Electrical impedance tomography compared to positron emission tomography for the measurement of regional lung ventilation: an experimental study.

INTRODUCTION: Electrical impedance tomography (EIT), which can assess regional lung ventilation at the bedside, has never been compared with positron-emission tomography (PET), a gold-standard to quantify regional ventilation. This experiment systematically compared both techniques in injured and non-injured lungs. METHODS: The study was performed in six mechanically ventilated female piglets. In normal lungs, tidal volume (VT) was randomly changed to 6, 8, 10 and 15 ml/kg on zero end-expiratory pressure (ZEEP), then, at VT 10 ml/kg, positive end-expiratory pressure (PEEP) was randomly changed to 5, 10 and 15 cmH2O. Afterwards, acute lung injury (ALI) was subsequently created in three animals by injecting 3 ml/kg hydrochloric acid into the trachea. Then at PEEP 5 cmH2O, VT was randomly changed to 8 and 12 ml/kg and PEEP of 10 and 15 cmH2O applied at VT 10 ml/kg. EIT and PET examinations were performed simultaneously. EIT ventilation (VTEIT) and lung volume (VL) were measured in the anterior and posterior area of each lung. On the same regions of interest, ventilation (VPET) and aerated lung volume (VAatten) were determined with PET. RESULTS: On ZEEP, VTEIT and VPET significantly correlated for global (VTEIT = VPET - 2E-13, R2 = 0.95, P < 0.001) and regional (VTEIT = 0.81VPET+7.65, R2 = 0.63, P < 0.001) ventilation over both conditions. For ALI condition, corresponding R2 were 0.91 and 0.73 (P < 0.01). Bias was = 0 and limits of agreement were -37.42 and +37.42 ml/min for global ventilation over both conditions. These values were 0.04 and -29.01 and +29.08 ml/min, respectively, for regional ventilation. Significant correlations were also found between VL and VAatten for global (VL = VAatten+1E-12, R2 = 0.93, P < 0.0001) and regional (VL = 0.99VAatten+0.92, R2 = 0.65, P < 0.001) volume. For ALI condition, corresponding R2 were 0.94 (P < 0.001) and 0.54 (P < 0.05). Bias was = 0 and limits of agreement ranged -38.16 and +38.16 ml for global ventilation over both conditions. These values were -0.24 and -31.96 to +31.48 ml, respectively, for regional ventilation. CONCLUSIONS: Regional lung ventilation and volume were accurately measured with EIT in healthy and injured lungs and validated by simultaneous PET imaging.

Double dissociation in neural correlates of visual working memory: a PET study.

Using positron emission tomography (PET), we investigated the organisation of spatial versus object-based visual working memory in 11 normal human subjects. The paradigm involved a conditional colour-response association task embedded within two visual working memory tasks. The subject had to remember a position (spatial) or shape (object-based) and then use this to recover the colour of the matching element for the conditional association. Activation of the nucleus accumbens and the anterior cingulate cortex was observed during the conditional associative task, indicating a possible role of these limbic structures in associative memory. When the 2 memory tasks were contrasted, we observed activation of 2 distinct cortical networks: (1) The spatial task activated a dorsal stream network distributed in the right hemisphere in the parieto-occipital cortex and the dorsal prefrontal cortex, and (2) The non spatial task activated a ventral stream network distributed in the left hemisphere in the temporo- occipital cortex, the ventral prefrontal cortex and the striatum. These results support the existence of a domain-specific dissociation with dorsal and ventral cortical systems involved respectively in spatial and non spatial working memory functions.

Effect of position, nitric oxide, and almitrine on lung perfusion in a porcine model of acute lung injury.

In a porcine model of oleic acid-induced lung injury, the effects of inhaled nitric oxide (iNO) and intravenous almitrine bismesylate (ivALM), which enhances the hypoxic pulmonary vasoconstriction on the distribution of regional pulmonary blood flow (PBF), were assessed. After injection of 0.12 ml/kg oleic acid, 20 anesthetized and mechanically ventilated piglets [weight of 25 +/- 2.6 (SD) kg] were randomly divided into four groups: supine position, prone position, and 10 ppm iNO for 40 min followed by 4 microg x kg(-1) x min(-1) ivALM for 40 min in supine position and in prone position. PBF was measured with positron emission tomography and H(2)15O. The redistribution of PBF was studied on a pixel-by-pixel basis. Positron emission tomography scans were performed before and then 120, 160, and 200 min after injury. With prone position alone, although PBF remained prevalent in the dorsal regions it was significantly redistributed toward the ventral regions (P < 0.001). A ventral redistribution of PBF was also obtained with iNO regardless of the position (P = 0.043). Adjunction of ivALM had no further effect on PBF redistribution. PP and iNO have an additive effect on ventral redistribution of PBF.

Effects of morphine upon the lamina V type cells activities in the dorsal horn of the decerebrate cat.

The effects of morphine (2 mg/kg i.v.) upon the transmission of nociceptive messages at the spinal level have investigated in decerebrate cats by studying its effects on the activities of lamina V dorsal horn interneurons. In contrast to previous results obtained on the spinal cat, morphine had little or no effects on lamina V type cells in the decerebrate preparation. The mean values for spontaneous activity and responses to natural noxious stimulation were practically identical before and after morphine administration. Moreover, no significant depressive effect was found on responses induced by supramaximal transcutaneous stimulation. However, for this type of activity a depressive effect was revealed, if only the late component of units which presented bimodal responses were considered. We were unable to demonstrate after morphine administration an increase of the descending inhibitory effects induced on lamina V cells by stimulation of the central inferior nucleus of the raphe. Additional experiments using reversible spinalization (by cooling the cord at the thoracic level) suggest that the lack of effect of morphine on decerebrate animals could be explained by the fact that in this preparation, descending inhibitory influences are strongly exacerbated and thus may mask the depressive effects of this drug. These results indicate that the direct electrophysiological evidence of an increase of the descending control systems after morphine administration must be performed in the intact preparation in order to avoid the effects ot their exacerbation in the decerebrate state.

Paradoxical metabolic response of the human brain to a single electroconvulsive shock.

Regional brain protein synthesis was evaluated with positron emission tomography (PET) and L-(S-[11C]methyl)methionine ([11C]MET) in depressive patients, before and 3 h after an electroconvulsive shock (ECS), when energy supply is restored, and in healthy volunteers. Depressive patients presented apparent lower protein synthesis than normals, in agreement with known reduction of cerebral activity. In contrast, ECS resulted in a significant increase (56%, P < 0.05) in global cortical protein synthesis. This paradoxical hyperactivation of cellular protein metabolism in response to seizures and the fact that synaptic activity is further reduced after electroconvulsive therapy (ECT), may provide new insights for understanding the mechanism of action of ECT.

Proteolytic specificity of chymosin on caprine alpha s1-caseins A and F.

From hydrolysis experiments carried out on alpha s1-caseins A and F at pH 5.2 in the presence of 30 g NaCl/l, i.e. the conditions encountered in many young goats' cheeses, it was found that minima of 19 and 9 bonds were sensitive to chymosin in variants A and F respectively. Variant A was hydrolysed faster than variant F and the proteolytic pattern (reversed-phase HPLC and polyacrylamide agarose gel electrophoresis) differed between the variants. Hydrolysates from both variants had a number of cleavage sites in common (Leu20-Leu21, Phe23-Ala24 and Phe32-Arg33 in both variants, Leu101-Lys102 and Leu64-Lys65, Leu120-His121 and Leu83-His84, Leu142-Ala143 and Leu105-Ala106, Leu149-Phe150 and Leu112-Phe113, Leu156-Asp157 and Leu119-Asp120, Trp164-Tyr165 and Trp127-Tyr128 in variants A and F respectively), while other bonds were split only in variant A (Leu16-Asn17, Glu18-Asn19, Phe28-Pro29, Ile44-Gly45, Tyr80-Ile81, Gln82-Lys83, Tyr91-Leu92, Tyr94-Leu95, Leu109-Glu110 and Phe179-Ser180). Major cleavage sites appeared to be at Phe23-Val24, Leu142-Ala143 and Trp164-Tyr165 for variant A, and Phe23-Val24 and Leu64-Lys65 for variant F. Cleavage site Phe23-Val24 could be the origin of the first breakdown product from goat alpha s1-caseins A and F visible in polyacrylamide agarose gel electrophoresis.