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PubMed2003

Effects of gastric electrical field stimulation with long pulses on gastric emptying in dogs.

The aim was to investigate the effects of electrical field stimulation (EFS) with long and short pulses on gastric emptying, gastric contractility and vagal activity in dogs. Sixteen dogs were equipped with a duodenal cannula, electrodes and strain gauges (10 dogs) in the stomach. Each dog was fed with Ensure and gastric effluent was collected from the cannula. Electrical stimulation was applied via two electrodes (about 12 cm apart, one in the corpus and the other in the antrum) with long pulses (a frequency of 6 cycles min-1, pulse amplitude of 6 mA and width of 100 ms) in 10 dogs and with short pulses (frequency of 30 Hz and pulse width of 300 micros) in six dogs. The electrocardiogram was also recorded and heart rate variability was derived to assess the vagal activity. It was found that: (i). EFS with long pulses did not alter gastric emptying during stimulation but increased gastric emptying during the 45 min immediately after stimulation; (ii). EFS with long pulses increased gastric contractility in both proximal and distal antrum during and after the stimulation; (iii). EFS with long pulses resulted in an increase in vagal tone during the 45 min immediately after stimulation. However, there is no difference during the 45 min period of stimulation; (iv). EFS with short pulses had no effect on gastric emptying. We concluded that long pulse gastric electrical field stimulation with one electrode in the corpus and the other electrode in the antrum has postponed effects on gastric emptying of liquid, gastric contractility and vagal activity.

Animals↗
PubMed2002

A new method for preventing pulse pileup in scintillation detectors.

A new method for preventing pulse pileup in scintillation detectors is proposed. In the new method (G-INT), the energy of an event is calculated from the 'gated integral' of the pulse signal and the period of integration. The period of integration is not fixed but is shortened by the arrival of the succeeding pulse so as to avoid post-pulse pileup. The effect of pre-pulse pileup is corrected by subtracting the remnant energy of the preceding pulses, which is calculated from the gated integral of the preceding pulse. To avoid error due to short pulse intervals, pre- and post-pulse deadtimes are imposed. The method is similar to Wong's method (W-SUM) that depicts the energy by the 'weighted sum' of the current signal and the integrated signal. The performance of G-INT has been studied by Monte Carlo simulation in comparison with W-SUM, the variable sampling-time technique and simple delay-line clipping. It is shown that G-INT provides the smallest degradation in pulse height resolution for a given count rate capability. The difference between G-INT and W-SUM is explained by the difference in the amount of statistical noise involved in the gated integral and in the weighted sum.

Algorithms↗
PubMed2003

Age-related changes in the characteristics of the photoplethysmographic pulse shape at various body sites.

It is accepted that older subjects have increasing arterial stiffness resulting in changes in the propagation of the pulse to the periphery, and thereby influencing the peripheral pulse timing and shape characteristics. However, this age association with pulse shape is less clear in younger subjects and for different peripheral measurement sites. The aim of this study was to determine the association between age and changes in pulse shape characteristics at the ears, fingers and toes. Photoplethysmography pulse waveforms were recorded non-invasively from the right and left sides at the ears, index fingers and great toes of 116 normal healthy human subjects. Their median age was 41 years (range 13-72) allowing four distinct age groups to be considered (subjects younger than 30 years, 30-39 years, 40-49 years and 50 years of age or older). Normalized ear, finger and toe pulse shapes were calculated, for the whole subject group, and for the subjects within each age group. The differences in shape, relative to the oldest group, were also calculated for two distinct regions of interest: the systolic rising edge and the dicrotic notch of the pulse. Subtle, gradual and significant changes in the pulse shape were found at all sites with overall elongation of the systolic rising edge (p < 0.05) and damping of the dicrotic notch (p < 0.05) with age. The overall age-related changes in multi-site PPG pulse shape characteristics at the ear, finger and toe sites have been demonstrated and quantified. Age-matched normal ranges must be considered when evaluating pulses from patients with possible vascular disease.

Adolescent↗
PubMed2005

Photoplethysmography detection of lower limb peripheral arterial occlusive disease: a comparison of pulse timing, amplitude and shape characteristics.

The assessment and diagnosis of lower limb peripheral arterial occlusive disease (PAOD) is important since it can lead progressively to disabling claudication, ischaemic rest pain and gangrene. Historically, the first assessment has been palpation of the peripheral pulse since it can become damped, delayed and diminished with disease. In this study we investigated the clinical value of objective photoplethysmography (PPG) pulse measurements collected simultaneously from the right and left great toes to diagnose disease in the lower limbs. In total, 63 healthy subjects and 44 patients with suspected lower limb disease were studied. Pulse wave analysis techniques extracted timing, amplitude and shape characteristics for both toes and for right-to-left toe differences. Normative ranges of pulse characteristics were then calculated for the healthy subject group. The relative diagnostic values of the different pulse features for detecting lower limb arterial disease were determined, referenced to the established ankle-brachial pressure index (ABPI) measurement. The ranges of pulse characteristics and degree of bilateral similarity in healthy subjects were established, and the degrees of pulse delay, amplitude reduction, and damping and bilateral asymmetry were quantified for different grades of disease. When pulse timing, amplitude and shape features were ranked in order of diagnostic performance, the shape index (SI) gave substantial agreement with ABPI (>90% accuracy, kappa 0.75). SI also detected higher grade disease, for legs with an ABPI less than 0.5, with a sensitivity of 100%. The simple-to-calculate timing differences between pulse peaks produced a diagnostic accuracy of 88% for all grades of arterial disease (kappa 0.70), and 93% for higher grade disease (kappa 0.77). These contrasted with the limited discriminatory value of PPG pulse amplitude. The low-cost and simplicity of this optical-based technology could offer significant benefits to healthcare, such as in primary care where non-invasive, accurate and simple-to-use (de-skilled) diagnostic techniques are desirable.

Adult↗
PubMed2004

Photosynthetic responses and N allocation in Douglas-fir needles following a brief pulse of nutrients.

The temporal distribution of soil nutrients is heterogeneous, and thus the uptake, storage and later remobilization of brief nutrient pulses may be critical for growth in nutrient-limited habitats. We investigated the response of photosynthesis and the major nitrogen (N) fractions in needles of 2-year-old Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) seedlings to a 15-day nutrient pulse (containing 250 ppm N). The nutrient pulse (N pulse) was imposed in late July, toward the end of the seedlings' third growing season, and subsequent changes in photosynthesis and needle N fractions were examined over the following 3 months. Needles are sites of photosynthesis and putative storage organs. Thus we tested two hypotheses: (1) N from the N pulse is quickly synthesized from soluble non-protein N into soluble proteins, especially Rubisco, and (2) the N pulse increases photosynthetic rates and thus growth. We also examined an alternative hypothesis that Rubisco functions also as a storage protein, in which case we would predict increases in amount of Rubisco in response to the N pulse without concomitant increases in photosynthesis. Soluble non-protein N was the most dynamic N pool and may have constituted a temporary storage reservoir; however, the quantitative significance of soluble non-protein N is questionable because this pool was at most only 7% of total N. Concentrations of Rubisco were unaffected by the N-pulse treatment and there was little evidence that Rubisco served as a storage protein. Nutrient-pulse seedlings added twice as much dry mass as controls during the 3 months post-treatment (Warren et al. 2003a). Over the same period, the maximum rate of light-saturated photosynthesis (A(max)) declined to low rates in control seedlings, whereas A(max) increased in N-pulse seedlings. Nevertheless, treatment and temporal trends in N and Rubisco content per unit area were poorly related to A(max), and it seems likely that photosynthesis was limited by additional factors, perhaps thylakoid proteins or an inadequate supply of other nutrients.

Nitrogen↗
PubMed1996

Effects of motion on the performance of pulse oximeters in volunteers.

BACKGROUND: Pulse oximetry is considered a standard of care in both the operating room and the postanesthetic care unit, and it is widely used in all critical care settings. Pulse oximeters may fail to provide valid pulse oximetry data in various situations that produce low signal-to-noise ratio. Motion artifact is a common cause of oximeter failure and loss of accuracy. This study compares the accuracy and data dropout rates of three current pulse oximeters during standardized motion in healthy volunteers. METHODS: Ten healthy volunteers were monitored by three different pulse oximeters: Nellcor N-200, Nellcor N-3000, and Masimo SET (prototype). Sensors were placed on digits 2, 3, and 4 of the test hand, which was strapped to a mechanical motion table. The opposite hand was used as a stationary control and was monitored with the same pulse oximeters and an arterial cannula. Arterial oxygen saturation rate varied from 100% to 75% by changing the inspired oxygen concentration. While pulse oximetry was both constant and changing, the oximeter sensors were connected before and during motion. Oximeter errors and dropout rates were digitally recorded continuously during each experiment. RESULTS: If the oximeter was functioning before motion began, the following are the percentages of time when the instrument displayed a pulse oximetry value within 7% of control: N-200 = 76%, N-3000 = 87%, and Masimo = 99%. When the oximeter sensor was connected after the beginning of motion, the values were N-200 = 68%, N-3000 = 47%, and Masimo = 97%. If the alarm threshold was chosen as pulse oximetry less than 90%, then the positive predictive values (true alarms/ total alarms) are N-200 = 73%, N-3000 = 81%, and Masimo = 100%. In general, N-200 had the greatest pulse oximetry errors and N-3000 had the highest dropout rates. CONCLUSIONS: The mechanical motions used in this study significantly affected oximeter function, particularly when the sensors were connected during motion, which requires signal acquisition during motion. The error and dropout rate performance of the Masimo was superior to that of the other two instruments during all test conditions. Masimo uses a new paradigm for oximeter signal processing, which appears to represent a significant advance in low signal-to-noise performance.

Adult↗
PubMed2001

Pulse oximetry in sickle cell anemia.

OBJECTIVES: To determine whether pulse oximetry is accurate and if it correlates with arterial blood gas saturation in pediatric patients with sickle cell anemia. DESIGN: Prospective, comparative study using a convenience sample of patients with sickle cell anemia who had simultaneous arterial blood gas sampling and pulse oximetry. SETTING: Children's Memorial Hospital, a large tertiary care pediatric hospital in Chicago, IL. Patients selected from the emergency department and the pediatric intensive care unit. PATIENTS: Twenty-four consecutive patients with sickle cell anemia who had simultaneous arterial blood gas sampling and pulse oximetry. MEASUREMENTS AND MAIN RESULTS: Twenty-four patients had a total of 70 simultaneous pulse oximeter and blood gas pair samples. Each patient's initial pulse oximeter/blood gas pair was used in the statistical analysis. Three patients had venous samples and were excluded from comparison, leaving 21 arterial blood gas/pulse oximeter pairs for analysis. The pulse oximeter correlated well with the cooximeter-measured arterial saturation (r(2) =.74). The pulse oximeter significantly underestimated saturation by a mean of -1.6% (95% confidence interval, -0.3 to -3; p =.03). CONCLUSIONS: Pulse oximetry correlates well with cooximeter-measured saturation in patients with sickle cell anemia. Pulse oximetry significantly underestimates true arterial saturation, but the bias is clinically insignificant. Pulse oximetry can be used reliably to estimate the arterial oxygen saturation in patients with sickle cell anemia.

Adolescent↗
PubMed1987

The Stanford Linear Accelerator Center pulsed x-ray facility.

The Stanford Linear Accelerator Center (SLAC) operates a high-energy (up to 33 GeV) linear accelerator delivering pulses up to a few microseconds wide. The pulsed nature of the electron beam creates problems in the detection and measurement of radiation both from the accelerator beam and the klystrons that provide the radio-frequency power for the accelerator. Hence, a pulsed x-ray facility has been built at SLAC mainly for testing the response of different radiation detection instruments to pulsed radiation fields. The x-ray tube consists of an electron gun with a control grid. This provides a stream of pulsed electrons that can be accelerated towards a confined target window. The window consists of Al 0.051 cm (20 mils) thick, plated on the vacuum side with a layer of Au 0.0006 cm (1/4 mil) thick. The frequency of electron pulses can be varied by an internal pulser from 60 to 360 pulses per second with pulse widths of 360 ns to 5 microseconds. The pulse amplitude can be varied over a wide range of currents. An external pulser can be used to obtain other frequencies or special pulse shapes. The voltage across the gun can be varied from 0 to 100 kV. The maximum absorbed dose rate obtained at 6.35 cm below the target window as measured by an ionization chamber is 258 Gy/h. The major part of the x-ray tube is enclosed in a large walk-in cabinet made of 1.9-cm-thick (3/4-inch-thick) plywood and lined with 0.32-cm-thick (1/8-inch-thick) Pb to make a very versatile facility.

Electrons↗
PubMed1997

The effect of pulsed electromagnetic fields on instrumented posterolateral spinal fusion and device-related stress shielding.

STUDY DESIGN: This study was designed to examine stress-shielding effects on the spine caused by rigid implants and to investigate the effects of pulsed electromagnetic fields on the instrumented spine. OBJECTIVES: To investigate the effects of pulsed electromagnetic fields on posterolateral spinal fusion, and to determine if osteopenia induced by rigid instrumentation can be diminished by pulsed electromagnetic fields. SUMMARY OF BACKGROUND DATA: Although device-related osteopenia on vertebral bodies is of a great clinical importance, no method for preventing bone mineral loss in vertebrae by stiff spinal implants has been effective. METHODS: Twenty-eight adult beagles underwent L5-L6 destabilization followed by posterolateral spinal fusion. The study was divided into four groups: 1) Group CNTL: without instrumentation, without pulsed electromagnetic fields, 2) Group PEMF: without Steffee, with pulsed electromagnetic fields, 3) Group INST: with Steffee, without pulsed electromagnetic fields, 4) Group PEMF + INST: with Steffee, with pulsed electromagnetic fields. At the end of 24 weeks, the dogs were killed, and L4-L7 segments were tested biomechanically without instrumentation. Radiographs and quantitative computed tomography assessed the condition of the fusion mass. RESULTS: Stress shielding was induced in the anterior vertebral bodies of L6 with the Steffee plates; bone mineral density was increased with the addition of pulsed electromagnetic fields, regardless of the presence or absence of fixation. A decrease in flexion and bending stiffness was observed in the Group INST; pulsed electromagnetic fields did increase the flexion stiffness regardless of the presence or absence of fixation, although this was not statistically significant. CONCLUSIONS: Use of pulsed electromagnetic fields has the potential to minimize device-related vertebral-bone mineral loss.

Animals↗
PubMed2005

Exposure to pulsed low intensity ultrasound stimulates extracellular matrix metabolism of bovine intervertebral disc cells cultured in alginate beads.

STUDY DESIGN: In vitro study on the effects of pulsed low intensity ultrasound on the cellular metabolism of bovine intervertebral disc cells. OBJECTIVE: To determine whether pulsed low intensity ultrasound has effects on cell proliferation and extracellular matrix metabolism by bovine intervertebral disc cells. SUMMARY OF BACKGROUND DATA: The application of pulsed low intensity ultrasound is known to be effective in stimulating fracture and cartilage repair. However, the effects of pulsed low intensity ultrasound on intervertebral disc cells are not known. METHODS: Cells of the nucleus pulposus and inner and outer anulus fibrosus were enzymatically isolated from bovine coccygeal tissue and precultured in alginate beads for 14 days. In the ultrasound group, pulsed low intensity ultrasound was administered to the culture for 20 minutes daily for an additional 20 days. The control group was cultured in the same way but without administration of ultrasound. Cell viability, DNA content, proteoglycan and collagen synthesis, and proteoglycan content at days 10 and 20 after the initiation of treatment were evaluated. Characterization of newly synthesized collagen and proteoglycan was performed. RESULTS: No significant differences in cell viability and DNA content were observed between the two groups. On day 20, proteoglycan synthesis was increased by the application of pulsed low intensity ultrasound in nucleus pulposus and inner and outer anulus fibrosus cells (24%-26% increase, P < 0.001). The application of pulsed low intensity ultrasound increased proteoglycan content in alginate beads containing inner and outer anulus fibrosus cells (P < 0.05). Collagen synthesis by cells isolated from all three zones of the intervertebral disc was increased by the application of pulsed low intensity ultrasound (16%-19% increase, P < 0.05-0.0001). CONCLUSIONS: The application of pulsed low intensity ultrasound stimulated extracellular matrix metabolism in intervertebral disc cells. Pulsed low intensity ultrasound may prove useful for the physical stimulation of cell metabolism for tissue engineering of intervertebral disc tissue.

Animals↗
PubMed1999

Enhanced pulse propagation in nonlinear arrays of oscillators.

The propagation of a pulse in a nonlinear array of oscillators is influenced by the nature of the array and by its coupling to a thermal environment. For example, in some arrays a pulse can be speeded up while in others a pulse can be slowed down by raising the temperature. We begin by showing that an energy pulse (one dimension) or energy front (two dimensions) travels more rapidly and remains more localized over greater distances in an isolated array (microcanonical) of hard springs than in a harmonic array or in a soft-springed array. Increasing the pulse amplitude causes it to speed up in a hard chain, leaves the pulse speed unchanged in a harmonic system, and slows down the pulse in a soft chain. Connection of each site to a thermal environment (canonical) affects these results very differently in each type of array. In a hard chain the dissipative forces slow down the pulse while raising the temperature speeds it up. In a soft chain the opposite occurs: the dissipative forces actually speed up the pulse, while raising the temperature slows it down. In a harmonic chain neither dissipation nor temperature changes affect the pulse speed. These and other results are explained on the basis of the frequency vs energy relations in the various arrays.

Journal Article↗
PubMed2002

Transit time of optical pulses propagating through a finite length medium.

We present experimental and theoretical results on the transit time of optical pulses propagating through bulk media of finite length, specifically GaAs and silica. The transit time of the peak of the pulse varies with the central wavelength due to the étalon effects caused by the reflectivity at the air/medium boundaries. For transform limited optical pulses, the transit time as a function of wavelength follows the transmittance spectrum, that is, the longest transit time occurs at the transmittance maxima where the cavity dwell time is the longest and the shortest transit time occurs at the transmittance minima. The results are dramatically different for chirped pulses obtained by modulating the injection current of a diode laser. The range in the transit times for chirped pulses is a factor of four times larger compared with transform limited pulses. In addition, the transit time for chirped pulses propagating through the GaAs sample is negative at certain wavelengths. Also, the transmitted pulse is not distorted. Although modulating the injection current of a diode laser is the most common method for generating optical pulses, to our knowledge this is the first reported observation of the transit time of these chirped optical pulses propagating through a simple étalon structure.

Journal Article↗
PubMed1989

Effect of naloxone and luteinizing hormone releasing hormone pulses on plasma luteinizing hormone concentration in ewe lambs.

A study was conducted to determine the effect of pulses of naloxone on plasma LH concentration in prepubertal ewes and to see if this treatment affects the pituitary response to subsequent LHRH pulses. Prepubertal ewes (n = 5) received three intracarotidal pulses of naloxone (NAL, 1 mg/kg BW) and four pulses of Luteinizing Hormone Releasing Hormone (LHRH, 1 micrograms/pulse) at hourly intervals. Control ewes (n = 5) received saline instead of NAL followed by the LHRH pulses at the same frequency. Blood samples were collected from one hour before the first pulse of saline or NAL at 15 min intervals for four hours and at 30 min intervals for another four hours. Plasma LH concentration was measured by radioimmunoassay. The first pulse of NAL increased plasma LH levels compared to the basal levels and compared to control animals (P less than 0.01). The succeeding pulses were ineffective. LHRH provoked an increase in plasma LH concentration in control as well as in treated animals but the amplitude of the net peak height increased progressively up to the third pulse in NAL treated animals, while there was no increase in pituitary responsiveness to LHRH in control prepubertal ewes. Also, the area under the LHRH response curve was greater (P less than 0.05) in animals pretreated with NAL than in lambs pretreated with saline. The results suggest that there is an inhibitory opioid tone over LH secretion in female lambs. NAL increases the responsiveness to exogenous LHRH pulses, probably as a result of endogenous LHRH release.

Animals↗
PubMed2006

Effect of sildenafil on arterial stiffness, as assessed by pulse wave velocity, in patients with erectile dysfunction.

BACKGROUND: The problems of patients with erectile dysfunction have been recognized, leading to the emergence of sildenafil, which has led to successful treatment in many cases. The purpose of this study is to examine the effect of sildenafil on the pulse wave velocity of patients with erectile dysfunction. METHODS: Fifteen patients with erectile dysfunction were enrolled for this study. The brachial/ankle pulse wave velocity was determined before dosing and at 30, 60, 120, and 180 min after dosing with 25 or 50 mg of sildenafil citrate. Concurrently, the changes in blood pressure, heart rate, and brachial/ankle pulse wave velocity were measured. For the consideration of revised brachial/ankle pulse wave velocity by blood pressure, the systolic blood pressure-derived brachial/ankle pulse wave was also investigated, and we classified and examined those results with and without risk factors for arteriosclerosis. RESULTS: The systolic blood pressure decreased significantly at 60 min after dosing compared with the placebo control. The heart rate decreased at 120 min after dosing compared with the placebo control but that decrease was not significant. The brachial/ankle pulse wave velocity transiently decreased at 30 or 60 min after dosing compared with the placebo control, but the decrease was not significant; however, the systolic blood pressure-derived brachial/ankle pulse wave velocity decreased significantly. In those patients with risk factors for arteriosclerosis, the pulse wave velocity decreased significantly. CONCLUSION: In patients with erectile dysfunction who were administered sildenafil, the pulse wave velocity, along with blood pressure, tended to decrease transiently after dosing. There is a possibility that sildenafil affects the improvement of erectile dysfunction via the decrease of pulse wave velocity, especially in patients with risk factors for arteriosclerosis.

Adult↗
PubMed2004

Intense pulsed light treatment of persistent facial hypermelanosis following drug-induced toxic epidermal necrolysis.

BACKGROUND: Cutaneous hyperpigmentation is one of the most cosmetically disturbing sequel of drug-induced toxic epidermal necrolysis. Intense pulsed light is a promising tool for treating some melanocytic lesions. OBJECTIVE: The objective was to assess the effect of intense pulsed light in treating post-toxic epidermal necrolysis facial hypermelanosis. METHODS: Two Caucasian men aged 35 and 50 years presented with long-standing (32 and 39 years) severe hypermelanosis of the face after sulfonamide-induced toxic epidermal necrolysis. They were treated by intense pulsed light. Cutoff filters of 550, 590, and 615 nm were employed for five intense pulsed light sessions at 4-week intervals. The treatment was characterized by energy fluence of 25 to 32 J/cm2, pulse width of 2.2 to 3.2 ms, and double- to triple-pulse mode respecting a 30-ms delay. Before intense pulsed light treatment, and 2 months after the fifth intense pulsed light session, clinical photographs and skin biopsies were performed in combination with quantitative narrow-band remittance spectrophotometry of melanin pigmentation. Patients were clinically followed-up for 8 months after the end of the treatment. RESULTS: In both patients, clinical, histologic, and spectrophotometric assessments showed an average of 80% decrease in the hypermelanosis. No clinical recurrence of the hypermelanosis developed during the 8-month follow-up after intense pulsed light treatment. No major persistent side effects were experienced, especially hypopigmentation. CONCLUSION: Intense pulsed light appears to be effective and safe for treating post-toxic epidermal necrolysis hypermelanosis in Caucasian patients.

Adult↗
PubMed1991

Electroporation of cardiac cell membranes with monophasic or biphasic rectangular pulses.

During defibrillation, cardioversion, and electrocution trauma, heart cells are exposed to potential gradients that increase the transmembrane potential (Vm). At sufficiently high Vm, pathological increases in cell permeability can occur. With enzymatically isolated frog heart cells (n = 29) we investigated the voltage and time sufficient for electroporation or cardiac cell membranes with rectangular voltage pulses, particularly with 5-msec monophasic, and 5- or 10-msec biphasic pulses. The rectangular voltage pulse (monophasic 0.1-1.5 V, 0.1-100 msec or symmetric biphasic 0.1-1 V, 0.4-10 msec [total duration]) was applied to the cell membrane using the cell-attached patch clamp technique, and a low voltage pulse train was added so that membrane conductance could be monitored continuously. Step increases in membrane conductance (breakdown) were observed, indicative of electroporation, and occurred with different combinations of pulse amplitude and duration; for example, for monophasic square pulses: (1 V, 0.2 msec) or (0.5 V, 0.5 msec), and for biphasic pulses: (1 V, 0.4 msec total duration) or (0.5 V, 0.8 msec). Using 5- or 10-msec rectangular pulses, breakdown occurred at a voltage around 0.4 V independent of polarity or waveform. The recovery of the permeabilized cell membrane after the voltage pulse was highly variable, in some cases not recovering at all while in other cases recovering after a lapse of seconds to minutes. These results suggest that monophasic and biphasic pulses of approximately 1 V, 0.2-0.4 msec and approximately 0.4 V, 5 msec can permeabilize the heart cell membrane even for minutes, time enough to cause an alteration in the cellular ionic composition leading to depressed or unexcitable tissue, a precursor for cardiac arrhythmia.

Animals↗
PubMed1999

Double pulse transthoracic defibrillation in the calf using percent fibrillation cycle length as spacing determinate.

Recent studies have found that when multiple pulses of energy are used for defibrillation with implantable electrodes, the spacing between these pulses is better determined as a percentage of the fibrillation cycle length (CL), rather than as a fixed function of time. Here, this concept is further tested in the transthoracic defibrillation of calves, which are approximately the size of heavy humans. Eleven 90-110 kg calves (101 +/- 6 kg) were used in evaluating the effectiveness in achieving transthoracic ventricular defibrillation of ten double pulse waveforms (two 50 A 4-ms rectangular monopulses) having leading edge-to-edge spacings of 4 ms (a 50 A 8-ms rectangular monopulse) and 50, 60, 70, 80, 90, 100, 110, 120, 130 percent fibrillation CL, respectively. In each of these waveforms, the total time when 50 A current was flowing (on time) was 8 ms. Our results show an unequivocal adverse interaction between the pulses, when the spacing is around 60%-70% fibrillation CL; but that the two pulses combined to defibrillate as effectively as a single 8-ms pulse when the spacing is around 110%-130% fibrillation CL. Electrocardiographic analysis suggests that the adverse interaction is due to a refibrillation phenomenon. This study confirms that double pulses can interact and have a negative effect on defibrillation efficacy. Our data suggests that the mechanism of this interaction involves the second pulse reinitiating fibrillation when the pulse separation is in a critical range of values. Our results are also compatible with the hypothesis that the spacing of multiple pulses is better determined as a percentage of the fibrillation CL than as absolute time, although more study is necessary to fully test this hypothesis.

Animals↗
PubMedDate not supplied

Morphological effects of nanosecond- and femtosecond-pulsed laser ablation on human middle ear ossicles.

We evaluate the feasibility of nanosecond-pulsed and femtosecond-pulsed lasers for otologic surgery. The outcome parameters are cutting precision (in micrometers), ablation rate (in micrometers per second), scanning speed (in millimeters per second), and morphological effects on human middle ear ossicles. We examine single-spot ablations by a nanosecond-pulsed, frequency-tripled Nd:YAG laser (355 nm, beam diameter 10 microm, pulse rate 2 kHz, power 250 mW) on isolated human mallei. A similar system (355 nm, beam diameter 20 microm, pulse rate 10 kHz, power 160-1500 mW) and a femtosecond-pulsed CrLi:SAF-Laser (850 nm, pulse duration 100 fs, pulse energy 40 microJ, beam diameter 36 microm, pulse rate 1 kHz) are coupled to a scanner to perform bone surface ablation over a defined area. In our setups 1 and 2, marginal carbonization is visible in all single-spot ablations of 1-s exposures and longer: With an exposure time of 0.5 s, precise cutting margins without carbonization are observed. Cooling with saline solution result is in no carbonization at 1500 mW and a scan speed of 500 mms. Our third setup shows no carbonization but greater cutting precision, although the ablation volume is lower. Nanosecond- and femtosecond-pulsed laser systems bear the potential to increase cutting precision in otologic surgery.

Cadaver↗