4 research outputs found
Measurement of sacroiliac joint stiffness with color Doppler imaging and the importance of asymmetric stiffness in sacroliac pathology
Aerosol delivery from spacers in wheezy infants: a daily life study
The aims of this study were to assess and compare dose delivery and dose
variability of pressurized metered dose inhalers (pMDI)/spacers in wheezy
infants in daily life and to investigate factors influencing aerosol
delivery. In an open randomized crossover study in 25 wheezy infants aged
5-26 months, a metal spacer (Nebuchamber), a detergent coated (DC) and a
non-detergent coated (nonDC) plastic spacer (Babyhaler) were tested at
home for 7 days each. Budesonide (200 microg b.i.d) was administered via a
Nebuchamber or fluticasone (125 microg b.i.d) via a Babyhaler. Aerosol was
trapped in filters, positioned between the spacer and face mask.
Cooperation was scored on diary cards. Electrostatic charge (ESC) of the
spacers was measured. Evaluations of the administration technique were
made from video recordings. Median (range) dose delivery of the filters
expressed as per cent (%) of nominal dose, was 34% (3-59), 23% (1-49), and
41% (12-55) for the Nebuchamber, nonDC-Babyhaler, and DC-Babyhaler
respectively. Considerable dose variability was found, median (range)
within-subject dose variability, expressed as coefficient of variation,
for the Nebuchamber (49% (15-249)) was significantly higher when compared
with both nonDC- (36% (12-325)) and DC-Babyhalers (27% (10-122)), for
which dose variabilities were similar. Detergent coating was effective to
reduce electrostatic charge, and to increase dose delivery, but had no
effect on dose variability. Bad cooperation was an important cause for
high dose variability for all spacers (r=0.5-0.6, p<0.02). Many mistakes
were made during the administration procedure
Laser speckle imaging identification of increases in cortical microcirculatory blood flow induced by motor activity during awake craniotomy ; Clinical article
Object. The goal of awake neurosurgery is to maximize resection of brain lesions with minimal injury to functional brain areas. Laser speckle imaging (LSI) is a noninvasive macroscopic technique with high spatial and temporal resolution used to monitor changes in capillary perfusion. In this study, the authors hypothesized that LSI can be useful as a noncontact method of functional brain mapping during awake craniotomy for tumor removal. Such a modality would be an advance in this type of neurosurgery since current practice involves the application of invasive intraoperative single-point electrocortical (electrode) stimulation and measurements. Methods. After opening the dura mater, patients were woken up, and LSI was set up to image the exposed brain area. Patients were instructed to follow a rest-activation-rest protocol in which activation consisted of the handclenching motor task. Subsequently, exposed brain areas were mapped for functional motor areas by using standard electrocortical stimulation (ECS). Changes in the LSI signal were analyzed offline and compared with the results of ECS. Results. In functional motor areas of the hand mapped with ECS, cortical blood flow measured using LSI significantly increased from 2052 ±818 AU to 2471 ±675 AU during hand clenching, whereas capillary blood flow did not change in the control regions (areas mapped using ECS with no functional activity). Conclusions. The main finding of this study was that changes in laser speckle perfusion as a measure of cortical microvascular blood flow when performing a motor task with the hand relate well to the ECS map. The authors have shown the feasibility of using LSI for direct visualization of cortical microcirculatory blood flow changes during neurosurgery
Threshold Amplitude and Frequency for Ocular Tissue Release from a Vibrating Instrument:An Experimental Study
Purpose. During retinal pigment epithelium (RPE) and choroid graft translocation in the treatment of patients with exudative age-related macular degeneration, the adhesion of the graft to the translocation instrument complicated its submacular release. Vibration of the instrument improved the release of the graft. This study was conducted to validate the effectiveness of the principle of vibration and to determine the threshold amplitude and frequency required for development of an optimized instrument. Methods. An experimental in vitro model with fresh porcine RPE-choroid grafts was used. Release of the graft was studied by a masked observer for amplitudes in the range of 0.05 to 1.2 mm and frequencies in the range of 25 to 200 Hz in the horizontal plane. Results. The minimum threshold amplitude required to release the graft was approximately 0.15 mm from a frequency of 100 Hz and higher. Conclusions. This study confirmed the clinical experience that vibration of an instrument induces the release of the RPE- choroid graft. The minimum threshold amplitude and frequency needed for optimum tissue release were estimated. Copyrigh