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PubMed2006

A portable and low-cost fMRI compatible pneumatic system for the investigation of the somatosensensory system in clinical and research environments.

There still is a need for devices that allow reproducible stimulation of skin areas of the human body. We constructed a stimulation system and tested it by using brief pneumatic stimulation to the right thumb of nine healthy volunteers. BOLD-signals in response to tactile stimulation with frequencies of 1, 3 and 5 Hz were measured using a 3T MRI scanner. The stimulation device consists of synthetic membranes connected to plastic tubes capable of carrying compressed air, and an electronic component, which controls the on- and off-switching of an electromagnetic valve. The valve near the MR-scanner did not lower the image quality. Primary somatosensory activation contralateral to the stimulation site was reliably detected in response to a stimulus magnitude of 3.5 bar in all volunteers. 1 Hz stimulation resulted in higher maximal percentage BOLD-signal changes. Our device is an easy-to-construct, low-cost and portable tool suitable for research and clinical environments. It permits passive non-painful stimulation relevant for clinical assessments and is also compatible with magnetoencephalography (MEG) and electroencephalography (EEG). In basic and clinical research, this device therefore contributes to meaningful comparisons between results obtained with different techniques.

Adult↗
PubMed2006

Laughter and the mesial and lateral premotor cortex.

We report the induction of laughter and smiling by cortical electrical stimulation of the frontal lobe of two patients: an 18-month-old boy with a left frontal cortical lesion extending to the vertex and the central gyrus, and a 35-year-old woman with a lesion in the right supplementary sensorimotor area (SSMA). The subjects underwent presurgical epilepsy evaluation with subdural grid electrodes to determine surgical candidacy. Stimulation of the prefrontal area reproducibly induced laughter. The adult patient reported absence of emotional content. Slowing of speech occurred under stimulation of electrodes in the upper and posterior vicinity. In this patient laughter was elicited in the anterior part of the SSMA. In the child, this response was induced by stimulation of the lateral prefrontal cortex near the midline. We conclude that the anterior portion of the SSMA/lateral premotor cortex is involved in generating the motor pattern of laughter.

Adult↗
PubMed2006

Chemical sensors based on micromachined transducers with integrated piezoresistive readout.

We demonstrate an approach for the development of chemical sensors utilizing silicon micromachined physical transducers with integrated piezoresistive readout. Originally, these transducers were developed and optimized as sensitive accelerometers for automotive applications. However, by applying a chemically responsive layer onto the transducer, we convert these transducers into chemical sensors. These transducers are attractive for chemical sensing applications for several key reasons. First, the required sensitivity of the chemical sensor can be achieved by choosing the right spring constant of the transducer. Second, the integrated piezoresistive readout of the transducer is already optimized and is very straightforward, providing a desired reproducibility in measurements, while not requiring bulky equipment. Third, chemically responsive film deposition is simple due to the ease of access to the transducer's surface. Fourth, such transducers are already available for another (automotive) application, making these sensors very cost-effective. The applicability of this approach is illustrated by the fabrication of highly sensitive CO2 sensors. To study hysteresis effects, we selected high CO2 concentrations (10-100% CO2) to provide the worst-case scenario for the sensor operation. These sensors demonstrate a hysteresis-free performance over the concentration range from 10 to 100% vol CO2, have detection limits of 160-370 ppm of CO2, and exhibit a relatively rapid response time, T(90) = 45 s. Importantly, we demonstrate a simple method for cancellation of vibration effects when these physical transducers, initially developed as accelerometers, are applied as chemical sensors.

Journal Article↗
PubMed2001

Transient ST segment elevation in right precordial leads induced by psychotropic drugs: relationship to the Brugada syndrome.

Psychotropic Drugs and ST Segment Elevation. Transient ST segment elevation in right precordial leads with use of psychotropic drugs is reported in two cases of overdose and one case of therapeutic administration. Flecainide did not reproduce ST segment elevation. The relationship of these abnormalities to the Brugada syndrome and the electrophysiologic hypothesis are discussed.

Adult↗
PubMed1987

Interpretation of DNA vibration modes. II--The adenosine and thymidine residues involved in oligonucleotides and polynucleotides.

Normal coordinate analysis of the adenosine and thymidine residues involved in the right- and left-handed conformations of oligonucleotides and polynucleotides has been performed. The valence force field, employed in this work, allowed recently to reproduce the vibrational spectra of 2'-deoxythymidine and 2'-deoxyadenosine. The calculated wavenumbers based on a non-redundant set of internal coordinates have been compared to the Raman and infrared peak positions arising from A, B, C, D and Z conformations, in the 1550-1250 cm-1 and 800-600 cm-1 spectral regions: i.e. characteristic of adenosine and thymidine residues. Moreover, a systematic study has been performed on the evolution of the vibrational wavenumbers as a function of the glycosidic angle (chi) and the sugar pucker conformation.

Adenosine↗
PubMed2003

Simple model for training in the laparoscopic vesicourethral running anastomosis.

PURPOSE: To create a simple model for training in the complex technique of laparoscopic vesicourethral anastomosis after radical prostatectomy. MATERIALS AND METHODS: A model simulating the performance of a laparoscopic running urethrovesical anastomosis was fashioned using skin of a supermarket chicken set in a laparoscopic training box. A circular continuous anastomosis was performed, following exactly the technique we use in vivo for performing a vesicourethral anastomosis after laparoscopic radical prostatectomy. Details regarding the use of the right or the left needle holder, needle positioning, precise stitch position, and use of forehand or backhand stitch were strictly respected in order to reproduce the continuous stitch currently done in vivo in our department. The learning curve was analyzed in terms of the time necessary to perform the task and the quality of the anastomosis. RESULTS: The model was created and used by the junior authors during their year of fellowship in advanced laparoscopic urology. The authors had no previous experience with hands-on laparoscopic suturing but have assisted in a great number of laparoscopic radical prostatectomies. The time required for performing the anastomosis on the model declined from 75 minutes initially to 20 minutes after the trainees had performed 20 anastomoses each. After this training, it was possible to create a watertight running laparoscopic vesicourethral anastomosis in patients in a mean time of 40 minutes (range 30-55 minutes). CONCLUSION: This simple model allows the trainee in laparoscopic urology to acquire the skills necessary to perform a laparoscopic vesicourethral anastomosis, one of the most complex steps in laparoscopic radical prostatectomy, as well as to develop dexterity and facility in laparoscopic manipulation of needles, sutures, and fragile tissues.

Anastomosis, Surgical↗
PubMedDate not supplied

Cardiac arrhythmias elicited by interaction between acute myocardial ischemia and sympathetic hyperactivity: a new experimental model for the study of antiarrhythmic drugs.

The choice of an adequate model for the study of antiarrhythmic drugs, relevant to the clinical problem of life-threatening arrhythmia, is a difficult and important task for contemporary cardiovascular pharmacology. Guided by pathophysiological considerations, we have designed an arrhythmia model in which ventricular tachyarrhythmias can be reproducibly elicited by combining the two clinically relevant stimuli of acute myocardial ischemia and augmented sympathetic activity. In anesthetized cats, following ablation of the right stellate ganglion, the left anterior descending coronary artery is occluded for 2 min. After 1 min of occlusion the left stellate ganglion is electrically stimulated for 30 s. In most experiments ventricular tachyarrhythmias, usually ventricular tachycardia or fibrillation, can be regularly elicited for six to eight trials. The consistency of the arrhythmic response allows an internally controlled study, since a drug may be administered after three trials under control conditions. This avoids the limitations due to individual variability of comparisons between groups. This model seems to be particularly well suited for preliminary evaluation, before final study in conscious animals, of drugs thought to have a protective effect against malignant arrhythmias associated with acute myocardial ischemia.

Animals↗
PubMed1994

Feminist method and qualitative research about midlife.

This paper identifies criteria seen as essential to feminist research. In light of these criteria, issues which have arisen during our current research on women and their experiences of midlife and menopause are discussed. Issues considered include the researchers' responsibilities to participants when exploring sensitive and highly personal issues relating to participants' life experiences, and less clear cut issues such as knowledge construction, power and control. In relation to the latter the balance of power in the research-participant relationship, and the role and responsibilities of the researcher in knowledge construction, are explored. Foucault's notions of knowledge construction and power and control and the feminist researcher's position, are considered in terms of rigour in feminist research and dissemination of research reports. Issues which are seen as problematic and worthy of further debate are: the relations between interviewer and interviewee; the intellectual (the researcher) as the bearer of universal values and as truth teller; and the level of critical activism possible in research studies of this nature.

Age Factors↗
PubMed1979

Ventricular tachycardia and ventricular fibrillation in a young population.

In this study, we describe the findings in 18 young patients (age range 4 days to 24 years, mean 16.6 years) who had ventricular tachycardia and/or ventricular fibrillation and were followed for 4--70 months (mean 22.4 months). Patients had a variety of problems associated with their arrhythmia, including mitral valve prolapse, cardiomyopathy, myocarditis, prolonged QT syndrome and hypokalemia. Six patients had no clinically recognizable cardiac abnormality. The ventricular tachycardia showed a left bundle branch block contour in 10 of 17 patients, right bundle branch block in four, was multiform in two and had an indeterminate contour in one. Sustained ventricular tachycardia was initiated and terminated reproducibly by atrial and ventricular stimulation in three of seven patients who did not have spontaneous episodes of ventricular tachycardia during the electrophysiologic study. In one other patient, short bursts of ventricular tachycardia were induced. Patients who had ventricular fibrillation, those who died, and those who are still symptomatic with poorly controlled ventricular arrhythmias had significant heart disease. In one patient, a ventricular tachyarrhythmia that had required more than 100 electrical cardioversions spontaneously disappeared after requiring 1 year of antiarrhythmic therapy.

Adolescent↗
PubMed1995

Chronic rapid atrial pacing. Structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation.

BACKGROUND: Despite the clinical importance of atrial fibrillation (AF), the development of chronic nonvalvular AF models has been difficult. Animal models of sustained AF have been developed primarily in the short-term setting. Recently, models of chronic ventricular myopathy and fibrillation have been developed after several weeks of continuous rapid ventricular pacing. We hypothesized that chronic rapid atrial pacing would lead to atrial myopathy, yielding a reproducible model of sustained AF. METHODS AND RESULTS: Twenty-two halothane-anesthetized mongrel dogs underwent insertion of a transvenous lead at the right atrial appendage that was continuously paced at 400 beats per minute for 6 weeks. Two-dimensional echocardiography was performed in 11 dogs to assess the effects of rapid atrial pacing on atrial size. Atrial vulnerability was defined as the ability to induce sustained repetitive atrial responses during programmed electrical stimulation and was assessed by extrastimulus and burst-pacing techniques. Effective refractory period (ERP) was measured at two endocardial sites in the right atrium. Sustained AF was defined as AF > or = 15 minutes. In animals with sustained AF, 10 quadripolar epicardial electrodes were surgically attached to the right and left atria. The local atrial fibrillatory cycle length (AFCL) was measured in a 20-second window, and the mean AFCL was measured at each site. Marked biatrial enlargement was documented; after 6 weeks of continuous rapid atrial pacing, the left atrium was 7.8 +/- 1 cm2 at baseline versus 11.3 +/- 1 cm2 after pacing, and the right atrium was 4.3 +/- 0.7 cm2 at baseline versus 7.2 +/- 1.3 cm2 after pacing. An increase in atrial area of at least 40% was necessary to induce sustained AF and was strongly correlated with the inducibility of AF (r = .87). Electron microscopy of atrial tissue demonstrated structural changes that were characterized by an increase in mitochondrial size and number and by disruption of the sarcoplasmic reticulum. After 6 weeks of continuous rapid atrial pacing, sustained AF was induced in 18 dogs (82%) and nonsustained AF was induced in 2 dogs (9%). AF occurred spontaneously in 4 dogs (18%). Right atrial ERP, measured at cycle lengths of 400 and 300 milliseconds at baseline, was significantly shortened after pacing, from 150 +/- 8 to 127 +/- 10 milliseconds and from 147 +/- 11 to 123 +/- 12 milliseconds, respectively (P < .001). This finding was highly predictive of inducibility of AF (90%). Increased atrial area (40%) and ERP shortening were highly predictive for the induction of sustained AF (88%). Local epicardial ERP correlated well with local AFCL (R2 = .93). Mean AFCL was significantly shorter in the left atrium (81 +/- 8 milliseconds) compared with the right atrium 94 +/- 9 milliseconds (P < .05). An area in the posterior left atrium was consistently found to have a shorter AFCL (74 +/- 5 milliseconds). Cryoablation of this area was attempted in 11 dogs. In 9 dogs (82%; mean, 9.0 +/- 4.0; range, 5 to 14), AF was terminated and no longer induced after serial cryoablation. CONCLUSIONS: Sustained AF was readily inducible in most dogs (82%) after rapid atrial pacing. This model was consistently associated with biatrial myopathy and marked changes in atrial vulnerability. An area in the posterior left atrium was uniformly shown to have the shortest AFCL. The results of restoration of sinus rhythm and prevention of inducibility of AF after cryoablation of this area of the left atrium suggest that this area may be critical in the maintenance of AF in this model.

Animals↗
PubMed1975

Patterns of LH and FSH release from perifused rat pituitaries in response to infusions of hypothalamic extract.

A continuous flow incubation (perufusion) system was developed in which the secretory responses of pools of hemipituitaries from adult male rats to hypothalamic extract (HE) were characterized by serial radioimmunoassay of LH and FSH in the effluent medium. There was in initial massive release of LH and FSH which, in the absence of HE, declined to low basal levels at a rate which depended on the flow rate. Thereafter, the baseline for LH continued to decline gradually while that for FSH was stable. The rate of LH and FSH release rose abruptly after addition of the HE to the medium and returned promptly to baseline after withdrawal of the HE. During continuous infusion of HE for five hours, LH secretion was maintained at a relatively constant, elevated level. The responses to repeated identical pulses of HE were highly reproducible. The variability between responses by any one pool of tissue was significantly less than between responses of separate pituitary pools including pools comprising right and left halves of the same glands. For any given pool of pituitaries of the relationships were linear between: 1) duration of HE pulses (concentration constant) and increases in LH output, and 2) log of concentration of HE (pulse duration constant) and increases inLH and in FSH output. Consistent responses were obtained for up to 12 hr, the maximum period tested.

Animals↗
PubMed1999

Comparison of bone mass in forearm, lumbar vertebra and hip by single and/or dual energy X-ray absorptiometry.

OBJECTIVE: Bone mineral density (BMD) was measured in normal Chinese women with single X-ray absorptiometry (SXA) and dual energy X-ray absorptiometry (DEXA). These two methods were compared to evaluate the sensitivity in reflecting bone loss. METHODS: Measurements were performed in 300 women aged 20 to approximately 79 (5 for each age). The 8mm distal, 1/4 distal, ultra distal site of the nondominant forearm were measured with SXA; the AP spine (L2-4), right femoral neck (Neck), Ward's triangle (Ward) and trochantor (Troch) were measured with DEXA. Ten women had 5 repeated measurements to evaluate the reproducibility of the equipments. RESULTS: The BMD peak for Neck and Ward was found between age 20 to approximately 29, for ultra distal and L2-4 at age 30 to approximately 39, for 8mm distal, 1/4 distal and Troch at age 40 to approximately 49. After reaching the peak values, BMD at all sites decreased with increasing age. The highest rate of yearly loss of BMD was at 8mm distal. Results of measurement showed significant correlation between SXA and DEXA. Comparing with premenopausal women, the bone loss rate in postmenopausal women was faster and highest up to 11 to approximately 15 years and the highest rate was at the Ward. CONCLUSION: The present study gives the normal values of BMD at seven sites for normal Chinese women. The ages of BMD peak were different at seven sites. The yearly loss of BMD was highest at 8mm distal, it seemed to be the sensitive region for bone loss with age. The postmenopausal women had highly significantly loss bone mass than the premenopausal women. Comparing with premenopause, postmenopause BMD for Ward's triangle with DEXA seemed to be most sensitive to the effect of menopause.

Absorptiometry, Photon↗
PubMed2004

[A clinical evaluation of the practical reliability in video-assisted thoracic surgery for right primary lung cancer].

Recently, lobectomy by video-assisted thoracic surgery (VATS lobectomy: VL) has been widely applied to peripheral lung cancer because of its less invasive approach compared to standard thoracotomy (ST). However, the appropriate approach in VL still remains to be solved. The aim of this study was to evaluate the practical reliability of our technical devices in VL for right primary lung cancer. For the VATS procedures, a mini-thoracotomy measuring about 6-7 cm was made in the fourth or fifth intercostal space (ICS) under the auscultatory triangle without rib resection. Two access holes 12 mm in size were also made in the fourth ICS at the anterior axillary line and in the seventh ICS at the posterior axillary line, respectively. These access holes were used for insertion of thoracoscope, endoscopic stapler or retracting instrument according to operative procedure. After stapling of the vessels and bronchus, the resected pulmonary lobe was removed from the thorax using a plastic retrieval bag. The present study showed the technical feasibility of this unique thoracoscopic approach in the standard lobectomy with systematic nodal dissection for right lung cancer.

Aged↗
PubMed1992

The hydrocarbon breath test in the study of lipid peroxidation: principles and practice.

Lipid peroxidation has gained increasing interest in recent years as one of the more prominent features of free radical-induced damage in biology. The study of lipid peroxidation might increase our understanding of the etiology and pathophysiology of a great number of diseases. Ethane and pentane are among the numerous end-products of lipid peroxidation and although they represent only a small and possibly variable proportion of the total amount of peroxidized polyunsaturated fatty acids, their determination in head space or exhaled breath enables accurate assessment of oxidative stress both in vitro and in vivo. To date, the number of studies utilizing the hydrocarbon breath test as a marker of lipid peroxidation in humans is small. Technical difficulties are among the main reasons for the limited use of this method. An appropriate washout period, the use of the right materials, the scrupulous avoidance of air contamination, adequate preinjection concentrations of the samples, and a sensitive gas chromatographic technique enable the accurate and reproducible measurement of hydrocarbons in human breath. The hydrocarbon breath test provides a noninvasive and extremely sensitive instrument for the assessment of oxidative stress status in adults as well as in children.

Breath Tests↗
PubMed1986

Upper extremity proprioception in idiopathic scoliosis.

Twenty-three patients with idiopathic scoliosis were tested for upper extremity proprioceptive function. All subjects had documented progression of deformity, with an average curvature of 34 degrees. The average ages for scoliotics and 18 control subjects were 16.1 and 20.8 years, respectively. Controls had no spinal deformity and underwent identical test procedures. The test results showed that scoliotic subjects had significant asymmetry between right and left limbs in their threshold for detection of joint motion (p less than or equal to 0.005) and in their ability to reproduce angles to which their elbow joint had been previously positioned (p less than or equal to 0.025). Slight asymmetry also was observed in the reproduction tests of the control group (p less than or equal to 0.013); however, there was no significant asymmetry seen in this group for the threshold test. Performance of bilateral limbs was designated good and bad for both groups; the limb that performed better in proprioceptive function was designated good limb. Analysis of data showed that the scoliotics' good and bad limbs performed inferiorly in both threshold and angle reproduction tests when compared with normal controls. The results of this study imply, but do not localize, a neurologic deficit in scoliotic patients.

Adolescent↗
PubMed1995

[Cerebral diplopia and triplopia--a proposal for responsible lesion and mechanism].

We reported 2 cases of multiple images of cerebral origin. Case 1 was a 26-year-old right-handed woman, who showed a defect in the peripheral part of right visual field, with photopsia in the defective field, and cerebral diplopia within the perimetry-determined preserved part of the right hemifield. This was associated with a small infarction in the deep and anterior part of the area 17. The phenomenon was well-illustrated by her own detailed drawing. Case 2 was a 67-year-old right-handed man, who, following a hypoxic accident, developed monocular triplopia. MRI revealed laminar necrosis in the areas 18 and 19 bilaterally. Triplopia was reproducible when he fixed his attention upon the circumscribed afterimage given by a strobo-flash. This would serve as counterevidence against the Bender's hypothesis that this phenomenon was caused by the pseudofovea. In both cases, multiple images occurred only to objects upon which they fixed their gaze, only in the specific sector of the visual field. Both experienced diplopia and triplopia only after a few seconds of fixation. When they turned away the gaze, the extraimages disappeared. We proposed a new hypothesis for this phenomenon, i.e., it is caused by the impaired lateral inhibition, selective to the magnocellular system in the area 17 or other early visual cortices.

Adult↗
PubMed1997

[Guided anti-arrhythmia therapy by programmed ventricular stimulation. A case of arrhythmogenic dysplasia of the right ventricle].

Right ventricle dysplasia (RVD) is a rare clinical entity, described in young people, and a known cause of ventricular arrhythmias and sudden death. A genetic transmission has been suggested from the study of familial cases. The disease is characterized by a dilated right ventricle, cardiac infiltration with fatty tissue and focal fibrosis. Lymphoplasmocyte infiltrates are documented. The diagnosis is based on electrocardiography, echocardiography, magnetic resonance imaging and right ventricular endomyocardial biopsy. The authors report a case of a young woman with symptomatic ventricular tachycardia (VT) in whom the diagnosis of RVD was established. Programmed ventricular stimulation was used to reproduce the clinical VT and to test the efficacy of the anti-arrhythmic drug therapy. The diagnosis criteria and therapeutic options are discussed.

Adult↗