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Biomedical subjects

L G Hellström

Publications and source records attributed to L G Hellström.

7 recordsLinked to original sources

Growth hormone treatment increases CO(2) response, ventilation and central inspiratory drive in children with Prader-Willi syndrome.

UNLABELLED: We studied whether the beneficial effects of growth hormone (GH) treatment on growth and body composition in PWS are accompanied by an improvement in respiratory function. We measured resting ventilation, airway occlusion pressure (P(0.1)) and ventilatory response to CO(2) in nine children, aged 7-14 years, before and 6-9 months after the start of GH treatment. During GH treatment, resting ventilation increased by 26%, P(0.1) by 72% and the response to CO(2) by 65% (P < 0.002, <0.04 and <0.02, respectively). This observed increase in ventilatory output was not correlated to changes in body mass index. CONCLUSION: Treatment of children with Prader-Willi syndrome (PWS) seems to have a stimulatory effect on central respiratory structures. The observed increase in ventilation and inspiratory drive may contribute to the improved activity level reported by parents of PWS children during growth hormone therapy.

Adolescent↗

Implementation of a respiratory drive monitor on a Servo Ventilator.

OBJECTIVE: To design and evaluate a clinical monitor of respiratory drive (P0.1) and other respiratory variables in a simple way, using a commercial ventilator. METHODS: Nine healthy males were studied as they were breathing spontaneously in a Servo 900C Ventilator, at rest and during light exercise (50 W). The ventilator was slightly modified to improve its mechanical performance during spontaneous breathing, and was used as a measuring instrument. All the relevant information was retrieved, calculated and monitored by a PC. Respiratory drive was assessed as occlusion pressures from the inspiratory airway pressure signal. The equipment was compared with a two-way non-rebreathing laboratory system. Furthermore, negative and positive inspiratory pressures were applied from the ventilator, to study respiratory responses to mechanical loads. RESULTS: At rest, the ventilator introduced a minor influence on inspiratory time and P0.1, but not in ventilation, tidal volume, expiratory duration and respiratory frequency. During exercise, the influence was more evident. This effect could also be noticed in the coefficients of variation. The responses to mechanical loads were easily recorded and can be used as a simple test of central load-compensating mechanisms. CONCLUSIONS. The ventilator, with limitations, may be an alternative to conventional techniques, especially in clinical studies of the central inspiratory activity with and without respiratory loading.

Adult↗

A paediatric canopy system for aerosol administration and minimized environmental pollution.

BACKGROUND: A canopy system for ribavirin aerosol administration to infants has been developed in order to improve the control of aerosol treatment, facilitate access to the infant and minimize environmental pollution. The system comprises a transparent canopy, fitted with four sealable apertures. An evacuation flow that is 3 l/min higher than the gas supply was anticipated to prevent aerosol leakage from the canopy. METHOD: In a clinical evaluation, 10 infants with body weights of 1.8-7.1 kg were placed inside the canopy during 1 hour of simulated treatment. The temperature, relative humidity and carbon dioxide concentration within the canopy were measured repeatedly to study the stability of these variables and their dependence on body weight. Infant body temperature, skin temperature and the respiratory frequency were measured. In a laboratory evaluation, aerosol leakage was studied using an ambient air admixture procedure and smoke tests. The sound level inside the canopy was measured. RESULTS: All physical variables inside the canopy remained stable. The sound level was 52 dBA. The carbon dioxide concentration (1000-3900 PPM) correlated with infant body weight (P < 0.001), as did canopy temperature (25.1-29.6 degrees C, P < 0.05). The relative humidity was 52-88%. Infant body temperatures were not influenced. The respiratory frequency decreased by 13% (P < 0.01). No aerosol leakage was observed. CONCLUSION: The canopy system facilitates a controlled aerosol therapy with good infant surveillance and accessibility a minimum of environmental pollution and a comfortable physical environment without apparent risks of carbon dioxide rebreathing or cooling stress at body weights of 1.8-7.1 kg.

Administration, Inhalation↗

Breath-by-breath determination of inspiratory occlusion pressure.

In order to determine the influence of breath-by-breath measurement of inspiratory occlusion pressure (P0.1) on the pulmonary ventilation, the respiratory timing and the central inspiratory activity as reflected by P0.1 per se, nine healthy males were studied as they breathed in a valve assembly including an externally controlled occlusion valve. A new technique was used, terminating occlusions at a preset inspiratory threshold pressure and determining P0.1 from linear regression of the mouth pressure curve. Subjects were studied at rest and during light exercise, with the occluding function (threshold pressure) on or off during alternating periods. Breath-by-breath variability of P0.1 was of the order of 30%. We found no detectable influence of breath-by-breath short-lasting inspiratory occlusions on tidal volume and ventilation. However, mean inspiratory flow was slightly increased due to a shortened inspiratory duration at rest and during light exercise. Also, raising the threshold pressure for occlusions from 69 to 147 Pa (0.7 to 1.5 cm H2O) resulted in a 20% increase of P0.1. We conclude that breath-by-breath measurement of P0.1 is a feasible technique, and that the slightly shortened inspiratory duration and the increased P0.1 with increased threshold pressure may not necessarily be expressions of a true stimulation of the central inspiratory activity.

Adult↗

Ectomography--a tomographic method for gamma camera imaging.

In computerised gamma camera imaging the projections are readily obtained in digital form, and the number of picture elements may be relatively few. This condition makes emission techniques suitable for ectomography--a tomographic technique for directly visualising arbitrary sections of the human body. The camera rotates around the patient to acquire different projections in a way similar to SPECT. This method differs from SPECT, however, in that the camera is placed at an angle to the rotational axis, and receives two-dimensional, rather than one-dimensional, projections. Images of body sections are reconstructed by digital filtration and combination of the acquired projections. The main advantages of ectomography--a high and uniform resolution, a low and uniform attenuation and a high signal-to-noise ratio--are obtained when imaging sections close and parallel to a body surface. The filtration eliminates signals representing details outside the section and gives the section a certain thickness. Ectomographic transverse images of a line source and of a human brain have been reconstructed. Details within the sections are correctly visualised and details outside are effectively eliminated. For comparison, the same sections have been imaged with SPECT.

Brain↗

Transverse tomography with incoherent optical reconstruction.

A thin layer of an object can be imaged by reconstruction from a so-called sinogram. It is produced by an x-ray fan beam rotating around the object while a recording film is moved in a direction perpendicular to the plane of the fan beam. Before reconstruction the sinogram image is convoluted according to a special function to remove artifacts consisting of spurious shadows between different object elements. The reconstruction is done from the convoluted sinogram by means of a back projector, which operates according to a prinicple that is the reverse of the recording of the original sinogram. Tomograms of phantoms, pork chops and the head of a dog show that the process is capable of high spatial resolution but is limited by low contrast.

Animals↗

Bone mineral content and mechanical strength of the femoral neck.

The bone mineral content of the femoral neck of 61 autopsy specimens was assayed by x-ray spectrophotometry. The mechanical strength of the specimens was also determined experimentally by applying a compressive force perpendicularly to the shaft. The ultimate force at fracture was obtained from force/displacement plots. A coefficient of correlation of 0.89 between bone mineral content of the femoral neck and the ultimate force at fracture was found. Even when limited to a group of women aged 67-80 a fairly close correlation was found. This indicates that the bone mineral level, measured in vivo, can be used as a criterion of the risk of fracture in elderly women.

Age Factors↗