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Radiofrequency catheter ablation in familial paroxysmal supraventricular tachycardia due to accessory atrioventricular pathways.

Radiofrequency catheter ablation (RF-CA) has been widely used to cure paroxysmal supraventricular tachycardia (PSVT). However, its use has never been reported in familial PSVT caused by an accessory atrioventricular pathway (AP), which is known as one of the typical familial cardiovascular diseases. Two cases of using RF-CA for familial PSVT due to APs are presented, in a brother and sister, supporting a potential genetic role in the developmental failure to lose the atrioventricular connection during fetal life. The sister, a 24-year-old woman, had intermittent episodes of palpitation accompanied by chest pain for 2 years. An electrophysiologic study (EPS) confirmed her clinical tachycardia was atrioventricular reentrant tachycardia (AVRT) due to a left lateral concealed AP, which was subsequently successfully ablated with RF-CA. The brother, a 22-year-old man, had a 5-year history of paroxysmal palpitation. A resting electrocardiogram showed a right bundle branch block and left axis deviation with a delta wave. During his EPS, AVRT was reproducibly induced and a manifest AP was localized and then ablated at the left posteroseptal site, resulting in disappearance of the delta wave. PSVT, however, recurred 1 month later and during a repeat EPS the tachycardia was proved to be AVRT due to a right anterior concealed AP. The right anterior AP was successfully ablated with RF-CA. Both patients remained asymptomatic for more than 3 years following the successful ablation procedures.

Adult↗

Modelling the reproducibility of acoustic rhinometry.

This paper presents an application of a linear model with correlated errors to the assessment of the precision of acoustic rhinometry in clinical medicine. The design of the reproducibility study involved 20 healthy subjects measured by five investigators with three replicate measurements of four variates taken from the right and left nasal cavities, altogether 2400 measurements. The parametric model may be structured to account for random variation between subjects, serial correlation within subjects and measurement error. The model-based reproducibility correlation coefficient was estimated to be fair both for the nasal volume measurements and for the nasal minimal cross-sectional area measurements with an overall average of 0.65. An alternative measure, the within-subject coefficient of variation, averaged 15 per cent. The choice between the measures of reproducibility depends on the degree of heterogeneity of the studied populations, the presence of time trend and the scale of measurement of the rhinometric variates. In clinical practice, repeated measurements should always be made to attain a reasonable level of reproducibility in acoustic rhinometry.

Adult↗

Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study.

BACKGROUND: Doppler Myocardial Imaging (DMI) is a new technique currently being studied for the assessment of regional systolic and diastolic left ventricular (LV) function. No normal values or data on age-related changes in regional myocardial right ventricular (RV) velocities are available. METHODS AND RESULTS: Color DMI was used in 32 healthy volunteers (aged 16-76 years) to derive regional velocities from basal, medial, and apical segments of the RV free wall in the apical 4-chamber view, and from distal segments as well as from the tricuspid annulus in the parasternal long-axis view. Both mitral annular and regional LV velocities (4-chamber, long-axis parasternal view) were also recorded and compared with corresponding RV regional velocities. The M-mode displacement of the cardiac base was measured. Corresponding RV and LV DMI data sets were compared. For longitudinal function, RV free wall systolic velocities were consistently higher than velocities recorded in corresponding LV segments (analysis of variance, P <.05). Older subjects (40-76 years; 13 men, 2 women) had lower RV long-axis regional velocities than younger subjects (16-39 years; 15 men, 2 women), but had higher short-axis RV systolic velocities. For diastolic velocities, a negative correlation between age and the ratio of regional early diastolic to late diastolic velocity was shown for all RV free wall segments (eg, basal segment: r = -0.63, P <.0001). CONCLUSIONS: The right ventricle has higher long-axis regional velocities, a greater excursion of its lateral atrioventricular valve ring, and reduced circumferential shortening velocities compared with the left ventricle. Right ventricular longitudinal shortening is dominant over short-axis function in healthy young subjects. Normal age-related changes of diastolic velocities for each segment of the normal RV free wall have been defined.

Adolescent↗

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): a systematic study of standard cardiac views assessed by different observers.

OBJECTIVE: To test the agreement between observers and reproducibility of a technique to display standard cardiac views of the left and right ventricular outflow tracts from four-dimensional volume datasets acquired with Spatiotemporal Image Correlation (STIC). METHODS: A technique was developed to obtain dynamic multiplanar images of the left ventricular outflow tract (LVOT) and right ventricular outflow tract (RVOT) from volume datasets acquired with STIC. Volume datasets were acquired from fetuses with normal cardiac anatomy. Twenty volume datasets of satisfactory quality were pre-selected by one investigator. The data was randomly assigned for a blinded review by two independent observers with previous experience in fetal echocardiography. Only one volume dataset was used for each fetus. After a training session, the observers obtained standardized cardiac views of the LVOT and RVOT, which were scored on a scale of 1 to 5, based on diagnostic value and image quality (1=unacceptable, 2=marginal, 3=acceptable, 4=good, and 5=excellent). Median scores and interquartile range, as well as inter- and intraobserver agreement were calculated for each view. RESULTS: The mean menstrual age at the time of volume acquisition was 25.5+/-4.5 weeks. Median scores (interquartile range) for LVOT images, obtained by the first and second observers, were 3.5 (2.25-5.00) and 4 (3.00-5.00), respectively. The median scores (interquartile range) for RVOT images obtained by the first and second observers were 3 (3.00-5.00) and 3 (2.00-4.00), respectively. The interobserver intraclass correlation coefficient for the LVOT was 0.693 (95% CI 0.380-0.822), and 0.696 (95% CI 0.382-0.866) for the RVOT. For the intraobserver agreement analysis, observer 1 gave higher scores to the LVOT the second time the volumes were analyzed [LVOT: 3.50 (2.25-5.00) vs. 5.00 (4.00-5.00, p=0.008)]. CONCLUSION: STIC can be reproducibly used to evaluate fetal cardiac outflow tracts by independent examiners. Slightly better image quality rating scores during the intraobserver variability trial suggests the presence of a learning curve for the manipulation and analysis of volume data obtained by STIC.

Double-Blind Method↗

The speech evoked potential in normal subjects and patients with cerebral hemispheric lesions.

The present study deals with observations on the "speech evoked potential"-a late positive potential evoked by word repetition. These potentials, evoked by "silent" repetition of polysyllabic words, were averaged and recorded from the scalp overlying the inferior frontal regions on both sides in 20 normal healthy subjects of ages ranging from 13-58 years. The potential had a triphasic negative, positive, negative morphology and was present over both hemispheres in left as well as right handed subjects. The main positive deflection and mean latencies of 219.2 msec and 221.6 msec and mean amplitude of 6.2 muv and 6.5 muv respectively on the left and right sides. Though there were interindividual variations in latency, amplitude and morphology, there was a high degree of intraindividual similarity and reproducibility in subjects. The variations in these parameters with age, sex and handedness are discussed. In 10 patients with cerebral lesions, the evoked potential was normal in 5 cases with right frontal lesions and showed abnormalities in 3 of 5 cases with left frontal lesions. The speech evoked potential may be useful in the further study of electrical correlates of speech output in speech disorders.

Adolescent↗

Background on methods of stimulation in galvanic-induced body sway in young healthy adults.

The aim of this study was to develop a standardized procedure for reproducible quantification of galvanic-induced body sway (GBS). This was a prospective experimental study conducted in a tertiary referral centre. An exploratory study was first conducted to define the galvanic vestibular stimulation (GVS) method that resulted in the best reproducible responses. Ten subjects underwent computer-controlled GVS using five different types of monaural and binaural stimulation with 2-mA currents. Cosinusoidal stimulation gave the most reproducible responses. The frequency and current variability of this stimulus type were then tested in the same 10 subjects. A monaural continuous 1-cosinusoidal current of 0.5 Hz and 2 mA gave the most reproducible responses (< 20% test-retest variation) and the largest GBS amplitude. The other (sinusoidal) stimuli resulted in variabilities exceeding 50%. This stimulus was thus used for further testing in our normative study. In this study we measured GBS amplitude at 0.5 Hz in 60 subjects, with eyes closed and an inter-feet distance of 0 cm, using a force platform. In addition to body sway, responses included slight dizziness, taste sensations and a tingling sensation at the site of stimulation. Habituation to the applied stimulus was seen. Binaural prestimulation, performed in 50/60 test subjects, is necessary to reduce habituation and achieve optimal reproducibility in order to be able to compare the sensitivity of the left and right vestibular systems. The test-retest variability was determined in detail in 12 additional subjects. Prestimulation reduced habituation, but improved the sensitivity of the method; some test-retest variability persisted (< 20%).

Adult↗

[Feasibility of combination mapping utilizing a duo-decapolar electrode catheter and the CARTO system for incisional reentrant atrial tachycardia with cycle length alternation: a case report].

A 43-year-old woman had undergone patch closure operation for atrial septal defect 27 years ago. She was referred to our hospital for evaluation of frequent palpitations since 1 year ago. Electrophysiological study was performed with recording of the coronary sinus, His bundle, and low lateral right free wall electrography utilizing a steerable duo-decapolar electrode catheter(Livewire, Daig). Supraventricular tachycardia with cycle length alternation of 300 and 320 msec similar to atrial flutter was reproducibly provoked by burst pacing from the coronary sinus. During the supraventricular tachycardia, abnormal atrial potentials occurred in the low lateral right free wall region with very low amplitude and splitting potentials. The cycle length alternation of the supraventricular tachycardia depended on the occurrence of the splitting potentials, that is, the splitting potentials were present during the supraventricular tachycardia with a long cycle and the splitting potentials were absent during the supraventricular tachycardia with a short cycle. This phenomenon suggested that the splitting potentials resulted from 2:1 functional intra-atrial local conduction block. In addition, during sinus rhythm the abnormal electrograms revealed fractionated activity. Thus, these findings strongly imply that the supraventricular tachycardia is due to a macro-reentrant right atrial tachycardia utilizing an anatomical obstacle caused by the atrial septal defect operation as a central area, namely incisional reentrant atrial tachycardia. Three-dimensional electroanatomical mapping using the CARTO system(Biosense-Webster) was conducted to investigate whether the low lateral right free wall area possessed the critical isthmus essential to the reentry circuit. Electroanatomical mapping revealed that the very low amplitude potentials and the splitting potentials corresponded to the scars and the functional conduction block area detected by mapping using the multipolar catheter, respectively. According to the propagation mapping, the incisional reentrant atrial tachycardia slowly conducted the channel created by multiple neighboring scars clockwise and the alternation of the tachycardia cycle length was dependent on the development of the functional local intra-atrial conduction block within the channel. An approximately 1.5 cm successful linear lesion was created by radiofrequency catheter ablation to transect the isthmus based on the electroanatomical mapping findings. Afterwards, the incisional reentrant atrial tachycardia could not be induced by burst stimuli from the coronary sinus even under administration of isoproterenol. The use of three dimensional electroanatomical mapping(CARTO system) to evaluate the reentry circuit after the detection of abnormal potentials by using multipolar catheter in advance is a very useful method to determine optimal target site of ablation for a patient with incisional reentrant atrial tachycardia.

Adult↗

[Measurement of scotopic pupils comparing green light test and wave-front analyser WASCA].

OBJECTIVE: The aim of this study was to compare the accuracy and the reproducibility of scotopic pupil measurements using 2 different methods. METHODS: Scotopic pupil diameter was measured in 56 eyes of 28 volunteers and the results were compared between the green light test at the slit lamp (Haag-Streit, Switzerland) and the automatic measurements of the wave-front analyser WASCA (Carl-Zeiss-Meditec) by 2 independent examiners. Non-parametric sign test as well as All Pairwise Multiple Comparison Procedures (Student-Newman-Keuls method) were performed for the comparison of means for each individual eye as well as the results of both eyes tested by both examiners. RESULTS: Mean age of the subjects was 34.9 years. The colour of iris was green or blue in 22 cases and brown in 6 cases. REPRODUCIBILITY: For the green light test we found for the first investigator in the right eye a mean pupil diameter of 6.58 mm (SD 0.68). The measurement of the second investigator for the same eye was 6.64 mm (SD 0.61). The left eye values were as follows: 6.36 mm (SD 0.68) and 6.75 mm (SD 0.68). For WASCA we found for the first investigator in the right eye 6.33 mm (SD 0.64) vs. 6.30 mm (SD 0.64) for the second investigator, in the left eye 6.39 mm (SD 0.69) vs. 6.36 mm (SD 0.60). There was a statistically significant difference between the two investigators when the green light test was used (6.47 mm vs. 6.69 mm for both eyes). No difference was found using the WASCA integrated pupillometer (6.35 mm vs. 6.33 mm). There was a significant difference between the means of combined data for both measurement methods: 6.58 mm for the green light test (SD 0.57) vs. 6.34 mm for WASCA (SD 0.62). CONCLUSIONS: The integrated pupillometry of the WASCA analyser showed better reproducibility of measurements than the green light test. The green light test measures a slightly larger diameter (in the mean by 0.25 mm) than WASCA. Because of the fair and clinically sufficient reproducibility as well as virtually non-existing additional costs the green light test can be strongly recommended to referring ophthalmologists and low-volume refractive surgeons.

Adult↗

Neuromuscular fatigue of elbow flexor muscles of dominant and non-dominant arms in healthy humans.

The purpose of this study was to assess differences in fatigue-related changes in variables related to structures within the neuromuscular system, between the dominant and non-dominant elbow flexor muscles of right-handed individuals. Two experimental sessions were performed on the right arm and one on the left arm. For each session, maximum voluntary torque, level of voluntary activation, M-wave amplitude, twitch/train or twitch/doublet torque ratio and EMG median frequency were obtained before and up to 20 min after a sustained maximum isometric fatigue task. Our main results were: 1) reproducible fatigue-induced changes in all variables of interest between the two sessions performed with the right arm, 2) significantly greater failure in voluntary activation and neuromuscular propagation with sustained activity for the non-dominant compared with dominant side, and 3) no effect of dominance on MVC torque, endurance time, and fatigue-induced changes in EMG median frequency and elicited torques. These results suggest that the preferential use of elbow flexor muscles with the dominant arm leads to more fatigue resistance in certain structures/mechanisms of the neuromuscular system, but not in others.

Adult↗

HIV/AIDS, human rights, and development.

In just two decades, AIDS has become the leading cause of death in Africa, and now kills more people worldwide than any other infectious disease. Although current treatments are expensive, and an affordable vaccine in the developing world is many years away, HIV/AIDS prevention programs and activities often remain narrow in their scope, applicability, and impact. A human rights approach to the HIV/AIDS epidemic moves beyond a focus on the individual to address social, economic, and political factors that drive the epidemic, such as gender-based inequalities, poverty, corruption, and government inaction. A rights-based approach empowers affected individuals and communities, and challenges governments to justify their actions (or inaction) to the people they represent and, ultimately, to the global community. We reproduce a fact sheet written by David Patterson for the Interagency Coalition on AIDS and Development (ICAD). It sets out a rights-based approach to development, examines the human rights dimensions of the HIV/AIDS pandemic, and gives examples of right-based programming in the context of the developing world. It concludes with sources of further information, both in hard copy and on the web.

Africa, Southern↗

Quantitative echocardiographic assessment of the performance of the functionally single right ventricle after the Fontan operation.

BACKGROUND: Performance of the functionally single right ventricle may deteriorate over time. Quantitative assessment of this chamber, however, is complicated by its asymmetric geometry. Automatic detection of borders, and the Doppler-derived index of myocardial performance, are echocardiographic techniques that allow for quantitative assessment regardless of ventricular shape. We sought to evaluate the mechanics of contraction and relaxation in the functionally single right ventricle using these parameters. METHODS: We evaluated systemic ventricular function in 35 asymptomatic patients with functionally single right ventricle, having a mean age of 7.8+/-3.1 years, who had undergone the Fontan procedure. We compared them with 32 age-matched normal controls using both automatic detection of borders and Doppler indexes. RESULTS: When compared with the controls, the group with a functionally single right ventricle demonstrated diminished systolic function as evidenced by a lower fractional change in area (42.7+/-10.1% vs. 54.6+/-10.5%, p = 0.001), and diminished diastolic function, as demonstrated by a greater reliance on atrial contraction to achieve ventricular filling (32.0+/-4.4% vs. 22.2+/-4.1%, p = 0.001). The mean index of myocardial performance in those with functionally single right ventricles was also greater than in controls (0.41+/-0.12 vs. 0.30+/-0.05, p = 0.001), and the indexed ejection time was shorter (0.35+/-0.05 vs. 0.39+/-0.05, p = 0.01), suggesting less efficient ventricular mechanics. CONCLUSIONS: These data demonstrate that the systolic and diastolic properties of the functionally single right ventricle differ significantly from those of the normal systemic left ventricle. Use of the echocardiographic techniques provide insight into ventricular mechanics in patients with functionally single ventricles, and may be valuable tools for serial quantitative follow-up.

Adolescent↗

A Rho-kinase inhibitor, Y-27632, reduces cholinergic contraction but not neurotransmitter release.

This study examined the effects of the selective Rho-kinase inhibitor Y-27632 [(+)-(R)-trans-4-(1-aminoethyl)-(4-pyridyl)cyclohexanecarboxamide dihydrochloride]) on cholinergic nerve-mediated contraction and neurotransmitter release in murine and guinea-pig isolated tracheal preparations. In tracheal preparations obtained from both species, Y-27632 shifted carbachol concentration-effect curves to the right and reduced the maximal contractile response. Repeated electrical field stimulation (EFS) evoked transient, consistent and reproducible contractions in murine and guinea-pig tracheal preparations. Y-27632 inhibited these cholinergic nerve-mediated contractions in a concentration-dependent manner. EFS (0.1-30 Hz) elicited frequency-dependent cholinergic nerve-mediated contractile responses. In murine tracheal preparations, Y-27632 (3 microM and 10 microM) shifted frequency-response curves to EFS to the right by 5.5 and 13.0 fold respectively and markedly reduced the maximal contractile response. In murine and guinea-pig tracheal preparations loaded with [(3)H]-choline, Y-27632 (10 microM) significantly increased the EFS-induced outflow of radioactivity from airway cholinergic nerves by 27% and 54% respectively. Thus, Y-27632 inhibited both carbachol-induced and cholinergic nerve-mediated contractile responses. Conversely, Y-27632 increased neurotransmitter release from airway cholinergic nerves. However, since antagonism of acetylcholine-induced contraction by Y-27632 overwhelmed the increased neurotransmitter release, the overall effect of this Rho-kinase inhibitor was to inhibit cholinergic nerve-mediated contraction.

Amides↗

Dynamic contour tonometry (DCT) versus Goldmann applanation tonometry (GAT) - a comparison of agreement and reproducibility.

BACKGROUND: The PASCAL dynamic contour tonometer (DCT) is a novel device designed for intraocular pressure (IOP) measurements. It is assumed to be largely independent of corneal properties. In a previous study we compared DCT with Goldmann applanation tonometry (GAT) in 100 right eyes with normal corneas. The aim of the present study is to evaluate whether differences DCT-GAT >or= 2.0 mmHg found in the previous study are reproducible and also present in the fellow eye. METHODS: Twenty-three of the 100 patients (M:F = 8:15, mean age: 36 +/- 11 SD, range 22-53 years) with a previous difference DCT-GAT >or= 2.0 mmHg were included in the present study. The minimum interval between the initial and the current examination was 3 weeks. The IOP-values of the fellow eyes in this subgroup were assessed in parallel. RESULTS: The difference DCT-GAT was 2.44 +/- 0.4 SEM mmHg in the subgroup of the 23 right eyes and 2.03 +/- 0.5 SEM mmHg for the fellow eyes, compared to 0.94 +/- 0.5 SEM mmHg in the initial sample of 100 eyes. CONCLUSIONS: In cases with higher difference between DCT-GAT, the difference is reproducible and even present in the fellow eye. We, therefore, assume that the differences are not caused by chance, but by differing biomechanical corneal properties.

Adult↗

[Variability of findings in light sense and ring perimetry].

The variability of the interpretation of visual fields by physicians has so far been thoroughly examined only with reference to light sense perimetry. Therefore, we studied the variability in assigning visual fields to topical diagnoses of the visual pathway with the ring perimeter. For this purpose we examined the proportion of correct assignments of physicians and the reproducibility of their assignments. Two experienced ophthalmologists had to assign 76 selected pairs of right and left visual fields to one of the following diagnosis without any information about further clinical findings: (1) normal (n = 5), (2) media opacity (n = 5), (3) retinal lesion (n = 5), (4) optic disc lesion (n = 6), (5) optic nerve lesion (n = 6), (6) lesion of the chiasma (n = 5) and (7) retrochiasmal lesion (n = 6). The assignment was repeated after intervals of 6 weeks and 10 months. Our statistical analysis of the number of correct assignments revealed no significant differences between the perimeters or between the physicians. The amount of correct assignments with both perimeters decreased from 75% and 66% during the first run through 60% and 70% during the second run to 58% and 60% during the third. Neither perimeter showed any major differences in the reproducibility of the assignments (Fig. 4). During the three runs only 47% (physician 1) and 58% (physician 2) of the cases were assigned three times to the same diagnoses with the octopus. The corresponding figures for the ring perimeter were 58% and 60%. This is regarded as an indicator of the unreliability in the interpretation of visual fields.

Adult↗

Determining the accuracy of articulator interchangeability and hinge axis reproducibility.

STATEMENT OF PROBLEM: It has been reported that articulators are interchangeable, which means that a clinician should be able to use one articulator and send casts to a dental laboratory with the assurance that the casts will be remounted with positional accuracy on a similar articulator. PURPOSE: The purpose of the study was to determine whether mounted casts could be transferred from 1 articulator to another with positional accuracy and whether the hinge axis was reproducible in each of the articulators tested. MATERIAL AND METHODS: This study compared left and right second premolars and first molar occlusal contact areas with respective contact areas of like-mounted casts. Five calibrated Whip Mix 3040, 5 calibrated Girrbach Artex AL, and 5 calibrated KaVo Protar articulators were tested. Impact-resistant resin casts mounted in occlusion on 1 articulator were transferred to 4 like articulators. Each of the 5 articulators of each brand was opened and closed 10 times. Ten vinyl polysiloxane right and left posterior interocclusal records of the occluded casts were made for each articulator. The use of a computerized image analysis program provided quantitative measurements of light transmitted through the occlusal records. A Kruskal-Wallis test was used for each of the 4 independent variables of the study (molar differences, premolar differences, left differences, right differences). By using a calibrated grid, a numerical assessment of positional changes was made in millimeters. RESULTS: None of the articulator systems was found to be exact, and no single articulator was an exact duplicate of another (P<.01). The Whip Mix articulator showed greater deviation both in hinge axis repeatability and in articulator interchangeability than the KaVo. The Artex articulator provided the most consistent hinge axis repeatability and interchangeability of the 3 brands of articulators. CONCLUSION: The Artex brand reproduced dental cast positions more consistently than the other articulators tested.

Acrylic Resins↗

[Transient loss of preexcitation by acute coronary ischemia--a case report].

We present a case of WPW syndrome with an accessory pathway in the right free wall. Two prolonged and failed attempts at radiofrequency catheter ablation of this accessory pathway in other institutions led to a third attempt in our hospital. With a 7F catheter in the right coronary artery, transient ischemia in the right ventricular myocardium developed with consecutive loss of bidirectional preexcitation within 45 seconds prior to catheter ablation. Removal of the guiding catheter, while the mapping catheter in the coronary artery was still in place, was reproducibly followed by the reoccurrence of the preexcitation pattern. Successful outcome of accessory pathway ablation was achieved by mapping the right free wall using an intracoronary catheter in the right coronary artery and ablating the accessory pathway using a modified long vascular sheet.

Adult↗

Ventilation and perfusion imaging by electrical impedance tomography: a comparison with radionuclide scanning.

Electrical impedance tomography (EIT) is a technique that makes it possible to measure ventilation and pulmonary perfusion in a volume that approximates to a 2D plane. The possibility of using EIT for measuring the left-right division of ventilation and perfusion was compared with that of radionuclide imaging. Following routine ventilation (81mKr) and perfusion scanning (99mTc-MAA), EIT measurements were performed at the third and the sixth intercostal level in 14 patients with lung cancer. A correlation (r = 0.98, p < 0.005) between the left-right division for the ventilation measured with EIT and that with 81mKr was found. For the left-right division of pulmonary perfusion a correlation of 0.95 (p < 0.005) was found between the two methods. The reliability coefficient (RC) was calculated for estimating the left-right division with EIT. The RC for the ventilation measurements was 94% and 96% for the perfusion measurements. The correlation analysis for reproducibility of the EIT measurements was 0.95 (p < 0.001) for the ventilation and 0.93 (p < 0.001) for the perfusion measurements. In conclusion, EIT can be regarded as a promising technique to estimate the left-right division of pulmonary perfusion and ventilation.

Adult↗

Reproducibility with the Keeler Pulsair 2000 non-contact tonometer.

AIMS: The IOP variation on repeated testing with the recently introduced Keeler Pulsair 2000 instrument was investigated. METHODS: One hundred normal individuals (50 male and 50 female) new to the instrument had three sets of IOP recordings within a 15 minute time period. RESULTS: The mean of the first set of IOPs from both right and left eyes was significantly higher than those from subsequent sets (p < 0.0001 for right eyes and p = 0.01 and < 0.0002 for left eyes). This tendency increased significantly with increasing IOP. Second and third IOP sets were, however, similar indicating stabilisation of IOP measurements. The coefficient of repeatability of the instrument between second and third sets was 4.2 mm Hg for right eyes and 3.6 mm Hg for left eyes. CONCLUSION: The Pulsair 2000 passes the British standard for reproducibility of a standard test method.

Adult↗