Biomedical subjects

Y Afework

Publications and source records attributed to Y Afework.

4 recordsLinked to original sources

PubMed1995

Pulmonary nodules: improved detection with vascular segmentation and extraction with spiral CT. Work in progress.

PURPOSE: To determine whether extraction of pulmonary vessels from computed tomographic (CT) images with automated segmentation improves the detection of pulmonary nodules. MATERIALS AND METHODS: Simulated nodules were superimposed on normal spiral CT images. Eight patients referred for CT assessment of pulmonary nodules were selected for clinical evaluation. Vessels were extracted from both the simulation and clinical study with a three dimensional seeded region-growing algorithm. Three experienced radiologists were asked to locate the nodules and assign a level of confidence to their findings. Sensitivity and proportion of false-positive results per case (FPC) were calculated. Observer performance was evaluated by alternate free-response receiver operating characteristic analysis. RESULTS: Extraction of vascular structures from CT scans improved sensitivity from 63% to 84% in the simulation study and from 58% to 78% in the clinical study. The proportion of FPC decreased from 52% to 24% and from 55% to 12%, respectively. Radiologists performed consistently better with the segmented images than with the original images in both the simulation (P = .006) and the clinical (P = .0013) study. CONCLUSION: Automated vessel subtraction and extraction improves detection of pulmonary nodules.

Adult↗

PubMed1993

Effects of monophasic and biphasic shocks on action potentials during ventricular fibrillation in dogs.

This study determined the response of action potentials during ventricular fibrillation (VF) to timed monophasic and biphasic shocks. A floating glass microelectrode was used to record intracellularly from the anterior right ventricle in 10 open-chest dogs. After 10 seconds of electrically induced VF, 5-millisecond monophasic and 2.5/2.5-millisecond biphasic shocks or 16-millisecond monophasic and 8/8-millisecond biphasic shocks were given via mesh electrodes on either side of the microelectrode. Monophasic and biphasic truncated exponential shocks of 5 V/cm were given with coupling intervals timed from the beginning of a VF action potential to the shock ranging from 50 to 70 milliseconds in 5-millisecond increments. Each coupling interval for each waveform was tested during a different VF episode. The interval between successive activations during VF was 86 +/- 15 milliseconds (mean +/- SD). The refractory period during VF was 61 +/- 5 milliseconds for 5-millisecond monophasic shocks and 66 +/- 6 milliseconds for 2.5/2.5-millisecond biphasic shocks (P < .05). At each coupling interval, action potential duration at 50% repolarization (APD50) was significantly prolonged by the shocks compared with the mean preshock APD50 (P < .05). ADP50 duration increased significantly with increases in the coupling interval (P < .05) for both monophasic and biphasic waveforms. For all coupling intervals together, APD50 prolongation as a percent of the mean preshock APD50 was 170 +/- 55%, 192 +/- 45%, 151 +/- 44%, and 175 +/- 45% for 5- and 16-millisecond monophasic and 2.5/2.5- and 8/8-millisecond biphasic waveforms, respectively. This APD50 prolongation was greater for monophasic than biphasic shocks and was greater for longer than shorter waveforms (P < .05). Thus, during VF, (1) the refractory period for 5-V/cm truncated exponential waveforms lasting 5 milliseconds is approximately 75% of the VF activation interval; (2) the refractory period is shorter for monophasic than for comparable biphasic waveforms; (3) both monophasic and biphasic 5-V/cm shock fields cause prolongation of action potential duration; (4) prolongation of action potential duration increases as the coupling interval increases; and (5) prolongation of action potential duration is greater for monophasic shocks and for longer shock waveforms.

Action Potentials↗

PubMed1992

Three-dimensional potential gradient fields generated by intracardiac catheter and cutaneous patch electrodes.

BACKGROUND: Defibrillation may be improved if electrode configurations can be found that create a larger and more even voltage gradient field across the heart. This study determined the magnitude of the shock gradient fields generated by four nonthoracotomy electrode configurations for defibrillation. METHODS AND RESULTS: In six dogs, a catheter was inserted containing a right ventricular apical electrode (V) and a right atrial electrode (A). A cutaneous patch electrode (P) was placed on the left lateral thorax. Shock potentials were recorded simultaneously from 128 electrodes in the left ventricular and right ventricular subepicardium and subendocardium, ventricular septum, and atria. With the chest closed, 50-mA shocks were given during diastole via the following lead configurations: V----A (V, cathode; A, anode); V----P; V----A+P; and V+A----P. Potential gradients were calculated at the subepicardium and subendocardium in millivolts per centimeter per volt of shock. In most dogs, the V----A+P configuration produced higher gradients throughout the ventricles than did V----A, V----P, or V+A----P. The maximum potential gradient was smaller for the V+A----P configuration than for V----A, V----P, or V----A+P. The gradient fields for the configurations with the catheter alone or combined with P were uneven. CONCLUSIONS: It is possible to estimate shock gradient fields in three dimensions. Of the four configurations tested, V----A+P produced the highest gradients and V+A----P produced the lowest high gradient. The gradient fields were uneven throughout the ventricles.

Animals↗

PubMed1991

Dispersion of repolarization induced by a nonuniform shock field.

Dispersion of repolarization may contribute to arrhythmias. To determine whether an electrical field stimulus (S2) with a nonuniform potential gradient can induce a dispersion of repolarization, we applied 5 ms rectangular S2 that had a nonuniform or uniform potential gradient during the action potential (AP) of bathed frog ventricular strips. One group had a partitioned bath to produce a nonuniform S2 of 39 +/- 11 V/cm (mean +/- SD) in one half of the 1 x 6 mm strip (H) and 0.3 +/- 0.2 V/cm in the other half (L), and simultaneous intracellular AP recordings in H and L with glass microelectrodes positioned 1.4 +/- 0.4 mm apart. Another group had uniform S2 and an AP recorded near the center of the strip. S1 pacing at 0.5 Hz was performed at one end of the strip and conduction along the strip was monitored. In each experiment, the S2 trials had an S1-S2 interval of 300 ms so that S2 was given during an AP (shocked AP). In both H and L, nonuniform S2 produced cumulative shortening of paced APs and lengthening of each shock AP compared with the paced AP preceding it. Uniform S2 of 1 V/cm did not shorten the paced APs or lengthen the shocked APs indicating that the AP changes in L were not due to the small potential gradient in L. Before beginning nonuniform S2 trials, the AP duration determined at the maximum repolarization rate was 601 +/- 72 ms in H and 602 +/- 71 ms in L (P = ns). During 13-20 nonuniform S2 trials over a 60-80 minute period, paced APs were shortened to 490 +/- 51 ms in H and 515 +/- 39 ms in L while each shocked AP was lengthened, compared with the paced AP preceding it, to 636 +/- 40 ms in H and 561 +/- 21 ms in L (P less than 0.05). Therefore, paced APs after shocks repolarized 25 ms earlier in H than in L and shocked APs repolarized 75 ms later in H than in L. The results show that during the shortened AP in H, the AP in L is shortened, which is consistent with intracellular current from L to H during repolarization. During the prolonged AP in H, the AP in L is prolonged compared with the paced AP preceding it, consistent with intracellular current from H to L during repolarization. Thus, nonuniform shocks can induce a dispersion of repolarization and may induce cell-to-cell interactions during repolarization.

Action Potentials↗