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Biomedical subjects

K R Smith

Publications and source records attributed to K R Smith.

At least 181 records · Page 10Linked to original sources

Frameless stereotactic ultrasonography: method and applications.

In stereotactic neurosurgery, computed tomography (CT) and magnetic resonance (MR) images are registered in a coordinate system defined with respect to the skull. By intraoperatively tracking the coordinate position of a surgical instrument, various displays can be formed which show the position of the instrument in the MR and/or CT images. However, the accuracy of this display varies because intracranial structures may shift or warp from their position prior to surgery. Ultrasonic imaging systems provide real-time images of the brain, but structures in these images are difficult to interpret because the images are based on ultrasonic echoes. A method has been developed for the real-time registration of these images. With this registration, software continuously updates a corresponding image constructed from the set of MR and/or CT images used for guidance. By developing this second view of the structures in the ultrasound image, the surgeon can easily interpret the ultrasound image, and it becomes possible to determine the extent of the intra-operative structure shift between the two images.

Algorithms↗

The NeuroStation--a highly accurate, minimally invasive solution to frameless stereotactic neurosurgery.

The NeuroStation is an image-guided neurosurgery workstation designed to deliver frameless stereotaxy within an ergonomic, integrated surgical environment. Generally, stereotaxy can provide the neurosurgeon with important intra-operative localization information using diagnostic images such as computerized tomography (CT) or magnetic resonance imaging (MRI). To date, however, stereotaxy has not been widely accepted by neurosurgeons due to the procedural difficulties of incorporating conventional stereotaxy. The NeuroStation addresses the problems of conventional stereotaxy through the use of frameless stereotactic methods wherein state-of-the-art instrumentation and computer innovations allow: a) standard surgical instruments to be used as the localization device; b) multipoint registration methods in place of frame-based registration; and c) real-time interactive surgical localization. The NeuroStation can thus be transparently integrated into the neurosurgical procedure providing the neurosurgeon with image-guidance for surgical planning, biopsies, craniotomies, endoscopy, intra-operative ultrasound, radiation therapy, etc.

Adult↗

An accurate and ergonomic method of registration for image-guided neurosurgery.

We have developed a system for accurately and conveniently achieving surgical registration for image-guided neurosurgery, based on alignment and matching of patient forehead contours. The system consists of a contour digitizer that is used in the operating room to acquire patient contours, editing software for extracting contours from patient image data sets, and a contour-match algorithm for aligning the two contours and performing data set registration. Initial tests of the individual portions of the system have found each to be robust; we are in the process of refining the design of the optical digitizer in order to further automate the procedure as well as provide increased accuracy.

Algorithms↗

Indoor/outdoor PM10 and PM2.5 in Bangkok, Thailand.

Twenty-four-hour averaged PM10 and PM2.5 concentrations were obtained by using 4-liter-per-minute-pumps and impactors in microenvironments of a busy shopping district and a university hospital campus. In both areas, most people live directly adjacent to their worksites--minimizing the need to measure commuting exposure as part of total daily exposure. Co-located samplers were set in indoor microenvironments, the near-ambient zone of the households, and at nearby streetside central ambient monitoring stations. Smoking and use of other indoor PM sources were recorded daily via questionnaires. Consistent with previous studies, smoking and the use of charcoal stoves increased indoor particulate matter levels. The sampled air-conditioned hospital area had substantially lower particle concentrations than outdoors. A simple total exposure model was used to estimate the human exposure. The averaged ratios of co-located PM2.5/PM10 concentrations in various microenvironments are reported for each location. A single daily indoor average PM10 concentration for all households measured in a given sampling day is calculated for correlation analysis. Results showed that day-to-day fluctuations of these calculated indoor PM10 levels correlated well with near-ambient data and moderately well with ambient data collected at the nearby central monitoring site. This implies that ambient monitors are able to capture the daily variations of indoor PM levels or even personal exposure and may help explain the robust association of ambient PM levels and health effects found in many epidemiological studies. Absolute PM exposures, however, were substantially underestimated by ambient monitors in the shopping district, probably because of strong local sources.

Air Pollution↗

Indoor and outdoor PM2.5 and CO in high- and low-density Guatemalan villages.

Continuous particles less than 2.5 microm in diameter (PM2.5) and carbon monoxide (CO) were monitored during breakfast, lunch, and dinner in three high-density and four low-density villages near Quetzaltenango, Guatemala to help assess the viability of this region for a proposed respiratory health and stove intervention study. Approximately 15 homes were visited during each mealtime in each of the seven villages; in all, 98 homes were visited, with a sampling duration of 2-3 min per home per meal. For each village, a line (transect) was drawn on a village map along existing roads from one end of the village to the other; homes and between-home outside locations along the transect were monitored. Although the predominant stove type was the open fire, several other stoves, in various levels of disrepair, were observed frequently. The highest indoor concentrations of PM2.5 were observed in homes using the open fire (avg. = 5.31 mg/m3; SD=4.75 mg/m3) or equivalent, although homes using the plancha--indigenous wood-burning stove with chimney--also had measurements > 13.8 mg/m3, PM2.5 limit of detection. The highest indoor concentrations of CO were also observed in homes using the open fire (avg. = 22.9 ppm; SD = 28.1 ppm), with a maximum measurement of > 250 ppm. For both PM2.5 and CO, levels measured in homes with plancha, lorena, or open fire were significantly higher than levels taken in the street or in homes using a gas stove. The Spearman correlation coefficient between PM2.5 and CO for all data combined was 0.81, and ranged from 0.30 for the lorena to 0.68 for the plancha in homes using wood-fueled stoves. Although indoor PM2.5 and CO levels were not significantly different between high- and low-density villages, street-level PM2.5 (p = 0.002) and CO (p= 0.002), were significantly higher in the high - density villages. These data provide a useful picture of the pollution levels coming from a range of cooking stoves in various levels ofdisrepair, as well as a representation of how outdoor particle mass and CO levels vary from high- versus low-density villages.

Air Pollution, Indoor↗

Risk of mortality following widowhood: age and sex differences by mode of death.

This study examines how spouses' deaths from sudden or lengthy illnesses differentially affect the mortality risks of surviving widows and widowers by age. Using the Panel Study of Income Dynamics, we find the mortality risk differs by gender, age, and type of widowhood. For nonelderly (< 65) widowers, there is an elevated risk when their wives died suddenly. For older (> or = 65) widows, the mortality risk is lower than that of comparably aged married women when their husbands died after a long-term illness. These gender, age, and mode-of-death differences are consistent with role theory and theories of social support.

Adult↗

Children's health and their mothers' risk of divorce or separation.

The purpose of this study is to determine how children's health conditions are related to their mothers' risk of divorce or separation. The study is based on data from over 7,000 children born to once-married mothers identified in the 1988 Child Health Supplement to the National Health Interview Survey. The effects of 15 childhood health conditions on the mothers' risk of divorce are estimated with Cox's proportional hazard models. Controlling for demographic, marital, and reproductive measures, we find that mothers' prospects for divorce are affected both positively or negatively by their children's health status, depending on the type of childhood condition and, in the case of low birth weight children, timing within the marriage. Women whose children have congenital heart disease, cerebral palsy, are blind, or had low birth weight appear to have higher risks of marital disruption than mothers of healthy children. In contrast, mothers whose children have migraines, learning disabilities, respiratory allergies, missing/deformed digits or limbs, or asthma have somewhat lower rates of divorce.

Adolescent↗

Recombination, statistical power, and genetic studies of sexual isolation in Drosophila.

Genetic studies of sexual isolation in Drosophila have generally failed to fully evaluate the effects of their sample size and recombination between markers on their conclusions. In this study we evaluate recombinational distances between markers in Drosophila pseudoobscura and D. persimilis, a species pair in which numerous genetic mapping studies have been performed. We conclude that, contrary to assertions, the inversions that distinguish these two species still allow for much recombination within most of their chromosome arms in F1 hybrid females. Such recombination may have caused previous mapping studies in these species to miss (or grossly underestimate) the effects of several genomic regions. We also evaluate the effects of sample size and recombination on genetic studies of sexual isolation in other Drosophila species groups. We conclude that some of these studies may have been heavily biased toward detecting only genes of large effect. Future studies of sexual isolation should be preceded by detailed statistical power analyses that determine the effects of recombination and sample size in the species pair being studied to avoid these complications.

Animals↗

synthesis and biological testing of nonionic iodinated x-ray contrast media.

A series of nonionic x-ray contrast media containing novel linkages between the triiodobenzene and polyhydroxy moieties have been prepared and screened against established criteria. Of the coupler groups examined (amide including dipeptide, carbamate, ureido, and ester), amide showed the greatest overall utility in terms of safety, solubility, stability, and ease of synthesis. Acute toxicity, solubility and stability data are summarized for each series. In the CNS, certain compounds were well tolerated and some were devoid of any excitatory effects. Intrathecal tissue irritant effects were also unremarkable. Most agents exhibited relatively high osmolalities, raising questions as to the influence of this factor on the safety of myelographic agents. Intravascularly, nonionic media appear also to offer advantages over classical ionic media. However, nonionic media can exert positive inotropic effects and exhibit high viscosity at higher iodine concentrations. Nevertheless, overall results continue to demonstrate the radiographic potential of nonionic contrast media.

Animals↗