Effect of torso resistivity variation on the electrocardiograms of children, using a grid lead system.
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OBJECTIVES: To determine the association between an abdominal "seat belt sign" (SBS) and intra-abdominal injury (IAI) in children presenting to the emergency department (ED) after blunt trauma. METHODS: The authors performed a prospective, observational study of children at risk for IAI who presented to a Level 1 trauma center following a motor vehicle collision (MVC) during a two-year period. Physical examination findings were recorded prior to abdominal imaging or surgery. The SBS was defined as an area of erythema, ecchymoses, and/or abrasions across the patient's abdominal wall resulting from a seat belt restraint. Patients were divided into two cohorts based on the presence or absence of an SBS, then further subdivided based on abdominal tenderness or pain. The authors compared patients with and without SBS, and those with and without abdominal pain or tenderness for the presence of IAI. RESULTS: Three hundred ninety children, of whom 46 (12%, 95% CI = 9% to 15%) had an SBS, were enrolled. IAIs were more common in patients with, versus without, an SBS (14/46 vs. 36/344, relative risk 2.9; 95% CI = 1.7 to 5.0; p < 0.001). Patients with an SBS were more likely to have gastrointestinal injuries than those without an SBS (12/46 vs. 7/344, relative risk 12.8; 95% CI = 5.3 to 31; p = 0.001). Pancreatic injuries were also more common among patients with an SBS (3/46 vs. 1/344, relative risk 22; 95% CI = 2.4 to 211; p = 0.006). There was no difference in the prevalence of solid organ injuries between those with and without an SBS (4/46 vs. 34/344, relative risk 0.9, 95% CI = 0.3 to 2.4; p = 1.00). None of the six patients (0%, 95% CI = 0 to 39%) with an SBS, but without abdominal pain or tenderness, had IAIs. CONCLUSIONS: Patients with an SBS after an MVC are more likely to have IAIs than patients without an SBS, predominately due to a higher rate of gastrointestinal injuries. Patients with an SBS but without abdominal pain or tenderness appear to be at low risk for IAI.
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Isopotential map was obtained every 3 msec after the onset of ventricular activation from 85 unipolar lead ECGs of a normal subject (Measured map) and similar map at the corresponding instant (Simulated map) was also obtained by means of mathematical calculation under the assumption that the cardiac electromotive force can be represented by a single electric dipole fixed at the heart center. These 2 maps were quantitatively compared and difference was delineated on a map (Difference map). Although, in major aspect, there was a fairly good agreement between Measured and Simulated maps during early stages of ventricular activation, a remarkable difference of potential distribution began to appear between them around the time of occurrence of epicardial breakthrough of the ventricular activation front. From that t me on, it became impossible to represent the cardiac electromotive force into 2 or more electric dipoles in Difference map. Difference maps around the instant of epicardial breakthrough of the ventricular activation were supposed to be helpful for the estimation of the spread of ventricular activation.
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Because SPECT images are acquired under normal respiration, the respiratory motion induces artifacts and decreases resolution. In this study we developed a novel method of acquiring SPECT data during deep inhalation breath-hold (BrST) and assessed its efficacy in reducing motion artifacts and improving resolution. Reproducibility studies found that variations in SPECT image homogeneity were reduced using the BrST method to within a clinically non-problematic range. An experiment using a custom-built respiration phantom showed almost complete elimination of motion artifacts and significant improvement in resolution using the BrST method. Clinical assessment confirmed a significant reduction in motion artifacts along with the improvement in resolution. The BrST method enabled visualization of lesions that previously had been impossible to detect by standard acquisition under normal respiration. The BrST method is expected to both significantly reduce motion artifacts and improve resolution.
Differentiation of the embryonic termini in Drosophila depends on signaling by the Tor RTK, which induces terminal gene expression by inactivating at the embryonic poles a uniformly distributed repressor activity that involves the Gro corepressor. Here, we identify a new gene, cic, that acts as a repressor of terminal genes regulated by the Tor pathway. cic also mediates repression along the dorsoventral axis, a process that requires the Dorsal morphogen and Gro, and which is also inhibited by Tor signaling at the termini. cic encodes an HMG-box transcription factor that interacts with Gro in vitro. We present evidence that Tor signaling regulates terminal patterning by inactivating Cic at the embryo poles. cic has been evolutionarily conserved, suggesting that Cic-like proteins may act as repressors regulated by RTK signaling in other organisms.
A computer simulation study has been conducted to investigate the performance of body surface Laplacian maps (BSLMs) in localizing and imaging spatially separated myocardial electrical events. A cellular automaton model of ventricles simulates cardiac electrical activity using a two-site pacing protocol to induce dual simultaneously active myocardial electrical events. The heart model is embedded in a realistically shaped inhomogeneous volume conductor. The BSLMs are numerically computed from the induced electrical activity in the heart model. The present computer simulation results show that the BSLM can provide better separation and localization of two regional myocardial electrical events as compared with the body surface potential map (BSPM).
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