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The Camino intracranial pressure device in clinical practice: reliability, handling characteristics and complications.

Intracranial pressure monitoring has a key role in the management of patients developing increased intracranial pressure (ICP). We adopted the Camino fiberoptic system for intracranial pressure measurement in 1993 in our neurosurgical department. The aim of this study was to investigate reliability, handling characteristics and complication rate of the Camino intracranial pressure device. In an eighteen month period, we prospectively investigated 118 patients with intracranial pathology undergoing Camino fiberoptic intraparenchymal or intraventricular ICP monitoring. The assessment of reliability of ICP monitoring according to patients clinical condition, to cranial computed tomography (CCT) findings and ICP waveform was carried out. Position of the probe and intracranial bleeding complications related to probe insertion were confirmed by CCT. Technical complications, as well as infections due to the device, were documented. In vivo recalibration was performed in 22 patients. At the end of the measuring period the drift of the probe was evaluated and the accuracy of the fiberoptic device was measured by performing a two point calibration. Recordings of intracranial pressure were carried out with 136 Camino devices (104 parenchymal, 32 ventricular) in 118 patients with an average measuring time of 94.1 +/- 79.1 hrs. One hundred and fifteen Camino intracranial pressure devices (85.2%) demonstrated reliability according to the predetermined clinical parameters. The actual mean drift after removal of the devices was 3.4 mmHg +/- 3.2 with an actual daily drift of 3.2 +/- 17.2 mmHg. Recorded complications included infection (0.7%), intraparenchymal haematoma (5.1%), and a high complication rate (23.5%) with regard to technical aspects. The Camino intracranial pressure system offers reliable ICP measurements in an acceptable percentage of devices, and the advantage of in vivo recalibration. The high incidence of technical complications identifies a need for improvement in the fiberoptic cable and the fixation system.

Adolescent↗

Human ocular following responses are plastic: evidence for control by temporal frequency-dependent cortical adaptation.

Optokinetic nystagmus (OKN) induced by wide-field visual stimulation was measured with and without prior adaptation to moving sinusoidal gratings. Under unadapted conditions the mean gains of the slow phases of OKN in the first 500 ms were 0.5-0.8, and the eye velocities and amplitudes had rise times with time constants of 0.1-0.2 s. By contrast, following adaptation to as little as 1 s of image motion, the magnitude of the initial gains fell and the rise times of the velocities and amplitudes increased markedly. The degree of adaptation depended on the adapting temporal frequency, the optimum adaptive frequencies being 1.7-3.4 Hz. In this range of temporal frequencies, the initial gains fell to 0.1-0.3 and the rise times for velocity and amplitude ranged from 0.4 to 7.0 s, depending on the length of the adapting period. Thus the observed changes in the time constant were up to 70-fold. Neither spatial frequency or image velocity had any marked influence on the level of adaptation. The dependence on temporal frequency rather than image velocity suggests that the motion detectors feeding the adaptive system respond to local motion-related changes in luminance. The adaptive effects were direction-selective, showing that this must also be the case for the motion detectors. The adaptive effects were observed both when the drift temporal frequency on the retina was established by artificially maintaining a fixed gaze or when the adapting temporal frequency was induced by retinal slip during OKN. Time constants for recovery from adaptation were similar to motion aftereffects measured by psychophysical and physiological methods. The results suggest a link between cortical motion adaptation and adaptive mechanisms effecting the oculomotor system.

Adaptation, Physiological↗

Clinical evaluation of the Codman microsensor intracranial pressure monitoring system.

INTRODUCTION: The use of the Camino fibre-optic subdural device for measuring Intracranial Pressure (ICP) in patients, has been shown to correlate well with recordings from the "gold standard" intraventricular fluid filled catheter [1]. Following this work, its use has become standard in the clinical monitoring of patients. More recently, laboratory studies have demonstrated accuracy, acceptable drift and high fidelity for the new Codman Microsensor ICP Transducer, a miniature strain gauge mounted on a flexible nylon catheter [3]. Its performance in patients, however, has yet to be fully assessed, in comparative studies. METHODS: Eight patients (5 head injured, 3 with an Intracerebral haematoma) had a Codman Microsensor inserted. A Camino Transducer was fitted immediately adjacent to it. A computerised system was used to continuously record both ICP readings. RESULTS: In total 140,323 recordings were made over a wide range of ICP values. Study periods ranged from 0.5 to 116 hours. In one patient the Codman transducer tracing failed after several days, probably due to fracture of electrical cable close to the interface box. The readings from the two ICP transducers were compared on Time Series, logistic regression and Altman-Bland plots. Drift of the ICP recorded by the Codman microsensor, was noted in 2 patients, 1 in positive direction (maximum 30 mmHg), 1 negative (max. 20 mmHg). In both cases the Camino ICP recording was relatively stable. In 24% of the recordings the Codman microsensor recorded ICP as 5 or more mmHg greater than the Camino, this difference was 10 mmHg or greater in 9% of recordings. Conversely the Camino recording was 5 mmHg or more, than the Codman, in 5% of all recordings, and 10 mmHg or more in 3%. CONCLUSION: These differences could in the majority of cases (excepting the negative drift) be explained by a constant offset of the Codman transducer, as described previously [6]. Further examination of this device is required.

Brain Injuries↗

Validation of a radiotelemetry system for continuous blood pressure and heart rate monitoring in dogs.

A blood pressure telemetry system with catheter placement in the femoral artery was evaluated over a 119-day period in eight mongrel dogs. Every 3 weeks, the pressures recorded by telemetry were compared with direct, simultaneously recorded blood pressures measured from a femoral artery catheter implanted on the contralateral side. One telemetry device failed within 1 week of implant and was replaced before the beginning of data collection. Continuous blood pressure measures were accurate for a minimum of 17 weeks in all eight dogs. Acute changes in blood pressure and heart rate were not evaluated. Validation by simultaneous recording with a physiological monitor indicated that there was no drift in the telemetry blood pressure or heart rate during the 17-week period. Heart rates recorded by telemetry and a physiological monitor were identical, as were mean arterial pressures. The systolic pressure measured by the physiological monitor was consistently higher than that measured by telemetry. This may have been due to differences in the compliance of the catheter material in the two systems. Two devices failed within approximately 6 months of implant, apparently because of exhaustion of the battery. These findings indicate that this telemetry device can be used for periods of up to 17 weeks without appreciable drift or attenuation of the blood pressure signal. The results also describe a validation procedure for monitoring the accuracy of the telemetry system over extended periods of use. We conclude that this telemetry device can be used for the long-term assessment of blood pressure and heart rate in the dog.

Animals↗

Investigation of low frequency drift in fMRI signal.

Low frequency drift (0.0-0.015 Hz) has often been reported in time series fMRI data. This drift has often been attributed to physiological noise or subject motion, but no studies have been done to test this assumption. Time series T*2-weighted volumes were acquired on two clinical 1.5 T MRI systems using spiral and EPI readout gradients from cadavers, a normal volunteer, and nonhomogeneous and homogeneous phantoms. The data were tested for significant differences (P = 0.001) from Gaussian noise in the frequency range 0.0-0.015 Hz. The percentage of voxels that were significant in data from the cadaver, normal volunteer, nonhomogeneous and homogeneous phantoms were 13.7-49.0%, 22.1-61.9%, 46.4-68.0%, and 1.10%, respectively. Low frequency drift was more pronounced in regions with high spatial intensity gradients. Significant drifting was present in data acquired from cadavers and nonhomogeneous phantoms and all pulse sequences tested, implying that scanner instabilities and not motion or physiological noise may be the major cause of the drift.

Adult↗

Fluorescence-assisted image analysis of freshwater microalgae.

We exploit a property of microalgae-that of their ability to autofluoresce when exposed to epifluorescence illumination-to tackle the problem of detecting and analysing microalgae in sediment samples containing complex scenes. We have added fluorescence excitation to the hardware portion of our microalgae image processing system. We quantitatively measured 120 characteristics of each object detected through fluorescence excitation, and used an optimized subset of these characteristics for later automated analysis and species classification. All specimens used for training and testing our system came from natural populations found in Lake Biwa, Japan. Without the use of fluorescence excitation, automated analysis of images containing algae specimens in sediment is near impossible. We also used fluorescence imaging to target microalgae in water samples containing large numbers of obtrusive nontargeted objects, which would otherwise slow processing speed and decrease species analysis and classification accuracy. Object drift problems associated with the necessity to use both a fluorescence and greyscale image of each microscope scene were solved using techniques such as template matching and a novel form of automated seeded region growing (SRG). Our system proved to be not only user-friendly, but also highly accurate in classifying two major genera of microalgae found in Lake Biwa-the cyanobacteria Anabaena spp. and Microcystis spp. Classification accuracy was measured to be over 97%.

Anabaena↗

Dwarfism in insular sloths: biogeography, selection, and evolutionary rate.

The islands of Bocas del Toro, Panama, were sequentially separated from the adjacent mainland by rising sea levels during the past 10,000 years. Three-toed sloths (Bradypus) from five islands are smaller than their mainland counterparts, and the insular populations themselves vary in mean body size. We first examine relationships between body size and physical characteristics of the islands, testing hypotheses regarding optimal body size, evolutionary equilibria, and the presence of dispersal in this system. To do so, we conduct linear regressions of body size onto island area, distance from the mainland, and island age. Second, we retroactively calculate two measures of the evolutionary rate of change in body size (haldanes and darwins) and the standardized linear selection differential, or selection intensity (i). We also test the observed morphological changes against models of evolution by genetic drift. The results indicate that mean body size decreases linearly with island age, explaining up to 97% of the variation among population means. Neither island area nor distance from the mainland is significant in multiple regressions that include island age. Thus, we find no evidence for differential optimal body size among islands, or for dispersal in the system. In contrast, the dependence of body size on island age suggests uniform directional selection for small body size in the insular populations. Although genetic drift cannot be discounted as the cause for this evolution in body size, the probability is small given the consistent direction of evolution (repeated dwarfism). The insular sloths show a sustained rate of evolution similar to those measured in haldanes over tens of generations, appearing to unite micro- and macroevolutionary time scales. Furthermore, the magnitude and rate of this example of rapid differentiation fall within predictions of theoretical models from population genetics. However, the linearity of the relationship between body size and island age is not predicted, suggesting that either more factors are involved than those considered here, or that theoretical advances are necessary to explain constant evolutionary rates over long time spans in new selective environments.

Animals↗

Molecular and quantitative genetic divergence among populations of house mice with known evolutionary histories.

Evolutionary biologists have long been interested in the processes influencing population differentiation, but separating the effects of neutral and adaptive evolution has been an obstacle for studies of population subdivision. A recently developed method allows tests of whether disruptive (ie, spatially variable) or stabilizing (ie, spatially uniform) selection is influencing phenotypic differentiation among subpopulations. This method, referred to as the F(ST) vs Q(ST) comparison, separates the total additive genetic variance into within- and among-population components and evaluates this level of differentiation against a neutral hypothesis. Thus, levels of neutral molecular (F(ST)) and quantitative genetic (Q(ST)) divergence are compared to evaluate the effects of selection and genetic drift on phenotypic differentiation. Although the utility of such comparisons appears great, its accuracy has not yet been evaluated in populations with known evolutionary histories. In this study, F(ST) vs Q(ST) comparisons were evaluated using laboratory populations of house mice with known evolutionary histories. In this model system, the F(ST) vs Q(ST) comparisons between the selection groups should reveal quantitative trait differentiation consistent with disruptive selection, while the F(ST) vs Q(ST) comparisons among lines within the selection groups should suggest quantitative trait differentiation in agreement with drift. We find that F(ST) vs Q(ST) comparisons generally produce the correct evolutionary inference at each level in the population hierarchy. Additionally, we demonstrate that when strong selection is applied between populations Q(ST) increases relative to Q(ST) among populations diverging by drift. Finally, we show that the statistical properties of Q(ST), a variance component ratio, need further investigation.

Animals↗

MHC studies in nonmodel vertebrates: what have we learned about natural selection in 15 years?

Elucidating how natural selection promotes local adaptation in interaction with migration, genetic drift and mutation is a central aim of evolutionary biology. While several conceptual and practical limitations are still restraining our ability to study these processes at the DNA level, genes of the major histocompatibility complex (MHC) offer several assets that make them unique candidates for this purpose. Yet, it is unclear what general conclusions can be drawn after 15 years of empirical research that documented MHC diversity in the wild. The general objective of this review is to complement earlier literature syntheses on this topic by focusing on MHC studies other than humans and mice. This review first revealed a strong taxonomic bias, whereby many more studies of MHC diversity in natural populations have dealt with mammals than all other vertebrate classes combined. Secondly, it confirmed that positive selection has a determinant role in shaping patterns of nucleotide diversity in MHC genes in all vertebrates studied. Yet, future tests of positive selection would greatly benefit from making better use of the increasing number of models potentially offering more statistical rigour and higher resolution in detecting the effect and form of selection. Thirdly, studies that compared patterns of MHC diversity within and among natural populations with neutral expectations have reported higher population differentiation at MHC than expected either under neutrality or simple models of balancing selection. Fourthly, several studies showed that MHC-dependent mate preference and kin recognition may provide selective factors maintaining polymorphism in wild outbred populations. However, they also showed that such reproductive mechanisms are complex and context-based. Fifthly, several studies provided evidence that MHC may significantly influence fitness, either by affecting reproductive success or progeny survival to pathogens infections. Overall, the evidence is compelling that the MHC currently represents the best system available in vertebrates to investigate how natural selection can promote local adaptation at the gene level despite the counteracting actions of migration and genetic drift. We conclude this review by proposing several directions where future research is needed.

Animals↗

A low drift micropipette holder.

A novel micropipette holder has been designed to overcome the problem of drift encountered when experimenting on small preparations using patch-clamp techniques. In order to increase the stiffness and thermal stability of the system, the holder is designed such that the micropipette is clamped to a rigid quartz rod, and isolated from stresses arising in the connectors. The pressure line, made from stiff tubing, and electrical leads are firmly attached to the table and micromanipulator. This design was able to hold the micropipette tip stable to with 100 nm for more than 1 h, even with changes of 26.7 kPa (200 mmHg) in the pressure line.

Amplifiers, Electronic↗

The district concept for primary health care planning: attempts at implementation in The Netherlands.

Strengthening district-level primary health care systems has high priority in the WHO's 'Health for All' strategy. This article reviews governmental efforts to implement district health care systems in the Netherlands. Up to 1987, these activities corresponded to the WHO objectives, but their impact was limited. In 1987, government policy drifted away from these goals; the regulation of market forces and the increased influence of financing institutions have replaced planning by local government. Attempts to implement the district concept have, in fact, set primary health care planning back without offering the prospect of a leap forward.

Catchment Area, Health↗

Incidence of 1/29 translocation in Bolivian Creole and Brahman Yacumeño cattle.

In Bolivia, four different Creole cattle breeds can be found, as well as other European and Zebu breeds adapted to local environments. The relationship between the occurrence of the 1/29 translocation and subfertility is well known, and analysis of Y chromosome morphology is useful to determine a possible introgression with Bos indicus. The incidence of the 1/29 translocation was analyzed in four Bolivian Creole cattle breeds and the Brahman Yacumeño population, as well as on four farms with phenotypical Creole-type cattle. In 259 (164 dams and 95 sires) Bolivian Creole cattle, 10.42% of the individuals demonstrated the 1/29 translocation, with a variation from 0 to 28.20% between the breeds. In contrast, 43 (19 dams and 24 sires) Yacumeño Brahman and the Creole-type cattle did not show the centric fusion. The highly significant differences between Creole cattle breeds in relation to the incidence of 1/29 translocation could be a consequence of factors such as founder group, genetic drift, and selection. The low frequency observed in the Saavedreñio Creole dairy cattle might be explained by its breeding under a more intensive system, and selection according to milk yield and fertility traits. Finally, no relation between acrocentric Y chromosomes and 1/29 translocation was observed.

Animals↗

Theoretical study of near neutrality. I. Heterozygosity and rate of mutant substitution.

In order to clarify the nature of "near neutrality" in molecular evolution and polymorphism, extensive simulation studies were performed. Selection coefficients of new mutations are assumed to be small so that both random genetic drift and selection contribute to determining the behavior of mutants. The model also incorporates normally distributed spatial fluctuation of selection coefficients. If the system starts from "average neutrality," it will move to a better adapted state, and most new mutations will become "slightly deleterious." Monte Carlo simulations have indicated that such adaptation is attained, but that the rate of such "progress" is very low for weak selection. In general, the larger the population size, the more effective the selection becomes. Also, as selection becomes weaker, the behavior of the mutants approaches that of completely neutral genes. Thus, the weaker the selection, the smaller is the effect of population size on mutant dynamics. Increase of heterozygosity with population size is very pronounced for subdivided populations. The significance of these results is discussed in relation to various observed facts on molecular evolution and polymorphism, such as generation-time dependency and overdispersion of the molecular clock, or contrasting patterns of DNA and protein polymorphism among some closely related species.

Biological Evolution↗

Automatic alignment of a displacement-measuring heterodyne interferometer.

A technique to align automatically the beams of displacement-measuring interferometric gauges is described. The pointing of the launched beam is modulated in a circular pattern, and the resulting displacement signal is demodulated synchronously to determine the alignment error. This error signal is used in a control system that maintains the alignment for maximum path between a pair of fiducial hollow-cube corner retroreflectors, which minimizes sensitivity to alignment drift. The technique is tested on a developmental gauge of the type intended for the Space Interferometry Mission. The displacement signal for the gauge is generated in digital form; and the lock-in amplifier functions of modulation, demodulation, and filtering are all implemented digitally.

Journal Article↗

[Influence of population's genetic structure on the load size of monogenic hereditary diseases in Russia].

The paper presents the results of genetic and epidemiological study of populations in 5 Russian regions: the Kirov, Kostroma, and Bryansk Provinces, Krasnodar Territory, and the Republic of Mari El. The total size of the study population was over 1.5 million. Random inbreeding (Fst) in all Russian rural populations was significant and varied from 0.34 x 10(-3) to 7.6 x 10(-3). The prevalence rates for autosomal dominant (AD) disorders ranged from 0.22 to 3.93 per 1000. The load of autosomal recessive (AR) disorders varied from 0.17 to 2.01. The prevalence rates for AD and AR disorders was twice lower in the urban populations than those in the rural ones. The prevalence of X-linked recessive disorders was 0.33 per 1000 males. An analysis was made to examine the correlation between inherited diseases and Fst. The Pierson correlation coefficient was 0.81 and 0.87 for AD and AR disorders, respectively. The regression suggested that genetic differentiation of the populations with genes for hereditary disorders is partially related to gene drift. This suggestion was proved by genetic geographical mapping analysis. The similarity in the patterns of genetic distance distribution for all 3 genetic systems was revealed by the correlation coefficients between the maps for neutral genetic markers and the genes of AD and AR disorders which were equal to 0.67 and 0.65. There was the highest correlation coefficient between the maps of genetic distances for the genes of AD and AR disorders (Rs = 0.88).

Consanguinity↗

Intracranial pressure telemetry system. II. Animal testing.

A small, implantable, telemetric device for the long-term monitoring of intracranial pressure has been described in part I of this article. This portion of the study is designed to demonstrate the in vivo operational characteristics of that implant device in experimental animals. Results indicate that this system can provide long-term in vivo operation with rapid and accurate responses to acute changes in pressure. Data also indicate some drift in the baseline measurement of pressure. No signs of abnormal body reactions to the units were observed.

Animals↗

Phylodynamic analysis of human immunodeficiency virus type 1 in distinct brain compartments provides a model for the neuropathogenesis of AIDS.

"Phylodynamic" analysis combines various statistical procedures that can be used to correlate the epidemiological and evolutionary behavior of viral pathogens with the immune system of the host. We utilized this approach to examine human immunodeficiency virus type 1 (HIV-1) gp120 envelope DNA sequences (V1, V2, and V3) isolated from different brain compartments of a T-cell-depleted patient diagnosed with severe HIV-associated dementia at the time of death. In agreement with previous reports, phylogenetic analysis showed distinct virodemes but also revealed a significant amount of viral gene flow among different brain compartments. Local-molecular-clock analysis showed that HIV-1 meninges and temporal lobe subpopulations evolve about 30 and 100 times faster, respectively, than the other viral populations in the brain. However, maximum likelihood codon-based substitution models did not detect any site under significant positive selective pressure, and the main cause of HIV-1 genetic variation appeared to be random genetic drift. Therefore, the higher evolutionary rate in the meninges and temporal lobe could be due to an enhanced infection/expansion rate of macrophages as a consequence of the immune system failure. In conclusion, in this case study, viral infection in the brain progressed with a nonspecific genetic evolution, recurrent migration events, and an expansion of macrophage-tropic sequences. The data suggest that after immune failure newly produced viral variants, which would be rapidly cleared under normal conditions, begin to productively infect macrophages in a "self-amplifying" cycle of infection/inflammatory response that could be at the origin of HIV-associated dementia.

AIDS Dementia Complex↗

The use of the FST statistic of Wright for estimating the effects of genetic drift, selection and migration populations, with special reference to Ireland.

The Fst of Wright has been used to examine the available blood group, serum protein and enzyme data for the world, NW Europe and the counties of Ireland. These include the ABO, secretor, Lewis, MNSs, Rh, Kell, Duffy, Lutheran, Kidd, P, Diego, haptoglobin, Gc, Lp, Ag, adenosine deaminase, adenylate kinase, acid phosphatase, 6-phosphogluconate, phosphoglucomutase and transferrin systems. The highest value was found for the Fy gene. Much lower values than those calculated for world data were found for NW Europe and Ireland with the exception of the Lpa antigen which had high values in Ireland. sigma2p was used to estimate rates of genetic drift in an Irish population and it was estimated that a migration rate of 4% would counter genetic drift in Ireland.

Blood Group Antigens↗