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Biomedical subjects

A Johansson

Publications and source records attributed to A Johansson.

At least 55 records · Page 3Linked to original sources

Neural network for photoplethysmographic respiratory rate monitoring.

The reflection mode photoplethysmographic (PPG) signal was studied with the aim of determining respiratory rate. The PPG signal includes respiratory synchronous components, seen as frequency modulation of the heart rate (respiratory sinus arrhythmia), amplitude modulation of the cardiac pulse and respiratory-induced intensity variations (RIIVs) in the PPG baseline. PPG signals were recorded from the foreheads of 15 healthy subjects. From these signals, the systolic wave-form, diastolic waveform, respiratory sinus arrhythmia, pulse amplitude and RIIVs were extracted. Using basic algorithms, the rates of false positive and false negative detection of breaths were calculated separately for each of the five components. Furthermore, a neural network was assessed in a combined pattern recognition approach. The error rates (sum of false positive and false negative breath detections) for the basic algorithms ranged from 9.7% (pulse amplitude) to 14.5% (systolic waveform). The corresponding values for the neural network analysis were 9.5-9.6%. These results suggest the use of a combined PPG system for simultaneous monitoring of respiratory rate and arterial oxygen saturation (pulse oximetry).

Adult↗

Respiratory variations in the reflection mode photoplethysmographic signal. Relationships to peripheral venous pressure.

Photoplethysmography (PPG) is a non-invasive optical way of measuring variations in blood volume and perfusion in the tissue, used in pulse oximetry for instance. Respiratory-induced intensity variations (RIIVs) in the PPG signal exist, but the physiological background is not fully understood. Respiration causes variations in the blood volume in the peripheral vascular bed. It was hypothesised that the filling of peripheral veins is one of the important factors involved. In 16 healthy subjects, the respiratory synchronous variations from a PPG reflection mode signal and the peripheral venous pressure (PVP) were recorded. Variations of tidal volume, respiratory rate and contribution from abdominal and thoracic muscles gave significant and similar amplitude changes in both RIIV and the respiratory variation of PVP (p<0.01). The highest amplitudes of both signals were found at the largest tidal volume, lowest respiratory rate and during mainly thoracic breathing, respectively. The coherence between PVP and RIIV signals was high, the median (quartile range) being 0.78 (0.42). Phase analysis showed that RIIV was usually leading PVP, but variations between subjects were large. Although respiratory-induced variations in PVP and PPG showed a close correlation in amplitude variation, a causal relationship between the signals could not be demonstrated.

Adult↗

From local interactions to population dynamics in site-based models of ecology.

A central problem in ecology is relating the interactions of individuals-described in terms of competition, predation, interference, etc.-to the dynamics of the populations of these individuals-in terms of change in numbers of individuals over time. Here, we address this problem for a class of site-based ecological models, where local interactions between individuals take place at a finite number of discrete resource sites over non-overlapping generations and, between generations, individuals move randomly between sites over the entire system. Such site-based models have previously been applied to a wide range of ecological systems: from those involving contest or scramble competition for resources to host-parasite interactions and meta-populations. We show how the population dynamics of site-based models can be accurately approximated by and understood through deterministic and stochastic difference equations. Conversely, we use the inverse of this approximation to show what implicit assumptions are made about individual interactions by modelling of population dynamics in terms of difference equations. To this end, we prove a useful and general theorem: that any model in our class of site-based models has a corresponding stochastic difference equation population model, by which it can be approximated. This theorem allows us to calculate long-term population dynamics, evolutionary stable strategies and, by extending our theory to account for large deviations, extinction probabilities for a wide range of site-based systems. Our methodology is then illustrated to various examples of between species competition, predator-prey interactions and co-operation.

Competitive Behavior↗

The effect of heat and moisture exchanger on humidity and body temperature in a low-flow anaesthesia system.

BACKGROUND: Artificial humidification of dry inspired gases seems to reduce the drop in body temperature during surgery. The aim of this study was to evaluate the humidity and temperature of anaesthetic gases with heat and moisture exchangers (HMEs). The secondary aim was to evaluate if HMEs in combination with low-flow anaesthesia could prevent a decrease in the body temperature during general anaesthesia. METHODS: Ninety patients scheduled for general surgery were randomised to receive a fresh gas flow of 1.0, 3.0 or 6.0 l min-1 with or without HMEs in a circle anaesthesia system. Relative humidity, absolute humidity, temperature of inspired gases and body temperatures were measured during 120 min of anaesthesia. RESULTS: The inspiratory absolute humidity levels with HMEs were 32.7 +/- 3.1, 32.1 +/- 1.1 and 29.2 +/- 1.9 mg H2O l(-1) and 26.6 +/- 2.3, 22.6 +/- 3.0 and 13.0 +/- 2.6 mg H2O l(-1) without HMEs after 120 min of anaesthesia with 1.0, 3.0, or 6.0 l min(-1) fresh gas flows (P < 0.05, between with and without HME). The relative humidity levels with HMEs were 93.8 +/- 3.3, 92.7 +/- 2.2 and 90.7 +/- 3.5%, and without the HMEs 95.2 +/- 4.5, 86.8 +/- 8.0 and 52.8 +/- 9.8% (P < 0.05, between with and without HMEs in the 3.0 and 6.0 l min(-1) groups). The inspiratory gas temperatures with HMEs were 32.5 +/- 2.0, 32.4 +/- 0.5 and 31.0 +/- 1.9 degrees C, and 28.4 +/- 1.5, 27.1 +/- 0.8 and 26.1 +/- 0.6 degrees C without HMEs after 120 min of anaesthesia (P < 0.05, between with and without HME). The tympanic membrane temperatures at 120 min of anaesthesia were 35.8 +/- 0.6, 35.5 +/- 0.6 and 35.4 +/- 0.8 degrees C in the groups with HMEs, and 35.8 +/- 0.6, 35.3 +/- 0.7 and 35.3 +/- 0.9 degrees C in the groups without the HMEs (NS). CONCLUSIONS: The HMEs improved the inspiratory absolute humidity, relative humidity and temperature of the anaesthetic gases during different fresh gas flows. However, the HMEs were not able to prevent a body temperature drop during low-flow anaesthesia.

Adult↗

Serum-mediated release of leukotoxin from the cell surface of the periodontal pathogen Actinobacillus actinomycetemcomitans.

The leukotoxin of the periodontopathogen Actinobacillus actinomycetemcomitans is an important virulence factor that lyses human neutrophils and monocytes and thus, it may enable the bacterium to evade the local host defense. The toxin also induces degranulation of neutrophils and cytokine release in monocytes. To trigger these biological activities, leukotoxin has to be released from the bacterium and diffuse into the periodontal tissues. To date, the conditions found to cause toxin release have been artificial and have included high ion concentration and alkaline conditions. To study the release of the toxin under conditions mimicking the natural environment of the periodontium the ability of human serum to enable leukotoxin release from the bacterial surface was examined. Suspensions of leukotoxic A. actinomycetemcomitans strains were incubated with various concentrations of human serum or serum albumin. The suspensions were centrifuged and the leukotoxin in the supernatants or the cell pellets was detected by gel electrophoresis and immunoblotting. Serum was found to cause the rapid release of leukotoxin from the bacteria in a concentration-dependent manner. Pure albumin exhibited a similar effect. The leukotoxin released was active against human neutrophils. Only a minor proportion of it was associated with membranous vesicles produced by the bacteria. The results indicate that serum, a fluid closely related to the exudate in inflamed periodontal pockets, releases leukotoxin from the cell surface of A. actinomycetemcomitans. The process may enable the diffusion of the toxin from the bacterial biofilm into the surrounding tissues, where it can exert its biological effect.

Aggregatibacter actinomycetemcomitans↗

Periodontitis, caries and salivary factors in Sjögren's syndrome patients compared to sex- and age-matched controls.

The aims of this investigation were: (i) to study a group of dry mouth Sjögren's syndrome (SS) patients comprising individuals with pathological and non-pathological amounts of rest saliva and (ii) to compare these two categories of SS patients with a sex- and age-matched control group with respect to their periodontal and dental status. Thirty-three dry mouth patients and 33 sex- and age-matched patients, referred to the same private dental clinic in southern Norway, were examined for rest and stimulated saliva, as well as their dental and periodontal status. All patients were referred to the local hospital for blood and urine examinations. The dry mouth SS patients were all of the secondary type. Volumes of rest and stimulated saliva were significantly lower in the low saliva SS group compared with the high saliva SS group; the values for immunoglobulin G (IgG) and IgA were similarly lower for the low saliva group, but not for IgM which was significantly higher. The two SS subgroups and their controls were compared for the volume of rest and stimulated saliva, which showed a statistically significant lower volumes for the low saliva SS group compared with the control group. None of the subgroups and their controls differed concerning filled or missing teeth, but the total SS group revealed significantly higher number of missing teeth. The periodontal and dental status did not show any statistically significant differences except for a few scattered higher periodontal level losses of attachment in the SS subgroups. The blood and urine analyses showed statistically significant higher values for sedimentation rate, white blood cell count and haemoglobin in the SS low saliva group compared with the control group while anti-streptolysin was lower. In the high saliva SS group only sedimentation rate and white cell count were higher compared with the control. The conclusions is SS patients do not have an increased risk for developing periodontitis.

Adolescent↗

Development, reliability and validity of the Diabetes Illness Representations Questionnaire: four studies with adolescents.

AIMS: This article reports on the development and validity of a Diabetes-specific Illness Representations Questionnaire (DIRQ) to assess all five dimensions of an individual's perception of diabetes, for adolescents with Type 1 diabetes mellitus. METHODS: There were two development studies. Study 1: participants (n = 115) completed a questionnaire assessing perceptions of the consequences of diabetes and the effectiveness of treatment, along with a questionnaire assessing self-care. Study 2: participants (n = 79) completed a questionnaire assessing their identity, timeline and causal beliefs, along with a diabetes self-efficacy and barriers to adherence questionnaire. Subsequently there were two validation studies. Study 3: participants (n = 44 adolescents and 28 parents) completed the DIRQ and questionnaires assessing their self-care and psychological well-being. Glycaemic control was assessed through retrieval of routine assay results. Study 4: participants (n = 70) completed the DIRQ and questionnaires to assess their psychological well-being, with glycaemic control assessed through retrieval of routine assay results. RESULTS: The development studies suggest that the perceived consequences of diabetes consist of two subscales, perceived threat and perceived impact, and provide further support for the distinction between treatment effectiveness to control diabetes and treatment effectiveness to prevent complications. Along with the validation studies, the results indicate that the questionnaire scales showed good internal consistency and construct validity through their associations with measures of self-care and psychological well-being. CONCLUSION: The data reported here suggest that the DIRQ has the potential to be a useful tool for clinical assessment and evaluating the impact of psycho-educational and medical interventions.

Adaptation, Psychological↗

Macrocirculation is not the sole determinant of respiratory induced variations in the reflection mode photoplethysmographic signal.

Photoplethysmography (PPG) is a non-invasive optical technique sensitive to variations in blood volume and perfusion in the tissue. Reflection mode PPG may have clinical advantages over transmission mode PPG. To improve clinical usefulness and further development of the reflection mode PPG, studies on factors that modify the signal are warranted. We studied the coherence between the respiratory induced intensity variations (RIIV) of the PPG signal and respiratory synchronous pressure variations in central venous pressure (CVP), peripheral venous pressure (PVP) and arterial blood pressure (ABP) during positive pressure ventilation on 12 patients under anaesthesia and on 12 patients with spontaneous breathing. During positive pressure ventilation the coherence between all signals was high. Inspiration was followed first by an increase in CVP, then by increases in ABP and PVP and lastly by RIIV indicating less back-scattered light. In spontaneously breathing patients the coherence was high, but the phases between the signals were changed. During inspiration, ABP decreased slightly before CVP, followed by a decrease in RIIV and PVP. The phase relation between RIIV and respiratory induced variation in macrocirculation changed with ventilatory mode, but not in a uniform way, indicating the influence of mechanisms other than macrocirculation involved in generating the RIIV signal.

Adolescent↗

Evaluation of various attenuation corrections in lung SPECT in healthy subjects.

The effect of increasingly more sophisticated attenuation correction methods on image homogeneity has been studied in seven healthy subjects. The subjects underwent computed tomography (CT), single photon emission computed tomography (SPECT) and transmission computed tomography (TCT) of the thorax region in the supine position. Density maps were obtained from the CT and TCT studies. Attenuation corrections were performed using five different methods: (1) uniform correction using only the body contour; (2) TCT based corrections using the average lung density; (3) TCT based corrections using the pixel density; (4) CT based corrections using average lung density; and (5) CT based corrections using the pixel density. The isolated attenuation effects were assessed on quotient images generated by the division of images obtained using various attenuation correction methods divided by the non-uniform attenuation correction based on CT pixel density (reference method). The homogeneity was calculated as the coefficient of variation of the quotient images (CV(att)), showing the isolated attenuation effects. Values of CV(att) were on average 12.8% without attenuation correction, 10.7% with the uniform correction, 8.1% using TCT map using the average lung density value and 4.8% using CT and average lung density corrections. There are considerable inhomogeneities in lung SPECT slices due to the attenuation effect. After attenuation correction the remaining inhomogeneity is considerable and cannot be explained by statistical noise and camera non-uniformity alone.

Adult↗

Caspase 1 involvement in human monocyte lysis induced by Actinobacillus actinomycetemcomitans leukotoxin.

Actinobacillus actinomycetemcomitans, an oral bacterium implicated in the etiology of periodontal diseases, produces a leukotoxin that selectively lyses primate neutrophils and monocytes, the major populations of defense cells in the periodontium. Though lysis requires expression of the receptor lymphocyte function-associated molecule 1 (LFA-1) on the cell surface, not all LFA-1-expressing leukocyte populations are equally susceptible to the toxin. In this study, the susceptibility of human leukocytes to leukotoxin-induced lysis is compared to their expression of LFA-1 and the activity of caspase 1. Cytolysis was determined by the activity of lactate dehydrogenase released from peripheral human leukocytes after 1-h exposure to leukotoxin. Monocytes were lysed at leukotoxin concentrations of > or = 5 ng/ml, while the corresponding values for neutrophils and lymphocytes were approximately 10 times greater. Similar LFA-1 expression was found in all susceptible cell populations irrespective of their degree of sensitivity to the toxin. Exposure of monocytes to leukotoxin increased their caspase 1 activity about fivefold within 10 to 20 min. Presence of the caspase 1 inhibitor Ac-YVAD-CMK significantly blocked the leukotoxin-induced lysis of monocytes only. At sublytic concentrations, leukotoxin induced no apoptotic activity in monocytes, as revealed by the lack of caspase 3 activation and DNA fragmentation. Monocytes are the most lysis-sensitive leukocytes for A. actinomycetemcomitans leukotoxin. Their lysis by this toxin depends on caspase 1 activation and proceeds through a process that differs from classical apoptosis.

Actinobacillus Infections↗

On visual determination of full inspiration on CT images.

The aim of this study was to evaluate the ability of experienced thoracic radiologists to assess full inspiration based on two CT slices, one above and one below the carina, in normal subjects. Ten healthy volunteers were studied. Total lung capacity (TLC) was measured with a body plethysmograph. High-resolution computed tomography (HRCT) was performed in two slices at TLC and at various expired volumes. Mean Hounsfield values (HU) were calculated. Unidentifiable images, stored on a web server, were analysed visually by experienced thoracic radiologists. The results show that the mean lung density at TLC varied by approximately 40 HU between individuals. Within an individual this may correspond to a decrease in lung volume of approximately 25% of TLC. On visual determination of images taken at 65-74% of TLC, more than one-third of the images were assessed as taken at full inspiration; of the images taken at 75-84% of TLC, approximately 50% were assessed as taken at full inspiration. We conclude that visual determination of full inspiration on CT images in normal subjects is highly inaccurate. If quantitative density measurements are to be used in the diagnosis or follow-up of lung disease, thorough control of full inspiration is recommended.

Adult↗

Ultrasound anatomy in the neonatal clubfoot.

Our objective was to assess clubfoot anatomy by US in newborn babies before and in the early phase of treatment. Reproducible US projections and measurements were carried out on 30 untreated clubfeet in 22 children, consecutively included in the study. The position of the navicular in relation to the head of the talus was visualised in all feet. The mean distance between the medial malleolus and the navicular was significantly shorter in the clubfeet than in normal feet. There was a tendency to medial displacement of the cuboid. Soft tissue thickness at the medial side of the foot was increased in all deformed feet. The measurements showed an acceptable intra- and inter-observer reliability for the different variables assessed ( r=0.71-0.96, Pearson's correlation coefficient). With US it is possible to obtain well-defined planes of investigation that give important information about the clubfoot deformity concerning the talo-crural, the talo-navicular and the calcaneo-cuboid joints. The method is simple enough to be used in everyday clinical practice and we recommend it as a guide during the non-operative treatment and for preoperative planning.

Clubfoot↗

Exclusive measurement of the pp --> pppi(+)pi(-) reaction near threshold.

The pp-->pp pi(+) pi(-) reaction has been measured exclusively near threshold at CELSIUS. The total cross sections are nearly an order of magnitude lower than expected from previous inclusive measurements. The differential cross sections reveal pp-->pp(*)(1440)-->pp sigma = pp(pi(+)pi(-))(I = l = 0) as the dominant process as well as significant contributions from p(*)-->Delta(++)pi(-)-->psigma. The observed anisotropy in the proton angular dependence is consistent with heavy-meson exchange. In the invariant mass spectra, no narrow structures of statistical relevance (3sigma) are found.

Journal Article↗

Time-frequency characterization of femtosecond extreme ultraviolet pulses.

We present energy-resolved cross-correlation measurements of an extreme ultraviolet (XUV) pulse, generated as the fifth harmonic (15.5 eV) of an intense 80 fs laser pulse centered at 400 nm. Spectrally resolving the cross-correlation signal allows us to characterize the time-dependent frequency of the XUV pulse. We find that the fifth harmonic has a small negative chirp in excess of that predicted by perturbation theory. In addition, by manipulating the chirp of the driving laser we can induce and measure a positive or a negative chirp on the XUV pulse.

Journal Article↗

Ultrasound anatomy in the normal neonatal and infant foot: an anatomic introduction to ultrasound assessment of foot deformities.

The aim of this study was to establish guidelines for US assessment of the talo-crural, the talo-navicular and the calcaneo-cuboid joints during the first year of life, which could serve as a reference while studying foot deformities. The feet of 54 healthy children were examined at birth and at the age of 4, 7 and 12 months by using three easily defined and reproducible US projections. With a medial projection the relation of the navicular in relation to the medial malleolus and the head of the talus was studied. A lateral projection revealed the calcaneo-cuboid relationship and a dorsal projection the talo-navicular alignment in the sagittal plane. Normal values for measurements of these cartilaginous relationships were established for the different age groups. Intra- and inter-observer reliability was assessed and found to be acceptable ( r=0.53-0.90, Pearson correlation coefficient). With US it is possible to obtain reproducible planes of investigation that give reliable information about the talo-crural, the talo-navicular and the calcaneo-cuboid relationships during the first year of life.

Female↗

H2O2 production by cells on titanium and polystyrene surfaces using an in vivo model of exudate and surface related cell function.

The determination of secreted levels of reactive oxygen species by implant-adherent cells in vivo is required for understanding of the role(s) of such reactive oxygen species for the tissue response around medical devices. A model with subcutaneous implants of c.p. titanium (Ti) or polystyrene (PS) (cell culture grade) inserted on the back of rats were used. Implants and associated cells were retrieved and assayed after 1, 3, 5, 7, 14, 21 and 28 days. Morphological analysis of exudate cells showed that polymorphonuclear leukocytes (PMN) predominated after one day whereas macrophages were predominant after three days. The number of implant-adherent cells, as reflected by measurement of DNA, decreased with time. Ultrastructural observations showed that macrophages were predominant cells in contact with the implant surface. Measurement of hydrogen peroxide (H(2)O(2)) secretion by implant-adherent cells during 40 min incubation ex vivo revealed a constitutive generation of 40-400 pmol H(2)O(2)/microg DNA, depending on implantation time. Stimulation with protein kinase C agonist phorbol myristate acetate (PMA) caused an increased H(2)O(2) generation by adherent cells at early (up to five days) but not later (7-28 days) time periods. No major differences between Ti and PS were observed. Taken together, these findings show that Ti and PS implant-adherent cells secrete H(2)O(2) under in vivo conditions. Further, a reduced capacity to mount an enhanced H(2)O(2) secretion upon stimulation was demonstrated at late time periods. The role of this mediator for biocompatibility remains to be established.

Journal Article↗

Soda lime temperatures during low-flow sevoflurane anaesthesia and differences in dead-space.

BACKGROUND: Sevoflurane degrades during low-flow anaesthesia to compound A, and high carbon dioxide absorbent temperatures cause increased degradation. The purpose of this investigation was to determine if larger tidal volumes, without increasing alveolar ventilation, decrease the temperature in the carbon dioxide absorber during low- and minimal-flow sevoflurane anaesthesia. METHODS: Prospective, randomized study, including 45 patients (ASA 1-2), scheduled for elective general or urology surgery. The patients were randomly assigned to one of three treatments. Patients in group 1 (NDS) received fresh gas flow of 1 litre/min without using additional dead-space volumes. In group 2 (DS + 1.0), the patients received fresh gas flow of 1 litre/min using additional dead-space volumes, placed between the Y-piece and the HME, and patients in group 3 (DS + 0.5) received the same technique with a fresh gas flow of 0.5 litre/min. The soda lime temperatures, dead-space volumes, end-tidal carbon dioxide, sevoflurane concentrations, ventilation volumes and pressures, absorbent weight and ear temperatures were measured. RESULTS: The maximum temperature of the soda lime was 44.1 +/- 1.1 degrees C in the NDS group, 37.8 +/- 0.8 degrees C in the DS + 1.0 group and 38.5 +/- 2.7 degrees C in the DS + 0.5 group (P<0.0001). The dead-space volume between the Y-piece the tracheal tube was 164 +/- 69 ml in the DS + 1.0 group and 196 +/- 15 ml in the DS + 0.5 group (P<0.05). The ventilator pressure were higher in the DS groups compared with the NDS group (P<0.001). Soda lime weight increased in all groups. End-tidal carbon dioxide, sevoflurane concentrations and ear temperatures were similar between the groups. CONCLUSION: Increasing dead-space volumes can reduce carbon dioxide absorber temperature during low- and minimal-flow sevoflurane anaesthesia.

Aged↗