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At least 91 records · Page 5Linked to original sources
PubMed1994

Thermodilution right ventricular ejection fraction measurements: room temperature versus cold temperature injectate.

OBJECTIVE: To compare thermodilution right ventricular ejection fraction measurements using 10 mL room temperature injectate vs. 10 mL cold temperature injectate. DESIGN: Prospective, clinical study. SETTING: Adult surgical intensive care unit (ICU) in a university hospital. PATIENTS: Sixty adult surgical ICU patients requiring hemodynamic monitoring by a pulmonary artery catheter. INTERVENTIONS: Patients were in a supine position with the bed flat during thermodilution measurements. Four 10 mL room temperature injections were alternated with four 10 mL cold temperature injections. MEASUREMENTS AND MAIN RESULTS: One hundred eleven paired thermodilution right ventricular ejection fraction measurements were made in patients during a "steady state." There were no restrictions regarding body temperature, cardiac index, heart rate or rhythm. Injectate temperature was measured by an in-line temperature probe. Injections were synchronized with end-expiration of mechanical ventilator breaths. The first injection was deleted from each temperature group. Reproducibility of individual right ventricular ejection fraction measurements was assessed by calculating the mean variation of triplicate measurements in each temperature group. Mean values of room temperature measurements were compared with cold temperature measurements by Student's t-test. Linear regression analysis, bias, and precision were also calculated. There was no significant difference (p = .752) between mean right ventricular ejection fraction measurements determined with room temperature (23.9 +/- 1 degrees C) vs. cold temperature (8.0 +/- 1.1 degrees C) injectate. There was a high degree of correlation between measurements (r2 = .876, p < .001). The bias of room temperature measurements compared with cold temperature was -0.39% and the precision was +/- 3.3%. The mean variation between individual measurements in all room temperature and cold temperature right ventricular ejection fraction measurements was 9.7% and 8.0%, respectively. There was no significant difference and there was a high degree of correlation in mean right ventricular ejection fraction measurements when data were grouped according to body temperature, heart rate, cardiac index, right ventricular ejection fraction, central venous pressure, pulmonary vascular resistance index, right ventricular end-diastolic volume index, or right ventricular stroke work index. CONCLUSIONS: The results suggest that room temperature injectate may be used for right ventricular ejection fraction measurements in critically ill adult surgical patients. Utilizing room temperature injectate for right ventricular ejection fraction measurements may save time and costs in the critical care unit.

Adult↗
PubMed1987

Pedal asymmetry in the reproduction of spatial locations.

Roy and MacKenzie (1978) showed that the left thumb is superior to the right thumb in reproducing a spatial location. This study replicated and extended their findings to the reproduction of spatial locations by the feet. We attribute the left foot advantage in this study to the superiority of the right hemisphere in processing spatial information.

Adult↗
PubMed1998

No-go dominant brain activity in human inferior prefrontal cortex revealed by functional magnetic resonance imaging.

We investigated the response inhibition function of the prefrontal cortex associated with the go/no-go task using functional magnetic resonance imaging in five human subjects. The go/no-go task consisted of go and no-go trials given randomly with roughly equal probability. In go trials a green square was presented and the subjects had to respond by promptly pushing a button using their right or left thumbs, but in no-go trials a red square was presented and subjects were instructed not to respond. When brain activity in no-go trials is dominant over that in go trials in areas in the prefrontal cortex, this no-go dominant brain activity would reflect the neural processes for inhibiting inherent response tendency. We used a new strategy of image data analysis by which transient brain activity in go or no-go trials can be analysed separately, and looked for the prefrontal areas in which the brain activity in no-go trials is dominant over that in go trials. We found the no-go dominant foci in the posterior part of the right inferior frontal sulcus reproducibly among the subjects. This was true whether the right or left hand was used. These results suggest that this region in the prefrontal cortex is related to the neural mechanisms underlying the response inhibition function.

Adult↗
PubMed1989

The right to be born.

The right to be born embodies several different rights: the right to be conceived, the right to be implanted in the uterus, and the right to live (or not be aborted). The right to be conceived, or the right of parents to reproduce, may depend upon circumstances. Do couples have the right to have children to whom they cannot offer an adequate upbringing? Do couples have the right to have as many children as they wish if in this way they will reduce the amount of food available to other families? Is the right to have children coupled with a responsibility not to have more children than a community, a country or the world can support? Fertilisation occurs in the fallopian tube, but only about 30% of fertilised ova normally become successfully implanted in the uterus. Fertilisation can also be achieved in a test tube and the resultant embryo then implanted in the mother's uterus to grow into a "test tube baby". Is it ethical to allow the use of donor sperm or ova, a surrogate mother, experimentation on embryos, and what should be done with "spare" embryos? The British Unborn Child (Protection) Bill 1986 prohibits anyone from possessing a fertilised embryo unless it is for the purpose of enabling a specific women to have a child. The right to live and not be aborted may involve a conflict of interests between a mother and her unborn child. A mother may claim absolute rights over her own body, including the right to have an abortion if she desires.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗
PubMed1997

Use of only a regular diagnostic His-bundle catheter for both fast and reproducible "para-Hisian pacing" and stable right ventricular pacing.

INTRODUCTION: Para-Hisian pacing, i.e., pacing the anteroseptal right ventricle (RV) with or without direct capture of the His bundle (HB), allows the differentiation of VA conduction over the AV node from conduction over an accessory pathway. Classically, it is performed by maneuvering a separate pacing catheter around the HB catheter, which may be difficult and time-consuming. METHODS AND RESULTS: This study prospectively evaluated the use of a single standard octapolar HB catheter with 2-mm interelectrode spacing for simultaneous (para-Hisian) pacing from the distal bipole and recording from the three proximal bipoles in 148 consecutive patients. Para-Hisian pacing was successful in 146 of 148 patients, performed within a median of only 10 seconds, and easily repeated several times during the course of an electrophysiologic study. Retrograde HB activation could be recorded in 132 of 146 patients; a clearly different surface ECG configuration confirmed the presence or absence of HB capture in all other patients. Interestingly, stable RV pacing could be performed from the HB catheter for the rest of the electrophysiologic study in 138 of 142 patients in whom this was tried. RV pacing from this site also led to better interpretation of retrograde conduction, due to clear visualization of retrograde HB activation. CONCLUSION: Pacing from the distal bipole of a regular diagnostic HB catheter provides a fast and reliable way to perform para-Hisian pacing. Therefore, it may be advocated as a routine diagnostic protocol during electrophysiologic procedures. Moreover, pacing from this site obviates the need for a separate RV pacing catheter in most patients.

Adolescent↗
PubMed1978

Echocardiographic assessment of pulmonary arterial pressure in children with complete right bundle branch block.

The time interval between tricuspid valve closure and pulmonary valve opening, termed the isovolumic contraction time of the right ventricle, was evaluated echographically in 38 normal children and within 24 hours of cardiac catheterization in 53 children with congenital heart disease and normal conduction as assessed with the electrocardiogram. In the 53 patients with congenital heart disease, isovolumic contraction time was strongly influenced by right ventricular afterload, as defined by pulmonary arterial end-diastolic pressure (r = 0.87). It was possible to utilize isovolumic contraction time to separate patients with normal or elevated values for pulmonary arterial end-diastolic pressure. Similar correlations were demonstrated between isovolumic contraction time and mean pulmonary arterial pressure and calculated pulmonary vascular resistance. Evaluation of 15 children with complete right bundle branch block revealed values for isovolumic contraction time that did not significantly differ from those of patients with similar pulmonary arterial end-diastolic pressure but no conduction abnormalities. These findings indicate that serial echographic evaluation of the interval from tricuspid valve closure to pulmonary valve opening can give an accurate reproducible assessment of right ventricular afterload in many children with congenital heart disease and complete right bundle branch block

Adolescent↗
PubMedDate not supplied

Quantitative assessment of regional right ventricular myocardial velocities in awake dogs by Doppler tissue imaging: repeatability, reproducibility, effect of body weight and breed, and comparison with left ventricular myocardial velocities.

Right ventricular myocardial (RVM) motion is poorly documented. The objective of this study was to determine the variability of RVM velocities by tissue Doppler imaging (TDI) in healthy dogs (study 1), to analyze RVM motion in a large healthy canine population (study 2), and to compare the results with those obtained for the left ventricular free wall. Six healthy Beagle Dogs were monitored in study 1, and 64 healthy dogs of 14 different breeds were monitored in study 2. Velocities were recorded in 2 segments (basal and apical) of the right and left myocardial walls. In study 1, 36 TDI examinations were performed for 4 days, whereas a single TDI examination was performed on each dog in study 2. All velocity profiles included 1 positive systolic wave and 2 negative diastolic waves. The lowest intraday and interday coefficient of variation values of the right TDI variables were observed at the base (3.5-16.1%). The variability of the right apical velocities was much higher, with most coefficient of variation values > 15%. RVM velocities were higher in the basal than in the apical segments (P < .001) and were higher than the left velocities of the corresponding segment (P < .01). Body weight and breed had an effect on only a few right and left TDI variables. TDI provides a repeatable and reproducible method for evaluating basal RV function in the dog. These data also demonstrate the heterogeneity of the myocardial velocities between the left and the right ventricles and between the base and the apex.

Aging↗
PubMed1998

Castability of a commercial castable glass ceramics.

This study was carried out to determine the design and thickness of the cervical margin of a castable ceramic restoration from the point of view of its castability. Castability of castable ceramics was lower compared to Ag-Pd-Au and Co-Cr alloy with the use of the mesh pattern and rod pattern test (p < 0.05). It was more dependent on the pattern thickness than alloys (p < 0.05), and perfect reproducibility with non-measurable variability could be estimated to reach 1.0 mm thickness of the original pattern (p < 0.001). Marginal shape was certainly more reproducible in a right angle shoulder than in 30, or 45 degree bevels (p < 0.05). From these results, it is suggested that a right angle shoulder margin with 1.0 mm thickness is more suitable to castable glass ceramic restoration than any other design.

Analysis of Variance↗
PubMed1994

Experimental duplication of the important physical evidence of the lapel bulge of the jacket worn by Governor Connally when bullet 399 went through him.

By duplicating the wound to the neck of President Kennedy, which caused bullet 399 to turn sideways, and having it then hit a Connally-type rib cage with shirt and jacket, we reproduced the right-sided bulge of the jacket worn by Connally, with lapel eversion, which is so significant in frame 224. The extensive damage to his shirtfront was from the hail of rib fragments and soft tissue, exactly as described with his own shirt. Our tumbling bullet then went on to fracture a radius and be recovered intact except that it was somewhat flattened and bent and had lead extruded from the rear, as did bullet 399. Fragments of this lead were scraped off on the ragged bone-ends of some of our fractured radiuses, just as with Governor Connally's radius. It is believed that this duplication of the jacket and lapel bulge of Governor Connally, which occurred dependably, when we reproduced the circumstances at Dallas, confirmed this very important detail in this technical demonstration of the findings in the shooting of President Kennedy and Governor Connally. The bulge and the lapel eversion of the jacket worn by Governor Connally, starting in Zapruder frame 224, does indeed establish, beyond any shadow of a doubt, the exact moment when bullet 399 went through him. The right arms of both men were seen to react simultaneously, immediately thereafter. It also permits us to establish that there was plenty of time (three and one-half seconds) between the first two shots (frames 160 to 224) and even more time (five seconds) between the last two shots (frames 224 to 313), for Oswald to reload, reacquire his target (the head of President Kennedy) plus two full seconds to lock onto it. If the bullet does not traverse the neck of President Kennedy, it does not cause Governor Connally's jacket and lapel to bulge. The lapel bulge is a very important bit of actual physical evidence in establishing the fact that one bullet hit both men and that Oswald had plenty of time to hit the President, first in the neck and then in the head. These experiments confirm the mechanism of the lapel bulge and the behavior of the bullet.

Famous Persons↗
PubMed1988

A simple model of right ventricular hypertrophy.

Previous models of right ventricular hypertrophy (RVH) created by pulmonary artery (PA) banding in adult large animals have been associated with an unpredictable response of the right ventricle to the band and a high mortality due to the variable degree of acute stenosis. We studied the efficacy of PA banding in young pigs to produce RVH by progressive gradual stenosis during growth. Sixteen Yorkshire pigs at 6 weeks of age had nonconstricting 5-mm wide Dacron strips placed around the PA via a left minithoracotomy. The animals were returned for study in 2-3 months. There were no deaths during the growth period. Five sham-operated pigs acted as controls. Right ventricular free wall (RVFW) to total heart weight ratio was greater in the banded group (0.38 +/- 0.05 vs. 0.28 +/- 0.01, P less than .005) as was the RVFW to left ventricular free wall (LVFW) weight (1.09 +/- 0.25 versus 0.66 +/- 0.03, P less than .005). While the LVFW to total heart weight ratio decreased (0.36 +/- 0.04 vs 0.45 +/- 0.05, P less than .005), the septal ratio did not change (0.26 +/- 0.04 vs. 0.29 +/- 0.02, NS), indicating concomitant septal hypertrophy. This technique is simple, reliable, and reproducible in creating right ventricular and septal hypertrophy in the young pig with no mortality during maturation.

Animals↗
PubMed1983

Self-conversion of drug resistant ventricular tachycardia by rapid atrial pacing.

A 523-year-old man with recurrent ventricular tachycardia two months post myocardial infarction is described. The tachycardia resulted in low output and heart failure at the time of presentation. Following electrocardioversion of ventricular tachycardia, sinus rhythm would last for only a few seconds, and ventricular tachycardia could not be terminated or prevented by drugs, nor by overdrive pacing. Over a 20-hour period, asynchronous right ventricular pacing at 30/min resulted in repeated random interruption of successive paroxysms of ventricular tachycardia, resulting in maintenance of sinus rhythm about 60 to 70% of the time. This produced marked hemodynamic improvement and a decrease in the frequency of paroxysms of tachycardia which, however, continued to recur once every few days. Despite their reduced frequency, these paroxysms continued to be resistant to drugs and had to be terminated by cardioversion. At this point it was discovered that rapid atrial pacing was able to terminate the patient's tachycardia reliably and reproducibly. A permanent right atrial externally activated radio frequency pacemaker device was inserted and over the ensuing eighteen-month period the patient self-terminated over fifty discrete episodes of ventricular tachycardia.

Anti-Arrhythmia Agents↗
PubMed1999

Influence of speech stimuli intensity on the activation of auditory cortex investigated with functional magnetic resonance imaging.

Understanding the impact of variations in the acoustic signal is critical for the development of auditory and language fMRI as an experimental tool. We describe the dependence of the BOLD signal and speech intelligibility on the intensity of auditory stimuli. Eighteen subjects were imaged on a 1.5-T MRI scanner. Speech stimuli were English monosyllabic words played at five intensity levels. Intrasubject reproducibility was measured on one subject by presenting the stimulus five times at the same intensity level. Intelligibility was measured during data acquisition as subjects signaled when hearing two targets. Each functional trial consisted of four cycles (30 s off-30 s on). Five oblique slices covering primary and association auditory areas were imaged. Activated voxels were identified by cross-correlation analysis and their percent signal change (delta S) was measured. Intersubject differences in activation extent, asymmetry, and dependence on intensity were striking. Volume of activation was significantly greater in the left than in the right hemisphere. Intrasubject reproducibility for delta S was higher than for volume of activation. delta S and intelligibility showed a similar dependence on intensity suggesting that not only intensity but also intelligibility affect the fMRI signal.

Adult↗
PubMed1985

Right ventricular ejection fraction measured by first-pass intravenous krypton-81m: reproducibility and comparison with technetium-99m.

Study of the effects of various diseases and therapeutic manipulation of pulmonary vascular resistance on the right ventricle has been restricted by methodologic limitations. The radioactive gas in solution, krypton-81m was used to study the right ventricle and the technique was compared with a technetium-99m method. In 22 subjects, first-pass krypton-81m right ventricular ejection fraction, acquired both in list mode and electrocardiogram-gated frame mode, correlated well (r = 0.81 and 0.86, respectively, p less than 0.01) with that determined by technetium-99m first-pass studies over a broad range of ventricular function. The reproducibility of the technique was excellent (r = 0.84 and 0.95 for each acquisition mode, respectively). Krypton-81m first-pass studies provide accurate and reproducible estimates of right ventricular function. Use of krypton allows multiple measurements, with or without perturbations, over a short period of time.

Heart Ventricles↗
PubMed2001

Evaluation of different recording parameters to establish a standard for flash electroretinography in rodents.

Different electrodes and stimulus protocols commonly used for electroretinography in rodent eyes were compared for convenience of use, degree of damage to corneal epithelium, and for magnitude of amplitude, reproducibility, left versus right eye accuracy, and reliability of recorded parameters of the flash electroretinogram (ERG). Adult C57BL/6 pigmented mice and albino Wistar rats were used to determine scotopic ERGs in response to Ganzfeld or strobe-light stimulation and light-adapted (photopic) ERGs recorded from both eyes at the same time. Test-retest data were used for statistical analyses to compare a monopolar gold-wire contact lens electrode (CLE), a cotton-wick silver-silver chloride electrode (CSCE), a DTL fiber electrode (DTLE), and a circular stainless steel wire electrode (SSE). Corneas were evaluated for abrasion after ERG recordings using fluorescein staining and also for the time taken, ease of insertion, and re-insertions required for the different electrodes. Compared to CSCE, DTLE, and SSE, the ERG potentials recorded by CLE had significantly larger scotopic amplitudes and oscillatory potentials under strobe or Ganzfeld stimulation and for light-adapted ERG b-wave amplitudes in both mice and rats. In analyzing test-retest data of scotopic ERG a-wave and b-wave amplitudes, the intraclass correlation coefficient showed the best agreement for the CLE (range 0.61-0.94) compared to the SSE (0.13-0.77), DTLE (0.02-0.69), and CSCE (0.12-0.51). In mice and rats, logistic regression analyses revealed significant correlations for amplitudes of most scotopic ERG parameters between contralateral eyes obtained with CLE and for some ERG components recorded by SSE. When comparing ERG amplitudes for stimulation by strobe or Ganzfeld, the difference was least with the CLE compared to DTLE, CSCE, or SSE. The time taken to insert the four different electrodes was greatest for the CLE in both mice and rats. The extent of corneal abrasion resulting from electrode use in mice was largest for the SSE followed by the CLE. However, in rats there was almost no corneal damage after ERG recordings with the CLE. Because of the stability of eye contact, the CLE allows ERGs to be determined over a longer recording session. Recording of scotopic and photopic (light-adapted) ERGs in rodents with monopolar gold-wire contact lens electrodes provides greater amplitudes and higher reproducibility when compared to other commonly used corneal electrodes. These electrodes are significantly better overall than others that were evaluated and should be considered for a standard protocol to monitor retinal function in rodent eyes.

Analysis of Variance↗
PubMed1986

Precision of measurements of right and left ventricular volume by cine computed tomography.

Precise determination of left and right ventricular stroke volumes is limited with conventional imaging techniques. We determined whether right and left ventricular stroke volumes could be precisely measured with cine computed tomography (CT). Cine CT enables simultaneous imaging of the right and left ventricles at an 8 mm slice thickness with a maximal scanning rate of 17 frames/sec (50 msec acquisition intervals). In eight dogs, true right ventricular and left ventricular stroke volumes were determined by dividing thermodilution cardiac output by heart rate and/or with the use of an aortic electromagnetic flow probe implanted over a long term. After at least 5 sec of suspended respiration, cine CT images were acquired during central venous injection of a nonionic contrast agent. Multiple perturbations in stroke volume were induced in each dog by the administration of dobutamine, sodium pentobarbital, or sodium nitroprusside or by coronary artery occlusion. Right and left ventricular stroke volumes were obtained by Simpson's reconstruction of end-diastolic and end-systolic short-axis tomograms from apex to base. The cine CT left ventricular stroke volume (range 11 to 45 ml) correlated highly with the true left ventricular stroke volume (r = .99, slope = 1.01, y intercept = -0.2 ml, SEE = 1.5 ml, n = 25). The cine CT right ventricular stroke volume (range 11 to 34 ml) also correlated highly with the true right ventricular stroke volume (r = .98, slope = 0.9, y intercept = 2.2 ml, SEE = 1.7 ml, n = 15). In 12 studies, the mean difference between nearly simultaneous right and left ventricular stroke volumes by cine CT was 1.1 ml (range 0.1 to 3.2 ml). Calculation of right and left ventricular stroke volumes from data from cine CT were highly reproducible. Intraobserver variability in measurements of right ventricular stroke volume (r = 1.0, slope = 0.99, y intercept = 0.19 ml) and left ventricular stroke volume (r = 1.0, slope = 1.02, y intercept = -0.21 ml) was minimal. Interobserver variability in measurements of right ventricular stroke volume (r = .98, slope = 0.90, y intercept = 1.66 ml) and left ventricular stroke volume (r = .99, slope = 0.97, y intercept = -0.02 ml) was likewise minimal. Thus, precise and highly reproducible measurements of right and left ventricular stroke volumes can be obtained with cine CT.

Animals↗
PubMed1998

Hemispheric organization of local- and global-level visuospatial processes in deaf signers and its relation to sign language aphasia.

Previous work has shown that deficits in the production and perception of signed language are linked to left hemisphere damage but not right hemisphere damage in deaf lifelong signers, whereas severe deficits in nonlinguistic visuospatial abilities are more frequent following right hemisphere damage than left hemisphere damage in this population. In the present study we investigated the extent to which sign language deficits in deaf individuals can be dissociated from more subtle visuospatial deficits commonly associated with left hemisphere damage in the hearing/speaking population. A group of left- or right-lesioned deaf signers were asked to reproduce (1) two line drawings (a house and an elephant) and (2) four hierarchical figures. Drawings were scored separately for the presence of local vs global features. Consistent with data from hearing patients, left hemisphere-damaged deaf subjects were significantly better at reproducing global-level features, whereas right hemisphere-damaged deaf subjects were significantly better at reproducing local-level features. This effect held for both types of stimuli. Local-level performance in the LHD group did not correlate with performance on sign language tasks, suggesting that language deficits in LHD deaf signers are in fact linguistic specific.

Aged↗
PubMed1989

Measurement of tendon reflexes by surface electromyography in normal subjects.

A simple method for measuring the tendon reflexes was developed. A manually operated, electronic reflex hammer was applied that enabled measurement of the strength of tendon taps. Reflex responses were recorded by surface electromyography. Stimulus-response relations and latencies of tendon reflexes in the biceps, triceps, quadriceps and triceps surae were examined in 40 healthy subjects. A characteristic relation between stimulus strength and response amplitude was found which could be described by an empirical function. Latencies of both arm and leg reflexes were linearly related to the height of the subjects. Variations of reflex amplitudes within and between subjects were comparable with previous results obtained with more complicated techniques. Although repeatability of measurement of the amplitude is limited by the variability of reflexes, significant agreement was found between repeated measurements. Most reflex amplitudes were diminished during repeated examination after a short interval. Both measurement and clinical examination showed the frequent occurrence of left-right asymmetry of reflex amplitudes. These left-right differences were reproducible to a significant degree on repeated measurements after more than 2 years.

Adult↗