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Biomedical subjects

M Arnold

Publications and source records attributed to M Arnold.

At least 19 recordsLinked to original sources

Simultaneous spike detection and topographic classification in pediatric surface EEGs.

In this study, an algorithm is introduced for the automatic detection and simultaneous topographic classification of interictal regional spike activity in pediatric surface EEG records. The algorithm is based on the classification of the topographic distribution of instantaneous power by means of a 'group' trained classifier. The results of automatic spike analysis were compared with the decisions of two experienced electroencephalographers. Four routine EEG records exhibiting (multi)regional spikes were examined. The mean selectivity for the automatic spike detector was 84.6% (mean sensitivity 88.1%, mean specificity 89.3%) and for the electroencephalographers 85.3%. All spikes detected by the algorithm were simultaneously classified according to their topographic characteristics. The results of automatic spike classification (lateralization/localization) corresponded to the results of visual analysis.

Algorithms

Continuous intraoperative monitoring of middle cerebral artery blood flow velocities and electroencephalography during carotid endarterectomy. A comparison of the two methods to detect cerebral ischemia.

BACKGROUND AND PURPOSE: Intraoperative monitoring of brain function may influence the outcome of carotid endarterectomy (CEA). METHODS: We performed transcranial Doppler (TCD) monitoring of middle cerebral artery blood flow velocities (VMCAs) and eight-channel electroencephalographic (EEG) recording simultaneously in 82 patients undergoing CEA. Thiopental narcosis limited EEG interpretation in 11 patients, thus allowing direct comparison of both methods in 71 patients. RESULTS: There was a significant correlation between VMCA decrease and the frequency of EEG changes after carotid clamping (P < .001). Eight patients (11%) showed a VMCA decrease exceeding 60%, accompanied by EEG changes in 7 patients. Altogether, 16 patients (22%) showed severe or moderate EEG changes. Stenosis or occlusion of the contralateral carotid artery led to an increase of abnormal findings with both monitoring methods, which was, however, significant only for TCD (P < .05). Four patients (4.8%) suffered intraoperative transient ischemic attacks. In 3 of these patients, there were no abnormal findings with either of the methods. The events were thus unpredictable and probably of embolic origin. The fourth patient showed VMCA decrease to 0 and severe EEG changes. Nine patients had severe or moderate EEG changes without significant VMCA decrease and without complications. EEG monitoring alone in these would have led to unnecessary use of a shunt with the increased risk of embolism. CONCLUSION: EEG and TCD monitoring are complementary techniques. Their results showed a good overall correlation but with marked differences in the individual patient. TCD monitoring alone was sensitive enough to prevent ischemic intraoperative complications. EEG findings are of limited value when barbiturates are used.

Aged

Well done.

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Complementary Therapies

Dynamic coherence analysis of vasomotion and flow motion in skeletal muscle microcirculation.

The aim of our study was to determine the cause of fluctuations in microvascular blood flow measured by laser Doppler perfusion monitoring (LDPM) in microvessels of the hamster skin fold preparation. LDPM flow fluctuations (flow motion) were compared to simultaneous records of diameter changes obtained from arterioles and venules. Time-varying coherence analysis was used to quantify the frequency of flow and diameter changes in awake hamsters in control conditions and during sodium nitroprusside-induced vasodilation. Power spectrum analysis of LDPM signals of order 4 and 3 arterioles indicated frequencies of 0.06 +/- 0.01 and 0.08 +/- 0.02 Hz, respectively. Order 3 arterioles exhibited significant temporal coherence between flow motion and vasomotion signals at a frequency of the order of 0.1 Hz. There was lack of coherence when vasomotion was absent in arterioles. Order 4 arterioles had several coherent frequencies in addition to that around 0.1 Hz. In conclusion, time-variant coherence analysis indicated that spontaneous fluctuations in flow are caused by vasomotion of order 3 arterioles with frequency around 0.1 Hz that appears to coordinate local control processes in the microcirculation. Additional frequency components present in LDPM signals are unrelated to vasomotion.

Animals

Effects of L-carnitine supplementation on physical performance and energy metabolism of endurance-trained athletes: a double-blind crossover field study.

A double-blind crossover field study was performed to investigate the effects of acute L-carnitine supplementation on metabolism and performance of endurance-trained athletes during and after a marathon run. Seven male subjects were given supplements of 2 g L-carnitine 2 h before the start of a marathon run and again after 20 km of the run. The plasma concentration of metabolites and hormones was analysed 1 h before, immediately after and 1 h after the run, as well as the next morning after the run. In addition, the respiratory exchange ratio (R) was determined before and at the end of the run, and a submaximal performance test was completed on a treadmill the morning after the run. The administration of L-carnitine was associated with a significant increase in the plasma concentration of all analysed carnitine fractions (i.e. free carnitine, short-chain acylcarnitine, long-chain acylcarnitine, total acid soluble carnitine, total carnitine) but caused no significant change in marathon running time, in R, in the plasma concentrations of carbohydrate metabolites (glucose, lactate, pyruvate), of fat metabolites (free fatty acids, glycerol, beta-hydroxybutyrate), of hormones (insulin, glucagon, cortisol), and of enzyme activities (creatine kinase, lactate dehydrogenase). Moreover, there was no difference in the result of the submaximal performance test the morning after the run. In conclusion, acute administration of L-carnitine did not affect the metabolism or improve the physical performance of the endurance-trained athletes during the run and did not alter their recovery.

Adult

Use of adaptive Hilbert transformation for EEG segmentation and calculation of instantaneous respiration rate in neonates.

Broad, as well as narrow, band Hilbert transform filters (HTFs) were used as preprocessing units in the analysis of electroencephalogram (EEG) and respiratory movements in neonates. For these applications, new algorithms for the adaptation of the resonance frequency of a narrow-band-pass filter to the actual signal properties on the basis of an analytic filter design were developed. For the segmentation of the discontinuous EEG, the location of the resonance frequency was imbedded into the learning algorithm of a neural network (NN). In such automatic EEG pattern recognition, the detection of spike activity was taken into consideration. The spike detection scheme introduced uses broad-band HTFs as basis units. Additionally, the algorithm for the continuous control of the resonance frequency was applied to achieve the adaptation of the processing unit that performed the calculation of the instantaneous respiration rate, in this framework, a new on-line method for adaptive frequency estimation that is less sensitive to low signal-to-noise ratios (SNRs) was obtained. The new approaches introduced were tested in comparison with processing methods that have been established for the analysis of experimental and clinical data.

Algorithms

Characterisation of the acute phase response of heifers to a prolonged low dose infusion of lipopolysaccharide.

The effect of a prolonged low dose infusion of bacterial lipopolysaccharide (LPS) on acute phase-like reactions was examined in heifers. LPS (2 micrograms kg-1 dissolved in 100 ml water), or saline was infused (at 1 ml min-1) intravenously for 100 minutes and blood samples were taken at various times before, during and after the infusion. The serum concentrations of tumour necrosis factor-alpha (TNF alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and serum amyloid A (SAA) and the rectal temperature increased in response to the LPS infusion. Serum TNF alpha increased before the increases in IL-1 beta and IL-6 and remained high from 20 minutes after the onset of the infusion until the end of the sampling period (six hours). The LPS-induced increases in serum IL-1 beta and IL-6 were biphasic. Plasma cortisol and lactate concentrations also increased, and plasma glucose and beta-hydroxybutyrate concentrations decreased in response to the LPS infusion. The similarity of these reactions to changes observed in response to bacterial infections shows that the prolonged infusion of low doses of LPS is a good model for studying the acute phase response to Gram-negative bacterial infection in heifers.

Acute-Phase Proteins

A quantitative electrophoretic migration shift assay for analyzing the specific binding of proteins to lipid ligands in vesicles or micelles.

We present a new assay for analyzing the specific binding of proteins to lipid ligands contained within vesicles or micelles. This assay, referred to as the electrophoretic migration shift assay, was developed using a model system composed of cholera toxin and of its physiological receptor, monosialoganglioside GM1. Using polyacrylamide gel electrophoresis in non-denaturing conditions, the migration of toxin components known to interact with GM1 was retarded when GM1 was present in either lipid vesicles or micelles. This effect was specific, as the migration of proteins not interacting with GM1 was not modified. The localization of retarded proteins and of lipids on gels was further determined by autoradiography. The stoichiometry of binding between cholera toxin and GM1 was determined, giving a value of five GM1 per one pentameric assembly of cholera toxin B-subunits, in agreement with previous studies. The general applicability of this assay was further established using both streptavidin and annexin V together with specific lipid ligands. This assay is fast, simple, quantitative, and requires only microgram quantities of protein.

Annexin A5

Radiation-induced impairment of osseous healing: quantitative studies using a standard drilling defect in rat femur.

The femora of adult Wistar rats were locally irradiated with single doses of X rays and 1 day later were wounded by a standardized drilling defect that extended through the diaphyseal cortex into the marrow cavity. Healing of the lesion was followed over 30 weeks to assess the time course of osseous closure. In unirradiated bones healing was complete by week 7. Irradiation with doses up to 15 Gy imparted a dose-dependent delay in the formation of primary callus and its subsequent replacement by more mature bone, while after higher doses healing remained permanently compromised or even suppressed. Using histomorphometry, osseous closure was also measured quantitatively for healing periods of 7, 10, 16 and 30 weeks and the data were expressed as the percentage of responders with < or = 40% fractional closure. The resulting dose-response curves were steep, displaying a large threshold dose and ED50 values between 16.8 to 17.5 Gy (7 to 16 weeks) and 19.4 Gy (30 weeks), respectively.

Animals

Trial of a topically administered local anesthetic (EMLA cream) for pain relief during central venous port accesses in children with cancer.

Procedure-related pain is a significant problem for many children receiving cytotoxic chemotherapy. In an effort to lessen this toxicity, we studied the efficacy and safety of administering topical local anesthesia using EMLA cream in 47 evaluable children with cancer undergoing implanted central venous port injections. Children (< 21 years old) scheduled to undergo repeated venous access procedures were selected for study. A placebo-controlled, randomized, double-blind, crossover study design was utilized. Statistically significant decreases in pain intensity scores (P < 0.002) were recorded by both children and investigators during the use of EMLA cream as compared with placebo. There was a good correlation between pain scores recorded by both patients and health care providers using both visual analog scales and categorized pain measurement tools. The topical application of EMLA cream 5% provides highly effective superficial anesthesia, and promises to be extremely useful for pain relief during percutaneous access procedures in cancer patients.

Administration, Cutaneous

Laparoscopic Excision of Ovarian Endometriomas: Does Post-Operative Medical Treatment Prevent Recurrence?

Of 103 women undergoing laparoscopic excision of ovarian endometriomas, 41 patients were prescribed to 3 to 6 months therapy with GnRH analogs or danazol postoperatively and 62 received no additional treatment. No significant difference in extent of disease was present between the two groups at the time of surgery. Follow-up longer than 3 months, including a sonogram, was available for 40 patients of the treatment group and for 42 patients of the group receiving no additional treatment. Four recurrences (10%) at 3, 12, 16 and 21 months occurred in the treatment group, and 3 recurrences (7%) at 5, 6 and 6 months occurred in the no-treatment group (p=NS). Postoperative medical treatment does not prevent recurrence of laparoscopically excised ovarian endometriomas.

Journal Article

TMD observed.

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Dental Occlusion, Traumatic

Media, children, and violence: a public policy perspective.

Pediatrician advocacy concerning the impact of television violence on children should be clearly grounded in the holistic concern of pediatricians with children's health and well-being. Pediatricians should not promote legislative or regulatory efforts to reduce children's exposure to television violence by proscribing certain kinds of program content. Instead, priority should be given to strategies that improve the content and quality of television programming viewed by children and that enhance the viewing choices made by children and their families. Such strategies include providing parent education and pressing for strong implementation of the Children's Television Act. Pediatricians should dedicate their efforts to increasing the awareness of broadcasters and the general public, acting as educators and persuaders. In order to advocate and educate effectively, pediatricians need to amplify their own knowledge and understanding of television-related issues and their significance. Finally, because children's exposure to television violence is but one part of a larger social context, pediatricians concerned with this issue should devote significant attention to related problems that diminish the health and well-being of children.

Child

[Muscle aches and biochemical changes following a ultra-marathon in the cold--modification by diclofenac].

After the Swiss Alpine Marathon in Davos (67 km, altitude difference of 2300 m) the majority of the athletes are suffering from muscle soreness. The goal of the study was therefore to investigate muscle damage, inflammatory reactions and soreness perception during and after this ultramarathon. 27 athletes took part in the study. Creatine-kinase (CK) and C-reactive protein (CRP) were measured 24 hours before the race, immediately before and after the race as well as 2 hours, 24 hours and 48 hours, after the race respectively. Muscle soreness of the lower extremities before and during stretching were assessed at the same time points using a visual analog scale from 1 to 10 (VAS). Significant CK elevations were found in all runners ranging from 600 to 28,000 U/l. Compared to the values before and 48 hours after the start all athletes showed 24 hours after the start significantly elevated CRP values, indicating a pronounced systemic inflammatory reaction. Immediately after the race all runners reported a significantly elevated muscle soreness with maximal pain in the posterior muscles of the lower leg. In order to assess the influence of a nonsteroidal antiinflammatory agent on muscle damage, muscle soreness and inflammatory reactions 16 of the 27 runners received *Diclofenac SR. We were unable to find a difference in the mean plasma CK and CRP activity after the race between both groups, but there was a highly significant, till now to our knowledge never described correlation between the degree of muscle damage and systemic inflammatory reaction (r = 0.75, p < 0.02) in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult