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Biomedical subjects

D J Wyper

Publications and source records attributed to D J Wyper.

At least 19 recordsLinked to original sources
PubMed1992

Effects of a single dose of the acetylcholinesterase inhibitor velnacrine on recognition memory and regional cerebral blood flow in Alzheimer's disease.

The effects of a single oral dose of the acetylcholinesterase inhibitor velnacrine maleate on word and object recognition memory and regional uptake of 99mTc-exametazime were examined in patients with Alzheimer's disease. Word recognition memory was marginally improved 2 h after 75 mg velnacrine. With the same dose of velnacrine a relative increase in superior frontal uptake of 99mTc-exametazime was shown with single photon emission computed tomography (SPECT). This suggests increased regional perfusion and metabolism as a consequence of cholinergic stimulation. The effect did not co-vary with the degree of memory improvement, but, instead, more cognitively impaired patients showed a greater increase in tracer uptake after velnacrine, suggesting cholinergic hypersensitivity in the brains of Alzheimer patients.

Aged↗
PubMed1991

Cerebral pharmacodynamics of physostigmine in Alzheimer's disease investigated using single-photon computerised tomography.

The effects of physostigmine on patterns of rCBF in patients with pre-senile Alzheimer's disease were studied using 99mTc-labelled HMPAO SPECT. Regional CBF increased in the left cortex relative to right, with the most significant effect in left frontal and higher frontal regions. Measures of regional brain function, such as SPECT, are an important complement to psychological test batteries in understanding the effects in brain of putative antidementia drugs. SPECT brain imaging could extend our understanding of the action of psychotropic drugs in other major psychiatric illnesses.

Aged↗
PubMed1990

Tc99m HM-PAO single photon emission computed tomography in temporal lobe epilepsy.

We present the results of single photon emission computed tomography (SPECT) in 40 patients with temporal lobe epilepsy and normal computed transmission tomography (CT). Abnormalities of regional cerebral blood flow were found in 26 patients. There was focal hypoperfusion alone in 14, focal hyperperfusion alone in 6, and both types of abnormality in 6. In 4 patients there were bilateral abnormalities. Repeat SPECT showed persistence of interictal hyperperfusion in 5/12 patients. There were no significant correlations between SPECT findings and clinical parameters, and no relation between the persistence of interictal hyperperfusion and time since last seizure or seizure frequency. Where SPECT and multiple surface EEG recordings were both lateralising, agreement between them was good. The results of this study support the usefulness of HMPAO SPECT in detecting lateralising abnormalities in temporal lobe epilepsy. Interictal hyperperfusion may be commoner than previous publications suggest, and may be persistent in some cases.

Adolescent↗
PubMed1990

CT, MR and SPECT imaging in temporal lobe epilepsy.

Cranial computed tomography (CT) with modified temporal lobe technique, 0.15T magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) were carried out on 30 patients with intractable temporal lobe epilepsy. Lateralising abnormalities were detected in 21/30 patients overall. Specific lesions were detected by CT in one patient and by MRI in seven patients (in one case bilateral). In addition CT detected asymmetry of the sylvian fissures or temporal horns in 10 patients, and MRI in eight patients. SPECT detected lateralising abnormalities in 19 patients (in five cases bilateral). It is concluded that low field MRI is superior to modified CT in demonstrating subtle structural lesions of the temporal lobe. Functional scanning with SPECT supports the evidence of origin of an epileptic focus in a substantial proportion of cases and may improve the selection of patients for surgery.

Adolescent↗
PubMed1989

The Pocket Speech Aid.

A rapid-access but limited vocabulary communication aid for the non-vocal and speech impaired is useful in some well defined situations. The design and construction of such a device is described. Three distinct situations have been identified where an aid is essential and an initial evaluation has shown the Pocket Speech Aid to be very successful.

Biomedical Engineering↗
PubMed1989

Computer linked apparatus for upper limb therapy: a new system of resistive exercise.

A need has been recognised for equipment that can be used to provide objective evaluation of exercise of the upper limb in occupational therapy while being motivational to the patient. The microcomputer was seen to be a suitable tool as part of a system that might satisfy this need. After consulting experienced hand therapists the criteria were established for equipment that would encourage and quantify exercise. Three systems were built that represented three methods of resistive exercise. These were presented to therapists in a structured assessment to determine the most suitable. As a result of this a system employing a dashpot and a potentiometer connected to a BBC microcomputer was designed. Software was written in the form of activities that could be controlled by the movements of exercise on the equipment. Dashpot resistance could be varied and graded and the range of software was of varied motivational content. This allowed the principal movements of the wrist and forearm to be objectively exercised. After suitably calibrating the system it was used to assess patient effort and ability, and hence progress of treatment.

Arm Injuries↗
PubMed1989

Changes in cranial CSF volume during hypercapnia and hypocapnia.

Magnetic resonance imaging was used to measure the effect of inhalation of 7% CO2 and hyperventilation with 60% O2 on human cranial cerebrospinal fluid volume. During CO2 inhalation there was a reduction in the cranial CSF volume ranging from 0.7-23.7 ml (mean 9.36 ml). The degree of reduction in cranial CSF volume was independent of the individual subject's increase in end-expiratory pCO2 or mean arterial blood pressure, in response to hypercapnia. During hyperventilation with high concentration oxygen the cranial CSF volume increased in all subjects (range 0.7-26.7 ml, mean 12.7 ml). The mean changes in cranial CSF volume, induced by hypercapnia and hypocapnia, were very similar to the expected reciprocal changes in cerebral blood volume.

Adult↗
PubMed1986

Accuracy of stereotaxic localisation using MRI and CT.

The accuracy of stereotaxic coordinates determined using the Leksell apparatus with CT and MRI was investigated using an Agar filled head phantom. Both imaging techniques were found to produce an accuracy of better than 2 mm with the exception of the Z coordinate as measured by CT (2.3 mm). This latter error is greater because of the 3 mm slice width used. Direct coronal views were used to determine Z more accurately using MRI. The measurement procedures are described and it is shown that the Leksell system of using orthogonal coordinates enables the scaling of images, which is particularly necessary with MRI, to be done easily.

Humans↗
PubMed1980

Effects of hypercapnia and arterial hypotension and hypertension on cerebrospinal fluid pulse pressure and intracranial volume-pressure relationships.

In twelve anaesthetised, ventilated dogs the effects of hypercapnia and pharmacologically induced arterial hypotension and hypertension on the interrelation between volume-pressure response (VPR) and cerebro-spinal fluid (CSF) pulse pressure were studied during continuous inflation of a supratentorial extradural balloon. Hypercapnia did not significantly affect the intracranial volume-pressure relationships, but did cause a significant increase in gradient of the relationship between CSF pulse pressure and intracranial pressure (ICP). Alteration of the arterial blood pressure showed opposite effects on VPR and CSF pulse pressure. A decrease in VPR and an increase in pulse pressure were observed during arterial hypotension; the reverse was found during arterial hypertension. The discrepancy between the effects on VPR and CSF pulse pressure of the variables under study was explained by changes in the transient increase in cerebral blood volume per cardiac cycle. On the basis of the results of this study it will be possible, during clinical ICP monitoring, to interpret changes in the CSF pulse pressure to ICP ratio in terms of changes in intracranial volume-pressure relationships.

Animals↗
PubMed1979

Monitoring cerebral blood flow during intracranial operations: an intravenous injection method.

A method of measuring cerebral blood flow during neurosurgery is described. It is an adaptation of the standard 133Xe intravenous injection method, with computation restricted to data collected over the first 3 min. In addition to a theoretical presentation of the method and an analysis of the effect of residual 133Xe activity when sequential runs are performed in close approximation, the technique is validated experimentally by comparison with intracarotid 133Xe injection in baboons.

Brain Diseases↗
PubMed1979

Accuracy of ventricular volume estimation.

Sources of error in the estimation of ventricular volume from CAT scans are discussed and the accuracy of the measurement assessed. Two methods of calculating ventricular volume from an intraventricular injection of radioisotope are described and compared. Finally, the CAT scan and isotope methods are compared and contrasted. The error associated with a single measurement of volume by any of these techniques is between 20% and 30%. In patients with no ventricular catheter there is no choice other than to use CAT scanning, but if intraventricular injection is possible this method offers a potentially more accurate volume determination because of his higher signal-to-noise ratio.

Cerebral Ventricles↗
PubMed1979

Cerebrospinal fluid pulse pressure and intracranial volume-pressure relationships.

In six anaesthetised and ventilated dogs the CSF pulse pressure was compared with the volume-pressure response (VPR) during continuous inflation of an extradural balloon. Both pulse pressure and VPR increased linearly with the ventricular fluid pressure (VFP) up to a mean VFP of 60 mmHg. At this pressure a breakpoint occurred above which the CSF pulse pressure showed a steeper linear increase, while the VPR remained constant. It is suggested that the breakpoint is related to failure of autoregulation, and that in non-autoregulating patients the CSF pulse pressure is a better parameter of the clinical state than the VPR.

Animals↗
PubMed1979

Successful operation of a regional scheme for the maintenance of automatic analysers.

The main operational and financial aspects of the maintenance service provided by the West of Scotland Health Boards' Department of Clinical Physics and Bio-Engineering (DCPB) to the clinical chemistry laboratories in the region are described. The scheme, in operation since March 1976, covers all breakdown servicing and engineering preventive maintenance for Technicon Auto-Analyzer equipment valued at pounds 1 1/4 million in terms of direct replacement costs. The engineering team works closely with the laboratory staffs to ensure that the performance of the equipment is maintained to specification. The direct economies for the Health Boards through savings in maintenance contract charges total around pounds 60,000 per year. In addition, considerable sums have been saved by servicing, modifying, and constructing other instruments for the laboratories outwith the immediate remit of Technicon maintenance. Other economic and operational benefits which result from the scheme are commercially disinterested advice on equipment obsolescence and replacement, and redistribution between the laboratories of old but useful equipment to meet specific needs of the service in the region.

Autoanalysis↗