A modified single breath method for estimation of cardiac output in humans at rest and during exercise

1987 ◽  
Vol 72 (4) ◽  
pp. 437-441 ◽  
Author(s):  
Y. M. H. Al-Shamma ◽  
R. Hainsworth ◽  
N. P. Silverton
Keyword(s):  
Cardiac Output ◽  
Normal Subjects ◽  
Random Errors ◽  
O2 Uptake ◽  
Mean Values ◽  
Single Breath ◽  
Expired Gas ◽  
The Mean ◽  
Rest And Exercise ◽  
Single Breath Method

1. This study was undertaken to determine the accuracy of a modification of a single breath method for estimation of cardiac output. The technique incorporated a single rebreathing stage followed by a prolonged expiration. Cardiac output was determined from the O2 uptake and the instantaneous changes in O2 and CO2 in the expired gas during the prolonged expiration. 2. The mean values and the random errors (determined from the differences between pairs of estimates) of cardiac outputs in normal subjects at rest and exercise were 5.42 and ± 0.60 litres/min (2 sd, 60 pairs) and 14.1 and ±1.8 litres/min (40 pairs). 3. Larger random errors were obtained in a group of cardiac patients but, except in hypoxic patients, the mean values obtained by the single breath and the direct (Fick) methods were almost identical. 4. We conclude that our modification of the single breath method is simple to use and sufficiently reliable for use in humans both at rest and during steady states of light exercise.

Evaluation of a method for estimating cardiac output from a single breath in humans

1982 ◽  
Vol 53 (4) ◽  
pp. 1034-1038 ◽  
Author(s):  
H. Chen ◽  
N. P. Silverton ◽  
R. Hainsworth
Keyword(s):  
Cardiac Output ◽  
Normal Subjects ◽  
Random Errors ◽  
Tolerance Limits ◽  
Mean Values ◽  
Single Breath ◽  
Significant Difference ◽  
Venous Pco2 ◽  
Mixed Venous ◽  
Single Breath Method

We have modified the single-breath method of Kim et al. (J. Appl. Physiol. 21: 1338–1344, 1966) for estimating cardiac output and arterial and mixed venous carbon dioxide tensions (PCO2). We assessed this using 30 normal subjects and 23 cardiac patients. The procedure was performed satisfactorily in all but two patients. The random errors, from 60 pairs of estimates of cardiac output in normal subjects and 50 pairs in patients, were +/- 12.8 and +/- 19.6% (95% tolerance limits; i.e., coefficient of variation multiplied by 2 for n greater than 50). The systematic error was assessed in 15 patients from comparisons with results obtained by the direct Fick method. There was no significant difference except in two patients with large intracardiac shunts. Mean values of cardiac output by single-breath and direct Fick estimates were 3.80 and 3.83 l/min. Arterial and mixed venous PCO2 were estimated by the single-breath method with random errors of +/- 1.5 and +/- 1.4 Torr, respectively, and no significant systematic errors. We conclude that our modification of the single-breath method is reliable in humans at rest, although the procedures for delivering the breath and processing the data are of critical importance.

A COMPARISON OF TWO METHODS FOR MEASUREMENT OF ALDOSTERONE SECRETION RATE IN MAN

1966 ◽  
Vol 53 (2) ◽  
pp. 177-188 ◽  
Author(s):  
P. Lund-Johansen ◽  
T. Thorsen ◽  
K. F. Støa
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Secretion Rate ◽  
Aldosterone Secretion ◽  
Simple Method ◽  
Mean Values ◽  
Pathological Conditions ◽  
Significant Difference ◽  
Derivative Method ◽  
The Mean

ABSTRACT A comparison has been made between (A), a relatively simple method for the measurement of aldosterone secretion rate, based on paper chromatography and direct densitometry of the aldosterone spot and (B) a more elaborate isotope derivative method. The mean secretion rate in 9 normal subjects was 112 ± 26 μg per 24 hours (method A) and 135 ± 35 μg per 24 hours (method B). The »secretion rate« in one adrenalectomized subject after the intravenous injection of 250 μg of aldosterone was 230 μg per 24 hours (method A) and 294 μg per 24 hours (method B). There was no significant difference in the mean values, and correlation between the two methods was good (r = 0.80). It is concluded that the densitometric method is suitable for clinical purposes as well as research, being more rapid and less expensive than the isotope derivative method. Method A also measures the urinary excretion of the aldosterone 3-oxo-conjugate, which is of interest in many pathological conditions. The densitometric method is obviously the less sensitive and a prerequisite for its use is an aldosterone secretion of 20—30 μg per 24 hours. Lower values are, however, rare in adults.

Establishing inherent uncertainty in the shifts determined by volumetric imaging

2017 ◽  
Vol 16 (3) ◽  
pp. 258-264
Author(s):  
Upendra Kumar Giri ◽  
Anirudh Pradhan
Keyword(s):  
Linear Accelerator ◽  
Systematic Errors ◽  
Cone Beam ◽  
Random Errors ◽  
Mean Values ◽  
Volumetric Imaging ◽  
X Ray ◽  
Image Quality Control ◽  
The Mean ◽  
Six Degree Of Freedom

AbstractObjectiveThis study was conducted for establishing inherent uncertainty in the shift determination by X-ray volumetric imaging (XVI) and calculating margins due to this inherent uncertainty using van Herk formula.Material and methodsThe study was performed on the XVI which was cone-beam computed tomography integrated with the Elekta AxesseTM linear accelerator machine having six degree of freedom enabled HexaPOD couch. Penta-Guide phantom was used for inherent translational and rotational shift determination by repeated imaging. The process was repeated 20 times a day without moving the phantom for 30 consecutive working days. The measured shifts were used for margins calculation using van Herk formula.ResultsThe mean standard deviations were calculated as 0·05, 0·05, 0·06 mm in the three translational (x, y and z) and 0·05°, 0·05°, 0·05° in the three rotational axes (about x, y, z). Paired sample t-test was performed between the mean values of translational shifts (x, y, z) and rotational shifts. The systematic errors were found to be 0·03, 0·04 and 0·03 mm while the random errors were 0·05, 0·06 and 0·06 mm in the lateral, cranio-caudal and anterio-posterior directions, respectively. For the rotational shifts, the systematic errors were 0·02, 0·03 and 0·03 and the random errors were 0·06, 0·05 and 0·05 in the pitch, roll and yaw directions, respectively.ConclusionOur study concluded that there was an inherent uncertainty associated with the XVI tools, on the basis of these six-dimensional shifts, margins were calculated and recorded as a baseline for the quality assurance (QA) programme for XVI imaging tools by checking its reproducibility once in a year or after any major maintenance in hardware or upgradation in software. Although the shift determined was of the order of submillimetre order, still that shift had great significance for the image quality control of the XVI tools. Every departments practicing quality radiotherapy with such imaging tools should establish their own baseline value of inherent shifts and margins during the commissioning and must use an important QA protocol for the tools.

Power spectral analysis of the diaphragm electromyogram

1983 ◽  
Vol 54 (6) ◽  
pp. 1579-1584 ◽  
Author(s):  
T. K. Aldrich ◽  
J. M. Adams ◽  
N. S. Arora ◽  
D. F. Rochester
Keyword(s):  
Power Spectrum ◽  
Signal To Noise Ratio ◽  
Normal Subjects ◽  
Chronic Obstructive ◽  
Signal To Noise ◽  
Low Frequencies ◽  
Mean Values ◽  
The Mean ◽  
Noise Ratio ◽  
Diaphragm Fatigue

We studied the power spectrum of the diaphragm electromyogram (EMG) at frequencies between 31 and 246 Hz in four young normal subjects and five patients with chronic obstructive lung disease (COPD). Diaphragm EMGs were analyzed during spontaneous breathing and maximum inspiratory efforts to determine the effect of signal-to-noise ratio on the power spectrum and if treadmill exercise to dyspnea was associated with diaphragm fatigue. We found that the centroid frequencies of the power spectra (fc) were strongly correlated (r = 0.93) with ratios of power at high frequencies to power at low frequencies (H/L) for all subjects. Of the two indices, H/L had the largest standard deviation expressed as a percentage of the mean. The mean values of both of these decreased significantly after exercise, fc from 100.2 to 97.3 and H/L from 1.07 to 0.97. Signal-to-noise ratios were higher in maximal inspiratory efforts and after exercise in normal subjects and higher in COPD patients. The signal-to-noise ratio was correlated negatively with fc and H/L, indicating that these indices of the shape of the power spectrum are influenced by signal strength and noise levels as well as muscle function. We conclude that the fc and H/L index similar qualities of the power spectrum, that they are partially determined by the signal-to-noise ratio, and that, in some cases, exercise to dyspnea is associated with apparently mild diaphragm fatigue.

Urinary excretion of glycated protein determined with a specific radioimmunoassay

1991 ◽  
Vol 37 (4) ◽  
pp. 504-507 ◽  
Author(s):  
Chizuko Ukita ◽  
Mitsushige Nishikawa ◽  
Akira Shouzu ◽  
Mitsuo Inada
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Mean Values ◽  
Specific Radioimmunoassay ◽  
Glycated Protein ◽  
Highly Sensitive ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract We developed a simple and highly sensitive RIA for glycated protein (GP), and used it to measure GP in serum and urine from 15 normal controls and 30 diabetics (14 with urinary excretion rate of albumin, Ualb less than 15 micrograms/min, group A; nine with 15 less than or equal to Ualb less than or equal to 150 micrograms/min, group B; and seven with Ualb greater than 150 micrograms/min, group C). The mean serum concentration of GP was above normal in all groups of diabetics, and the mean glycation ratios of serum protein (SGP) were higher in groups B and C than in normal subjects. Urinary concentrations of GP also were increased in groups B and C, although the glycation ratio of urinary protein (UGP) was decreased in group C. Consequently, the selectivity of urinary excretion of GP (UGP/SGP) was significantly decreased in group C. Moreover, there was a significant difference in the mean values of selectivity between groups of patients with various degrees of retinopathy. We suggest that measurements of serum and urinary GP are useful to evaluate the progression of diabetic complications.

scholarly journals A novel prediction of simulated fluid responsiveness by echocardiography assessment of tricuspid annulus tissue velocity with passive leg raising

2019 ◽  
Vol 27 (5) ◽  
pp. 270-276
Author(s):  
Erden Erol Ünlüer ◽  
Arif Karagöz ◽  
Serdar Bayata ◽  
Sibel Çatalkaya ◽  
Hüseyin Bozdemir
Keyword(s):  
Cardiac Output ◽  
Fluid Responsiveness ◽  
Vital Signs ◽  
Peak Systolic Velocity ◽  
Passive Leg Raising ◽  
Tricuspid Annulus ◽  
Mean Values ◽  
Before And After ◽  
The Mean ◽  
Level Of Significance

Background: Fluid responsiveness can be predicted by the effect of passive leg raising on cardiac output. Objectives: This research aimed to compare the changes in cardiac output and the peak systolic velocity values of Tricuspid annulus velocity at the free wall (S’) before and after passive leg raising in healthy volunteers. Methods: The study was approved by ethical commission. The desired sample size was 28, and 57 volunteers were included after they signed informed consent. The first measurements, including vital signs, S’, and cardiac output, were taken with the participants lying supine and were performed in the morning after 12 h fast. The participants were then asked to lie in a semirecumbent position for 3 min. After 3 min, the head of the bed was lowered to the supine position and the participants’ legs were elevated at 45°. Secondary measurements were repeated in this position. The differences between vital signs, cardiac output, and S’ measurements before and after passive leg raising were statistically compared. The level of significance was set as p < 0.05. Results: The mean values of cardiac output and S’ before passive leg raising was 9.59 L/min and 11.57 cm/s, respectively; however, those increased to 11.44 L/min and 13.72 cm/s after passive leg raising. The average increases were 16.17% for cardiac output and 15.67% for S’. The changes of cardiac output and S’ were statistically significant. The changes of vital signs before and after passive leg raising were statistically insignificant. Conclusion: This study has demonstrated the concordance of rise in cardiac output with S’ change by passive leg raising in healthy subjects. Further studies are needed to validate the use of S’ values in critically ill subjects.

Flow and age dependence of airway closure and dynamic compliance

1975 ◽  
Vol 38 (2) ◽  
pp. 199-207 ◽  
Author(s):  
R. Begin ◽  
A. D. Renzetti ◽  
A. H. Bigler ◽  
S. Watanabe
Keyword(s):  
Flow Rate ◽  
Normal Population ◽  
Dynamic Compliance ◽  
Normal Subjects ◽  
Closing Volume ◽  
Tolerance Interval ◽  
Flow Rates ◽  
Mean Values ◽  
Single Breath ◽  
Expiratory Flow

The influence of expiratory flow rate and age on the results of measurement of closing volume (CV) of the lung have been studied by a nitrogen single-breath method in 66 asymptomatic lifetime nonsmoking normal subjects between 20 and 82 yr of age. Normal was defined as having values for spirometric measurements within a 95% tolerance interval of reported predicted normal mean values. For the CV determination, inspiratory flow rate was held constant at 0.51/s and studies were carried out at expiratory flow rates of 0.25, 0.5, 1.0, and 1.5 1/s. Our results show that CV expressed as a percentage of vital capacity (VC) and the slope of the alveolar plateau increases with increasing flow rate and age. Dynamic compliance (Cdyn) at frequencies corresponding to peak flow rates of 0.5 and 1.5 1/s was also measured and correlated well with the CV results. Frequency dependence of compliance with aging was demonstrated. Nine smokers with normal spirometric measurements and abnormal CV %VC were also studied. Since the results of Cdyn measurement differentiated only two-thirds of the smokers from the normal population, we suggest that the CV method is probably more sensitive than the Cdyn method for the detection of small airway obstruction.

CD59 Deficient Granulocytes in High Risk Groups of Myelodysplastic Syndromes (MDS).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4717-4717
Author(s):  
Georgia Kaiafa ◽  
Vasiliki Tsavdaridou ◽  
Athanasios Papadopoulos ◽  
Christos Savopoulos ◽  
Apostolos Hatzitolios ◽  
...  
Keyword(s):  
Normal Subjects ◽  
Risk Groups ◽  
Mean Value ◽  
Control Group ◽  
Refractory Anaemia ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean ◽  
Group B ◽  
Pnh Clone

Abstract Background: Blood cells are deficient in membrane-bound glycosyl-phosphatidylinositol (GPI)-anchored proteins in paroxysmal nocturnal hemoglobinuria (PNH) because of an acquired disorder of the pluripotent stem cell. CD55 and CD59 antigens are the most common GPI-anchored proteins that are used for the diagnosis of the presence of PNH clone. The association of MDS with PNH is rather controversial. There are few published individual cases of PNH arrived from a previous MDS or MDS following PNH. Aim: Recent studies have demonstrated the existence of PNH clone in some MDS patients. These studies were performed mostly on erythrocytes and to the best of our knowledge they are only 4. Granulocytes appear to be more sensitive markers of PNH clone existence than erythrocytes and therefore we investigate the expression of PNH clone on granulocytes of patients with MDS. Material-Methods: A total number of 95 patients 25–80 yrs old with MDS {A:19 with refractory anaemia (RA), B:9 with refractory anaemia with ring sideroblasts (RARS), C:17 with refractory anaemia with excess blasts (RAEB), D: 12 with refractory anaemia with excess blasts in transformation (RAEB-t) and E: 19 with chronic myelomonocytic leukemia (CMLL)} and 19 healthy donors were included in our study. The presence of GPI-anchored proteins (CD55, CD59)-deficient granulocytes was examined by flow cytometry. For the detection of the PNH clone the commercial kit by Beckman Coulter (cellquant CD55/CD59) was used. Statistical analysis was made by ANOVA, while Robust test was performed because there was no homogeneity of variances by ANOVA. Results: Table 1 shows the percentages of CD55 and CD59 deficient granulocytes in the 5 groups of pts with MDS comparing with the control group. a) Although the mean values of CD55 deficient granulocytes in the groups RAEB, RAEB-t and CMLL were higher enough than those of the normal subjects, there were no statistically significant differences (p>0.10) in the comparison of the mean values of CD55 deficient granulocytes between each group of patients with the control group. b) On the contrary there was a very statistically significant difference in the comparison of the mean value of CD59 deficient granulocytes between the three last groups (C, D and E) of pts with the control group (p< 0.086, p< 0.001 and p<0.001 respectively). The percentages of CD55 and CD59 deficient granulocytes in the 5 groups of patients with MDS and in the control group CD55 CD55 CD59 CD59 Groups N Mean Value Std deviation Mean Value Std deviation A (RA) 19 2.89 2.79 2.91 2.85 B (RARS) 9 1.05 1.14 3.89 3.63 C (RAEB) 17 4.78 4.76 11.75 6.06 D (RAEB-t) 12 4.23 2.85 23.76 8.53 E (CMLL) 19 6.01 4.97 38.26 16.18 Control 19 3.67 2.89 3.67 2.89 Total 95 4.00 3.87 14.44 16.39 Conclusions: There are relatively large CD59 negative subpopulations (mean values 11.75–38.26%) of granulocytes in the last three groups (RAEB, RAEB-t, CMLL) of MDS patients. On the contrary the two low risk forms (RA, RARS) revealed no such populations. Non-expression of CD59 antigen on granulocytes is a more sensitive marker than that of CD55 antigen for the presence of a possible PNH clone in MDS patients.

Effect of Erythropoietin on Platelet Function and Glycoprotein Expression in Patients with MDS.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3993-3993
Author(s):  
Fotis F.I. Girtovitis ◽  
Dimitrios D. Bougiouklis ◽  
Michel M.P. Makris ◽  
Elefteria E. Pithara ◽  
Pantelis P.E. Makris
Keyword(s):  
Flow Cytometry ◽  
Platelet Function ◽  
Normal Subjects ◽  
Mean Value ◽  
Special Treatment ◽  
Recombinant Erythropoietin ◽  
Mean Values ◽  
Human Recombinant Erythropoietin ◽  
The Mean ◽  
The Difference

Abstract Aim: We decide to study the effect of erythropoietin on the platelet function and glycoproteins expression in patients (pts) with myelodysplastic syndrome (MDS). All patients suffered from primary MDS but none of them received any special treatment. From our study pts that suffered from diseases or they were receiving medication that affect the function of platelets were excluded. Furthermore pts with platelet count&lt;50,000/μl were excluded also because we were unable to check the aggregation of platelets. Material: 41 subjects were studied, 15 normal subject (10 men and 5 women mean age 66,6±14 years old)and 26 pts (17 men and 9 women with mean age70,9±7,4 years old) suffered from all types of MDS according to FAB criteria (9 with RA, 3 with RARS, 7 RAEB, 4 with CMML and 3 with RAEB-t). We divided them in 2 groups: 1st - 7 Pts receiving human recombinant erythropoietin (rEPO) with mean dose 30.000 iu subcutaneous weekly and 2nd - 19 without rEPO. Methods. 1- The platelet function was studied in Platelet Ionized Calcium Aggregometer (PICA) using Ristocetin, ADP, Collagen and Adrenalin as stimulators. 2- The expression of platelet glycoproteins (GPIb, IX, IIb, IIIa and P-selectin) was studied using the flow cytometry and special monoclonal antibodies. This way the percentage of glycoprotein expressed in platelet membrane and MFI were estimated. We performed the statistical analysis of our results using the t-test with common standard deviation.. Results: our results concerning the aggregation test and flow cytometry are presented in tables 1,2 and 3. From the study of our results we can see that while the decrease of aggregation between the patients under EPO and normal subjects is statistically non significant (p&lt;0.1)the decrease of the corresponding values between the pts that did not received EPO and normal subjects was statistically very significant for all stimulators (p &lt;0,001). pts under EPO show an important increase of platelet expressing GPIIb percentage grater than the expressed percentage of patients without EPO (60% vs. 46,1% correspondingly, p&lt;0.001). The difference of expressed MFI was not statistically significant. Conclusion: The findings of our study show us that erythropoietin improves the function of platelets in patients with MDS, probably through the increase of platelet percentage which express glycoproteins. Table 1 Comparison of the mean value of aggregation between the groups Table 2 Comparison of the mean values of the platelets expressing corresponding glycoproteins percentage between the groups Table 3 Comparison of the mean value of MFI between the groups

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