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PubMed1999

Intra- and interoperator variations in region-of-interest drawing and their effect on the measurement of glomerular filtration rates.

PURPOSE: Quantitative results are often obtained from images after drawing regions of interest (ROIs) about the organ or area being evaluated. The accuracy and reproducibility of ROIs is an important aspect of quality-control protocols. Attempts to increase ROI accuracy and precision by generating them automatically must be compared with manually processed images to evaluate the success of the automatic methods. Operators' abilities to reproduce ROIs and the effect this has on the reproducibility of estimating glomerular filtration rate from renograms were assessed. METHODS: Estimation of the glomerular filtration rate using Sampson's method requires a) exclusion ROIs around both kidneys for background subtraction, b) whole-kidney ROIs, and c) exclusion ROIs for the collecting system. Two nuclear medicine professionals were asked to produce glomerular filtration rate estimates for 20 patients with diverse renal function. This was repeated 1 month later. The intra- and interoperator variations were calculated for the glomerular filtration rate results and on a pixel basis for the ROIs. RESULTS: THE percentage of common pixels, on average, for a) intraoperator repeats and b) interoperator comparisons were a) 95%, 94%, 85%, and b) 94%, 93%, and 81% for region types 1, 2, and, 3, respectively. Analysis of variance for the glomerular filtration rate estimates showed significant variations in estimates for left kidneys (P < 0.025) but none (P > 0.1) for right kidneys. CONCLUSION: Spatial reproducibility in ROI drawing does not necessarily relate directly to the associated quantitative reproducibility.

Glomerular Filtration Rate↗
PubMed2005

Nerve fiber layer measurement using scanning laser polarimetry with fixed corneal compensator in normal cynomolgus monkey eyes.

PURPOSE: The purpose of this study was to examine retinal nerve fiber layer thickness in normal cynomolgus monkeys using a scanning laser polarimeter with a fixed corneal compensator (GDx FCC), and to clarify the reproducibility and symmetries (right-left differences) between both eyes for the GDx parameters. METHODS: GDx parameters were measured in 36 normal eyes of 18 cynomolgus monkeys aged 4.0-5.5 years. The retardation values (thickness parameters) at peripapillary and macular areas obtained from the GDx FCC were measured and calculated thickness, ratio, and modulation parameters in the superior and inferior quadrants. Mean and standard deviation (SD), coefficient of variation (CV), and binocular differences were obtained for each parameter from three independent measurements made during a 1-week period. Correlation between both eyes in macular retardation and baseline values, which indicated the combined minimum retardation values for the nasal and temporal quadrants, and between macular retardation and baseline values were analyzed. RESULTS: The intraocular pressure values (mean +/- SD, n = 18) obtained for the right and left eyes were 20.7 +/- 3.8 and 20.0 +/- 3.2 mm Hg, respectively (no significant differences in both eyes). No significant differences between right and left eyes were detected for any GDx parameters. All parameters showed small right-left differences. The CVs (SD/mean x 100) for all parameters were less than 10%. Highly significant correlations were seen between bilateral eyes for macular retardation (r = 0.936, p < 0.0001) or baseline values (r = 0.946, p < 0.0001). A significant correlation (r = 0.883, p < 0.0001) was also seen between macular retardation and baseline values. CONCLUSIONS: Considering individual differences in corneal birefringence, GDx parameters obtained from a GDx FCC may be useful for the objective evaluation of time-related changes in individual eyes or for binocular comparisons in cynomolgus monkeys.

Animals↗
PubMed1999

Dichotic listening in patients with situs inversus: brain asymmetry and situs asymmetry.

In order to investigate the relation between situs asymmetry and functional asymmetry of the human brain, a consonant-vowel syllable dichotic listening test known as the Standard Dichotic Listening Test (SDLT) was administered to nine subjects with situs inversus (SI) that ranged in age from 6 to 46 years old (mean of 21.8 years old, S.D. = 15.6); the four males and five females all exhibited strong right-handedness. The SDLT was also used to study twenty four age-matched normal subjects that were from 6 to 48 years old (mean 21.7 years old, S.D. = 15.3); the twelve males and twelve females were all strongly right-handed and served as a control group. Eight out of the nine subjects (88.9%) with SI more often reproduced the sounds from the right ear than sounds from the left ear; this is called right ear advantage (REA). The ratio of REA in the control group was almost the same, i.e., nineteen out of the twenty-four subjects (79.1%) showed REA. Results of the present study suggest that the left-right reversal in situs inversus does not involve functional asymmetry of the brain. As such, the system that produces functional asymmetry in the human brain must independently recognize laterality from situs asymmetry.

Adolescent↗
PubMed1999

Development of a new mouse brain tumor model using implantable micro-cannulas.

The objective of this study was to develop a brain tumor model in a mouse where gene therapy could be delivered either directly into a pre-established tumor bed or prophylacticly prior to tumor delivery (protective treatment). Micro-cannulas were constructed from metal tubing, implanted into the right frontal lobe of mice, and then secured in place in the skull with cement. Experiments evaluating the usefulness, reproducibility and morbidity of the system were performed. It was found that tumor cells could reproducibly be delivered into the right frontal lobe of the mice. Two tumors could be precisely delivered into the same area following injections at different times. Repeat injections were performed without a stereotaxic frame and without the need for repeat intracerebral needle tracts. There were no noticeable side effects of maintaining the cannulas in place for long periods of time. In summary, this system is useful for studying the effects of various treatment strategies on established brain tumors in a mouse model which more closely simulates the clinical situation. It obviates the need for time consuming stereotaxic procedures or repeat invasive intracerebral injections.

Animals↗
PubMed1995

Recall of self-generated arm movements by patients with unilateral cortical excisions.

In previous work, Leonard and Milner (Neuropsychologia, 29, 47-58, 1991) demonstrated that patients with large excisions from the right frontal lobe have difficulty in reproducing accurately the extent of examiner-defined arm movements, the displacements being made without the aid of vision. The impairment in the right frontal-lobe group was not dependent on recall-condition, being apparent irrespective of the presence of a delay, suggesting that the deficit was primarily one of encoding. We then went on to show that these same patients have a short-term memory deficit when recalling terminal position of examiner-defined arm movements (Neuropsychologia 29, 629-640, 1991). From these investigations we concluded that the right frontal lobe is critically involved in the monitoring of information related to movement. In the present study 58 patients with unilateral temporal- or frontal-lobe excisions were tested on two kinesthetic tasks that required the subjects themselves to select terminal positions, or movement extents, thereby reducing dependence on peripheral feedback. Patients with right frontal-lobe lesions could reproduce these self-generated movements normally, indicating that when demands on feedback are reduced the frontal-lobe contribution is not critical.

Adolescent↗
PubMedDate not supplied

Echocardiographic contrast imaging of the human right heart: a multicenter study of the efficacy, safety, and reproducibility of intravenous SHU-454.

The contrast agent SHU-454 was intravenously injected in 103 patients during echocardiography: 37 mL/patient +/- 7 ml/patient. The quality of the contrast effect was optimal in 13, good in 51, sufficient in 30, and poor in 9 patients; reproducibility was optimal in 38, good in 46, sufficient in 17, and poor in 2 patients. Taste sensation, arm discomfort, or atypical chest pain occurred in 5 patients, premature ventricular contractions in 3. An isolated anginal attack occurred in 1 patient with frequent episodes at rest. A slight reduction in hematologic indices was attributed to hemodilution. Thus, SHU-454 produces a good and reproducible contrast effect with tolerable side effects.

Contrast Media↗
PubMed1995

Phrenic nerve conduction study in normal subjects.

Phrenic nerve conduction studies were performed in 50 phrenic nerves from 25 normal subjects using a technique modified from previously described methods. The normal ranges for latency, amplitude, negative peak area, and duration were established. The latency correlates with age and the amplitude increases with chest circumference. With our method, the amplitude increases and the duration decreases with lung volume. We found good right-left agreement and reproducibility. Therefore, the unaffected side can be used as a reference in unilateral phrenic nerve lesions and previous studies can be used for comparison in serial studies. We recommend that phrenic nerve conduction studies be used routinely to diagnose and monitor patients with respiratory involvement from neuromuscular diseases.

Action Potentials↗
PubMed1988

Termination of sustained ventricular tachycardia by external noninvasive pacing.

Cardiac pacing has proven useful in the termination of sustained ventricular tachycardia (VT). In this study, the effectiveness of external noninvasive temporary pacing was compared with traditional endocardial burst ventricular pacing for the termination of sustained and hemodynamically stable VT. In 14 patients, 16 VT morphologies induced by programmed right ventricular extrastimulation were reproducibly terminated by endocardial burst pacing (3 to 9 complexes). VT cycle lengths averaged 392 +/- 97 ms (standard deviation) and ranged from 300 to 690 ms. The endocardial burst pacing cycle length used to terminate VT averaged 298 +/- 93 ms (range 220 to 600 ms). External burst pacing terminated 14 of 16 VT morphologies (88%). The pacing cycle length used to terminate these 14 VTs averaged 282 +/- 44 ms. The number of ventricular captures ranged from 5 to 20 beats. Failure to terminate 2 VT morphologies probably represented a failure of the device to capture the ventricle. Acceleration of VT occurred in 1 patient with burst external noninvasive pacing. These observations suggest that external burst pacing may be an effective means of terminating sustained VT in some patients.

Aged↗
PubMed1989

Role of antitachycardia devices in the treatment of ventricular tachyarrhythmias.

Chronic recurrent ventricular tachycardia (VT) can be terminated reproducibly by programmed endocardial right ventricular stimulation. However, antitachycardia pacing is associated with possible acceleration of VT, while frequent occurrence of VT and discomfort of the patient can limit treatment with an automatic implantable cardioverter/defibrillator (AICD; Cardiac Pacemakers Inc.). The combined use of antitachycardia pacing (Tachylog pacemaker; Siemens-Elema) and AICD was therefore evaluated in 6 of 35 patients (aged 50 to 70 years, mean 60.1 +/- 7.7) in whom AICD had been implanted because of VT, which could be terminated by temporary overdrive pacing. With the interactive mode of the Tachylog, termination of VT by the pacemaker as well as by the AICD was assessed after implantation. In the automatic mode, the Tachylog functioned as a bipolar ventricular inhibited (VVI) device with antitachycardia burst stimulation: 2 to 5 stimuli, interval 260 to 300 ms, 1 to 2 interventions. During follow-up of 32 +/- 17 months, the Tachylog terminated VT reliably 50 to 505 times per patient. When burst stimulation accelerated VT, termination was achieved by AICD discharge. Thus, drug-resistant VT can be terminated by antitachycardia pacing avoiding patient discomfort. In case of acceleration, VT can be controlled by the AICD. A universal pacemaker should combine antibradycardia and antitachycardia pacing with backup cardioversion/defibrillation mode.

Electric Countershock↗
PubMed1997

Length representation in normal and neglect subjects with opposite reading habits studied through a line extension task.

In the first part of this paper, 45 French (left-to-right readers) and 30 Israeli (right-to-left readers) normal dextrals were given half a line and requested to construct the missing other with the same length (either the left one or the right one). Using this line extension task, a significant effect of reading habits on the performance was found, with no significant bias for Israeli subjects, and a significant underconstruction when building the left half from the right one for French subjects. In the second part, two patients with opposite reading habits (one French, one Israeli) suffering from left unilateral neglect were submitted to the same protocol. Both patients were found to under-construct the right half of the line from the left given half, and to over-construct the left half from the right given one, hence reproducing the well-known line bisection bias. Results are discussed with regard to enhancement and activation hypotheses, and current theories of the neglect syndrome.

Adult↗
PubMed2000

Physiologic decrease of single thenar motor units in the F-response in stroke patients.

OBJECTIVE: To investigate the left-right difference and the reproducibility by the F-wave motor unit number estimation and to compare the motor unit number between the hemiplegic and unaffected side in stroke patients. SETTING: A referral center and institutional practice providing outpatient care. SUBJECTS: Seven healthy volunteers and 15 consecutive stroke patients. DESIGN: Diagnostic statistical test and correlational study. METHOD: Submaximal stimuli were used to evoke a sample of surface motor unit action potentials (S-MUAPs) in the F-waves that are entirely representative of the relative numbers of detected S-MUAPs of different sizes. The average S-MUAP amplitude was calculated from a selected population of F-wave responses for each abductor pollicis brevis (APB) muscle. The motor unit number was calculated by dividing the maximum M-potential negative peak amplitude by the average S-MUAP negative peak amplitude. RESULT: There was no statistical difference between motor unit numbers on either side and between test and retest in this motor unit number estimation method among normal subjects. The motor unit number on the hemiplegic side was significantly lower than on the unaffected side (p < .05, Mann-Whitney test) among stroke patients. CONCLUSION: The motor unit could decrease in the hemiplegic side after a moderate-to-severe hemiplegic stroke and this decrement might be due to the transsynaptic degeneration secondary to an upper motor neuron lesion.

Action Potentials↗
PubMed1983

An application of the background interference procedure to the Benton Visual Retention Test.

This study involved applying Canter's Background Interference Procedure to the Benton Visual Retention Test. In a heterogeneous sample of psychiatric and brain-damaged patients, it was found that brain-damaged patients reproduced fewer designs and made more errors in reproducing those designs than did psychiatric patients. Right-hemisphere and diffusely brain-damaged patients reproduced fewer designs correctly and made more errors than did left-hemisphere damaged patients. This pattern was maintained when the effects of level of intellectual functioning and age were statistically controlled. These results suggest that the Background Interference Procedure in conjunction with the Benton Visual Retention Test may make a contribution to the assessment of brain-injured patients.

Adult↗
PubMed1994

The chief nurse executive and intellectual property law. Selected concerns.

At first, consideration of intellectual property law may seem a remote concern. However, CNEs have developed and led the advent of innovative work redesigns, unique measurement instruments, patient care documentation tools, and other administrative research and teaching originations. Consider intellectual property ownership and the rights to use or reproduce that "property" as soon as possible to avoid misunderstandings and potential infringements.

Commerce↗
PubMed2000

Ventricular tachycardia in a patient with primary hyperparathyroidism.

We present a case of primary hyperparathyroidism with hypercalcemia in a patient who had spontaneous attacks of ventricular tachycardia. Right ventricular burst pacing reproducibly induced ventricular tachycardia in the electrophysiological laboratory after intravenous administration of calcium-gluconate, and verapamil could terminate the tachycardia. After resection of the parathyroid adenoma, the calcium level was restored to normal, and ventricular tachycardia did not occur again during the follow-up period.

Adenoma↗
PubMed2004

A pilot study of physiotherapy education using videoconferencing.

We investigated the possibility of instructing people in how to assist patients with activities of daily living via videoconferencing. A videoconference system was installed in two rooms to simulate a connection between a home and an institution. The subjects were five first-year university students. First, they saw a video-tape on several general assistance procedures to help a patient with sitting up, standing up and walking with a cane. Then they assisted a simulated patient who reproduced the effects of right hemiplegia due to a stroke. They also received instructions from a physiotherapist in another room using the videoconference system. The students experienced most difficulty in assisting the patient to stand up from sitting with legs stretched in a tatami room. Their mean score in the first session for this was 34.5 points out of 45, and this increased to 38.5 in a second session, after a question and answer period. The present study shows that the delivery of rehabilitation services is feasible in remote places.

Activities of Daily Living↗
PubMed1985

[Prevention of reciprocal tachycardia by programmed electrostimulation].

10 patients with an accessory atrioventricular pathway were studied by means of programmed electrical stimulation to test the feasibility of tachycardia prevention with an extrastimulus delivered after the tachycardia-initiating beat. Reciprocating atrioventricular tachycardia was reproducibly initiated from high right atrium in all 10 patients with a single extrastimulus. A second extrastimulus delivered to the same site resulted in prevention of tachycardia in all patients, when this extrastimulus was given within a "preventive zone" which started 10 ms after the effective atrial refractory period of the tachycardia initiating beat. The average width of the preventive zone was 50 ms in our patients, independent of the initial tachycardia interval or tachycardia cycle length. Tachycardia prevention was always successful with a single atrial extrastimulus, whereas termination of an ongoing tachycardia required at least two atrial or ventricular extrastimuli.

Adolescent↗
PubMed1989

In vitro study on mechanisms of bupivacaine-induced depression of myocardial contractility.

Although several mechanisms have been proposed to explain bupivacaine cardiotoxicity, the predominant effect remains to be determined. In this study, we used an isolated rabbit right atrial model that reproduces the effects on inotropic and chronotropic functions induced by 0.5 micrograms/mL bupivacaine; then we tried to counteract these events by electrical stimulation or by addition of CaCl2 or adenosine triphosphate (ATP) to the bathing solution. Contractile force was dramatically depressed by bupivacaine alone (-68%), even when the preparation was paced (-59%). CaCl2 partially counteracted this decrease (-37%). Inotropic function was almost completely restored (-9%) when ATP was added before administration of bupivacaine. Inhibition of energy metabolism seems to be a major explanation for bupivacaine cardiotoxicity.

Adenosine Triphosphate↗