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Joseph A Fisher, FRCPC, MD

Senior Scientist
Division of Advanced Diagnostics - Cardiovascular
Toronto General Research Institute (TGRI)

Keywords: carbon monoxide poisoning, cardiac output, vascular reactivity, SARS, oxygen mask. 

Research Interests
  1. Efficient oxygen administration. We previously pioneered the development of highly efficient methods of administering oxygen. We have developed some mask and circuit designs for this purpose (currently available commercially from Viasys Healthcare). We are presently extending this work to further increase the efficiency of oxygen administration in the field for civilian and military needs.


  2. Measurement of cardiac output. We have developed a method of measuring cardiac output that falls into the classic category of 'respiratory, CO2-based Fick' methods. We have just completed a large clinical study here at UHN and provide some consultation to a number of in house clinical services.


  3. Cerebral and ocular vascular reactivity. We have developed an automated system that induces step changes in blood gas partial pressures of CO2 and O2 independent of each other and of minute ventilation. This is currently used with MRI and ophthalmic vascular Doppler devices to quantify and map vascular reactivity. In addition to the research and diagnostic applications this can be used, for example, to optimize tumor blood flow and thus its susceptibility to ablation by radiation.


  4. Carbon monoxide poisoning: In the past, we have studied the kinetics of carbon monoxide poisoning. This work lead to the development of novel methods and technology to accelerate the rate of elimination from the body of not only carbon monoxide, but any volatile hydrocarbon. The device we developed is compact, inexpensive, and can be applied at the point of rescue. This device has been licensed to and developed by Viasys Healthcare of Yorba Linda CA.

 
 
Selected Publications

  • Cardiovascular response to functional electrical stimulation and dynamic tilt table thereapy to improve orthostatic tolerance. Chi L, Masani K, Miyatani M, Thrasher AT, Johnston WK, Mardimae A, Kessler C, Fisher JA, Popovic MR. J Electromyogr Kinesiol. 2008 Dec;18(6):900-7.

  • Cocaine induced intra-cranial vasculopathy: High resolution vessels wall MRI and BOLD MRI reactivity findings. Han JS, Mandell DM, Poublanc J, Mardimae A, Slessarev M, Jaigobin C, Fisher JA, Mikulis DJ. Nature Clin Pract Neurol. 2008 Nov;4(11):628-32. Epub 2008 Oct 7.

  • Retinal arteriolar and capillary vascular reactivity in response to isoxic hypercapnia. Venkataraman ST, Hudson C, Fisher JA, Rodrigues L, Mardimae A, Flanagan JG. Experimental Eye Research. 2008 Dec;87(6):535-42. Epub 2008 Sep 18.

  • Comparison of two methods of clinical measurement. Preiss D, Fisher JA. J. Clin Monit and Comput. 2008 Aug;22(4):257-9.

  • Mapping cerebrovascular reactivity using BOLD MRI in patients with arterial steno-occlusive disease: comparison with arterial spin labeling MRI. Mandell DM, Han JS, Poublanc J, Crawley AP, Stainsby JA, Fisher JA, Mikulis DJ. Stroke. 2008 Jul;39(7):2021-8.

  • Selective reduction of blood flow to white matter during hypercapnia corresponds with leukoaraiosis. Mandell DM, Han JS, Poublanc J, Crawley AP, Stainsby JA, Kassner A, Fisher JA, Mikulis DJ. Stroke. 2008 Jul;39(7):1993-8.

  • Adaptation and maladaptation to ambient hypoxia: Andean, Ethiopian and Himalayan patterns. Xing G, Qualls C, Huicho L, Rivera M, Stobdan T, Slessarev M, Prisman E, Ito S, Wu H, Norboo A, Diskit D, Kunzang M, Norboo T, Gamboa JL, Claydon VE, Fisher J, Zenebe G, Gebremedhin A, Hainsworth R, Verma A, Appenzeller O. PLoS ONE 2008 Jun 4;3(6):e2342.

  • Retinal arteriolar and middle cerebral artery responses to combined hypercarbic/hyperoxic stimuli. Kisilevsky M, Mardimae A, Slessarev M, Han J, Fisher JA, Hudson C. Investigative Opthalmology & Visual Science. 2008 Dec;49(12):5503-9. Epub 2008 May 23.

  • Accelerated Recovery from Sevoflurane Anesthesia with Isocapnic Hyperpnoea. Katznelson R, Minkovich L, Friedman Z, Fedorko L, Beattie S, Fisher JA. Anesth Analg 2008 Feb;106(2):486-91.

  • Comparison of the effects of independently controlled end-tidal PCO2 and PO2 on BOLD MRI. Prisman E, Slessarev M, Han JS, Poublanc J, Mardimae A, Crawley A, Fisher JA, Mikulis D. J Magn Reson Imaging. 2008 Jan;27(1):185-91

  • Recurrent reversible coma in an adolescent. Kirton A, Tan M, Mikulis DJ, Fisher JA, Han JS, deVeber G, Rubin B. Lancet-Neurology. Lancet Neurol. 2008 Jan; 7(1):110-2.

  • Concentration dependent vasoconstrictive effect of hyperoxia on hypercarbia-dilated retinal arterioles. Kisilevsky M, Hudson C, Wong T, Mardimae A, Fisher JA. Microvascular Research. 2008 Mar;75(2):263-8. Epub 2007 Aug 28.

  • Modified oxygen mask to induce target levels of hyperoxia and hypercarbia during radiotherapy: a more effective alternative to carbogen. Prisman E, Slessarev M, Nayot D, Rucker J, Preiss D, Somogyi R, Vesely A, Azami T, Fisher JA. Int J Radiat Biol. 2007 Jul;83(7):457-62.

  • Cardiac output increases the fate of CO elimination in hyperpneic but nnot normally ventilated dogs. Ishida S, Takeuchi A, Azami T, Sobue K, Sasano H, Katsuya H, Fisher JA. J Anesth. 2007;21(2):181-6. Epub 2007 May 30.

  • Prospective targeting and control of end-tidal CO2 and O2 concentrations. Slessarev M, Prisman E, Han JS, Mardimae A, Volgyesi G, Ansel C, Duffin J, Fisher JA. J. Phys.(Lond.) 2007 Jun 15;581(Pt 3):1207-19. Epub 2007 Apr 19.

  • Modified N95 mask delivers high inspired oxygen concentrations while effectively filtering aerosolized micro-particles. Mardimae A, Slessarev M, Han JS, Sasano H, Sasano N, Azami T, Fedorko L, Savage T, Fowler R, Fisher JA. Ann Emerg Med. 2006 Oct;48(4):391-9.

  • Novel methodology to comprehensively assess retinal arteriolar vascular reactivity to hypercapnia. Venkataraman ST, Hudson C, Fisher JA, Flanagan JG. Microvascular Research. 2006 Nov;72(3):101-7. Epub 2006 Aug 22.

  • Oxygen administration in the ED: choosing the appropriate dosage and technology. Slesarev M, Fisher JA. Israeli Journal of Emergency Medicine. 2006. 1(6):10-21.

  • Efficiency of oxygen administration: sequential gas delivery versus ''flow into a cone'' methods. Slessarev M, Somogyi R, Preiss D, Vesely A, Sasano H, Fisher JA. Critical Care Medicine. 2006. 43(3):829-834.

  • Effects of maternal hyperoxia with and without normocapnia in uteroplacental and fetal Doppler studies. Simchen JM, Tesler J, Azami T, Preiss D, Fedorko L, Goldszmidz E, Fisher J, Kingdom J, Slorach C, Hornberber LK. Ultrasound Obstet. Gynecol. 2005;26:495-499.

  • Precise control of end-tidal P CO2 using sequential breathing circuits. Somogyi RB, Vesely AE, Preiss D, Prisman E, Volgyesi G, Azami T, Iscoe S, Fisher JA, Sasano H. Anaesthisia And Intensive Care. 2005;33:726-732.
 
 
  Joseph  A Fisher
Mailing Address
Additional
Toronto General Hospital
Eaton North Wing
12th Floor Rm 12EN242
200 Elizabeth St.
Toronto, Ontario
Canada M5G 2C4

 
Email

Phone Numbers
416.340.4800 x3071(Primary)
(416) 597-1325 -235(LAB)

 

   
 
 
 
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