Electrocardiographic abnormalities associated with raised intracranial pressure.
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Serial electrocardiographic (E.C.G.) recordings were taken in seven patients suffering from intracranial conditions, for which their intracranial pressure was directly and continuously monitored with a Konigsberg extradural transducer. The E.C.G. changes observed in patients with raised intracranial pressure were prominent U waves, ST-T segment changes, notched T waves, and shortening and prolongation of Q-T intervals. Two patients with normal intracranial pressure showed no E.C.G. abnormalities but also establish a relationship between E.C.G. abnormalities and changing intracranial pressure. (+info)
Experience with fetal monitoring in a university teaching hospital.
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Fetal monitoring during labour may be expected to decrease perinatal losses and the number of infants born with brain damage. In a prospective study of intrapartum fetal monitoring in selected high-risk pregnancies in a Winnipeg hospital the monitoring rate was 26.5% and the cesarean section rate in the monitored group was 22.0%. The fetal outcome in the monitored group was better than in the unmonitored group. The establishment of a fetal intensive care unit is believed to be strongly desirable in improving fetal surveillance during labour. Fetal monitors should be stationed in the delivery room as well as in the first-stage room. (+info)
Physical properties of experimental vitreous membranes. I. Tensile strength.
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The tensile strength of vitreous membranes, induced by silk sutures imbedded in the vitreous body and removed one to two weeks later, was investigated in rabbits. Three types of membranes were distinguished by their appearance under an operating microscope; dense, opaque, cylindrical membranes, (Type 1), broken with 2 to 16 Gm. of force and elongated from 127 to 200 per cent before breaking; thin, cylindrical membranes, (Type 2), broken with 200 mg. to 2 Gm. of force and elongated from 51 to 152 per cent before breaking; and thin film-like membranes imbedded in formed vitreous gel, (Type 3), broken with 200 mg. to 5.5 Gm. of force and elongated from 53 to 186 per cent before breaking. Vitreous membranes formed two to eight weeks after surgery resisted forces greater than those required to detach rabbit retina. The results of the experiment are relevant in the design of vitrectomy instruments. (+info)
Porcine malignant hyperthermia: effects of temperature and extracellular calcium concentration on halothane-induced contracture of susceptible skeletal muscle.
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Skeletal muscle from malignant hyperthermic (MH) pigs incubated at 37 C in 2.3 mM calcium-Krebs-Ringer solution contracts spontaneously when exposed to halothane. In contrast, halothane did not induce contracture in MH muscle incubated in 2.3 mM calcium-Krebs-Ringer solution at 25 C or in calcium-free Krebs-Ringer's solution at 37 C. Halothane did not induce contracture in normal control muscle in 2.3 mM Krebs-Ringer solution at 25 or 37 C. In the presence of halothane, addition of caffeine produced greater contracture in MH muscle than in normal controls. Halothane-caffeine-induced contractures of MH and control muscles at 25 and 37 C were similar. Elucidation that under certain experimental conditions halothane induces contracture in MH muscle, but not in normal muscle 1) may aid in development of a diagnostic test; 2) establishes further evidence for skeletal muscle as the target tissue for anesthetic-induced MH; 3) suggests that halothane may affect systems that regulate sarcoplasmic calcium concentration below contracture threshold in MH muscle. (Key words: Hyperthermia, malignant; Anesthetics, volatile, halothane; Ions, calcium; Muscle, skeletal, malignant hyperthermia.). (+info)
Relationships between voltage and tension in sheep cardiac Purkinje fibers.
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The two-microelectrode technique of voltage clamping sheep cardiac Purkinje fibers was used to examine the changes in contraction which occur during trains of voltage clamps. (A "train" is defined as a series of voltage clamps delivered at a particular rate, beginning after a rest long enough that the effects of previous stimulation have died away.) Contractions showed striking staircases, or progressive changes in peak isometric tension, during trains. Short clamps, clamps to voltages more negative than --20 or --30 mV, or holding potentials less negative than the resting potential favored negative staircases, while long clamps, clamps to positive voltages, and holding potentials near the resting potential each favored positive staircases. The staircase behavior appeared to be due to changes in the initial rate of recovery of the ability to contract. The changes in staircase behavior as a function of clamp voltage suggested that the relationship between peak tension and clamp voltage should depend on the experimental design. When the steady-state contraction was plotted as a function of clamp voltage, voltage-tension relations like those recently reported for working ventricle were obtained, with a threshold between --30 and --40 mV and a steep relation between tension and voltage. When the first contraction after a rest was plotted, the threshold voltage was more negative, the curve was flatter, and the peak tensions at inside positive voltages were reduced. (+info)
Fetal monitoring during maternal cardiac surgery with cardiopulmonary bypass.
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Fetal cardiac activity was monitored with an external ultrasound transducer in two patients with clinical class III heart disease due to severe mitral stenosis complicated by pulmonary hypertension, undergoing open heart surgery with cardiopulmonary bypass in the 2nd trimester of pregnancy. Fetal distress was detected in one patient, who had mitral valvuloplasty, and was corrected by increasing the rate of blood flow, and the other patient had a mitral valve replacement but no fetal distress was noted. The postoperative course of both mothers and fetuses was uneventful. (+info)
Correlation between high frequency intravascular ultrasound and histomorphology in human coronary arteries.
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OBJECTIVE: To test the efficacy of high frequency intravascular ultrasound (IVUS) transducers in identifying lipid/necrotic pools in atherosclerotic plaques. METHODS: 40 MHz transducers were used for in vitro IVUS assessment of 12 arterial segments (10 coronary and two carotid arteries, dissected from five different necropsy cases). IVUS acquisition was performed at 0.5 mm/s after ligature of the branching points to generate a closed system. Lipid/necrotic areas were defined by IVUS as large echolucent intraplaque areas surrounded by tissue with higher echodensity. To obtain histopathological sections corresponding to IVUS cross sections, vessels were divided into consecutive 3 mm long segments using the most distal recorded IVUS image as the starting reference. Samples were then fixed with 10% buffered formalin, processed for histopathological study, serially cut, and stained using the Movat pentacrome method. RESULTS: 122 sections were analysed. Lipid pools were observed by histology in 30 sections (25%). IVUS revealed the presence of lipid pools in 19 of these sections (16%; sensitivity 65%, specificity 95%). CONCLUSIONS: In vitro assessment of lipid/necrotic pools with high frequency transducers was achieved with good accuracy. This opens new perspectives for future IVUS characterisation of atherosclerotic plaques. (+info)
Novel method for assessing myocardial perfusion: visualization and measurement of intramyocardial coronary blood flow in the entire left ventricular wall using contrast enhanced, high frequency Doppler echocardiography.
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Using a high frequency ultrasonic transducer, intramyocardial coronary blood flow (IM-CBF) can be visualized and evaluated during hemodynamic changes in the anterior wall and septum of the left ventricle (LV). We tested the hypothesis that detection and quantitative measurement of IM-CBF of entire LV segments are feasible using a high frequency ultrasonic transducer in conjunction with intravenous contrast injection in vivo. A 3 - 8 MHz transducer was used to image and measure IM-CBF in 10 anesthetized dogs. We obtained a color Doppler image of IM-CBF in the LV short-axis view after intravenous Levovist injection (25 mg/ml). The IM-CBF velocity was recorded using spectral Doppler in the antero-septal and infero-posterior wall of closed chest dogs and in the entire LV after opening the chest. A significant increase in IM-CBF velocity was observed in all LV regions after adenosine 5'- triphosphate (ATP) administration. After Levovist(TM) injection, the visualization of IM-CBF was improved and the spectral Doppler pattern of coronary flow velocity was clarified compared to baseline. IM-CBF was assessed in the antero-septal region of the LV before and after left anterior descending coronary artery occlusion. A high frequency ultrasonic transducer in conjunction with intravenous contrast injection improved IM-CBF visualization, enabling quantitative evaluation of the intramyocardial coronary circulation in the entire LV after coronary occlusion and hyperemia. This study may represent a step towards noninvasive assessment of myocardial perfusion before and after coronary reperfusion. (+info)