Biomedical subjects
Publications and source records attributed to M Kohl.
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Using the modified Lambert-Beer law to analyze attenuation changes measured noninvasively during functional activation of the brain might result in an insufficient separation of chromophore changes ("cross talk") due to the wavelength dependence of the partial path length of photons in the activated volume of the head. The partial path length was estimated by performing Monte Carlo simulations on layered head models. When assuming cortical activation (e.g., in the depth of 8-12 mm), we determine negligible cross talk when considering changes in oxygenated and deoxygenated hemoglobin. But additionally taking changes in the redox state of cytochrome-c-oxidase into account, this analysis results in significant artifacts. An analysis developed for changes in mean time of flight--instead of changes in attenuation--reduces the cross talk for the layers of cortical activation. These results were validated for different oxygen saturations, wavelength combinations and scattering coefficients. For the analysis of changes in oxygenated and deoxygenated hemoglobin only, low cross talk was also found when the activated volume was assumed to be a 4-mm-diam sphere.
New data are presented on the p(e,e'p)pi(0) reaction at threshold at a four-momentum transfer of Q(2) = 0.05 GeV(2)/c(2). The data were taken with the three-spectrometer setup of the A1 Collaboration at the Mainz Microtron MAMI. The complete center of mass solid angle was covered up to a center of mass energy of 4 MeV above threshold. Combined with measurements at three different values of the virtual photon polarization epsilon, the structure functions sigma(T), sigma(L), sigma(TT), and sigma(TL) are determined. The results are compared with calculations in heavy baryon chiral perturbation theory and with a phenomenological model. The measured cross section is significantly smaller than both predictions.
We used near infrared spectroscopy (NIRS) to investigate the vascular and metabolic response to brain activation in human primary and adjacent secondary visual cortex. NIRS is able to measure concentration changes in deoxygenated hemoglobin ([deoxy-Hb]) (which mainly contribute to the blood oxygenation level-dependent (BOLD) signal in functional magnetic resonance imaging (fMRI)) as well as concentration changes of oxygenated hemoglobin ([oxy-Hb]) and corpuscular blood volume ([total-Hb] = [oxy-Hb] + [deoxy-Hb]) and changes in the redox status of the cytochrome c oxidase ([Cyt-Ox]), a putative parameter for cellular oxygenation. A sound understanding of the transfer functions between stimulus parameters, neuronal activity, and vascular/metabolic parameters is important for interpretation of data acquired with indirect neuroimaging techniques like fMRI, especially in event-related design studies. In the present study we tested whether the vascular/metabolic response to stimulation can be described as a linear and time invariant system. Since linearity is a property attributed to systems that satisfy the scaling and superposition properties, as a first simple test, superposition of the responses obtained from short duration visual stimuli was used to predict the responses of longer duration stimuli. Our results showed that the predictions of [deoxy-Hb] and [Cyt-Ox] responses to stimuli of 6- to 24-s duration were satisfactory whereas predictions of [oxy-Hb] and [total-Hb] were insufficient. In a second step, a calculated convolution function of an assumed impulse response function and the stimulus function was fitted with the measured [deoxy-Hb] and [Cyt-Ox] curves to obtain amplitude, time delay, and time constant parameters. We show that predictions of cellular and vascular oxygenation responses to visual stimulation are good for 6- to 24-s stimuli duration under the assumption of a linear transfer characteristic. This model is not valid for corpuscular volume changes which affect mainly the [oxy-Hb] response. Noninvasive NIRS is shown to be a suitable method to get more direct information about neuronal-activity-associated changes in cerebral parameters which are partly reflected in BOLD signal but are not fully understood yet.
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This work is the first to report optical intensity changes (DeltaI/I approximately 0.05%) with a latency between 60 and 160ms after electrical median nerve stimulation at 5Hz detected non-invasively through the intact adult human skull in volunteers. The signal is localised and reproducible when measuring at the same position on successive examinations. Compared to previous reports of fast optical changes in the human adult by a single group (Psychophysiology, 32 (1995) 505) the here reported changes are much smaller. They are in line with results from a photon transport calculation on a head model employing data from exposed cortical tissue. The origin of the signal found here is still unclear, however, they might be the non-invasive equivalent to the scattering changes found in exposed cortical tissue studies (J. Neurophysiol., 78 (1997) 1707).
Surface modes in a Bose-Einstein condensate of sodium atoms have been studied. We observed excitations of standing and rotating quadrupolar and hexadecapolar modes. The modes were excited with high spatial and temporal resolution using the optical dipole force of a rapidly scanning laser beam. This novel technique is very flexible and should be useful for the study of rotating Bose-Einstein condensates and vortices.
The mutation specific for myotonic dystrophy (DM) is an unstable expanded CTG repeat located in the 3'-untranslated region of the myotonin protein kinase gene. Expansion of the CTG repeat shows a positive correlation with the severity of the disease and increases in successive generations of DM patients. Children with the congenital form of DM show the most severe phenotype and have large expansions, usually > 1000 repeats. For pregnant women with DM, prenatal diagnosis of DM may be offered. To reduce the time between chorionic villus sampling or amniocentesis and final results of DNA analysis in these cases, a fast and efficient method has been developed. This method combines direct PCR analyses for normal alleles with a nested PCR system followed by non-radioactive hybridization with a single-stranded probe.
UNLABELLED: We investigated slow spontaneous oscillations in cerebral oxygenation in the human adult's visual cortex. The rationale was (1) to demonstrate their detectability by near infrared spectroscopy (NIRS); (2) to analyze the spectral power of as well as the phase relationship between the different NIRS parameters (oxygenated and deoxygenated hemoglobin and cytochrome-oxidase; oxy-Hb/deoxy-Hb/Cyt-ox). Also (3) influences of functional stimulation and hypercapnia on power and phase shifts were investigated. The results show that-in line with the literature-low frequency oscillations (LFO) centred around 0.1 s(-1) and even slower oscillations at about 0.04 s(-1) (very low frequency, VLFO) can be distinguished. Their respective power differs between oxy-Hb, deoxy-Hb, and Cyt-ox. Either frequency (LFO and VLFO) is altered in magnitude by functional stimulation of the cortical area examined. Also we find a change of the phase shift between the vascular parameters (oxy-Hb, tot-Hb) and the metabolic parameter (Cyt-ox) evoked by the stimulation. It is shown that hypercapnia attenuates the LFO in oxy-Hb and deoxy-Hb. CONCLUSIONS: (1) spontaneous vascular and metabolic LFO and VLFO can be reproducibly detected by NIRS in the human adult. (2) Their spectral characteristics and their response to hypercapnia are in line with those described in exposed cortex (for review see (Hudetz et al., 1998)) and correspond to findings with transcranial doppler sonography (TCD) (Diehl et al., 1995) and fMRI (Biswal et al., 1997). (3) The magnitude of and phase relation between NIRS-parameters at the LFO may allow for a local noninvasive assessment of autoregulatory mechanisms in the adult brain.
Changes in optical properties of biological tissue can be examined by near-infrared spectroscopy (NIRS). The relative transparency of tissues including the skull to near-infrared light is the prerequisite to apply the method to brain research. We describe the methodology with respect to its applicability in non-invasive functional research of the adult cortex. A summary of studies establishing the 'typical' response in NIRS vascular parameters, i.e. changes in the concentration of oxygenated and deoxygenated haemoglobin, over an activated area is followed by the validation of changes in the cytochrome-oxidase redox state in response to a visual stimulus. Proceeding from these findings a rough mapping of this metabolic response over the motion-sensitive extrastriate visual area is demonstrated. NIRS measures concentration changes in deoxygenated haemoglobin [deoxy-Hb] which are assumed to be the basis of fMRI BOLD contrast (blood oxygenation level-dependent). The method is therefore an excellent tool to validate assumptions on the physiological basis underlying the fMRI signal, due to its high specificity as to the parameters measured. Questions concerning the concept of 'activation'/'deactivation' and that of the linearity of the vascular response are discussed. To challenge the method we finally present results from a complex single-trial motor paradigm study testing the hypothesis, that premotor potentials (contingent negative variation) can be examined by functional techniques relying on the vascular response. Some of the work described here has been published elsewhere.
We used Monte Carlo simulations and the diffusion approximation to estimate correction terms for the analysis of reflectance spectra of cortical intrinsic optical signals. These corrections depend on scattering and absorption properties, i.e. they are dependent on assumptions on the tissue blood content and oxygen saturation. The analysis was applied to reflectance spectra acquired during whisker barrel stimulation in the rat where attenuation spectra were converted to changes in oxygenated and deoxygenated haemoglobin concentration. The description of the experimental data as judged by the residual and sensitivity to variations of wavelength was considerably improved when the correction terms were included. Inclusion of the correction does have a considerable impact on the time course of deoxyhaemoglobin concentration changes. In contrast to the calculation without correction terms, there is no indication for an early increase in deoxyhaemoglobin ('early dip'). This finding might further current interpretation of the coupling between neuronal activation and oxygen extraction and supply.
This study investigated how a decrease in neuronal activity affects cerebral blood oxygenation employing a paradigm of acoustically triggered saccades in complete darkness. Known from behavioral evidence as saccadic suppression, electrophysiologically it has been shown in monkeys that during saccades an attenuation of activity occurs in visual cortex neurons (Duffy and Burchfiel, 1975). In study A, using blood oxygen level-dependent (BOLD) contrast functional magnetic resonance imaging (fMRI), the authors observed signal intensity decreases bilaterally at the occipital pole during the performance of saccades at 2 Hz. In study B.1, the authors directly measured changes in deoxyhemoglobin [deoxy-Hb] and oxyhemoglobin [oxy-Hb] concentration in the occipital cortex with near-infrared spectroscopy (NIRS). Whereas a rise in [deoxy-Hb] during the performance of saccades occurred, there was a drop in [oxy-Hb]. In a second NIRS study (B.2), subjects performed saccades at different rates (1.6, 2.0, and 2.3 Hz). Here the authors found the increase in deoxy-Hb and the decrease of oxy-Hb to be dependent on the frequency of the saccades. In summary, the authors observed a focal hypooxygenation in the human visual cortex dependent on the saccade-frequency in an acoustically triggered saccades paradigm. This could be interpreted as evidence that corresponding to the focal hyperoxygenation observed in functional brain activation, caused by an excessive increase in cerebral blood flow (CBF) over the increase in CMRO2 during decreased neuronal activity CBF, is more reduced than oxygen delivery.
The quantification of tissue optical properties for calculating blood saturation and hemoglobin concentration using measurements of diffuse photon density waves at some distance away from an intensity-modulated light source, generally requires the determination of the amplitude and phase of this light source. This determination may become a severe impediment for measurements performed in the clinical environment. In this work we extend a self-calibrating methodology developed for constant wave and modulation depth-phase measurements, to include amplitude and phase measurements of diffuse photon density waves. The method uses amplitude and phase changes of intensity modulated light, under the assumption of known index of refraction and invariant reduced scattering coefficient mu's, to quantify the absorption coefficient mu(a) without requiring initial amplitude and phase knowledge. Quantification of the mu(a) at selected time points during a measurement can then be employed to calibrate numerical solutions of the diffusion equation and compute the mu(a) for the remaining time points of the experiment. It is shown that the method is quite insensitive to the knowledge of the exact mu's value so that an assumption on the average mu's value for the tissue measured may be employed. The sensitivity of calculating blood saturation and hemoglobin concentration, as a function of the deviation of the mu's used in the calculation versus the real mu's value is investigated using simulated data. It is also demonstrated that the saturation calculation is especially insensitive to the mu's guess. The performance of the method to quantify blood oxygen saturation and the concentrations of oxy- and deoxy-hemoglobin is examined with experimental measurements at two wavelengths on specially constructed blood model phantoms. To validate the method the measurements are monitored by a time-resolved spectrometer. The method is shown to be accurate to within +/-5% in calculating blood saturation and to within +/-10% in calculating hemoglobin concentration compared to the results obtained with the time-resolved spectrometer and the expected theoretical values.
UNLABELLED: Intussusception is an extremely rare disorder in preterm infants. An infant of 29 weeks gestational age with this condition is reported and a retrospective analysis of 17 previously reported cases presented. In the reviewed preterm infants, risk factors for intussusception seemed to be multifactorial. Clinical features included severe abdominal distension (17/17), gastric aspirates (13/17), commonly bilious, bloody stools (10/17) and rarely a palpable abdominal mass (5/17). Diagnostic features were signs of small bowel obstruction on the abdominal radiographs. Signs and symptoms were similar to those seen in necrotizing enterocolitis, therefore difficulties in establishing a correct diagnosis led to an average delay of 7 days between the onset of symptoms and abdominal surgery, increasing the risk of developing a compromised bowel. CONCLUSION: The differential diagnosis of an intussusception should be considered in preterm infants with acute abdominal distension and tenderness.
The effects of epidermal pigmentation and hair covering on the relative transparency of various animal tissues to near infrared (NIR) light were examined, and the pathlengths of NIR light through tissues at four wavelengths in the NIR range were subsequently determined. Black hair covering and black or dark-coloured hooves prevented NIR light from penetration sufficient for conduction of pathlength or NIR spectroscopy measurements. Non-pigmented hair covering of the head did not appear to be a barrier to successful NIR light transmission. Tissues sufficiently transparent to NIR light had the differential pathlength factor (DPF, i.e. the ratio of the observed light pathlength and the geometric light source-detector separation) of NIR light determined by intensity modulated spectroscopy at the wavelengths 744, 806, 834 and 860 nm. Horse gluteal muscles had DPFs of 6.2, 6.2, 6.0, and 5.6, whereas forelimb muscles had DPF of 4.7, 4.4, 4.5 and 3.9 at the respective wavelengths. Sheep heads had DPF of 7.2 +/- 0.3, 5.8 +/- 0.5, 5.5 +/- 0.4 and 4.4 +/- 0.6 (+/- SEM) for the above respective wavelengths, of which the pathlengths all differed significantly from the other, except for between 806 and 834 nm, and 834 and 860 nm. The DPF of horse hooves were 4.8 +/- 0.1, 4.8 +/- 0.1, 4.7 +/- 0.1 and 4.4 +/- 0.1 (SEM) for the above noted wavelengths, of which the pathlength at 744 and 806 nm differed from the pathlength at 860 nm (P>0.05). These results show that NIRS is possible through lighter pigmented hair and epidermal tissues, and provide DPFs of horse feet and muscle and the sheep head that enables quantitative NIRS in these species
UNLABELLED: Deep vein thrombosis requires intensive therapy--either the patients require hospitalisation or their rehabilitation scheme must be adjusted and medical treatment applied. The total number of patients with deep vein thrombosis undetected before admission to rehabilitation facilities is unknown. AIM: Study parameters: 1. The occurrence of undetected deep vein thrombosis upon admittance to a rehabilitation facility. 2. The value of sonography in diagnosing, localising and determining the extent of deep vein thrombosis and 3. the influence of prophylactic antithrombotic treatment applied in the surgical hospital, as well as during the intermittent outpatient phase before admittance to the rehabilitation centre, on the occurrence of deep vein thrombosis. METHODS: 305 patients were examined between Nov. 95 and Dec. 96. The first check was carried out on the day of admission (on the 26th postoperative day, on average). The second check was done on the day of discharge from the rehabilitation centre. RESULTS: Deep vein thrombosis was found in 30 patients (10%). In 27 cases the thrombosis was located in the thigh, in one case it was found in the contralateral leg. 18 of these patients had been discharged from the surgical hospital on the 22nd postoperative day, for an average time of 7 days of outpatient care, before being admitted to the rehabilitation centre. 11 of these patients had not received any prophylactic antithrombotic treatment. One patient developed deep vein thrombosis of the thigh during the rehabilitation phase despite of prophylactic treatment. CONCLUSION: Postoperative sonographic screening of all patients undergoing hip surgery is a useful method to detect deep vein thrombosis. Prophylactic postoperative antithrombotic treatment in the rehabilitation phase is mandatory.
In this study the authors used a whole-spectrum near-infrared spectroscopy approach to noninvasively assess changes in hemoglobin oxygenation and cytochrome-c oxidase redox state (Cyt-Ox) in the occipital cortex during visual stimulation. The system uses a white light source (halogen lamp). The light reflected from the subject's head is spectrally resolved by a spectrograph and dispersed on a cooled charge-coupled device camera. The authors showed the following using this approach: (1) Changes in cerebral hemoglobin oxygenation (increase in concentration of oxygenated hemoglobin, decrease in concentration of deoxygenated hemoglobin) in the human occipital cortex during visual stimulation can be assessed quantitatively. (2) The spectral changes during functional activation cannot be completely explained by changes in hemoglobin oxygenation solely; Cyt-Ox has to be included in the analysis. Only if Cyt-Ox is considered can the spectral changes in response to increased brain activity be explained. (3) Cytochrome-c oxidase in the occipital cortex of human subjects is transiently oxidized during visual stimulation. This allows us to measure vascular and intracellular energy status simultaneously.
An 11 year old girl presented with hypertension and tachycardia. Excess urinary catecholamine excretion suggested phaeochromocytoma but imaging studies failed to demonstrate a tumour. Other symptoms included insomnia and weight loss, and she was found to have a raised concentration of mercury in blood and urine. Mercury intoxication should be considered in the differential diagnosis of hypertension with tachycardia even in patients presenting without the skin lesions typical of mercury intoxication and without a history of exposure.