scholarly journals Asymmetric TCD Findings in Malignant MCA Infarction, Resolution after Decompressive Hemicraniectomy: A Case Report

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 127-136
Author(s):  
Hazel Gaile  Barrozo ◽  
Maria Anna De Guzman ◽  
Jose  Navarro ◽  
Narayanaswamy Venketasubramanian
Keyword(s):  
Pressure Effects ◽  
Mean Flow ◽  
Brain Swelling ◽  
Decompressive Hemicraniectomy ◽  
Non Invasive ◽  
Invasive Method ◽  
Malignant Mca Infarction ◽  
Subsequent Rise ◽  
Very High ◽  
Hemispheric Infarct

Transcranial Doppler (TCD) is a non-invasive method for assessing cerebral hemodynamics in the acute phase of stroke. We report a case of a 33-year-old man who presented with a massive left hemispheric infarct developing into “malignant” MCA infarction. TCD was utilized to monitor intracranial hemodynamics while the clinical and neuroimaging findings were used to help us in the decision to proceed with decompressive craniectomy (DC). Pre-operatively, there was reduced mean flow velocities (MFV) of the middle cerebral artery (MCA) with increasing pulsatility index (PI) ipsilateral to the infarct. The subsequent but smaller rise in the PI in the contralateral MCA was suggestive of very high intracranial pressure (ICP) from massive brain swelling. Serial TCD examinations post-operatively showed normalization of the PI, and subsequent rise in the left MCA MFV. Clinical improvement was also noted as the TCD findings improved. The asymmetry in TCD findings can be attributed to occlusion of the MCA with subsequent spontaneous recanalisation, occlusion of the MCA with subsequent recanalisation due to the DC, or initial occlusion and subsequent pressure effects on the arterioles of the MCA due to the “malignant” edema of that hemisphere that was relieved by DC. This case illustrates the value of TCD as a useful modality in monitoring intracranial hemodynamics in acute stroke.

Research of Pelvimetry Based on Electromagnetic Tracker

2011 ◽  
Vol 346 ◽  
pp. 607-614
Author(s):  
Yao Sheng Lu ◽  
Wen Bo Wang ◽  
Yao Xiong Huang
Keyword(s):  
Pregnant Women ◽  
High Accuracy ◽  
Line Of Sight ◽  
Measuring Error ◽  
Electromagnetic Tracking ◽  
Non Invasive ◽  
Invasive Method ◽  
Electromagnetic Tracker ◽  
Tracking Technology ◽  
Very High

Traditional pelvimetry for a pregnant women is mainly relied on a ruler or estimation based on the vaginal touch, which results a very high measuring error. A new pelvimetry based on electromagnetic tracker is proposed in this paper , and a measure system has been developed . It’s a non-invasive method to measure key parameters of a pelvis because of the character of high accuracy, without line-of-sight restrictions and non-radiation of electromagnetic tracking technology. Its precise measuring data can well fulfill clinical pelvimetry needs, and be helpful for a physician to make decisions to go on a vaginal delivery or not during a labor.

CAD diagnosis by predicting stenosis in arteries using data mining process

2021 ◽  
Vol 15 (1) ◽  
pp. 59-68
Author(s):  
Akansha Singh ◽  
Ashish Payal
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Non Invasive ◽  
The World ◽  
Improve Accuracy ◽  
Supervised Classifiers ◽  
Invasive Method ◽  
Artery Disease ◽  
Using Data ◽  
Very High

Coronary artery disease (CAD) is the most common cardiovascular disease, causing death all over the world. An invasive method, Angiography is used to diagnose this disease but it is very costly and has some side effects. Hence, non-invasive methods such as machine learning were being used for diagnosing CAD. One of the ways to detect the presence of CAD is to find out the stenotic artery. The proposed study has diagnosed whether the arteries are stenotic or not. This study aims to provide the best accuracy while balancing the dataset using a spreadsubsample filter. Data pre-processing and feature selection has been done on the dataset to improve accuracy. Different supervised classifiers were applied to the selected features. The highest accuracies for left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) obtained by Random Forest are 95.70%, 91.41%, and 94.38% respectively. Among all the arteries, LAD has the highest accuracy indicating that chances of a person having LAD as stenotic are very high.

Malfunctional Reorganization in the Developing Limbo-Prefrontal System in Animals: Implications for Human Psychoses?

2001 ◽  
Vol 12 (1) ◽  
pp. 8-14
Author(s):  
Gertraud Teuchert-Noodt ◽  
Ralf R. Dawirs
Keyword(s):  
Prefrontal Cortex ◽  
Mental Disorders ◽  
Dentate Gyrus ◽  
Cognitive Functions ◽  
Experimental Approach ◽  
Regulatory Mechanisms ◽  
Hippocampal Dentate Gyrus ◽  
Non Invasive ◽  
Invasive Method ◽  
Activity Dependent

Abstract: Neuroplasticity research in connection with mental disorders has recently bridged the gap between basic neurobiology and applied neuropsychology. A non-invasive method in the gerbil (Meriones unguiculus) - the restricted versus enriched breading and the systemically applied single methamphetamine dose - offers an experimental approach to investigate psychoses. Acts of intervening affirm an activity dependent malfunctional reorganization in the prefrontal cortex and in the hippocampal dentate gyrus and reveal the dopamine position as being critical for the disruption of interactions between the areas concerned. From the extent of plasticity effects the probability and risk of psycho-cognitive development may be derived. Advance may be expected from insights into regulatory mechanisms of neurogenesis in the hippocampal dentate gyrus which is obviously to meet the necessary requirements to promote psycho-cognitive functions/malfunctions via the limbo-prefrontal circuit.

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

scholarly journals Cerebral Hemodynamics and Intracranial Compliance Impairment in Critically Ill COVID-19 Patients: A Pilot Study

2021 ◽  
Vol 11 (7) ◽  
pp. 874
Author(s):  
Sérgio Brasil ◽  
Fabio Silvio Taccone ◽  
Sâmia Yasin Wahys ◽  
Bruno Martins Tomazini ◽  
Filippo Annoni ◽  
...  
Keyword(s):  
Critically Ill ◽  
Cerebral Arteries ◽  
Receiver Operating Curve ◽  
Severe Illness ◽  
Mean Flow ◽  
Non Invasive ◽  
Intracranial Compliance ◽  
Middle Cerebral Arteries ◽  
Primary Composite Outcome ◽  
Cerebrovascular Hemodynamics

Introduction: One of the possible mechanisms by which the new coronavirus (SARS-Cov2) could induce brain damage is the impairment of cerebrovascular hemodynamics (CVH) and intracranial compliance (ICC) due to the elevation of intracranial pressure (ICP). The main objective of this study was to assess the presence of CVH and ICC alterations in patients with COVID-19 and evaluate their association with short-term clinical outcomes. Methods: Fifty consecutive critically ill COVID-19 patients were studied with transcranial Doppler (TCD) and non-invasive monitoring of ICC. Subjects were included upon ICU admission; CVH was evaluated using mean flow velocities in the middle cerebral arteries (mCBFV), pulsatility index (PI), and estimated cerebral perfusion pressure (eCPP), while ICC was assessed by using the P2/P1 ratio of the non-invasive ICP curve. A CVH/ICC score was computed using all these variables. The primary composite outcome was unsuccessful in weaning from respiratory support or death on day 7 (defined as UO). Results: At the first assessment (n = 50), only the P2/P1 ratio (median 1.20 [IQRs 1.00–1.28] vs. 1.00 [0.88–1.16]; p = 0.03) and eICP (14 [11–25] vs. 11 [7–15] mmHg; p = 0.01) were significantly higher among patients with an unfavorable outcome (UO) than others. Patients with UO had a significantly higher CVH/ICC score (9 [8–12] vs. 6 [5–7]; p < 0.001) than those with a favorable outcome; the area under the receiver operating curve (AUROC) for CVH/ICC score to predict UO was 0.86 (95% CIs 0.75–0.97); a score > 8.5 had 63 (46–77)% sensitivity and 87 (62–97)% specificity to predict UO. For those patients undergoing a second assessment (n = 29), after a median of 11 (5–31) days, all measured variables were similar between the two time-points. No differences in the measured variables between ICU non-survivors (n = 30) and survivors were observed. Conclusions: ICC impairment and CVH disturbances are often present in COVID-19 severe illness and could accurately predict an early poor outcome.

CEUS detection of biliary ischaemia during the first 4 weeks after liver transplantation predicts non-anastomotic biliary stricture

2021 ◽  
pp. 1-12
Author(s):  
Bo-wen Zheng ◽  
Shu-hong Yi ◽  
Tao Wu ◽  
Mei Liao ◽  
Ying-cai Zhang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Predictive Value ◽  
Biliary Stricture ◽  
Characteristic Curve ◽  
Validation Group ◽  
Gamma Glutamyl Transpeptidase ◽  
Full Cohort ◽  
Non Invasive ◽  
Invasive Method ◽  
Nas Score

BACKGROUND: Biliary ischaemia is an important factor in the pathogenesis of non-anastomotic biliary stricture (NAS) after liver transplantation (LT). Contrast-enhanced ultrasound (CEUS) can be used to detect biliary ischaemia, but no study has examined the utility of CEUS in predicting NAS. OBJECTIVE: To evaluate whether repeated CEUS as a non-invasive method of biliary ischaemia can identify NAS. METHODS: Consecutive LT patients who underwent CEUS examinations at 1–4 weeks after LT from September 2012 to December 2015 at our institution were included. The CEUS images and clinical data were analysed. RESULTS: Among 116 eligible LT patients, 39 (33.6%) were diagnosed with NAS within 1 year after LT. The patients with NAS had a significantly higher CEUS score at weeks 2–4 (all P <  0.05) and a higher slope of CEUS score progression (0.480 vs –0.044, P <  0.001). The accuracy of CEUS in identifying NAS improved over time after LT, reaching its maximum at week 4, with a sensitivity of 66.7%, a specificity of 87.9%, a positive predictive value (PPV) of 75.9%, a negative predictive value (NPV) of 82.3%, and an accuracy of 80.2%in the full cohort when a CEUS score≥3 was used as the cut-off. Multivariate analysis identified gamma-glutamyl transpeptidase (GGT), alanine transaminase (ALT) and the CEUS score at week 4 as independent predictors of NAS. In the task of identifying NAS, an NAS score combining the above 3 variables at week 4 showed areas under the receiver operating characteristic curve of 0.88 (95%CI, 0.78–0.99) in the estimation group (n = 60) and 0.82 (95%CI, 0.69–0.96) in the validation group (n = 56). An NAS score cut-off of 0.396 identified 87.2%of NAS cases in the estimation group, with a PPV of 93.3%; and 75.0%of NAS cases in the validation group, with a PPV of 58.8%. CONCLUSIONS: CEUS examination during the first 4 weeks is useful in assessing the risk of NAS within 1 year after LT. In particular, an NAS score combining the CEUS score, GGT level, and ALT level at week 4 can be used to accurately predict the risk of NAS in LT patients.

scholarly journals Monitoring New Long-Lasting Intravitreal Formulation for Glaucoma with Vitreous Images Using Optical Coherence Tomography

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 217
Author(s):  
Maria Jesus Rodrigo ◽  
Amaya Pérez del Palomar ◽  
Alberto Montolío ◽  
Silvia Mendez-Martinez ◽  
Manuel Subias ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Relative Intensity ◽  
Therapeutic Option ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Aggregate Size ◽  
Daily Practice ◽  
Optical Coherence ◽  
Non Invasive ◽  
Invasive Method

Intravitreal injection is the gold standard therapeutic option for posterior segment pathologies, and long-lasting release is necessary to avoid reinjections. There is no effective intravitreal treatment for glaucoma or other optic neuropathies in daily practice, nor is there a non-invasive method to monitor drug levels in the vitreous. Here we show that a glaucoma treatment combining a hypotensive and neuroprotective intravitreal formulation (IF) of brimonidine–Laponite (BRI/LAP) can be monitored non-invasively using vitreoretinal interface imaging captured with optical coherence tomography (OCT) over 24 weeks of follow-up. Qualitative and quantitative characterisation was achieved by analysing the changes in vitreous (VIT) signal intensity, expressed as a ratio of retinal pigment epithelium (RPE) intensity. Vitreous hyperreflective aggregates mixed in the vitreous and tended to settle on the retinal surface. Relative intensity and aggregate size progressively decreased over 24 weeks in treated rat eyes as the BRI/LAP IF degraded. VIT/RPE relative intensity and total aggregate area correlated with brimonidine levels measured in the eye. The OCT-derived VIT/RPE relative intensity may be a useful and objective marker for non-invasive monitoring of BRI/LAP IF.

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