PubMed HealthSearch

Biomedical subjects

R A Wolthuis

Publications and source records attributed to R A Wolthuis.

At least 19 recordsLinked to original sources

Development of a medical fiber-optic oxygen sensor based on optical absorption change.

A new fiber-optic oxygen sensor has been developed for use in medical applications. The sensor's viologen indicator becomes strongly absorbent after brief UV stimulation, and then returns to the transparent state. The rate of indicator return to transparency is proportional to the local oxygen concentration. Indicator absorbance is monitored with a red LED and receiving photodiode, and absorbance data are processed by a dedicated cpu. The solid-state sensor system has performance comparable to existing oxygen measurement techniques, and may be applicable for both in vitro and in vivo oxygen measurements.

Absorption

Development of medical pressure and temperature sensors employing optical spectrum modulation.

Fiber optic Fabry-Perot sensors have been developed whose optical reflectance varies with optical cavity depth (pressure) or with change in a material's refractive index (temperature). These sensors employ a unique combination of features: they are interrogated by an LED; they are designed to operate within a single reflectance cycle; and their returned light is analyzed by a dichroic ratio technique. The sensors use a step index glass fiber and are relatively insensitive to absolute light levels and fiber bending. They have an expanded linear operating range and can be built for low cost disposable applications. Sensor performance meets or exceeds established medical requirements.

Blood Pressure Determination

New criteria for computer interpretation of exercise electrocardiograms in a largely asymptomatic population.

We developed new discriminant functions for analyzing treadmill ECGs from a largely asymptomatic population. Treadmill ECG data were gathered from two patient groups: 70 patients with coronary artery disease with occlusions greater than or equal to 30% by angiography, and 138 patients without coronary artery disease. The group without coronary artery disease consisted of 76 false positive responders to treadmill testing using standard ST segment criteria, 22 supraventricular tachycardia patients (both groups free of coronary artery disease by angiography), and 40 patients at very low risk for having coronary artery disease. ECG leads CC5, CM5, V5, Yh and Z were recorded before, during and after exercise protocol conditions. Computer-averaged ECGs were processed to provide Q, R, S and T-wave amplitudes, ST amplitudes and slope, and QS and RT intervals. Each patient provided over 100 variables per lead for analysis. Stepwise statistical procedures yielded lead-specific linear discriminant functions containing four to six variables/lead. Application of these functions provided sensitivity and specificity in the range 70-84%. When compared with other standard interpretive criteria, these results provided improved diagnostic accuracy for the largely asymptomatic population.

Angiography

Normal electrocardiographic waveform characteristics during treadmill exercise testing.

Forty asymptomatic male patients at low risk for cardiovascular disease completed maximal treadmill testing. Electrocardiograms from leads CC5, CM5, V5, Yh and Z were recorded across multiple pretest, exercise and recovery conditions. ECG waveforms were subsequently digitized, averaged and processed to provide Q-, R-, S- and T-wave amplitudes, ST-segment means and slopes, and QS- and RT-interval durations. Average R-wave amplitude increased during early exercise and then dramatically decreased to maximum effort. Average S-wave amplitude became greater as exercise progressed. Average J junction was slightly positive before exercise, became negative during exercise (except lead Z) and returned to zero after exercise. The ST-segment slope increased dramatically with progressive exercise. The response of T-wave amplitude, RT and QS intervals are also described. Separately, 22 asymptomatic male subjects each completed two maximal treadmill tests 2 weeks apart. ECG data acquisition and processing were similar to those noted above. Pooled, within-subject estimates of variability were computed for the ECG leads, ECG measurements and protocol conditions. These variability estimates are useful for interpreting ECG responses to exercise testing.

Adult

Blood pressure variability of the individual in orthostatic testing.

Within-subject blood pressure (BP) variability was studied in the context of orthostatic testing. Nineteen healthy men volunteered for biweekly orthostatic testing. BP's were taken on alternate minutes during 5 min of supine rest and a subsequent 5 min of quiet standing. Within-subject variance was computed for systole and diastole by protocol condition; respective variances were than pooled (i.e. averaged) across subjects. The within-subject estimate of variance for a single BP reading in either position was approximately 6 torr (i.e. 1 S.D.). This variance estimate was reduced by averaging additional BP readings from the same visit, and more so by averaging BP readings from multiple visits. These findings have use in the design of orthostatic protocols and in the interpretation of BP data derived therefrom.

Adult

Relaxed +GZ tolerance in healthy men: effect of age.

Fifty-three healthy US Air Force aircrewmen, 26-55 yr old, volunteered for a centrifuge study designed to determine the effect of age on relaxed +GZ tolerance. Each was subjected to G forces of gradual and rapid onset, with G tolerance determined by standardized contraction of peripheral visual fields. Of the subject characteristics studied, only age was positively correlated with rapid-onset G tolerance; both age and weight were positively correlated with gradual-onset G tolerance. A combination of age and weight gave a stronger positive correlation with G tolerance (rapid- and gradual-onset) than did either characteristic alone. No significant negative correlations were observed. We conclude that aging may offer some protection from G stress; there is no evidence that aging leads to a decrement in G tolerance.

Adaptation, Physiological

Treatment of hypertension in aviators: a clinical trial with Aldactazide.

Thirty-two USAF aircrewmen with mild or moderate, uncomplicated essential hypertension were treated with Aldactazide (spironolactone and hydrochlorothiazide). The study was designed to determine the efficacy and safety of this drug combination in aircrew subject to the stress of flying high-performance aircraft. All patients were investigated in detail before, and again 6 weeks after, beginning Aldactazide treatment. Adequate blood pressure control was achieved in 94% of patients; 84% were able to return to flying duties. Treatment was associated with a moderate loss of weight and plasma volume, and a slight reduction in renal function. Tolerance to multiple stress tests was unimpaired after treatment. Symptoms attributable to treatment were minimal. We conclude that in the dose used, four tablets or less daily, Aldactazide is a safe and fairly effective secondline treatment for hypertensive aircrewmen.

Adult

New practical treadmill protocol for clinical use.

A new continuous treadmill protocol (USAFSAM) has been designed using a constant treadmill speed (3.3 miles/hour) and regular equal increments in treadmill grade (5%/3min). The constant treadmill speed requires only initial adaptation in patient stride, reduces technician adjustments and produces less electrocardiographic motion artifact than do protocols using multiple or higher treadmill speeds, or both. The regular equal increments in treadmill grade are easy to implement and provide a larger number of work loads than do protocols that are discontinuous or require larger changes in work load. The USAFSAM protocol was compared with the older Balke-Ware protocol in 26 healthy men (aged 30 to 59 years). Each fasting subject completed two maximal treadmill tests from each protocol. Measurements included minute heart rate from the electrocardiogram, auscultatory blood pressures and oxygen consumption obtained with standard techniques. Similarities in between-protocol measurements for submaximal and maximal treadmill efforts were impressive; differences were small and unimportant. Further, both protocols showed equal reproducibility for the measurements noted. Importantly, time to maximal effort was reduced by 24% with the USAFSAM protocol. The USAFSAM treadmill protocol has since been used in more than 500 clinical and screening examinations, thus confirming its advantages and practicality for routine clinical stress testing. Normal reference values previously established for the Balke-Ware protocol are shown to apply to the new USAFSAM protocol as well.

Adult

The response of healthy men to treadmill exercise.

Heart rates, blood pressures, and functional responses to submaximal, maximal and postexertional treadmill testing are presented for a group of 704 healthy, asymptomatic aircrewmen referred to the USAF School of Aerospace Medicine. The indicated measurements are individually described by the use of percentiles. These data provide the practicing clinician with an accurate and complete description of the response of healthy men to treadmill exercise.

Adult

Pre- and postflight systolic time intervals during LBNP: the second manned Skylab mission.

After space flight of 59 d, Skylab 3 astronauts were stressed with lower body negative pressure (LBNP). During this stress procedure vectorcardiograms, pneumograms, phonocardiograms, and carotid pulse tracings were monitored and recorded onto analog tape. Accepted techniques were used to measure the intervals of systole. The postflight results were compared to multiple preflight tests and each of the three crewmen served as his own control. Immediately postflight, there were elevations in heart rate and blood pressure in response to a fixed level (-50 mm Hg) of LBNP. Total electromechanical systole, (Q-S2) I, was unchanged. Ejection time index (ETI) was depressed at rest and during stress, while pre-ejection period was elevated compared with preflight values. Systolic time intervals (STI) were within preflight limits after 1 month on earth in all crewmen. Resting STI returned sooner than did stressed STI. The magnitude and direction of STI in the postflight period were similar to those obtained from patients with moderate heart disease, although signs and symptoms were absent in the astronauts. However, the abnormality of the stressed STI persisted after both blood volume repletion and lowered afterload. These findings suggest a compromise in cardiac function, peripheral circulatory integrity, or both after exposure to long-duration space flight, and are consistent with findings reported after 3 weeks of absolute bedrest.

Adult

VECTAN II: A computer program for the spatial analysis of the vectorcardiogram.

This paper presents the operation of a digital computer program, VECTAN II, for the spatial analysis of the vectorcardiogram (VCG). The program incorporates a unique waveform recognition algorithm based on the spatial vector length which has been shown to perform better than previous algorithms. The waveform analysis employed by the program considers the vectorcardiogram as a three dimensional entity rather than as scalar or planar representations. VECTAN II is designed chiefly to measure and quantify the VCG response of normal subjects to a controlled stress by analyzing one VCG complex every five seconds throughout a long experiment. The program has been used to analyzeom the NASA Johnson Space Center Cardiovascular Laboratory, from the pre- and postflight medical examinations of the Apollo 15, 16 and 17 crewmen, and from onboard Skylab experiments.

Aerospace Medicine

Response of local vascular volumes to lower body negative pressure stress.

The present study involved an intravenous injection of radio-active iodinated serum albumin, equilibration of this isotope within the vascular space, and the continuous measurement of isotope activity over selected anatomical areas before, during and following multiple human LBNP tests. Both rate and magnitude of vascular pooling were distinctly different within each of five selected lower body anatomical areas. In the upper body, all areas except the abdomen showed depletions from their resting vascular volumes during LBNP. The presence of uniquely different pooling patterns in the lower body, the apparent stability of abdominal vascular volumes, and a possible decrease in cerebral blood volume during LBNP represent the major findings of this study.

Abdomen