Prediction of persistent ventricular dilation by initial ventriculomegaly and clot volume in a porcine model

2021 ◽  
pp. 1-8
Author(s):  
Grace Y. Lai ◽  
William Chu Kwan ◽  
Karolina Piorkowska ◽  
Matthias W. Wagner ◽  
Pouya Jamshidi ◽  
...  
Keyword(s):  
Porcine Model ◽  
Autologous Blood ◽  
Ventricular Volume ◽  
Intraventricular Injection ◽  
Clot Lysis ◽  
Ventricular Dilation ◽  
Ventricular Volumes ◽  
Clot Burden ◽  
The Right ◽  
The Relationship

OBJECTIVE While intraventricular hemorrhage (IVH) is associated with posthemorrhagic ventricular dilation (PHVD), not all infants affected by high-grade IVH develop PHVD. The authors aimed to determine clot-associated predictors of PHVD in a porcine model by varying the amount and rate of direct intraventricular injection of whole autologous blood. METHODS Seven 1-week-old piglets underwent craniectomy and injection of autologous blood into the right lateral ventricle. They survived for a maximum of 28 days. MRI was performed prior to injection, immediately postoperatively, and every 7 days thereafter. T1-weighted, T2-weighted, and susceptibility-weighted imaging (SWI) sequences were used to segment ventricular and clot volumes. Spearman correlations were used to determine the relationship between blood and clot volumes and ventricular volumes over time. RESULTS The maximum ventricular volume was up to 12 times that of baseline. One animal developed acute hydrocephalus on day 4. All other animals survived until planned endpoints. The interaction between volume of blood injected and duration of injection was significantly associated with clot volume on the postoperative scan (p = 0.003) but not the amount of blood injected alone (p = 0.38). Initial postoperative and day 7 clot volumes, but not volume of blood injected, were correlated with maximum (p = 0.007 and 0.014) and terminal (p = 0.014 and 0.036) ventricular volumes. Initial postoperative ventricular volume was correlated with maximum and terminal ventricular volume (p = 0.007 and p = 0.014). CONCLUSIONS Initial postoperative, maximum, and terminal ventricular dilations were associated with the amount of clot formed, rather than the amount of blood injected. This supports the hypothesis that PHVD is determined by clot burden rather than the presence of blood products and allows further testing of early clot lysis to minimize PHVD risk.

scholarly journals Hydrocephalus after Intraventricular Hemorrhage: The Role of Thrombin

2013 ◽  
Vol 34 (3) ◽  
pp. 489-494 ◽  
Author(s):  
Feng Gao ◽  
Fuyi Liu ◽  
Zhi Chen ◽  
Ya Hua ◽  
Richard F Keep ◽  
...  
Keyword(s):  
Lateral Ventricle ◽  
Intraventricular Hemorrhage ◽  
Autologous Blood ◽  
Intraventricular Injection ◽  
Sprague Dawley ◽  
Blood Brain Barrier Disruption ◽  
Sprague Dawley Rats ◽  
Blood Injection ◽  
Brain Barrier Disruption ◽  
The Right

Previous studies demonstrated that thrombin is an important factor in brain injury after intracerebral hemorrhage. This study investigated the effect of thrombin on hydrocephalus development in a rat intraventricular hemorrhage (IVH) model. There were three parts in this study. First, male Sprague–Dawley rats had an injection of 200  μL saline, autologous blood or heparinized blood, into the right lateral ventricle. Second, rats had an injection of 50  μL saline or 3U thrombin into the right lateral ventricle. Third, rats had an injection of thrombin (3U) with a protease-activated receptor-1 (PAR-1) antagonist, SCH79797 (0.15 nmol), or vehicle into the right lateral ventricle. Lateral ventricle volumes were measured by magnetic resonance imaging and the brains were used for immunohistochemistry and western blot analyses. Intraventricular injection of autologous blood induced hydrocephalus from day 1 to 28. Heparinized blood injection resulted in less hydrocephalus at all time points compared with blood injection alone ( P<0.05). Intraventricular injection of thrombin caused significant hydrocephalus, ventricular wall damage, and periventricular blood–brain barrier disruption. Thrombin-induced hydrocephalus was reduced by co-injection of the PAR-1 antagonist SCH79797 ( P<0.05). In conclusion, thrombin contributes to hydrocephalus development after IVH and thrombin-induced hydrocephalus is through PAR-1.

Measurement of left and right ventricular volume from implanted radiopaque markers

1981 ◽  
Vol 240 (6) ◽  
pp. H896-H900
Author(s):  
W. P. Santamore ◽  
R. Carey ◽  
D. Goodrich ◽  
A. A. Bove
Keyword(s):  
Standard Deviation ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Ventricular Volumes ◽  
Radiopaque Markers ◽  
Left And Right ◽  
The Right

To better understand biventricular mechanics, an algorithm was developed to simultaneously calculate right and left ventricular volumes from randomly placed subendocardial radiopaque markers. Mathematically, the ventricle is represented as a stack of circular discs. The radius R of each disc is calculated as the distance from the subendocardial radiopaque marker to a computer generated base-to-apex line, and the height H of each disc is determined by the projected distance between radiopaque markers along the base-to-apex line. Accordingly, the volume (V) is calculated as V = pi . sigma Hi . Ri2. The validity of this algorithm was tested on 10 canine left ventricular casts, on 10 human right ventricular casts, and in five experiments. For the left ventricle, the regression line between the casts (VT) and calculated (VC) volumes was VC = 0.55 VT + 6.6, with r = 0.95, standard error of estimate (Sy) = 1.9 ml, and the standard deviation of percent error = 12.6%. For the right ventricle, VC = 1.75 VT = 42.5, with r = 0.86, Sy = 16.2 ml, and the standard deviation of percent error = 24.8%. In five animal experiments, radiopaque markers were implanted into the endocardium of the left and right ventricles and comparisons were made between angiographic- and marker-determined ventricular volumes. For the five experiments, the mean correlation coefficient, relating the marker volumes to the angiographic volumes, were 0.92 +/- 0.01 for the left ventricle and 0.89 +/- 0.02 for the right ventricle. The results, which are similar to other volume-determination methods, indicate that this method can be applied to determine right and left ventricular volume. Once implanted, fluoroscopy of these markers provides a noninvasive means of calculating ventricular volume.

scholarly journals The role of cell-free DNA in fibrinolysis for intraventricular hemorrhage

2021 ◽  
pp. 1-8
Author(s):  
Fangke Xie ◽  
Qiang Tan ◽  
Anyong Yu ◽  
Peiwen Guo ◽  
Ling Wang ◽  
...  
Keyword(s):  
Intraventricular Hemorrhage ◽  
Ventricular Volume ◽  
Intraventricular Injection ◽  
Ventricular Dilation ◽  
Cell Free Dna ◽  
Astrocyte Proliferation ◽  
Free Dna ◽  
Intraventricular Fibrinolysis

OBJECTIVETissue plasminogen activator (tPA) fibrinolysis did not improve functional outcomes of patients with intraventricular hemorrhage (IVH), largely because of the unsatisfactory clot clearance. The presence of neutrophil extracellular traps (NETs) within the clot has been confirmed to impair tPA fibrinolysis, but the mechanism has been unclear. The authors hypothesized that cell-free DNA (cfDNA), the main framework of NETs, might be the important reason for the fibrinolysis resistance, and they validated the hypothesis, hoping to provide a new target to promote intraventricular fibrinolysis.METHODSFirst, cfDNA was detected in IVH clots by immunofluorescence staining in a rat model of IVH. Second, after blood (with or without exogenous cfDNA) intraventricular injection, IVH rats were given intraventricular infusion of 2 μl of saline, tPA, or tPA + DNase1 randomly. Then, the ventricular volume, animal behavior, and reactive astrocyte proliferation were assessed. Third, the IVH clots were collected for fibrinolysis assay in vitro. Finally, the effects of exogenous cfDNA in IVH were evaluated.RESULTSThe presence of cfDNA in clots was observed as early as 1 hour after IVH. Compared with the whole-blood model, blood + cfDNA caused more severe ventricular dilation (day 7: blood 32.47 ± 2.096 mm3 vs blood + DNA 40.09 ± 2.787 mm3, p < 0.05), increased fibrinolysis resistance to tPA (day 7: tPA + DNA 26.04 ± 1.318 mm3 vs tPA 22.15 ± 1.706 mm3, p < 0.05), and further deteriorated the functional defects in rats (blood vs blood + DNA, p < 0.05). Degradation of cfDNA by DNase1 further enhanced the fibrinolysis effects on relieving the ventricular dilation (day 7: tPA + DNase1 11.67 ± 2.023 mm3 vs tPA, p < 0.05), improving the functional outcome (tPA vs tPA + DNase1, p < 0.05) and reducing periventricular astrocyte proliferation.CONCLUSIONScfDNA impaired tPA fibrinolysis for IVH, and degradation of cfDNA may be a new target to improve this condition.

Tanggung Jawab Hukum Penilai Publik terhadap Laporan Penilaian Kegiatan Pengadaan Tanah bagi Pembangunan untuk Kepentingan Umum (Studi Atas Kantor Jasa Penilai Publik Toto Suharto)

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Gagah Yaumiyya Riyoprakoso ◽  
AM Hasan Ali ◽  
Fitriyani Zein
Keyword(s):  
Future Development ◽  
Public Interest ◽  
Legal Responsibility ◽  
Legal Research ◽  
The Public ◽  
The Government ◽  
Conducting Research ◽  
The Right ◽  
The Relationship ◽  
Systematic Explanation

This study is based on the legal responsibility of the assessment of public appraisal reports they make in land procurement activities for development in the public interest. Public assessment is obliged to always be accountable for their assessment. The type of research found in this thesis is a type of normative legal research with the right-hand of the statue approach and case approach. Normative legal research is a study that provides systematic explanation of rules governing a certain legal category, analyzing the relationship between regulations explaining areas of difficulty and possibly predicting future development. . After conducting research, researchers found that one of the causes that made the dispute was a lack of communication conducted between the Government and the landlord. In deliberation which should be the place where the parties find the meeting point between the parties on the magnitude of the damages that will be given, in the field is often used only for the delivery of the assessment of the compensation that has been done.

Rancangan Sistem Pengukuran Kinerja Berbasis Human Resource Scorecard Pada Universitas Muhammadiyah Luwuk

2020 ◽  
Vol 10 (1) ◽  
pp. 63-71
Author(s):  
Nurhaeda Abbas ◽  
Anggraini Sukmawati ◽  
Muhammad Syamsun
Keyword(s):  
Performance Measurement ◽  
Human Resource ◽  
Performance Measurement System ◽  
Group Discussions ◽  
Strategic Objectives ◽  
Depth Interview ◽  
And Performance ◽  
The Right ◽  
Hierarchy Process ◽  
The Relationship

Today the performance measurement of Muhammadiyah Luwuk uUniversity’s performance has not formulated yet based on University’s vision and mission. It will affect the strategic steps needed and performance improvement efforts in the future.  Human resource scorecard is the right system to be applied in Muhammadiyah Luwuk University. The purpose of this study is to designed a performance measurement system at Muhammadiyah Luwuk University using the Human Resource Scorecard with four perspectives: stakeholder, academic management and kemuhammadiyaan, operational and innovation, as well as and learning. Data was analyzed by analytical hierarchy process method. This research was conducted by distributing questionnaires, focus group discussions and in-depth interview with stakeholders at Muhammadiyah Luwuk University. The results showed that there were 14 strategic objectives and 33 key performance indicators to be achieved by the priority objectives, which are: empowerment and development of faculty, increased administrative process quality, improved sound budget performance and, improvement of the relationship with stakeholders.

Penanganan Issu Terkait Keselamatan Pasien di Rumah Sakit

2020 ◽  
Author(s):  
Kristin Natal Riang Gea
Keyword(s):  
Patient Safety ◽  
Health Workers ◽  
Sampling Technique ◽  
Good Health ◽  
Bivariate Analysis ◽  
P Value ◽  
Patient Identification ◽  
Cross Sectional ◽  
The Right ◽  
The Relationship

AbstrakKeselamatan pasien merupakan dasar dari pelayanan kesehatan yang baik. Pengetahuan tenaga kesehatan dalam sasaran keselamatan pasien terdiri dari ketepatan identifikasi pasien, peningkatan komunikasi yang efektif, peningkatan keamanan obat yang perlu diwaspadai, kepastian tepat lokasi, prosedur, dan tepat pasien operasi, pengurangan risiko infeksi, pengurangan risiko pasien jatuh. Tujuan penelitian untuk mengetahui hubungan antara pengetahuan dengan penerapan keselamatan pasien pada petugas kesehatan di Puskesmas Kedaung Wetan Kota Tangerang. Metode Penelitian menggunakan deskriptif korelasi menggunakan pendekatan cross sectional. Populasi sebanyak 50 responden. Teknik pengambilan sampel menggunakan total sampling. Instrumen yang digunakan berupa lembar kuesioner. Teknik analisa diatas menggunakan analisa Univariat dan Bivariat. Hasil Penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien pada Petugas Kesehatan, dengan hasil, p value sebesar 0,013 &lt; 0,05 maka dapat disimpulkan bahwa ada Hubungan Pengetahuan dengan Penerapa Keselamatan Pasien pada Petugas Kesehatan. Kesimpulan penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien.. AbstrackPatient safety is the basis of good health services. Knowledge of health personnel in patient safety targets consists of accurate patient identification, increased effective communication, increased safety of the drug that needs to be watched, certainty in the right location, procedure, and precise patient surgery, reduction in risk of infection, reduction in risk of falling patients. The purpose of this study was to determine the relationship between knowledge and the application of patient safety to health workers in the Kedaung Wetan Health Center, Tangerang City. The research method uses descriptive correlation using cross sectional approach. The population is 50 respondents. The sampling technique uses total sampling. The instrument used was a questionnaire sheet. The analysis technique above uses Univariate and Bivariate analysis. The results of the study there is a Relationship of Knowledge with the Implementation of Patient Safety in Health Officers, with the result, p value of 0.013 &lt;0.05, it can be concluded that there is a Relationship between Knowledge and Patient Safety Implementation in Health Officers. The conclusion of the study is the Relationship between Knowledge and the Implementation of Patient Safety.Keywords Knowledge, Patient safety, Health workers

Normal cerebral ventricular volume growth in childhood

2020 ◽  
Vol 26 (5) ◽  
pp. 517-524
Author(s):  
Noah S. Cutler ◽  
Sudharsan Srinivasan ◽  
Bryan L. Aaron ◽  
Sharath Kumar Anand ◽  
Michael S. Kang ◽  
...  
Keyword(s):  
Brain Mri ◽  
Volume Growth ◽  
Ventricular Volume ◽  
Growth Patterns ◽  
Diagnostic Process ◽  
Growth Charts ◽  
Normal Brain ◽  
Mr Images ◽  
Ventricular Volumes ◽  
Brain Mr Images

OBJECTIVENormal percentile growth charts for head circumference, length, and weight are well-established tools for clinicians to detect abnormal growth patterns. Currently, no standard exists for evaluating normal size or growth of cerebral ventricular volume. The current standard practice relies on clinical experience for a subjective assessment of cerebral ventricular size to determine whether a patient is outside the normal volume range. An improved definition of normal ventricular volumes would facilitate a more data-driven diagnostic process. The authors sought to develop a growth curve of cerebral ventricular volumes using a large number of normal pediatric brain MR images.METHODSThe authors performed a retrospective analysis of patients aged 0 to 18 years, who were evaluated at their institution between 2009 and 2016 with brain MRI performed for headaches, convulsions, or head injury. Patients were excluded for diagnoses of hydrocephalus, congenital brain malformations, intracranial hemorrhage, meningitis, or intracranial mass lesions established at any time during a 3- to 10-year follow-up. The volume of the cerebral ventricles for each T2-weighted MRI sequence was calculated with a custom semiautomated segmentation program written in MATLAB. Normal percentile curves were calculated using the lambda-mu-sigma smoothing method.RESULTSVentricular volume was calculated for 687 normal brain MR images obtained in 617 different patients. A chart with standardized growth curves was developed from this set of normal ventricular volumes representing the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. The charted data were binned by age at scan date by 3-month intervals for ages 0–1 year, 6-month intervals for ages 1–3 years, and 12-month intervals for ages 3–18 years. Additional percentile values were calculated for boys only and girls only.CONCLUSIONSThe authors developed centile estimation growth charts of normal 3D ventricular volumes measured on brain MRI for pediatric patients. These charts may serve as a quantitative clinical reference to help discern normal variance from pathologic ventriculomegaly.

Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations

2020 ◽  
Vol 18 (2) ◽  
pp. 135-150
Author(s):  
Harsha S. Nagarajarao ◽  
Chandra P. Ojha ◽  
Archana Kedar ◽  
Debabrata Mukherjee
Keyword(s):  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Narrow Channel ◽  
Paradoxical Embolism ◽  
Current Evidence ◽  
Foramen Ovale ◽  
The Right ◽  
The Relationship ◽  
Current Guidelines

: Cryptogenic stroke and its relation to the Patent Foramen Ovale (PFO) is a long-debated topic. Recent clinical trials have unequivocally established the relationship between cryptogenic strokes and paradoxical embolism across the PFO. This slit-like communication exists in everyone before birth, but most often closes shortly after birth. PFO may persist as a narrow channel of communication between the right and left atria in approximately 25-27% of adults. : In this review, we examine the clinical relevance of the PFO with analysis of the latest trials evaluating catheter-based closure of PFO’s for cryptogenic stroke. We also review the current evidence examining the use of antiplatelet medications versus anticoagulants for stroke prevention in those patients with PFO who do not qualify for closure per current guidelines.

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