, intra-operative epi-endocardial mapping, the latter performed automatically when possible. Surgical techniques were: classical Guiraudon's encircling endocardial ventriculotomy (EEV); partial EEV, endocardial resection (ER); cryoablation or a combination of these procedures. The in-hospital mortality (30 days) was 8.3% (3 patients). During the follow-up period (1-68 months), 3 patients (9%) died of cardiac but not VT related causes. Of the survivors, 92% are VT-free. We consider electrophysiologically guided surgery a safe and reliable method for the treatment of post-infarction VT and suggest its more extensive use. We stress the importance of automatic mapping in pleomorphic and non-sustained VT, and the necessity of tailoring the surgical technique to the characteristics of each case.

Catheter ablation of fatal ventricular tachyarrhythmias storm in acute coronary syndrome--role of Purkinje fiber network.

PubMed

Enjoji, Yoshihisa; Mizobuchi, Masahiro; Muranishi, Hiromi; Miyamoto, Chinae; Utsunomiya, Makoto; Funatsu, Atsushi; Kobayashi, Tomoko; Nakamura, Shigeru

2009-12-01

Ventricular fibrillation (VF) or ventricular tachycardia (VT) storm is a life-threatening arrhythmia. Antiarrhythmic drugs (AADs) are not necessarily effective to rescue life from such conditions. Catheter ablation (CA) targeting triggering premature ventricular contractions (PVCs) of VF or VT that originates from Purkinje fiber network (PFN) is reported to be effective, especially in idiopathic patients. However, in condition of acute coronary syndrome (ACS), the efficacy of CA is not well understood. To clarify the usefulness of CA as an alternative way to AADs, we performed CA in four patients with VF or VT storm. The Purkinje potential was seen just before the myocardial ventricular wave during sinus rhythm that became more prominent and double components during the initiating PVC at the targeted area. Following CA, spontaneous episodes of VF or VT were no longer observed. CA is an efficacious way to bail out PFN-related VF or VT storm even in ACS.

Vasculotide reduces endothelial permeability and tumor cell extravasation in the absence of binding to or agonistic activation of Tie2.

PubMed

Wu, Florence T H; Lee, Christina R; Bogdanovic, Elena; Prodeus, Aaron; Gariépy, Jean; Kerbel, Robert S

2015-06-01

Angiopoietin-1 (Ang1) activation of Tie2 receptors on endothelial cells (ECs) reduces adhesion by tumor cells (TCs) and limits junctional permeability to TC diapedesis. We hypothesized that systemic therapy with Vasculotide (VT)-a purported Ang1 mimetic, Tie2 agonist-can reduce the extravasation of potentially metastatic circulating TCs by similarly stabilizing the host vasculature. In vitro, VT and Ang1 treatments impeded endothelial hypermeability and the transendothelial migration of MDA-MB-231∙LM2-4 (breast), HT29 (colon), or SN12 (renal) cancer cells to varying degrees. In mice, VT treatment inhibited the transit of TCs through the pulmonary endothelium, but not the hepatic or lymphatic endothelium. In the in vivo LM2-4 model, VT monotherapy had no effect on primary tumors, but significantly delayed distant metastatic dissemination to the lungs. In the post-surgical adjuvant treatment setting, VT therapeutically complemented sunitinib therapy, an anti-angiogenic tyrosine kinase inhibitor which limited the local growth of residual disease. Unexpectedly, detailed investigations into the putative mechanism of action of VT revealed no evidence of Tie2 agonism or Tie2 binding; alternative mechanisms have yet to be determined. © 2015 The Authors. Published under the terms of the CC BY 4.0 license.

In Silico Template Selection of Short Antimicrobial Peptide Viscotoxin for Improving Its Antimicrobial Efficiency in Development of Potential Therapeutic Drugs.

PubMed

Senthilkumar, B; Rajasekaran, R

2017-03-01

Rapid increase in antibiotic resistance has posed a worldwide threat, due to increased mortality, morbidity, and expenditure caused by antibiotic-resistant microbes. Recent development of the antimicrobial peptides like viscotoxin (Vt) has been successfully comprehended as a substitute for classical antibiotics. A structurally stable peptide, Vt can enhance antimicrobial property and can be used for various developmental purposes. Thus, structural stability among the antimicrobial peptides, Vt A1 (3C8P), A2 (1JMN), A3 (1ED0), B (1JMP), and C (1ORL) of Viscus album was computationally analyzed. In specific, the static confirmation of VtA3 showed high number of intramolecular interactions, along with an increase in hydrophobicity than others comparatively. Further, conformational sampling was used to analyze various geometrical parameters such as root mean square deviation, root mean square fluctuation, radius of gyration, and ovality which also revealed the structural stability of VtA3. Moreover, the statistically validated contours of surface area, lipophilicity, and distance constraints of disulfide bonds also supported the priority of VtA3 with respect to stability. Finally, the functional activity of peptides was accessed by computing their free energy of membrane association and membrane interactions, which defined VtA3 as functionally stable. Currently, peptide-based antibiotics and nanoparticles have attracted the pharmaceutical industries for their potential therapeutic applications. Thereby, it is proposed that viscotoxin A3 (1ED0) could be used as a preeminent template for scaffolding potentially efficient antimicrobial peptide-based drugs and nanomaterials in future.

Eruption Forecasting in Alaska: A Retrospective and Test of the Distal VT Model

NASA Astrophysics Data System (ADS)

Prejean, S. G.; Pesicek, J. D.; Wellik, J.; Cameron, C.; White, R. A.; McCausland, W. A.; Buurman, H.

2015-12-01

United States volcano observatories have successfully forecast most significant US eruptions in the past decade. However, eruptions of some volcanoes remain stubbornly difficult to forecast effectively using seismic data alone. The Alaska Volcano Observatory (AVO) has responded to 28 eruptions from 10 volcanoes since 2005. Eruptions that were not forecast include those of frequently active volcanoes with basaltic-andesite magmas, like Pavlof, Veniaminof, and Okmok volcanoes. In this study we quantify the success rate of eruption forecasting in Alaska and explore common characteristics of eruptions not forecast. In an effort to improve future forecasts, we re-examine seismic data from eruptions and known intrusive episodes in Alaska to test the effectiveness of the distal VT model commonly employed by the USGS-USAID Volcano Disaster Assistance Program (VDAP). In the distal VT model, anomalous brittle failure or volcano-tectonic (VT) earthquake swarms in the shallow crust surrounding the volcano occur as a secondary response to crustal strain induced by magma intrusion. Because the Aleutian volcanic arc is among the most seismically active regions on Earth, distinguishing distal VT earthquake swarms for eruption forecasting purposes from tectonic seismicity unrelated to volcanic processes poses a distinct challenge. In this study, we use a modified beta-statistic to identify pre-eruptive distal VT swarms and establish their statistical significance with respect to long-term background seismicity. This analysis allows us to explore the general applicability of the distal VT model and quantify the likelihood of encountering false positives in eruption forecasting using this model alone.

Effects of Analgesic Use on Inflammation and Hematology in a Murine Model of Venous Thrombosis

PubMed Central

Hish, Gerald A; Diaz, Jose A; Hawley, Angela E; Myers, Daniel D; Lester, Patrick A

2014-01-01

Venous thrombosis (VT) is a significant cause of morbidity and mortality in humans. Surgical animal models are crucial in studies investigating the pathogenesis of this disease and evaluating VT therapies. Because inflammation is critical to both the development and resolution of VT, analgesic medications have the potential to adversely affect multiple parameters of interest in VT research. The objective of this study was to determine how several common analgesics affect key variables in a murine ligation model of deep vein thrombosis. Male C57BL/6 mice were randomly assigned to receive either local (bupivacaine) or systemic parenteral analgesia (buprenorphine, tramadol, or carprofen) or 0.9% NaCl (control). All mice underwent laparotomy and ligation of the inferior vena cava, and treatment was continued until euthanasia at 6 or 48 h after surgery. Analysis of harvested tissues and blood included: hematology, thrombus weight, serum and vein-wall cytokines (IL1β, IL6, IL10, TNFα), soluble P-selectin, and vein-wall leukocyte infiltration. Compared with 0.9% NaCl, all of the analgesics affected multiple parameters important to VT research. Carprofen and tramadol affected the most parameters and should not be used in murine models of VT. Although they affected fewer parameters, a single dose of bupivacaine increased thrombus weight at 6 h, and buprenorphine was associated with reduced vein wall macrophages at 48 h. Although we cannot recommend the use of any of the evaluated analgesic dosages in this mouse model of VT, buprenorphine merits additional investigation to ensure the highest level of laboratory animal care and welfare. PMID:25255071

Ventricular antitachycardia pacing therapy in patients with heart failure implanted with a cardiac resynchronization therapy defibrillator device: Efficacy, safety, and impact on mortality.

PubMed

Landolina, Maurizio; Lunati, Maurizio; Boriani, Giuseppe; Pietro Ricci, Renato; Proclemer, Alessandro; Facchin, Domenico; Rordorf, Roberto; Morani, Giovanni; Maines, Massimiliano; Gasparini, Gianni; Molon, Giulio; Turrini, Pietro; Gasparini, Maurizio

2016-02-01

Cardiac resynchronization therapy defibrillator can terminate ventricular tachycardia (VT) and fast VT (FVT) via antitachycardia pacing (ATP). We evaluated efficacy and safety of ATP, whether ATP induces ventricular arrhythmias after inappropriate ATP or atrial fibrillation (AF) after appropriate ATP, and whether ATP is associated with mortality. A total of 1404 patients with a cardiac resynchronization therapy defibrillator were followed in a prospective multicenter observational research. All-cause mortality rates were estimated in patient subgroups in order to uncouple the trigger (VT/FVT or other rhythms causing inappropriate detections) from ATP therapy. Over a median follow-up of 31 months, 2938 VT/FVT episodes were treated with ATP in 360 patients. The adjusted ATP success rate was 63% (95% confidence interval [CI] 57%-69%) on FVTs and 68% (95% CI 62%-74%) on VTs. Acceleration occurred in 55 (1.87%) and syncope in 4 (0.14%) of all ATP-treated episodes. In 14 true VT/FVT episodes in 5 patients, AF followed ATP therapy. In 4 episodes in 2 patients, VT followed ATP inappropriately applied during AF. Death rate per 100 patient-years was 5.6 (95% CI 4.3-7.5) in patients with appropriate ATP and 1.5 (95% CI 0.4-6.1) in patients with inappropriate ATP (P = .045). ATP was effective in terminating VT/FVT episodes and displayed a good safety profile. ATP therapies by themselves did not increase death risk; prognosis was indeed better in patients without arrhythmic episodes, even if they received inappropriate ATP, than in patients with ATP on VT/FVT episodes. Adverse outcomes observed in patients receiving implantable cardioverter-defibrillator therapies are probably related to the arrhythmia itself, a marker of disease progression, rather than to adverse effects of ATP. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Patterns of volcanotectonic seismicity and stress during the ongoing eruption of the Soufrière Hills Volcano, Montserrat (1995-2007)

USGS Publications Warehouse

Roman, D.C.; De Angelis, S.; Latchman, J.L.; White, Rickie

2008-01-01

The ongoing eruption of the Soufrière Hills Volcano, Montserrat, has been accompanied throughout by varying levels of high-frequency, ‘volcanotectonic’ (VT), seismicity. These earthquakes reflect the brittle response of the host rock to stresses generated within the magmatic system and thus reveal interesting and useful information about the structure of the volcanic conduit system and processes occurring within it. In general, systematic changes in the rate, location, and fault-plane solutions of VT earthquakes correspond to changes in the volcano's behavior, and indicate that the main conduit for the eruption is a dike or system of dikes trending NE–SW and centered beneath the eruptive vent. To date, the eruption has comprised three extrusive phases, separated by two ~ 1–2 year-long periods of residual activity. Prior to the start of each extrusive phase, VT earthquakes with fault-plane solution p-axes oriented perpendicular to inferred regional maximum compression dominate the data set, consistent with stresses induced by the inflation of the mid-level conduit system. ~ 90°-rotated VT fault-plane solutions are also observed preceding a change in eruption style from effusive to explosive in 1997. While increases in the rate of VT earthquakes precede eruption phase onsets, high rates of VT seismicity are also observed during the first period of residual activity and in this case appear to reflect the relaxation of host rock following withdrawal of magma from the mid-crustal system. Most VT earthquakes are located directly beneath the eruptive vent, although two ‘distal VT clusters’ were observed during the first six months of the eruption (late 1995–early 1996). Both of these distal clusters likely resulted from stresses generated during the establishment of the main conduit system.

Expression of RXR, EcR, E75 and VtG mRNA levels in the hepatopancreas and ovary of the freshwater edible crab, Oziothelphusa senex senex (Fabricius, 1798) during different vitellogenic stages

NASA Astrophysics Data System (ADS)

Girish, B. P.; Swetha, CH.; Reddy, P. Sreenivasula

2015-04-01

The objective of the present study was to investigate the expression profile of retinoid X receptor ( RXR), ecdysone receptor ( EcR) and ecdysone inducible gene ( E75) in the hepatopancreas and ovary of Oziothelphusa senex senex during different vitellogenic stages. RXR, EcR and E75 complementary DNAs (cDNAs) were isolated from the ovaries, while vitellogenin ( VtG) cDNA was isolated from the hepatopancreas of vitellogenic female crab. Deduced amino acid sequence of the messenger RNAs (mRNAs) of RXR, EcR and E75 showed more than 80 % identity with their respective mRNAs of other brachyurans. VtG mRNA was not detected in the ovary throughout vitellogenic stages. RXR and EcR were significantly increased in the ovaries during vitellogenic stage I. The levels of EcR, E75 and VtG in the hepatopancreas elevated significantly during vitellogenic stages I and II, whereas the levels of RXR elevated only in vitellogenic stage I. During vitellogenic stage III, the levels of RXR, EcR and VtG in the hepatopancreas were significantly decreased. Immunoprecipitation analysis revealed the presence of VtG in the haemolymph, hepatopancreas and ovary extracts from the females but absent in haemolymph and hepatopancreas extract of males. It can be inferred that RXR, EcR and E75 are involved in the regulation of synthesis of VtG in hepatopancreas, whereas in ovary, it is hypothesized that they play an important role in the uptake of VtG from the haemolymph, probably by regulating the levels of vitellogenin receptor. These are the first data showing an association between the expression levels of RXR, EcR and E75 and vitellogenesis and provide an alternative molecular intervention mechanism to the traditional eyestalk ablation to induce vitellogenesis and ovarian maturation in crustaceans.

Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study

PubMed Central

Benchimol-Barbosa, P.R.; Tura, B.R.; Barbosa, E.C.; Kantharia, B.K.

2013-01-01

The SEARCH-RIO study prospectively investigated electrocardiogram (ECG)-derived variables in chronic Chagas disease (CCD) as predictors of cardiac death and new onset ventricular tachycardia (VT). Cardiac arrhythmia is a major cause of death in CCD, and electrical markers may play a significant role in risk stratification. One hundred clinically stable outpatients with CCD were enrolled in this study. They initially underwent a 12-lead resting ECG, signal-averaged ECG, and 24-h ambulatory ECG. Abnormal Q-waves, filtered QRS duration, intraventricular electrical transients (IVET), 24-h standard deviation of normal RR intervals (SDNN), and VT were assessed. Echocardiograms assessed left ventricular ejection fraction. Predictors of cardiac death and new onset VT were identified in a Cox proportional hazard model. During a mean follow-up of 95.3 months, 36 patients had adverse events: 22 new onset VT (mean±SD, 18.4±4‰/year) and 20 deaths (26.4±1.8‰/year). In multivariate analysis, only Q-wave (hazard ratio, HR=6.7; P<0.001), VT (HR=5.3; P<0.001), SDNN<100 ms (HR=4.0; P=0.006), and IVET+ (HR=3.0; P=0.04) were independent predictors of the composite endpoint of cardiac death and new onset VT. A prognostic score was developed by weighting points proportional to beta coefficients and summing-up: Q-wave=2; VT=2; SDNN<100 ms=1; IVET+=1. Receiver operating characteristic curve analysis optimized the cutoff value at >1. In 10,000 bootstraps, the C-statistic of this novel score was non-inferior to a previously validated (Rassi) score (0.89±0.03 and 0.80±0.05, respectively; test for non-inferiority: P<0.001). In CCD, surface ECG-derived variables are predictors of cardiac death and new onset VT. PMID:24270912

[Relevance of Vascular Trauma in Trauma Care - Impact on Clinical Course and Mortality].

PubMed

Lech, L; Jerkku, T; Kanz, K-G; Wierer, M; Mutschler, W; Koeppel, T A; Lefering, R; Banafsche, R

2016-10-01

There is a lack of evidence as to the relevance of vascular trauma (VT) in patients with severe injuries. Therefore, we reviewed registry data in the present study in order to systematically objectify the effect of VT in these patients. This study aimed to provide an adequate picture of the relevance of vascular trauma and to identify adverse prognostic factors. In a retrospective analysis of records from the TraumaRegister DGU® (TR-DGU) in two subgroups with moderate and severe VT, we examined the records for differences in terms of morbidity, mortality, follow-up and prognostic parameters compared to patients without VT with the same ISS. From a total of 42,326 patients, 2,961 (7 %) had a VT, and in 2,437 cases a severe VT (AIS ≥ 3) was diagnosed (5.8 %). In addition to a higher incidence of shock and a 2 to 3-fold increase in fluid replacement and erythrocyte transfusion, patients with severe VT had a 60 % higher rate of multiple organ failure, and in-hospital mortality was twice as high (33.8 %). The massively increased early mortality (8.0 vs. 25.2 %) clearly illustrates how severely injured patients are placed at risk by the presence of a relevant VT with a comparable ISS. In our opinion, due to an unexpected poor prognosis in the TR-DGU data for vascular injuries, increased attention is required in the care of severely injured patients. Based on our comprehensive analysis of negative prognostic factors, a further adjustment to the standards of vascular medicine could be advisable. The influence of the level of care provided by the admitting hospital and the relevance of a further hospital transfer to prognosis and clinical outcome is currently being analysed. Georg Thieme Verlag KG Stuttgart · New York.

A Novel Low-Energy Electrotherapy That Terminates Ventricular Tachycardia With Lower Energy than a Biphasic Shock When Anti-Tachycardia Pacing Fails

PubMed Central

Janardhan, Ajit H.; Li, Wenwen; Fedorov, Vadim V.; Yeung, Michael; Wallendorf, Michael J.; Schuessler, Richard B.; Efimov, Igor R.

2015-01-01

Objectives To develop a low-energy electrotherapy that terminates ventricular tachycardia (VT) when anti-tachycardia pacing (ATP) fails. Background High-energy ICD shocks are associated with device failure, significant morbidity and increased mortality. A low-energy alternative to ICD shocks is desirable. Methods Myocardial infarction (MI) was created in 25 dogs. Sustained, monomorphic VT was induced by programmed stimulation. Defibrillation electrodes were placed in the RV apex, and coronary sinus (CS) and LV epicardium (LVP). If ATP failed to terminate sustained VT, the defibrillation thresholds (DFTs) of standard versus experimental electrotherapies were measured. Results Sustained VT ranged from 276–438 bpm (mean 339 bpm). The RV-CS shock vector had lower impedance than RV-LVP (54.4±18.1 Ω versus 109.8±16.9, Ω p<0.001). A single shock required between 0.3±0.2 J to 5.9±2.5 J (mean 2.64±3.22 J; p=0.008) to terminate VT, and varied depending upon the phase of the VT cycle at which it was delivered. In contrast, multiple shocks delivered within 1 VT cycle length were not phase-dependent and achieved lower DFT compared to a single shock (0.13±0.09 J for 3 shocks, 0.08±0.04 J for 5 shocks, 0.09±0.07 J for 7 shocks; p<0.001). Finally, a multi-stage electrotherapy (MSE) achieved significantly lower DFT compared to a single biphasic shock (0.03±0.05 J versus 2.37±1.20 J, respectively, p<0.001). At a peak shock amplitude of 20 V, MSE achieved 91.3% of terminations versus 10.5% for a biphasic shock (p<0.001). Conclusions MSE achieved a major reduction in DFT compared to a single biphasic shock for ATP-refractory monomorphic VT, and represents a novel electrotherapy to reduce high-energy ICD shocks. PMID:23141483

Infection by verocytotoxin-producing Escherichia coli.

PubMed Central

Karmali, M A

1989-01-01

Verocytotoxin (VT)-producing Escherichia coli (VTEC) are a newly recognized group of enteric pathogens which are increasingly being recognized as common causes of diarrhea in some geographic settings. Outbreak studies indicate that most patients with VTEC infection develop mild uncomplicated diarrhea. However, a significant risk of two serious and potentially life-threatening complications, hemorrhagic colitis and the hemolytic uremic syndrome, makes VTEC infection a public health problem of serious concern. The main reservoirs of VTEC appear to be the intestinal tracts of animals, and foods of animal (especially bovine) origin are probably the principal sources for human infection. The term VT refers to a family of subunit exotoxins with high biological activity. Individual VTEC strains elaborate one or both of at least two serologically distinct, bacteriophage-mediated VTs (VT1 and VT2) which are closely related to Shiga toxin and are thus also referred to as Shiga-like toxins. The holotoxins bind to cells, via their B subunits, to a specific receptor which is probably the glycolipid, globotriosyl ceramide (Gb3). Binding is followed by internalization of the A subunit, which, after it is proteolytically nicked and reduced to the A1 fragment, inhibits protein synthesis in mammalian cells by inactivating 60S ribosomal subunits through selective structural modification of 28S ribosomal ribonucleic acid. The mechanism of VTEC diarrhea is still controversial, and the relative roles of locally acting VT and "attaching and effacing adherence" of VTEC to the mucosa have yet to be resolved. There is increasing evidence that hemolytic uremic syndrome and possibly hemorrhagic colitis result from the systemic action of VT on vascular endothelial cells. The role of antitoxic immunity in preventing the systemic complications of VTEC infection is being explored. Antibiotics appear to be contraindicated in the treatment of VTEC infection. The most common VTEC serotype associated with human disease is O157:H7, but over 50 different VT-positive O:H serotypes have now been identified. The best strategies for diagnosing human VTEC infection include testing for the presence of free VT in fecal filtrates and examining fecal cultures for VTEC by means of deoxyribonucleic acid probes that specify genes encoding VT1 and VT2. Both methods are currently confined to specialized laboratories and await commercial development for wider use. In the meantime, most laboratories should continue to screen for the most common human VTEC serotype, O157:H7, using a sorbitol-containing MacConkey medium. Images PMID:2644022

On the Generation of Stress and Deformation in Elastic Solids by High Powered Lasers

DTIC Science & Technology

1980-09-01

isothermal shock problems and are of particular signifi- cance in the absa rpion of x rays. However, this class would appear to be of an academic interest only...distributions, measured above and 97 below ielting , i.e., T ÷T + U and T - T + U, respectively U - d(t) + e(t)x + fVt)x0 on 0 < x < a (21a) U - a(t

[Effects of tillage at pre-planting of winter wheat and summer maize on leaf senescence of summer maize].

PubMed

Li, Xia; Zhang, Ji-wang; Ren, Bai-zhao; Fan, Xia; Dong, Shu-ting; Liu, Peng; Zhao, Bin

2015-05-01

This study explored the effects of different tillage treatments at pre-planting winter wheat and summer maize on leaf senescence physiological characteristics of summer maize in double cropping system. Zhengdan 958 was used as experimental material. Three tillage treatments, including rotary tillage before winter wheat seeding and no-tillage before summer maize seeding (RN), mold- board plow before winter wheat seeding and no-tillage before summer maize seeding (MN), and moldboard plow before winter wheat seeding and rotary tillage before summer maize seeding (MR), were designed to determine the effects of different tillage treatments on leaf area (LA) , leaf area reduction, photosynthetic pigments content, superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) activities and malondialdehyde (MDA) content in ear leaves of summer maize after tasselling (VT). LA of MN and MR were higher than that of RN from VT to 40 days after tasseling (VT + 40) and LA reduction of MR was the highest after VT + 40. As for MR, MN and NT, the photosynthetic pigments content got the maximum value at 20 days after tasselling (VT + 20) and then decreased, following the change of unimodal curve. At VT + 20, the contents of chlorophyll a in MR and MN were increased by 11.4% and 9.7%, the contents of chlorophyll b in MR and MN were increased by 14.9% and 15.9%, compared with RN. The soluble protein content in ear leaves decreased following the growth process in all treatments, and that of MR and MN remained 11.5% and 24.4% higher than that of RN from VT to VT + 40. SOD, CAT and POD activities of three treatments got the maximum values at VT + 20 and then decreased, following the change of unimodal curve. MDA content increased following the growth process in all treatments and that of RN always remained at high levels. Grain yields of MN and MR were 24.0% and 30.6% greater than that of RN, respectively. Grain yield of MR was 5.2% higher than that of MN. In conclusion, the ability of leaf senescence resistance of MN was improved, which was helpful to increase the yield of summer maize.

Dual chamber arrhythmia detection in the implantable cardioverter defibrillator.

PubMed

Dijkman, B; Wellens, H J

2000-10-01

Dual chamber implantable cardioverter defibrillator (ICD) technology extended ICD therapy to more than termination of hemodynamically unstable ventricular tachyarrhythmias. It created the basis for dual chamber arrhythmia management in which dependable detection is important for treatment and prevention of both ventricular and atrial arrhythmias. Dual chamber detection algorithms were investigated in two Medtronic dual chamber ICDs: the 7250 Jewel AF (33 patients) and the 7271 Gem DR (31 patients). Both ICDs use the same PR Logic algorithm to interpret tachycardia as ventricular tachycardia (VT), supraventricular tachycardia (SVT), or dual (VT+ SVT). The accuracy of dual chamber detection was studied in 310 of 1,367 spontaneously occurring tachycardias in which rate criterion only was not sufficient for arrhythmia diagnosis. In 78 episodes there was a double tachycardia, in 223 episodes SVT was detected in the VT or ventricular fibrillation zone, and in 9 episodes arrhythmia was detected outside the boundaries of the PR Logic functioning. In 100% of double tachycardias the VT was correctly diagnosed and received priority treatment. SVT was seen in 59 (19%) episodes diagnosed as VT. The causes of inappropriate detection were (1) algorithm failure (inability to fulfill the PR

Nasopharyngeal Pneumococcal Colonization and Impact of a Single Dose of 13-Valent Pneumococcal Conjugate Vaccine in Indian Children With HIV and Their Unvaccinated Parents.

PubMed

Arya, Bikas K; Bhattacharya, Sangeeta Das; Sutcliffe, Catherine G; Ganaie, Feroze; Bhaskar, Arun; Bhattacharyya, Subhasish; Niyogi, Swapan Kumar; Moss, William J; Panda, Samiran; Ravikumar, Kadahalli Lingegowda; Das, Ranjan Saurav; Mandal, Sutapa

2018-05-01

Human immunodeficiency virus (HIV) infection increases risk of invasive disease from Streptococcus pneumoniae. Pneumococcal conjugate vaccines (PCV) prevent invasive disease and acquisition of vaccine type (VT) pneumococcus in the nasopharynx. To look at the safety and impact of one dose of PCV13 on acquisition of VT pneumococcal carriage in Indian children with HIV. We conducted a cohort study in families of HIV-infected children (CLH) and families of HIV-uninfected children (HUC) in West Bengal. All children received one dose of PCV13. Nasopharyngeal swabs were collected from children and parents at baseline and 2 months after vaccination. One hundred and fifteen CLH and 47 HUC received one dose of PCV13. Fifty-eight percent of CLH were on antiretroviral therapy (ART), and the median nadir CD4 count was 287. There were no significant adverse events in either group. HUC had more VT colonization than CLH-55% versus 23% of all pneumococcal isolates. HIV infection doubled the risk of nonvaccine serotype colonization (P = 0.03). There was no difference in acquisition of VT isolates in CLH (4.4%) and HUC (4.5%) post-PCV13; however, older CLH (>5 years) had decreased clearance of VT strains. ART made no difference in pneumococcal colonization at baseline or after PCV13; however, CLH with higher nadir CD4 counts before starting ART were less likely to have VT colonization post-PCV13 (prevalence ratio, 0.2; 95% confidence interval: 0.1-0.5). While there was no difference in acquisition of VT nasopharyngeal carriage of pneumococcus in CLH and HUC after one dose of PCV13, earlier access to ART may impact response to PCV13 in CLH.

Cellular Mechanism Underlying Hypothermia-Induced VT/VF in the Setting of Early Repolarization and the Protective Effect of Quinidine, Cilostazol and Milrinone

PubMed Central

Gurabi, Zsolt; Koncz, István; Patocskai, Bence; Nesterenko, Vladislav V.; Antzelevitch, Charles

2014-01-01

Background Hypothermia has been reported to induce ventricular tachycardia and fibrillation (VT/VF) in patients with early repolarization (ER) pattern. This study examines the cellular mechanisms underlying VT/VF associated with hypothermia in an experimental model of ER syndrome (ERS) and examines the effectiveness of quinidine, cilostazol and milrinone to prevent hypothermia-induced arrhythmias. Method and Results Transmembrane action potentials (AP) were simultaneously recorded from 2 epicardial and 1 endocardial site of coronary-perfused canine left-ventricular wedge preparations, together with a pseudo-ECG. A combination of NS5806 (3–10 µM) and verapamil (1µM) was used to pharmacologically model the genetic mutations responsible for ERS. Acetylcholine (3µM) was used to simulate increased parasympathetic tone, which is known to promote ER. In control, lowering the temperature of the coronary perfusate to induce mild hypothermia (32°C-34°C) resulted in increased J wave area on the ECG and accentuated epicardial AP notch but no arrhythmic activity. In the setting of ER, hypothermia caused further accentuation of the epicardial AP notch, leading to loss of the AP dome at some sites but not others, thus creating the substrate for development of phase-2-reentry and VT/VF. Addition of the Ito antagonist quinidine (5 µM) or the phosphodiesterase III inhibitors cilostazol (10 µM) or milrinone (5 µM), diminished the ER manifestations and prevented the hypothermia-induced phase 2 reentry and VT/VF. Conclusions Hypothermia leads to VT/VF in the setting of ER by exaggerating repolarization abnormalities, leading to development of phase-2-reentry. Quinidine, cilostazol and milrinone suppress the hypothermia-induced VT/VF by reversing the repolarization abnormalities. PMID:24429494

QT/RR relationship in patients after remote anterior myocardial infarction with left ventricular dysfunction and different types of ventricular arrhythmias.

PubMed

Szydlo, Krzysztof; Trusz-Gluza, Maria; Wita, Krystian; Filipecki, Artur; Orszulak, Witold; Urbanczyk, Dagmara; Krauze, Jolanta; Kolasa, Jaroslaw; Tabor, Zbigniew

2008-01-01

QT/RR relationship was found to be both rate-dependent and rate-independent, what suggests the influence of autonomic drive and other not-autonomic related factors on it. The steeper QT/RR slope in patients after acute myocardial infarction (MI) was described, but the relationship to ventricular arrhythmias is unknown. The purpose of this study was to calculate differences in QT/RR relationship in patients after remote anterior MI with left ventricular dysfunction and different types of ventricular arrhythmias. The cohort of 95 patients (age: 63 +/- 11 years, LVEF: 35 +/- 9%) with previous anterior MI (mean 1.1 years) was divided into two well-matched groups-50 patients without episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) (NoVT/VF: 39 males, 64 +/- 12 years, LVEF 37 +/- 8%) and 45 patients with VT and/or VF (all with ICD implanted) (VT/VF: 35 males, 62 +/- 10 years, LVEF 34 +/- 10%). No true antiarrhythmics were used. QT/RR slope was calculated from 24-hour Holter ECG for the entire recording (E), daytime (D) and nighttime (N) periods. Groups did not differ in basic clinical data (age, LVEF, treatment). QT/RR slopes were steeper in VT/VF than in NoVT/VF group in all analyzed periods: E - 0.195 +/- 0.03 versus 0.15 +/- 0.03 (P < 0.001), N - 0.190 +/- 0.03 versus 0.138 +/- 0.03 (P < 0.001) and D - 0.200 +/- 0.04 versus 0.152 +/- 0.03 (P < 0.001). No significant day-to-night differences were found in both groups. Steeper QT/RR slope and complete lack of day-to-night differences in VT/VF patients show inappropriate QT adaptation to the heart rate changes. The prognostic significance of this parameter needs prospective studies.

Value of right ventricular mapping in patients with postinfarction ventricular tachycardia.

PubMed

Yokokawa, Miki; Good, Eric; Crawford, Thomas; Chugh, Aman; Pelosi, Frank; Latchamsetty, Rakesh; Oral, Hakan; Morady, Fred; Bogun, Frank

2012-06-01

Postinfarction ventricular tachycardia (VT) typically involves the left ventricular endocardium. Right ventricular involvement in the arrhythmogenic substrate of postinfarction VT is considered unusual. To assess the role of right ventricular mapping and ablation in patients with prior septal myocardial infarction. From among 37 consecutive patients with recurrent postinfarction VT, 18 patients with evidence of left ventricular septal involvement of myocardial infarction were identified; these patients were the subjects of this report. In these 18 patients, 166 VTs (cycle length 372 ± 117 ms) were induced. Right ventricular voltage mapping was performed in all 18 patients with left ventricular septal myocardial infarction. Right ventricular voltage mapping showed areas of low voltage in 11 patients; pace mapping from these areas revealed matching pace maps for 17 VTs, and radiofrequency ablation from the right ventricular endocardium but not the left ventricular endocardium eliminated 14 of 17 VTs. VTs with critical components in the right ventricle had a left bundle branch block morphology that had similar characteristics as left bundle branch block VTs with critical areas involving the left ventricular septum. Patients with right ventricular VT breakthrough sites had a lower ejection fraction than did patients without VT breaking out on the right ventricular septum (18% ± 5% vs 33% ± 15%; P = .01). Right ventricular mapping and ablation may be necessary in order to eliminate all inducible VTs in patients with postinfarction VT. More than half the patients with septal myocardial infarction have right ventricular septal areas that are critical for postinfarction VT and that cannot be eliminated by left ventricular ablation alone. Copyright © 2012 Heart Rhythm Society. All rights reserved.

Endotoxaemia-augmented murine venous thrombosis is dependent on TLR-4 and ICAM-1, and potentiated by neutropenia.

PubMed

Obi, Andrea T; Andraska, Elizabeth; Kanthi, Yogendra; Kessinger, Chase W; Elfline, Megan; Luke, Cathy; Siahaan, Teruna J; Jaffer, Farouc A; Wakefield, Thomas W; Henke, Peter K

2017-01-26

Venous thromboembolism is a major cause of death during and immediately post-sepsis. Venous thrombosis (VT) is mediated by cell adhesion molecules and leukocytes, including neutrophil extracellular traps (NETs). Sepsis, or experimentally, endotoxaemia, shares similar characteristics and is modulated via toll like receptor 4 (TLR4). This study was undertaken to determine if endotoxaemia potentiates early stasis thrombogenesis, and secondarily to determine the role of VT TLR4, ICAM-1 and neutrophils (PMNs). Wild-type (WT), ICAM-1 -/- and TLR4 -/- mice underwent treatment with saline or LPS (10 mg/kg i. p.) alone, or followed by inferior vena cava (IVC) ligation to generate stasis VT. In vivo microscopy of leukocyte trafficking was performed in non-thrombosed mice, and tissue and plasma were harvested during early VT formation. Pre-thrombosis, circulating ICAM-1 was elevated and increased leukocyte adhesion and rolling occurred on the IVC of LPS-treated mice. Post-thrombosis, endotoxaemic mice formed larger, platelet-poor thrombi. Endotoxaemic TLR4 -/- mice did not have an augmented thrombotic response and exhibited significantly decreased circulating ICAM-1 compared to endotoxaemic WT controls. Endotoxaemic ICAM-1 -/- mice had significantly smaller thrombi compared to controls. Hypothesising that PMNs localised to the inflamed endothelium were promoting thrombosis, PMN depletion using anti-Ly6G antibody was performed. Paradoxically, VT formed without PMNs was amplified, potentially related to endotoxaemia induced elevation of PAI-1 and circulating FXIII, and decreased uPA. Endotoxaemia enhanced early VT occurs in a TLR-4 and ICAM-1 dependent fashion, and is potentiated by neutropenia. ICAM-1 and/or TLR-4 inhibition may be a unique strategy to prevent sepsis-associated VT.

Dissociation of hemodynamic and electrocardiographic indexes of myocardial ischemia in pigs with hibernating myocardium and sudden cardiac death.

PubMed

Pizzuto, Matthew F; Suzuki, Gen; Banas, Michael D; Heavey, Brendan; Fallavollita, James A; Canty, John M

2013-06-15

Many survivors of sudden cardiac death (SCD) have normal global ventricular function and severe coronary artery disease but no evidence of symptomatic ischemia or infarction before the development of lethal ventricular arrhythmias, and the trigger for ventricular tachycardia (VT)/ventricular fibrillation (VF) remains unclear. We sought to identify the role of spontaneous ischemia and temporal hemodynamic factors preceding SCD using continuous telemetry of left ventricular (LV) pressure and the ECG for periods up to 5 mo in swine (n = 37) with hibernating myocardium who experience spontaneous VT/VF in the absence of heart failure or infarction. Hemodynamics and ST deviation at the time of VT/VF were compared with survivors with hibernating myocardium as well as sham controls. All episodes of VT/VF occurred during sympathetic activation and were initiated by single premature ventricular contractions, and the VT degenerated into VF in ∼ 30 s. ECG evidence of ischemia was infrequent and no different from those that survived. Baseline hemodynamics were no different among groups, but LV end-diastolic pressure during sympathetic activation was higher at the time of SCD (37 ± 4 vs. 26 ± 4 mmHg, P < 0.05) and the ECG demonstrated QT shortening (155 ± 4 vs. 173 ± 5 ms, P < 0.05). The week before SCD, both parameters were no different from survivors. These data indicate that there are no differences in the degree of sympathetic activation or hemodynamic stress when VT/VF develops in swine with hibernating myocardium. The transiently elevated LV end-diastolic pressure and QT shortening preceding VT/VF raises the possibility that electrocardiographically silent subendocardial ischemia and/or mechanoelectrical feedback serve as a trigger for the development of SCD in chronic ischemic heart disease.

Efficacy of implantable cardioverter defibrillators in young patients with catecholaminergic polymorphic ventricular tachycardia: success depends on substrate.

PubMed

Miyake, Christina Y; Webster, Gregory; Czosek, Richard J; Kantoch, Michal J; Dubin, Anne M; Avasarala, Kishor; Atallah, Joseph

2013-06-01

The effectiveness of implantable cardioverter-defibrillator (ICD) therapy for the management of catecholaminergic polymorphic ventricular tachycardia (VT) in young patients is not known. ICD discharges are not always effective and inappropriate discharges are common, both resulting in morbidity and mortality. This is a multicenter, retrospective review of young patients with catecholaminergic polymorphic VT and ICDs from 5 centers. ICD discharges were evaluated to determine arrhythmia mechanism, appropriateness, efficacy of therapy, and complications. A total of 24 patients were included. Median (interquartile range) ages at onset of catecholaminergic polymorphic VT symptoms and ICD implant were 10.6 (5.0-13.8) years and 13.7 (10.7-16.3) years, respectively. Fourteen patients received 140 shocks. Ten patients (42%) experienced 75 appropriate shocks and 11 patients (46%) received 65 inappropriate shocks. On actuarial analysis, freedom from appropriate shock at 1 year after ICD implant was 75%. Of appropriate shocks, only 43 (57%) demonstrated successful primary termination. All successful appropriate ICD discharges were for ventricular fibrillation. No episodes of polymorphic VT or bidirectional VT demonstrated successful primary termination. The adjusted mean (95% confidence interval) cycle length of successful discharges was significantly shorter than unsuccessful discharges (168 [152-184] ms versus 245 [229-262] ms; adjusted P=0.002). Electrical storm occurred in 29% (4/14) and induction of more malignant ventricular arrhythmias in 36% (5/14). There were no deaths. ICD efficacy in catecholaminergic polymorphic VT depends on arrhythmia mechanism. Episodes of ventricular fibrillation were uniformly successfully treated, whereas polymorphic and bidirectional VT did not demonstrate successful primary termination. Inappropriate shocks, electrical storm, and ICD complications were common.

Scar extent as a predictive factor of ventricular tachycardia cycle length after myocardial infarction: implications for implantable cardioverter-defibrillator programming optimization.

PubMed

Alexandre, Joachim; Saloux, Eric; Lebon, Alain; Dugué, Audrey Emmanuelle; Lemaitre, Adrien; Roule, Vincent; Labombarda, Fabien; Champ-Rigot, Laure; Gomes, Sophie; Pellissier, Arnaud; Scanu, Patrice; Milliez, Paul

2014-02-01

After an old myocardial infarction (MI), patients are at risk for reentrant ventricular tachycardia (VT) due to scar tissue that can be accurately identified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Although the ability of LGE-CMR to predict sustained VT in implantable cardioverter-defibrillator (ICD) recipients has been well established, its use to predict monomorphic VT (sustained or not) cycle length (CL) and so, optimize ICD programming has never been investigated. We included retrospectively 49 consecutive patients with an old MI who had undergone LGE-CMR before ICD implantation over a 4-year period (2006-09). Patients with amiodarone used were excluded. Scar extent was assessed by measuring scar mass, percent scar, and transmural scar extent. The endpoint was the occurrence of monomorphic VT, requiring an ICD therapy or not. The endpoint occurred in 26 patients. The median follow-up duration was 31 months. Scar extent parameters were significantly correlated with the study endpoint. With univariate regression analysis, the scar mass had the highest correlation with the VT CL (R = 0.671, P = 0.0002). Receiver-operating characteristic curve showed that scar mass can predict VT CL (area under the curve = 0.977, P < 0.0001). For a cut-off value of scar mass at 17.6 g, there is 100% specificity and 94.4% sensitivity. In this observational and retrospective study, scar mass studied by LGE-CMR was specific and sensitive to predict VT CL and so could be a promising option to improve ICD post-implantation programming and decrease appropriate and inappropriate shocks. These conclusions must now be confirmed in a large and prospective study.

Three-dimensional assessment of postural tremor during goal-directed aiming.

PubMed

Kelleran, K J; Morrison, S; Russell, D M

2016-12-01

The performance of fine motor tasks which require a degree of precision can be negatively affected by physiological tremor. This study examined the effect of different aiming positions on anterior-posterior (AP), medial-lateral (ML) and vertical (VT) postural tremor. Participants were required to aim a mock handgun at a target located in front of them at eye level. Changes in AP, ML and VT tremor from the forearm and gun barrel were assessed as a function of limb (i.e., whether one or both arms were used) and upper arm position (elbow bent or extended). Tremor was recorded using triaxial accelerometers. Results showed that, across all tasks, the ML and VT tremor for any point was characterized by two frequency peaks (between 1-4 and 8-12 Hz) with amplitude increasing from proximal (forearm) to distal (gun barrel). Interestingly, irrespective of the posture adopted, ML accelerations were of greater amplitude than VT oscillations. AP oscillations were markedly smaller compared to VT and ML tremor, did not display consistent frequency peaks, and were not altered by the arm conditions. Altering the aiming posture resulted in changes in VT and ML tremor amplitude, with oscillations being greater when using a single arm as compared to when two arms were used together. Similarly, tremor amplitude was reduced when the task was performed with the elbow bent compared to the straight arm condition. Overall, these results highlight that ML oscillations make as significant a contribution to the overall tremor dynamics as those observed in the VT direction. However, the origin of ML tremor is not simply the product of voluntary adjustments to maintain aim on the target, but also exhibits features similar to the neural generated 8-12-Hz tremor seen under postural conditions.

Comparative proteomic analysis of two wasps venom, Vespa tropica and Vespa affinis.

PubMed

Rungsa, Prapenpuksiri; Incamnoi, Paroonkorn; Sukprasert, Sophida; Uawonggul, Nunthawun; Klaynongsruang, Sompong; Daduang, Jureerut; Patramanon, Rina; Roytrakul, Sittiruk; Daduang, Sakda

2016-09-01

Vespid venom is composed of many bioactive compounds. The venom of the banded tiger wasp (Vespa affinis, or VA) and the great banded wasp (Vespa tropica, or VT)-which are locally found in the northeastern part of Thailand and are well known for their life-threatening venom potency-were comparatively studied in terms of potency, composition and biological activity. Clinical studies that included word-of-mouth information shared by traditional healers in local areas noted that the venom of VT is more potent than that of VA. Our previous study showed that the venom of VA is lower in potency (PD50 = 12.5 μg/g body weight) than that of VT (PD50 = 3 μg/g body weight). Analysis with the PAGE technique showed that these two venoms showed similar patterns of active proteins. Most protein spots were basic proteins at an isoelectric point (pI) ranging from 5 to 10, with molecular weights between 27 and 50 kDa. These spots were identified as hyaluronidase, phospholipase, antigen 5, dipeptidyl peptidase and albumin-like protein. The proportion of hyaluronidase was 2.5 times higher in VT than in VA. VT also showed higher hyaluronidase, phospholipase and dipeptidyl peptidase activities, suggesting that these components made VT venom more potent than VA venom. Copyright © 2016 Elsevier Ltd. All rights reserved.

Increased apical Na+ permeability in cystic fibrosis is supported by a quantitative model of epithelial ion transport

PubMed Central

O’Donoghue, Donal L; Dua, Vivek; Moss, Guy W J; Vergani, Paola

2013-01-01

Cystic fibrosis (CF) is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which encodes an anion channel. In the human lung CFTR loss causes abnormal ion transport across airway epithelial cells. As a result CF individuals produce thick mucus, suffer persistent bacterial infections and have a much reduced life expectancy. Trans-epithelial potential difference (Vt) measurements are routinely carried out on nasal epithelia of CF patients in the clinic. CF epithelia exhibit a hyperpolarised basal Vt and a larger Vt change in response to amiloride (a blocker of the epithelial Na+ channel, ENaC). Are these altered bioelectric properties solely a result of electrical coupling between the ENaC and CFTR currents, or are they due to an increased ENaC permeability associated with CFTR loss? To examine these issues we have developed a quantitative mathematical model of human nasal epithelial ion transport. We find that while the loss of CFTR permeability hyperpolarises Vt and also increases amiloride-sensitive Vt, these effects are too small to account for the magnitude of change observed in CF epithelia. Instead, a parallel increase in ENaC permeability is required to adequately fit observed experimental data. Our study provides quantitative predictions for the complex relationships between ionic permeabilities and nasal Vt, giving insights into the physiology of CF disease that have important implications for CF therapy. PMID:23732645

Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults.

PubMed

Lip, Ryan W T; Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Guo, X

2015-03-01

[Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation.

Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults

PubMed Central

Lip, Ryan W.T.; Fong, Shirley S.M.; Ng, Shamay S.M.; Liu, Karen P.Y.; Guo, X.

2015-01-01

[Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation. PMID:25931704

Unraveling torsional bath interactions with the CO stretching state in methanol

NASA Astrophysics Data System (ADS)

Pearson, John C.; Daly, Adam M.; Lees, Ronald M.

2015-12-01

Quantum mechanical models describing the effects of a C3 internal rotor have been successful in modeling all the torsional manifolds of isolated vibrational states. However, modeling the coupling between nearly degenerate small amplitude vibrations in the C3 internal rotation case remains far from satisfactory and a variety of practical and fundamental questions persist on basis sets, the relative importance of effects and how the problem should be approached. The ν8 C-O stretching state of methanol has been well studied with infrared techniques and has the potential to serve as an experimental reference data set for the development of models for the coupled large and small amplitude motion case. A combined infrared-microwave study of the lowest K A-states of vt = 3, vt = 4 and ν8 has been performed to understand the nature of the interactions between ν8 the excited torsional states. The interaction between vt = 4 and ν8 at K = 0+ has been confirmed to be Fermi type with magnitude of 2.5 cm-1. Additionally, the fundamental a-symmetry and b-symmetry Coriolis interactions between vt = 3 and ν8 have been estimated to be 8900 MHz and -360 MHz, respectively. The magnitude of these interactions suggests that modeling the ν8 state, the vt = 3 state, and the vt = 4 states will have to carefully account for these interactions.

Apolipoprotein A-IV interacts synergistically with melanocortins to reduce food intake.

PubMed

Gotoh, Koro; Liu, Min; Benoit, Stephen C; Clegg, Deborah J; Davidson, W Sean; D'Alessio, David; Seeley, Randy J; Tso, Patrick; Woods, Stephen C

2006-01-01

Apolipoprotein (apo) A-IV is an anorexigenic gastrointestinal peptide that is also synthesized in the hypothalamus. The goal of these experiments was to determine whether apo A-IV interacts with the central melanocortin (MC) system in the control of feeding. The third ventricular (i3vt) administration of a subthreshold dose of apo A-IV (0.5 microg) potentiated i3vt MC-induced (metallothionein-II, 0.03 nmol) suppression of 30-min feeding in Long-Evans rats. A subthreshold dose of the MC antagonist (SHU9119, 0.1 nmol, i3vt) completely attenuated the anorectic effect of i3vt apo A-IV (1.5 microg). The i3vt apo A-IV significantly elevated the expression of c-Fos in neurons of the paraventricular nucleus of the hypothalamus, but not in the arcuate nucleus or median eminence. In addition, c-Fos expression was not colocalized with proopiomelanocortin-positive neurons. These data support a synergistic interaction between apo A-IV and melanocortins that reduces food intake by acting downstream of the arcuate.

Darwin's wind hypothesis: does it work for plant dispersal in fragmented habitats?

PubMed

Riba, Miquel; Mayol, Maria; Giles, Barbara E; Ronce, Ophélie; Imbert, Eric; van der Velde, Marco; Chauvet, Stéphanie; Ericson, Lars; Bijlsma, R; Vosman, Ben; Smulders, M J M; Olivieri, Isabelle

2009-08-01

Using the wind-dispersed plant Mycelis muralis, we examined how landscape fragmentation affects variation in seed traits contributing to dispersal. Inverse terminal velocity (Vt(-1)) of field-collected achenes was used as a proxy for individual seed dispersal ability. We related this measure to different metrics of landscape connectivity, at two spatial scales: in a detailed analysis of eight landscapes in Spain and along a latitudinal gradient using 29 landscapes across three European regions. In the highly patchy Spanish landscapes, seed Vt(-1)increased significantly with increasing connectivity. A common garden experiment suggested that differences in Vt(-1) may be in part genetically based. The Vt(-1) was also found to increase with landscape occupancy, a coarser measure of connectivity, on a much broader (European) scale. Finally, Vt(-1)was found to increase along a south-north latitudinal gradient. Our results for M. muralis are consistent with 'Darwin's wind dispersal hypothesis' that high cost of dispersal may select for lower dispersal ability in fragmented landscapes, as well as with the 'leading edge hypothesis' that most recently colonized populations harbour more dispersive phenotypes.

High-intensity interval training and β-hydroxy-β-methylbutyric free acid improves aerobic power and metabolic thresholds.

PubMed

Robinson, Edward H; Stout, Jeffrey R; Miramonti, Amelia A; Fukuda, David H; Wang, Ran; Townsend, Jeremy R; Mangine, Gerald T; Fragala, Maren S; Hoffman, Jay R

2014-01-01

Previous research combining Calcium β-hydroxy-β-methylbutyrate (CaHMB) and running high-intensity interval training (HIIT) have shown positive effects on aerobic performance measures. The purpose of this study was to examine the effect of β-hydroxy-β-methylbutyric free acid (HMBFA) and cycle ergometry HIIT on maximal oxygen consumption (VO2peak), ventilatory threshold (VT), respiratory compensation point (RCP) and time to exhaustion (Tmax) in college-aged men and women. Thirty-four healthy men and women (Age: 22.7 ± 3.1 yrs ; VO2peak: 39.3 ± 5.0 ml · kg(-1) · min(-1)) volunteered to participate in this double-blind, placebo-controlled design study. All participants completed a series of tests prior to and following treatment. A peak oxygen consumption test was performed on a cycle ergometer to assess VO2peak, Tmax, VT, and RCP. Twenty-six participants were randomly assigned into either a placebo (PLA-HIIT) or 3 g per day of HMBFA (BetaTor™) (HMBFA-HIIT) group. Eight participants served as controls (CTL). Participants in the HIIT groups completed 12 HIIT (80-120% maximal workload) exercise sessions consisting of 5-6 bouts of a 2:1 minute cycling work to rest ratio protocol over a four-week period. Body composition was measured with dual energy x-ray absorptiometry (DEXA). Outcomes were assessed by ANCOVA with posttest means adjusted for pretest differences. The HMBFA-HIIT intervention showed significant (p < 0.05) gains in VO2peak, and VT, versus the CTL and PLA-HIIT group. Both PLA-HIIT and HMBFA-HIIT treatment groups demonstrated significant (p < 0.05) improvement over CTL for Tmax, and RCP with no significant difference between the treatment groups. There were no significant differences observed for any measures of body composition. An independent-samples t-test confirmed that there were no significant differences between the training volumes for the PLA-HIIT and HMBFA-HIIT groups. Our findings support the use of HIIT in combination with HMBFA to improve aerobic fitness in college age men and women. These data suggest that the addition of HMBFA supplementation may result in greater changes in VO2peak and VT than HIIT alone. The study was registered on ClinicalTrials.gov (ID NCT01941368).

[Effects of noninvasive proportional assist vs pressure support ventilation on respiratory work in chronic obstructive pulmonary disease patients with hypercapnia].

PubMed

Zhang, J H; Luo, Q; Zhang, H J; Chen, R C

2017-06-12

Objective: To investigate the effect of noninvasive proportional assist ventilation (PAV) on respiratory work in chronic obstructive pulmonary disease(COPD) patients, in comparison to noninvasive pressure support ventilation(PSV). Methods: Ten severe COPD patients with hypercapnia during acute exacerbation were examined. The baseline inspiratory pressure of PSV (PS) and the assistance level of PAV(PA) were titrated by patients' tolerance. In addition to the baseline PS and PA, an additional decrease by 25% (PS-=75% PS, PA-=75% PA) or increase by 25% (PS+ =125% PS, PA+ =125% PA) of the assist level were applied to the patients. After the assessment of unassisted spontaneous breathing (SB), the patient was placed on the 6 levels of noninvasive-PSV and noninvasive-PAV in random sequence. Each level lasted at least 20 minutes. Respiratory rate (RR), tidal volume (Vt), and respiratory work(Wex, Wip and Wv) were measured. Asynchrony index (AI) was calculated. Results: During ventilation, Vt was significantly higher with each assist level than with SB. The Vt was significant increased with PS+ than with PA+ . An increase in expiratory work(Wex) and decrease in inspiratory work(Wip) were observed respectively, with the increasing assist level. The inspiratory muscles assessed by Wip were more unloaded at PS compared with PA [PS: (1.59±1.27) J/min vs PA: (4.99±3.48) J/min P <0.01]. However, the Wex was significantly higher with PS+ than with PA+ [PS+ : (1.17±0.54) J/min vs PA+ : (0.49±0.56)J/min, P <0.01]. The AI was increased with the increasing assist level of PSV [PS-: (0.46±0.57)%, PS: (1.36±1.24)% PS+ : (5.26±4.77)]. No asynchrony events were observed at PA- and PA. "Runaway" (expiratory asynchrony) was observed during PA+ [AI: (2.62±2.72)%]. Conclusions: Noninvasive-PAV can increase the Vt and decrease the Wip of the COPD patients with hypercapnia and avoid the over-assistance. The "Runaway" will occur at assist level higher than that set by tolerance. Physiological data can monitor the patient's responses and the ventilator-patient interaction, which may provide objective criteria for ventilator setting.

Dense Array Studies of Volcano-Tectonic and Long-Period Earthquakes Beneath Mount St. Helens

NASA Astrophysics Data System (ADS)

Glasgow, M. E.; Hansen, S. M.; Schmandt, B.; Thomas, A.

2017-12-01

A 904 single-component 10-Hz geophone array deployed within 15 km of Mount St. Helens (MSH) in 2014 recorded continuously for two-weeks. Automated reverse-time imaging (RTI) was used to generate a catalog of 212 earthquakes. Among these, two distinct types of upper crustal (<8 km) earthquakes were classified. Volcano-tectonic (VT) and long-period (LP) earthquakes were identified using analysis of array spectrograms, envelope functions, and velocity waveforms. To remove analyst subjectivity, quantitative classification criteria were developed based on the ratio of power in high and low frequency bands and coda duration. Prior to the 2014 experiment, upper crustal LP earthquakes had only been reported at MSH during volcanic activity. Subarray beamforming was used to distinguish between LP earthquakes and surface generated LP signals, such as rockfall. This method confirmed 16 LP signals with horizontal velocities exceeding that of upper crustal P-wave velocities, which requires a subsurface hypocenter. LP and VT locations overlap in a cluster slightly east of the summit crater from 0-5 km below sea level. LP displacement spectra are similar to simple theoretical predictions for shear failure except that they have lower corner frequencies than VT earthquakes of similar magnitude. The results indicate a distinct non-resonant source for LP earthquakes which are located in the same source volume as some VT earthquakes (within hypocenter uncertainty of 1 km or less). To further investigate MSH microseismicity mechanisms, a 142 three-component (3-C) 5 Hz geophone array will record continuously for one month at MSH in Fall 2017 providing a unique dataset for a volcano earthquake source study. This array will help determine if LP occurrence in 2014 was transient or if it is still ongoing. Unlike the 2014 array, approximately 50 geophones will be deployed in the MSH summit crater directly over the majority of seismicity. RTI will be used to detect and locate earthquakes by back-projecting 3-C data with a local 3-D P and S velocity model. Earthquakes will be classified using the previously stated techniques, and we will seek to use the dense array of 3-C waveforms to invert for focal mechanisms and, ideally, moment tensor sources down to M0.

Do 12-week yoga program influence respiratory function of elderly women?

PubMed

Bezerra, Lídia Aguiar; de Melo, Helton Fabrício; Garay, Ana Paula; Reis, Victor Machado; Aidar, Felipe José; Bodas, Ana Rita; Garrido, Nuno Domingos; de Oliveira, Ricardo Jacó

2014-09-29

Aging produces several respiratory limitations and reduces tolerance to physical efforts, sometimes leading to pulmonary diseases in the elderly. The literature draws attention to the possible benefits of Yoga practice among the elderly, presenting evidence for significant improvements in quality of life. It was hypothesized that yoga practice can improve respiratory function in the elderly. The effects of a yoga program on pulmonary volumes and respiratory muscle strength were verified in 36 elderly women divided into a yoga group [YG] (63.1 ± 13.3 years of age) and a control group (61.0 ± 6.9 years of age). Maximal inspiratory and expiratory pressure (MIP and MEP) were assessed by a manovacuometer and tidal volume (VT), vital capacity (VC) and minute ventilation (VE) were measured by a ventilometer. The program comprised 65 min sessions, 3 times/week during 12 weeks. The heart rate and respiratory rate decreased significantly in the YG (76-39 ± 8-03 vs. 74-61±10.26 bpm and 18.61 ± 3.15 vs. 16.72 ± 3.12 resp/min, respectively). In the YG, VT and VE increased significantly (0.55 ± 0.22 vs. 0.64 ± 0.2 ml and 9.19 ± 2.39 vs. 10.05 ± 2.11 ml, respectively), as well as VC (1.48 ± 0.45 vs. 2.03 ± 0.72 ml). Improvements were also found in MIP and MEP in the YG (62.17 ± 14.77 vs. 73.06 ± 20.16 cmH2O and 80.56 ± 23.94 vs. 86.39 ± 20.16 cmH2O, respectively). It was concluded that a 12-week yoga program significantly improves pulmonary function of aged women.

Protective effects of ghrelin in ventilator-induced lung injury in rats.

PubMed

Li, Guang; Liu, Jiao; Xia, Wen-Fang; Zhou, Chen-Liang; Lv, Li-Qiong

2017-11-01

Ghrelin has exhibited potent anti-inflammatory effects on various inflammatory diseases. The aim of this study was to investigate the potential effects of ghrelin on a model of ventilator-induced lung injury (VILI) established in rats. Male Sprague-Dawley rats were randomly divided into three groups: low volume ventilation (LV, Vt=8ml/kg) group, a VILI group (Vt=30ml/kg), and a VILI group pretreated with ghrelin (GH+VILI). For the LV group, for the VILI and GH+VILI groups, the same parameters were applied except the tidal volume was increased to 40ml/kg. After 4h of MV, blood gas, lung elastance, and levels of inflammatory mediators, including tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1β, and (MIP)-2 and total protein in bronchoalveolar lavage fluid (BALF) were analyzed. Myeloperoxidase (MPO), (TLR)-4, and NF-κB, were detected in lung tissues. Water content (wet-to-dry ratio) and lung morphology were also evaluated. The VILI group had a higher acute lung injury (ALI) score, wet weight to dry ratio, MPO activity, and concentrations of inflammatory mediators (TNF-α, IL-6, IL-1β, and MIP-2) in BALF, as well as higher levels of TLR4 and NF-κB expression than the LV group (P<0.05). All histopathologic ALI, the inflammatory profile, and pulmonary dynamics have been improved by ghrelin pretreatment (P<0.05). Ghrelin pretreatment also decreased TLR4 expression and NF-κB activity compared with the VILI group (P<0.05). Ghrelin pretreatment attenuated VILI in rats by reducing MV-induced pulmonary inflammation and might represent a novel therapeutic candidate for protection against VILI. Copyright © 2017 Elsevier B.V. All rights reserved.

EARLY STABILIZING ALVEOLAR VENTILATION PREVENTS ARDS- A NOVEL TIMING-BASED VENTILATORY INTERVENTION TO AVERT LUNG INJURY

PubMed Central

Roy, Shreyas; Sadowitz, Benjamin; Andrews, Penny; Gatto, Louis; Marx, William; Ge, Lin; Wang, Guirong; Lin, Xin; Dean, David A.; Kuhn, Michael; Ghosh, Auyon; Satalin, Joshua; Snyder, Kathy; Vodovotz, Yoram; Nieman, Gary; Habashi, Nader

2012-01-01

Background Established ARDS is often refractory to treatment. Clinical trials have demonstrated modest treatment effects, and mortality remains high. Ventilator strategies must be developed to prevent ARDS. Hypothesis Early ventilatory intervention will block progression to ARDS if the ventilator mode: 1) maintains alveolar stability and 2) reduces pulmonary edema formation. Methods Yorkshire Pigs (38–45kg) were anaesthetized and subjected to "2-hit" Ischemia-Reperfusion and Peritoneal Sepsis. Following injury, animals were randomized into two groups: Early Preventative Ventilation (Airway Pressure Release Ventilation- APRV) vs. Non-Preventative Ventilation (NPV) and followed for 48hr. All animals received anesthesia, antibiotics, and fluid/vasopressor therapy per Surviving Sepsis Campaign. Ventilation parameters: 1) NPV Group - Tidal volume (Vt): 10cc/kg + PEEP- 5 cm/H2O volume-cycled mode, 2) APRV Group - Vt: 10–15 cc/kg; Phigh, Plow, Thigh, Tlow were titrated for optimal alveolar stability. Physiologic data and plasma were collected throughout the 48hr study period, followed by BAL and necropsy. Results APRV prevented development of ARDS (p<0.001 vs NPV) by PaO2/FiO2 ratio. Quantitative histological scoring showed APRV prevented lung tissue injury (p<0.001 vs. NPV). BALF showed APRV lowered total protein and IL-6, while preserving surfactant proteins A & B (p<0.05 vs. NPV). APRV significantly lowered lung water (p<0.001 vs. NPV). Plasma IL-6 concentrations were similar between groups. Conclusions Early preventative mechanical ventilation with APRV blocked ARDS development, preserved surfactant proteins, and reduced pulmonary inflammation and edema, despite systemic inflammation similar to NPV. These data suggest early preventative ventilation strategies stabilizing alveoli and reducing pulmonary edema can attenuate ARDS after ischemia-reperfusion-sepsis. PMID:22846945

Physiological and perceptual responses to incremental exercise testing in healthy men: effect of exercise test modality.

PubMed

Muscat, Kristina M; Kotrach, Houssam G; Wilkinson-Maitland, Courtney A; Schaeffer, Michele R; Mendonca, Cassandra T; Jensen, Dennis

2015-11-01

In a randomized cross-over study of 15 healthy men aged 20-30 years, we compared physiological and perceptual responses during treadmill and cycle exercise test protocols matched for increments in work rate - the source of increased locomotor muscle metabolic and contractile demands. The rates of O2 consumption and CO2 production were higher at the peak of treadmill versus cycle testing (p ≤ 0.05). Nevertheless, work rate, minute ventilation, tidal volume (VT), breathing frequency (fR), inspiratory capacity (IC), inspiratory reserve volume (IRV), tidal esophageal (Pes,tidal) and transdiaphragmatic pressure swings (Pdi,tidal), peak expiratory gastric pressures (Pga,peak), the root mean square of the diaphragm electromyogram (EMGdi,rms) expressed as a percentage of maximum EMGdi,rms (EMGdi,rms%max), and dyspnea ratings were similar at the peak of treadmill versus cycle testing (p > 0.05). Ratings of leg discomfort were higher at the peak of cycle versus treadmill exercise (p ≤ 0.05), even though peak O2 consumption was lower during cycling. Oxygen consumption, CO2 production, minute ventilation, fR, Pes,tidal, Pdi,tidal and Pga,peak were higher (p ≤ 0.05), while VT, IC, IRV, EMGdi,rms%max, and ratings of dyspnea and leg discomfort were similar (p > 0.05) at all or most submaximal work rates during treadmill versus cycle exercise. Our findings highlight important differences (and similarities) in physiological and perceptual responses at maximal and submaximal work rates during incremental treadmill and cycle exercise testing protocols. The lack of effect of exercise test modality on peak work rate advocates for the use of this readily available parameter to optimize training intensity determination, regardless of exercise training mode.

Ventricular Tachycardia or not? An Unexpected Reason of Wide QRS Complex Tachycardia in a Young Healthy Man: Sodium Bicarbonate.

PubMed

Eyuboglu, Mehmet

2016-10-01

Ventricular tachycardia (VT) is life-threatening subgroup of wide QRS complex tachycardia (WCT). VT is usually associated with structural heart diseases, but it can occur in the absence of any cardiovascular diseases. Adverse cardiac effect of sodium bicarbonate in healthy subjects is not well described. A 30-year-old healthy man with excessive intake of sodium bicarbonate-related VT is presented. He was using sodium bicarbonate during last 2 months to lose weight. He has no risk factors and any cardiovascular or systemic diseases. After intravenous administration of amiodarone, tachycardia ended and his rhythm converted to sinus rhythm with normal electrocardiogram. Patient is asymptomatic, and no VT was observed without any medications at 1 year of follow-up.

Analytical model for the threshold voltage of III-V nanowire transistors including quantum effects

NASA Astrophysics Data System (ADS)

Marin, E. G.; Ruiz, F. G.; Tienda-Luna, I. M.; Godoy, A.; Gámiz, F.

2014-02-01

In this work we propose an analytical model for the threshold voltage (VT) of III-V cylindrical nanowires, that takes into consideration the two dimensional quantum confinement of the carriers, the Fermi-Dirac statistics, the wave-function penetration into the gate insulator and the non-parabolicity of the conduction band structure. A simple expression for VT is obtained assuming some suitable approximations. The model results are compared to those of a 2D self consistent Schrödinger-Poisson solver, demonstrating a good fit for different III-V materials, insulator thicknesses and nanowire sizes with diameter down to 5 nm. The VT dependence on the confinement effective mass is discussed. The different contributions to VT are analyzed showing significant variations among different III-V materials.

Shots ESS through MET and SHOT ZUCCHINI. The Final TEAPOT Tests, 23 March-15 May 1955

DTIC Science & Technology

1981-11-27

organizations in addition to those writers listed in block 7. I __ A00*55io" ror Jstificato . . ..- s ] Distribut ion/ Availabilit -Y Co04s _=_ Vt . i ,Distf...over asphalt, water , concrete, and plant material. Reports furnished by the radiological safety monitors indicate that, following the detonation...Pressure versus Time and Distance, was designed to determine the increase in air pressure produced by a nuclear detonation over three surfaces: water

A novel low-energy electrotherapy that terminates ventricular tachycardia with lower energy than a biphasic shock when antitachycardia pacing fails.

PubMed

Janardhan, Ajit H; Li, Wenwen; Fedorov, Vadim V; Yeung, Michael; Wallendorf, Michael J; Schuessler, Richard B; Efimov, Igor R

2012-12-11

The authors sought to develop a low-energy electrotherapy that terminates ventricular tachycardia (VT) when antitachycardia pacing (ATP) fails. High-energy implantable cardioverter-defibrillator (ICD) shocks are associated with device failure, significant morbidity, and increased mortality. A low-energy alternative to ICD shocks is desirable. Myocardial infarction was created in 25 dogs. Sustained, monomorphic VT was induced by programmed stimulation. Defibrillation electrodes were placed in the right ventricular apex, and coronary sinus and left ventricular epicardium. If ATP failed to terminate sustained VT, the defibrillation thresholds (DFTs) of standard versus experimental electrotherapies were measured. Sustained VT ranged from 276 to 438 beats/min (mean 339 beats/min). The right ventricular-coronary sinus shock vector had lower impedance than the right ventricular-left ventricular patch (54.4 ± 18.1 Ω versus 109.8 ± 16.9 Ω; p < 0.001). A single shock required between 0.3 ± 0.2 J to 5.9 ± 2.5 J (mean 2.64 ± 3.22 J; p = 0.008) to terminate VT, and varied depending upon the phase of the VT cycle in which it was delivered. By contrast, multiple shocks delivered within 1 VT cycle length were not phase dependent and achieved lower DFT compared with a single shock (0.13 ± 0.09 J for 3 shocks, 0.08 ± 0.04 J for 5 shocks, and 0.09 ± 0.07 J for 7 shocks; p < 0.001). Finally, a multistage electrotherapy (MSE) achieved significantly lower DFT compared with a single biphasic shock (0.03 ± 0.05 J versus 2.37 ± 1.20 J; respectively, p < 0.001). At a peak shock amplitude of 20 V, MSE achieved 91.3% of terminations versus 10.5% for a biphasic shock (p < 0.001). MSE achieved a major reduction in DFT compared with a single biphasic shock for ATP-refractory monomorphic VT, and represents a novel electrotherapy to reduce high-energy ICD shocks. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Adaptive Circuits for the 0.5-V Nanoscale CMOS Era

NASA Astrophysics Data System (ADS)

Itoh, Kiyoo; Yamaoka, Masanao; Oshima, Takashi

The minimum operating voltage, Vmin, of nanoscale CMOS LSIs is investigated to breach the 1-V wall that we are facing in the 65-nm device generation, and open the door to the below 0.5-V era. A new method using speed variation is proposed to evaluate Vmin. It shows that Vmin is very sensitive to the lowest necessary threshold voltage, Vt0, of MOSFETs and to threshold-voltage variations, ΔVt, which become more significant with device scaling. There is thus a need for low-Vt0 circuits and ΔVt-immune MOSFETs to reduce Vmin. For memory-rich LSIs, the SRAM block is particularly problematic because it has the highest Vmin. Various techniques are thus proposed to reduce the Vmin: using RAM repair, shortening the data line, up-sizing, and using more relaxed MOSFET scaling. To effectively reduce Vmin of other circuit blocks, dual-Vt0 and dual-VDD circuits using gate-source reverse biasing, temporary activation, and series connection of another small low-Vt0 MOSFET are proposed. They are dynamic logic circuits enabling the power-delay product of the conventional static CMOS inverter to be reduced to 0.09 at a 0.2-V supply, and a DRAM dynamic sense amplifier and power switches operable at below 0.5V. In addition, a fully-depleted structure (FD-SOI) and fin-type structure (FinFET) for Vt-immune MOSFETs are discussed in terms of their low-voltage potential and challenges. As a result, the height up-scalable FinFETs turns out to be quite effective to reduce Vmin to less than 0.5V, if combined with the low-Vt0 circuits. For mixed-signal LSIs, investigation of low-voltage potential of analog circuits, especially for comparators and operational amplifiers, reveals that simple inverter op-amps, in which the low gain and nonlinearity are compensated for by digitally assisted analog designs, are crucial to 0.5-V operations. Finally, it is emphasized that the development of relevant devices and fabrication processes is the key to the achievement of 0.5-V nanoscale LSIs.

Gene expression in Citrus sinensis fruit tissues harvested from huanglongbing-infected trees: comparison with girdled fruit.

PubMed

Liao, Hui-Ling; Burns, Jacqueline K

2012-05-01

Distribution of viable Candidatus Liberibacter asiaticus (CaLas) in sweet orange fruit and leaves ('Hamlin' and 'Valencia') and transcriptomic changes associated with huanglongbing (HLB) infection in fruit tissues are reported. Viable CaLas was present in most fruit tissues tested in HLB trees, with the highest titre detected in vascular tissue near the calyx abscission zone. Transcriptomic changes associated with HLB infection were analysed in flavedo (FF), vascular tissue (VT), and juice vesicles (JV) from symptomatic (SY), asymptomatic (AS), and healthy (H) fruit. In SY 'Hamlin', HLB altered the expression of more genes in FF and VT than in JV, whereas in SY 'Valencia', the number of genes whose expression was changed by HLB was similar in these tissues. The expression of more genes was altered in SY 'Valencia' JV than in SY 'Hamlin' JV. More genes were also affected in AS 'Valencia' FF and VT than in AS 'Valencia' JV. Most genes whose expression was changed by HLB were classified as transporters or involved in carbohydrate metabolism. Physiological characteristics of HLB-infected and girdled fruit were compared to differentiate between HLB-specific and carbohydrate metabolism-related symptoms. SY and girdled fruit were smaller than H and ungirdled fruit, respectively, with poor juice quality. However, girdling did not cause misshapen fruit or differential peel coloration. Quantitative PCR analysis indicated that many selected genes changed their expression significantly in SY flavedo but not in girdled flavedo. Mechanisms regulating development of HLB symptoms may lie in the host disease response rather than being a direct consequence of carbohydrate starvation.

1D-¹H-nuclear magnetic resonance metabolomics reveals age-related changes in metabolites associated with experimental venous thrombosis.

PubMed

Obi, Andrea T; Stringer, Kathleen A; Diaz, Jose A; Finkel, Michael A; Farris, Diana M; Yeomans, Larisa; Wakefield, Thomas; Myers, Daniel D

2016-04-01

Age is a significant risk factor for the development of venous thrombosis (VT), but the mechanism(s) that underlie this risk remain(s) undefined and poorly understood. Aging is known to adversely influence inflammation and affect metabolism. Untargeted metabolomics permits an agnostic assessment of the physiological landscape and lends insight into the mechanistic underpinnings of clinical phenotypes. The objective of this exploratory study was to test the feasibility of a metabolomics approach for identifying potential metabolic mechanisms of age-related VT. We subjected whole blood samples collected from young and old nonthrombosed controls and VT mice 2 days after thrombus induction using the electrolytic inferior vena cava, to a methanol:chloroform extraction and assayed the resulting aqueous fractions using 1D-(1)H- nuclear magnetic resonance. Normalized mouse metabolite data were compared across groups using analysis of variance (ANOVA) with Holm-Sidak post-testing. In addition, associations between metabolite concentrations and parameters of thrombosis such as thrombus and vein wall weights, and markers of inflammation, vein wall P- and E-selectin levels, were assessed using linear regression. The relatedness of the found significant metabolites was visually assessed using a bioinformatics tool, Metscape, which generates compound-reaction-enzyme-gene networks to aid in the interpretation of metabolomics data. Old mice with VT had a greater mean vein wall weight compared with young mice with VT (P < .05). Clot weight differences between old and young mice followed the same trend as vein wall weight (0.011 ± 0.04 g vs 0.008 ± 0.003 g; P = not significant). Glutamine (ANOVA, P < .01), proline (ANOVA, P < .01), and phenylalanine (ANOVA, P < .05) levels were increased in old VT mice compared with age-matched controls and young VT mice. Betaine and/or trimethylamine N-oxide levels were increased in aged mice compared with young animals. Vein wall weight was strongly associated with glutamine (P < .05), and phenylalanine (P < .01) concentrations and there was a trend toward an association with proline (P = .09) concentration. Vein wall P-selectin, but not E-selectin levels, were increased in old VT mice and were associated with the three found metabolites of age-related VT. Collectively, with the addition of glutamate, these metabolites form a single compound-reaction-enzyme-gene network that was generated by Metscape. We used 1D-(1)H-nuclear magnetic resonance-metabolite profiling to identify, for the first time, in an experimental model, three potential metabolites, glutamine, phenylalanine, and proline, associated with age-related VT. These metabolites are metabolically related and their levels are associated with vein wall weight and P-selectin concentrations. In aggregate, these findings provide a "roadmap" of pathways that could be interrogated in future studies, which could include provocation of the glutamine, phenylalanine, and proline pathways in the vein wall. This study introduces metabolomics as a new approach to furthering knowledge about the mechanisms of age-related VT. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Micromechanical properties of single crystals and polycrystals of pure α-titanium: anisotropy of microhardness, size effect, effect of the temperature (77-300 K)

NASA Astrophysics Data System (ADS)

Lubenets, S. V.; Rusakova, A. V.; Fomenko, L. S.; Moskalenko, V. A.

2018-01-01

The anisotropy of microhardness of pure α-Ti single crystals, indentation size effect in single-crystal, course grained (CG) pure and nanocrystalline (NC) VT1-0 titanium, as well as the temperature dependences of the microhardness of single-crystal and CG Ti in the temperature range 77-300 K were studied. The minimum value of hardness was obtained when indenting into the basal plane (0001). The indentation size effect (ISE) was clearly observed in the indentation of soft high-purity single-crystal iodide titanium while it was the least pronounced in a sample of nanocrystalline VT1-0 titanium. It has been demonstrated that the ISE can be described within the model of geometrically necessary dislocations (GND), which follows from the theory of strain gradient plasticity. The true hardness and others parameters of the GND model were determined for all materials. The temperature dependence of the microhardness is in agreement with the idea of the governing role of Peierls relief in the dislocation thermally-activated plastic deformation of pure titanium as has been earlier established and justified in macroscopic tensile investigations at low temperatures. The activation energy and activation volume of dislocation motion in the strained region under the indenter were estimated.

Phase Behavior of Three PBX Elastomers in High-Pressure Chlorodifluoromethane

NASA Astrophysics Data System (ADS)

Lee, Byung-Chul

2017-10-01

The phase equilibrium behavior data are presented for three kinds of commercial polymer-bonded explosive (PBX) elastomers in chlorodifluoromethane (HCFC22). Levapren^{{registered }} ethylene- co-vinyl acetate (LP-EVA), HyTemp^{{registered }} alkyl acrylate copolymer (HT-ACM), and Viton^{{registered }} fluoroelastomer (VT-FE) were used as the PBX elastomers. For each elastomer + HCFC22 system, the cloud point (CP) and/or bubble point (BP) pressures were measured while varying the temperature and elastomer composition using a phase equilibrium apparatus fitted with a variable-volume view cell. The elastomers examined in this study indicated a lower critical solution temperature phase behavior in the HCFC22 solvent. LP-EVA showed the CPs at temperatures of 323 K to 343 K and at pressures of 3 MPa to 10 MPa, whereas HT-ACM showed the CPs at conditions between 338 K and 363 K and between 4 MPa and 12 MPa. For the LP-EVA and HT-ACM elastomers, the BP behavior was observed at temperatures below about 323 K. For the VT-FE + HCFC22 system, only the CP behavior was observed at temperatures between 323 K and 353 K and at pressures between 6 MPa and 21 MPa. As the elastomer composition increased, the CP pressure increased, reached a maximum value at a specific elastomer composition, and then remained almost constant.

Mechanism of the 1996-97 non-eruptive volcano-tectonic earthquake swarm at Iliamna Volcano, Alaska

USGS Publications Warehouse

Roman, D.C.; Power, J.A.

2011-01-01

A significant number of volcano-tectonic(VT) earthquake swarms, some of which are accompanied by ground deformation and/or volcanic gas emissions, do not culminate in an eruption.These swarms are often thought to represent stalled intrusions of magma into the mid- or shallow-level crust.Real-time assessment of the likelihood that a VTswarm will culminate in an eruption is one of the key challenges of volcano monitoring, and retrospective analysis of non-eruptive swarms provides an important framework for future assessments. Here we explore models for a non-eruptive VT earthquake swarm located beneath Iliamna Volcano, Alaska, in May 1996-June 1997 through calculation and inversion of fault-plane solutions for swarm and background periods, and through Coulomb stress modeling of faulting types and hypocenter locations observed during the swarm. Through a comparison of models of deep and shallow intrusions to swarm observations,we aim to test the hypothesis that the 1996-97 swarm represented a shallow intrusion, or "failed" eruption.Observations of the 1996-97 swarm are found to be consistent with several scenarios including both shallow and deep intrusion, most likely involving a relatively small volume of intruded magma and/or a low degree of magma pressurization corresponding to a relatively low likelihood of eruption. ?? 2011 Springer-Verlag.

Whole-Genome Characterization and Strain Comparison of VT2f-Producing Escherichia coli Causing Hemolytic Uremic Syndrome

PubMed Central

Michelacci, Valeria; Bondì, Roslen; Gigliucci, Federica; Franz, Eelco; Badouei, Mahdi Askari; Schlager, Sabine; Minelli, Fabio; Tozzoli, Rosangela; Caprioli, Alfredo; Morabito, Stefano

2016-01-01

Verotoxigenic Escherichia coli infections in humans cause disease ranging from uncomplicated intestinal illnesses to bloody diarrhea and systemic sequelae, such as hemolytic uremic syndrome (HUS). Previous research indicated that pigeons may be a reservoir for a population of verotoxigenic E. coli producing the VT2f variant. We used whole-genome sequencing to characterize a set of VT2f-producing E. coli strains from human patients with diarrhea or HUS and from healthy pigeons. We describe a phage conveying the vtx2f genes and provide evidence that the strains causing milder diarrheal disease may be transmitted to humans from pigeons. The strains causing HUS could derive from VT2f phage acquisition by E. coli strains with a virulence genes asset resembling that of typical HUS-associated verotoxigenic E. coli. PMID:27584691

Musculoskeletal strength, balance performance, and self-efficacy in elderly ving tsun chinese martial art practitioners: implications for fall prevention.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Pang, Marco Y C; Lee, H W; Chung, Joanne W Y; Lam, Priscillia L; Guo, X

2014-01-01

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = -0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

Management of ventricular tachycardia in the ablation era: results of the European Heart Rhythm Association Survey.

PubMed

Tilz, Roland Richard; Lenarczyk, Radoslaw; Scherr, Daniel; Haugaa, Kristina Herman; Iliodromitis, Konstantinos; Pürerfellner, Helmut; Kiliszek, Marek; Dagres, Nikolaos

2018-01-01

Patients with sustained ventricular tachycardia (VT) are at risk of sudden death. Treatment options for VT include antiarrhythmic drug therapy, insertion of an implantable cardioverter-defibrillator, and catheter ablation. Evidence on indications for VT ablation, timing, ablation strategies, and periprocedural management is sparse. The aim of this European Heart Rhythm Association (EHRA) survey was to evaluate clinical practice regarding management of VT among the European countries. An electronic questionnaire was sent to members of the EHRA Electrophysiology Research Network. Responses were received from 88 centres in 12 countries. The results have shown that management of VTs is very heterogeneous across the participating centres. Indications, periprocedural management, and ablation strategies vary substantially. This EP Wire survey has revealed that catheter ablation is the first-line therapy for the treatment of recurrent monomorphic stable VT in patients without structural heart disease as well as in patients with ischaemic cardiomyopathy and impaired left ventricular ejection fraction in the majority of centres. Furthermore, in patients with ischaemic cardiomyopathy and the first episode of monomorphic VT, most centres (62.0%) performed catheter ablation. On the contrary, in patients with non-ischaemic cardiomyopathy, amiodarone (41.4%) and catheter ablation (37.1%) are used in a very similar proportion. Ablation strategies, endpoints, and post-ablation antithrombotic management vary substantially among European centres. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Alcohol responsiveness in laryngeal dystonia: A survey study

PubMed Central

Kirke, Diana N.; Frucht, Steven J.; Simonyan, Kristina

2015-01-01

Laryngeal dystonia (LD) is a task-specific focal dystonia of unknown pathophysiology affecting speech production. We examined the demographics of anecdotally reported alcohol use and its effects on LD symptoms using an online survey based on Research Electronic Data Capture (REDCap™) and National Spasmodic Dysphonia Association’s patient registry. From 641 participants, 531 were selected for data analysis, and 110 were excluded because of unconfirmed diagnosis. A total of 406 patients (76.5%) had LD and 125 (23.5%) had LD and voice tremor (LD/VT). The consumption of alcohol was reported by 374 LD (92.1%) and 109 LD/VT (87.2%) patients. Improvement of voice symptoms after alcohol ingestion was noted by 227 LD (55.9% of all patients) and 73 LD/VT (58.4%), which paralleled the improvement observed by patient’s family and/or friends in 214 LD (57.2%) and 69 LD/VT (63.3%) patients. The benefits lasted 1–3 hours in both groups with the maximum effect after 2 drinks in LD patients (p = 0.002), whereas LD/VT symptoms improved independent of the consumed amount (p = 0.48). Our data suggest that isolated dystonic symptoms, such as in LD, are responsive to alcohol intake and this responsiveness is not attributed to the presence of VT, which is known to have significant benefits from alcohol ingestion. Alcohol may modulate the pathophysiological mechanisms underlying abnormal neurotransmission of γ-aminobutyric acid (GABA) in dystonia and as such provide new avenues for novel therapeutic options in these patients. PMID:25929664

Musculoskeletal Strength, Balance Performance, and Self-Efficacy in Elderly Ving Tsun Chinese Martial Art Practitioners: Implications for Fall Prevention

PubMed Central

Fong, Shirley S. M.; Ng, Shamay S. M.; Liu, Karen P. Y.; Pang, Marco Y. C.; Lee, H. W.; Chung, Joanne W. Y.; Lam, Priscillia L.; Guo, X.

2014-01-01

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = −0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly. PMID:25530782

Prefrontal oxygenation and the acoustic startle eyeblink response during exercise: A test of the dual-mode model.

PubMed

Tempest, Gavin D; Parfitt, Gaynor

2017-07-01

The interplay between the prefrontal cortex and amygdala is proposed to explain the regulation of affective responses (pleasure/displeasure) during exercise as outlined in the dual-mode model. However, due to methodological limitations the dual-mode model has not been fully tested. In this study, prefrontal oxygenation (using near-infrared spectroscopy) and amygdala activity (reflected by eyeblink amplitude using acoustic startle methodology) were recorded during exercise standardized to metabolic processes: 80% of ventilatory threshold (below VT), at the VT, and at the respiratory compensation point (RCP). Self-reported tolerance of the intensity of exercise was assessed prior to, and affective responses recorded during exercise. The results revealed that, as the intensity of exercise became more challenging (from below VT to RCP), prefrontal oxygenation was larger and eyeblink amplitude and affective responses were reduced. Below VT and at VT, larger prefrontal oxygenation was associated with larger eyeblink amplitude. At the RCP, prefrontal oxygenation was greater in the left than right hemisphere, and eyeblink amplitude explained significant variance in affective responses (with prefrontal oxygenation) and self-reported tolerance. These findings highlight the role of the prefrontal cortex and potentially the amygdala in the regulation of affective (particularly negative) responses during exercise at physiologically challenging intensities (above VT). In addition, a psychophysiological basis of self-reported tolerance is indicated. This study provides some support of the dual-mode model and insight into the neural basis of affective responses during exercise. © 2017 Society for Psychophysiological Research.

Separation of components from a scale mixture of Gaussian white noises

NASA Astrophysics Data System (ADS)

Vamoş, Călin; Crăciun, Maria

2010-05-01

The time evolution of a physical quantity associated with a thermodynamic system whose equilibrium fluctuations are modulated in amplitude by a slowly varying phenomenon can be modeled as the product of a Gaussian white noise {Zt} and a stochastic process with strictly positive values {Vt} referred to as volatility. The probability density function (pdf) of the process Xt=VtZt is a scale mixture of Gaussian white noises expressed as a time average of Gaussian distributions weighted by the pdf of the volatility. The separation of the two components of {Xt} can be achieved by imposing the condition that the absolute values of the estimated white noise be uncorrelated. We apply this method to the time series of the returns of the daily S&P500 index, which has also been analyzed by means of the superstatistics method that imposes the condition that the estimated white noise be Gaussian. The advantage of our method is that this financial time series is processed without partitioning or removal of the extreme events and the estimated white noise becomes almost Gaussian only as result of the uncorrelation condition.

Decreased nicotinic receptor availability in smokers with slow rates of nicotine metabolism

PubMed Central

Dubroff, Jacob G.; Doot, Robert K.; Falcone, Mary; R, Robert A. Schnoll; Ray, Riju; Tyndale, Rachel F.; Brody, Arthur L.; Hou, Catherine; Schmitz, Alexander; Lerman, Caryn

2015-01-01

The nicotine metabolite ratio (NMR), a stable measure of hepatic nicotine metabolism via the CYP2A6 pathway and total nicotine clearance, is a predictive biomarker of response to nicotine replacement therapy, with increased quit rates in slower metabolizers. Nicotine binds directly to nicotinic acetylcholine receptors (nAChRs) to exert its psychoactive effects. This study examined the relationship between NMR and nAChR availability (α4β2* subtype) using positron emission tomography (PET) imaging of the radiotracer 2-18F-FA-85380 (2-18F-FA). Methods Twenty four smokers, 12 slow metabolizers (NMR <0.26) and 12 normal metabolizers (NMR ≥0.26), underwent 2-18F-FA-PET brain imaging following overnight nicotine abstinence (18 hours prior to scanning), using a validated bolus plus infusion protocol. Availability of nAChRs was compared between NMR groups in a priori volumes of interest (VOIs), with total distribution volume (VT/fP) being the measure of nAChR availability. Cravings to smoke were assessed prior to and following the scans. Results Thalamic nAChR α4β2* availability was significantly reduced in slow (versus normal) nicotine metabolizers (P=0.04). Slow metabolizers exhibited greater reductions in craving than normal metabolizers from pre- to post-scanning; however, craving was unrelated to availability. Conclusion The rate of nicotine metabolism is associated with thalamic nAChR availability. Additional studies could examine whether altered nAChR availability underlies differences in treatment response between slow and normal metabolizers of nicotine. PMID:26272810

Decreased Nicotinic Receptor Availability in Smokers with Slow Rates of Nicotine Metabolism.

PubMed

Dubroff, Jacob G; Doot, Robert K; Falcone, Mary; Schnoll, Robert A; Ray, Riju; Tyndale, Rachel F; Brody, Arthur L; Hou, Catherine; Schmitz, Alexander; Lerman, Caryn

2015-11-01

The nicotine metabolite ratio (NMR), a stable measure of hepatic nicotine metabolism via the CYP2A6 pathway and total nicotine clearance, is a predictive biomarker of response to nicotine replacement therapy, with increased quit rates in slower metabolizers. Nicotine binds directly to nicotinic acetylcholine receptors (nAChRs) to exert its psychoactive effects. This study examined the relationship between NMR and nAChR (α4β2* subtype) availability using PET imaging of the radiotracer 2-(18)F-fluoro-3-(2(S)-azetidinylmethoxy)pyridine (2-(18)F-FA-85380, or 2-(18)F-FA). Twenty-four smokers-12 slow metabolizers (NMR < 0.26) and 12 normal metabolizers (NMR ≥ 0.26)-underwent 2-(18)F-FA-PET brain imaging after overnight nicotine abstinence (18 h before scanning), using a validated bolus-plus-infusion protocol. Availability of nAChRs was compared between NMR groups in a priori volumes of interest, with total distribution volume (VT/fP) being the measure of nAChR availability. Cravings to smoke were assessed before and after the scans. Thalamic nAChR α4β2* availability was significantly reduced in slow nicotine metabolizers (P = 0.04). Slow metabolizers exhibited greater reductions in cravings after scanning than normal metabolizers; however, craving was unrelated to nAChR availability. The rate of nicotine metabolism is associated with thalamic nAChR availability. Additional studies could examine whether altered nAChR availability underlies the differences in treatment response between slow and normal metabolizers of nicotine. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Mutations in the Paxillin-binding Site of Integrin-linked Kinase (ILK) Destabilize the Pseudokinase Domain and Cause Embryonic Lethality in Mice*

PubMed Central

Moik, Daniel; Böttcher, Anika; Makhina, Tatiana; Grashoff, Carsten; Bulus, Nada; Zent, Roy; Fässler, Reinhard

2013-01-01

Integrin-linked kinase (ILK) localizes to focal adhesions (FAs) where it regulates cell spreading, migration, and growth factor receptor signaling. Previous reports showed that overexpressed ILK in which Val386 and Thr387 were substituted with glycine residues (ILK-VT/GG) could neither interact with paxillin nor localize to FA in cells expressing endogenous wild-type ILK, implying that paxillin binding to ILK is required for its localization to FAs. Here, we show that introducing this mutation into the germ line of mice (ILK-VT/GG) caused vasculogenesis defects, resulting in a general developmental delay and death at around embryonic day 12.5. Fibroblasts isolated from ILK-VT/GG mice contained mutant ILK in FAs, showed normal adhesion to and spreading on extracellular matrix substrates but displayed impaired migration. Biochemical analysis revealed that VT/GG substitutions decreased ILK protein stability leading to decreased ILK levels and reduced binding to paxillin and α-parvin. Because paxillin depletion did not affect ILK localization to FAs, the embryonic lethality and the in vitro migration defects are likely due to the reduced levels of ILK-VT/GG and diminished binding to parvins. PMID:23658024

Pacing-induced palmar sweating evaluated by unique hygrometer: possible implications of sympathetic activation during tachycardia.

PubMed

Maruyama, T; Yanaga, T; Makino, N

2000-03-01

Although reflex sympathetic activation is a major determinant of the haemodynamic tolerability of ventricular tachycardia (VT), the methods for evaluating this aspect during on-going VT remain invasive and complicated. Palmar sweating as an indirect but non-invasive measure of sympathetic activity was estimated by means of a unique hygrometer under right ventricular (RV) rapid pacing (up to 150 beats min-1) replicating VT, and concurrent monitoring of aortic blood pressure in five patients with various kinds of cardiac arrhythmias in our electrophysiological laboratory. The peak palmar sweating rate in arbitrary units was augmented as the RV pacing rate increased and was proportional to the pacing-induced fall in systolic blood pressure (SBP), with a correlation coefficient of more than 0.903 (P<0.006). The slope of linearity between the sweating rate and the fall in SBP varied among individual patients, with greater sweating amplitude in the younger patients even with the same extent of fall in SBP. This preliminary study suggests sympathetic acceleration caused by haemodynamic deterioration under simulated VT, and therefore this protocol may be able to predict the haemodynamic tolerability of sustained monomorphic VT.

8. Photocopy of photograph (Original in possesssion of the Division ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopy of photograph (Original in possesssion of the Division of Mechanical and Cicil Engineering, Smithsonian Institute) PARKER TRUSS BRIDGE IN NORTHFIELD, VT - Elm Street Bridge, Spanning Ottauquechee River, Woodstock, Windsor County, VT

Effect of a microstructure and surface hydrogen alloying of a VT6 alloy on diffusion welding

NASA Astrophysics Data System (ADS)

Senkevich, K. S.; Skvortsova, S. V.; Kudelina, I. M.; Knyazev, M. I.; Zasypkin, V. V.

2014-01-01

The effect of a structural type (lamellar, fine, gradient) and additional surface alloying with hydrogen on the diffusion bonding of titanium alloy VT6 samples is studied. It is shown that the surface alloying of VT6 alloy parts with hydrogen allows one to decrease the diffusion welding temperature by 50-100°C, to obtain high-quality pore-free bonding, and to remove the "structural" boundary between materials to be welded that usually forms during welding of titanium alloys with a lamellar structure.

Desert Express: An Analysis on Improved Customer Service

DTIC Science & Technology

1991-09-01

Nt MARQ 3,199 Of. DESERT EXPRESS: AN ANALYSIS ON IMPROVED CUSTOMER SERVICE THESIS Thomas C Thaiheim, Majo-,r USAF AFTT/GLM/LSM,/91S-64 ?Z; W...Astq vt.: tyc a l AFIT/GLM/,LSM/91S-64 DESERT EXPRESS: AN ANALYSIS ON IMPROVED CUSTOMER SERVICE THESIS Thomas C. Thalheim, Major, USAF AFIT/GLM/LSM...91S-64 Approved for public release; distribution unlimited AFIT/GLM/LSM/91S-64 DESERT EXPRESS: AN ANALYSIS ON IMPROVED CUSTOMER SERVICE THESIS

Predecisional Processes Involved in the Enlistment Decision

DTIC Science & Technology

1987-11-01

NUMBER S . TYPE OF REPORT • PERIOD COVERED Interim Report December 85 - May 86 S . PERFORMING ORG. REPORT NUMBER S . CONTRACT OR GRANT NUMBERfaj...U. S . Army Research Institute for the Behavioral and Social Sciences November 1987 Approvad for public rdiatt; distribution unlimittd. 87 12...14 176 0OUI**r*JfnJ"W?# V V nFJ^^/tVT:*W»jmF«^™ vnim wa \\rm uwu-wx^« t-^i U. S . ARMY RESEARCH INSTITUTE FOR THE BEHAVIORAL AND SOCIAL SCIENCES k

A conceptual model of the Mount Spurr magmatic system from seismic and geochemical observations of the 1992 Crater Peak eruption sequence

USGS Publications Warehouse

Power, J.; Jolly, A.; Nye, C.; Harbin, M.

2002-01-01

A conceptual model of the geometry and dynamics of the Mount Spurr magmatic system is developed using seismic, geochemical, and visual observations of the 1992 Crater Peak eruption sequence. The basis for this model is a new classification of all located seismic events and results from prior studies of seismology, geology, geochemistry, and geophysics of the Mount Spurr area. Significant seismic features of the 1992 eruption sequence include (1) a distinct swarm of volcano-tectonic (VT) earthquakes in August 1991 directly beneath the Crater Peak vent, (2) a caldera-wide increase in VT earthquakes, lasting 7 months, which preceded the 27 June eruption, (3) two shallow swarms of VT earthquakes that occured on 5 June and 27 June, the latter immediately preceding the 27 June eruption, (4) a mix of VT, long-period (LP), and hybrid events at depths of 20-40 km, which began coincident with the onset of seismic unrest and reached a peak after eruptive activity ended, (5) a strong swarm of VT earthquakes that began as the 16-17 September eruption was ending, (6) a prominent swarm of VT earthquakes on 9-10 November at depths of 1 to 4 km beneath Crater Peak, and (7) a smaller swarm of VT earthquakes in late December 1992, which were located between 7 and 10 km depth. These seismic observations, combined with geological, geochemical, and geophysical data and observations, suggest a deep magmatic source zone for Crater Peak andesites at depths of 20-40 km, a smaller mid-crustal storage zone at about 10 km depth, and a conduit that extends to the surface. We infer that the magmas erupted in 1992 were generated at depths of 20-40 km and rose to the mid-crustal storage zone that fed all three 1992 eruptions. The 1992 eruption sequence may have terminated when additional magma solidified at shallow depths.

Crystal Structure of the New Investigational Drug Candidate VT-1598 in Complex with Aspergillus fumigatus Sterol 14α-Demethylase Provides Insights into Its Broad-Spectrum Antifungal Activity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hargrove, Tatiana Y.; Garvey, Edward P.; Hoekstra, William J.

ABSTRACT Within the past few decades, the incidence and complexity of human fungal infections have increased, and therefore, the need for safer and more efficient, broad-spectrum antifungal agents is high. In the study described here, we characterized the new tetrazole-based drug candidate VT-1598 as an inhibitor of sterol 14α-demethylase (CYP51B) from the filamentous fungusAspergillus fumigatus. VT-1598 displayed a high affinity of binding to the enzyme in solution (dissociation constant, 13 ± 1 nM) and in the reconstituted enzymatic reaction was revealed to have an inhibitory potency stronger than the potencies of all other simultaneously tested antifungal drugs, including fluconazole, voriconazole,more » ketoconazole, and posaconazole. The X-ray structure of the VT-1598/A. fumigatusCYP51 complex was determined and depicts the distinctive binding mode of the inhibitor in the enzyme active site, suggesting the molecular basis of the improved drug potency and broad-spectrum antifungal activity. These data show the formation of an optimized hydrogen bond between the phenoxymethyl oxygen of VT-1598 and the imidazole ring nitrogen of His374, the CYP51 residue that is highly conserved across fungal pathogens and fungus specific. Comparative structural analysis ofA. fumigatusCYP51/voriconazole andCandida albicansCYP51/VT-1161 complexes supports the role of H bonding in fungal CYP51/inhibitor complexes and emphasizes the importance of an optimal distance between this interaction and the inhibitor-heme iron interaction. Cellular experiments using twoA. fumigatusstrains (strains 32820 and 1022) displayed a direct correlation between the effects of the drugs on CYP51B activity and fungal growth inhibition, indicating the noteworthy anti-A. fumigatuspotency of VT-1598 and confirming its promise as a broad-spectrum antifungal agent.« less

Visceral Thromboses in Pancreas Adenocarcinoma: Systematic Review.

PubMed

Hicks, Angel Mier; DeRosa, Antonio; Raj, Micheal; Do, Richard; Yu, Kenneth H; Lowery, Maeve A; Varghese, Anna; O'Reilly, Eileen M

2018-06-01

Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes. To perform a systematic review to study PVT, MVT, and SVT associated with PDAC, and to provide a comprehensive review. Medline/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library. Data Extraction and Assessment: Two blinded independent observers extracted and assessed the studies for diagnosis of PVT, MVT, and SVT in PDAC. Studies were restricted to English-language literature published between 2007 and 2016. Eleven articles were identified. Five case reports and 7 retrospective studies were found, with a total of 127 patients meeting the inclusion criteria. The mean age at diagnosis was 64 years. PVT was found in 35% (n = 46), SVT in 52% (n = 65), and MVT in 13% (n = 15). Mean follow-up time was 26 months. Only 3 of the selected articles studied the impact of anticoagulation in VT. All patients with nonvisceral thrombosis (eg, deep-vein thrombosis, pulmonary emboli) were therapeutically treated; in contrast, patients with VT only rarely received treatment. VT in PDAC is a frequent finding at diagnosis or during disease progression. Evidence to guide treatment choices is limited, and current management is based on inferred experience from nononcologic settings. Anticoagulation appears to be safe in VT, with most of the large studies recommending a careful assessment for patients at a high risk of bleeding. Copyright © 2017 Elsevier Inc. All rights reserved.

Crystal Structure of the New Investigational Drug Candidate VT-1598 in Complex with Aspergillus fumigatus Sterol 14α-Demethylase Provides Insights into Its Broad-Spectrum Antifungal Activity

PubMed Central

Hargrove, Tatiana Y.; Garvey, Edward P.; Hoekstra, William J.; Yates, Christopher M.; Wawrzak, Zdzislaw; Rachakonda, Girish; Villalta, Fernando

2017-01-01

ABSTRACT Within the past few decades, the incidence and complexity of human fungal infections have increased, and therefore, the need for safer and more efficient, broad-spectrum antifungal agents is high. In the study described here, we characterized the new tetrazole-based drug candidate VT-1598 as an inhibitor of sterol 14α-demethylase (CYP51B) from the filamentous fungus Aspergillus fumigatus. VT-1598 displayed a high affinity of binding to the enzyme in solution (dissociation constant, 13 ± 1 nM) and in the reconstituted enzymatic reaction was revealed to have an inhibitory potency stronger than the potencies of all other simultaneously tested antifungal drugs, including fluconazole, voriconazole, ketoconazole, and posaconazole. The X-ray structure of the VT-1598/A. fumigatus CYP51 complex was determined and depicts the distinctive binding mode of the inhibitor in the enzyme active site, suggesting the molecular basis of the improved drug potency and broad-spectrum antifungal activity. These data show the formation of an optimized hydrogen bond between the phenoxymethyl oxygen of VT-1598 and the imidazole ring nitrogen of His374, the CYP51 residue that is highly conserved across fungal pathogens and fungus specific. Comparative structural analysis of A. fumigatus CYP51/voriconazole and Candida albicans CYP51/VT-1161 complexes supports the role of H bonding in fungal CYP51/inhibitor complexes and emphasizes the importance of an optimal distance between this interaction and the inhibitor-heme iron interaction. Cellular experiments using two A. fumigatus strains (strains 32820 and 1022) displayed a direct correlation between the effects of the drugs on CYP51B activity and fungal growth inhibition, indicating the noteworthy anti-A. fumigatus potency of VT-1598 and confirming its promise as a broad-spectrum antifungal agent. PMID:28461309

Successful ventricular tachycardia ablation in patients with electrical storm reduces recurrences and improves survival.

PubMed

Vergara, Pasquale; Tung, Roderick; Vaseghi, Marmar; Brombin, Chiara; Frankel, David; Di Biase, Luigi; Nagashima, Koichi; Tedrow, Usha; Tzou, Wendy S; Sauer, William H; Mathuria, Nilesh; Nakahara, Shiro; Vakil, Kairav; Tholakanahalli, Venkat; Bunch, T Jared; Weiss, J Peter; Dickfeld, Timm; Vunnam, Rama; Lakireddy, Dhanunjaya; Burkhardt, J David; Correra, Anna; Santangeli, Pasquale; Callans, David; Natale, Andrea; Marchlinski, Francis; Stevenson, William G; Shivkumar, Kalyanam; Della Bella, Paolo

2018-01-01

The purpose of this study was to evaluate the characteristics and outcome of patients undergoing ablation after electrical storm (ES). Clinical and procedural characteristics, ventricular tachycardia (VT) recurrence, and mortality rates from 1940 patients undergoing VT ablation were compared between patients with and without ES. The group of 677 patients with ES (34.9%) were older, were more frequently men, and had a lower ejection fraction, more advanced heart failure, and a higher prevalence of cardiovascular comorbidities as compared with those without ES (86.1% patients with ES had ≥2 comorbidities vs 71.4%; P < .001). Patients with ES had more inducible VTs (2.5 ± 1.8 vs 1.9 ± 1.9; P < .001), required longer procedures (296.1 ± 119.1 minutes vs 265.7 ± 110.3 minutes; P < .001), and had a higher in-hospital mortality (42 deaths [6.2%] vs 18 deaths [1.4%]; P < .001). At 1-year follow-up, patients with ES experienced a higher risk of VT recurrence and mortality (32.1% vs 22.6% and 20.1% vs 8.5%; long-rank, P < .001 for both). Among patients with ES, those without any inducible VT after ablation had a higher survival rate (86.3%) than did those with nonclinical VTs only (72.9%), those with clinical VTs inducible at programmed electrical stimulation (51.2%), and not-tested patients (65.0%) (long-rank, P < .001 for all). In multivariate analysis, ES remained an independent predictor of in-hospital mortality, VT recurrence, and 1-year mortality (P < .001). Patients with ES have a high risk of VT recurrence and mortality. Patient and procedure characteristics are consistent with advanced cardiac disease and longer and more complex procedures. In patients with ES, acute procedural success is associated with a significant reduction in VT recurrence and improved 1-year survival. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Long-term outcome of surgical cryoablation for refractory ventricular tachycardia in patients with non-ischemic cardiomyopathy.

PubMed

Liang, Jackson J; Betensky, Brian P; Muser, Daniele; Zado, Erica S; Anter, Elad; Desai, Nimesh D; Callans, David J; Deo, Rajat; Frankel, David S; Hutchinson, Mathew D; Lin, David; Riley, Michael P; Schaller, Robert D; Supple, Gregory E; Santangeli, Pasquale; Acker, Michael A; Bavaria, Joseph E; Szeto, Wilson Y; Vallabhajosyula, Prashanth; Marchlinski, Francis E; Dixit, Sanjay

2018-03-01

Limited data exist on the long-term outcome of patients (pts) with non-ischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) refractory to conventional therapies undergoing surgical ablation (SA). We aimed to investigate the long-term survival and VT recurrence in NICM pts with VT refractory to radiofrequency catheter ablation (RFCA) who underwent SA. Consecutive pts with NICM and VT refractory to RFCA who underwent SA were included. VT substrate was characterized in the electrophysiology lab and targeted by RFCA. During SA, previous RFCA lesions/scars were identified and targeted with cryoablation (CA; 3 min/lesion; target -150 °C). Follow-up comprised office visits, ICD interrogations and the social security death index. Twenty consecutive patients with NICM who underwent SA (age 53 ± 16 years, 18 males, LVEF 41 ± 20%; dilated CM = 9, arrhythmogenic right ventricular CM = 3, hypertrophic CM = 2, valvular CM = 4, and mixed CM = 2) were studied. Percutaneous mapping/ablation in the electrophysiology lab was performed in 18 and 2 pts had primary SA. During surgery, 4.9 ± 4.0 CA lesions/pt were delivered to the endocardium (2) and epicardium (11) or both (7). VT-free survival was 72.5% at 1 year and over 43 ± 31 months (mos) (range 1-83mos), there was only one arrhythmia-related death. There was a significant reduction in ICD shocks in the 3-mos preceding SA vs. the entire follow-up period (6.6 ± 4.9 vs. 2.3 ± 4.3 shocks/pt, P = 0.001). In select pts with NICM and VT refractory to RFCA, SA guided by pre-operative electrophysiological mapping and ablation may be a therapeutic option. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Announcing the Venus Transit 2004 (VT-2004) Programme

NASA Astrophysics Data System (ADS)

2004-02-01

Rare Celestial Event to be Observed by Millions Summary On June 8, 2004, Venus - the Earth's sister planet - will pass in front of the Sun. This event, a 'transit', is extremely rare - the last one occurred in 1882, 122 years ago. Easily observable in Europe, Asia, Africa and Australia, it is likely to attract the attention of millions of people on these continents and, indeed, all over the world. On this important occasion, the European Southern Observatory (ESO) has joined forces with the European Association for Astronomy Education (EAAE), the Institut de Mécanique Céleste et de Calcul des Éphémérides (IMCCE) and the Observatoire de Paris in France, as well as the Astronomical Institute of the Academy of Sciences of the Czech Republic to establish the Venus Transit 2004 (VT-2004) public education programme. It is supported by the European Commission in the framework of the European Science and Technology Week and takes advantage of this extraordinary celestial event to expose the public - in a well-considered, interactive and exciting way - to a number of fundamental issues at the crucial interface between society and basic science. VT-2004 has several components, including an instructive and comprehensive website (www.vt-2004.org). It is directed towards the wide public in general and the media, school students and their teachers, as well as amateur astronomers in particular. It invites all interested persons to participate actively in the intercontinental VT-2004 Observing Campaign (that reenacts historical Venus Transit observations) and the VT-2004 Video Contest. During the VT-2004 Final Event in November, the winners of the Video Contest will be chosen by an international jury. This meeting will also serve to discuss the project and its impact. The outcome of this rare celestial event and the overall experience from this unique public education project will clearly be of very wide interest, not just in the field of astronomy.

Arrhythmic effects of Epac-mediated ryanodine receptor activation in Langendorff-perfused murine hearts are associated with reduced conduction velocity.

PubMed

Li, Mengye; Hothi, Sandeep S; Salvage, Samantha C; Jeevaratnam, Kamalan; Grace, Andrew A; Huang, Christopher L-H

2017-06-01

Recent papers have attributed arrhythmic substrate in murine RyR2-P2328S hearts to reduced action potential (AP) conduction velocities (CV), reflecting acute functional inhibition and/or reduced expression of sodium channels. We explored for acute effects of direct exchange protein directly activated by cAMP (Epac)-mediated ryanodine receptor-2 (RyR2) activation on arrhythmic substrate and CV. Monophasic action potential (MAP) recordings demonstrated that initial steady (8 Hz) extrinsic pacing elicited ventricular tachycardia (VT) in 0 of 18 Langendorff-perfused wild-type mouse ventricles before pharmacological intervention. The Epac activator 8-CPT (8-(4-chlorophenylthio)-2'-O-methyladenosine-3',5'-cyclic monophosphate) (VT in 1 of 7 hearts), and the RyR2 blocker dantrolene, either alone (0 of 11) or with 8-CPT (0 of 9) did not then increase VT incidence (P>.05). Both progressively increased pacing rates and programmed extrasystolic (S2) stimuli similarly produced no VT in untreated hearts (n=20 and n=9 respectively). 8-CPT challenge then increased VT incidences (5 of 7 and 4 of 8 hearts respectively; P<.05). However, dantrolene, whether alone (0 of 10 and 1 of 13) or combined with 8-CPT (0 of 10 and 0 of 13) did not increase VT incidence relative to those observed in untreated hearts (P>.05). 8-CPT but not dantrolene, whether alone or combined with 8-CPT, correspondingly increased AP latencies (1.14±0.04 (n=7), 1.04±0.03 (n=10), 1.09±0.05 (n=8) relative to respective control values). In contrast, AP durations, conditions for 2:1 conduction block and ventricular effective refractory periods remained unchanged throughout. We thus demonstrate for the first time that acute RyR2 activation reversibly induces VT in specific association with reduced CV. © 2017 The Authors. Clinical and Experimental Pharmacology and Physiology Published by John Wiley & Sons Australia, Ltd.

RadNet Air Data From Burlington, VT

EPA Pesticide Factsheets

This page presents radiation air monitoring and air filter analysis data for Burlington, VT from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

A Lenz's law experiment revisited

NASA Astrophysics Data System (ADS)

Sawicki, Charles A.

2000-10-01

A dipole magnet model predicts a terminal velocity VT proportional to 1/n for n attached identical cylindrical magnets dropped down a copper pipe. Experiments show that VT increases approximately linearly with n. The explanation for this difference is presented.

MAGNITUDE STUDIES CONDUCTED UNDER PROJECTS VT/5054 AND VT/5055.

DTIC Science & Technology

statistical model for Blue Mountains Seismological Observatory, Cumberland Plateau Seismological Observatory, Tonto Forest Seismological Observatory, Uinta ... Basin Seismological Observatory, and Wichita Mountains Seismological Observatory. Azimuthal dependence of station correction is not established at any of

[Detection of verotoxin-producing E. coli (VTEC) in healthy cattle and swine with the DNA-DNA colony hybridization method].

PubMed

Bülte, M; Montenegro, M A; Helmuth, R; Trumpf, T; Reuter, G

1990-11-01

With the DNA-DNA colony hybridization technique using specific gene probes for Verotoxin 1 (VT 1) and Verotoxin 2 (VT 2) 2100 E. coli strains from healthy animals were tested. Ten out of 82 milk cows (21.2%), 20 out of 212 beef cattle (9.4%) and five out of 75 pigs (6.7%) were found to carry genes for VT 1, VT 2 or both toxins, respectively. Among these strains the biotypes 5 and 6 were predominant. Some of the serotyped isolates have been described to be pathogenic for humans, like O157:H7, 082:H8, 0116, 0113, 0126 and 091, respectively. The unexpected high incidence of VTEC positive healthy animals possibly indicates a health hazard for human beings. Further investigations on the incidence of VTEC in food are necessary.

High Levels of S100A8/A9 Proteins Aggravate Ventilator-Induced Lung Injury via TLR4 Signaling

PubMed Central

Aslami, Hamid; Jongsma, Geartsje; van den Berg, Elske; Vlaar, Alexander P. J.; Roelofs, Joris J. T. H.; Juffermans, Nicole P.; Schultz, Marcus J.; van der Poll, Tom; Roth, Johannes; Wieland, Catharina W.

2013-01-01

Background Bacterial products add to mechanical ventilation in enhancing lung injury. The role of endogenous triggers of innate immunity herein is less well understood. S100A8/A9 proteins are released by phagocytes during inflammation. The present study investigates the role of S100A8/A9 proteins in ventilator-induced lung injury. Methods Pulmonary S100A8/A9 levels were measured in samples obtained from patients with and without lung injury. Furthermore, wild-type and S100A9 knock-out mice, naive and with lipopolysaccharide-induced injured lungs, were randomized to 5 hours of spontaneously breathing or mechanical ventilation with low or high tidal volume (VT). In addition, healthy spontaneously breathing and high VT ventilated mice received S100A8/A9, S100A8 or vehicle intratracheal. Furthermore, the role of Toll-like receptor 4 herein was investigated. Results S100A8/A9 protein levels were elevated in patients and mice with lung injury. S100A8/A9 levels synergistically increased upon the lipopolysaccharide/high VT MV double hit. Markers of alveolar barrier dysfunction, cytokine and chemokine levels, and histology scores were attenuated in S100A9 knockout mice undergoing the double-hit. Exogenous S100A8/A9 and S100A8 induced neutrophil influx in spontaneously breathing mice. In ventilated mice, these proteins clearly amplified inflammation: neutrophil influx, cytokine, and chemokine levels were increased compared to ventilated vehicle-treated mice. In contrast, administration of S100A8/A9 to ventilated Toll-like receptor 4 mutant mice did not augment inflammation. Conclusion S100A8/A9 proteins increase during lung injury and contribute to inflammation induced by HVT MV combined with lipopolysaccharide. In the absence of lipopolysaccharide, high levels of extracellular S100A8/A9 still amplify ventilator-induced lung injury via Toll-like receptor 4. PMID:23874727

Influence of smoking and obesity on alveolar-arterial gas pressure differences and dead space ventilation at rest and peak exercise in healthy men and women.

PubMed

Gläser, Sven; Ittermann, Till; Koch, Beate; Schäper, Christoph; Felix, Stephan B; Völzke, Henry; Könemann, Raik; Ewert, Ralf; Hansen, James E

2013-06-01

Besides exercise intolerance, the assessment of ventilatory and perfusion adequacy allows additional insights in the disease pathophysiology in many cardiovascular or pulmonary diseases. Valid measurements of dead space/tidal volume ratios (VD/VT), arterial (a') - end-tidal (et) carbon dioxide (CO2) and oxygen (O2) pressure differences (p(a'-et)CO2) and (p(et-a')O2), and alveolar (A)-a' O2 pressure differences (p(A-a')O2) require using blood samples in addition to gas exchange analyses on a breath-by-breath-basis. Smoking and nutritional status are also important factors in defining disorders. Using a large healthy population we considered the impact of these factors to develop useful prediction equations. Incremental cycle exercise protocols were applied to apparently healthy volunteer adults who did not have structural heart disease or echocardiographic or lung function pathologies. Age, height, weight, and smoking were analysed for their influence on the target parameters in each gender. Reference values were determined by regression analyses. The final study sample consisted of 476 volunteers (190 female), aged 25-85 years. Smoking significantly influences p(A-a')O2 and p(a'-et)CO2 at rest and peak exercise, and VD/VT during exercise. Obesity influences upper limits of VD/VT, p(a'-et)CO2 and p(et-a')O2 at rest as well as p(A-a')O2 and p(et-a')O2 at exercise. Reference equations for never-smokers as well as for apparently healthy smokers considering influencing factors are given. Gender, age, height, weight, and smoking significantly influence gas exchange. Considering all of these factors this study provides a comprehensive set of reference equations derived from a large number of participants of a population-based study. Copyright © 2013 Elsevier Ltd. All rights reserved.

Pharmacokinetic properties of radiolabeled mutant Interleukin-2v: a PET imaging study

PubMed Central

Hartimath, Siddesh V.; Manuelli, Valeria; Zijlma, Rolf; Signore, Alberto; Nayak, Tapan K.; Freimoser-Grundschober, Anne; Klein, Christian; Dierckx, Rudi A.J.O.; de Vries, Erik F.J.

2018-01-01

Interleukin-2 (IL2) is a cytokine that can stimulate cytotoxic immune cells to attack infected and malignant cells. Unfortunately, IL2 can also cause serious immune-related toxicity. Recently, a mutant of IL2 (IL2v) with abolished CD25 binding, increased plasma half-life and less toxicity was engineered. Unlike wild-type IL2 (wt-IL2), mutant IL2v does not bind to the α-subunit (CD25) of the high affinity IL2αβγ receptor, but only to its β and γ subunit. Here, we investigated the biological properties of IL2v and compared with the wt-IL2 using fluorine-18 and PET. [18F]FB-IL2v binds specifically to IL2 receptors (IL2R) on activated human peripheral blood monocytes (hPBMCs) and is cleared mainly by the kidneys (Balb/c mice). [18F]FB-IL2v PET studies in SCID mice injected with hPBMCs revealed high uptake in the implant (0.85 ± 0.15 SUV), which was significantly reduced after pretreatment with wt-IL2 or mutant IL2v (SUV 0.26 ± 0.1 and 0.46 ± 0.1, p < 0.01). Compartment modeling and Logan graphical analysis in wistar rats inoculated with hPBMCs indicated that the binding of [18F]FB-IL2v to IL2R was reversible. The volume of distribution (VT) and the non-displaceable binding potential (BPnd) of mutant [18F]FB-IL2v in the implant were approximately 3 times lower than those of wild-type [18F]FB-IL2 (p < 0.01). Pretreatment with wt-IL2 significantly reduced the VT and BPnd of mutant [18F]FB-IL2v in the implant (p < 0.001). This demonstrates that wild-type [18F]FB-IL2 binds stronger to IL2R and has faster kinetics than [18F]FB-IL2v, which makes it less suitable as a therapeutic drug. [18F]FB-IL2v, on the other hand, seems to have better properties for use as a therapeutic drug. PMID:29467958

Reproducibility of Quantitative Brain Imaging Using a PET-Only and a Combined PET/MR System

PubMed Central

Lassen, Martin L.; Muzik, Otto; Beyer, Thomas; Hacker, Marcus; Ladefoged, Claes Nøhr; Cal-González, Jacobo; Wadsak, Wolfgang; Rausch, Ivo; Langer, Oliver; Bauer, Martin

2017-01-01

The purpose of this study was to test the feasibility of migrating a quantitative brain imaging protocol from a positron emission tomography (PET)-only system to an integrated PET/MR system. Potential differences in both absolute radiotracer concentration as well as in the derived kinetic parameters as a function of PET system choice have been investigated. Five healthy volunteers underwent dynamic (R)-[11C]verapamil imaging on the same day using a GE-Advance (PET-only) and a Siemens Biograph mMR system (PET/MR). PET-emission data were reconstructed using a transmission-based attenuation correction (AC) map (PET-only), whereas a standard MR-DIXON as well as a low-dose CT AC map was applied to PET/MR emission data. Kinetic modeling based on arterial blood sampling was performed using a 1-tissue-2-rate constant compartment model, yielding kinetic parameters (K1 and k2) and distribution volume (VT). Differences for parametric values obtained in the PET-only and the PET/MR systems were analyzed using a 2-way Analysis of Variance (ANOVA). Comparison of DIXON-based AC (PET/MR) with emission data derived from the PET-only system revealed average inter-system differences of −33 ± 14% (p < 0.05) for the K1 parameter and −19 ± 9% (p < 0.05) for k2. Using a CT-based AC for PET/MR resulted in slightly lower systematic differences of −16 ± 18% for K1 and −9 ± 10% for k2. The average differences in VT were −18 ± 10% (p < 0.05) for DIXON- and −8 ± 13% for CT-based AC. Significant systematic differences were observed for kinetic parameters derived from emission data obtained from PET/MR and PET-only imaging due to different standard AC methods employed. Therefore, a transfer of imaging protocols from PET-only to PET/MR systems is not straightforward without application of proper correction methods. Clinical Trial Registration: www.clinicaltrialsregister.eu, identifier 2013-001724-19 PMID:28769742

PET Imaging of D2/3 agonist binding in healthy human subjects with the radiotracer [11C]-N-propyl-nor-apomorphine (NPA): preliminary evaluation and reproducibility studies

PubMed Central

Narendran, Rajesh; Frankle, W. Gordon; Mason, N. Scott; Laymon, Charles M.; Lopresti, Brian J; Price, Julie C.; Kendro, Steve; Vora, Shivangi; Litschge, Maralee; Mountz, James M.; Mathis, Chester A.

2009-01-01

Objective (-)-N-[11C]-Propyl-norapomorphine (NPA) is a full dopamine D2/3 receptor agonist radiotracer suitable for imaging D2/3 receptors configured in a state of high affinity for agonists using Positron Emission Tomography (PET). The aim of the present study was to define the optimal analytic method to derive accurate and reliable D2/3 receptor parameters with [11C]NPA. Methods Six healthy subjects (4 females/2 males) underwent two [11C]NPA scans in the same day. D2/3 receptor binding parameters were estimated using kinetic analysis (using 1- and 2- tissue compartment models) as well as simplified reference tissue method in the three functional subdivisions of the striatum (associative striatum, AST; limbic striatum LST and sensorimotor striatum SMST). The test-retest variability and intraclass correlation coefficient were assessed for distribution volume (VT), binding potential relative to plasma concentration (BPP), and binding potential relative to nondisplaceable uptake (BPND) Results A two-tissue compartment kinetic model adequately described the functional subdivisions of the striatum as well as cerebellum time-activity data. The reproducibility of VT was excellent (≤ 10%) in all regions, for this approach. The reproducibility of both BPP (≤ 12%) and BPND (≤ 10%) was also excellent. The intraclass correlation coefficient of BPP and BPND were acceptable as well (> 0.75) in the three functional subdivisions of the striatum. Although SRTM led to an underestimation of BPND values relative to that estimated by kinetic analysis by 8 to 13%, the values derived using both the methods were reasonably well correlated (r2 = 0.89, n = 84). Both methods were similarly effective at detecting the differences in [11C]NPA BPND between subjects. Conclusion The results of this study indicate that [11C]NPA can be used to measure D2/3 receptors configured in a state of high affinity for the agonists with high reliability and reproducibility in the functional subdivisions of the human striatum. PMID:19301416

Phenotype and genotype of Escherichia coli isolated from pigs with postweaning diarrhea in Hungary.

PubMed Central

Nagy, B; Casey, T A; Moon, H W

1990-01-01

A total of 205 Escherichia coli isolates from 88 diarrheal weanling (4- to 10-week-old) pigs from 59 farms were tested by slide agglutination for K88, K99, F41, and 987P antigens. K88 antigen was detected in 61% of the isolates representing 60% of the pigs and 56% of the farms. K88 antigen was associated with serogroup O149 and 91% of the K88+ isolates. K99, F41, and 987P were not detected. Of the K88- isolates, 70 were additionally tested by colony hybridization with DNA probes for adherence factors K88, K99, 987P, and F41 and for enterotoxin genes STaP, STaH, STb, and LT and by Vero cell assay for verotoxins (VT). The 70 K88- isolates could be divided into three categories: LT-, VT-, STaP+, and/or STb+ (34 isolates); LT-, STaP+, STb+, and/or VT+ (17 isolates); and nontoxigenic (19 isolates). Only one of the K88- isolates carried a known adherence factor (987P) detectable with DNA probes. Most of the STaP+ and STb+ isolates belonged to O groups O141, O147, and O157. All but 1 of the 17 VT+ isolates belonged to O groups O138, O139, O141, and O149. Only three of the VT+ strains were isolated from pigs with edema disease. We concluded that 73% of the K88- isolates had the capability to produce enterotoxins or VT that could have contributed to weanling pig diarrhea. PMID:1970575

Phase mapping of radionuclide gated biventriculograms in patients with sustained ventricular tachycardia or Wolff-Parkinson-White syndrome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Guludec, D.; Bourguignon, M.; Sebag, C.

1987-01-01

Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT-Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Groupmore » I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localization of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown.« less

Wastewater toxicity of tannin- versus chromium-based leather tanneries in Marrakesh, Morocco.

PubMed

De Nicola, E; Meriç, S; Della Rocca, C; Gallo, M; Iaccarino, M; Manini, P; Petruzzelli, D; Belgiorno, V; Cheggour, M; Di Gennaro, A; Moukrim, A; Tünay, O; Pagano, G

2007-10-01

The toxicity of leather tanning wastewater from a traditional tannery (TT), which is based on vegetable tannin (VT), was compared with wastewater from a tannery combining the use of chromium-based tanning (CT) with VT-based tanning operations. Wastewater samples from a TT and a CT plant as well as from five sewer sampling points were collected in Marrakesh, Morocco, and the concentrations of VT and some selected inorganics were measured. A set of bioassays were used to test wastewater toxicity in sea urchin (Paracentrotus lividus) embryos and sperm, in Daphnia magna, and in marine microalgae (Dunaliella tertiolecta). Toxicity end points included: (1) developmental defects, embryonic mortality, sperm fertilization success, and offspring damage in sea urchins; (2) D. magna immobilization; and (3) algal growth rate inhibition. Toxicity tests on TT and CT effluents (TTE and CTE) were run at dilutions ranging from 0.1% to 2% (sea urchins and algae) or up to 12% in D. magna. Parallel bioassays were run on VT extract (VTE) at nominal tannin concentrations ranging from 0.1 to 10 mg l(-1). The results showed higher toxicity of CTE compared with TTE. CTE toxicity in sea urchins and algae showed concentration-related trends, whereas TTE exerted hormetic effects at levels of 0.1% to 0.2% and toxic effects at levels >or=1%. The same trends were observed for VTE, suggesting a prevailing role of tannin in TTE-associated effects. The moderate wastewater toxicity of VT-based tanneries might prompt interest in the VT tanning process.

Variable Ventilation Improved Respiratory System Mechanics and Ameliorated Pulmonary Damage in a Rat Model of Lung Ischemia-Reperfusion

PubMed Central

Soluri-Martins, André; Moraes, Lillian; Santos, Raquel S.; Santos, Cintia L.; Huhle, Robert; Capelozzi, Vera L.; Pelosi, Paolo; Silva, Pedro L.; de Abreu, Marcelo Gama; Rocco, Patricia R. M.

2017-01-01

Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV) has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV) in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models. Thirty-six animals were randomly assigned to one of two groups: (1) ischemia-reperfusion (IR), in which the left pulmonary hilum was completely occluded and released after 30 min; and (2) Sham, in which animals underwent the same surgical manipulation but without hilar clamping. Immediately after surgery, the left (IR-injured) and right (contralateral) lungs from 6 animals per group were removed, and served as non-ventilated group (NV) for molecular biology analysis. IR and Sham groups were further randomized to one of two ventilation strategies: VCV (n = 6/group) [tidal volume (VT) = 6 mL/kg, positive end-expiratory pressure (PEEP) = 2 cmH2O, fraction of inspired oxygen (FiO2) = 0.4]; or VV, which was applied on a breath-to-breath basis as a sequence of randomly generated VT values (n = 1200; mean VT = 6 mL/kg), with a 30% coefficient of variation. After 5 min of ventilation and at the end of a 2-h period (Final), respiratory system mechanics and arterial blood gases were measured. At Final, lungs were removed for histological and molecular biology analyses. Respiratory system elastance and alveolar collapse were lower in VCV than VV (mean ± SD, VCV 3.6 ± 1.3 cmH20/ml and 2.0 ± 0.8 cmH20/ml, p = 0.005; median [interquartile range], VCV 20.4% [7.9–33.1] and VV 5.4% [3.1–8.8], p = 0.04, respectively). In left lungs of IR animals, VCV increased the expression of interleukin-6 and intercellular adhesion molecule-1 compared to NV, with no significant differences between VV and NV. Compared to VCV, VV increased the expression of surfactant protein-D, suggesting protection from type II epithelial cell damage. In conclusion, in this experimental lung ischemia-reperfusion model, VV improved respiratory system elastance and reduced lung damage compared to VCV. PMID:28512431

Ventilatory muscle endurance training in quadriplegia: effects on breathing pattern.

PubMed

Loveridge, B; Badour, M; Dubo, H

1989-10-01

We examined the effects of ventilatory muscle endurance training on resting breathing pattern in 12 C6-C7 traumatic quadriplegics at least 1 year post-injury. All subjects had complete motor loss below the lesion level. Subjects were randomly assigned to a training (N = 6), or a control group (N = 6). Baseline tests included measurement of resting ventilation and breathing pattern using mercury in rubber strain gauges for 20 minutes in a seated position; maximum inspiratory mouth pressure (MIP) at FRC, and sustainable inspiratory mouth pressure for 10 minutes (SIP); lung volumes, and arterial blood gases (ABG's). The training protocol consisted of breathing through an inspiratory resistor equivalent to 85% SIP for 15 minutes twice daily, 5 days a week for 8 weeks. Both trainers and controls attended the lab every 2 weeks for reassessment of MIP and SIP and the inspiratory resistance was increased in the training group as SIP increased. At the end of 8 weeks, baseline tests were repeated. All subjects had normal ABG's. There was a significant increase in mean MIP and SIP in both the control group (30% +/- 19% and 31% +/- 18% respectively), and in the training group (42% +/- 24% and 78% +/- 49% respectively). Although the absolute values for both MIP and SIP were greater in the training group than in the control group, the differences were not significant. The alterations in resting breathing pattern were also the same in both groups. Mean frequency decreased significantly in the control group (20.2/minute to 16.9/minute) and, while insignificant, the change in frequency in the training group was the same, 19.4/minute to 16.4/minute. Mean tidal volume (Vt) increased 18.2% of baseline Vt in the control group and 17.0% baseline in the trainers, resulting in no change in minute ventilation. As MIP and SIP increased similarly in both groups, the data from the control and trainers was pooled and timing changes re-evaluated pre- and post-study. A significant decrease in mean Ti/Ttot was observed, while no change in Vt/Ti was found. We concluded that the testing procedure itself provided the stimulus resulting in a significant increase in MIP and SIP. The addition of training did not increase MIP and SIP further. The increased MIP and SIP resulted in a slower and deeper breathing pattern and a significantly shorter Ti/Ttot in both trainers and control subjects.

Comparison of results from simple expressions for MOSFET parameter extraction

NASA Technical Reports Server (NTRS)

Buehler, M. G.; Lin, Y.-S.

1988-01-01

In this paper results are compared from a parameter extraction procedure applied to the linear, saturation, and subthreshold regions for enhancement-mode MOSFETs fabricated in a 3-micron CMOS process. The results indicate that the extracted parameters differ significantly depending on the extraction algorithm and the distribution of I-V data points. It was observed that KP values vary by 30 percent, VT values differ by 50 mV, and Delta L values differ by 1 micron. Thus for acceptance of wafers from foundries and for modeling purposes, the extraction method and data point distribution must be specified. In this paper measurement and extraction procedures that will allow a consistent evaluation of measured parameters are discussed.

33 CFR 110.8 - Lake Champlain, N.Y. and Vt.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.8 Lake Champlain, N.Y. and Vt. (a) Ticonderoga...°14′05″ W. Note: The anchoring of vessels and placement of temporary moorings in the anchorage area...

33 CFR 110.8 - Lake Champlain, N.Y. and Vt.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.8 Lake Champlain, N.Y. and Vt. (a) Ticonderoga...°14′05″ W. Note: The anchoring of vessels and placement of temporary moorings in the anchorage area...

33 CFR 110.8 - Lake Champlain, N.Y. and Vt.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.8 Lake Champlain, N.Y. and Vt. (a) Ticonderoga...°14′05″ W. Note: The anchoring of vessels and placement of temporary moorings in the anchorage area...

33 CFR 110.8 - Lake Champlain, N.Y. and Vt.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.8 Lake Champlain, N.Y. and Vt. (a) Ticonderoga...°14′05″ W. Note: The anchoring of vessels and placement of temporary moorings in the anchorage area...

In-flight automated external defibrillator use and consultation patterns

PubMed Central

Brown, AM; Rittenberger, JC; Ammon, CM; Harrington, S; Guyette, FX

2010-01-01

Background Limited information exists about the in-flight use and outcomes associated with automatic external defibrillators (AED) on commercial airlines. Methods We collected self-reported cases of AED use to an airline consultation service from three US airlines between May 2004 and March 2009. We reviewed all available data files, related consult forms, and recordings. For each case, demographics, initial rhythm, shock delivery/success, survival to admission, and ground medical consultation use were obtained. Success was defined as the return of a perfusing rhythm. Initial rhythms were classified as: sinus, heart block, SVT, atrial fibrillation/flutter, asystole, PEA and VF/VT. Results There were a total of 169 AED applications with 40 cardiac arrests. The mean ages were 58 years (SD 15) and 63 years (SD 12) respectively; both populations were 64% male. AEDs were applied for monitoring in 129 (76%) cases with initial rhythms of: sinus 114 (88%); atrial fibrillation/flutter 7 (5%); complete heart block 4 (3%); and SVT 4 (3%). Presenting rhythms among the cardiac arrest population were: asystole 16 (40%); ventricular fibrillation/ventricular tachycardia 10 (25%); and PEA 14 (35%). Fourteen patients were defibrillated including nine of the 10 patients with initial VF/VT and five for the presence of VF/VT after resuscitation for initial PEA/asystole. Defibrillation was advised but not performed in the remaining case of initial VF/VT and no medical consult was obtained. All five successful defibrillations occurred in patients with initial VF/VT. There were 6 (15%; 95% CI 3–27%) survivors with 5 occurring after successful defibrillation for initial VF/VT and one with return of a perfusing rhythm after CPR for a junctional rhythm. Survival in those with VF/VT was 5/10 (50%; 95% CI 14–86%). Medications were delivered twice. The median time to first shock was 19 (IQR 12–24) seconds from AED application. Medical consultation was obtained in 56 (33%) of the 169 AED cases and 14 (35%) of the cardiac arrests. Conclusion AEDs resulted in 50% survival among those with VT/VF in-flight and 14% overall survival for cardiac arrest. Survival is poor among patients presenting with non-shockable rhythms. AEDs are used extensively for in-flight monitoring with significant rhythms identified. Ground medical consultation is sought in only one-third of AED uses and cardiac arrests. PMID:20128705

Certain relativistic phenomena in crystal optics

NASA Astrophysics Data System (ADS)

Chee-Seng, Lim

1980-01-01

Relativistic unsteady phenomena are established for a crystalline medium with unaligned sets of permittivity and permeability principal axes, but incorporating a compounded uniaxiality about some nonprincipal direction. All effects originate from a suddenly activated, arbitrarily oriented, maintained line current conducted with a finite velocity v. Integral representations studied in another paper (Chee-Seng) are applied. The original coordinate system is subjected to a series of rotational and translational, scaled and unscaled transformations. No specific coordinate frame is strictly adhered to. Instead, it is often expedient and advantageous to exploit several reference frames simultaneously in the course of the analysis and interpretations. The electric field is directly related to a net scalar field Δ involving another scalar Ψ and its complement Ψ¯ which can be deduced from Ψ; Ψ and Ψ¯ are associated with two expanding, inclined ellipsoidal wavefronts ξ and ξ¯; these are cocentered at the current origin and touch each other twice along the uniaxis. Elsewhere, ξ leads ξ¯. For a source current faster than ξ:vt ∈ extξ, Ψ≢0 within a finite but growing ''ice-cream cone'' domain, its nontrivial composition being χ-1/2 inside ξ and 2χ-1/2 inside part of a tangent cone from the advancing current edge vt to, and terminating at, ξ; the function χ vanishes along such a tangent cone. Alternatively, for a source current slower than ξ:vt∈ intξ, if vt is avoided, χ≳0 everywhere, while Ψ=χ-1/2 inside ξ but vanishes identically outside ξ. However, the crucial scalar field Δ depends on three separate current-velocity regimes. Over a slow regime: vt∈ intξ¯, Δ is nontrivial inside ξ wherein it is discontinuous across ξ¯. Over an intermediate regime: vt ∈ intξ extξ¯, Δ takes four distinct forms on 12 adjacent domains bounded by ξ, ξ¯ and a double-conical tangent surface linking vt to ξ¯. But for a fast regime: vt∈ extξ, Δ assumes six distinct forms on 18 adjacent domains bounded by ξ, ξ¯ plus two double-conical tangent surfaces, convertexed at vt, to both ξ and ξ¯. Singularities are normally confined to these boundaries. Relative to a moving frame, χ is time-independent. Nevertheless, Ψ and, consequently, Δ evolve unsteadily, principally because of transitions across the expanding ellipsoids ξ and ξ¯ which also acquire a relative retreat from the current edge vt. An evolution scheme is discussed in detail. This produces, among other things, a steady state corollary which, in turn, covers Čerenkov radiation. A quadrical symmetry exists with respect to a family {Qν} of constant χ-surfaces. These are quadric surfaces cocentered at vt and having principal axes inclined to those of ξ (and ξ¯). Their interactions with ξ are closely examined. If vt ∈ extξ, each Qν is a hyperboloid of two sheets which are asymptotic to the double-conical tangent surface connecting ξ to vt; Ψ can become nontrivial on only one sheet, viz., that which is approached by ξ as the latter retreats from vt; eventually, two permanent intersections, one following the other, occur along two expanding and travelling parallel plane circuits. But if vt ∈ intξ, each Qν is an ellipsoid inside which ξ initially evolves until an encounter occurs, first as a point contact which immediately grows into a plane circuit; as this traverses Qν, it expands and then contracts to a diametrically opposite point where contact breaks off. Finally, an elliptical axisymmetry about a principal direction of {Qν} is demonstrated. Corresponding behaviors hold in relation to ξ¯.

Age-dependent prevalence of nasopharyngeal carriage of streptococcus pneumoniae before conjugate vaccine introduction: a prediction model based on a meta-analysis.

PubMed

Le Polain de Waroux, Olivier; Flasche, Stefan; Prieto-Merino, David; Edmunds, W John

2014-01-01

Data on the prevalence of nasopharyngeal carriage of S.pneumoniae in all age groups are important to help predict the impact of introducing pneumococcal conjugate vaccines (PCV) into routine infant immunization, given the important indirect effect of the vaccine. Yet most carriage studies are limited to children under five years of age. We here explore the association between carriage prevalence and serotype distribution in children aged ≥5 years and in adults compared to children. We conducted a systematic review of studies providing carriage estimates across age groups in healthy populations not previously exposed to PCV, using MEDLINE and Embase. We used Bayesian linear meta-regression models to predict the overall carriage prevalence as well as the prevalence and distribution of vaccine and nonvaccine type (VT and NVT) serotypes in older age groups as a function of that in <5 y olds. Twenty-nine studies compromising of 20,391 individuals were included in the analysis. In all studies nasopharyngeal carriage decreased with increasing age. We found a strong positive linear association between the carriage prevalence in pre-school childen (<5 y) and both that in school aged children (5-17 y olds) and in adults. The proportion of VT serotypes isolated from carriers was consistently lower in older age groups and on average about 73% that of children <5 y among 5-17 y olds and adults respectively. We provide a prediction model to infer the carriage prevalence and serotype distribution in 5-17 y olds and adults as a function of that in children <5 years of age. Such predictions are helpful for assessing the potential population-wide effects of vaccination programmes, e.g. via transmission models, and thus assist in the design of future pneumococcal conjugate vaccination strategies.

Imaging changes in synaptic acetylcholine availability in living human subjects

PubMed Central

Esterlis, Irina; Hannestad, Jonas O.; Bois, Frederic; Sewell, R. Andrew; Tyndale, Rachel; Seibyl, John P.; Picciotto, Marina R.; Laruelle, Marc; Carson, Richard E.; Cosgrove, Kelly P.

2013-01-01

Introduction In vivo estimation of beta2-nicotinic acetylcholine receptor (β2*-nAChR) availability with molecular neuroimaging is complicated by competition between the endogenous neurotransmitter ACh and the radioligand [123I]5-IA-85380 ([123I]5-IA). We examined whether binding of [123I]5-IA is sensitive to increases in extracellular levels of ACh in humans, as suggested in non-human primates (1). Methods Six healthy subjects (31±4yrs) participated in one [123I]5-IA SPECT study. After baseline scans, physostigmine (1–1.5mg) was administered IV over 60 min, and additional scans were collected (8–14h). Results We observed a significant reduction in VT/fp (total volume of distribution) after physostigmine (29±17% cortex, 19±15% thalamus, 19±15% striatum, and 36±30% cerebellum; p<.05). This reflected a combination of a region-specific 7–16% decrease in tissue concentration of tracer and 9% increase in plasma parent concentration. Conclusion These data suggest that increases in ACh compete with [123I]5-IA for binding to β2*-nAChRs. Additional validation of this paradigm is warranted, but it may be used to interrogate changes in extracellular ACh. PMID:23160789

76 FR 59479 - Vermont Disaster Number VT-00021

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12784 and 12785] Vermont Disaster Number VT-00021 AGENCY: U.S. Small Business Administration. ACTION: Amendment 5. SUMMARY: This is an amendment of... original declaration remains unchanged. (Catalog of Federal Domestic Assistance Numbers 59002 and 59008...

76 FR 58329 - Vermont Disaster Number VT-00021

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 12784 and 12785] Vermont Disaster Number VT-00021 AGENCY: U.S. Small Business Administration. ACTION: Amendment 4. SUMMARY: This is an amendment of... in the original declaration remains unchanged. (Catalog of Federal Domestic Assistance Numbers 59002...

Speech-evoked brainstem frequency-following responses during verbal transformations due to word repetition.

PubMed

Galbraith, G C; Jhaveri, S P; Kuo, J

1997-01-01

Speech-evoked brainstem frequency-following responses (FFRs) were recorded to repeated presentations of the same stimulus word. Word repetition results in illusory verbal transformations (VTs) in which word perceptions can differ markedly from the actual stimulus. Previous behavioral studies support an explanation of VTs based on changes in arousal or attention. Horizontal and vertical dipole FFRs were recorded to assess responses with putative origins in the auditory nerve and central brainstem, respectively. FFRs were recorded from 18 subjects when they correctly heard the stimulus and when they reported VTs. Although horizontal and vertical dipole FFRs showed different frequency response patterns, dipoles did not differentiate between perceptual conditions. However, when subjects were divided into low- and high-VT groups (based on percentage of VT trials), a significant Condition x Group interaction resulted. This interaction showed the largest difference in FFR amplitudes during VT trials, with the low-VT group showing increased amplitudes, and the high-VT group showing decreased amplitudes, relative to trials in which the stimulus was correctly perceived. These results demonstrate measurable subject differences in the early processing of complex signals, due to possible effects of attention on the brainstem FFR. The present research shows that the FFR is useful in understanding human language as it is coded and processed in the brainstem auditory pathway.

Variable Temperature Nuclear Magnetic Resonance and Magnetic Resonance Imaging System as a Novel Technique for In Situ Monitoring of Food Phase Transition.

PubMed

Song, Yukun; Cheng, Shasha; Wang, Huihui; Zhu, Bei-Wei; Zhou, Dayong; Yang, Peiqiang; Tan, Mingqian

2018-01-24

A nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) system with a 45 mm variable temperature (VT) sample probe (VT-NMR-MRI) was developed as an innovative technique for in situ monitoring of food phase transition. The system was designed to allow for dual deployment in either a freezing (-37 °C) or high temperature (150 °C) environment. The major breakthrough of the developed VT-NMR-MRI system is that it is able to measure the water states simultaneously in situ during food processing. The performance of the VT-NMR-MRI system was evaluated by measuring the phase transition for salmon flesh and hen egg samples. The NMR relaxometry results demonstrated that the freezing point of salmon flesh was -8.08 °C, and the salmon flesh denaturation temperature was 42.16 °C. The protein denaturation of egg was 70.61 °C, and the protein denaturation occurred at 24.12 min. Meanwhile, the use of MRI in phase transition of food was also investigated to gain internal structural information. All these results showed that the VT-NMR-MRI system provided an effective means for in situ monitoring of phase transition in food processing.

A study of acoustic-to-articulatory inversion of speech by analysis-by-synthesis using chain matrices and the Maeda articulatory model

PubMed Central

Panchapagesan, Sankaran; Alwan, Abeer

2011-01-01

In this paper, a quantitative study of acoustic-to-articulatory inversion for vowel speech sounds by analysis-by-synthesis using the Maeda articulatory model is performed. For chain matrix calculation of vocal tract (VT) acoustics, the chain matrix derivatives with respect to area function are calculated and used in a quasi-Newton method for optimizing articulatory trajectories. The cost function includes a distance measure between natural and synthesized first three formants, and parameter regularization and continuity terms. Calibration of the Maeda model to two speakers, one male and one female, from the University of Wisconsin x-ray microbeam (XRMB) database, using a cost function, is discussed. Model adaptation includes scaling the overall VT and the pharyngeal region and modifying the outer VT outline using measured palate and pharyngeal traces. The inversion optimization is initialized by a fast search of an articulatory codebook, which was pruned using XRMB data to improve inversion results. Good agreement between estimated midsagittal VT outlines and measured XRMB tongue pellet positions was achieved for several vowels and diphthongs for the male speaker, with average pellet-VT outline distances around 0.15 cm, smooth articulatory trajectories, and less than 1% average error in the first three formants. PMID:21476670

Bovine Colostral Antibody Against Verotoxin 2 Derived from Escherichia coli O157:H7: Resistance to Proteases and Effects in Beagle Dogs

PubMed Central

Kuribayashi, Takashi; Seita, Tetsuro; Matsumoto, Mariko; Furuhata, Katsunori; Tagata, Kazutoshi; Yamamoto, Shizuo

2009-01-01

A bovine colostral antibody against verotoxin (VT) 2 of Escherichia coli O157:H7 was administered orally to beagle dogs. The antibody remained in the dogs’ small intestine for at least 2 h, whereas little serum antibody remained 1.5 h after administration. Furthermore, the antibody activity of secretory IgA did not change until 2 h after administration; however, the activity of IgG and IgM antibodies decreased by approximately 60% and 40% at 2 h after administration, respectively. Seven beagle dogs inoculated with Escherichia coli O157:H7 producing VT2 were administered bovine colostral antibody or bovine colostral whey without antibody. With administration of bovine colostral whey without antibody, the amount of VT2 in feces decreased gradually after administration and increased again at 5 d after inoculation, whereas bovine colostral antibody significantly reduced the amount of VT2 in feces on the day after administration. In addition, 9 beagle dogs were given bovine colostral antibody, bovine plasma antibody, or saline. The amount of VT2 in feces again decreased significantly more rapidly after administration of bovine colostral antibody than after administration of bovine plasma antibody or saline. PMID:19389308