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PubMed1993

US-guided pseudoaneurysm repair with a compression device.

A simple commercially available compression device allowed intermittent ultrasound scanning of the compression site during compression repair of a femoral artery pseudoaneurysm in six patients. All six of the pseudoaneurysms (five superficial femoral and one common femoral) were compressed without compression of the underlying vessels. The procedure was successful in four of the six patients, without complications. Use of this device may decrease operator fatigue during compression repair of pseudoaneurysm.

Aneurysm↗

PubMed1996

Neonatal hydrocephalus: hemodynamic response to fontanelle compression-- correlation with intracranial pressure and need for shunt placement.

PURPOSE: To determine whether the hemodynamic response to fontanelle compression during Doppler sonography can be used to indirectly assess intracranial pressure and help determine the need for shunt placement in hydrocephalic infants. MATERIALS AND METHODS: Sixty Doppler sonographic examinations were performed to obtain resistive indexes before and during fontanelle compression in 14 hydrocephalic infants. Twenty-five intracranial pressure measurements were obtained in 12 infants during cerebrospinal fluid removal and correlated with the change in resistive index during compression of the anterior fontanelle. RESULTS: Baseline resistive index without fontanelle compression was not correlated with intracranial pressure (r = .1, P = .63). A statistically significant correlation was found between the change in resistive index during compression and elevated intracranial pressure (r = .8, P < .0001). Maximum change in resistive index was significantly higher (P < .001) in infants who subsequently required surgical intervention (mean [+/- standard deviation], 74% +/- 9; range, 47%-132%) than in infants who did not require ventricular drainage (mean, 19% +/- 6; range, 3%-29%, P < .0003). CONCLUSION: Hemodynamic response to fontanelle compression can be used as a noninvasive predictor of progressive or persistently elevated intracranial pressure in newborns with hydrocephalus and may be helpful in predicting need for shunt placement.

Hemodynamics↗

PubMed2001

CT colonography with teleradiology: effect of lossy wavelet compression on polyp detection--initial observations.

PURPOSE: To assess the consequences of lossy compression on the diagnostic accuracy of CT colonography for detecting colonic polyps. MATERIALS AND METHODS: Helical CT images of cleansed colonic segments were evaluated. Source images were compressed to 1:1, 10:1, and 20:1 ratios with lossy wavelet compression. Two independent readers blinded to corresponding colonoscopic results analyzed 144 randomly ordered colonic segments in multiplanar and volume-rendered endoscopic views. Sensitivity, specificity, and receiver operating characteristic curves were generated for each compression ratio on the basis of expressed confidence in lesion presence. Similar analyses were performed to assess distention and bowel preparation adequacy and evaluation time required. RESULTS: Results based on video colonoscopy-confirmed lesions revealed 100% (four of four) sensitivity for lesions larger than 10 mm for compression ratios 1:1, 10:1, and 20:1 for both readers; sensitivities for all lesions smaller than 10 mm were 50%-78%, 38%-67%, and 38%-67% for respective ratios for both readers. Differences in diagnostic performance for each reader across ratios were not significant (P =.30-.99, McNemar test). The time required to evaluate and assess bowel preparation and distention adequacy did not change significantly across ratios. CONCLUSION: On the basis of the patient sample, lossy compression of transverse source images to at least a 20:1 ratio did not adversely affect diagnostic performance or evaluation time for CT colonography.

Aged↗

PubMed1989

Acute effects of partial compression of ductus arteriosus on fetal pulmonary circulation.

To determine the acute effects of increased pulmonary artery pressure and flow on the fetal pulmonary circulation, we studied the response of pulmonary blood flow and vascular reactivity to partial compression of the ductus arteriosus in 22 chronically prepared late-gestation fetal lambs. An inflatable occluder was placed loosely around the ductus arteriosus for compression. Partial compression of the ductus rapidly increased mean pulmonary artery pressure from 45 +/- 1 to 60 +/- 1 mmHg (mean +/- SE) and left pulmonary artery blood flow from 65 +/- 6 to 151 +/- 11 ml/min at 30 min (P less than 0.001; 12 animals). Despite keeping pulmonary artery pressure constant, pulmonary blood flow steadily declined and by 2 h was not different from base-line values. Pulmonary vascular resistance initially fell during the first 30 min of partial compression but then steadily increased and remained elevated above base-line values for at least 30 min after the release of the occluder (P less than 0.001). The decline of pulmonary vascular resistance during the first 30 min of compression was blunted after treatment with the cyclooxygenase inhibitor, meclofenamate (P less than 0.001; 6 animals). Rapid incremental ductus compressions demonstrated a decrease in the slope of the pressure-flow relationship from 3.30 +/- 0.27 (control) to 1.59 +/- 0.21 ml.min-1.mmHg-1 during the postcompression period (P less than 0.001; 12 animals). The vasodilation response to small increases of fetal PO2 was markedly blunted during the postcompression period (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1984

Effects of addition of nitrogen during rapid compression of baboons.

A series of dives was carried out to depths of 600 and 800 m seawater (msw) using baboons (Papio papio). Experiments were designed to study the effects of compression and the use of a He-N2-O2 gas mixture on high-pressure nervous syndrome (HPNS). When N2 was added to the He-O2 mixture at the beginning of a linear compression (200 msw/h), the symptoms associated with HPNS were still seen; in addition, the electroencephalogram (EEG) changes were more severe than those seen without N2. By use of an identical mixture, a 2-h exponential compression to 600 msw produced less severe signs of HPNS than the nonexponential profile. By use of a 2-h exponential compression to 600 msw and with addition of N2 at the end of compression, the HPNS that had been started under the He-O2 mixture decreased. Progressive addition of N2 during compression reduced the behavioral signs of HPNS without further EEG changes. These results show that the action of N2 is more complex than can be explained by a simple narcotic pressure antagonism and that the HPNS differed according to the gas mixture used.

Animals↗

PubMed1987

Opposing effects of anesthetics on pressure tolerance and compression rate effect.

Inert gas narcotics increase intrinsic pressure tolerance (1,000Pc) in CD-1 mice but interfere with development of the protective responses raising seizure thresholds during slower compression (e.g., 60Pc). This secondary narcotic effect can block up to 40% of the total attainable increase in Pc. The narcosis susceptible moiety of this compression rate effect develops early, whereas a narcosis resistant remnant accounts for increase in Pc occurring after 90 min of compression or pressure exposure. Pressure conditioning by multiday pressure exposure entails increases in both 60Pc and 1,000Pc and in virtual annullment of the compression rate effect. The effect can be completely blocked by narcotic gases in the conditioning atmosphere. In addition to blocking part of the compression rate effect the presence of narcotic gases under these conditions can reverse the effects of previously established pressure conditioning. 60Pc regresses much more slowly under these conditions than 1,000Pc. Either reversal rate is much more rapid in air at 1 ATA than at 80 ATA under 0.9 atm N2O. The implications of these data are discussed with regard to evaluation of the hypothesis of antagonism between inert gas narcotics and high pressures and to elaboration of the monoamine hypothesis to account for the modification of the compression rate effect by narcotic gases.

Anesthetics↗

PubMed1987

Effects of exponential compression curves with nitrogen injection in humans.

Two series of experiments were carried out on humans to study the effects of fast and slow exponential compression curves with N2 additions. Eight subjects in the first series and 13 subjects in the second series were analyzed up to the depths of 400-450 m of seawater (msw). The data indicated that injections of N2 in He-O2 mixture reduced or suppressed the hyperbaric tremor in the two series. Electroencephalographic (EEG) changes were recorded with the two types of compression, but these changes (increase in slow waves, decrease in alpha-activity, appearance of microsleep EEG traces) were more important with the fast exponential compression curves between 200 and 300 msw than with the slow exponential curves. The effects of the fast rates of compression on EEG activities were not compensated by addition of 4-5% N2. Consequently, the fast exponential compression curves, even with N2 injections, cannot be used without risk and must be avoided; the slow exponential compression curve with N2 injection allowed a human subject to reach 450 msw in satisfactory condition, i.e., without tremor and with light EEG changes.

Brain↗

PubMed2005

External compression increases forearm perfusion.

Application of compression stockings to the lower extremities is a widely used therapeutic intervention to improve venous return, but there is little information about the effects of compression on local arterial perfusion. Therefore, we tested the hypothesis that a positive external pressure increases forearm perfusion. The relation of increasing external pressure induced by standardized compression to the arterial inflow and arterial flow reserve of the forearm was critically evaluated in a group of healthy young men (n = 9). Flow was measured with venous occlusion plethysmography after a 10-min application of six different stockings with compression pressure increasing from 13 to 23 mmHg. During compression, the arterial inflow increased significantly from 3.7 +/- 0.85 to 8.8 +/- 2.01 ml.min(-1).100 ml tissue(-1) (P < 0.001) and the arterial flow reserve increased from 17.7 +/- 4.7 to 28.3 +/- 7.0 ml.min(-1).100 ml tissue(-1). The flow increase was persistent after 3 h of constant application of external pressure and also during simultaneous low-intensity hand grip. Similar results obtained with occlusion plethysmography were seen with MRI. During the interventions, forearm temperature was unchanged, and the volunteers reported no discomfort. In conclusion, 1) arterial perfusion of the human forearm increases more than twofold during application of external compression over a pressure range of 13-23 mmHg, and 2) the result is interpreted as an autoregulatory response following the decrease of the vascular transmural pressure gradient.

Adult↗

PubMed2002

Encoding of compressive stress during indentation by slowly adapting type I mechanoreceptors in rat hairy skin.

The mechanical state encoded by slowly adapting type 1 mechanoreceptors (SAI) during indentation was examined using an isolated preparation in a rat model. Skin and its intact innervation were harvested from the medial thigh of the rat hindlimb and placed in a dish, with the corium side down, containing synthetic interstitial fluid. The margins of the skin were coupled to an apparatus that could stretch and apply compression to the skin. Using a standard teased nerve preparation, the neural responses of single SAIs were identified. SAIs were stimulated, using controlled compressive stress while simultaneously measuring displacement, by compressing the skin between indenters (flat cylinders) of different diameters and a hard platform. SAIs were subcategorized according to whether their neural response saturated above or below 10 kPa compressive stress (SAI-H or SAI-L, respectively). Linear regression was used to evaluate the relationships between neuron response and stress and force and displacement. For all SAIs, the mean neural response was significantly and substantially more highly correlated with compressive stress than force or displacement. For the SAI-L subcategory, the mean correlation coefficient was significantly and substantially greater for stress than for force but not significantly different for displacement. The data from this study support the hypothesis that SAI mechanoreceptors stimulated by indentation encode compressive stress rather than force, displacement, or strain.

Adaptation, Physiological↗

PubMed1992

Interposed abdominal compression-cardiopulmonary resuscitation and resuscitation outcome during asystole and electromechanical dissociation.

BACKGROUND: Coronary perfusion pressure has been shown to be a significant determinant of return of spontaneous circulation from cardiac arrest during asystole and electromechanical dissociation. The addition of interposed abdominal compression to otherwise standard cardiopulmonary resuscitation (CPR) increases coronary perfusion pressure in animal and human models. METHODS AND RESULTS: Accordingly, we conducted a randomized prospective study of 143 consecutive patients experiencing cardiac arrest in a large university-affiliated teaching hospital in whom the initial arrest rhythm was asystole or electromechanical dissociation. Patients were randomized to receive either interposed abdominal compression-CPR or standard CPR. The two end points studied were return of spontaneous circulation and 24-hour survival. In addition, we studied the complications associated with interposed abdominal compression-CPR. Sixty-nine men and 74 women with a mean age of 64 years (range, 19-97 years) were studied. The overall rate of return of spontaneous circulation was 38%. Return of spontaneous circulation was significantly greater in the group receiving interposed abdominal compression-CPR compared with the group receiving standard CPR (49% versus 28%, p = 0.01). At 24 hours, there was a significantly greater number of patients alive in the experimental group than in the control group (33% versus 13%, p = 0.009). We found no complication directly related to the procedure of interposed abdominal compression in a small subset of patients who died and underwent necropsy. CONCLUSIONS: We conclude that the addition of interposed abdominal compression may be a useful adjunct to otherwise standard CPR that can improve resuscitation outcome of patients experiencing in-hospital cardiac arrest from asystole and electromechanical dissociation.

Abdomen↗

PubMed1994

Evaluation of standard and active compression-decompression CPR in an acute human model of ventricular fibrillation.

BACKGROUND: The mechanisms that underlie cardiopulmonary resuscitation (CPR) in humans remain controversial and difficult to study. This report describes a new human model to evaluate CPR during the first 1 to 2 minutes after the onset of ventricular fibrillation (VF). With this model, standard CPR was compared with active compression-decompression (ACD) CPR, a method that uses a handheld suction device to actively compress and actively decompress the chest. METHODS AND RESULTS: During routine inductions of VF as part of a transvenous lead cardioverter/defibrillator implantation procedure, CPR was performed in 21 patients if the first defibrillation shock failed and until a successful rescue shock was delivered. Compressions during CPR were performed according to American Heart Association guidelines. For ACD CPR, decompression was performed with up to -30 lbs. Radial arterial and right atrial pressures were measured in all patients. Esophageal pressures, intratracheal pressures, or minute ventilation was measured in the last 13 patients. Application of both CPR techniques increased arterial and right atrial pressures. The mean coronary perfusion pressure was increased throughout the entire CPR cycle with ACD CPR (compression, 21.5 +/- 9.0 mm Hg; decompression, 21.9 +/- 8.7 mm Hg) compared with standard CPR (compression, 17.9 +/- 8.2 mm Hg; decompression, 18.5 +/- 6.9 mm Hg; P < .02 and P < .02, respectively). Ventilation per compression-decompression cycle was 97.3 +/- 65.6 mL with standard CPR and 168.4 +/- 68.6 mL with ACD CPR (n = 7, P < .001). Negative inspiratory pressure was -0.8 +/- 4.8 mm Hg with standard CPR and -11.4 +/- 6.3 mm Hg with ACD CPR (n = 6, P < .04). CONCLUSIONS: Patients undergoing multiple inductions of VF during cardioverter/defibrillator implantation with transvenous leads provide a well-controlled and reproducible model to study the mechanisms of CPR. Using this model, ACD CPR significantly increased arterial blood pressure, coronary perfusion pressure, minute ventilation, and negative inspiratory pressure compared with standard CPR.

Acute Disease↗

PubMed1997

Lossy (15:1) JPEG compression of digital coronary angiograms does not limit detection of subtle morphological features.

BACKGROUND: Development of the "all-digital" cardiac catheterization laboratory has been slowed by substantial computer archival and transfer requirements. Lossy data compression reduces this burden but creates irreversible changes in images, potentially impairing detection of clinically important angiographic features. METHODS AND RESULTS: Fifty image sequences from 31 interventional procedures were viewed both in the original (uncompressed) state and after 15:1 lossy Joint Photographic Expert's Group (JPEG) compression. Experienced angiographers identified dissections, suspected thrombi, and coronary stents, and their results were compared with those from a consensus panel that served as a "gold standard." The panel and the individual observers reviewed the same image sequences 4 months after the first session to determine intraobserver variability. Intraobserver agreement for original images was not significantly different from that for compressed images (89.8% versus 89.5% for 600 pairs of observations in each group). Agreement of individual observers with the consensus panel was not significantly different for original images from that for compressed images (87.6% versus 87.3%; CIs for the difference, -4.0%, 4.0%). Subgroup analysis for each observer and for each detection task (dissection, suspected thrombus, and stent) revealed no significant difference in agreement. CONCLUSIONS: The identification of dissections, thrombi, and coronary stents is not substantially impaired by the application of 15:1 lossy JPEG compression to digital coronary angiograms. These data suggest that digital angiographic images compressed in this manner are acceptable for clinical decision-making.

Coronary Angiography↗

PubMedDate not supplied

Sustained blood pressure elevation to lower body compression in pigs and dogs.

Inflatable suits were constructed for lower body compression in pigs and dogs. The suit for pigs encompassed hindquarters and part of the abdomen, and the smaller suit for dogs compressed only the hindquarters, leaving free the abdominal cavity. In conscious, diazepam-pretreated pigs, the compression lasted 30 minutes; during that period the blood pressure increased 50/38 mm Hg over the baseline. In chloralose-anesthetized dogs, the compression was extended to 3 hours; the blood pressure increase was 44/53 mm Hg. Blood pressure fell to the baseline immediately after decompression in both animals. In both species the substantial blood pressure increase was due to an increase of vascular resistance; this did not induced the expected baroreceptor-mediated bradycardia. In dogs, the blood pressure increase was accompanied by a large increase of plasma norepinephrine (from 179 to 975 pg/ml). To test whether the increase of vascular resistance reflected the mechanical compression of the vessels under the suit, animals were pretreated with trimethaphan. In pigs the trimethaphan substantially decreased the vascular resistance and the blood pressure response. This indicated that a portion of the vasoconstriction occurred in areas outside the suit. Lower body compression is a new model to cause prolonged blood pressure elevation by noninvasive and nonpharmacologic means. The mechanism of the blood pressure elevation requires further investigation.

Abdomen↗

PubMed1994

Venous velocity increase with a pneumatic foot compression garment.

Intermittent compression garments have been widely accepted for prophylaxis of deep venous thrombosis. They have broad applicability in both elective and emergent situations. Development of a new type of garment that acts to compress the plantar plexus of the foot provides a potential method of prophylaxis for patients with contraindications to the traditional calf- or thigh-high garments. Evaluation of the ability of the foot compression garment demonstrates a statistically significant increase in peak femoral venous velocity (40.6 cm/sec) as compared with the resting state (25.9 cm/sec). This increase in femoral venous velocity is comparable to that seen with single-cell compression socks. The authors conclude that the recently introduced foot garment produces increases in peak femoral venous velocity similar to those produced by existing garments and that use of the foot compression garment may provide deep venous thrombosis prophylaxis in patients who previously have not been candidates for a compression garment.

Bandages↗

PubMed1990

Effects of lateral manual compression upon glottic incompetence: objective evaluations.

Forceful manual compression of the thyroid and cricoid cartilages modifies the position, shape, and tension of the vocal folds. This is the basis of the four laryngeal manual compression tests, adjunctive examinations used as a means of preoperative assessment of patients for medialization laryngoplasty, ie, Isshiki thyroplasty types I and IV and arytenoid adduction. The laryngeal manual compression tests are simple to perform and noninvasive. Each of the four examinations yields valuable information on the effects on the voice of changes in vocal cord characteristics produced by manual compression. In this report, one of the four tests, lateral manual compression, is evaluated objectively with well-attested methods of videostroboscopic, aerodynamic, and acoustic analysis. The technique of performing lateral manual compression is described, and advantages and disadvantages are noted and compared in 10 patients. Preliminary findings in 4 patients in this group indicate that medialization laryngoplasty should be considered when test results are conclusive of effective glottic closure. Data derived in this preliminary study will be augmented as patients are added to the series.

Adult↗

PubMed2003

Minimally displaced intra-capsular femoral neck fractures in the elderly--comparison of multiple threaded pins and sliding compression screws surgical techniques.

PURPOSE: To determine the outcome of treatment for minimally displaced femoral neck fractures using multiple threaded pins versus sliding compression screws for internal fixation. METHODS: The medical records of 62 consecutive elderly patients with minimally displaced intra-capsular femoral neck fractures who underwent internal fixation of the fracture (37 with multiple threaded pins, and 25 with sliding compression screws) were reviewed. Clinical and radiological assessment of fracture healing at follow-up visits were noted. RESULTS: In the 55 patients seen for follow-up at 3 months, 21.9% (n=7) of those treated by pinning demonstrated non-union of the fracture, and 0% of fractures treated with sliding compression screws (p=0.02). 46 patients were seen for follow-up at one year, with 10% (n=2) of those treated with sliding compression screws found to have osteonecrosis of the femoral head. The 2 fractures in the group treated by pinning demonstrating non-union at 3 months failed to unite by one year (p=0.11). 34 patients were seen for follow-up for at least 2 years, with no additional complications noted. CONCLUSION: Using sliding compression screws to treat minimally displaced femoral neck fractures can achieve a higher union rate than using pinning. The reason may be the better stability in the osteoporotic bone. However, osteonecrosis of the femoral head may occur with use of sliding compression screws because of greater intramedullary vascular damage as a result of wider reaming.

Aged↗

PubMed2001

Dynamic compression nail: a preliminary report.

BACKGROUND: Interlocking nailing, which has become the method of choice for treating fractures of the femoral and tibial shafts, still lacks ability to provide the important contact-compression at the fracture. An intramedullary compression nail is described, which provides axial compression at the fracture site with tightening of the specially designed distal interlocking screw. This uses the same principle as dynamic compression plating. METHODS: The study included 11 femoral and tibial nailings performed for various clinical applications such as acute fractures, non-unions and malunions. RESULTS: All the fractures attained radiological union, with good skeletal continuity across the fracture, within an average time of 13 weeks in fresh fractures and 18 weeks in non-unions. CONCLUSIONS: Active compression through intramedullary compression nailing has great utility for treating non-unions where it provides greater degree of impaction of its irregular ends. This may prove greatly advantageous to the fracture union through increased stability and the osteogenic potential, particularly when utilized in combination with the small diameter unreamed nails.

Journal Article↗

PubMed2006

Mining, compressing and classifying with extensible motifs.

BACKGROUND: Motif patterns of maximal saturation emerged originally in contexts of pattern discovery in biomolecular sequences and have recently proven a valuable notion also in the design of data compression schemes. Informally, a motif is a string of intermittently solid and wild characters that recurs more or less frequently in an input sequence or family of sequences. Motif discovery techniques and tools tend to be computationally imposing, however, special classes of "rigid" motifs have been identified of which the discovery is affordable in low polynomial time. RESULTS: In the present work, "extensible" motifs are considered such that each sequence of gaps comes endowed with some elasticity, whereby the same pattern may be stretched to fit segments of the source that match all the solid characters but are otherwise of different lengths. A few applications of this notion are then described. In applications of data compression by textual substitution, extensible motifs are seen to bring savings on the size of the codebook, and hence to improve compression. In germane contexts, in which compressibility is used in its dual role as a basis for structural inference and classification, extensible motifs are seen to support unsupervised classification and phylogeny reconstruction. CONCLUSION: Off-line compression based on extensible motifs can be used advantageously to compress and classify biological sequences.

Journal Article↗