• 제목/요약/키워드: Hemodynamic Interpretation

검색결과 8건 처리시간 0.019초

Hemodynamic Interpretation of Various Extraanatomical Bypasses: Clinical & Engineering Views

  • Lee, Byung-Boong;Kim, Young-Wook;Suh, Sang-Ho;Roh, Hyung-Woon;Kim, Dong-Ik;Yoo, Sang-Sin;Cho, Min-Tae;Huh, Sung
    • International Journal of Vascular Biomedical Engineering
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    • 제1권1호
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    • pp.32-40
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    • 2003
  • Axillo-bifemoral (Ax-Fem) bypass are now well accepted for bilateral iliac artery occlusion as the second best option. This extra-anatomical (unnatural) bypasses, however, have various hemodynamic liabilities affecting the patency. Hemodynamic conditions of each different type of Ax-Fem bypass were assessed with computer simulation model to determine the hemodynamically more sound type. Simulation models of five different types of Ax-Fem bypass were constructed. Our investigation based on the computer simulation models have shown distinct differences between two most popular Lazy-S type and Inverted-C type on the distribution of flow volume, shear stress and recirculation zone, etc., though both types have shown similar clinical results. Lazy-S type has shown better hemodyanmic status than inverted-C type. The theoretical advantage of "Lazy-S" type has never been adequately proved for its superiority clinically over the inverted-C type. Inverted-C type is now in more favor with clinically better results in spite of many hemodynamic liabilities including retrograde flow to the branching graft. The improvement of over-all long-term patency rate of various extra-anatomical bypasses is still warranted through proper correction of the hemodynamic liability. Even though clinical outcome of the extra-anatomical bypass has been equal regardless of the type of crossover femoral graft configuration, there are distinct differences on the hemodynamic characteristics among various types of configuration. Further hemodynamic study in the pulsatile flow status is warranted to correct hemodynamic defects with proper modification of various hemodynamic factors of each model.

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Optical imaging of epileptic activity and epilepsy treatments in neocortex

  • Suh, Min-Ah
    • 한국광학회:학술대회논문집
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    • 한국광학회 2009년도 동계학술발표회 논문집
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    • pp.427-428
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    • 2009
  • Optical imaging offers excellent spatio-temporal sensitivity that is unparalleled by any other perfusion based imaging techniques. We used in vivo optical recording of intrinsic signals (ORIS) to map neurovascular hemodynamics of perfusion, oximetry and membrane potential during epileptic events in rat and mouse neocortex. Studies of hemodynamic changes with ORIS alone were also performed in human. Laboratory studies in rodent epilepsy models have demonstrated a persistent increase in deoxygenated hemoglobin (Hbr) and a decrease in tissue oxygenation during interictal spikes and ictal events. This "epileptic dip", like the "initial dip" recorded during normal sensory processing, implies that the enormous rise in cerebral blood flow (CBF) is inadequate to meet the increased metabolic demands associated with synchronized epileptic activity. These findings are critically important to the interpretation of the perfusion-based imaging studies, such as fMRI. In addition, we visualized the effect of direct cortical electrical stimulation, an alterative epilepsy treatment. The optical data following direct cortical electrical stimulation showed that hemodynamic signals are sensitive to different electrical stimulation parameters. Furthermore, our recent data demonstrated that the application of unilateral electrical stimulation is able to elicit bilateral hemodynamic responses in rat neocortex.

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Autonomic dysfunction in patients with orthostatic dizziness

  • Hyung Lee;Hyun Ah Kim
    • Annals of Clinical Neurophysiology
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    • 제25권1호
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    • pp.27-31
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    • 2023
  • Orthostatic dizziness is feeling dizzy or lightheaded when standing up. Hemodynamic orthostatic dizziness can be caused by autonomic dysfunction such as orthostatic hypotension or postural tachycardia syndrome. The interpretation of the autonomic function test results in patients with orthostatic dizziness is crucial for diagnosing and managing the underlying condition. The head-up tilt and Valsalva tests are especially important for evaluating adrenergic function in patients with hemodynamic orthostatic dizziness. However, it is important to note that autonomic function tests do not cover the entire diagnostic process, since their findings need to be considered along with the detailed history and physical examination results of the patient because various differential diagnoses exist for orthostatic dizziness. Ensuring appropriate treatment by interpreting the autonomic function test results can help to determine the improvement of and prevents falls from orthostatic dizziness.

Transcranial Doppler Ultrasonography (TCD)의 시행 방법 및 정상치 (The Technique and Normal Values of Transcranial Doppler Ultrasonography(TCD))

  • 손영호
    • Annals of Clinical Neurophysiology
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    • 제1권1호
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    • pp.39-46
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    • 1999
  • Transcranial doppler ultrasonography (TCD) is a new, non-invasive and easily applicable method to evaluate cerebral hemodynamics. Last 10 years, its use in Korea has been dramatically expanded, but the qualification of TCD laboratory has yet to be settled. Since duplex sonography is seldom used in Korea, we have to depend totally on TCD to evaluate cerebral hemodynamic changes. Thus, all of the available data from every detectabler cerebral arteries has to be obtained for accurate interpretation of TCD measurements. Moreover, flow direction and wave form should be concerned in addition to the flow velocity. In this article, I present technique to measure the anterior, meddle and posterior cerebral arteries, the internal carotid artery siphon and at cervical level, and the vertebral and the basilar artery, and normal values for these measurements which is essential for the adequate interpretation.

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관상동맥질환에서 심장 하이브리드 영상의 임상적 이용 (Clinical Application of Cardiac Hybrid Imaging in Coronary Artery Disease)

  • 조인호;공은정
    • Journal of Yeungnam Medical Science
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    • 제26권1호
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    • pp.15-23
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    • 2009
  • Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can he done using single photon emission computed tomography (SPECT) or positron emission tomography (PET) and multidetector CT (MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronaty lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate development of a comprehensive non-invasive assessment of coronary artery disease.

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심근관류 SPECT와 64채널 전산화 단층혈관 촬영 사진 융합으로 증명된 radius intermedius 협착에 의한 심근관류 저하 (Radius Intermedius Stenosis Induced Myocardial Perfusion Defect: Provened by the Fusion Images of Myocardial Perfusion SPECT and 64 Channel CTA)

  • 공은정;조인호;천경아;원규장;이형우;박종선
    • Nuclear Medicine and Molecular Imaging
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    • 제42권1호
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    • pp.77-78
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    • 2008
  • A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of $^{99m}Tc$-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical & mid area of anterior & lateral wall and mid & basal inferior wall. Coronary CT angiograph was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion softwear package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.

Effect of the respiratory rate on the pulse pressure variation induced by hemorrhage in anesthetized dogs

  • Dalhae, Kim;Won-Gyun, Son;Donghwi, Shin;Jiyoung, Kim;Inhyung, Lee
    • Journal of Veterinary Science
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    • 제23권6호
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    • pp.68.1-68.8
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    • 2022
  • Background: Studies on anesthetized dogs regarding pulse pressure variation (PPV) are increasing. The influence of respiratory rate (RR) on PPV, in mechanically ventilated dogs, has not been clearly identified. Objectives: This study evaluated the influence of RR on PPV in mechanically ventilated healthy dogs after hemorrhage. Methods: Five healthy adult Beagle dogs were premedicated with intravenous (IV) acepromazine (0.01 mg/kg). Anesthesia was induced with alfaxalone (3 mg/kg IV) and maintained with isoflurane in 100% oxygen. The right dorsal pedal artery was cannulated with a 22-gauge catheter for blood removal, and the left dorsal pedal artery was cannulated and connected to a transducer system for arterial blood pressure monitoring. The PPV was automatically calculated using a multi-parameter monitor and recorded. Hemorrhage was induced by withdrawing 30% of blood (24 mL/kg) over 30 min. Mechanical ventilation was provided with a tidal volume of 10 mL/kg and a 1:2 inspiration-to-expiration ratio at an initial RR of 15 breaths/min (baseline). Thereafter, RR was changed to 20, 30, and 40 breaths/min according to the casting lots, and the PPV was recorded at each RR. After data collection, the blood was transfused at a rate of 10 mL/kg/h, and the PPV was recorded at the baseline ventilator setting. Results: The data of PPV were analyzed using the Friedman test followed by the Wilcoxon signed-rank test (p < 0.05). Hemorrhage significantly increased PPV from 11% to 25% at 15 breaths/min. An increase in RR significantly decreased PPV from 25 (baseline) to 17%, 10%, and 10% at 20, 30, and 40 breaths/min, respectively (all p < 0.05). Conclusions: The PPV is a dynamic parameter that can predict a dog's hemorrhagic condition, but PPV can be decreased in dogs under high RR. Therefore, careful interpretation may be required when using the PPV parameter particularly in the dogs with hyperventilation.