Low PV's and overestimation of sleep currently disqualify actigraphy as an accurate sleep-wake indicator. Actigraphy may, however, by useful for measuring circadian period and sleep-wake consolidation and has face validity as a measure of rest/activity.
Previous work from this laboratory has described a rat spinal cord injury (SCI) model in which the mid-thoracic spinal cord is subjected to a single rapid and calibrated displacement at the site of a dorsal laminectomy. Injury is initiated at the tip of a vertical shaft driven by an electromagnetic shaker. Transducers arranged in series with the shaft record the patterns of displacement and force during the impact sequence. In the present study, this device and the relevant surgical procedures were adapted to produce a spinal contusion injury model in laboratory mice. The signal generator for the injury device has also been converted to a computer-controlled interface to permit extension of the model to other laboratories. Mice were subjected to SCI across a range of severities by varying the amplitude of displacement and the magnitude of measured preload force on the dural surface. A moderate injury produced by displacement of 0.5 mm over 25 msec resulted in initial paralysis and recovery of locomotion with chronic deficits in hindlimb function. The magnitude of the peak force, impulse, power, and energy generated at impact were correlated with behavioral outcome at 1 day postinjury, while peak displacement and impulse were the best predictors of behavioral outcome at 28 days postinjury. The shape of the force recording proved to be a highly sensitive measure of subtle variations in the spinal compartment that were otherwise difficult to detect in this small species. The results demonstrate that the electromagnetic spinal cord injury device (ESCID) can be used to produce a well-controlled contusion injury in mice. The unique features of controlled displacement and monitoring of the biomechanical parameters at the time of impact provide advantages of this model for reducing outcome variability. Use of this model in mice with naturally occurring and genetically engineered mutations will facilitate understanding of the molecular mechanisms of pathophysiology following traumatic spinal cord injury.
The diaphragm electromyogram (EMGdi) conveys information relating to the mechanisms of respiration; however, electrocardiogram (ECG) contamination can compromise the accuracy of data derived from this signal. We examine the EMGdi recorded from anesthetized spontaneously breathing dogs via implanted electrodes to assess the extent of the error introduced by the ECG contamination and the effectiveness of ECG gating in reducing this error. Because ECG subtraction has been shown to generate accurate results for such applications, it is used as the gold standard. Analysis of variance methods are employed to compare results derived from the EMGdi data after ECG subtraction with corresponding results derived from the original data and from the data after ECG gating. Estimates of EMGdi variables obtained by using subtraction and gating techniques were not significantly different, indicating that gating can be employed on these signals to reduce ECG contamination without affecting the accuracy of the derived data. Results also show that at EMG-to-ECG power ratios > 13.3 dB, ECG contamination does not significantly affect estimates of the EMGdi variables.
Purpose: To compare low-field (0.15 T) intraoperative magnetic resonance imaging (iMRI)-guided tumor resection with both conventional magnetic resonance imaging (cMRI)-guided tumor resection and high-field (1.5 T) iMRI-guided resection from the clinical and economic point of view.
Materials and Methods:We retrospectively compared 65 iMRI patients with 65 cMRI patients in terms of hospital length of stay, repeat resection rate, repeat resection interval, complication rate, cost to the patient, cost to the hospital, and cost effectiveness. In addition, we compared our low-field results with previously published high-field results.Results: The complication rate was lower for iMRI vs. cMRI in patients presenting for their initial tumor resection (45 vs. 57 complications, P ¼ 0.048). The iMRI repeat resection interval was longer for this cohort (20.1 vs. 6.7 months, P ¼ 0.020). iMRI was more cost-effective than cMRI for patients who had repeat resections ($10,690/ RFY vs. $76,874/RFY, P < 0.001). We found no other clinical or economic differences between iMRI-and cMRIguided tumor resection surgeries. Overall, we did not find the advantages to low-field iMRI that have been reported for high-field iMRI.
Conclusion:There is no adequate justification for the widespread installation of low-field iMRI in its current development state.
The objective of this study was to determine the efficacy of a two-electrode myocardial electrical impedance (MEI) monitor in reproducibly detecting induced myocardial ischemia by comparing MEI changes with hemodynamic changes, including sonomicrometric changes. With institutional approval, 80 dogs were anesthetized with sodium thiamylal, intubated, ventilated, and had venous, arterial, and pulmonary artery catheters placed. Medial sternotomy was performed to facilitate myocardial exposure and allow the left anterior descending coronary artery (LAD) to be isolated. Two pacing electrodes were attached to the myocardium to measure MEI with a monitor. Seventy dogs were randomly assigned to the 15, 30, 45, 60, or 120 min LAD occlusion group. Sonomicrometric transducers were attached to the myocardium of the ten remaining dogs and their LAD was occluded for 36 min. MEI increased immediately after LAD occlusion to a level significantly more (P < 0.05) than baseline and returned to the baseline level upon reperfusion. Twenty dogs developed ventricular fibrillation with no attempts at resuscitation. MEI changes paralleled the sonomicrometric changes expected with ischemia. No significant cardiovascular hemodynamic changes were found with less than 45 min of LAD occlusion. Sixty and 120 min LAD occlusion resulted in significant decreases in cardiac output. The results of these experiments demonstrate that the two-electrode MEI monitor reproducibly changes in response to myocardial ischemia.
Previous studies have shown that obese surgical patients have a greater volume of acidic stomach contents than lean patients, despite a routine preoperative fast. We have reexamined this issue and found that among otherwise healthy, fasted, obese surgical patients, there is a lower incidence of combined high-volume, low-pH stomach contents compared with lean patients.
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