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Biomedical subjects

D C Howse

Publications and source records attributed to D C Howse.

12 recordsLinked to original sources
PubMed2001

Regional access to acute ischemic stroke intervention.

BACKGROUND AND PURPOSE: Benefit-risk ratios from recombinant tissue plasminogen activator (rtPA) therapy for acute ischemic stroke demonstrate lack of efficacy if intravenous administration is commenced beyond 3 hours of symptom onset. We undertook to enhance therapeutic effectiveness by ensuring equitable access to rtPA for patients affected by acute ischemic stroke within a 20 000 km(2) population referral base served by a tertiary facility. METHODS: Representatives of all provider groups involved in emergency medical services developed a Regional Acute Stroke Protocol (RASP), a coordinated regional system response by dispatch personnel, paramedics, physicians, community service providers, emergency and inpatient staff in community hospitals, and the tertiary facility acute stroke team. RESULTS: As of July 26, 1999, all ambulance services in Southeastern Ontario began bypassing the closest hospital to deliver patients meeting the criteria for the RASP to the Kingston General Hospital. At 12 months, approximately 403 ischemic strokes have occurred in the region, the RASP has been activated 191 times, and 42 patients have received rtPA. CONCLUSIONS: We conclude that (1) acute stroke patients in Southeastern Ontario have improved access to interventions for stroke care; (2) geography of the region is not a barrier to access to interventions for patients with acute stroke; and (3) acute ischemic stroke patients treated with rtPA account for 5% of all acute strokes and 10% of all ischemic strokes in this region.

Aged↗
PubMed1993

Reversible parkinsonism induced by hypercalcemia and primary hyperparathyroidism.

We describe a patient who had the recent onset of both primary hyperparathyroidism and parkinsonism. Surgical removal of a parathyroid adenoma was followed by spontaneous resolution of the parkinsonism. Hypoparathyroidism and other disorders of calcium metabolism are recognized causes of secondary parkinsonism, while hyperparathyroidism is not. We review the relevant literature, which supports the hypothesis that hypercalcemia may have induced cytotoxic changes in the basal ganglia of this patient.

Adenoma↗
PubMed1992

Removing the interference error between attenuation correction and scatter subtraction in 3D PET imaging.

A method to remove the interference between attenuation correction and scatter subtraction has been developed for the QPET 3D imaging system at Queen's University. Because the detector system has more than 10(10) lines of response, we reconstruct the image by first backprojecting, then filtering. We correct for attenuation at backprojection by weighting each event by the inverse of the attenuation factor calculated by reprojection through an attenuation image. Since the scatter background has not been corrected at backprojection time, this has the side effect that a fraction of the detected scattered events get incorrectly weighted. When a scatter subtraction is subsequently applied, the correction is inaccurate because the scatter distribution has been modified by the attenuation correction procedure. The residual interference error in the reconstructed image is a distorted image of the attenuator. An approximation to this error is obtained by reprojecting through the attenuation image, backprojecting with appropriate weights, then reconstructing. This image is then scaled and multiplied by the calculated scatter distribution to obtain an estimate of the interference error. Both simulations and measurements indicate that for our system, this method provides a reasonable approximation of the interference error in the image.

Image Processing, Computer-Assisted↗
PubMed1991

Accurate attenuation correction for a 3D PET system.

An accurate attenuation correction has been developed for a small-volume three-dimensional positron emission tomography (PET) system. Transmission data were measured as twenty-four 2D slices which were reconstructed and combined to form a 3D attenuation image. Emission data were reconstructed using a backproject-then-filter technique, and each event was corrected for attenuation at backprojection time by a reprojection through the attenuation image. This correction restores the spatial invariance of the point response function, thus allowing a valid deconvolution and producing an undistorted emission image. Scattering corrections were not applied to either the transmission or the emission data but simulation studies indicated that scattering made only a small contribution to the attenuation measurement. Results are presented for two phantoms, in which transmission scans of 57,500 and 18,700 events/slice were used to correct emission images of 5.2 and 2.8 million events. Although the attenuation images had poor statistical accuracy and a resolution of 13 mm, the method resulted in accurate attenuation-corrected images with no degradation in image resolution (which was 3 mm for the first emission image), and with little effect on image noise.

Image Processing, Computer-Assisted↗
PubMed1979

Metabolic responses to status epilepticus in the rat, cat, and mouse.

Prolonged sustained seizure activity (status epilepticus) was created in rats and cats using paralysis and ventilation to prevent muscular contraction and its secondary systemic effects. Under physiologic control, seizure activity was maintained for 30, 60, and 120 min. At this time the brains were frozen using the in situ technique and the cortical tissue was analyzed for energy-related metabolites. The alteration of metabolites found at these times was similar to that previously described in the first 10 min of seizure activity. No evidence was found of any significant or progressive derangement of oxidative metabolism. A progressive lactic acidemia developed in spite of adequate arterial oxygen tensions. In contrast, when mice received a similar dose of the convulsant and were allowed to convulse freely in an oxygen-enriched environment, major derangements of energy metabolism were found which were progressive and persisted following recovery for at least 18 h.

Acidosis↗
PubMed1979

Computerized cranial tomography in Wilson disease.

Hepatolenticular degeneration (Wilson disease) is suspected by the clinical picture and confirmed by characteristic laboratory demonstration of impaired copper metabolism. Three patients with Wilson disease involving the basal ganglia were shown to have abnormalities on computerized tomography (CT) scan, whereas four other patients without signs of cerebral involvement had normal brain scans. Wilson disease may be added to the long list of diseases to which the EMI scan may make a useful diagnostic contribution.

Adult↗