Electrical impedance tomography. Comments on reconstruction algorithms.
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Biomedical subjects
Publications and source records attributed to D Isaacson.
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A prospective study to investigate risk factors for CMV disease was conducted in 94 renal transplant recipients. CMV disease was defined as either unexplained fever for greater than 3 days with viremia or unexplained fever for greater than 3 days with isolation of CMV from the urine or throat wash and at least one of the following: leukopenia, elevated serum alanine aminotransferase, or biopsy-proved invasive tissue infection of the lung or gastrointestinal tract. Fifty-three patients received immunosuppressive regimens consisting of prednisone and cyclosporine, with or without azathioprine. The remaining 41 patients were treated with these agents plus OKT3 (21 received OKT3 to treat rejection, 20 received OKT3 prophylactically). Thirty-seven patients were at minimal risk of CMV disease (donor and recipient seronegative for CMV); 12 patients were at risk of primary disease (donor seropositive, recipient seronegative), and 45 were at risk of reactivation disease (recipient seropositive at the time of transplantation). The incidences of CMV disease in the 3 groups were 0%, 58%, and 36%, respectively. Although the incidence of CMV disease in patients at risk of primary disease was not influenced by the immunosuppressive regimen, immunosuppression had a profound effect on the occurrence of CMV disease in CMV-seropositive transplant recipients. The incidence of CMV disease in those receiving OKT3 was 59%; but only 21% in those who did not receive OKT3. OKT3 increased the risk of CMV disease five-fold (odds ratio 5.2 (95% confidence limits 1.4-17.5)). In the CMV-seropositive patient, OKT3 was also the most important predictor of CMV disease by multivariate analysis (P less than 0.002). A pilot study of preemptive therapy with ganciclovir (2.5 mg/kg daily during OKT3 therapy) in 17 patients decreased the incidence of CMV disease without appreciable toxicity.
Impedance imaging systems apply currents to the surface of a body, measure the induced voltages on the surface, and from this information, reconstruct an approximation to the electrical conductivity in the interior. This paper gives a detailed discussion of several ways to measure the ability of such a system to distinguish between two different conductivity distributions. The subtle differences between these related measures are discussed, and examples are provided to show that these different measures can give rise to different answers to various practical questions about system design.
The in vitro activity of saperconazole against eight candidal species (81 strains) was determined and compared with fluconazole, Sch 39304 and amphotericin B. Using brain heart infusion broth with an inoculum of 10(4) CFU/ml, the MIC ranges (micrograms/ml) of saperconazole were: less than or equal to 0.015- greater than 32 for Candida albicans, less than or equal to 0.015-16 for C. tropicalis, less than or equal to 0.015-32 for C. glabrata, less than or equal to 0.015-32 for C. parapsilosis, less than or equal to 0.015-0.12 for C. guilliermondii and less than or equal to 0.015-0.06 for C. krusei. Saperconazole was the most active agent tested against Candida species. Saperconazole and 5-fluorocytosine combinations showed synergistic interactions against Candida species, and no antagonistic interaction was demonstrated. In a rat vaginal candidiasis infection model, saperconazole and fluconazole were equipotent producing 75-100% cures at levels of 0.016-0.25%, respectively, when dosed intravaginally. After single oral dosing, saperconazole was 5-fold more potent than fluconazole with an ED50 value of 0.53 mg/kg. These data demonstrate that saperconazole is effective in a rat vaginal candidiasis infection either with a single oral dose or by intravaginal treatment.
This paper is concerned with low frequency electrical impedance imaging, which is the process of constructing images of the electrical impedance of a body's interior based upon measurements of voltage and current made at the body's surface. The electrical impedance accounts for both resistivity and permittivity. This paper shows how permittivity can be exploited to improve the performance of an electrical impedance imaging system. We show that explicit use of the independent information in the data due to the permittivity will ehance a system's ability to distinguish objects in the interior of a body. In addition, we report the results of experiments performed using the Rensselaer ACT 2 system on a saline bath containing various objects. These objects include both living tissue and metal conductors with oxide layers. We demonstrate the system's ability to distinguish these objects, and we exhibit gray scale images of both their resistivity and permittivity distributions.
The effects of ofloxacin in Salmonella typhimurium infection in mice were compared with those of ciprofloxacin, ampicillin and chloramphenicol. Oral administration of ofloxacin at 10, 50 or 100 mg/kg once per day for seven days significantly (P less than 0.02) increased survival (20.1 days at 100 mg/kg) of infected mice relative to non-treated controls (4.1 days). In addition, after oral treatment with 100 mg/kg of each of the antibiotics, ofloxacin was significantly more effective than ampicillin (9.9 days), chloramphenicol (8.4 days) or ciprofloxacin (14.9 days) in prolonging the mean survival time of these mice. A comparison of oral potencies indicates that ofloxacin is five times more potent than ciprofloxacin (oral ED50 = 13.3 mg/kg vs ciprofloxacin = 69.9 mg/kg) and over eight times more potent than either of the other two antibiotics. When the number of bacteria from livers and spleens was quantitated, only ofloxacin (25 or 100 mg/kg,po) significantly (P less than 0.02) reduced the number of viable bacteria in both of these tissues in comparison with untreated controls, and, relative to the other antibiotics, ofloxacin (100 mg/kg) caused a significantly greater reduction. Single oral dosing of 20 mg/kg of either ofloxacin or ciprofloxacin showed that ofloxacin achieves approximately a four-fold higher peak serum or liver concentration than ciprofloxacin, which may contribute to its better efficacy in this infection model. These results taken together suggest that oral ofloxacin may be of value in treating systemic salmonella infections in humans.
Electric current computed tomography is a process for determining the distribution of electrical conductivity inside a body based upon measurements of voltage or current made at the body's surface. Most such systems use different electrodes for the application of current and the measurement of voltage. This paper shows that when a multiplicity of electrodes are attached to a body's surface, the voltage data are most sensitive to changes in resistivity in the body's interior when voltages are measured from all electrodes, including those carrying current. This assertion is true despite the presence of significant levels of skin impedance at the electrodes. This conclusion is supported both theoretically and by experiment. Data were first taken using all electrodes for current and voltage. Then current was applied only at a pair of electrodes, with voltages measured on all other electrodes. We then constructed the second data set by calculation from the first. Targets could be detected with better signal-to-noise ratio by using the reconstructed data than by using the directly measured voltages on noncurrent-carrying electrodes. Images made from voltage data using only noncurrent-carrying electrodes had higher noise levels and were less able to accurately locate targets. We conclude that in multiple electrode systems for electric current computed tomography, current should be applied and voltage should be measured from all available electrodes.
Electrical impedance imaging is the technique for producing images of the resistivity of internal body structures based on measurements of voltage and current from electrodes applied to the body's surface. When a multiplicity of electrodes are applied in one or more rows around a body structure such as the thorax or limb, it is useful to be able to rapidly assess the general status of the electrode-body interface to determine if the skin has been suitably prepared, and that electrode and skin impedance are suitably low. In addition, assessment of the impedance of individual electrodes should precede acquisition of data for image formation. This communication presents techniques for assessing the overall skin and electrode impedances relative to the impedance of the body interior, and for assessing the integrity of each electrode's contact impedance.
Syringomas are benign appendageal tumors with differentiation toward the intraepidermal portion of the eccrine sweat duct. A 35-year-old black woman with lesions confined to the labia majora is presented. Syringomas involving the genitalia are rare, and usually the genital tumors are part of a more generalized distribution. A review of English literature showed only four reported cases of syringomas limited to the vulva. Vulvular syringomas present as multiple, bilateral, skin-colored papules over the labia majora that may or may not be pruritic. The lesions should therefore be considered in the differential diagnosis of multiple papular lesions of the vulva and are probably more common than is generally recognized.
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