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1

Cardiac abnormalities in liver cirrhosis.  

PubMed Central

Cirrhosis is associated with several circulatory abnormalities. A hyperkinetic circulation characterized by increased cardiac output and decreased arterial pressure and peripheral resistance is typical. Despite this hyperkinetic circulation, some patients with alcoholic cirrhosis have subclinical cardiomyopathy with evidence of abnormal ventricular function unmasked by physiologic or pharmacologic stress. Florid congestive alcoholic cardiomyopathy develops in a small percentage, but the concurrent presence of cirrhosis seems to retard the occurrence of overt heart failure. Even nonalcoholic cirrhosis may be associated with latent cardiomyopathy, although overt heart failure is not observed. Tense ascites is associated with some cardiac compromise, and removing or mobilizing ascitic fluid by paracentesis or peritoneovenous shunting results in short-term increases in cardiac output. Cirrhosis also appears to be associated with a decreased risk of major coronary atherosclerosis and an increased risk of bacterial endocarditis. Small hemodynamically insignificant pericardial effusions may be seen in ascitic patients. The release of atrial natriuretic peptide appears to be unimpaired in cirrhosis, although the kidney may be hyporesponsive to its natriuretic effects. PMID:2690463

Lee, S S

1989-01-01

2

[No compression of cardiac cavities in transthoracic ultrasound does not exclude cardiac tamponade.  

PubMed

The clinical presentation of cardiac tamponade is difficult to distinguish from other causes of shock. Pericardial fluid is easy to visualize with cardiac ultrasound and a key sign of overt cardiac tamponade is the compression of right side cavities. We present two cases in which cardiac tamponade was present, but where compression of cardiac cavities could not be demon-strated with transthoracic cardiac ultrasound. This emphasizes that cardiac tamponade is still a clinical diagnosis. PMID:25430575

Juhl-Olsen, Peter; Frederiksen, Christina Alcaraz; Sloth, Erik

2014-11-24

3

Ultrasound image guidance of cardiac interventions  

NASA Astrophysics Data System (ADS)

Surgical procedures often have the unfortunate side-effect of causing the patient significant trauma while accessing the target site. Indeed, in some cases the trauma inflicted on the patient during access to the target greatly exceeds that caused by performing the therapy. Heart disease has traditionally been treated surgically using open chest techniques with the patient being placed "on pump" - i.e. their circulation being maintained by a cardio-pulmonary bypass or "heart-lung" machine. Recently, techniques have been developed for performing minimally invasive interventions on the heart, obviating the formerly invasive procedures. These new approaches rely on pre-operative images, combined with real-time images acquired during the procedure. Our approach is to register intra-operative images to the patient, and use a navigation system that combines intra-operative ultrasound with virtual models of instrumentation that has been introduced into the chamber through the heart wall. This paper illustrates the problems associated with traditional ultrasound guidance, and reviews the state of the art in real-time 3D cardiac ultrasound technology. In addition, it discusses the implementation of an image-guided intervention platform that integrates real-time ultrasound with a virtual reality environment, bringing together the pre-operative anatomy derived from MRI or CT, representations of tracked instrumentation inside the heart chamber, and the intra-operatively acquired ultrasound images.

Peters, Terry M.; Pace, Danielle F.; Lang, Pencilla; Guiraudon, Gérard M.; Jones, Douglas L.; Linte, Cristian A.

2011-03-01

4

[Use of Doppler ultrasound in cardiac diagnosis].  

PubMed

In cardiac diagnosis Doppler ultrasound provides quantitative data in the assessment of pressure gradient and valve area in stenotic lesions. In atrioventricular valves pressure half-time can be determined. In regurgitant lesions the only method capable of providing quantitative analysis of aortic regurgitation is calculation of forward-to-reverse flow ratio by multigate Doppler. All the other single-gate Doppler or 2-D-echo Doppler methods, such as LV or LA mapping, recording of impaired mitral flow and diastolic/systolic flow ratio, permit only semiquantitative assessment of regurgitant volumes. Finally, semiquantitative analysis of shunt volumes appears possible in children. PMID:4081685

Burckhardt, D; Hoffmann, A; Jenni, R; Friedli, B

1985-11-01

5

Extracting Cardiac Myofiber Orientations from High Frequency Ultrasound Images  

PubMed Central

Cardiac myofiber plays an important role in stress mechanism during heart beating periods. The orientation of myofibers decides the effects of the stress distribution and the whole heart deformation. It is important to image and quantitatively extract these orientations for understanding the cardiac physiological and pathological mechanism and for diagnosis of chronic diseases. Ultrasound has been wildly used in cardiac diagnosis because of its ability of performing dynamic and noninvasive imaging and because of its low cost. An extraction method is proposed to automatically detect the cardiac myofiber orientations from high frequency ultrasound images. First, heart walls containing myofibers are imaged by B-mode high frequency (>20 MHz) ultrasound imaging. Second, myofiber orientations are extracted from ultrasound images using the proposed method that combines a nonlinear anisotropic diffusion filter, Canny edge detector, Hough transform, and K-means clustering. This method is validated by the results of ultrasound data from phantoms and pig hearts. PMID:24392208

Qin, Xulei; Cong, Zhibin; Jiang, Rong; Shen, Ming; Wagner, Mary B.; Kishbom, Paul; Fei, Baowei

2013-01-01

6

Extracting Cardiac Myofiber Orientations from High Frequency Ultrasound Images.  

PubMed

Cardiac myofiber plays an important role in stress mechanism during heart beating periods. The orientation of myofibers decides the effects of the stress distribution and the whole heart deformation. It is important to image and quantitatively extract these orientations for understanding the cardiac physiological and pathological mechanism and for diagnosis of chronic diseases. Ultrasound has been wildly used in cardiac diagnosis because of its ability of performing dynamic and noninvasive imaging and because of its low cost. An extraction method is proposed to automatically detect the cardiac myofiber orientations from high frequency ultrasound images. First, heart walls containing myofibers are imaged by B-mode high frequency (>20 MHz) ultrasound imaging. Second, myofiber orientations are extracted from ultrasound images using the proposed method that combines a nonlinear anisotropic diffusion filter, Canny edge detector, Hough transform, and K-means clustering. This method is validated by the results of ultrasound data from phantoms and pig hearts. PMID:24392208

Qin, Xulei; Cong, Zhibin; Jiang, Rong; Shen, Ming; Wagner, Mary B; Kishbom, Paul; Fei, Baowei

2013-03-29

7

Cardiac phase detection in intravascular ultrasound images  

NASA Astrophysics Data System (ADS)

Image gating is related to image modalities that involve quasi-periodic moving organs. Therefore, during intravascular ultrasound (IVUS) examination, there is cardiac movement interference. In this paper, we aim to obtain IVUS gated images based on the images themselves. This would allow the reconstruction of 3D coronaries with temporal accuracy for any cardiac phase, which is an advantage over the ECG-gated acquisition that shows a single one. It is also important for retrospective studies, as in existing IVUS databases there are no additional reference signals (ECG). From the images, we calculated signals based on average intensity (AI), and, from consecutive frames, average intensity difference (AID), cross-correlation coefficient (CC) and mutual information (MI). The process includes a wavelet-based filter step and ascendant zero-cross detection in order to obtain the phase information. Firstly, we tested 90 simulated sequences with 1025 frames each. Our method was able to achieve more than 95.0% of true positives and less than 2.3% of false positives ratio, for all signals. Afterwards, we tested in a real examination, with 897 frames and ECG as gold-standard. We achieved 97.4% of true positives (CC and MI), and 2.5% of false positives. For future works, methodology should be tested in wider range of IVUS examinations.

Matsumoto, Monica M. S.; Lemos, Pedro Alves; Yoneyama, Takashi; Furuie, Sergio Shiguemi

2008-03-01

8

Evaluation of a Cardiac Ultrasound Segmentation Algorithm using a Phantom  

E-print Network

Evaluation of a Cardiac Ultrasound Segmentation Algorithm using a Phantom Yong Yue1 , Hemant D Engineering, Yale University, New Haven, CT 06520 3 Department of Medical Physics, University of Wisconsin for segmenting the endocardium in short-axis ultrasound images. The evaluation is carried out using

Duncan, James S.

9

Prenatal Ultrasound Screening for External Ear Abnormality in the Fetuses  

PubMed Central

Objectives. To investigate the best time of examination and section chosen of routine prenatal ultrasound screening for external ear abnormalities and evaluate the feasibility of examining the fetal external ear with ultrasonography. Methods. From July 2010 until August 2011, 42118 pregnant women with single fetus during 16–40 weeks of pregnancy were enrolled in the study. Fetal auricles and external auditory canal in the second trimester of pregnancy were evaluated by routine color Doppler ultrasound screening and systematic screening. Ultrasound images of fetal external ears were obtained on transverse-incline view at cervical vertebra level and mandible level and on parasagittal view and coronal view at external ear level. Results. Five fetuses had anomalous ears including bilateral malformed auricles with malformed external auditory canal, unilateral deformed external ear, and unilateral microtia. The detection rate of both auricles was negatively correlated with gestational age. Of the 5843 fetuses undergoing a routine ultrasound screening, 5797 (99.21%) had bilateral auricles. Of the 4955 fetuses following systematic screening, all fetuses (100%) had bilateral auricles. The best time for fetal auricles observation with ultrasonography is 20–24 weeks of pregnancy. Conclusions. Detection of external ear abnormalities may assist in the diagnosis of chromosomal abnormalities. PMID:25050343

Wei, Jun; Ran, Suzhen; Yang, Zhengchun; Lin, Yun; Tang, Jing

2014-01-01

10

Coronary artery abnormalities and sudden cardiac death.  

PubMed

Anomalous origin of a coronary artery (AOCA) can be associated with sudden cardiac death (SCD), particularly in young athletes. The diagnosis usually can be made by transthoracic echocardiography. In the case of patients for whom this method is not diagnostic, other methods are available including transesophageal echocardiography, cardiac magnetic resonance imaging (CMRI), and computed tomographic (CT) angiography. The decision to intervene is dependent on the type of lesion, the course of the coronary artery, its known association with SCD, and any symptoms present at the time of diagnosis. For patients without symptoms who have lesions less clearly associated with SCD [e.g., anomalous origin of the right coronary artery (AORCA)], the decision to intervene is more controversial. Further prospective studies hopefully will elucidate the optimum treatment pathway for such patients. PMID:22322562

Camarda, Joseph; Berger, Stuart

2012-03-01

11

Abnormal cardiac nerve function in syndrome X  

Microsoft Academic Search

Syndrome X is likely to be caused by a dysfunction of small coronary arteries. Several authors suggested that an increased\\u000a adrenergic activity could be involved in the pathogenesis of syndrome X, but studies investigating this topic by indirect\\u000a methods led to conflicting results. p We directly investigated cardiac sympathetic nerve function in syndrome X by myocardial\\u000a radionuclide studies with123I-metaiodobenzylguanidine (MIBG).

Gaetano Antonio Lanza

1999-01-01

12

Cardiac abnormalities in end stage renal failure and anaemia.  

PubMed Central

Thirteen anaemic children on dialysis were assessed to determine the incidence of cardiac changes in end stage renal failure. Nine children had an increased cardiothoracic ratio on radiography. The electrocardiogram was abnormal in every case but no child had left ventricular hypertrophy as assessed by voltage criteria. However, left ventricular hypertrophy, often gross, was found on echocardiography in 12 children and affected the interventricular septum disproportionately. Cardiac index was increased in 10 patients as a result of an increased left ventricular stroke volume rather than heart rate. Left ventricular hypertrophy was significantly greater in those on treatment for hypertension and in those with the highest cardiac index. Abnormal diastolic ventricular function was found in 6/11 children. Children with end stage renal failure have significant cardiac abnormalities that are likely to contribute to the high cardiovascular mortality in this group. Anaemia and hypertension, or its treatment, probably contribute to these changes. Voltage criteria on electrocardiogram are of no value in detecting left ventricular hypertrophy. Echocardiography must be performed, with the results corrected for age and surface area, in order to detect and follow these abnormalities. Images PMID:8323332

Morris, K P; Skinner, J R; Wren, C; Hunter, S; Coulthard, M G

1993-01-01

13

Using Reduced Interference Distribution to Analyze Abnormal Cardiac Signal  

NASA Astrophysics Data System (ADS)

Due to the non-stationary, multicomponent nature of biomedical signals, the use of time-frequency analysis can be inevitable for these signals. The choice and selection of the proper Time-Frequency Distribution (TFD) that can reveal the exact multicomponent structure of biological signals is vital in many applications, including the diagnosis of medical abnormalities. In this paper, the instantaneous frequency techniques using two distribution functions are applied for analysis of biological signals. These distributions are the Wigner-Ville Distribution and the Bessel Distribution. The simulation performed on normaland abnormal cardiac signals show that the Bessel Distribution can clearly detect the QRS complexes. However, Wigner-Ville Distribution was able to detect the QRS complexes in the normal signa, but fails to detect these complexes in the abnormal cardiac signal.

Mousa, Allam; Saleem, Rashid

2011-05-01

14

Cardiac ultrasonography in structural abnormalities and arrhythmias. Recognition and treatment.  

PubMed Central

Fetal cardiac ultrasonography has become an important tool in the evaluation of fetuses at risk for cardiac anomalies. It can both guide prenatal treatment and assist the management and timing of delivery. We recommend that a fetal echocardiogram be done when there is a family history of congenital heart disease; maternal disease that may affect the fetus; a history of maternal drug use, either therapeutic or illegal; evidence of other fetal abnormalities; or evidence of fetal hydrops. The optimal timing of evaluation is 18 to 22 weeks' gestation. An entire range of structural cardiac defects can be visualized prenatally, including atrioventricular septal defect, ventricular septal defect, cardiomyopathy, ventricular outlet obstruction, and complex cardiac defects. The outcome for a fetus with a recognized abnormality is unfavourable, with less than 50% surviving the neonatal period. Fetal cardiac arrhythmias are also a common occurrence, 15% in the series described here. Premature atrial or ventricular contractions are most commonly seen and usually require no treatment. Supraventricular tachycardia can result in hydrops and require in utero treatment to prevent fetal demise. Complete heart block, particularly in association with structural heart disease, has a poor prognosis for fetal survival. Images PMID:8236970

Brook, M M; Silverman, N H; Villegas, M

1993-01-01

15

Extracorporeal acute cardiac pacing by High Intensity Focused Ultrasound.  

PubMed

Ultrasound has been shown to produce Premature Ventricular Contractions (PVC's). Two clinical applications in which acute cardiac pacing by ultrasound may be valuable are: (1) preoperative patient screening in cardiac resynchronization therapy surgery; (2) Emergency life support, following an event of sudden death, caused by cardiac arrest. Yet, previously the demonstrated mean success rate of extra-systole induction by High Intensity Focused Ultrasound (HIFU) in rats is below 4.5% (Miller et al., 2011). This stands in contrast to previous work in rats using ultrasound (US) and ultrasound contrast agents (UCAs), where success rates of close to 100% were reported (Rota et al., 2006). Herein, bi-stage temporal sequences of accentuated negative pressure (rarefaction) and positive pressure HIFU transmission (insonation) patterns were applied to anaesthetized rats under real-time vital-signs monitoring and US imaging. This pattern of insonation first produces a gradual growth of dissolved gas cavities in tissue (cavitation) and then an ultrasonic impact. Results demonstrate sequences of successive successful HIFU pacing. Triggering insonation at different delays from the preceding ECG R-wave demonstrated successful HIFU pacing induction from mid ECG T-wave till the next ECG complex's PR interval. Spatially focusing the beam at different locations allows cumulative coverage of the whole left ventricle. Analysis of the acoustic wave patterns and temporal characteristics of paced PVCs is suggested to provide new insight into the mechanisms of HIFU cardiac pacing. Specifically, the observed HIFU pacing temporal success rate distribution suggests against sarcomere length modulation current being the dominant cellular level mechanism of HIFU cardiac pacing and may allow postulating that membrane deformation currents are dominant at the applied insonation conditions. PMID:25157926

Livneh, Amit; Kimmel, Eitan; Kohut, Andrew R; Adam, Dan

2014-08-01

16

Cardiac structural and functional abnormalities in end stage renal disease patients with elevated cardiac troponin T  

Microsoft Academic Search

Objectives: To identify in a prospective observational study the cardiac structural and functional abnormalities and mortality in patients with end stage renal disease (ESRD) with a raised cardiac troponin T (cTnT) concentration.Methods: 126 renal transplant candidates were studied over a two year period. Clinical, biochemical, echocardiographic, coronary angiographic, and dobutamine stress echocardiographic (DSE) data were examined in comparison with cTnT

R Sharma; D C Gaze; D Pellerin; R L Mehta; H Gregson; C P Streather; P O Collinson; S J D Brecker

2006-01-01

17

Beyond ultrasound: advances in multimodality cardiac imaging.  

PubMed

The rapid technological evolution accomplished in noninvasive cardiac imaging techniques over the past few decades has provided physicians with a large armamentarium for the evaluation of patients with known or suspected coronary heart disease. Noninvasive assessment of coronary artery calcium or noninvasive coronary angiography may be performed using computed tomography or magnetic resonance imaging. These techniques evaluate the presence of atherosclerosis rather than ischemia. Conversely, nuclear cardiology is the most widely used noninvasive approach for the assessment of myocardial perfusion and function. These techniques coupled with the development of dedicated image fusion software packages to merge data sets from different modalities have paved the way for hybrid imaging. This article provides a description of the available noninvasive imaging techniques in the assessment of coronary anatomy, myocardial perfusion, and cardiac function in patients with known or suspected coronary heart disease. PMID:25037458

Nappi, Carmela; Acampa, Wanda; Pellegrino, Teresa; Petretta, Mario; Cuocolo, Alberto

2015-02-01

18

Mapping Cardiac Fiber Orientations from High-Resolution DTI to High-Frequency 3D Ultrasound.  

PubMed

The orientation of cardiac fibers affects the anatomical, mechanical, and electrophysiological properties of the heart. Although echocardiography is the most common imaging modality in clinical cardiac examination, it can only provide the cardiac geometry or motion information without cardiac fiber orientations. If the patient's cardiac fiber orientations can be mapped to his/her echocardiography images in clinical examinations, it may provide quantitative measures for diagnosis, personalized modeling, and image-guided cardiac therapies. Therefore, this project addresses the feasibility of mapping personalized cardiac fiber orientations to three-dimensional (3D) ultrasound image volumes. First, the geometry of the heart extracted from the MRI is translated to 3D ultrasound by rigid and deformable registration. Deformation fields between both geometries from MRI and ultrasound are obtained after registration. Three different deformable registration methods were utilized for the MRI-ultrasound registration. Finally, the cardiac fiber orientations imaged by DTI are mapped to ultrasound volumes based on the extracted deformation fields. Moreover, this study also demonstrated the ability to simulate electricity activations during the cardiac resynchronization therapy (CRT) process. The proposed method has been validated in two rat hearts and three canine hearts. After MRI/ultrasound image registration, the Dice similarity scores were more than 90% and the corresponding target errors were less than 0.25 mm. This proposed approach can provide cardiac fiber orientations to ultrasound images and can have a variety of potential applications in cardiac imaging. PMID:25328641

Qin, Xulei; Wang, Silun; Shen, Ming; Zhang, Xiaodong; Wagner, Mary B; Fei, Baowei

2014-03-12

19

Mapping cardiac fiber orientations from high-resolution DTI to high-frequency 3D ultrasound  

NASA Astrophysics Data System (ADS)

The orientation of cardiac fibers affects the anatomical, mechanical, and electrophysiological properties of the heart. Although echocardiography is the most common imaging modality in clinical cardiac examination, it can only provide the cardiac geometry or motion information without cardiac fiber orientations. If the patient's cardiac fiber orientations can be mapped to his/her echocardiography images in clinical examinations, it may provide quantitative measures for diagnosis, personalized modeling, and image-guided cardiac therapies. Therefore, this project addresses the feasibility of mapping personalized cardiac fiber orientations to three-dimensional (3D) ultrasound image volumes. First, the geometry of the heart extracted from the MRI is translated to 3D ultrasound by rigid and deformable registration. Deformation fields between both geometries from MRI and ultrasound are obtained after registration. Three different deformable registration methods were utilized for the MRI-ultrasound registration. Finally, the cardiac fiber orientations imaged by DTI are mapped to ultrasound volumes based on the extracted deformation fields. Moreover, this study also demonstrated the ability to simulate electricity activations during the cardiac resynchronization therapy (CRT) process. The proposed method has been validated in two rat hearts and three canine hearts. After MRI/ultrasound image registration, the Dice similarity scores were more than 90% and the corresponding target errors were less than 0.25 mm. This proposed approach can provide cardiac fiber orientations to ultrasound images and can have a variety of potential applications in cardiac imaging.

Qin, Xulei; Wang, Silun; Shen, Ming; Zhang, Xiaodong; Wagner, Mary B.; Fei, Baowei

2014-03-01

20

Evaluation of a Level Set Segmentation Method for Cardiac Ultrasound Images  

E-print Network

Evaluation of a Level Set Segmentation Method for Cardiac Ultrasound Images Yong Yue Hemant D to ultrasound segmentation where image speckle creates many local minima.1 In this paper, we experimentally Segmentation Specifically, we are interested in segmenting the endocardium in human cardiac images. For lack

Duncan, James S.

21

3D transvaginal ultrasound imaging for identification of endometrial abnormality  

NASA Astrophysics Data System (ADS)

A multi-center study has previously evaluated the use of 2-dimensional transvaginal ultrasound (TVS) to measure the thickness of the endometrium as a risk indicator for endometrial abnormality in women with postmenopausal bleeding. In this paper we present methods using 3-dimensional TVS in order to improve the measurement, shape analysis and visualization of the endometrium. Active contour techniques are applied to identify the endometrium in a 3D dataset. The shape of the endometrium is then visualized and utilized to do quantitative measurements of the thickness. The voxels inside the endometrium are volume rendered in order to emphasize inhomogeneities. Since these inhomogeneities can exist both on the outside and the inside of the endometrium, the rendering algorithm has a controllable opacity function. A 3-dimensional distance transform is performed on the data volume measuring the shortest distance to the detected endometrium border for each voxel. This distance is used as a basis for opacity computations which allows the user to emphasize different regions of the endometrium. In particular, the opacity function can be computed such that regions that violate the risk indicator for the endometrium thickness are highlighted.

Olstad, Bjoern; Berg, Sevald; Torp, Anders H.; Schipper, Klaus P.; Eik-Nes, Sturla H.

1995-05-01

22

Automated Heart Wall Motion Abnormality Detection From Ultrasound Images using Bayesian Networks  

E-print Network

Automated Heart Wall Motion Abnormality Detection From Ultrasound Images using Bayesian Networks± . maleeha.qazi@siemens.com , glenn.fung@siemens.com Abstract Coronary Heart Disease can be diagnosed by mea- suring and scoring regional motion of the heart wall in ultrasound images of the left ventricle (LV

Rosales, Rómer E.

23

Towards ultrasound cardiac image segmentation based on the radiofrequency signal.  

PubMed

In echocardiography, the radio-frequency (RF) image is a rich source of information about the investigated tissues. Nevertheless, very few works are dedicated to boundary detection based on the RF image, as opposed to envelope image. In this paper, we investigate the feasibility and limitations of boundary detection in echocardiographic images based on the RF signal. We introduce two types of RF-derived parameters: spectral autoregressive parameters and velocity-based parameters, and we propose a discontinuity adaptive framework to perform the detection task. In classical echographic cardiac acquisitions, we show that it is possible to use the spectral contents for boundary detection, and that improvement can be expected with respect to traditional methods. Using the system approach, we study on simulations how the spectral contents can be used for boundary detection. We subsequently perform boundary detection in high frame rate simulated and in vivo cardiac sequences using the variance of velocity, obtaining very promising results. Our work opens the perspective of a RF-based framework for ultrasound cardiac image segmentation and tracking. PMID:12946474

Dydenko, Igor; Friboulet, Denis; Gorce, Jean-Marie; D'hooge, Jan; Bijnens, Bart; Magnin, Isabelle E

2003-09-01

24

Prenatal diagnosis of trisomy 8 mosaicism in CVS after abnormal ultrasound findings at 12 weeks.  

PubMed

We describe a case of trisomy 8 mosaicism in which fetal chromosome analysis was prompted by ultrasound abnormalities, i.e., hygroma colli and dilatation of the renal pelves. Chorionic villus sampling (CVS) was performed, with a false-negative result on direct karyotype analysis, although cultured trophoblasts revealed trisomy 8 mosaicism. Fetal autopsy confirmed the abnormalities found on ultrasound examinations and fetal tissue examination showed different levels of trisomy 8 mosaicism. To our knowledge, this is the first prenatal diagnosis of trisomy 8 made on ultrasound findings. PMID:7479598

Guichet, A; Briault, S; Toutain, A; Paillet, C; Descamps, P; Pierre, F; Body, G; Moraine, C

1995-08-01

25

Ultrasound current source density imaging of the cardiac activation wave using a clinical cardiac catheter.  

PubMed

Ultrasound current source density imaging (UCSDI), based on the acoustoelectric (AE) effect, is a noninvasive method for mapping electrical current in 4-D (space + time). This technique potentially overcomes limitations with conventional electrical mapping procedures typically used during treatment of sustained arrhythmias. However, the weak AE signal associated with the electrocardiogram is a major challenge for advancing this technology. In this study, we examined the effects of the electrode configuration and ultrasound frequency on the magnitude of the AE signal and quality of UCSDI using a rabbit Langendorff heart preparation. The AE signal was much stronger at 0.5 MHz (2.99 ?V/MPa) than 1.0 MHz (0.42 ?V/MPa). Also, a clinical lasso catheter placed on the epicardium exhibited excellent sensitivity without penetrating the tissue. We also present, for the first time, 3-D cardiac activation maps of the live rabbit heart using only one pair of recording electrodes. Activation maps were used to calculate the cardiac conduction velocity for atrial (1.31 m/s) and apical (0.67 m/s) pacing. This study demonstrated that UCSDI is potentially capable of real-time 3-D cardiac activation wave mapping, which would greatly facilitate ablation procedures for treatment of arrhythmias. PMID:25122512

Qin, Yexian; Li, Qian; Ingram, Pier; Barber, Christy; Liu, Zhonglin; Witte, Russell S

2015-01-01

26

Abnormal cardiac enzymes in systemic sclerosis: a report of four patients and review of the literature.  

PubMed

Cardiac involvement in systemic sclerosis (SSc) is heterogeneous and can include primary involvement of the myocardium, pericardium and coronary arteries or be secondary to cardiac complications of pulmonary and renal disease. Primary cardiac involvement in SSc is uncommon but can result in ventricular dysfunction, organ failure, arrhythmias and death. It can remain clinically silent and the prevalence is likely to be under-reported. We report four cases of SSc associated with a raised serum troponin T (TnT), in a proportion of whom cardiac MRI myocardial abnormalities were detected. These cases highlight the heterogeneity of cardiac involvement in SSc, the role of cardiac MRI and promising biochemical responses to immunosuppression. Cardiac biomarkers such as TnT may be useful screening tools to identify subclinical cardiac disease and assess response to therapeutic intervention. PMID:24091585

Vasta, B; Flower, V; Bucciarelli-Ducci, C; Brown, S; Korendowych, E; McHugh, N J; Pauling, J D

2014-03-01

27

Ultrasound and Cadaveric Prosections as Methods for Teaching Cardiac Anatomy: A Comparative Study  

ERIC Educational Resources Information Center

This study compared the efficacy of two cardiac anatomy teaching modalities, ultrasound imaging and cadaveric prosections, for learning cardiac gross anatomy. One hundred and eight first-year medical students participated. Two weeks prior to the teaching intervention, students completed a pretest to assess their prior knowledge and to ensure that…

Griksaitis, Michael J.; Sawdon, Marina A.; Finn, Gabrielle M.

2012-01-01

28

Abnormal Cardiac Autonomic Regulation in Mice Lacking ASIC3  

PubMed Central

Integration of sympathetic and parasympathetic outflow is essential in maintaining normal cardiac autonomic function. Recent studies demonstrate that acid-sensing ion channel 3 (ASIC3) is a sensitive acid sensor for cardiac ischemia and prolonged mild acidification can open ASIC3 and evoke a sustained inward current that fires action potentials in cardiac sensory neurons. However, the physiological role of ASIC3 in cardiac autonomic regulation is not known. In this study, we elucidate the role of ASIC3 in cardiac autonomic function using Asic3?/? mice. Asic3?/? mice showed normal baseline heart rate and lower blood pressure as compared with their wild-type littermates. Heart rate variability analyses revealed imbalanced autonomic regulation, with decreased sympathetic function. Furthermore, Asic3?/? mice demonstrated a blunted response to isoproterenol-induced cardiac tachycardia and prolonged duration to recover to baseline heart rate. Moreover, quantitative RT-PCR analysis of gene expression in sensory ganglia and heart revealed that no gene compensation for muscarinic acetylcholines receptors and beta-adrenalin receptors were found in Asic3?/? mice. In summary, we unraveled an important role of ASIC3 in regulating cardiac autonomic function, whereby loss of ASIC3 alters the normal physiological response to ischemic stimuli, which reveals new implications for therapy in autonomic nervous system-related cardiovascular diseases. PMID:24804235

Cheng, Ching-Feng; Kuo, Terry B. J.; Chen, Wei-Nan

2014-01-01

29

The role of transvaginal ultrasound in the management of abnormal uterine bleeding  

Microsoft Academic Search

Abnormal uterine bleeding is a common symptom. Modern management should be based on a “one-stop” approach to which transvaginal ultrasound is ideally suited as a primary diagnostic tool. In premenopausal women focal pathology, such as fibroids and polyps, as well as extra uterine pathology, can be accurately diagnosed. In postmenopausal women endometrial cancer can be excluded. In the majority of

Emeka Okaro; George Condous; Tom Bourne

2004-01-01

30

Mechanisms of Human Arrhythmia Syndromes: Abnormal Cardiac Macromolecular Interactions  

NSDL National Science Digital Library

Many cardiac ion channels exist within macromolecular signaling complexes, comprised of pore-forming subunits that associate with auxiliary subunits, regulatory enzymes, and targeting proteins. This complex protein assembly ensures proper modulation of channel activity and ion homeostasis. The association of genetic defects in regulatory and targeting proteins to inherited arrhythmia syndromes has led to a better understanding of the critical role these proteins play in ion channel modulation.

2007-10-01

31

Contrast imaging ultrasound detects abnormalities in the marmoset ovary.  

PubMed

The development of a functional vascular tree within the primate ovary is critical for reproductive health. To determine the efficacy of contrast agents to image the microvascular environment within the primate ovary, contrast ultrasonography was performed in six reproductive-aged female common marmosets (Callithrix jacchus) during the late luteal phase of the cycle, following injection of Sonovue™. Regions of interest (ROIs), representing the corpus luteum (CL) and noncorpus luteum ovarian tissue (NCLOT), were selected during gray-scale B-mode ultrasound imaging. The magnitude of backscatter intensity of CL and NCLOT ROIs were calculated in XnView, post hoc: subsequent gamma-variate modeling was implemented in Matlab to determine perfusion parameters. Histological analysis of these ovaries revealed a total of 11 CL, nine of which were identified during contrast ultrasonography. The median enhancement ratio was significantly increased in the CL (5.54AU; 95% CI -2.21-68.71) compared to the NCLOT (2.82AU; 95% CI 2.73-15.06; P < 0.05). There was no difference in time parameters between the CL and NCLOT. An additional avascular ROI was identified in the ovary of Animal 5, both histologically and by ultrasonography. This cystic ROI displayed a markedly lower enhancement ratio (0.79AU) and higher time parameters than mean CL and NCLOT, including time to peak and time to wash out. These data demonstrate, for the first time, the ability of commercially available contrast agents, to differentiate structures within the nonhuman primate ovary. Contrast-enhanced ultrasonography has a promising future in reproductive medicine. PMID:22890799

Hastings, J M; Morris, K D; Allan, D; Wilson, H; Millar, R P; Fraser, H M; Moran, C M

2012-12-01

32

Abnormal Heart Rate Turbulence Predicts Cardiac Mortality in Low, Intermediate and High Risk Older Adults  

PubMed Central

Introduction We examined whether heart rate turbulence (HRT) adds to traditional risk factors for cardiac mortality in older adults at low, intermediate and high risk. Methods and Results N=1298, age ?65 years, with 24-hour Holter recordings were studied. HRT, which quantifies heart rate response to ventricular premature contractions, was categorized as: both turbulence onset (TO) and turbulence slope (TS) normal; TO abnormal; TS abnormal; or both abnormal. Independent risks for cardiac mortality associated with HRT or, for comparison, elevated C-reactive protein (CRP) (>3.0 mg/L), were calculated using Cox regression analysis adjusted for traditional cardiovascular disease risk factors and stratified by the presence of no, isolated subclinical (i.e., intermediate risk) or clinical CVD. Having both TS and TO abnormal compared to both normal was associated with cardiac mortality in the low risk group [HR 7.9, 95% CI 2.8–22.5, (p<0.001)]. In the high and intermediate risk groups, abnormal TS and TO ([HR 2.2, 95% CI 1.5–4.0, p=0.016] and [HR 2.7, 95% CI 1.2–5.9, p=0.012]), respectively, were also significantly associated with cardiac mortality. In contrast, elevated CRP was associated with increased cardiac mortality risk only in low risk individuals [HR 2.5, 95% CI 1.3–5.1, p=0.009]. In the low risk group, the c-statistic was 0.706 for the base model, 0.725 for the base model with CRP, and 0.767 for the base model with HRT. Conclusions Abnormal HRT independently adds to risk stratification of low, intermediate and high risk individuals but appears to add especially to the stratification of those considered at low risk. PMID:21134026

Stein, Phyllis K.; Barzilay, Joshua I.

2011-01-01

33

Early carotid atherosclerosis and cardiac diastolic abnormalities in hypertensive subjects  

Microsoft Academic Search

Despite the fact that it is known that hypertension may be associated to early atherosclerosis manifestations, few data are to date available on the relationship between early carotid abnormalities and left ventricular diastolic dysfunction. To address this issue, 142 hypertensive patients (64 females and 78 males) younger than 55 years, at the first diagnosis of mild-to-moderate essential hypertension (WHO\\/ISH criteria),

G Parrinello; D Colomba; P Bologna; A Licata; A Pinto; S Paterna; R Scaglione; G Licata

2004-01-01

34

Distal 10q trisomy syndrome with unusual cardiac and pulmonary abnormalities.  

PubMed Central

Since its description in 1965, distal 10q trisomy has become recognised as a well defined, although rare syndrome, almost always the result of an unbalanced translocation. Typical features consist of psychomotor delay, a distinctive dysmorphic appearance, growth retardation, and, in some cases, cardiac, renal, and ocular abnormalities. Images PMID:9475101

Davies, J; Jaffé, A; Bush, A

1998-01-01

35

Cranial ultrasound abnormalities in full term infants in a postnatal ward: outcome at 12 and 18 months  

Microsoft Academic Search

OBJECTIVETo investigate whether cranial ultrasound abnormalities found in low risk full term infants had any influence on neurodevelopmental outcome.METHODSFor 103 infants who had a neurological assessment, a cranial ultrasound examination, and for whom antenatal and perinatal data were collected within 48 hours of delivery, neurodevelopmental status was evaluated at 12 and 18 months. The results of a scored neurological examination

Leena Haataja; Eugenio Mercuri; Frances Cowan; Lilly Dubowitz

2000-01-01

36

A medical link between local maternity hospitals and a tertiary center using telediagnosis with fetal cardiac ultrasound image transmission.  

PubMed

Information and communication technology has been widely applied to various fields, including clinical medicine. We report here a telediagnosis system using ultrasound image transmission. The effect of telediagnosis, using a medical link between local maternity hospitals and our children's medical center, was verified. The number of fetal telediagnosis for cardiac disease, and cases referred to a perinatal care center and emergent transportation of neonates with congenital heart disease from maternity hospitals, were calculated based on the hospital records. The percentage of patients found to have heart disease was compared between out-patient clinic and telediagnosis cases. Telediagnosis increased, allowing maternity hospital staff to obtain support easily from a specialist when making a diagnosis. Many severe cases were transferred to tertiary centers with the correct diagnosis; consequently, the number of emergent transportations of neonates with severe cardiac anomalies continued to below. Telediagnosis was also useful as an educational tool for maternity hospital staff, who improved their skills during conversations with a specialist. Unlike in the outpatient clinic, consultation by telediagnosis was requested even for cases of mild abnormalities, and the number of false-positives increased, while many cardiac anomalies were found in the early stage. Furthermore, telediagnosis was helpful for pregnant women requiring bed rest, and also had the advantage of allowing a doctor to be able to talk with parents. Establishing a fetal telediagnosis system is a useful strategy to improve neonatal care through a medical link between local maternity hospitals and a tertiary center. PMID:24259010

Hishitani, Takashi; Fujimoto, Yoshitaka; Saito, Yukinori; Sugamoto, Kenji; Hoshino, Kenji; Ogawa, Kiyoshi

2014-04-01

37

[Ultrasound-guided interscalene block in a patient with supraclavicular anatomical abnormalities due to radiotherapy and surgery].  

PubMed

Regional blocks can be difficult in surgical patients with certain superficial anatomical abnormalities. Such blocks may be possible, however, under ultrasound guidance. We report a case in which a man with a fractured right humerus required an ultrasound-guided interscalene brachial plexus block. Secondary to radiotherapy, the patient had right cervical and facial abnormalities that had altered the location of external anatomical landmarks. We describe the approach used to insert the catheter and the exploration of the region by ultrasound. Nerve stimulation was not used to avoid painful contractions. Analgesia was excellent during surgery and over the following 24 hours. PMID:21688510

Errando, C L; Muñoz-Devesa, L; Soldado, M A

2011-05-01

38

Abnormal Calcium Handling and Exaggerated Cardiac Dysfunction in Mice with Defective Vitamin D Signaling  

PubMed Central

Aim Altered vitamin D signaling is associated with cardiac dysfunction, but the pathogenic mechanism is not clearly understood. We examine the mechanism and the role of vitamin D signaling in the development of cardiac dysfunction. Methods and Results We analyzed 1?-hydroxylase (1?-OHase) knockout (1?-OHase?/?) mice, which lack 1?-OH enzymes that convert the inactive form to hormonally active form of vitamin D. 1?-OHase?/? mice showed modest cardiac hypertrophy at baseline. Induction of pressure overload by transverse aortic constriction (TAC) demonstrated exaggerated cardiac dysfunction in 1?-OHase?/? mice compared to their WT littermates with a significant increase in fibrosis and expression of inflammatory cytokines. Analysis of calcium (Ca2+) transient demonstrated profound Ca2+ handling abnormalities in 1?-OHase?/? mouse cardiomyocytes (CMs), and treatment with paricalcitol (PC), an activated vitamin D3 analog, significantly attenuated defective Ca2+ handling in 1?-OHase?/? CMs. We further delineated the effect of vitamin D deficiency condition to TAC by first correcting the vitamin D deficiency in 1?-OHase?/? mice, followed then by either a daily maintenance dose of vitamin D or vehicle (to achieve vitamin D deficiency) at the time of sham or TAC. In mice treated with vitamin D, there was a significant attenuation of TAC-induced cardiac hypertrophy, interstitial fibrosis, inflammatory markers, Ca2+ handling abnormalities and cardiac function compared to the vehicle treated animals. Conclusions Our results provide insight into the mechanism of cardiac dysfunction, which is associated with severely defective Ca2+ handling and defective vitamin D signaling in 1?-OHase?/? mice. PMID:25268137

Choudhury, Sangita; Bae, Soochan; Ke, Qingen; Lee, Ji Yoo; Singh, Sylvia S.; St-Arnaud, René; del Monte, Federica; Kang, Peter M.

2014-01-01

39

Transcranial Doppler ultrasound identifies patients with right-to-left cardiac or pulmonary shunts.  

PubMed

We performed transcranial Doppler ultrasound (TCD) and transesophageal contrast echocardiography simultaneously in four patients. In one patient with a patent foramen ovale and another patient with pulmonary A-V fistulae, we detected micro air bubbles in the right middle cerebral artery three to five cardiac cycles after their appearance in the left atrium following intravenous injection of contrast. In two patients without right-to-left shunts, we did not detect air bubbles in the left atrium or middle cerebral artery following injection of contrast. These results show that TCD can identify patients with right-to-left cardiac or pulmonary shunts. PMID:1745345

Chimowitz, M I; Nemec, J J; Marwick, T H; Lorig, R J; Furlan, A J; Salcedo, E E

1991-12-01

40

Therapeutic Ultrasound to Non-Invasively Create Intra-Cardiac Communications in an Intact Animal Model  

PubMed Central

Objective To determine if pulsed cavitational ultrasound therapy (histotripsy) can accurately and safely generate ventricular septal defects (VSDs) through the intact chest of a neonatal animal, with the eventual goal of developing a non-invasive technique of creating intra-cardiac communications in patients with congenital heart disease. Background Histotripsy is an innovative ultrasonic technique that generates demarcated, mechanical tissue fractionation utilizing high intensity ultrasound pulses. Previous work has shown that histotripsy can create atrial septal defects in a beating heart in an open-chest canine model. Methods Nine neonatal pigs were treated with transcutaneous histotripsy targeting the ventricular septum. Ultrasound pulses of 5?s duration at a peak negative pressure of 13 MPa and a pulse repetition frequency of 1 kHz were generated by a 1 MHz focused transducer. The procedure was guided by real-time ultrasound imaging. Results VSDs were created in all pigs with diameters ranging from 2–6.5mm. Six pigs were euthanized within 2 hrs of treatment, while 3 were recovered and maintained for 2–3 days to evaluate lesion maturation and clinical side effects. There were only transient clinical effects and pathology revealed mild collateral damage around the VSD with no significant damage to other cardiac or extra-cardiac structures. Conclusions Histotripsy can accurately and safely generate VSDs through the intact chest in a neonatal animal model. These results suggest that with further advances, histotripsy can be a useful, non-invasive technique to create intra-cardiac communications, which currently require invasive catheter-based or surgical procedures, to clinically stabilize newborn infants with complex congenital heart disease. PMID:20853366

Owens, Gabe E.; Miller, Ryan M.; Ensing, Greg; Ives, Kimberly; Gordon, David; Ludomirsky, Achi; Xu, Zhen

2010-01-01

41

Analysis of 2-d ultrasound cardiac strain imaging using joint probability density functions.  

PubMed

Ultrasound frame rates play a key role for accurate cardiac deformation tracking. Insufficient frame rates lead to an increase in signal de-correlation artifacts resulting in erroneous displacement and strain estimation. Joint probability density distributions generated from estimated axial strain and its associated signal-to-noise ratio provide a useful approach to assess the minimum frame rate requirements. Previous reports have demonstrated that bi-modal distributions in the joint probability density indicate inaccurate strain estimation over a cardiac cycle. In this study, we utilize similar analysis to evaluate a 2-D multi-level displacement tracking and strain estimation algorithm for cardiac strain imaging. The effect of different frame rates, final kernel dimensions and a comparison of radio frequency and envelope based processing are evaluated using echo signals derived from a 3-D finite element cardiac model and five healthy volunteers. Cardiac simulation model analysis demonstrates that the minimum frame rates required to obtain accurate joint probability distributions for the signal-to-noise ratio and strain, for a final kernel dimension of 1 ? by 3 A-lines, was around 42 Hz for radio frequency signals. On the other hand, even a frame rate of 250 Hz with envelope signals did not replicate the ideal joint probability distribution. For the volunteer study, clinical data was acquired only at a 34 Hz frame rate, which appears to be sufficient for radio frequency analysis. We also show that an increase in the final kernel dimensions significantly affect the strain probability distribution and joint probability density function generated, with a smaller effect on the variation in the accumulated mean strain estimated over a cardiac cycle. Our results demonstrate that radio frequency frame rates currently achievable on clinical cardiac ultrasound systems are sufficient for accurate analysis of the strain probability distribution, when a multi-level 2-D algorithm and kernel dimensions on the order of 1 ? by 3 A-lines or smaller are utilized. PMID:24613642

Ma, Chi; Varghese, Tomy

2014-06-01

42

Association between elevated plasma norepinephrine levels and cardiac wall motion abnormality in poor-grade subarachnoid hemorrhage patients.  

PubMed

Patients with aneurysmal subarachnoid hemorrhage (SAH) are frequently complicated by acute cardiac dysfunctions, including cardiac wall motion abnormality (WMA). Massive release of catecholamine into the systemic circulation after aneurysmal rupture is believed to result in WMA, and poor-grade SAH seems to be the most important risk factor. However, plasma catecholamine levels have rarely been measured in SAH patients with WMA, and previous studies indicated that the elevated levels might not necessarily predict WMA. The objective of this study is (1) to evaluate relationship between WMA and plasma catecholamine levels in poor-grade SAH patients in the acute phase and (2) to clarify clinical characteristics of SAH patients with WMA. Among 142 poor-grade (World Federation of Neurosurgical Societies grades IV and V) SAH patients, 48 underwent both transthoracic ultrasound and measurement of plasma catecholamine levels within 24 h of SAH onset. They were divided into WMA+ (n?=?23) and WMA- (n?=?25) groups, and intergroup comparison was made on demographics, plasma catecholamine levels, and outcomes. Plasma norepinephrine levels were significantly higher in WMA+ group than in WMA- group (2,098.4?±?1,773.4 vs. 962.9?±?838.9 pg/mL, p?=?0.02), and the former showed significantly worse outcomes 90 days after admission. There were no intergroup differences in the plasma levels of epinephrine. Plasma norepinephrine levels were inversely correlated with left ventricular ejection fraction. Multivariate logistic regression analysis revealed that increased plasma norepinephrine levels were predictive of WMA, although age, female sex, and grade V SAH were not. This retrospective study highlights the role of norepinephrine in pathogenesis of SAH-induced WMA. PMID:22936520

Sugimoto, Keiko; Inamasu, Joji; Kato, Yoko; Yamada, Yasuhiro; Ganaha, Tsukasa; Oheda, Motoki; Hattori, Natsuki; Watanabe, Eiichi; Ozaki, Yukio; Hirose, Yuichi

2013-04-01

43

Association of Comorbidity Burden With Abnormal Cardiac Mechanics: Findings From the HyperGEN Study  

PubMed Central

Background Comorbidities are common in heart failure (HF), and the number of comorbidities has been associated with poor outcomes in HF patients. However, little is known about the effect of multiple comorbidities on cardiac mechanics, which could impact the pathogenesis of HF. We sought to determine the relationship between comorbidity burden and adverse cardiac mechanics. Methods and Results We performed speckle?tracking analysis on echocardiograms from the HyperGEN study (n=2150). Global longitudinal, circumferential, and radial strain, and early diastolic (e') tissue velocities were measured. We evaluated the association between comorbidity number and cardiac mechanics using linear mixed effects models to account for relatedness among subjects. The mean age was 51±14 years, 58% were female, and 47% were African American. Dyslipidemia and hypertension were the most common comorbidities (61% and 58%, respectively). After adjusting for left ventricular (LV) mass index, ejection fraction, and several potential confounders, the number of comorbidities remained associated with all indices of cardiac mechanics except global circumferential strain (eg, ?=?0.32 [95% CI ?0.44, ?0.20] per 1?unit increase in number of comorbidities for global longitudinal strain; ?=?0.16 [95% CI ?0.20, ?0.11] for e' velocity; P?0.0001 for both comparisons). Results were similar after excluding participants with abnormal LV geometry (P<0.05 for all comparisons). Conclusions Higher comorbidity burden is associated with worse cardiac mechanics, even in the presence of normal LV geometry. The deleterious effect of multiple comorbidities on cardiac mechanics may explain both the high comorbidity burden and adverse outcomes in patients who ultimately develop HF. PMID:24780206

Selvaraj, Senthil; Aguilar, Frank G.; Martinez, Eva E.; Beussink, Lauren; Kim, Kwang?Youn A.; Peng, Jie; Rasmussen?Torvik, Laura; Sha, Jin; Irvin, Marguerite R.; Gu, C. Charles; Lewis, Cora E.; Hunt, Steven C.; Arnett, Donna K.; Shah, Sanjiv J.

2014-01-01

44

Fluorescence imaging for real-time monitoring of high-intensity focused ultrasound cardiac ablation.  

PubMed

Side effects and limitations of radio-frequency ablation of cardiac arrhythmias prompted search for alternative energy sources and means of their application. High-intensity focused ultrasound (HIFU) is becoming an increasingly attractive modality for ablation because of its unique ability for non-invasive or minimally invasive, non-contact focal ablation in 3D volume without affecting intervening and surrounding cells. The purpose of this study is to develop a real-time monitoring technique to elucidate HIFU-induced modifications of electrical conduction in cardiac tissues and to investigate the HIFU cardiac ablation process to help to achieve optimal HIFU ablation outcome. We conducted experimental studies applying HIFU at 4.23 MHz to ablate the atrio-ventricular (AV) node and ventricular tissue of Langendorff-perfused rabbit hearts. We employed fluorescent voltage-sensitive dye imaging and surface electrodes to monitor the electrical conduction activity induced by HIFU application in real time. In ventricular epicardium HIFU ablation, fluorescent imaging revealed gradual reduction of the plateau phase and amplitude of the action potential. Subsequently, conduction block and cell death were observed at the site of ablation. When HIFU was applied to the AV node, fluorescent imaging and electrograms revealed the development of the AV block. The study establishes that real-time fluorescent imaging provides novel monitoring and assessment to study HIFU cardiac ablation, which may be able to provide improved understanding of HIFU cardiac ablation process and mechanism useful for development of successful clinical applications. PMID:16240084

Deng, Cheri X; Qu, Fujian; Nikolski, Vladimir P; Zhou, Yun; Efimov, Igor R

2005-10-01

45

Physiologic abnormalities of cardiac function in progressive systemic sclerosis with diffuse scleroderma  

SciTech Connect

To investigate cardiopulmonary function in progressive systemic sclerosis with diffuse scleroderma, we studied 26 patients with maximal exercise and redistribution thallium scans, rest and exercise radionuclide ventriculography, pulmonary-function testing, and chest roentgenography. Although only 6 patients had clinical evidence of cardiac involvement, 20 had abnormal thallium scans, including 10 with reversible exercise-induced defects and 18 with fixed defects (8 had both). Seven of the 10 patients who had exercise-induced defects and underwent cardiac catheterization had normal coronary angiograms. Mean resting left ventricular ejection fraction and mean resting right ventricular ejection fraction were lower in patients with post-exercise left ventricular thallium defect scores above the median (59 +/- 13 per cent vs. 69 +/- 6 per cent, and 36 +/- 12 per cent vs. 47 +/- 7 per cent, respectively). The authors conclude that in progressive systemic sclerosis with diffuse scleroderma, abnormalities of myocardial perfusion are common and appear to be due to a disturbance of the myocardial microcirculation. Both right and left ventricular dysfunction appear to be related to this circulatory disturbance, suggesting ischemically mediated injury.

Follansbee, W.P.; Curtiss, E.I.; Medsger, T.A. Jr.; Steen, V.D.; Uretsky, B.F.; Owens, G.R.; Rodnan, G.P.

1984-01-19

46

Exome sequencing improves genetic diagnosis of structural fetal abnormalities revealed by ultrasound  

PubMed Central

The genetic etiology of non-aneuploid fetal structural abnormalities is typically investigated by karyotyping and array-based detection of microscopically detectable rearrangements, and submicroscopic copy-number variants (CNVs), which collectively yield a pathogenic finding in up to 10% of cases. We propose that exome sequencing may substantially increase the identification of underlying etiologies. We performed exome sequencing on a cohort of 30 non-aneuploid fetuses and neonates (along with their parents) with diverse structural abnormalities first identified by prenatal ultrasound. We identified candidate pathogenic variants with a range of inheritance models, and evaluated these in the context of detailed phenotypic information. We identified 35 de novo single-nucleotide variants (SNVs), small indels, deletions or duplications, of which three (accounting for 10% of the cohort) are highly likely to be causative. These are de novo missense variants in FGFR3 and COL2A1, and a de novo 16.8 kb deletion that includes most of OFD1. In five further cases (17%) we identified de novo or inherited recessive or X-linked variants in plausible candidate genes, which require additional validation to determine pathogenicity. Our diagnostic yield of 10% is comparable to, and supplementary to, the diagnostic yield of existing microarray testing for large chromosomal rearrangements and targeted CNV detection. The de novo nature of these events could enable couples to be counseled as to their low recurrence risk. This study outlines the way for a substantial improvement in the diagnostic yield of prenatal genetic abnormalities through the application of next-generation sequencing. PMID:24476948

Carss, Keren J.; Hillman, Sarah C.; Parthiban, Vijaya; McMullan, Dominic J.; Maher, Eamonn R.; Kilby, Mark D.; Hurles, Matthew E.

2014-01-01

47

Exome sequencing improves genetic diagnosis of structural fetal abnormalities revealed by ultrasound.  

PubMed

The genetic etiology of non-aneuploid fetal structural abnormalities is typically investigated by karyotyping and array-based detection of microscopically detectable rearrangements, and submicroscopic copy-number variants (CNVs), which collectively yield a pathogenic finding in up to 10% of cases. We propose that exome sequencing may substantially increase the identification of underlying etiologies. We performed exome sequencing on a cohort of 30 non-aneuploid fetuses and neonates (along with their parents) with diverse structural abnormalities first identified by prenatal ultrasound. We identified candidate pathogenic variants with a range of inheritance models, and evaluated these in the context of detailed phenotypic information. We identified 35 de novo single-nucleotide variants (SNVs), small indels, deletions or duplications, of which three (accounting for 10% of the cohort) are highly likely to be causative. These are de novo missense variants in FGFR3 and COL2A1, and a de novo 16.8 kb deletion that includes most of OFD1. In five further cases (17%) we identified de novo or inherited recessive or X-linked variants in plausible candidate genes, which require additional validation to determine pathogenicity. Our diagnostic yield of 10% is comparable to, and supplementary to, the diagnostic yield of existing microarray testing for large chromosomal rearrangements and targeted CNV detection. The de novo nature of these events could enable couples to be counseled as to their low recurrence risk. This study outlines the way for a substantial improvement in the diagnostic yield of prenatal genetic abnormalities through the application of next-generation sequencing. PMID:24476948

Carss, Keren J; Hillman, Sarah C; Parthiban, Vijaya; McMullan, Dominic J; Maher, Eamonn R; Kilby, Mark D; Hurles, Matthew E

2014-06-15

48

In Vivo Evaluations of a Phased Ultrasound Array for Transesophageal Cardiac Ablation  

NASA Astrophysics Data System (ADS)

Atrial fibrillation is one of the most common arrhythmias that affects over 2.2 million Americans each year. Catheter ablation, one of the effective treatments, has shown high rate of success in treating paroxysmal atrial fibrillation. Currently, radiofrequency which is being used for catheter ablation is an invasive procedure. Measurable morbidity and significant costs and time are associated with this modality of treatment of permanent or persistent atrial fibrillation. In order to address these issues, a transesophageal ultrasound applicator for noninvasive cardiac ablation was designed, developed and evaluated. The ultrasound energy delivered by the phased array was used to create a lesion in the myocardial tissue. Various factors, simulation results of transducer arrays, current transesophageal medical devices, and throat anatomy, were considered while designing a phased ultrasound transducer that can be inserted into the esophagus. For this research, a two-dimensional sparse phased array with flat tapered elements was fabricated and evaluated in in vivo experiments. Five pigs were anesthetized; the array was passed transesophagealy and positioned over the heart. An operating frequency of 1.6 MHz and 8˜15 minutes of array operation resulted in both single and multiple lesions on atrial and ventricular myocardium. The average size of lesions was 5.1±2.1 mm in diameter and 7.8±2.5 mm in length. Experimental results indicate that the array delivered sufficient power to produce ablation at the focal point while not grossly damaging the tissue surrounding the area of interest. These results demonstrate a potential application of the ultrasound applicator for noninvasive transesophageal cardiac surgery in atrial fibrillation treatment.

Jaiswal, Devina; Werner, Jacob; Park, Eun-Joo; Francischelli, David; Smith, Nadine Barrie

2010-03-01

49

Seizure-related cardiac repolarization abnormalities are associated with ictal hypoxemia  

PubMed Central

Summary Purpose Cardiac arrhythmias and respiratory disturbances have been proposed as likely causes for sudden unexpected death in epilepsy. Oxygen desaturation occurs in one-third of patients with localization-related epilepsy (LRE) undergoing inpatient video-EEG telemetry (VET) as part of their pre-surgical workup. Ictal-related oxygen desaturation is accompanied by hypercapnia. Both abnormal lengthening and shortening of the corrected QT interval (QTc) on the electrocardiogram (EKG) have been reported with seizures. QTc abnormalities are associated with increased risk of sudden cardiac death. We hypothesized that there may be an association between ictal hypoxemia and cardiac repolarization abnormalities. Methods VET data from patients with refractory LRE were analyzed. Consecutive patients having at least one seizure with accompanying oxygen desaturation below 90% and artifact free EKG data were selected. EKG during the one minute prior to seizure onset (PRE) and during the ictal/postictal period with accompanying oxygen desaturation below 90%(DESAT) was analyzed. Consecutive QT and RR intervals were measured. In the same patients, DESAT seizures were compared with seizures without accompanying oxygen desaturation below 90% (NODESAT). For NODESAT seizures, QT and RR intervals for 2 minutes after seizure onset were measured. Key findings 37 DESAT seizures were analyzed in 17 patients with localization-related epilepsy. A total of 2448 QT and RR intervals were analyzed during PRE. During DESAT, 1554QT and RR intervals were analyzed. 12 of the 17patients had at least one NODESAT seizure. A total of 19 NODESAT seizures were analyzed, including 1558 QT and RR intervals during PRE and 3408 QT and RR intervals during NODESAT. The odds ratio for an abnormally prolonged (>457 msec) QTcH (Hodges correction method) during DESAT relative to PRE was 10.64(p<0.0001). The odds ratio for an abnormally shortened (<372 msec) QTcH during DESAT relative to PRE was 1.65 (p<0.0001). Seizure-related shortening and prolongation of QTc during DESAT were also observed when Fridericia correction of the QT was applied. During DESAT seizures, the mean range of QT values (QTr)(61.14 msec) was significantly different from that during PRE (44.43 msec) (p=0.01). There was a significant association between DESAT QTr and oxygen saturation nadir (p=0.025) and between DESAT QTr and duration of oxygen desaturation (p < 0.0001). Both QTcH prolongation and shortening also occurred with NODESAT seizures. A seizure-associated prolonged QTcH was more likely during DESAT than NODESAT with an odds-ratio of 4.30 (p<0.0001). A seizure-associated shortened QTcH was more likely during DESAT than NODESAT with an odds-ratio of 2.13 (p<0.0001). Significance We have shown that the likelihood of abnormal QTcH prolongation is increased 4.3-fold with seizures that are associated with oxygen desaturation when compared with seizures that are not accompanied with oxygen desaturation. The likelihood of abnormally shortened QTcH increases with seizures that are accompanied by oxygen desaturation with an odds-ratio of 2.13 compared with that in seizures without desaturations. There is a significant association between the depth and duration of oxygen desaturation and QTr increase. These findings may be related to the pathophysiology of SUDEP. PMID:21906052

Seyal, Masud; Pascual, Franchette; Lee, Chia-Yuan Michael; Li, Chin-Shang; Bateman, Lisa M.

2011-01-01

50

Prevalence of pre-transplant electrocardiographic abnormalities and post-transplant cardiac events in patients with liver cirrhosis  

PubMed Central

Background Although cardiovascular disease is thouht to be common in cirrhosis, there are no systematic investigations on the prevalence of electrocardiographic (ECG) abnormalities in these patients and data on the occurrence of post-transplant cardiac events in comparison with the general population are lacking. We aimed to study the prevalence and predictors of ECG abnormalities in patients with cirrhosis undergoing liver transplantation and to define the risk of cardiac events post-transplant compared to the general population. Methods Cirrhotic patients undergoing first-time liver transplantation between 1999–2007 were retrospectively enrolled. ECGs at pre-transplant evaluation were reviewed using the Minnesota classification and compared to healthy controls. Standardized incidence ratios for post-transplant cardiac events were calculated. Results 234 patients with cirrhosis were included, 186 with an available ECG (36% with alcoholic and 24% with viral cirrhosis; mean follow-up 4 years). Cirrhotics had a prolonged QTc interval, a Q wave, abnormal QRS axis deviation, ST segment depression and a pathologic T wave more frequently compared to controls (p?abnormalities. Compared to the general Swedish population, patients were 14 times more likely to suffer a cardiac event post-transplant (p?cardiac events (p?abnormalities are common in cirrhosis and are associated with cardiovascular risk factors and cirrhosis severity and etiology. Post-transplant cardiac events are more common than in the general population. PMID:24708568

2014-01-01

51

Highly abnormal thermotests in familial dysautonomia suggest increased cardiac autonomic risk  

PubMed Central

OBJECTIVE—Patients with familial dysautonomia have an increased risk of sudden death. In some patients with familial dysautonomia, sympathetic cardiac dysfunction is indicated by prolongation of corrected QT (QTc) interval, especially during stress tests. As many patients do not tolerate physical stress, additional indices are needed to predict autonomic risk. In familial dysautonomia there is a reduction of both sympathetic neurons and peripheral small nerve fibres which mediate temperature perception. Consequently, quantitative thermal perception test results might correlate with QTc values. If this assumption is correct, quantitative thermotesting could contribute to predicting increased autonomic risk.?METHODS—To test this hypothesis, QTc intervals were determined in 12 male and eight female patients with familial dysautonomia, aged 10 to 41 years (mean 21.7 (SD 10.1) years), in supine and erect positions and postexercise and correlated with warm and cold perception thresholds assessed at six body sites using a Thermotest.?RESULTS—Due to orthostatic presyncope, six patients were unable to undergo erect and postexercise QTc interval assessment. The QTc interval was prolonged (>440 ms) in two patients when supine and in two additional patients when erect and postexercise. Supine QTc intervals correlated significantly with thermal threshold values at the six body sites and with the number of sites with abnormal thermal perception (Spearman's rank correlation p<0.05). Abnormal Thermotest results were more frequent in the four patients with QTc prolongation and the six patients with intolerance to stress tests.?CONCLUSION—The results suggest that impaired thermal perception correlates with cardiac sympathetic dysfunction in patients with familial dysautonomia. Thus thermotesting may provide an alternative, albeit indirect, means of assessing sympathetic dysfunction in autonomic disorders.?? PMID:9728945

Hilz, M.; Kolodny, E.; Neuner, I.; Stemper, B.; Axelrod, F.

1998-01-01

52

Spinal cord stimulation normalizes abnormal cortical pain processing in patients with cardiac syndrome X.  

PubMed

Cardiac syndrome X (CSX) is characterized by effort angina, ST-segment depression during stress tests and normal coronary arteries. Abnormal nociception was suggested in these patients by studies showing a reduced cardiac pain threshold; furthermore, we recently found a lack of habituation to pain stimuli using recording of laser evoked potentials (LEPs). In CSX patients with severe angina, spinal cord stimulation (SCS) was shown to improve symptoms. In this study we investigated whether, in these patients, SCS has any effects on the excitability of the nociceptive system, assessed by LEPs recording. We studied 16 CSX patients (61.6+/-7 years; 4 men) who underwent SCS for refractory angina. Cortical LEPs were recorded during stimulation of the chest and right-hand during active SCS (SCS-ON) and in the absence of SCS (SCS-OFF), using a randomized cross-over design. Three sequences of painful stimuli were applied at each site during each test. During the first sequence of chest stimuli, the N2/P2 LEP amplitude was higher during the SCS-ON, compared to the SCS-OFF phase (18.2+/-7.8 vs. 11.5+/-4.4 microV, P=0.006). The N2/P2 amplitude did not change significantly across the three stimulation sequences during the SCS-OFF phase (P=0.22), whereas it decreased progressively during the second and third sequence (to 87.1+/-29.5% and 76.4+/-24.1%, respectively) compared with the first sequence, during the SCS-ON phase (P=0.014). Similar results were observed during right-hand stimulation. Our study shows that in CSX patients SCS is able to restore habituation to peripheral pain stimuli. This effect might contribute to restore the ability of CSX patients to better tolerate cardiac pain. PMID:18440702

Sestito, Alfonso; Lanza, Gaetano Antonio; Le Pera, Domenica; De Armas, Liala; Sgueglia, Gregory Angelo; Infusino, Fabio; Miliucci, Roberto; Tonali, Pietro Attilio; Crea, Filippo; Valeriani, Massimiliano

2008-09-30

53

Frequency and severity of myocardial perfusion abnormalities using Tc-99m MIBI SPECT in cardiac syndrome X  

PubMed Central

Background Cardiac syndrome X is defined by a typical angina pectoris with normal or near normal (stenosis <40%) coronary angiogram with or without electrocardiogram (ECG) change or atypical angina pectoris with normal or near normal coronary angiogram plus a positive none-invasive test (exercise tolerance test or myocardial perfusion scan) with or without ECG change. Studies with myocardial perfusion imaging on this syndrome have indicated some abnormal perfusion scan. We evaluated the role of myocardial perfusion imaging (MPI) and also the severity and extent of perfusion abnormality using Tc-99m MIBI Single Photon Emission Computed Tomography (SPECT) in these patients. Methods The study group consisted of 36 patients with cardiac syndrome X. The semiquantitative perfusion analysis was performed using exercise Tc-99m MIBI SPECT. The MPI results were analyzed by the number, location and severity of perfusion defects. Results Abnormal perfusion defects were detected in 13 (36.10%) cases, while the remaining 23 (63.90%) had normal cardiac imaging. Five of 13 (38.4%) abnormal studies showed multiple perfusion defects. The defects were localized in the apex in 3, apical segments in 4, midventricular segments in 12 and basal segments in 6 cases. Fourteen (56%) of all abnormal segments revealed mild, 7(28%) moderate and 4 (16%) severe reduction of tracer uptake. No fixed defects were identified. The vessel territories were approximately the same in all subjects. The Exercise treadmill test (ETT) was positive in 25(69%) and negative in 11(30%) patients. There was no consistent pattern as related to the extent of MPI defects or exercise test results. Conclusion Our study suggests that multiple perfusion abnormalities with different levels of severity are common in cardiac syndrome X, with more than 30 % of these patients having at least one abnormal perfusion segment. Our findings suggest that in these patients microvascular angina is probably more common than is generally believed. PMID:16503964

Saghari, Mohsen; Assadi, Majid; Eftekhari, Mohammad; Yaghoubi, Mohammad; Fard-Esfahani, Armaghan; Malekzadeh, Jan-Mohammad; Sichani, Babak Fallhi; Beiki, Davood; Takavar, Abbas

2006-01-01

54

Detection of abnormal cardiac activity using principal component analysis--a theoretical study.  

PubMed

Electrogram-guided ablation has been recently developed for allowing better detection and localization of abnormal atrial activity that may be the source of arrhythmogeneity. Nevertheless, no clear indication for the benefit of using electrograms guided ablation over empirical ablation was established thus far, and there is a clear need of improving the localization of cardiac arrhythmogenic targets for ablation. In this paper, we propose a new approach for detection and localization of irregular cardiac activity during ablation procedures that is based on dimension reduction algorithms and principal component analysis (PCA). Using an 8×8 electrode array, our method produces manifolds that allow easy visualization and detection of possible arrhythmogenic ablation targets characterized by irregular conduction. We employ mathematical modeling and computer simulations to demonstrate the feasibility of the new approach for two well established arrhythmogenic sources for irregular conduction--spiral waves and patchy fibrosis. Our results show that the PCA method can differentiate between focal ectopic activity and spiral wave activity, as these two types of activity produce substantially different manifold shapes. Moreover, the technique allows the detection of spiral wave cores and their general meandering and drifting pattern. Fibrotic patches larger than 2 mm(2) could also be visualized using the PCA method, both for quiescent atrial tissue and for tissue exhibiting spiral wave activity. We envision that this method, contingent to further numerical and experimental validation studies in more complex, realistic geometrical configurations and with clinical data, can improve existing atrial ablation mapping capabilities, thus increasing success rates and optimizing arrhythmia management. PMID:25073163

Greisas, Ariel; Zafrir, Zohar; Zlochiver, Sharon

2015-01-01

55

Tumor Necrosis Factor Is a Therapeutic Target for Immunological Unbalance and Cardiac Abnormalities in Chronic Experimental Chagas' Heart Disease  

PubMed Central

Background. Chagas disease (CD) is characterized by parasite persistence and immunological unbalance favoring systemic inflammatory profile. Chronic chagasic cardiomyopathy, the main manifestation of CD, occurs in a TNF-enriched milieu and frequently progresses to heart failure. Aim of the Study. To challenge the hypothesis that TNF plays a key role in Trypanosoma cruzi-induced immune deregulation and cardiac abnormalities, we tested the effect of the anti-TNF antibody Infliximab in chronically T. cruzi-infected C57BL/6 mice, a model with immunological, electrical, and histopathological abnormalities resembling Chagas' heart disease. Results. Infliximab therapy did not reactivate parasite but reshaped the immune response as reduced TNF mRNA expression in the cardiac tissue and plasma TNF and IFN? levels; diminished the frequency of IL-17A+ but increased IL-10+ CD4+ T-cells; reduced TNF+ but augmented IL-10+ Ly6C+ and F4/80+ cells. Further, anti-TNF therapy decreased cytotoxic activity but preserved IFN?-producing VNHRFTLV-specific CD8+ T-cells in spleen and reduced the number of perforin+ cells infiltrating the myocardium. Importantly, Infliximab reduced the frequency of mice afflicted by arrhythmias and second degree atrioventricular blocks and decreased fibronectin deposition in the cardiac tissue. Conclusions. Our data support that TNF is a crucial player in the pathogenesis of Chagas' heart disease fueling immunological unbalance which contributes to cardiac abnormalities. PMID:25140115

Pereira, Isabela Resende; Vilar-Pereira, Glaucia; Silva, Andrea Alice; Moreira, Otacilio Cruz; Britto, Constança; Sarmento, Ellen Diana Marinho

2014-01-01

56

Relationship between elevated serum troponin values in end-stage renal disease patients and abnormal isotopic cardiac scans following stress.  

PubMed

One hundred asymptomatic high-risk renal transplant candidates were screened for asymptomatic coronary artery disease using stress cardiac isotopic imaging. The cardiac markers, serum cTnT, cTnI, and CKMB, were collected pre and post stress testing. Of the 99 patients whose cardiac scans were technically satisfactory, 32 were normal, 49 had a definite imaging abnormality and the scan was indeterminate in the remaining 18 patients. Based on these results, patients were stratified into either normal, indeterminate or abnormal scan groups. They then were analyzed to detect any correlations between cardiac perfusion defects and either elevated pre-stress cardiac markers or consistent changes 24h after stress testing. While the mean pre-stress serum values for both cardiac troponin T (0.117 +/- 0.12 microgram/L) and cardiac troponin I (0.235 +/- 0.89 microgram/L) were increased in the abnormal cardiac scan group, only the cTnT value proved to differ significantly from the normal group (p < 0.01). For the indeterminate group neither marker was different from the normal scan group. Only an elevated serum cTnT > 0.1 microgram/L (OR 3.042, p = 0.030) proved to discriminate an abnormal scan in this population. It is concluded that the increase in pre-stress serum cTnT encountered in patients with chronic renal failure, with or without evidence of overt, symptomatic coronary artery disease, may represent a combination of subclinical myocardial damage and a prolonged half-life of the marker in the serum. Because of the frequency of elevated serum concentrations of cTnT and, to a lesser degree cTnI, the physician should exercise caution when interpreting a single elevated Troponin value during the evaluation of chest pain in patients with end-stage renal disease. A cTnT > 0.1 microgram/L increases the likelihood of finding significant coronary artery disease three fold in high-risk ESRD patients being evaluated for renal transplantation. PMID:12617333

Porter, George A; Norton, Theadore L; Lindsley, Jessie; Stevens, Jeffrey S; Phillips, David S; Bennett, William M

2003-01-01

57

Short-Lag Spatial Coherence (SLSC) Imaging of Cardiac Ultrasound Data: Initial Clinical Results  

PubMed Central

Short-Lag Spatial Coherence (SLSC) imaging is a novel beamforming technique that reduces acoustic clutter in ultrasound images. A clinical study was conducted to investigate clutter reduction and endocardial border detection in cardiac SLSC images. Individual channel echo data were acquired from the left ventricle of 14 volunteers, after informed consent and IRB approval. Paired B-mode and SLSC images were created from these data. Contrast, contrast-to-noise, and signal-to-noise ratios were measured in paired images, and these metrics were improved with SLSC imaging in most cases. Three cardiology fellows rated the visibility of endocardial segments in randomly ordered B-mode and SLSC cine loops. SLSC imaging offered 22–33% improvement (p < 0.05) in endocardial border visibility when B-mode image quality was poor (i.e. 80% or more of the endocardial segments could not be visualized by the three reviewers). The percentage of volunteers with poor-quality images was decreased from 21% to 7% with the SLSC beamformer. Results suggest that SLSC imaging has the potential to improve clinical cardiac assessments that are challenged by clutter. PMID:23932276

Lediju Bell, Muyinatu A.; Goswami, Robi; Kisslo, Joseph A.; Dahl, Jeremy J.; Trahey, Gregg E.

2013-01-01

58

Transmural Ultrasound Imaging of Thermal Lesion and Action Potential Changes in Perfused Canine Cardiac Wedge Preparations by High Intensity Focused Ultrasound Ablation  

PubMed Central

Intra-procedural imaging is important for guiding cardiac arrhythmia ablation. It is difficult to obtain intra-procedural correlation of thermal lesion formation with action potential (AP) changes in the transmural plane during ablation. This study tested parametric ultrasound imaging for transmural imaging of lesion and AP changes in high intensity focused ultrasound (HIFU) ablation using coronary perfused canine ventricular wedge preparations (n?=?13). The preparations were paced from epi/endocardial surfaces and subjected to HIFU application (3.5 MHz, 11 Hz pulse-repetition-frequency, 70% duty cycle, duration 4 s, 3500 W/cm2), during which simultaneous optical mapping (1 kframes/s) using di-4-ANEPPS and ultrasound imaging (30 MHz) of the same transmural surface of the wedge were performed. Spatiotemporally correlated AP measurements and ultrasound imaging allowed quantification of the reduction of AP amplitude (APA), shortening of AP duration at 50% repolarization, AP triangulation, decrease of optical AP rise, and change of conduction velocity along tissue depth direction within and surrounding HIFU lesions. The threshold of irreversible change in APA correlating to lesions was determined to be 43±1% with a receiver operating characteristic (ROC) area under curve (AUC) of 0.96±0.01 (n?=?13). Ultrasound imaging parameters such as integrated backscatter, Rayleigh (?) and log-normal (?) parameters, cumulative extrema of ? were tested, with the cumulative extrema of ? performing the best in detecting lesion (ROC AUC 0.89±0.01, n?=?13) and change of APA (ROC AUC 0.79±0.03, n?=?13). In conclusion, characteristic tissue and AP changes in HIFU ablation were identified and spatiotemporally correlated using optical mapping and ultrasound imaging. Parametric ultrasound imaging using cumulative extrema of ? can detect HIFU lesion and APA reduction. PMID:24349337

Wu, Ziqi; Gudur, Madhu S. R.; Deng, Cheri X.

2013-01-01

59

Association Between Tangential Beam Treatment Parameters and Cardiac Abnormalities After Definitive Radiation Treatment for Left-Sided Breast Cancer  

SciTech Connect

Purpose: To examine the association between radiation treatment (RT) parameters, cardiac diagnostic test abnormalities, and clinical cardiovascular diagnoses among patients with left-sided breast cancer after breast conservation treatment with tangential beam RT. Methods and Materials: The medical records of 416 patients treated between 1977 and 1995 with RT for primary left-sided breast cancer were reviewed for myocardial perfusion imaging and echocardiograms. Sixty-two patients (62/416, 15%) underwent these cardiac diagnostic tests for cardiovascular symptoms and were selected for further study. Central lung distance and maximum heart width and length in the treatment field were determined for each patient. Medical records were reviewed for cardiovascular diagnoses and evaluation of cardiac risk factors. Results: At a median of 12 years post-RT the incidence of cardiac diagnostic test abnormalities among symptomatic left-sided irradiated women was significantly higher than the predicted incidence of cardiovascular disease in the patient population, 6/62 (9%) predicted vs. 24/62 (39%) observed, p 0.001. As compared with patients with normal tests, patients with cardiac diagnostic test abnormalities had a larger median central lung distance (2.6 cm vs. 2.2 cm, p = 0.01). Similarly, patients with vs. without congestive heart failure had a larger median central lung distance (2.8 cm vs. 2.3 cm, p = 0.008). Conclusions: Contemporary RT for early breast cancer may be associated with a small, but potentially avoidable, risk of cardiovascular morbidity that is associated with treatment technique.

Correa, Candace R. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Das, Indra J. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)], E-mail: Das@xrt.upenn.edu; Litt, Harold I. [Department of Radiology-Cardiovascular Imaging Section, University of Pennsylvania, Philadelphia, PA (United States); Ferrari, Victor [Department of Medicine-Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA (United States); Hwang, W.-T. [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA (United States); Solin, Lawrence J.; Harris, Eleanor E. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

2008-10-01

60

Abnormal uterine bleeding as a presenting symptom is related to multiple uterine leiomyoma: an ultrasound-based study  

PubMed Central

Purpose To determine the prevalence of uterine leiomyomas, diagnosed by ultrasound, in a private health care setting located in the central eastern region of Portugal, and to explore the demographic and clinical factors related to diagnosis and symptomatology. Patients and methods The files of 624 patients attending a private clinic in Covilhã, Portugal, from January 2 to December 31, 2010 were retrieved for evaluation. Pelvic ultrasound record, age, weight, height, age at menarche, number of pregnancies and deliveries, marital status, menstrual cycles characteristic, and contraceptive method at consultation were included in the analysis. Results Uterine leiomyoma (UL) was diagnosed by ultrasonography in 161 (25.8%) patients. A single UL was diagnosed in 80 (49.7%) patients. In 79 (49.1%) patients, the largest leiomyoma had a dimension <20 mm. Prevalence of UL was age dependent: at 11.0% for women 20–39 years old; 45.4% for those aged 40–59 years; and 19.5% for women 60 years or older. Metrorrhagia was the most distressing presenting symptom. When menorrhagia was the presenting symptom, the probability of having an ultrasound diagnosis of UL was 73.3%. Metrorrhagia or menorrhagia, as presenting symptom, was significantly related to the ultrasound diagnosis of multiple ULs. Conclusion UL was especially prevalent in women aged between 40 and 59 years. Patients with multiple ULs had significantly more abnormal uterine bleeding. In patients with menorrhagia or metrorrhagia, special attention should be taken in searching for the presence of multiple ULs during ultrasound. PMID:24194648

Fonseca-Moutinho, José Alberto; Barbosa, Lígia Silva; Torres, Daniel Gonçalves; Nunes, Sara Morgado

2013-01-01

61

PET contributions to understanding normal and abnormal cardiac perfusion and metabolism.  

PubMed

Noninvasive positron emission tomography (PET)-based studies of myocardial blood flow and substrate metabolism characterized the human heart as an organ fully integrated with the general function of the human body. Cardiac energy demands are tightly coupled to peripheral needs in oxygen and, in turn, govern changes in myocardial blood flow and substrate supply. Substrate selection and utilization depend largely on substrate availability and, hence, on concentrations of fuel substrate in blood. Endocrine and neuronal factors together with regional transport processes modulate and fine tune regional rates of substrate utilization. Manipulation of substrate availability as for example through dietary or pharmacologic maneuvers offer a means to probe regional substrate interactions, to demonstrate shifts in substrate selection between free fatty acid and glucose and, hence, to confirm the operation of regulatory mechanisms established previously in animal experiments. In abnormal states, local factors modulate the generally integrated responses and synchronize regional substrate utilization and metabolism with regional needs. Diminished substrate delivery in chronic low flow conditions is matched by a down regulation in regional contractile function possibly as an energy saving measure, together with a decline in oxidative metabolism as evidenced by reduced oxidation of 11C-palmitate and delayed turnover of 11C-acetate. Activation of rate controlling enzymes together with enhanced transmembraneous transport systems represent flux generating steps for enhanced regional glucose consumption possibly as a means for reducing oxygen needs and at the same time, preserving cellular homeostasis. PET identifies such regional metabolic adjustments as regional increases in 18F-deoxyglucose uptake as a clinically useful hallmark of myocardial viability. Regional glucose utilization in this case no longer fully responds to general control mechanisms of substrate selection but is modified by local factors or, ultimately may become part of a local microsystem as a means of protection against potentially deleterious consequences of disease. PMID:11144676

Schelbert, H R

2000-08-01

62

Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The Prospective P2C2 HIV Study  

PubMed Central

Objective To describe the 5-year cumulative incidence of cardiac dysfunction in human immunodeficiency virus (HIV)-infected children. Study design We used a prospective cohort design, enrolling children at 10 hospitals. Group I included 205 vertically HIV-infected children enrolled at a median age of 1.9 years. Group II consisted of 600 HIV-exposed children enrolled prenatally or as neonates, of whom 93 were ultimately HIV-infected. The main outcome measures were echocardiographic indexes of left ventricular dysfunction. Results In group I, the 5-year cumulative incidence of left ventricular fractional shortening ?25% was 28.0%. The 5-year incidence of left ventricular end-diastolic dilatation was 21.7%, and heart failure and/or the use of cardiac medications 28.8%. The mortality rate 1 year after the diagnosis of heart failure was 52.5% [95% CI, 30.5-74.5]. Within group II, the 5-year cumulative incidence of decreased fractional shortening was 10.7% in the HIV-infected compared with 3.1% in the HIV-uninfected children (P = .01). Left ventricular dilation, heart failure, and/or the use of cardiac medications were more common in infected compared with uninfected children. Conclusions During 5 years of follow-up, cardiac dysfunction occurred in 18% to 39% of HIV-infected children and was associated with an increased risk of death. We recommend that HIV-infected children undergo routine echocardiographic surveillance for cardiac abnormalities. PMID:12219051

Starc, Thomas J.; Lipshultz, Steven E.; Easley, Kirk A.; Kaplan, Samuel; Bricker, J. Timothy; Colan, Steven D.; Lai, Wyman W.; Gersony, Welton M.; Sopko, George; Moodie, Douglas S.; Schluchter, Mark D.

2015-01-01

63

Breast biopsy - ultrasound  

MedlinePLUS

Biopsy - breast - ultrasound; Ultrasound-guided breast biopsy; Core needle breast biopsy - ultrasound ... to evaluate abnormal findings on a mammogram or breast ultrasound , or during a physical exam. To determine whether ...

64

Noninvasive Ambient Pressure Estimation using Ultrasound Contrast Agents -- Invoking Subharmonics for Cardiac and Hepatic Applications  

NASA Astrophysics Data System (ADS)

Ultrasound contrast agents (UCAs) are encapsulated microbubbles that provide a source for acoustic impedance mismatch with the blood, due to difference in compressibility between the gas contained within these microbubbles and the blood. When insonified by an ultrasound beam, these UCAs act as nonlinear scatterers and enhance the echoes of the incident pulse, resulting in scattering of the incident ultrasound beam and emission of fundamental (f0), subharmonic (f0/2), harmonic (n*f0; n ? N) and ultraharmonic (((2n-1)/2)*f0; n ? N & n > 1) components in the echo response. A promising approach to monitor in vivo pressures revolves around the fact that the ultrasound transmit and receive parameters can be selected to induce an ambient pressure amplitude dependent subharmonic signal. This subharmonic signal may be used to estimate ambient pressure amplitude; such technique of estimating ambient pressure amplitude is referred to as subharmonic aided pressure estimation or SHAPE. This project develops and evaluates the feasibility of SHAPE to noninvasively monitor cardiac and hepatic pressures (using commercially available ultrasound scanners and UCAs) because invasive catheter based pressure measurements are used currently for these applications. Invasive catheter based pressure measurements pose risk of introducing infection while the catheter is guided towards the region of interest in the body through a percutaneous incision, pose risk of death due to structural or mechanical failure of the catheter (which has also triggered product recalls by the USA Food and Drug Administration) and may potentially modulate the pressures that are being measured. Also, catheterization procedures require fluoroscopic guidance to advance the catheter to the site of pressure measurements and such catheterization procedures are not performed in all clinical centers. Thus, a noninvasive technique to obtain ambient pressure values without the catheterization process is clinically helpful. While an intravenous injection is required to inject the UCAs into the body, this procedure is considered noninvasive as per the definition provided by the Center for Medicare and Medicaid Services; invasive procedures include surgical procedures as well as catheterization procedures while minor procedures such as drawing blood (which requires a similar approach as injecting UCAs) are considered noninvasive. In vitro results showed that the standard error between catheter pressures and SHAPE results is below 10 mmHg with a correlation coefficient value of above 0.9—this experimental error of 10 mmHg is less than the errors associated with other techniques utilizing UCAs for ambient pressure estimation. In vivo results proved the feasibility of SHAPE to noninvasively estimate clinically relevant left and right ventricular (LV and RV) pressures. The maximum error in estimating the LV and RV systolic and diastolic pressures was 3.5 mmHg. Thus, the SHAPE technique may be useful for systolic and diastolic pressure estimation given that the standard recommendations require the errors for these pressure measurements to be within 5 mmHg. The ability of SHAPE to identify induced portal hypertension (PH) was also proved. The changes in the SHAPE data correlated significantly (p < 0.05) with the changes in the portal vein (PV) pressures and the absolute amplitudes of the subharmonic signal also correlated with absolute PV pressures. The SHAPE technique provides the ability to noninvasively obtain in vivo pressures. This technique is applicable not only for critically ill patients, but also for screening symptomatic patients and potentially for other clinical pressure monitoring applications, as well.

Dave, Jaydev K.

65

Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device  

PubMed Central

Background. The potential of pocket-sized ultrasound devices (PUDs) to improve global healthcare delivery is limited by the lack of a suitable imaging protocol and trained users. Therefore, we investigated the feasibility of performing a brief, evidence-based cardiac limited ultrasound exam (CLUE) through wireless guidance of novice users. Methods. Three trainees applied PUDs on 27 subjects while directed by an off-site cardiologist to obtain a CLUE to screen for LV systolic dysfunction (LVSD), LA enlargement (LAE), ultrasound lung comets (ULC+), and elevated CVP (eCVP). Real-time remote audiovisual guidance and interpretation by the cardiologist were performed using the iPhone 4/iPod (FaceTime, Apple, Inc.) attached to the PUD and transmitted data wirelessly. Accuracy and technical quality of transmitted images were compared to on-site, gold-standard echo thresholds. Results. Novice versus sonographer imaging yielded technically adequate views in 122/135 (90%) versus 130/135 (96%) (P < 0.05). CLUE's combined SN, SP, and ACC were 0.67, 0.96, and 0.90. Technical adequacy (%) and accuracy for each abnormality (n) were LVSD (85%, 0.93, n = 5), LAE (89%, 0.74, n = 16), ULC+ (100%, 0.94, n = 5), and eCVP (78%, 0.91, n = 1). Conclusion. A novice can perform the CLUE using PUD when wirelessly guided by an expert. This method could facilitate PUD use for off-site bedside medical decision making and triaging of patients. PMID:24024032

Mai, Tuan V.; Ahn, David T.; Phillips, Colin T.; Agan, Donna L.; Kimura, Bruce J.

2013-01-01

66

Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree  

Microsoft Academic Search

Gastroenterologists increasingly find themselves in the unenviable position of having to choose the optimal radiographic test\\u000a to visualize the biliary tree and the liver. This dilemma is compounded by the rapid evolution of the available technologies\\u000a and their ever-increasing resolution capabilities. Endoscopic ultrasound (EUS) has shown itself to be equally capable of providing\\u000a detailed imaging of the biliary tree and

Girish Mishra; Jason D. Conway

2009-01-01

67

Ultrasound  

Cancer.gov

Ultrasound uses sound waves with frequencies above those humans can hear. A transducer sends sound waves traveling into the body which are reflected back from organs and tissues, allowing a picture to be made of the internal organs. Ultrasound can show

68

Reversibility of cardiac wall-motion abnormalities predicted by positron tomography  

Microsoft Academic Search

Positron emission tomography (PET) can be used with nitrogen-13-ammonia (13NH3) to estimate regional myocardial blood flow, and with fluorine-18-deoxyglucose (18FDG) to measure exogenous glucose uptake by the myocardium. We used PET to predict whether preoperative abnormalities in left ventricular wall motion in 17 patients who underwent coronary-artery bypass surgery were reversible. The abnormalities were quantified by radionuclide or contrast angiography

J. Tillisch; R. Brunken; R. Marshall; M. Schwaiger; M. Mandelkern; M. Phelps; H. Schelbert

1986-01-01

69

Highly abnormal thermotests in familial dysautonomia suggest increased cardiac autonomic risk  

Microsoft Academic Search

OBJECTIVEPatients with familial dysautonomia have an increased risk of sudden death. In some patients with familial dysautonomia, sympathetic cardiac dysfunction is indicated by prolongation of corrected QT (QTc) interval, especially during stress tests. As many patients do not tolerate physical stress, additional indices are needed to predict autonomic risk. In familial dysautonomia there is a reduction of both sympathetic neurons

Max J Hilz; Edwin H Kolodny; Irene Neuner; Brigitte Stemper; Felicia B Axelrod

1998-01-01

70

Ultrasound  

MedlinePLUS

... findings that might indicate an increased risk for Down syndrome A pregnancy ultrasound may also be done in ... weeks of pregnancy to look for signs of Down syndrome or other problems in the developing baby. This ...

71

Ultrasound  

MedlinePLUS

... reflect off body structures. A computer receives the waves and uses them to create a picture. Unlike with an x-ray or CT scan, this test does not use ionizing radiation. The test is done in the ultrasound ...

72

Ultrasound  

MedlinePLUS Videos and Cool Tools

... procedure for monitoring the baby’s development in the uterus. Ultrasound uses inaudible sound waves to produce a ... image of the baby while inside the mother’s uterus. The sound waves bounce off solid structures in ...

73

Ultrasound of the equine acute abdomen.  

PubMed

Abdominal ultrasound is an invaluable aid in the evaluation of the colic patient but can be heavily influenced by patient preparation, individual horse-to-horse variation, availability of ultrasound transducers, technique, experience level of the examiner, and complexity of the abdominal disorder. This article describes ultrasonographic anatomy of the normal equine abdomen and technique for examination of the equine colic patient. Common abnormalities of the stomach, small intestine, large intestine, and peritoneal cavity are described along with other abnormalities that may be discovered with abdominal ultrasonography of the colic patient, such as masses, urolithiasis, cholelithiasis, and thoracic or cardiac lesions. PMID:25016496

le Jeune, Sarah; Whitcomb, Mary Beth

2014-08-01

74

Ultrasound demonstration of distal biceps tendon bifurcation: normal and abnormal findings.  

PubMed

We demonstrate the US appearance of the distal biceps tendon bifurcation in normal cadavers and volunteers and in those affected by various disease processes. Three cadaveric specimens, 30 normal volunteers, and 75 patients were evaluated by means of US. Correlative MR imaging was obtained in normal volunteers and patients. In all cases US demonstrated the distal biceps tendon shaped by two separate tendons belonging to the short and long head of the biceps brachii muscle. Four patients had a complete rupture of the distal insertion of the biceps with retraction of the muscle belly. Four patients had partial tear of the distal biceps tendon with different US appearance. In two patients the partial tear involved the short head of the biceps brachii tendon, while in the other two patients, the long head was involved. Correlative MR imaging is also presented both in normal volunteers and patients. US changed the therapeutic management in the patients with partial tears involving the LH of the biceps. This is the first report in which ultrasound considers the distal biceps tendon bifurcation in detail. Isolated tears of one of these components can be identified by US. Knowledge of the distal biceps tendon bifurcation ultrasonographic anatomy and pathology has important diagnostic and therapeutic implications. PMID:19657654

Tagliafico, Alberto; Michaud, Johan; Capaccio, Enrico; Derchi, Lorenzo E; Martinoli, Carlo

2010-01-01

75

Protective effect of low molecular weight heparin on oxidative injury and cellular abnormalities in adriamycin-induced cardiac and hepatic toxicity  

Microsoft Academic Search

The aim of the present work is to evaluate the effect of a heparin derivative, low molecular weight heparin (LMWH) on the biochemical changes, tissue peroxidative damage and abnormal antioxidant levels in adriamycin (ADR) induced cardiac and hepatic toxicity. Male Wistar rats (140±10g) were divided into four groups: untreated control (group I), ADR group (a single dose intravenous injection of

P. R. Deepa; P. Varalakshmi

2003-01-01

76

Ultrasound  

MedlinePLUS

... couldn't see my baby at my 7 week ultrasound. Why? At the 7th week of pregnancy, your baby is about ½ an ... 1 in 120 pregnancies at 15 to 20 weeks gestation. Most disappear during pregnancy or within several ...

77

Differences in cardiac autonomic function contributes to heart rate abnormalities in POTS and IST.  

PubMed

Our objective was to examine the differences in cardiac autonomic function in Postural Tachycardia Syndrome (POTS) versus inappropriate sinus tachycardia (IST). Subjects (IST, n=8; POTS, n=12) were studied using standard measurements of the autonomic reflex screen, baroreflex function and spectral analysis. Data was compared to age/gender-matched controls (n=20). The components of the autonomic reflex screen did not differ between groups. The exception was the significant but expected difference in postural heart rate increment on head-up tilt in POTS (47.9±13.8; n=12) compared to IST (30.9±9.7; n=8; p=0.008). Accordingly the Orthostatic Intolerance Scale showed significantly greater orthostatic symptoms in POTS (2.6±0.5; n=12) versus IST patients (0.4±0.5; n=8; p<0.001). Conversely, IST patients had a significantly higher resting heart rate (96±12; n=8) when compared to POTS patients (73±12; n=12; p=0.001). There was a significant difference in vagal baroreflex sensitivity (BRSv) in POTS (8.21±2.3, n=12) compared to IST patients (5.30±2.94, n=8, p=0.036) during the Valsalva maneuver. Only POTS subjects showed a significant increase in sympathovagal balance (LF/HF) with tilt (FFT, 8.29±6.38; AR, 7.84±5.24) compared to the supine position (FFT, 2.25±1.75; AR, 1.99±1.38; p<0.05) for both frequency domains. Differences in cardiac autonomic function contribute to changes in positional and non-positional heart rate in postural tachycardia syndrome versus inappropriate sinus tachycardia. These findings shed further light on the autonomic dysfunction underlying POTS and IST. PMID:25277318

Corkal, James C; Palamarchuk, Iryna; Kimpinski, Kurt

2014-12-01

78

Cardiac troponin I is abnormally expressed in non-small cell lung cancer tissues and human cancer cells  

PubMed Central

Cardiac troponin I (cTnI) is the only sarcomeric protein identified to date that is expressed exclusively in cardiac muscle. Its expression in cancer tissues has not been reported. Herein, we examined cTnI expression in non-small cell lung cancer (NSCLC) tissues, human adenocarcinoma cells SPCA-1 (lung) and BGC 823 (gastric) by immunohistochemistry, western blot analysis and real-time PCR. Immunopositivity for cTnI was demonstrated in 69.4% (34/49) NSCLC tissues evaluated, and was strong intensity in 35.3% (6/17) lung squamous cell carcinoma cases. The non-cancer-bearing lung tissues except tuberculosis (9/9, 100%) showed negative staining for cTnI. Seven monoclonal antibodies (mAbs) against human cTnI were applied in immunofluorescence. The result showed that the staining pattern within SPCA-1 and BGC 823 was dependent on the epitope of the cTnI mAbs. The membrane and nucleus of cancer cells were stained by mAbs against N-terminal peptides of cTnI, and cytoplasm was stained by mAbs against the middle and C-terminal peptides of cTnI. A ~25 kD band was identified by anti-cTnI mAb in SPCA-1 and BGC 823 extracts by western blot, as well as in cardiomyocyte extracts. The cTnI mRNA expressions in SPCA-1 and BGC 823 cells were about ten thousand times less than that in cardiomyocytes. Our study shows for the first time that cTnI protein and mRNA were abnormally expressed in NSCLC tissues, SPCA-1 and BGC 823 cells. These findings challenge the conventional view of cTnI as a cardiac-specific protein, enabling the potential use of cTnI as a diagnostic marker or targeted therapy for cancer. PMID:24817928

Chen, Chao; Liu, Jia-Bao; Bian, Zhi-Ping; Xu, Jin-Dan; Wu, Heng-Fang; Gu, Chun-Rong; Shi, Yi; Zhang, Ji-Nan; Chen, Xiang-Jian; Yang, Di

2014-01-01

79

Functional, morphological and electrocardiographical abnormalities in patients with apical hypertrophic cardiomyopathy and apical aneurysm: correlation with cardiac MR  

PubMed Central

Objective The prognosis of apical hypertrophic cardiomyopathy (APH) has been benign, but apical myocardial injury has prognostic importance. We studied functional, morphological and electrocardiographical abnormalities in patients with APH and with apical aneurysm and sought to find parameters that relate to apical myocardial injury. Methods Study design: a multicentre trans-sectional study. Patients: 45 patients with APH and 5 with apical aneurysm diagnosed with transthoracic echocardiography (TTE) in the database of Hamamatsu Circulation Forum. Measure: the apical contraction with cine-cardiac MR (CMR), the myocardial fibrotic scar with late gadolinium enhancement (LGE)-CMR, and QRS fragmentation (fQRS) defined when two ECG-leads exhibited RSR’s patterns. Results Cine-CMR revealed 27 patients with normal, 12 with hypokinetic and 11 with dyskinetic apical contraction. TTE misdiagnosed 11 (48%) patients with hypokinetic and dyskinetic contraction as those with normal contraction. Apical LGE was apparent in 10 (83%) and 11 (100%) patients with hypokinetic and dyskinetic contraction, whereas only in 11 patients (41%) with normal contraction (p<0.01). Patients with dyskinetic apical contraction had the lowest left ventricular ejection fraction, the highest prevalence of ventricular tachycardia, and the smallest ST depression and depth of negative T waves. The presence of fQRS was associated with impaired apical contraction and apical LGE (OR=8.32 and 8.61, p<0.05). Conclusions CMR is superior to TTE for analysing abnormalities of the apex in patients with APH and with apical aneurysm. The presence of fQRS can be a promising parameter for the early detection of apical myocardial injury. PMID:25332823

Suwa, Kenichiro; Satoh, Hiroshi; Sano, Makoto; Nobuhara, Mamoru; Saitoh, Takeji; Saotome, Masao; Urushida, Tsuyoshi; Katoh, Hideki; Tawarahara, Kei; Ohtani, Hayato; Wakabayashi, Yasushi; Takase, Hiroyuki; Terada, Hajime; Takehara, Yasuo; Sakahara, Harumi; Hayashi, Hideharu

2014-01-01

80

Fibroblast growth factor 23 (FGF23) gene polymorphism in children with Kawasaki syndrome (KS) and susceptibility to cardiac abnormalities  

PubMed Central

Background Fibroblast Growth Factor (FGF) 23 influences endothelial integrity and few reports have studied the association between FGF23 and Kawasaki syndrome (KS), a childhood vasculitis displaying a high risk of subsequent cardiac abnormalities (CaA). Aim To investigate the genetic variation in the FGF23 gene in a cohort of KS children and its association with serum FGF23 levels and eventual development of CaA, including both coronary artery dilatations and aneurysms. Patients and methods 84 Italian KS children were recruited; 24/84 (28.6%) developed CaA. Each patient underwent evaluation of serum FGF23 levels and FGF23 genotype: the frequency of the c.212-37insC (rs3832879) polymorphism in intron 1 was examined and compared with sex, age at disease onset, fever duration, laboratory data, and occurrence of CaA. Univariate statistical analysis of categorical parameters was performed by the Pearson’s Chi-square test or Fisher’s exact test as appropriate. Parametric variables were assessed by Student’s t-test for unpaired data. Independent predictors of disease were studied by a logistic regression model. Results 28/84 patients carried the FGF23 polymorphism (33.3%) and had higher serum FGF23 levels (p abnormalities in KS. PMID:24168888

2013-01-01

81

Ultrasound Shear Wave Elasticity Imaging Quantifies Coronary Perfusion Pressure Effect on Cardiac Compliance.  

PubMed

Diastolic Heart Failure (DHF) is a major source of cardiac related morbidity and mortality in the world today. A major contributor to, or indicator of DHF is a change in cardiac compliance. Currently, there is no accepted clinical method to evaluate the compliance of cardiac tissue in diastolic dysfunction. Shear Wave Elasticity Imaging (SWEI) is a novel ultrasoundbased elastography technique that provides a measure of tissue stiffness. Coronary perfusion pressure affects cardiac stiffness during diastole; we sought to characterize the relationship between these two parameters using the SWEI technique. In this work, we demonstrate how changes in coronary perfusion pressure are reflected in a local SWEI measurement of stiffness during diastole. Eight Langendorff perfused isolated rabbit hearts were used in this study. Coronary perfusion pressure was changed in a randomized order (0 to 90 mmHg range) and SWEI measurements were recorded during diastole with each change. Coronary perfusion pressure and the SWEI measurement of stiffness had a positive linear correlation with the 95% Confidence Interval (CI) for the slope of 0.009-0.011 m/s/mmHg (R2=0.88). Furthermore, shear modulus was linearly correlated to the coronary perfusion pressure with the 95% CI of this slope of 0.035-0.042 kPa/mmHg (R2 = 0.83). In conclusion, diastolic SWEI measurements of stiffness can be used to characterize factors affecting cardiac compliance specifically the mechanical interaction (cross-talk) between perfusion pressure in the coronary vasculature and cardiac muscle. This relationship was found to be linear over the range of pressures tested. PMID:25291788

Vejdani-Jahromi, Maryam; Nagle, Matt; Trahey, Gregg; Wolf, Patrick

2014-09-30

82

The electrocardiographic abnormalities in highly trained athletes compared to the genetic study related to causes of unexpected sudden cardiac death  

PubMed Central

Background: Electrocardiograms in elite endurance athletes sometimes show bizarre patterns suggestive of inherited channelopathies (Brugada syndrome, long QTc, catecholaminergic polymorphic ventricular tachycardia) and cardiomyopathies (arrhythmogenic right ventricular cardiomyopathy, hypertrophic cardiomyopathy) responsible for unexpected sudden cardiac death. Among other methods, genetic analyses are required for correct diagnosis. Objective: To correlate 12– lead electrocardiographic patterns suggestive of inherited channelopathies and cardiomyopathies to specific genetic analyses. Design: Prospective study (2004–2007) of screening 12–lead ECG tracings in standard position and higher intercostal spaces V1 to V3 precordial leads, performed in athletes and normal sedentary subjects aged match. Genetic analyses of subjects with ECG abnormalities suggested inherited channelopathies and cardiomyopathies. Setting: All cardiologic exams and electrocardiograms were performed at ‘Prof. Dr. C.C. Iliescu’ National Institute of Cardiovascular Diseases (Bucharest, Romania). The genetic studies were done at ‘Mina Minovici’ National Institute of Forensic Medicine (Bucharest, Romania). Participants: 347 elite endurance athletes (seniors–190, juniors–157), mean age of 20; 200 subjects mean age of 21, belonging to the control group of 505 normal sedentary population. Results: Seniors. RSR' (V1 to V3) pattern, in 45 cases (23.68%), 5 of them with questionable Brugada sign (elevated J wave and ‘coved’ ST segment,< 2mm in one lead, V1. Typically, Brugada 1 sign was found in one case (0.52%) with no SCN5A abnormalities. One athlete (0.52%) had normal ECG and exon1 SCN5A duplication. MRI confirmed three arrhythmic right ventricular cardiomypathy epsilon waves (1.57%), in one case. ST–segment elevation myocardial injury like in V1–V3 precordial leads in 34 athletes (17.89%).Genetic analyses–no gene mutations. Juniors Upright J wave was found in 43 cases (27.38%). Convex ST segment elevation in V1–V3/V4, in 39 cases (24.84%). Bifid T wave with two distinct peaks was found in 39 cases (24.84%), 5 of them with mild prolonged QTc (0.48 ‘–0.56’) and KCN genes mutations. Nine (5.73%) of the elevated ST segment juniors had questionable Brugada sign, two of which with KCN (n=1) and SCN5A (n=1) gene mutations. Ajmaline provocative test was negative in 4 and was refused by 5 subjects. Conclusion: Bizarre QRS, ST–T patterns suggestive of abnormal impulse conduction in the right ventricle, including the right outflow tract, associated with prolonged QTc interval in some cases were observed in highly trained endurance athletes. The genetic analyses, negative in most athletes, identified surprising mutations in SCN5A and KCN genes in some cases. PMID:20108749

Macarie, C; Dermengiu, D; Barbarii, L; Tepes Piser, I; Chioncel, O; Carp, A; Stoian, I

2009-01-01

83

Exercise training delays cardiac dysfunction and prevents calcium handling abnormalities in sympathetic hyperactivity-induced heart failure mice.  

PubMed

Exercise training (ET) is a coadjuvant therapy in preventive cardiology. It delays cardiac dysfunction and exercise intolerance in heart failure (HF); however, the molecular mechanisms underlying its cardioprotection are poorly understood. We tested the hypothesis that ET would prevent Ca(2+) handling abnormalities and ventricular dysfunction in sympathetic hyperactivity-induced HF mice. A cohort of male wild-type (WT) and congenic alpha(2A)/alpha(2C)-adrenoceptor knockout (alpha(2A)/alpha(2C)ARKO) mice with C57BL6/J genetic background (3-5 mo of age) were randomly assigned into untrained and exercise-trained groups. ET consisted of 8-wk swimming session, 60 min, 5 days/wk. Fractional shortening (FS) was assessed by two-dimensional guided M-mode echocardiography. The protein expression of ryanodine receptor (RyR), phospho-Ser(2809)-RyR, sarcoplasmic reticulum Ca(2+) ATPase (SERCA2), Na(+)/Ca(2+) exchanger (NCX), phospholamban (PLN), phospho-Ser(16)-PLN, and phospho-Thr(17)-PLN were analyzed by Western blotting. At 3 mo of age, no significant difference in FS and exercise tolerance was observed between WT and alpha(2A)/alpha(2C)ARKO mice. At 5 mo, when cardiac dysfunction is associated with lung edema and increased plasma norepinephrine levels, alpha(2A)/alpha(2C)ARKO mice presented reduced FS paralleled by decreased SERCA2 (26%) and NCX (34%). Conversely, alpha(2A)/alpha(2C)ARKO mice displayed increased phospho-Ser(16)-PLN (76%) and phospho-Ser(2809)-RyR (49%). ET in alpha(2A)/alpha(2C)ARKO mice prevented exercise intolerance, ventricular dysfunction, and decreased plasma norepinephrine. ET significantly increased the expression of SERCA2 (58%) and phospho-Ser(16)-PLN (30%) while it restored the expression of phospho-Ser(2809)-RyR to WT levels. Collectively, we provide evidence that improved net balance of Ca(2+) handling proteins paralleled by a decreased sympathetic activity on ET are, at least in part, compensatory mechanisms against deteriorating ventricular function in HF. PMID:17975126

Medeiros, Alessandra; Rolim, Natale P L; Oliveira, Rodrigo S F; Rosa, Kaleizu T; Mattos, Katt C; Casarini, Dulce E; Irigoyen, Maria Claúdia; Krieger, Eduardo M; Krieger, José Eduardo; Negrão, Carlos Eduardo; Brum, Patricia C

2008-01-01

84

AKAP13 Rho-GEF and PKD-Binding Domain Deficient Mice Develop Normally but Have an Abnormal Response to ?-Adrenergic-Induced Cardiac Hypertrophy  

PubMed Central

Background A-kinase anchoring proteins (AKAPs) are scaffolding molecules that coordinate and integrate G-protein signaling events to regulate development, physiology, and disease. One family member, AKAP13, encodes for multiple protein isoforms that contain binding sites for protein kinase A (PKA) and D (PKD) and an active Rho-guanine nucleotide exchange factor (Rho-GEF) domain. In mice, AKAP13 is required for development as null embryos die by embryonic day 10.5 with cardiovascular phenotypes. Additionally, the AKAP13 Rho-GEF and PKD-binding domains mediate cardiomyocyte hypertrophy in cell culture. However, the requirements for the Rho-GEF and PKD-binding domains during development and cardiac hypertrophy are unknown. Methodology/Principal Findings To determine if these AKAP13 protein domains are required for development, we used gene-trap events to create mutant mice that lacked the Rho-GEF and/or the protein kinase D-binding domains. Surprisingly, heterozygous matings produced mutant mice at Mendelian ratios that had normal viability and fertility. The adult mutant mice also had normal cardiac structure and electrocardiograms. To determine the role of these domains during ?-adrenergic-induced cardiac hypertrophy, we stressed the mice with isoproterenol. We found that heart size was increased similarly in mice lacking the Rho-GEF and PKD-binding domains and wild-type controls. However, the mutant hearts had abnormal cardiac contractility as measured by fractional shortening and ejection fraction. Conclusions These results indicate that the Rho-GEF and PKD-binding domains of AKAP13 are not required for mouse development, normal cardiac architecture, or ?-adrenergic-induced cardiac hypertrophic remodeling. However, these domains regulate aspects of ?-adrenergic-induced cardiac hypertrophy. PMID:23658642

Spindler, Matthew J.; Burmeister, Brian T.; Huang, Yu; Hsiao, Edward C.; Salomonis, Nathan; Scott, Mark J.; Srivastava, Deepak; Carnegie, Graeme K.; Conklin, Bruce R.

2013-01-01

85

The natural history of hip abnormalities detected by ultrasound in clinically normal newborns: a 6-8 year radiographic follow-up study of 93 children.  

PubMed

Ultrasound screening for hip dysplasia or dislocation has revealed a group of children with clinically normal hips, but with abnormal or suspicious ultrasound. During the 3-year period 1988-90, we found 170 children with this combination. We evaluated the natural history of these hips. 93 children were examined clinically and with standard radiography 6-8 years after birth. The center edge (CE) angle of Wiberg and migration percentage (MP) were measured on the radiographs. 87 children had not undergone any treatment, whereas treatment with an abduction orthosis had been initiated at approximately 4 months of age because of persisting dysplasia in 6 cases. All hips were radiographically normal at this follow-up. The mean CE value was 24 degrees (SD 6.5) and the mean MP was 13% (SD 5.2). 73 children had no complaints in their lower extremities, whereas 12 had intoeing gait, 1 had outtoeing gait, 2 had hip or knee pain, and 5 had other complaints not relevant to hip dysplasia. We conclude that infants with sonographically abnormal or suspicious hips, but with normal clinical findings, do not need immediate treatment because spontaneous resolution occurs in most of them. Postponement of treatment in the few with persistent dysplasia does not seem to affect the outcome. PMID:10569261

Tegnander, A; Holen, K J; Terjesen, T

1999-08-01

86

Ultrasound for the Anesthesiologists: Present and Future  

PubMed Central

Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum. PMID:24348179

Terkawi, Abdullah S.; Karakitsos, Dimitrios; Elbarbary, Mahmoud; Blaivas, Michael; Durieux, Marcel E.

2013-01-01

87

Ultrasound simulator-assisted teaching of cardiac anatomy to preclinical anatomy students: A pilot randomized trial of a three-hour learning exposure.  

PubMed

Ultrasound simulation allows students to virtually explore internal anatomy by producing accurate, moving, color, three-dimensional rendered slices from any angle or approach leaving the organs and their relationships intact without requirement for consumables. The aim was to determine the feasibility and efficacy of self-directed learning of cardiac anatomy with an ultrasound simulator compared to cadavers and plastic models. After a single cardiac anatomy lecture, fifty university anatomy students participated in a three-hour supervised self-directed learning exposure in groups of five, randomized to an ultrasound simulator or human cadaveric specimens and plastic models. Pre- and post-tests were conducted using pictorial and non-pictorial multiple-choice questions (MCQs). Simulator students completed a survey on their experience. Four simulator and seven cadaver group students did not attend after randomization. Simulator use in groups of five students was feasible and feedback from participants was very positive. Baseline test scores were similar (P = 0.9) between groups. After the learning intervention, there was no difference between groups in change in total test score (P = 0.37), whether they were pictorial (P = 0.6) or non-pictorial (P = 0.21). In both groups there was an increase in total test scores (simulator +19.8 ±12.4%% and cadaver: +16.4% ± 10.2, P < 0.0001), pictorial question scores (+22.9 ±18.0%, 19.7 ±19.3%, P < 0.001) and non-pictorial question scores (+16.7 ±18.2%, +13 ±15.4%, P = 0.002). The ultrasound simulator appears equivalent to human cadaveric prosections for learning cardiac anatomy. Anat Sci Educ 8: 21-30. © 2014 American Association of Anatomists. PMID:24706544

Canty, David Jeffrey; Hayes, Jenny A; Story, David Andrew; Royse, Colin Forbes

2015-01-01

88

Segmentation of left atrial intracardiac ultrasound images for image guided cardiac ablation therapy  

NASA Astrophysics Data System (ADS)

Intracardiac echocardiography (ICE), a technique in which structures of the heart are imaged using a catheter navigated inside the cardiac chambers, is an important imaging technique for guidance in cardiac ablation therapy. Automatic segmentation of these images is valuable for guidance and targeting of treatment sites. In this paper, we describe an approach to segment ICE images by generating an empirical model of blood pool and tissue intensities. Normal, Weibull, Gamma, and Generalized Extreme Value (GEV) distributions are fit to histograms of tissue and blood pool pixels from a series of ICE scans. A total of 40 images from 4 separate studies were evaluated. The model was trained and tested using two approaches. In the first approach, the model was trained on all images from 3 studies and subsequently tested on the 40 images from the 4th study. This procedure was repeated 4 times using a leave-one-out strategy. This is termed the between-subjects approach. In the second approach, the model was trained on 10 randomly selected images from a single study and tested on the remaining 30 images in that study. This is termed the within-subjects approach. For both approaches, the model was used to automatically segment ICE images into blood and tissue regions. Each pixel is classified using the Generalized Liklihood Ratio Test across neighborhood sizes ranging from 1 to 49. Automatic segmentation results were compared against manual segmentations for all images. In the between-subjects approach, the GEV distribution using a neighborhood size of 17 was found to be the most accurate with a misclassification rate of approximately 17%. In the within-subjects approach, the GEV distribution using a neighborhood size of 19 was found to be the most accurate with a misclassification rate of approximately 15%. As expected, the majority of misclassified pixels were located near the boundaries between tissue and blood pool regions for both methods.

Rettmann, M. E.; Stephens, T.; Holmes, D. R.; Linte, C.; Packer, D. L.; Robb, R. A.

2013-03-01

89

Abnormal gyration of the temporal lobe and megalencephaly are typical features of thanatophoric dysplasia and can be visualized prenatally by ultrasound.  

PubMed

Autopsies of fetuses with thanatophoric dysplasia (TD) have shown abnormal gyration of the temporal lobes. In addition, the head is relatively large compared with the abdomen. We evaluated by ultrasound six consecutive cases of TD at 19 + 0 to 19 + 6 gestational weeks based on last menstrual period. We observed abnormal and deep transverse sulci in the temporal lobes in all cases; these features were confirmed at autopsy. We performed biometric assessment, including biparietal diameter (BPD) and mean abdominal diameter (MAD). For each MAD value in the TD fetuses, we computed mean and SD of the corresponding BPD values from a population-based registry in the relevant age range, and used them to calculate Z-scores for each BPD/MAD ratio. In the general population, the average BPD/MAD ratio was 1.05. In the TD fetuses, the mean BPD was 51.5 (range, 49-54) mm, the MAD was 45 (range, 41-47) mm and the BPD/MAD ratio was 1.15 (range, 1.09-1.20). The average Z-score of the ratios for TD fetuses was 2.44 (range, 1.05-3.39). The ratios for the TD fetuses were significantly higher than were the population ratios (P = 0.016). At autopsy, the mean brain-to-body weight ratio was 20.6% (range, 15.4-24.1%), which was greater than the corresponding mean ratio of 14.9% in normal fetuses. We conclude that abnormal and deep transverse gyration of the temporal lobes can be visualized by ultrasound in mid-second-trimester fetuses with TD. Due to megalencephaly, fetuses with TD have significantly different body proportions, with a larger BPD compared with normal fetuses. PMID:22374812

Blaas, H-G K; Vogt, C; Eik-Nes, S H

2012-08-01

90

Detection and display of acoustic window for guiding and training cardiac ultrasound users  

NASA Astrophysics Data System (ADS)

Successful ultrasound data collection strongly relies on the skills of the operator. Among different scans, echocardiography is especially challenging as the heart is surrounded by ribs and lung tissue. Less experienced users might acquire compromised images because of suboptimal hand-eye coordination and less awareness of artifacts. Clearly, there is a need for a tool that can guide and train less experienced users to position the probe optimally. We propose to help users with hand-eye coordination by displaying lines overlaid on B-mode images. The lines indicate the edges of blockages (e.g., ribs) and are updated in real time according to movement of the probe relative to the blockages. They provide information about how probe positioning can be improved. To distinguish between blockage and acoustic window, we use coherence, an indicator of channel data similarity after applying focusing delays. Specialized beamforming was developed to estimate coherence. Image processing is applied to coherence maps to detect unblocked beams and the angle of the lines for display. We built a demonstrator based on a Philips iE33 scanner, from which beamsummed RF data and video output are transferred to a workstation for processing. The detected lines are overlaid on B-mode images and fed back to the scanner display to provide users real-time guidance. Using such information in addition to B-mode images, users will be able to quickly find a suitable acoustic window for optimal image quality, and improve their skill.

Huang, Sheng-Wen; Radulescu, Emil; Wang, Shougang; Thiele, Karl; Prater, David; Maxwell, Douglas; Rafter, Patrick; Dupuy, Clement; Drysdale, Jeremy; Erkamp, Ramon

2014-03-01

91

Focused cardiac ultrasound: a training course for pediatric intensivists and emergency physicians  

PubMed Central

Background Focused echocardiographic examinations performed by intensivists and emergency room physicians can be a valuable tool for diagnosing and managing the hemodynamic status of critically ill children. The aim of this study was to evaluate the learning curve achieved using a theoretical and practical training program designed to enable pediatric intensivists and emergency physicians to conduct targeted echocardiograms. Methods Theoretical and practical training sessions were conducted with 16 pediatric intensivist/emergency room physicians. The program included qualitative analyses of the left ventricular (LV) and right ventricular (RV) functions, evaluation of pericardial effusion/cardiac tamponade and valvular regurgitation and measurements of the distensibility index of the inferior vena cava (dIVC), ejection fraction (EF) and cardiac index (CI). The practical training sessions were conducted in the intensive care unit; each student performed 24 echocardiograms. The students in training were evaluated in a practical manner, and the results were compared with the corresponding examinations performed by experienced echocardiographers. The evaluations occurred after 8, 16 and 24 practical examinations. Results The concordance rates between the students and echocardiographers in the subjective analysis of the LV function were 81.3% at the first evaluation, 96.9% at the second evaluation and 100% at the third evaluation (p?

2014-01-01

92

Design and evaluation of a transesophageal HIFU probe for ultrasound-guided cardiac ablation: simulation of a HIFU mini-maze procedure and preliminary ex vivo trials.  

PubMed

Atrial fibrillation (AF) is the most frequent cardiac arrhythmia. Left atrial catheter ablation is currently performed to treat this disease. Several energy sources are used, such as radio-frequency or cryotherapy. The main target of this procedure is to isolate the pulmonary veins. However, significant complications caused by the invasive procedure are described, such as stroke, tamponade, and atrioesophageal fistula, and a second intervention is often needed to avoid atrial fibrillation recurrence. For these reasons, a minimally-invasive device allowing performance of more complex treatments is still needed. High-intensity focused ultrasound (HIFU) can cause deep tissue lesions without damaging intervening tissues. Left atrial ultrasound-guided transesophageal HIFU ablation could have the potential to become a new ablation technique. The goal of this study was to design and test a minimally-invasive ultrasound-guided transesophageal HIFU probe under realistic treatment conditions. First, numerical simulations were conducted to determine the probe geometry, and to validate the feasibility of performing an AF treatment using a HIFU mini-maze (HIFUMM) procedure. Then, a prototype was manufactured and characterized. The 18-mm-diameter probe head housing contained a 3-MHz spherical truncated HIFU transducer divided into 8 rings, with a 5-MHz commercial transesophageal echocardiography (TEE) transducer integrated in the center. Finally, ex vivo experiments were performed to test the impact of the esophagus layer between the probe and the tissue to treat, and also the influence of the lungs and the vascularization on lesion formation. First results show that this prototype successfully created ex vivo transmural myocardial lesions under ultrasound guidance, while preserving intervening tissues (such as the esophagus). Ultrasound-guided transesophageal HIFU can be a good candidate for treatment of AF in the future. PMID:24658718

Constanciel, Elodie; N'Djin, W Apoutou; Bessière, Francis; Chavrier, Françoise; Grinberg, Daniel; Vignot, Alexandre; Chevalier, Philippe; Chapelon, Jean Yves; Lafon, Cyril

2013-09-01

93

Abnormal splicing in the N?terminal variable region of cardiac troponin T impairs systolic function of the heart with preserved Frank?Starling compensation  

PubMed Central

Abstract Abnormal splice?out of the exon 7?encoded segment in the N?terminal variable region of cardiac troponin T (cTnT??E7) was found in turkeys and, together with the inclusion of embryonic exon (eTnT), in adult dogs with a correlation with dilated cardiomyopathy. Overexpression of these cTnT variants in transgenic mouse hearts significantly decreased cardiac function. To further investigate the functional effect of cTnT??E7 or ?E7+eTnT in vivo under systemic regulation, echocardiography was carried out in single and double?transgenic mice. No atrial enlargement, ventricular hypertrophy or dilation was detected in the hearts of 2?month?old cTnT??E7 and ?E7+eTnT mice in comparison to wild?type controls, indicating a compensated state. However, left ventricular fractional shortening and ejection fraction were decreased in ?E7 and ?E7+eTnT mice, and the response to isoproterenol was lower in ?E7+eTnT mice. Left ventricular outflow tract velocity and gradient were decreased in the transgenic mouse hearts, indicating decreased systolic function. Ex vivo working heart function showed that high afterload or low preload resulted in more severe decreases in the systolic function and energetic efficiency of cTnT??E7 and ?E7+eTnT hearts. On the other hand, increases in preload demonstrated preserved Frank?Starling responses and minimized the loss of cardiac function and efficiency. The data demonstrate that the N?terminal variable region of cardiac TnT regulates systolic function of the heart. PMID:25194024

Feng, Han?Zhong; Chen, Guozhen; Nan, Changlong; Huang, Xupei; Jin, Jian?Ping

2014-01-01

94

Abnormal splicing in the N-terminal variable region of cardiac troponin T impairs systolic function of the heart with preserved Frank-Starling compensation.  

PubMed

Abnormal splice-out of the exon 7-encoded segment in the N-terminal variable region of cardiac troponin T (cTnT-?E7) was found in turkeys and, together with the inclusion of embryonic exon (eTnT), in adult dogs with a correlation with dilated cardiomyopathy. Overexpression of these cTnT variants in transgenic mouse hearts significantly decreased cardiac function. To further investigate the functional effect of cTnT-?E7 or ?E7+eTnT in vivo under systemic regulation, echocardiography was carried out in single and double-transgenic mice. No atrial enlargement, ventricular hypertrophy or dilation was detected in the hearts of 2-month-old cTnT-?E7 and ?E7+eTnT mice in comparison to wild-type controls, indicating a compensated state. However, left ventricular fractional shortening and ejection fraction were decreased in ?E7 and ?E7+eTnT mice, and the response to isoproterenol was lower in ?E7+eTnT mice. Left ventricular outflow tract velocity and gradient were decreased in the transgenic mouse hearts, indicating decreased systolic function. Ex vivo working heart function showed that high afterload or low preload resulted in more severe decreases in the systolic function and energetic efficiency of cTnT-?E7 and ?E7+eTnT hearts. On the other hand, increases in preload demonstrated preserved Frank-Starling responses and minimized the loss of cardiac function and efficiency. The data demonstrate that the N-terminal variable region of cardiac TnT regulates systolic function of the heart. PMID:25194024

Feng, Han-Zhong; Chen, Guozhen; Nan, Changlong; Huang, Xupei; Jin, Jian-Ping

2014-09-01

95

Prenatal detection of epidermolysis bullosa letalis with pyloric atresia in a fetus by abnormal ultrasound and elevated alpha-fetoprotein.  

PubMed

We report on the prenatal diagnosis of epidermolysis bullosa letalis with pyloric atresia in a pregnancy not known to be at risk for this condition. Elevated maternal serum alpha-fetoprotein levels led to ultrasonography which demonstrated gastric dilatation, consistent with pyloric atresia, and echogenic particles in the amniotic fluid, the "snowflake sign," previously described in two pregnancies of fetuses with disorders of skin sloughing. Amniotic fluid alpha-fetoprotein was markedly elevated and the acetylcholinesterase was positive. The diagnosis of epidermolysis bullosa letalis with pyloric atresia was confirmed after delivery by electron microscopy of fetal skin which showed typical changes of hypoplastic absent hemidesmosomes and separation along the dermal-epidermal junction. None of these abnormal prenatal findings are consistently present in pregnancies with epidermolysis bullosa with pyloric atresia. Thus, although useful when abnormal, when the test results are normal, the need for confirmatory fetoscopy and fetal skin biopsy remains. PMID:7510931

Dolan, C R; Smith, L T; Sybert, V P

1993-09-01

96

Noninvasive assessment of cardiac abnormalities in experimental autoimmune myocarditis by magnetic resonance microscopy imaging in the mouse.  

PubMed

Myocarditis is an inflammation of the myocardium, but only -10% of those affected show clinical manifestations of the disease. To study the immune events of myocardial injuries, various mouse models of myocarditis have been widely used. This study involved experimental autoimmune myocarditis (EAM) induced with cardiac myosin heavy chain (Myhc)-? 334-352 in A/J mice; the affected animals develop lymphocytic myocarditis but with no apparent clinical signs. In this model, the utility of magnetic resonance microscopy (MRM) as a non-invasive modality to determine the cardiac structural and functional changes in animals immunized with Myhc-? 334-352 is shown. EAM and healthy mice were imaged using a 9.4 T (400 MHz) 89 mm vertical core bore scanner equipped with a 4 cm millipede radio-frequency imaging probe and 100 G/cm triple axis gradients. Cardiac images were acquired from anesthetized animals using a gradient-echo-based cine pulse sequence, and the animals were monitored by respiration and pulse oximetry. The analysis revealed an increase in the thickness of the ventricular wall in EAM mice, with a corresponding decrease in the interior diameter of ventricles, when compared with healthy mice. The data suggest that morphological and functional changes in the inflamed hearts can be non-invasively monitored by MRM in live animals. In conclusion, MRM offers an advantage of assessing the progression and regression of myocardial injuries in diseases caused by infectious agents, as well as response to therapies. PMID:24998332

Massilamany, Chandirasegaran; Khalilzad-Sharghi, Vahid; Gangaplara, Arunakumar; Steffen, David; Othman, Shadi F; Reddy, Jay

2014-01-01

97

42 CFR 37.54 - Notification of abnormal radiographic findings.  

...abnormality of cardiac shape or size, tuberculosis, lung cancer, or any other significant abnormal findings other...abnormality of cardiac shape or size, tuberculosis, cancer, complicated pneumoconiosis, and any other...

2014-10-01

98

42 CFR 37.54 - Notification of abnormal radiographic findings.  

Code of Federal Regulations, 2013 CFR

...abnormality of cardiac shape or size, tuberculosis, lung cancer, or any other significant abnormal findings other...abnormality of cardiac shape or size, tuberculosis, cancer, complicated pneumoconiosis, and any other...

2013-10-01

99

Disruption of the Podosome Adaptor Protein TKS4 (SH3PXD2B) Causes the Skeletal Dysplasia, Eye, and Cardiac Abnormalities of Frank-Ter Haar Syndrome  

PubMed Central

Frank-Ter Haar syndrome (FTHS), also known as Ter Haar syndrome, is an autosomal-recessive disorder characterized by skeletal, cardiovascular, and eye abnormalities, such as increased intraocular pressure, prominent eyes, and hypertelorism. We have conducted homozygosity mapping on patients representing 12 FTHS families. A locus on chromosome 5q35.1 was identified for which patients from nine families shared homozygosity. For one family, a homozygous deletion mapped exactly to the smallest region of overlapping homozygosity, which contains a single gene, SH3PXD2B. This gene encodes the TKS4 protein, a phox homology (PX) and Src homology 3 (SH3) domain-containing adaptor protein and Src substrate. This protein was recently shown to be involved in the formation of actin-rich membrane protrusions called podosomes or invadopodia, which coordinate pericellular proteolysis with cell migration. Mice lacking Tks4 also showed pronounced skeletal, eye, and cardiac abnormalities and phenocopied the majority of the defects associated with FTHS. These findings establish a role for TKS4 in FTHS and embryonic development. Mutation analysis revealed five different homozygous mutations in SH3PXD2B in seven FTHS families. No SH3PXD2B mutations were detected in six other FTHS families, demonstrating the genetic heterogeneity of this condition. Interestingly however, dermal fibroblasts from one of the individuals without an SH3PXD2B mutation nevertheless expressed lower levels of the TKS4 protein, suggesting a common mechanism underlying disease causation. PMID:20137777

Iqbal, Zafar; Cejudo-Martin, Pilar; de Brouwer, Arjan; van der Zwaag, Bert; Ruiz-Lozano, Pilar; Scimia, M. Cecilia; Lindsey, James D.; Weinreb, Robert; Albrecht, Beate; Megarbane, Andre; Alanay, Yasemin; Ben-Neriah, Ziva; Amenduni, Mariangela; Artuso, Rosangela; Veltman, Joris A.; van Beusekom, Ellen; Oudakker, Astrid; Millán, José Luis; Hennekam, Raoul; Hamel, Ben; Courtneidge, Sara A.; van Bokhoven, Hans

2010-01-01

100

Non-invasive in vivo measurement of cardiac output in C57BL/6 mice using high frequency transthoracic ultrasound: evaluation of gender and body weight effects.  

PubMed

Even though mice are being increasingly used as models for human cardiovascular diseases, non-invasive monitoring of cardiovascular parameters such as cardiac output (CO) in this species is challenging. In most cases, the effects of gender and body weight (BW) on these parameters have not been studied. The objective of this study was to provide normal reference values for CO in C57BL/6 mice, and to describe possible gender and/or BW associated differences between them. We used 30-MHz transthoracic Doppler ultrasound to measure hemodynamic parameters in the ascending aorta [heart rate (HR), stroke volume (SV), stroke index (SI), CO, and cardiac index (CI)] in ten anesthetized mice of either sex. No differences were found for HR, SV, and CO. Both SI and CI were statistically lower in males. However, after normalization for BW, these differences disappeared. These results suggest that if comparisons of cardiovascular parameters are to be made between male and female mice, values should be standardized for BW. PMID:24852337

Domínguez, Elisabet; Ruberte, Jesús; Ríos, José; Novellas, Rosa; Del Alamo, Maria Montserrat Rivera; Navarro, Marc; Espada, Yvonne

2014-10-01

101

Comparison of 3D OS-EM and 4D MAP-RBI-EM reconstruction algorithms for cardiac motion abnormality classification using a motion observer.  

PubMed

Using a heart motion observer, we compared the performance of two image reconstruction techniques, a 3D OS-EM algorithm with post Butterworth spatial filtering and a 4D MAP-RBI-EM algorithm. The task was to classify gated myocardial perfusion (GMP) SPECT images of beating hearts with or without regional motion abnormalities. Noise-free simulated GMP SPECT projection data was generated from two 4D NCAT beating heart phantom models, one with normal motion and the other with a 50% motion defect in a pie-shaped wedge region-of-interest (ROI) in the anterior-lateral left ventricular wall. The projection data were scaled to clinical GMP SPECT count level before Poisson noise was simulated to generate 40 noise realizations. The noise-free and noisy projection data were reconstructed using the two reconstruction algorithms, parameters chosen to optimize the tradeoff between image bias and noise. As a motion observer, a 3D motion estimation method previously developed was applied to estimate the radial motion on the ROI from two adjacent gates. The receiver operating characteristic (ROC) curves were computed for radial motion magnitudes corresponding to each reconstruction technique. The area under the ROC curve (AUC) was calculated as an index for classification of regional motion. The reconstructed images with better bias and noise tradeoff were found to offer better classification for hearts with or without regional motion defects. The 3D cardiac motion estimation algorithm, serving as a heart motion observer, was better able to distinguish the abnormal from the normal regional motion in GMP SPECT images obtained from the 4D MAP-RBI-EM algorithm than from the 3D OS-EM algorithm with post Butterworth spatial filtering. PMID:21516240

Tang, Jing; Lee, Taek-Soo; He, Xin; Segars, W Paul; Tsui, Benjamin M W

2010-08-26

102

Right atrial cardiac rhabdomyoma with premature foramen ovale restriction: A case report  

PubMed Central

Fetal cardiac rhabdomyoma is the most common cardiac tumor in fetuses. However, this benign tumor can cause hemodynamic repercussions and intrauterine fetal mortality. The present study reports a case of rare fetal cardiac rhabdomyoma located in the right atrium, accompanied by premature restriction of the foramen ovale and moderate pericardial effusion, as determined by tomographic ultrasound imaging (TUI). Fetal mortality subsequently occurred late in the second trimester of pregnancy and the diagnosis was confirmed by pathology. The present study discusses the occurrence and diagnosis of this rare abnormality. TUI mode with spatio-temporal image correlation offline imaging provides the physician with clear views of abnormal intracardiac structures in the beating heart. With improvements in sonographic technology, the diagnosis of fetal cardiac rhabdomyoma may be easier and more accurate in the clinical arena. PMID:25364426

LI, YI-DAN; HE, YI-HUA; LI, ZHI-AN; WEI, PING

2014-01-01

103

Autonomic, locomotor and cardiac abnormalities in a mouse model of muscular dystrophy: targeting the renin–angiotensin system  

PubMed Central

Muscular dystrophies are a heterogeneous group of genetic muscle diseases characterized by muscle weakness and atrophy. Mutations in sarcoglycans and other subunits of the dystrophin–glycoprotein complex cause muscular dystrophy and dilated cardiomyopathy in animals and humans. Aberrant autonomic signalling is recognized in a variety of neuromuscular disorders. We hypothesized that activation of the renin–angiotensin system contributes to skeletal muscle and autonomic dysfunction in mice deficient in the sarcoglycan-? (Sgcd) gene at a young age and that this early autonomic dysfunction contributes to the later development of left ventricular (LV) dysfunction and increased mortality. We demonstrated that young Sgcd?/? mice exhibit histopathological features of skeletal muscle dystrophy, decreased locomotor activity and severe autonomic dysregulation, but normal LV function. Autonomic regulation continued to deteriorate in Sgcd?/? mice with age and was accompanied by LV dysfunction and dilated cardiomyopathy at older ages. Autonomic dysregulation at a young age predicted later development of LV dysfunction and higher mortality in Sgcd?/? mice. Treatment of Sgcd?/? mice with the angiotensin type 1 receptor blocker losartan for 8–9 weeks, beginning at 3 weeks of age, decreased fibrosis and oxidative stress in skeletal muscle, increased locomotor activity and prevented autonomic dysfunction. Chronic infusion of the counter-regulatory peptide angiotensin-(1–7) resulted in similar protection. We conclude that activation of the renin–angiotensin system, at a young age, contributes to skeletal muscle and autonomic dysfunction in muscular dystrophy. We speculate that the latter is mediated via abnormal sensory nerve and/or cytokine signalling from dystrophic skeletal muscle to the brain and contributes to age-related LV dysfunction, dilated cardiomyopathy, arrhythmias and premature death. Therefore, correcting the early autonomic dysregulation and renin–angiotensin system activation may provide a novel therapeutic approach in muscular dystrophy. PMID:24334334

Sabharwal, Rasna; Chapleau, MarkW.

2015-01-01

104

Quantitative analysis of T-wave morphology increases confidence in drug-induced cardiac repolarization abnormalities: evidence from the investigational IKr inhibitor Lu 35-138.  

PubMed

This study investigates repolarization changes induced by a new candidate drug to determine whether a composite electrocardiographic (ECG) measure of T-wave morphology could be used as a reliable marker to support the evidence of abnormal repolarization, which is indicated by QT interval prolongation. Seventy-nine healthy subjects were included in this parallel study. After a baseline day during which no drug was given, 40 subjects received an I(Kr)-blocking antipsychotic compound (Lu 35-138) on 7 consecutive days while 39 subjects received placebo. Resting ECGs were recorded and used to determine a combined measure of repolarization morphology (morphology combination score [MCS]), based on asymmetry, flatness, and notching. Replicate measurements were used to determine reliable change and study power for both measures. Lu 35-138 increased the QTc interval with corresponding changes in T-wave morphology as determined by MCS. For subjects taking Lu 35-138, T-wave morphology was a more reliable indicator of I(Kr) inhibition than QTcF (chi(2) = 20.3, P = .001). At 80% study power for identifying a 5-millisecond placebo-adjusted change from baseline for QTcF, the corresponding study power for MCS was 93%. As a covariate to the assessment of QT interval liability, MCS offered important additive information to the effect of Lu 35-138 on cardiac repolarization. PMID:19843657

Graff, Claus; Matz, Jørgen; Christensen, Ellen B; Andersen, Mads P; Kanters, Jørgen K; Toft, Egon; Pehrson, Steen; Hardahl, Thomas B; Nielsen, Jimmi; Struijk, Johannes J

2009-11-01

105

Improved cardiac motion detection from ultrasound images using TDIOF: a combined B-mode/ tissue Doppler approach  

NASA Astrophysics Data System (ADS)

Quantitative motion analysis of echocardiographic images helps clinicians with the diagnosis and therapy of patients suffering from cardiac disease. Quantitative analysis is usually based on TDI (Tissue Doppler Imaging) or speckle tracking. These methods are based on two independent techniques - the Doppler Effect and image registration, respectively. In order to increase the accuracy of the speckle tracking technique and cope with the angle dependency of TDI, herein, a combined approach dubbed TDIOF (Tissue Doppler Imaging Optical Flow) is proposed. TDIOF is formulated based on the combination of B-mode and Doppler energy terms in an optical flow framework and minimized using algebraic equations. In this paper, we report on validations with simulated, physical cardiac phantom, and in-vivo patient data. It is shown that the additional Doppler term is able to increase the accuracy of speckle tracking, the basis for several commercially available echocardiography analysis techniques.

Tavakoli, Vahid; Stoddard, Marcus F.; Amini, Amir A.

2013-03-01

106

Ultrasound in pregnancy (image)  

MedlinePLUS

... conditions in the fetus including meningomyelocele, congenital heart disease, kidney abnormalities, hydrocephalus, anencephaly, club feet, and other deformities. Ultrasound does not produce ionizing radiation and is considered a very safe procedure for ...

107

Abnormal Calcium Cycling and Cardiac Arrhythmias Associated With the Human Ser96Ala Genetic Variant of Histidine?Rich Calcium?Binding Protein  

PubMed Central

Background A human genetic variant (Ser96Ala) in the sarcoplasmic reticulum (SR) histidine?rich Ca2+?binding (HRC) protein has been linked to ventricular arrhythmia and sudden death in dilated cardiomyopathy. However, the precise mechanisms affecting SR function and leading to arrhythmias remain elusive. Methods and Results We generated transgenic mice with cardiac?specific expression of human Ala96 HRC or Ser96 HRC in the null background to assess function in absence of endogenous protein. Ala96 HRC decreased (25% to 30%) cardiomyocyte contractility and Ca2+ kinetics compared with Ser96 HRC in the absence of any structural or histological abnormalities. Furthermore, the frequency of Ca2+ waves was significantly higher (10?fold), although SR Ca2+ load was reduced (by 27%) in Ala96 HRC cells. The underlying mechanisms involved diminished interaction of Ala96 HRC with triadin, affecting ryanodine receptor (RyR) stability. Indeed, the open probability of RyR, assessed by use of ryanodine binding, was significantly increased. Accordingly, stress conditions (5 Hz plus isoproterenol) induced aftercontractions (65% in Ala96 versus 12% in Ser96) and delayed afterdepolarizations (70% in Ala96 versus 20% in Ser96). The increased SR Ca2+ leak was accompanied by hyperphosphorylation (1.6?fold) of RyR at Ser2814 by calmodulin?dependent protein kinase II. Accordingly, inclusion of the calmodulin?dependent protein kinase II inhibitor KN93 prevented Ser2814 phosphorylation and partially reversed the increases in Ca2+ spark frequency and wave production. Parallel in vivo studies revealed ventricular ectopy on short?term isoproterenol challenge and increased (4?fold) propensity to arrhythmias, including nonsustained ventricular tachycardia, after myocardial infarction in Ala96 HRC mice. Conclusions These findings suggest that aberrant SR Ca2+ release and increased susceptibility to delayed afterdepolarizations underlie triggered arrhythmic activity in human Ala96 HRC carriers. PMID:24125847

Singh, Vivek P.; Rubinstein, Jack; Arvanitis, Demetrios A.; Ren, Xiaoping; Gao, Xiaoqian; Haghighi, Kobra; Gilbert, Mark; Iyer, Venkat R.; Kim, Do Han; Cho, Chunghee; Jones, Keith; Lorenz, John N.; Armstrong, Clara F.; Wang, Hong?Sheng; Gyorke, Sandor; Kranias, Evangelia G.

2013-01-01

108

Post-Pacing Abnormal Repolarization in Catecholaminergic Polymorphic Ventricular Tachycardia Associated with a Mutation in the Cardiac Ryanodine Receptor Gene (RyR2)  

PubMed Central

Background Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an arrhythmogenic disease for which electrophysiological studies (EPS) have shown to be of limited value. Objective We present a CPVT family in which marked post-pacing repolarization abnormalities during EPS were the only consistent phenotypic manifestation of RyR2 mutation carriers. Methods The study was prompted by the observation of transient marked QT prolongation preceding initiation of ventricular fibrillation during atrial fibrillation in a boy with a family history of sudden cardiac death (SCD). Family members underwent exercise and pharmacologic ECG testing with epinephrine, adenosine and flecainide. Non-invasive clinical tests were normal in 10 patients evaluated, except for both epinephrine and exercise-induced ventricular arrhythmias in 1. EPS included bursts of ventricular pacing and programmed ventricular extrastimulation reproducing short-long sequences. Genetic screening involved direct sequencing of genes involved in LQTS as well as RyR2. Results Six patients demonstrated a marked increase in QT interval only in the first beat after cessation of ventricular pacing and/or extrastimulation. All 6 patients were found to have a heterozygous missense mutation (M4109R) in RyR2. Two of them, presenting with aborted SCD also had a second missense mutation (I406T- RyR2). Four family members without RyR2 mutations did not display prominent post-pacing QT changes. Conclusions M4109R- RyR2 is associated with a high incidence of SCD. The contribution of I406T to the clinical phenotype is unclear. In contrast to exercise testing, marked post-pacing repolarization changes in a single beat accurately predicted carriers of M4109R- RyR2 in this family. PMID:21699856

Nof, Eyal; Belhassen, Bernard; Arad, Michael; Bhuiyan, Zahurul A.; Antzelevitch, Charles; Rosso, Raphael; Fogelman, Rami; Luria, David; Eli-Ani, Dalia; Mannens, Marcel M.A.M.; Viskin, Sami; Eldar, Michael; Wilde, Arthur A.M.; Glikson, Michael

2011-01-01

109

Comparison of transit-time and Doppler ultrasound methods for measurement of flow in aortocoronary bypass grafts during cardiac surgery.  

PubMed

To evaluate the accuracy of flow measurements in aortocoronary bypass grafts with the ultrasound transit-time method, an in vitro and in vivo comparison was carried out. The in vitro comparison with evaluation against both true flow and the ultrasound Doppler method, was carried out with a fresh saphenous vein mounted in a pulsatile flow rig. The two flow probes were placed on the graft 4-5 cm apart to avoid acoustic interference, and blood was pumped through the system at different flow rates. The comparison between the methods showed excellent agreement with a linear correlation coefficient of 0.996, and a mean error of -2.9 ml/min with limits of agreement +/- 13.1 ml/min (+/- 2 SD = 95% of measured differences between these limits). However, against true flow, both methods overestimated flow slightly with mean error 4.4 and 7.3 ml/min for the transit-time and Doppler, respectively. Both methods showed excellent correlation with true flow (correlation coefficient 0.998 for the transit-time and 0.997 for the Doppler method). The in vivo accuracy was evaluated by comparison of the two methods in 9 patients. The two probes were placed on the same saphenous vein grafts 4-5 cm apart, and a total of 34 measurements in 17 grafts were carried out including measurements at baseline and after papaverine injection. The correlation coefficient was 0.990 and linear regression analysis gave the equation: Transit-time flow = 1.00 x Doppler flow + 1.3. In terms of flow, the mean error was 1.5 ml with limits of agreement +/- 17.2 ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7940488

Matre, K; Birkeland, S; Hessevik, I; Segadal, L

1994-06-01

110

Women’s Expectations and Intention to Terminate Pregnancy in Case of Abnormal Findings at the Second Trimester Level II Ultrasound Scan  

Microsoft Academic Search

Objective: The aims of this study were: (1) to explore pregnant women’s background knowledge and expectations of 2nd trimester ultrasound screening, and (2) to investigate women’s intentions to proceed to pregnancy termination if fetal anomaly is detected at the 2nd trimester ultrasound screening. Methods: A prospective, cross-sectional, questionnaire-based study. 300 consecutive pregnant women served as a convenience sample for this

Apostolos P. Athanasiadis; Themistoklis Mikos; Konstantinos Pantazis; Efstratios Assimakopoulos; Filippos Tzevelekis; John N. Bontis

2009-01-01

111

Breast ultrasound: current concepts.  

PubMed

Breast ultrasound plays a major role in the identification, diagnosis, and staging of breast cancer. Gray-scale (brightness mode) is the most common form of ultrasound used in breast imaging (BI); newer techniques such as harmonic imaging, Doppler imaging, three-dimensional (3D) ultrasound, and elasticity imaging have also been employed. Breast lesions that are initially identified on mammography and magnetic resonance imaging can be further characterized with ultrasound. Breast ultrasound can differentiate solid from cystic masses, suspicious from benign lesions, and abnormal from normal lymph nodes. Ultrasound can guide needle biopsy of suspicious breast lesions and lymph nodes. Breast ultrasound can also be valuable when staging breast cancer and can help to determine if there is multifocal or multicentric disease, and also if there is associated regional lymphadenopathy. PMID:23768888

Candelaria, Rosalind P; Hwang, Lindsay; Bouchard, Richard R; Whitman, Gary J

2013-06-01

112

When Combined, Early Bedside Head Ultrasound and Electroencephalography Predict Abnormal Computerized Tomography or Magnetic Resonance Brain Images Obtained After Extracorporeal Membrane Oxygenation Treatment  

Microsoft Academic Search

Definitive neuroimaging of the brain using computerized tomography (CT) or magnetic resonance imaging (MRI) in extracorporeal membrane oxygenation (ECMO)–treated infants must be delayed until after this therapy is completed. Bedside head ultrasound (HUS) and electroencephalography (EEG) studies during ECMO, if highly correlated with later definitive neuroimaging, might be used to affect the acute clinical care and early parental counseling of

Catherine M Gannon; Michael S Kornhauser; George W Gross; Thomas E Wiswell; Stephen Baumgart; Leopold J Streletz; Leonard J Graziani; Alan R Spitzer

2001-01-01

113

Cardiac sarcoidosis: contemporary review.  

PubMed

Cardiac sarcoidosis can occur in up to 25% of patients with sarcoidosis in other organ systems and may present with conduction abnormalities, ventricular arrhythmias, or heart failure. This review will summarize the state of current knowledge and key questions that remain to be answered. Because cardiac sarcoidosis is a rare, complex disease, the most meaningful research will include interdisciplinary, multicenter collaborations. PMID:25231794

Kron, Jordana; Ellenbogen, Kenneth A

2015-01-01

114

Quasi-Static Ultrasound Elastography  

PubMed Central

Elastography is a new imaging modality where elastic tissue parameters related to the structural organization of normal and pathological tissues are imaged. Basic principles underlying the quasi-static elastography concept and principles are addressed. The rationale for elastographic imaging is reinforced using data on elastic properties of normal and abnormal soft tissues. The several orders of magnitude difference between the elastic modulus of normal and abnormal tissues which is the primary contrast mechanism in elastographic imaging underlines the probability of success with this imaging modality. Recent advances enabling the clinical practice of elastographic imaging in real-time on clinical ultrasound systems is also discussed. In quasi-static elastography, radiofrequency echo signals acquired before and after a small (about 1%) of applied deformation are correlated to estimate tissue displacements. Local tissue displacement vector estimates between small segments of the pre- and post-deformation signals are estimated and the corresponding strain distribution imaged. Elastographic imaging techniques are based on the hypothesis that soft tissues deform more than stiffer tissue, and these differences can be quantified in images of the tissue strain tensor or the Young’s modulus. Clinical applications of quasi-static elastography have mushroomed over the last decade, with the most commonly imaged areas being the breast, prostate, thyroid, cardiac, treatment monitoring of ablation procedures and vascular imaging applications. PMID:20798841

Varghese, Tomy

2010-01-01

115

Fetal cardiac anomalies  

Microsoft Academic Search

Fetal cardiac anomalies are increasingly identified during regular obstetric scanning. About 21000 pregnancies will have an abnormality of the four chamber view and a further 11000 will have an abnormality of the great arteries. These cases can then be referred to the specialist in fetal cardiology for further evaluation and counselling. There is a higher rate of chromosomal and other

Lindsey D. Allan

1996-01-01

116

Severe asthma with markedly increased asbestos of 2 types & TXB2, and markedly reduced acetylcholine, DHEA & drug uptake in parts of upper lungs, & similar abnormalities at respiratory & cardiac center of medulla oblongata: complete elimination of this asthma within 15 days using one optimal dose of astragalus & application of strong red light & EMF neutralizer on respiratory centers of abnormal medulla oblongata.  

PubMed

When the window of an Asbestos-contaminated room from a broken ceiling was opened wide, A 73 year-old male physician of Oriental origin, who was sitting in the next room, suddenly developed a severe asthma attack, which did not stop by the use of a hand-held Albuterol inhaler. Temporary relief was obtained only by using a Compressor-Nebulizer (Inspiration 626 with Albuterol Sulfate Inhalation Solution 0.083%). During the attack, abnormal areas were discovered at the upper lobes of both lungs, where Thromboxane B2 (TXB2) was markedly increased to 500 ng (BDORT units) (the rest of the lung had about 2.5 ng), 2 types of Asbestos (Chrysotile and Crocidolite) were abnormally increased to 0.120-0.135 mg, (BDORT units) Acetylcholine was markedly reduced to 0.5 ng (the rest of the lung was low, about 100 ng), DHEA was extremely reduced to 1 ng (the rest of the lung had about 52 ng), and telomere was less than 1 yg (= 10(-24) g). Bacterial & viral infections were also present in these abnormal areas, but no antibiotics entered the abnormal parts of the lungs. Therefore, one optimal dose of Astragalus was given once, which resulted in a rapid continuous excretion of large amounts of the above 2 types of Asbestos & TXB2 in urine & sputum, and Asthma symptoms reduced slightly in severity. Additional acupuncture & shiatsu given on all the known acupuncture points for lung disease only created slight, temporary improvement. Then, the respiratory & cardiac center of the Medulla Oblongata was found to have similar abnormalities as the lungs. Therefore, 100 mW output of Light Emitting Diode of red spectra (650 nm center spectrum) was projected on the abnormal area of the medulla oblongata on the back of the head. This resulted drug uptake of on and off and significantly reduced difficulty of breathing. Additional application of the EMF Neutralizer on the abnormal area of the Medulla Oblongata for 3 hours resulted in continuous drug uptake and complete disappearance of asthma. As a result of one optimal dose of Astragalus, the remaining Asbestos in the lungs & medulla oblongata was completely excreted in the urine and Sputum in 2 weeks. Then, even when the patient entered the Asbestos-contaminated room and slept there every day without opening the window, no asthma attack occurred even as late as 5 months later. PMID:19711774

Omura, Yoshiaki; Henoch, Avraham; Shimotsuura, Yasuhira; Duvvi, Harsha; Kawashima, Hiroshi; Ohki, Motomu

2009-01-01

117

Serum Levels of Tissue Inhibitors of Metalloproteinase 2 in Patients With Systemic Sclerosis With Duration More Than 2 Years: Correlation With Cardiac and Pulmonary Abnormalities  

PubMed Central

In this study, we measured the serum concentration of TIMP-2 in patients with systemic sclerosis (SSc) and explored its possible correlation with cardiac and pulmonary lesions. We studied 42 patients with SSc, with duration equal to or more than 2 years. CT chest, ECG, echocardiography, and serum TIMP-2 concentration measurement using ELISA technique were performed in all patients and in 25 normal controls. The mean serum levels of TIMP-2 in patients was higher than in controls (P = .005). The mean CT score of dSSc patients with elevated TIMP-2 levels was significantly higher than dSSc patients with normal levels (P = .013). Four patients out of five with elevated TIMP-2 levels showed diastolic dysfunction (80%), compared to 2 out of 15 lSSc patients with normal levels (13.3%), with P = .014. Our research, though involving a small group of patients, points to the probable role of TIMP-2 in the development of pulmonary lesions in dSSc patients and cardiac lesions in lSSc patients with duration equal to or more than 2 years. PMID:17392585

Shahin, Amira; Elsawaf, Amani; Ramadan, Shahira; Shaker, Olfat; Amin, Mona; Taha, Mohamed

2006-01-01

118

Complex patterns of abnormal heartbeats  

NASA Technical Reports Server (NTRS)

Individuals having frequent abnormal heartbeats interspersed with normal heartbeats may be at an increased risk of sudden cardiac death. However, mechanistic understanding of such cardiac arrhythmias is limited. We present a visual and qualitative method to display statistical properties of abnormal heartbeats. We introduce dynamical "heartprints" which reveal characteristic patterns in long clinical records encompassing approximately 10(5) heartbeats and may provide information about underlying mechanisms. We test if these dynamics can be reproduced by model simulations in which abnormal heartbeats are generated (i) randomly, (ii) at a fixed time interval following a preceding normal heartbeat, or (iii) by an independent oscillator that may or may not interact with the normal heartbeat. We compare the results of these three models and test their limitations to comprehensively simulate the statistical features of selected clinical records. This work introduces methods that can be used to test mathematical models of arrhythmogenesis and to develop a new understanding of underlying electrophysiologic mechanisms of cardiac arrhythmia.

Schulte-Frohlinde, Verena; Ashkenazy, Yosef; Goldberger, Ary L.; Ivanov, Plamen Ch; Costa, Madalena; Morley-Davies, Adrian; Stanley, H. Eugene; Glass, Leon

2002-01-01

119

Cardiological Ultrasound Imaging.  

PubMed

This review paper is intended for the interested outsider of the field of echocardiography and it presents a short introduction into the numerous ultrasound (US) methods and techniques for anatomical and functional diagnosis of the heart. The basic techniques are generally used for some time already, as there are the one dimensional (1D) M(otion) mode, the real time 2D B(rightness) mode technique and the various Doppler measurement techniques and imaging modes. The M-mode technique shows the movements of the tissue in a 1D B-mode display vs. time. The 2D B-mode images are showing the heart contractions and dilations in real time, thus making this technique the basic tool for detecting anatomical disturbances and myocardial (localized) abnormal functioning. Improved image quality is achieved by Second Harmonic Imaging and myocardial perfusion can be quantified using Contrast Agent Imaging. Doppler techniques were introduced in the fifties of last century and used for blood flow velocity measurement. Continuous wave (CW) Doppler has the advantage of allowing measurement of high velocities, as may occur in vascular or valvular stenosis and insufficiency. The exact location of the major Doppler signal received cannot be estimated making this technique ambiguous in some clinical problems. Single gated Pulse Wave (PW) Doppler velocity measurement delivers exact location of the measurement position by using an interactively positioned time (=depth) gate in which the velocity is being measured. The disadvantage of this technique is the relatively low maximum velocity that can be measured. Multigate PW Doppler techniques can be used for the assessment of a velocity profile over the vessel cross section. A more sophisticated use of this technique is the combination with 2D B-mode imaging in the color Doppler mode, called "color flow mapping", in which the multigate Doppler signal is color coded and shown in 2D format overlayed in the conventional 2D B mode image. In the past two decades, technique to quantify myocardial function were developed: Tissue Doppler Imaging (TDI), Strain Rate and Strain Imaging. The temporal resolution of ultrasound imaging can be further improved by Plane Wave Imaging, and Synthetic Aperture Imaging. The recent introduction of 2D matrix transducers extended the real time imaging potential by allowing 3D imaging and sophisticated segmentation techniques for the estimation of quantitative functional parameters, as for instance cardiac output. PMID:24745921

Thijssen, Johan M; de Korte, Chris L

2014-04-17

120

Obstetrical Ultrasound  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

121

Scrotal Ultrasound  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

122

Ultrasound - Breast  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

123

Abdominal Ultrasound  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

124

Ultrasound -- Vascular  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

125

Cardiac Rehabilitation After Acute Myocardial Infarction Resuscitated From Cardiac Arrest  

PubMed Central

Objective To examine the safety and effectiveness of cardiac rehabilitation on patients resuscitated from cardiac arrest due to acute myocardial infarction. Methods The study included 23 subjects, including 8 with history of cardiac arrest and 15 without history of cardiac arrest. Both groups underwent initial graded exercise test (GXT) and subsequent cardiac rehabilitation for 6 weeks. After 6 weeks, both groups received follow-up GXT. Results Statistically significant (p<0.05) increase of VO2peak and maximal MVO2 but significant (p<0.05) decrease of submaximal MVO2 and resting heart rate were observed in both groups after 6 weeks of cardiac rehabilitation. An increasing trend of maximal heart rates was observed in both groups. However, the increase was not statistically significant (p>0.05). There was no statistically significant change of resting heart rate, maximal heart rate, maximal MVO2, or submaximal MVO2 in both groups after cardiac rehabilitation. Fatal cardiac complications, such as abnormal ECG, cardiac arrest, death or myocardial infarction, were not observed. All subjects finished the cardiac rehabilitation program. Conclusion Improvement was observed in the exercise capacity of patients after aerobic exercise throughout the cardiac rehabilitation program. Therefore, cardiac rehabilitation can be safely administered for high-risk patients with history of cardiac arrest. Similar improvement in exercise capacity can be expected in patients without cardiac arrest experience. PMID:25566479

Kim, Chul; Choi, Hee Eun; Kang, Seong Hoon

2014-01-01

126

Ultrasound Despeckling for Contrast Enhancement  

PubMed Central

Images produced by ultrasound systems are adversely hampered by a stochastic process known as speckle. A despeckling method based upon removing outlier is proposed. The method is developed to contrast enhance B-mode ultrasound images. The contrast enhancement is with respect to decreasing pixel variations in homogeneous regions while maintaining or improving differences in mean values of distinct regions. A comparison of the proposed despeckling filter is compared with the other well known despeckling filters. The evaluations of despeckling performance are based upon improvements to contrast enhancement, structural similarity, and segmentation results on a Field II simulated image and actual B-mode cardiac ultrasound images captured in vivo. PMID:20227984

Tay, Peter C.; Garson, Christopher D.; Acton, Scott T.; Hossack, John A.

2010-01-01

127

Image guidance in cardiac electrophysiology  

E-print Network

Cardiac arrhythmias are characterized by a disruption or abnormal conduction of electrical signals within the heart. Treatment of arrhythmias has dramatically evolved over the past half-century, and today, minimally-invasive ...

Malchano, Zachary John

2006-01-01

128

Ultrasound in space  

NASA Technical Reports Server (NTRS)

Physiology of the human body in space has been a major concern for space-faring nations since the beginning of the space era. Ultrasound (US) is one of the most cost effective and versatile forms of medical imaging. As such, its use in characterizing microgravity-induced changes in physiology is being realized. In addition to the use of US in related ground-based studies, equipment has also been modified to fly in space. This involves alteration to handle the stresses of launch and different power and cooling requirements. Study protocols also have been altered to accommodate the microgravity environment. Ultrasound studies to date have shown a pattern of adaptation to microgravity that includes changes in cardiac chamber sizes and vertebral spacing. Ultrasound has been and will continue to be an important component in the investigation of physiological and, possibly, pathologic changes occurring in space or as a result of spaceflight.

Martin, David S.; South, Donna A.; Garcia, Kathleen M.; Arbeille, Philippe

2003-01-01

129

Polyamines mediate abnormal Ca/sup 2 +/ transport and Ca/sup 2 +/-induced cardiac cell injury in the calcium paradox  

SciTech Connect

Ca/sup 2 +/-free perfusion renders heart cells Ca/sup 2 +/-sensitive so that readmission of Ca/sup 2 +/ causes a sudden massive cellular injury attributed to abnormal entry of Ca/sup 2 +/ into cells (Ca paradox). Hormonal stimulation of Ca/sup 2 +/ fluxes was earlier shown to be mediated by polyamines (PA). 5 min perfusion of rat heart with Ca/sup 2 +/-free medium induce a prompt 40-50% decline in levels of the PA putrescine (PUT), spermidine and spermine and their rate-regulatory synthetic enzyme ornithine decarboxylase (ODC), and readmission of Ca/sup 2 +/-containing medium abruptly (< 30-60 sec) increased the levels of ODC and PA. The ODC inhibitor ..cap alpha..-difluoromethylornithine (DFMO, 5mM) blocked Ca/sup 2 +/ reperfusion-induced increases in ODC and PA and also prevented increased /sup 45/Ca/sup 2 +/ uptake and heart injury, manifested by loss of contractility, release of enzymes (CPK, LDH), myoglobin and protein, and E.M. lesions (contracture bands, mitochondrial changes). 1 mM PUT negated DFMO inhibition, repleted heart PA and restored Ca/sup 2 +/ reperfusion-induced /sup 45/Ca/sup 2 +/ influx and cell injury. These data indicate that the Ca/sup 2 +/-directed depletion-repletion cycle of ODC and PA triggers excessive transsarcolemmal Ca/sup 2 +/ transport leading to the calcium paradox.

Trout, J.J.; Koenig, H.; Goldstone, A.D.; Lu, C.Y.; Fan, C.C.

1986-03-05

130

Diagnostic ultrasound features and outcome of restrictive foramen ovale in fetuses with structurally normal hearts.  

PubMed

Intrauterine foramen ovale (FO) restriction in association with congenital heart disease (CHD) carries a poor prognosis. However, in the absence of CHD, the clinical importance of restrictive FO in the fetus is not well understood. We evaluated the antenatal prevalence, clinical presentation, diagnostic ultrasound features, and outcome of restrictive FO in fetuses without CHD. We reviewed the echocardiographic and clinical records of 23 fetuses diagnosed with a restrictive FO and structurally normal heart between 2001 and 2012. The atrial septum, dimensions of cardiac structures, left and right cardiac output and Doppler interrogation of cardiac flows were examined. The clinical outcomes of all fetuses with restrictive FO were analysed. Restrictive FO was identified in 23 of 1,682 (1.4%) fetuses with no CHD. Enlarged right heart structures (100%), hypermobile or redundant primum atrial septum (91%), increased right-to-left ventricular cardiac output ratio (91%), and posteriorly angulated ductus arteriosus (68%) were the most common echocardiographic findings associated with this rare phenomenon. Additional noncardiac systemic abnormalities were identified in 13 (56%) babies. Seven (30%) neonates developed persistent pulmonary hypertension, and 7 infants died. Antenatal restrictive FO is an underrecognised entity despite being a common cause of right heart dilatation in the fetus. In the absence of CHD, restrictive FO is well tolerated antenatally, but its frequent association with noncardiac abnormalities and pulmonary hypertension in the neonate are noteworthy. PMID:24585219

Uzun, Orhan; Babaoglu, Kadir; Ayhan, Yusuf I; Moselhi, Marsham; Rushworth, Fran; Morris, Sue; Beattie, Bryan; Wiener, Jarmilla; Lewis, Michael J

2014-08-01

131

Meiotic abnormalities  

SciTech Connect

Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

NONE

1993-12-31

132

Methodological approach for the assessment of ultrasound reproducibility of cardiac structure and function: a proposal of the study group of Echocardiography of the Italian Society of Cardiology (Ultra Cardia SIC) Part I  

PubMed Central

When applying echo-Doppler imaging for either clinical or research purposes it is very important to select the most adequate modality/technology and choose the most reliable and reproducible measurements. Quality control is a mainstay to reduce variability among institutions and operators and must be obtained by using appropriate procedures for data acquisition, storage and interpretation of echo-Doppler data. This goal can be achieved by employing an echo core laboratory (ECL), with the responsibility for standardizing image acquisition processes (performed at the peripheral echo-labs) and analysis (by monitoring and optimizing the internal intra- and inter-reader variability of measurements). Accordingly, the Working Group of Echocardiography of the Italian Society of Cardiology decided to design standardized procedures for imaging acquisition in peripheral laboratories and reading procedures and to propose a methodological approach to assess the reproducibility of echo-Doppler parameters of cardiac structure and function by using both standard and advanced technologies. A number of cardiologists experienced in cardiac ultrasound was involved to set up an ECL available for future studies involving complex imaging or including echo-Doppler measures as primary or secondary efficacy or safety end-points. The present manuscript describes the methodology of the procedures (imaging acquisition and measurement reading) and provides the documentation of the work done so far to test the reproducibility of the different echo-Doppler modalities (standard and advanced). These procedures can be suggested for utilization also in non referall echocardiographic laboratories as an "inside" quality check, with the aim at optimizing clinical consistency of echo-Doppler data. PMID:21943283

2011-01-01

133

[The importance of fetal echocardiography in the detection and management of congenital cardiac malformations].  

PubMed

Using present-day high-resolution ultrasound scanners, it is possible to visualize and study the heart during the different stages of fetal growth in patients at risk of some forms of congenital heart disease. Detailed anatomical knowledge of cardiac structures combined with the accurate interpretation of echocardiographic images made during fetal development enable early diagnosis of particular forms of congenital disease that have serious pathophysiologic consequences. In addition, it also becomes possible to select the most appropriate nature and timing of delivery, and to organize early treatment for the newborn. Any decision taken on how to treat a fetus in which a congenital cardiac abnormality has been identified must be taken by a multidisciplinary team. This will help in coordinating the measures that must be taken after delivery and, in the near future, in implementing intrauterine surgery. Fetal echocardiography is establishing itself as a valuable tool in the management of the various types of congenital malformation, which together comprise the main cause of death among the newborn. In addition, the technique can be used to confirm and broaden our knowledge of the natural history of cardiac malformations, which are the most common congenital malformations. There is no doubt that the application and understanding of this imaging technology will increase the survival rate of newborns with specific congenital cardiac abnormalities, and will have a significant impact on long-term clinical outcome and quality of life in these patients. PMID:17178061

Finch, Ana D

2006-11-01

134

Thyroid ultrasound  

PubMed Central

Thyroid ultrasonography has established itself as a popular and useful tool in the evaluation and management of thyroid disorders. Advanced ultrasound techniques in thyroid imaging have not only fascinated the radiologists but also attracted the surgeons and endocrinologists who are using these techniques in their daily clinical and operative practice. This review provides an overview of indications for ultrasound in various thyroid diseases, describes characteristic ultrasound findings in these diseases, and illustrates major diagnostic pitfalls of thyroid ultrasound. PMID:23776892

Chaudhary, Vikas; Bano, Shahina

2013-01-01

135

Congenital Abnormalities  

MedlinePLUS

... Ask your pediatrician for a referral to a genetic counseling service . These services have expertise with a variety ... Family Health History & Genetics Detecting Genetic Abnormalities Prenatal Genetic Counseling Children with Down Syndrome: Health Care Information for ...

136

Sudden cardiac death in Athletes  

Microsoft Academic Search

The impact of sudden cardiac death (SCD) in athletes has been highlighted by increasing media coverage, as well as medical\\u000a and lay awareness of the entities associated with SCD. Common etiologies include cardiac abnormalities such as hypertrophic\\u000a cardiomyopathy (HCM), arrhythmogenic right ventricular dysplasia\\/cardiomyopathy (ARVD), and coronary artery anomalies, each\\u000a with varying geographic incidence. New recommendations regarding noninvasive preparticipation screening have

Olaf Hedrich; Mark Estes; Mark S. Link

2006-01-01

137

Training guidelines for ultrasound: worldwide trends.  

PubMed

Sound travels through objects that block light. Only very recently has technology advanced enough to decipher ultrasound for medical use. Machines have become smaller, cheaper, more versatile and more advanced than ever before. The medical use of ultrasound spreads across many fields so that traditional areas no longer have a monopoly. With this comes the question of training doctors. This has been done by various colleges and societies worldwide. Some have been quicker to act than others. There also needs to be an understanding of when broad experience and advanced technical skills are required or when limited skills will do. In addition, some procedures can be performed more safely with ultrasound where the knowledge of ultrasound is not paramount. This article covers current provision of training in echocardiography and ultrasound in areas relevant to anaesthetists who are working in critical care (including accident and emergency) and complex surgery (mainly cardiac). PMID:19862894

Bennett, Sean

2009-09-01

138

Ultrasound in osteoarthritis.  

PubMed

Ultrasound (US) is a valuable imaging modality in the evaluation of joint and periarticular abnormalities in osteoarthritis (OA). It is able to image structural lesions as well as inflammatory changes in early and late disease. US is a relatively inexpensive, safe and quick-to-perform tool that can be used as a bedside procedure in the assessment of patients with OA. US shows abnormalities at different peripheral joint sites that can be assessed for variable aspects during the same scanning session. The easy accessibility of equipment facilitates its use and applications in the clinical practice. US is helpful in guiding local procedures (i.e. aspirations of joint and periarticular fluid collections, drug injections, biopsy) that can be easily and safely performed with optimal patient's tolerance. In addition, US allows for a monitoring of the disease process and follow-up of local and systemic treatments. PMID:24528550

Iagnocco, Annamaria

2014-01-01

139

Transvaginal ultrasound  

MedlinePLUS

... ovary, ultrasound imaging of pelvic structures. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ... cell neoplasms, sex-cord stromal tumors. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ...

140

[Ultrasound of gallbladder and bile duct.  

PubMed

The cystic nature of the gallbladder and bile duct when dilated, and the advantages of ultrasound as a quick, reproducible, convenient, cheap and low risk technique, with a high sensitivity and specificity, make it the most eligible technique in biliary pathology studies. Ultrasound has become a valuable tool for doctors studying biliary pathology and its complications, from abnormal liver function results, right upper quadrant pain, or jaundice, to cholelithiasis, cholecystitis, or suspicion of biliary tumors. PMID:25450432

Segura Grau, A; Joleini, S; Díaz Rodríguez, N; Segura Cabral, J M

2014-11-11

141

Cranial Ultrasound/Head Ultrasound  

MedlinePLUS

... collects the sounds that bounce back and a computer then uses those sound waves to create an ... Ultrasound scanners consist of a console containing a computer and electronics, a video display screen and a ...

142

Sudden Cardiac Death in Athletes  

Microsoft Academic Search

Sudden cardiac death in athletes, although relatively uncommon, is a well-recognized condition generally associated with some congenital abnormalities. It, however, continues to be of vast interest to the public as athletes are seen as a distinct group of individuals who are especially able to tolerate more intense physical activities than the general population. Obviously, intense activities predispose susceptible athletes to

Peem Lorvidhaya; Shoei K. Stephen Huang

2003-01-01

143

Electrophysiological abnormalities in the transplanted human heart.  

PubMed Central

Fourteen relatively long term survivors of cardiac transplantation underwent systematic electrophysiological evaluation and ambulatory electrocardiographic monitoring. Six patients had prolonged conduction intervals during sinus rhythm. Sinus node function could be assessed in all donor atria and in 10 recipient atria. Sinus node recovery times were prolonged in four of the donor atria and in six recipient atria. In the donor atria abnormalities of sinus node automaticity were invariably associated with abnormalities of sinoatrial conduction. Four patients showed functional duality of atrioventricular nodal conduction during programmed extrastimulation, but no patient developed re-entrant arrhythmia. During ambulatory electrocardiographic monitoring no pronounced tachyarrhythmias were recorded. Three patients showed abnormalities of sinus node impulse formation. All three patients had abnormal sinus node recovery times during their electrophysiological study. Long term survivors of cardiac transplantation have a high incidence of electrophysiological abnormalities. Abnormalities of donor sinus node function are probably of clinical significance. The clinical significance of abnormalities detected within the atrioventricular conduction system of the denervated heart remains to be elucidated. PMID:6360191

Bexton, R S; Nathan, A W; Hellestrand, K J; Cory-Pearce, R; Spurrell, R A; English, T A; Camm, A J

1983-01-01

144

Technological Solutions for Cardiac Surgery in the Elderly  

PubMed Central

The current review addresses contemporary technological advances in cardiac surgery performed on octogenarian patients, namely off-pump coronary artery bypass grafting (CABG), proximal anastomosis device, routine use of intraoperative epiaortic ultrasound, proximal anastomosis without clamping, transcatheter aortic valve implantation (TAVI), and brain protection during cardiac surgery. PMID:23908870

Nir, Rony-Reuven; Bolotin, Gil

2013-01-01

145

The ultrasound challenge 2.0: introducing interinstitutional competition in medical student ultrasound education.  

PubMed

The Ultrasound Challenge was developed at The Ohio State University College of Medicine to introduce focused ultrasound to medical students. The goal was to develop experience in ultrasound through practice and competition. Initially this competition was held between Ohio State University College of Medicine students from years 1 through 4. The Ultrasound Challenge 2.0 was held in 2013. The event expanded on the previous structure by including students from the Wayne State University College of Medicine. The goal of this article is to describe our experiences with expansion of our interinstitutional ultrasound event. The challenge consisted of 6 stations: focused assessment with sonography for trauma, aortic ultrasound, cardiac ultrasound, pelvic ultrasound, musculoskeletal ultrasound, and vascular access. The participants were given a handbook outlining the expectations for each station ahead of time. Vascular access was graded in real time using the Brightness Mode Quality Ultrasound Imaging Examination Technique (B-QUIET) method. The remainder were timed, saved, and graded after the event by 3 independent faculty members using the B-QUIET method. The highest score with the fastest time was the winner. The Ultrasound Challenge 2.0 included 40 participants: 31 from The Ohio State University College of Medicine and 9 from the Wayne State University College of Medicine. The makeup of the winners in all categories consisted of 1 first-year medical student, 7 second-year medical students, 3 third-year medical students, and 10 fourth-year medical students. The Ultrasound Challenge 2.0 was a success for those who participated. It provided the first known interinstitutional medical student ultrasound competition. Students from both institutions were able to practice their image acquisition skills, demonstrate abilities in a competitive environment, and develop collegiality and teamwork. PMID:25425378

Cortez, Eric J; Boulger, Creagh T; Eastin, Travis; Adkins, Eric J; Granitto, Emily; Pollard, Katherine; Bahner, David P

2014-12-01

146

PHOTOACOUSTIC IMAGING AND HIGH INTENSITY FOCUSED ULTRASOUND IN BIOMEDICAL APPLICATIONS  

E-print Network

with the effects of high intensity ultrasound for therapy rather than diagnosis. High intensity focused ultrasound (HIFU) is one of the non-invasive methods used primarily to treat abnormal tissue thermally through hyperthermia (27-29). During HIFU treatment.... With imaging systems such as ultrasound imaging and magnetic resonance imaging (MRI), the use of HIFU has been extended. 4 Since the treatment of bladder cancers with HIFU has been attempted, HIFU has been used as an effective treatment for ablation...

Jo, Janggu

2014-08-31

147

Small Animal Cardiac Ultrasound Seminar & Wetlab  

E-print Network

. Becky Gompf Noon­1:00 p.m. Lunch 1:00­5:00 p.m. Hands-on Laboratory 5:00 p.m. Wrap-up and adjourn Eight.vet.utk.edu/continuing_ed or contact: Barbara Campbell CMP, UTCVM Continuing Education 2407 River Drive Room A104D, Knoxville, TN 37996

Wang, Xiaorui "Ray"

148

Ultrasound Transducers  

NASA Astrophysics Data System (ADS)

Ultrasound imaging modality has the major advantage, as compared to other medical imaging modes, to provide real-time acquisitions. It is a cheap modality compared to MRI and others, and it is non-invasive. One interest in using ultrasound imaging is to study the dynamic behaviour of various organs such as arteries, liver, heart. Today's scanners allow the visualization of the structures in gray scale images and the visualization of the flow information in color Doppler mode images. Both information can be acquired simultaneously. In this chapter we will present the basic principles leading to the design of probes.

Bertora, Franco

149

Correlative magnetic resonance imaging in the evaluation of aortic and pulmonary artery abnormalities  

SciTech Connect

Magnetic resonance imaging (MRI) yields excellent quality images of the cardiovascular system utilizing the inherent natural contrast between flowing blood and the surrounding anatomic structures. To evaluate the clinical usefulness of MRI in the noninvasive diagnosis of large vessel disorders, the authors have performed MRI on 40 pts with either aortic or pulmonary artery abnormalities (18 thoracic or abdominal aortic aneurysms, 8 aorto-occlusive disease, 6 dissecting aneurysms, 4 Marfan's syndrome, 2 pulmonary artery aneurysms 1 pulmonary artery occlusion, 1 aortic coarctation). Images were obtained in the transverse, coronal and sagital body planes utilizing a 0.6T superconductive magnet. Cardiac and/or respiratory gating was employed in most cases. Correlation was made for all studies with conventional or digital subtraction angiography, computed tomography, and/or ultrasound. The diagnostic information obtained by MRI equaled or exceeded that obtained by other imaging techniques except for the few cases where cardiac arrhythmias precluded adequate gated acquisition. All aneurysms and their relationships to adjacent structures were readily demonstrated as were the presence or absence of mural thrombi and dissecting intimal flaps. Angiographically demonstrated atherosclerotic plaques and luminal stenoses were seen by MRI in all patients without arrhythmias. The authors concluded that MRI is a powerful noninvasive diagnostic aid in the delineation of large vessel disorders, especially where knowledge of anatomic interrelationships can guide surgical or other interventional planning.

Risius, B.; O'Donnell, J.K.; Geisinger, M.A.; Zelch, M.G.; George, C.R.; Graor, R.A.; Moodie, D.S.

1985-05-01

150

Medical ultrasound education for bioengineers  

NASA Astrophysics Data System (ADS)

The widespread adoption of ultrasound technologies in medicine has necessitated the development of educational programs to address the growing demand for trained expertise in both academia and industry. The demand has been especially great in the field of therapeutic ultrasound that has experienced a significant level of research and development activities in the past decade. The applications cover a wide range including cancer treatment, hemorrhage control, cardiac ablation, gene therapy, and cosmetic surgery. A comprehensive educational program in ultrasound is well suited for bioengineering departments at colleges and universities. Our educational program for students in Bioengineering at the University of Washington includes a year-long coursework covering theory and practice of ultrasound, conducting research projects, attending and presenting at weekly seminars on literature survey, presentations at scientific meetings, and attending specialized workshops offered by various institutions for specific topics. An important aspect of this training is its multi-disciplinary approach, encompassing science, engineering, and medicine. The students are required to build teams with expertise in these disciplines. Our experience shows that these students are well prepared for careers in academia, conducting cutting edge research, as well as industry, being involved in the transformation of research end-products to commercially viable technology.

Vaezy, Shahram

2005-04-01

151

Thyroid ultrasound  

MedlinePLUS

Abnormal results may be due to: Cysts Enlargement of the thyroid gland ( goiter ) Thyroid nodules Your doctor can use these results and the results of other tests to direct your care. Additional conditions ...

152

Cardiovascular applications of therapeutic ultrasound.  

PubMed

Ultrasound (US) has gained widespread use in diagnostic cardiovascular applications. At amplitudes and frequencies typical of diagnostic use, its biomechanical effects on tissue are largely negligible. However, these parameters can be altered to harness US's thermal and non-thermal effects for therapeutic indications. High-intensity focused ultrasound (HIFU) and extracorporeal shock wave therapy (ECWT) are two therapeutic US modalities which have been investigated for treating cardiac arrhythmias and ischemic heart disease, respectively. Here, we review the biomechanical effects of HIFU and ECWT, their potential therapeutic mechanisms, and pre-clinical and clinical studies demonstrating their efficacy and safety limitations. Furthermore, we discuss other potential clinical applications of therapeutic US and areas in which future research is needed. PMID:24297498

Nazer, Babak; Gerstenfeld, Edward P; Hata, Akiko; Crum, Lawrence A; Matula, Thomas J

2014-04-01

153

Novel flow quantification of the carotid bulb and the common carotid artery with vector flow ultrasound.  

PubMed

Abnormal blood flow is usually assessed using spectral Doppler estimation of the peak systolic velocity. The technique, however, only estimates the axial velocity component, and therefore the complexity of blood flow remains hidden in conventional ultrasound examinations. With the vector ultrasound technique transverse oscillation the blood velocities of both the axial and the transverse directions are obtained and the complexity of blood flow can be visualized. The aim of the study was to determine the technical performance and interpretation of vector concentration as a tool for estimation of flow complexity. A secondary aim was to establish accuracy parameters to detect flow changes/patterns in the common carotid artery (CCA) and the carotid bulb (CB). The right carotid bifurcation including the CCA and CB of eight healthy volunteers were scanned in a longitudinal plane with vector flow ultrasound (US) using a commercial vector flow ultrasound scanner (ProFocus, BK Medical, Denmark) with a linear 5 MHz transducer transverse oscillation vector flow software. CCA and CB areas were marked in one cardiac cycle from each volunteer. The complex flow was assessed by medical expert evaluation and by vector concentration calculation. A vortex with complex flow was found in all carotid bulbs, whereas the CCA had mainly laminar flow. The medical experts evaluated the flow to be mainly laminar in the CCA (0.82 ± 0.14) and mainly complex (0.23 ± 0.22) in the CB. Likewise, the estimated vector concentrations in CCA (0.96 ± 0.16) indicated mainly laminar flow and in CB (0.83 ± 0.07) indicated mainly turbulence. Both methods were thus able to clearly distinguish the flow patterns of CCA and CB in systole. Vector concentration from angle-independent vector velocity estimates is a quantitative index, which is simple to calculate and can differentiate between laminar and complex flow. PMID:25218449

Pedersen, Mads Møller; Pihl, Michael Johannes; Haugaard, Per; Hansen, Kristoffer Lindskov; Lange, Theis; Lönn, Lars; Nielsen, Michael Bachmann; Jensen, Jørgen Arendt

2014-11-01

154

Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis  

PubMed Central

The aim of this review is to illustrate the potential of different and newer ultrasound techniques beyond conventional B-mode imaging, including colour Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and tissue elastography, in the characterisation of both benign and malignant intratesticular lesions. Normally, testicular malignancies, either primary or secondary, demonstrate an increase in colour Doppler signal. However, there is a diversity of benign testicular lesions that may mimic testicular malignancies. The use of CEUS improves characterisation of testicular lesions, and confirms lack of vascularity in benign abnormalities such as epidermoid cysts, infarctions, abscesses and changes following trauma. Tissue elastography allows further evaluation of the cellular consistency of the abnormality. Familiarity with the appearances seen with these ultrasound techniques in both benign and malignant abnormalities should aid in improving confidence in arriving at the correct diagnosis. PMID:22674702

Huang, D Y; Sidhu, P S

2012-01-01

155

General Ultrasound Imaging  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

156

Venous Ultrasound (Extremities)  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

157

Journal of Abnormal Psychology  

Microsoft Academic Search

This article is reprinted from the Journal of Abnormal Psychology, 1965, 70, 1. The Journal of Abnormal Psychology will give priority to articles on problems related to abnormal behavior, broadly defined. The Journal's interests thus include the following: (a) psychopathology--its development or acquisition, its treatment or remission, and its symptomatology and course; (b) normal processes in abnormal individuals; (c) pathological

Howard F. Hunt; William N. Thetford

1965-01-01

158

Cardiac Arrest  

MedlinePLUS

... or it can stop beating. Sudden cardiac arrest (SCA) occurs when the heart develops an arrhythmia that ... is blocked. There are many possible causes of SCA. They include coronary heart disease, physical stress, and ...

159

Cardiac Paragangliomas.  

PubMed

Cardiac paraganglioma is a rare entity. We review the clinical data from 158 patients reported in 132 isolated papers, and discuss clinical presentations, imaging findings, pathology, location, therapy, and outcomes. PMID:25331372

Wang, Ji-Gang; Han, Jing; Jiang, Tao; Li, Yu-Jun

2014-10-20

160

Cardiac Catheterization  

MedlinePLUS

... done during a cardiac catheterization include: closing small holes inside the heart repairing leaky or narrow heart ... bandage. It's normal for the site to be black and blue, red, or slightly swollen for a ...

161

Drosophila Models of Cardiac Disease  

PubMed Central

The fruit fly Drosophila melanogaster has emerged as a useful model for cardiac diseases, both developmental abnormalities and adult functional impairment. Using the tools of both classical and molecular genetics, the study of the developing fly heart has been instrumental in identifying the major signaling events of cardiac field formation, cardiomyocyte specification, and the formation of the functioning heart tube. The larval stage of fly cardiac development has become an important model system for testing isolated preparations of living hearts for the effects of biological and pharmacological compounds on cardiac activity. Meanwhile, the recent development of effective techniques to study adult cardiac performance in the fly has opened new uses for the Drosophila model system. The fly system is now being used to study long-term alterations in adult performance caused by factors such as diet, exercise, and normal aging. The fly is a unique and valuable system for the study of such complex, long-term interactions, as it is the only invertebrate genetic model system with a working heart developmentally homologous to the vertebrate heart. Thus, the fly model combines the advantages of invertebrate genetics (such as large populations, facile molecular genetic techniques, and short lifespan) with physiological measurement techniques that allow meaningful comparisons with data from vertebrate model systems. As such, the fly model is well situated to make important contributions to the understanding of complicated interactions between environmental factors and genetics in the long-term regulation of cardiac performance. PMID:21377627

Piazza, Nicole; Wessells, R.J.

2013-01-01

162

Ultrasound annual, 1986  

SciTech Connect

This book provides an analyses of developments in the field of diagnostic ultrasound. Endoscopic ultrasound and ultrasound-guided aspiration of ovarian follicles for in vitro fertilization are addressed. The use of Doppler ultrasound to measure blood flow in obstetrics is also examined.

Sanders, R.C.; Hill, M.C.

1986-01-01

163

A novel algorithm for sudden cardiac death risk estimation using Lab VIEW  

Microsoft Academic Search

The need for quick diagnosis of cardiac abnormalities cannot be underestimated. Sudden cardiac death (SCD) is one such disease that needs immediate attention as it is fatal and is a leading cause of cardiovascular mortality. Most of the cardiovascular aberrations are due to irregular heart rhythm resulting in abnormal PQRST values which can be traced from the patient's ECG. ECG

N. Santhosha Priya; Ranjith Balakrishnan

2011-01-01

164

Hyperinsulinism in a child presenting with cardiac ischemia and bradycardia  

PubMed Central

A 5-year-old boy referred to our service with suspected sinus node dysfunction. In addition to the arrhythmia, he had moderate mitral valve regurgitation and depressed ventricular function during a hypoglycemic episode. Cardiac abnormalities resolved with glucose infusion. We believe that hypoglycemia was responsible for the cardiac manifestations and it should be considered in unexplained rhythm disturbances or ischemia.

Al-Fayyadh, Majid; Bulbul, Ziad; Al Maneea, Waleed; Abbas, Bassam Bin

2014-01-01

165

Second trimester ultrasound markers of fetal aneuploidy.  

PubMed

Although it is widely accepted that the best time to screen for chromosomal abnormalities is the first trimester, ultrasound evaluation of the fetus in the second trimester has also been shown to be useful for this purpose. A multitude of markers of varying strength has been developed over the past 30 years. In addition, the optimal time to diagnose fetal anomalies with confidence is also the mid second trimester. Therefore, performance of obstetrical ultrasound at this point in gestation continues to be an important component of prenatal care. PMID:24488055

Sonek, Jiri; Croom, Christopher

2014-03-01

166

Paradoxical Air Microembolism Induces Cerebral Bioelectrical Abnormalities and Occasionally Headache in Patent Foramen Ovale Patients With Migraine  

PubMed Central

Background Although controversial, paradoxical embolism via patent foramen ovale (PFO) may account for some of the migraine attacks in a subset of migraine with aura (MA) patients. Induction of MA attacks with air bubble injection during transcranial Doppler ultrasound in MA patients with PFO supports this view. It is likely that cerebral embolism in patients with right-to-left shunt induces bioelectrical abnormalities to initiate MA under some conditions. Methods and Results We investigated changes in cerebral bioelectrical activity after intravenous microbubble injection in 10 MA patients with large PFO and right-to-left cardiac shunt. Eight PFO patients without migraine but with large right-to-left shunt and 12 MA patients without PFO served as controls. Four MA patients with PFO were reexamined with sham injections of saline without microbubbles. Bioelectrical activity was evaluated using spectral electroencephalography and, passage of microbubbles through cerebral arteries was monitored with transcranial Doppler ultrasound. Microbubble embolism caused significant electroencephalographic power increase in MA+PFO patients but not in control groups including the sham-injected MA+PFO patients. Headache developed in 2 MA with PFO patients after microbubble injection. Conclusions These findings demonstrate that air microembolism through large PFOs may cause cerebral bioelectrical disturbances and, occasionally, headache in MA patients, which may reflect an increased reactivity of their brain to transient subclinical hypoxia–ischemia, and suggest that paradoxical embolism is not a common cause of migraine but may induce headache in the presence of a large PFO and facilitating conditions. PMID:23316313

Sevgi, Eser Ba?ak; Erdener, Sefik Evren; Demirci, Mehmet; Topcuoglu, Mehmet Akif; Dalkara, Turgay

2012-01-01

167

Segmentation of the Left Heart Ventricle in Ultrasound Images Using a Region Based Snake  

E-print Network

Segmentation of the Left Heart Ventricle in Ultrasound Images Using a Region Based Snake Matilda that uses a region based snake. To avoid any unwanted concavities in the segmentations due to the cardiac valve we use two anchor points in the snake that are located to the left and to the right of the cardiac

Lunds Universitet

168

Abnormal Head Position  

MedlinePLUS

... cause. Can a longstanding head turn lead to any permanent problems? Yes, a significant abnormal head posture could cause permanent ... occipitocervical synostosis and unilateral hearing loss. Are there any ... postures? Yes. Abnormal head postures can usually be improved depending ...

169

Non-invasive quick diagnosis of cardiovascular problems from visible and invisible abnormal changes with increased cardiac troponin I appearing on cardiovascular representation areas of the eyebrows, left upper lip, etc. of the face & hands: beneficial manual stimulation of hands for acute anginal chest pain, and important factors in safe, effective treatment.  

PubMed

Our previous study indicated that there are at least 7 cardiovascular representation areas on the face, including the "Eyebrows", both sides of the "Nose", "Lelt Upper Lip" and the "Outside of the corner of both sides of the mouth," in addition to 2 areas in each hand. When there are cardiovascular problems, some of the heart representation areas of these areas often show the following changes: 1) Most distinctive visible changes such as the initial whitening with or without long white hair, then hair loss and complete disappearance of the hairs of the heart representation area of "Eyebrows" 2) Invisible biochemical changes that happen in heart representation areas at the "Left Upper Lips", 3) "Nose" below eye level as well as 4) "3rd segment of Middle Finger of Hands." Most distinctive visible & invisible changes are found in heart representation areas on the "Eyebrow", located nearest to the midline of face, where the color of the hairs becomes white compared with the rest of the Eyebrow. Then the cardiovascular problem advances, and hair starts disappearing. When there are no hairs at the heart representation areas of the Eyebrow, usually Cardiac Troponin I is increased to a very serious, abnormal high value. Most of the cardiovascular representation areas of the face show, regardless of presence or absence of visible change. When there is a cardiovascular problem, not only simple Bi-Digital O-Ring Test can detect without using any instrument in several minutes but also, corresponding biochemical changes of abnormally increased Cardiac Troponin I level can often be detected non-invasively from these Organ Representation Areas of Face & Hands, although changes in Eyebrows, L-Upper Lip & 3rd segment of middle fingers are clinically the most reliable changes & easy to identify the locations. Manual Stimulation of Hand's heart representation areas often eliminated acute anginal chest pain before medical help became available. Important factors for safe, effective treatment of heart disease & cancer were also presented. Significant beneficial effect of optimal dose of Vitamin D3 400 I.U. for average adult on heart, brain and cancer, and harmful effect of widely used 2000 I.U., was emphasized. PMID:25219029

Omura, Yoshiaki; Jones, Marilyn K; Duvvi, Harsha; Shimotsuura, Yasuhiro; Ohki, Motomu; Rodriques, Aaron

2014-01-01

170

Cardiac amyloidosis  

MedlinePLUS

... disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it ... of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these ...

171

Relation between cyclic variation in echo amplitude and segmental contraction in normal and abnormal hearts.  

PubMed Central

OBJECTIVE--To study the relation between cardiac systolic activity and cardiac cycle dependent variation in the ultrasound signal arising from within the myocardium. DESIGN--Regional echo amplitude was used as a measure of the myocardial ultrasound signal. Relative echo amplitude values were assigned by standardising echo gain using the posterior parietal pericardium as an in-vivo calibration. M mode measurements of the left ventricle were used to assess cardiac systolic activity. Subjects were studied prospectively. Analysis of echo amplitude was performed by investigators who were blinded to the results of the M mode analysis. The influence of impaired left ventricular performance and abnormal wall motion were assessed. PATIENTS--11 cardiomyopathy patients with impaired ventricular function, eight patients with severe pulmonary hypertension and reversed septal motion, and 19 healthy controls. SETTING--All subject studies were performed at Harefield Hospital. Echo amplitude analysis was performed at the Royal Brompton Hospital. MAIN OUTCOME MEASURES--Cyclic variation in echo amplitude was determined as the change in echo amplitude from end diastole to end systole. Additionally, an index of cyclic variation defined as the ratio of the cyclic change in echo amplitude to end diastolic echo amplitude was measured. Both cyclic variation and the cyclic variation index were analysed to see whether they correlated with left ventricular dimensions, fractional shortening, and systolic wall thickening. RESULTS--Stepwise regression analysis showed systolic wall thickening to be the most significant independent variable that correlated with the cyclic variation index for both the septum and posterior wall (r = 0.68, p = 0.0001, septum; r = 0.69, p = 0.0001, posterior wall). The slopes and intercepts for both regression equations were similar (y = 0.005x + 0.006, septum; y = 0.006x + 0, posterior wall). Subgroup analysis showed that the healthy controls, patients with cardiomyopathy, and patients with pulmonary hypertension had similar slopes and intercepts for their individual regression equations. CONCLUSIONS--These data support the hypothesis of a quantitative relation between the extent of cyclic variation of echo amplitude and the degree of segmental myocardial shortening, as measured by systolic wall thickening, which is not significantly influenced by location within the myocardium, left ventricular performance, or wall motion. They provide further evidence of the usefulness of quantitative analysis of myocardial echo amplitude in the study of regional myocardial function in both normal and injured myocardium. Images PMID:1747276

Lythall, D A; Logan-Sinclair, R B; Ilsley, C J; Kushwaha, S S; Yacoub, M H; Gibson, D G

1991-01-01

172

Cardiac Involvement in Hypereosinophilia Associated with Toxocariasis  

PubMed Central

Cardiac involvement in hypereosinophilia is rare; when present, it manifests as ventricular thickening, usually with fibrous tissue and mural thrombosis. We present a case of a 57-year-old man with an abnormal right ventricular apex with eosinophilia, which was caused by Toxocara canis infection. PMID:25580199

Park, Hyun-Joon; You, Ga-In; Yang, Joung-Wook; Kim, Soo-Young; Kim, Hyun-Su; Cha, Tae-Joon

2014-01-01

173

Cardiac involvement in hypereosinophilia associated with toxocariasis.  

PubMed

Cardiac involvement in hypereosinophilia is rare; when present, it manifests as ventricular thickening, usually with fibrous tissue and mural thrombosis. We present a case of a 57-year-old man with an abnormal right ventricular apex with eosinophilia, which was caused by Toxocara canis infection. PMID:25580199

Park, Hyun-Joon; You, Ga-In; Cho, Kyoung-Im; Yang, Joung-Wook; Kim, Soo-Young; Kim, Hyun-Su; Cha, Tae-Joon

2014-12-01

174

Cardiac valve disease: an unreported feature in Ehlers Danlos syndrome arthrocalasia type?  

PubMed

Ehlers Danlos syndrome (EDS) athrocalasia type (type VII), is characterized by joint hypermobility, skin hyperextensibility and tissue fragility. No heart involvement has been reported. Two forms have been described: type VII A and VII B. The abnormally processed collagen ?2(I) and the skipping of the exon 6 in COL1A2 gene are typically detected in EDS type VII B. We describe a seven-year old female, with a phenotype consistent with EDS type VII B and a diagnosis further confirmed by biochemical and molecular analyses. Cardiac ultrasound showed normal data in the first year of life. When she was 5 years old, the patient developed mitral valve regurgitation, and aortic and tricuspidal insufficiency at 7 years of age. To our knowledge, this is the first report of cardiac valvular involvement in EDS VII B. This feature probably has been underreported for the limited follow-up of the patients. Echocardiography might be warranted in the clinical assessment of EDS VII patients. PMID:23158907

Melis, Daniela; Cappuccio, Gerarda; Ginocchio, Virginia Maria; Minopoli, Giorgia; Valli, Maurizia; Corradi, Massimiliano; Andria, Generoso

2012-01-01

175

Ultrasound Annual, 1983  

SciTech Connect

The 1983 edition of Ultrasound Annual features a state-of-the-art assessment of real-time ultrasound technology and a look at improvements in real-time equipment. Chapters discuss important new obstetric applications of ultrasound in measuring fetal umbilical vein blood flow and monitoring ovarian follicular development in vivo and in vitro fertilization. Other topics covered include transrectal prostate ultrasound using a linear array system; ultrasound of the common bile duct; ultrasound in tropical diseases; prenatal diagnosis of craniospinal anomalies; scrotal ultrasonography; opthalmic ultrasonography; and sonography of the upper abdominal venous system.

Sanders, R.C.; Hill, M.C.

1983-01-01

176

Automated whole breast ultrasound.  

PubMed

Bilateral whole breast (screening) ultrasound has been well established in multiple single- and multi-institution published studies as a valuable adjunct to mammography screening for early detection of breast cancer. However, implementation of screening breast ultrasound programs has been limited and has met with resistance because of the number of potential false positives generated by ultrasound screening, and the lack of available personnel to perform the examination. Automated breast ultrasound, which has recently been approved by the US Food and Drug Administration for use in whole-breast ultrasound screening, is a potential option for providing breast ultrasound screening on a widespread basis. PMID:24792655

Kaplan, Stuart S

2014-05-01

177

Systematic training in focused cardiopulmonary ultrasound affects decision-making in the prehospital setting - two case reports.  

PubMed

We present two cases from the Helicopter Emergency Medical Services (HEMS) in Denmark, in which prehospital physicians trained in cardiac ultrasound (FATE) disclosed significant pathology that induced a radical change for the critical patient's course. PMID:24886932

Jakobsen, Louise Kollander; Bøtker, Morten Thingemann; Lawrence, Lars Peter; Sloth, Erik; Knudsen, Lars

2014-01-01

178

Systematic training in focused cardiopulmonary ultrasound affects decision-making in the prehospital setting – two case reports  

PubMed Central

Abstact We present two cases from the Helicopter Emergency Medical Services (HEMS) in Denmark, in which prehospital physicians trained in cardiac ultrasound (FATE) disclosed significant pathology that induced a radical change for the critical patient’s course. PMID:24886932

2014-01-01

179

Simplifying the ultrasound findings of the major fetal chromosomal aneuploidies.  

PubMed

Sonographic aneuploidy markers and structural anomalies associated with the 5 most common chromosomal aneuploidies are organized and simplified to highlight the many sonographic findings that are commonly seen with each aneuploidy. Identification of these findings allows families to have the option to pursue prenatal genetic testing to confirm or exclude chromosomal abnormalities suggested by such prenatal ultrasound findings and make informed decisions about the subsequent management of their pregnancy. We review the most common major human chromosomal aneuploidies, including trisomies 21, 18, and 13; Turner syndrome; and triploidy. The focus is on the major structural anomalies seen with each of these, as well as ultrasound markers (findings associated with increased risk of chromosomal abnormality but also seen in normal fetuses). The role of clinical information such as maternal serum screening and new cell-free fetal DNA screening is also reviewed. As patients do not usually present for fetal ultrasound with a known diagnosis, a concise knowledge of ultrasound and clinical findings will alert radiologists to concerning cases and prompt a guided search for important associated anomalies. Fetal ultrasound can be challenging owing to the many findings and sometimes technically difficult evaluation. By simplifying the ultrasound findings seen with the major chromosomal abnormalities and highlighting the role of clinical history, we hope that an informed search for specific sonographic findings can be performed; thereby, reducing missed diagnoses. PMID:25239075

Liau, Joy; Romine, Lorene; Korty, Lauren A; Chao, Cherng; White, Katherine; Harmon, Sheena; Ho, Yoona; Hull, Andrew D; Pretorius, Dolores H

2014-01-01

180

Breast ultrasound tomography with total-variation regularization  

NASA Astrophysics Data System (ADS)

Breast ultrasound tomography is a rapidly developing imaging modality that that has the potential to impact breast cancer screening and diagnosis. A new ultrasound breast imaging device (CURE) with a ring array of transducers has been designed and built at Karmanos Cancer Institute, which acquires both reflection and transmission ultrasound signals. To extract the sound-speed information from the breast data acquired by CURE, we have developed an iterative sound-speed image reconstruction algorithm for breast ultrasound transmission tomography based on total-variation (TV) minimization. We investigate applicability of the TV tomography algorithm using in vivo ultrasound breast data from 61 patients, and compare the results with those obtained using the Tikhonov regularization method. We demonstrate that, compared to the Tikhonov regularization scheme, the TV regularization method significantly improves image quality, resulting in sound-speed tomography images with sharp (preserved) edges of abnormalities and few artifacts.

Li, Cuiping; Duric, Neb; Huang, Lianjie

2009-02-01

181

Breast ultrasound tomography with total-variation regularization  

SciTech Connect

Breast ultrasound tomography is a rapidly developing imaging modality that has the potential to impact breast cancer screening and diagnosis. A new ultrasound breast imaging device (CURE) with a ring array of transducers has been designed and built at Karmanos Cancer Institute, which acquires both reflection and transmission ultrasound signals. To extract the sound-speed information from the breast data acquired by CURE, we have developed an iterative sound-speed image reconstruction algorithm for breast ultrasound transmission tomography based on total-variation (TV) minimization. We investigate applicability of the TV tomography algorithm using in vivo ultrasound breast data from 61 patients, and compare the results with those obtained using the Tikhonov regularization method. We demonstrate that, compared to the Tikhonov regularization scheme, the TV regularization method significantly improves image quality, resulting in sound-speed tomography images with sharp (preserved) edges of abnormalities and few artifacts.

Huang, Lianjie [Los Alamos National Laboratory; Li, Cuiping [KARMANOS CANCER INSTIT.; Duric, Neb [KARMANOS CANCER INSTIT

2009-01-01

182

Smart Ultrasound Remote Guidance Experiment (SURGE) Preliminary Findings  

NASA Technical Reports Server (NTRS)

To date, diagnostic quality ultrasound images were obtained aboard the International Space Station (ISS) using the ultrasound of the Human Research Facility (HRF) rack in the Laboratory module. Through the Advanced Diagnostic Ultrasound in Microgravity (ADUM) and the Braslet-M Occlusion Cuffs (BRASLET SDTO) studies, non-expert ultrasound operators aboard the ISS have performed cardiac, thoracic, abdominal, vascular, ocular, and musculoskeletal ultrasound assessments using remote guidance from ground-based ultrasound experts. With exploration class missions to the lunar and Martian surfaces on the horizon, crew medical officers will necessarily need to operate with greater autonomy given communication delays (round trip times of up to 5 seconds for the Moon and 90 minutes for Mars) and longer periods of communication blackouts (due to orbital constraints of communication assets). The SURGE project explored the feasibility and training requirements of having non-expert ultrasound operators perform autonomous ultrasound assessments in a simulated exploration mission outpost. The project aimed to identify experience, training, and human factors requirements for crew medical officers to perform autonomous ultrasonography. All of these aims pertained to the following risks from the NASA Bioastronautics Road Map: 1) Risk 18: Major Illness and Trauna; 2) Risk 20) Ambulatory Care; 3) Risk 22: Medical Informatics, Technologies, and Support Systems; and 4) Risk 23: Medical Skill Training and Maintenance.

Hurst, Victor; Dulchavsky, Scott; Garcia, Kathleen; Sargsyan, Ashot; Ebert, Doug

2009-01-01

183

Cardiac sarcoidosis.  

PubMed

The prognosis of sarcoidosis often considered as "benign" is significantly changed in the presence of a cardiac localization. An in-depth interview, a clinical examination together with ECG are often for most of sarcoidosis. Certain conditions (severe multisystemic sarcoidosis, rares localizations in particular neurological, renal, gastric) lead to necessary investigations: Holter ECG, echocardiography, thallium scintigraphy with dipyridamole test, PET scanner and MRI in order to identify infraclinical presentations. Diagnosis relies on guidelines of Japansese criteria, but can benefit from MRI and PET scanner even though their place is not yet clearly defined in clinical pratice. Diagnosing cardiac sarcoidosis means deciding an immunosuppressive treatment. It is highly important to gather all criteria to validate a consistent diagnosis or at least a high probability. In order to best adapt therapy, a coordinated patient care involving the cardiologist and the sarcoidosis specialist is necessary. PMID:22608949

Chapelon-Abric, Catherine

2012-06-01

184

3D ultrafast ultrasound imaging in vivo  

NASA Astrophysics Data System (ADS)

Very high frame rate ultrasound imaging has recently allowed for the extension of the applications of echography to new fields of study such as the functional imaging of the brain, cardiac electrophysiology, and the quantitative imaging of the intrinsic mechanical properties of tumors, to name a few, non-invasively and in real time. In this study, we present the first implementation of Ultrafast Ultrasound Imaging in 3D based on the use of either diverging or plane waves emanating from a sparse virtual array located behind the probe. It achieves high contrast and resolution while maintaining imaging rates of thousands of volumes per second. A customized portable ultrasound system was developed to sample 1024 independent channels and to drive a 32? × ?32 matrix-array probe. Its ability to track in 3D transient phenomena occurring in the millisecond range within a single ultrafast acquisition was demonstrated for 3D Shear-Wave Imaging, 3D Ultrafast Doppler Imaging, and, finally, 3D Ultrafast combined Tissue and Flow Doppler Imaging. The propagation of shear waves was tracked in a phantom and used to characterize its stiffness. 3D Ultrafast Doppler was used to obtain 3D maps of Pulsed Doppler, Color Doppler, and Power Doppler quantities in a single acquisition and revealed, at thousands of volumes per second, the complex 3D flow patterns occurring in the ventricles of the human heart during an entire cardiac cycle, as well as the 3D in vivo interaction of blood flow and wall motion during the pulse wave in the carotid at the bifurcation. This study demonstrates the potential of 3D Ultrafast Ultrasound Imaging for the 3D mapping of stiffness, tissue motion, and flow in humans in vivo and promises new clinical applications of ultrasound with reduced intra—and inter-observer variability.

Provost, Jean; Papadacci, Clement; Esteban Arango, Juan; Imbault, Marion; Fink, Mathias; Gennisson, Jean-Luc; Tanter, Mickael; Pernot, Mathieu

2014-10-01

185

3D ultrafast ultrasound imaging in vivo.  

PubMed

Very high frame rate ultrasound imaging has recently allowed for the extension of the applications of echography to new fields of study such as the functional imaging of the brain, cardiac electrophysiology, and the quantitative imaging of the intrinsic mechanical properties of tumors, to name a few, non-invasively and in real time. In this study, we present the first implementation of Ultrafast Ultrasound Imaging in 3D based on the use of either diverging or plane waves emanating from a sparse virtual array located behind the probe. It achieves high contrast and resolution while maintaining imaging rates of thousands of volumes per second. A customized portable ultrasound system was developed to sample 1024 independent channels and to drive a 32? × ?32 matrix-array probe. Its ability to track in 3D transient phenomena occurring in the millisecond range within a single ultrafast acquisition was demonstrated for 3D Shear-Wave Imaging, 3D Ultrafast Doppler Imaging, and, finally, 3D Ultrafast combined Tissue and Flow Doppler Imaging. The propagation of shear waves was tracked in a phantom and used to characterize its stiffness. 3D Ultrafast Doppler was used to obtain 3D maps of Pulsed Doppler, Color Doppler, and Power Doppler quantities in a single acquisition and revealed, at thousands of volumes per second, the complex 3D flow patterns occurring in the ventricles of the human heart during an entire cardiac cycle, as well as the 3D in vivo interaction of blood flow and wall motion during the pulse wave in the carotid at the bifurcation. This study demonstrates the potential of 3D Ultrafast Ultrasound Imaging for the 3D mapping of stiffness, tissue motion, and flow in humans in vivo and promises new clinical applications of ultrasound with reduced intra--and inter-observer variability. PMID:25207828

Provost, Jean; Papadacci, Clement; Arango, Juan Esteban; Imbault, Marion; Fink, Mathias; Gennisson, Jean-Luc; Tanter, Mickael; Pernot, Mathieu

2014-10-01

186

Medical Ultrasound Imaging.  

ERIC Educational Resources Information Center

Explains the basic principles of ultrasound using everyday physics. Topics include the generation of ultrasound, basic interactions with material, and the measurement of blood flow using the Doppler effect. (Author/MM)

Hughes, Stephen

2001-01-01

187

Cardiac optogenetics  

PubMed Central

Optogenetics is an emerging technology for optical interrogation and control of biological function with high specificity and high spatiotemporal resolution. Mammalian cells and tissues can be sensitized to respond to light by a relatively simple and well-tolerated genetic modification using microbial opsins (light-gated ion channels and pumps). These can achieve fast and specific excitatory or inhibitory response, offering distinct advantages over traditional pharmacological or electrical means of perturbation. Since the first demonstrations of utility in mammalian cells (neurons) in 2005, optogenetics has spurred immense research activity and has inspired numerous applications for dissection of neural circuitry and understanding of brain function in health and disease, applications ranging from in vitro to work in behaving animals. Only recently (since 2010), the field has extended to cardiac applications with less than a dozen publications to date. In consideration of the early phase of work on cardiac optogenetics and the impact of the technique in understanding another excitable tissue, the brain, this review is largely a perspective of possibilities in the heart. It covers the basic principles of operation of light-sensitive ion channels and pumps, the available tools and ongoing efforts in optimizing them, overview of neuroscience use, as well as cardiac-specific questions of implementation and ideas for best use of this emerging technology in the heart. PMID:23457014

2013-01-01

188

Abnormal muscle mechanosignaling triggers cardiomyopathy in mice with Marfan syndrome  

PubMed Central

Patients with Marfan syndrome (MFS), a multisystem disorder caused by mutations in the gene encoding the extracellular matrix (ECM) protein fibrillin 1, are unusually vulnerable to stress-induced cardiac dysfunction. The prevailing view is that MFS-associated cardiac dysfunction is the result of aortic and/or valvular disease. Here, we determined that dilated cardiomyopathy (DCM) in fibrillin 1–deficient mice is a primary manifestation resulting from ECM-induced abnormal mechanosignaling by cardiomyocytes. MFS mice displayed spontaneous emergence of an enlarged and dysfunctional heart, altered physical properties of myocardial tissue, and biochemical evidence of chronic mechanical stress, including increased angiotensin II type I receptor (AT1R) signaling and abated focal adhesion kinase (FAK) activity. Partial fibrillin 1 gene inactivation in cardiomyocytes was sufficient to precipitate DCM in otherwise phenotypically normal mice. Consistent with abnormal mechanosignaling, normal cardiac size and function were restored in MFS mice treated with an AT1R antagonist and in MFS mice lacking AT1R or ?-arrestin 2, but not in MFS mice treated with an angiotensin-converting enzyme inhibitor or lacking angiotensinogen. Conversely, DCM associated with abnormal AT1R and FAK signaling was the sole abnormality in mice that were haploinsufficient for both fibrillin 1 and ?1 integrin. Collectively, these findings implicate fibrillin 1 in the physiological adaptation of cardiac muscle to elevated workload. PMID:24531548

Cook, Jason R.; Carta, Luca; Bénard, Ludovic; Chemaly, Elie R.; Chiu, Emily; Rao, Satish K.; Hampton, Thomas G.; Yurchenco, Peter; Costa, Kevin D.; Hajjar, Roger J.; Ramirez, Francesco

2014-01-01

189

Abnormal muscle mechanosignaling triggers cardiomyopathy in mice with Marfan syndrome.  

PubMed

Patients with Marfan syndrome (MFS), a multisystem disorder caused by mutations in the gene encoding the extracellular matrix (ECM) protein fibrillin 1, are unusually vulnerable to stress-induced cardiac dysfunction. The prevailing view is that MFS-associated cardiac dysfunction is the result of aortic and/or valvular disease. Here, we determined that dilated cardiomyopathy (DCM) in fibrillin 1-deficient mice is a primary manifestation resulting from ECM-induced abnormal mechanosignaling by cardiomyocytes. MFS mice displayed spontaneous emergence of an enlarged and dysfunctional heart, altered physical properties of myocardial tissue, and biochemical evidence of chronic mechanical stress, including increased angiotensin II type I receptor (AT1R) signaling and abated focal adhesion kinase (FAK) activity. Partial fibrillin 1 gene inactivation in cardiomyocytes was sufficient to precipitate DCM in otherwise phenotypically normal mice. Consistent with abnormal mechanosignaling, normal cardiac size and function were restored in MFS mice treated with an AT1R antagonist and in MFS mice lacking AT1R or ?-arrestin 2, but not in MFS mice treated with an angiotensin-converting enzyme inhibitor or lacking angiotensinogen. Conversely, DCM associated with abnormal AT1R and FAK signaling was the sole abnormality in mice that were haploinsufficient for both fibrillin 1 and ?1 integrin. Collectively, these findings implicate fibrillin 1 in the physiological adaptation of cardiac muscle to elevated workload. PMID:24531548

Cook, Jason R; Carta, Luca; Bénard, Ludovic; Chemaly, Elie R; Chiu, Emily; Rao, Satish K; Hampton, Thomas G; Yurchenco, Peter; Costa, Kevin D; Hajjar, Roger J; Ramirez, Francesco

2014-03-01

190

Ultrasound Imaging System Video  

NASA Technical Reports Server (NTRS)

In this video, astronaut Peggy Whitson uses the Human Research Facility (HRF) Ultrasound Imaging System in the Destiny Laboratory of the International Space Station (ISS) to image her own heart. The Ultrasound Imaging System provides three-dimension image enlargement of the heart and other organs, muscles, and blood vessels. It is capable of high resolution imaging in a wide range of applications, both research and diagnostic, such as Echocardiography (ultrasound of the heart), abdominal, vascular, gynecological, muscle, tendon, and transcranial ultrasound.

2002-01-01

191

Biological effects of ultrasound  

SciTech Connect

This book contains 14 selections. Some of the titles are: Ultrasonic Bioeffects and Ther Clinical Relevance: An Overview; Investigations into Genetic and Inherited Changes Produced by Ultrasound; Ultrasound and the Mammalian Fetus; Epidemiology and Human Exposure; and Local Hyperthermia by Ultrasound for Cancer Therapy.

Nyborg, W.L.; Ziskin, M.C.

1985-01-01

192

Medical ultrasound imaging  

Microsoft Academic Search

The paper gives an introduction to current medical ultrasound imaging systems. The basics of anatomic and blood flow imaging are described. The properties of medical ultrasound and its focusing are described, and the various methods for two- and three-dimensional imaging of the human anatomy are shown. Systems using both linear and non-linear propagation of ultrasound are described. The blood velocity

Jørgen Arendt Jensen

2007-01-01

193

Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause.  

PubMed

Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding, ultrasound is used to categorise women as at low or high risk of endometrial cancer, and the result of the ultrasound examination is the basis for further management. In women with abnormal vaginal bleeding before the menopause, the role of ultrasound is less clear. This is because some common causes of abnormal vaginal bleeding before the menopause cannot be diagnosed with ultrasound, such as infection, dysfunctional bleeding, or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may also sometimes be helpful in women with abnormal vaginal bleeding before the menopause. In this chapter, I present ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas, including submucous myomas and leiomyosarcoma, and describe ultrasound-based triage of women with postmenopausal bleeding. PMID:24834911

Valentin, Lil

2014-07-01

194

Structurally abnormal human autosomes  

SciTech Connect

Chapter 25, discusses structurally abnormal human autosomes. This discussion includes: structurally abnormal chromosomes, chromosomal polymorphisms, pericentric inversions, paracentric inversions, deletions or partial monosomies, cri du chat (cat cry) syndrome, ring chromosomes, insertions, duplication or pure partial trisomy and mosaicism. 71 refs., 8 figs.

NONE

1993-12-31

195

Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus  

SciTech Connect

Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.

Hosenpud, J.D.; Montanaro, A.; Hart, M.V.; Haines, J.E.; Specht, H.D.; Bennett, R.M.; Kloster, F.E.

1984-08-01

196

Morphological abnormalities among lampreys  

USGS Publications Warehouse

The experimental control of the sea lamprey (Petromyzon marinus) in the Great Lakes has required the collection of thousands of lampreys. Representatives of each life stage of the four species of the Lake Superior basin were examined for structural abnormalities. The most common aberration was the presence of additional tails. The accessory tails were always postanal and smaller than the normal tail. The point of origin varied; the extra tails occurred on dorsal, ventral, or lateral surfaces. Some of the extra tails were misshaped and curled, but others were normal in shape and pigment pattern. Other abnormalities in larval sea lampreys were malformed or twisted tails and bodies. The cause of the structural abnormalities is unknown. The presence of extra caudal fins could be genetically controlled, or be due to partial amputation or injury followed by abnormal regeneration. Few if any lampreys with structural abnormalities live to sexual maturity.

Manion, Patrick J.

1967-01-01

197

Transthoracic Cardiac Acoustic Radiation Force Impulse Imaging  

NASA Astrophysics Data System (ADS)

This dissertation investigates the feasibility of a real-time transthoracic Acoustic Radiation Force Impulse (ARFI) imaging system to measure myocardial function non-invasively in clinical setting. Heart failure is an important cardiovascular disease and contributes to the leading cause of death for developed countries. Patients exhibiting heart failure with a low left ventricular ejection fraction (LVEF) can often be identified by clinicians, but patients with preserved LVEF might be undetected if they do not exhibit other signs and symptoms of heart failure. These cases motivate development of transthoracic ARFI imaging to aid the early diagnosis of the structural and functional heart abnormalities leading to heart failure. M-Mode ARFI imaging utilizes ultrasonic radiation force to displace tissue several micrometers in the direction of wave propagation. Conventional ultrasound tracks the response of the tissue to the force. This measurement is repeated rapidly at a location through the cardiac cycle, measuring timing and relative changes in myocardial stiffness. ARFI imaging was previously shown capable of measuring myocardial properties and function via invasive open-chest and intracardiac approaches. The prototype imaging system described in this dissertation is capable of rapid acquisition, processing, and display of ARFI images and shear wave elasticity imaging (SWEI) movies. Also presented is a rigorous safety analysis, including finite element method (FEM) simulations of tissue heating, hydrophone intensity and mechanical index (MI) measurements, and thermocouple transducer face heating measurements. For the pulse sequences used in later animal and clinical studies, results from the safety analysis indicates that transthoracic ARFI imaging can be safely applied at rates and levels realizable on the prototype ARFI imaging system. Preliminary data are presented from in vivo trials studying changes in myocardial stiffness occurring under normal and abnormal heart function. Presented is the first use of transthoracic ARFI imaging in a serial study of heart failure in a porcine model. Results demonstrate the ability of transthoracic ARFI to image cyclically-varying stiffness changes in healthy and infarcted myocardium under good B-mode imaging conditions at depths in the range of 3-5 cm. Challenging imaging scenarios such as deep regions of interest, vigorous lateral motion and stable, reverberant clutter are analyzed and discussed. Results are then presented from the first study of clinical feasibility of transthoracic cardiac ARFI imaging. At the Duke University Medical Center, healthy volunteers and patients having magnetic resonance imaging-confirmed apical infarcts were enrolled for the study. The number of patients who met the inclusion criteria in this preliminary clinical trial was low, but results showed that the limitations seen in animal studies were not overcome by allowing transmit power levels to exceed the FDA mechanical index (MI) limit. The results suggested the primary source of image degradation was clutter rather than lack of radiation force. Additionally, the transthoracic method applied in its present form was not shown capable of tracking propagating ARFI-induced shear waves in the myocardium. Under current instrumentation and processing methods, results of these studies support feasibility for transthoracic ARFI in high-quality B-Mode imaging conditions. Transthoracic ARFI was not shown sensitive to infarct or to tracking heart failure in the presence of clutter and signal decorrelation. This work does provide evidence that transthoracic ARFI imaging is a safe non-invasive tool, but clinical efficacy as a diagnostic tool will need to be addressed by further development to overcome current challenges and increase robustness to sources of image degradation.

Bradway, David Pierson

198

Echocardiographic assessment of cardiac disease  

NASA Technical Reports Server (NTRS)

The physical principles and current applications of echocardiography in assessment of heart diseases are reviewed. Technical considerations and unresolved points relative to the use of echocardiography in various disease states are stressed. The discussion covers normal mitral valve motion, mitral stenosis, aortic regurgitation, atrial masses, mitral valve prolapse, and idiopathic hypertrophic subaortic stenosis. Other topics concern tricuspic valve abnormalities, aortic valve disease, pulmonic valve, pericardial effusion, intraventricular septal motion, and left ventricular function. The application of echocardiography to congenital heart disease diagnosis is discussed along with promising ultrasonic imaging systems. The utility of echocardiography in quantitative evaluation of cardiac disease is demonstrated.

Popp, R. L.

1976-01-01

199

Brain Embolism Monitoring with Transcranial Doppler Ultrasound.  

PubMed

Embolism is considered to be the main mechanism leading to brain infarction today; with the introduction of sophisticated neuroimaging tools, its impact is increasingly appreciated. Transcranial Doppler ultrasound allows noninvasive monitoring of in vivo embolism. Acute stroke, internal carotid artery stenosis, several cardiac conditions, internal carotid endarterectomy, and coronary artery bypass graft surgery have been extensively monitored. These investigations and other clinical and neuroimaging studies have expanded the understanding of brain embolism; they suggest it may be appropriate to think of it as a process that occurs in the context of other hemodynamic factors. Differences have been identified among several conditions regarding the temporal profile of embolism and the characteristics of embolic particles. This article presents a brief review of brain embolism monitoring with transcranial Doppler ultrasound. PMID:12777200

Babikian, Viken L.; Wijman, Christine A.

2003-07-01

200

Structural causes of cardiac dysfunction in uremia.  

PubMed

While coronary heart disease is undoubtedly a major cause of cardiac morbidity and mortality in uremia, important noncoronary problems contribute to the common presence of cardiac problems. Based on clinical and experimental studies, we could show: (i) Left ventricular hypertrophy (LVH) can be dissociated, at least in part, from elevation of blood pressure. (ii) In uremia, PTH-dependent intermyocardiocytic fibrosis occurs; it may account, at least in part, for disturbed LV compliance and contribute to the arrhythmogenic potential. (iii) Blood pressure-independent abnormalities of intracardiac arterioles and reduced myocardial capillary supply are observed. PMID:8516501

Rambausek, M; Amann, K; Mall, G; Ritz, E

1993-01-01

201

"Jeopardy" in Abnormal Psychology.  

ERIC Educational Resources Information Center

Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

Keutzer, Carolin S.

1993-01-01

202

Abnormal Uterine Bleeding  

MedlinePLUS

... as cancer of the uterus, cervix, or vagina • Polycystic ovary syndrome How is abnormal bleeding diagnosed? Your health care ... before the fetus can survive outside the uterus. Polycystic Ovary Syndrome: A condition characterized by two of the following ...

203

Tooth - abnormal colors  

MedlinePLUS

... age when teeth are forming Poor oral care Porphyria Severe neonatal jaundice Too much fluoride from environmental ... abnormal coloration began Foods you have been eating Medications you are taking Personal and family health history ...

204

High prevalence of incomplete right bundle branch block in facioscapulohumeral muscular dystrophy without cardiac symptoms  

PubMed Central

Summary The exact prevalence and nature of cardiac involvement in facioscapulohumeral muscular dystrophy (FSHD) is unknown. Nevertheless, the current opinion is that symptomatic cardiac disease is rare. We performed a cardiac screening [electrocardiogram (ECG) and echocardiography in the event of ECG abnormalities] in 75 genetically confirmed, ambulant FSHD patients without cardiac symptoms, with an eight-year follow-up of 57 patients, and compared the findings with results of previously performed cardiac screenings in the normal population. Baseline ECG demonstrated incomplete right bundle branch block (RBBB) in 33%, complete RBBB in 4%, and other minor abnormalities in 16%. Echocardiography showed no abnormalities. No significant changes were found after eight years of follow-up. Comparison with ECG abnormalities in the normal population showed a higher prevalence of incomplete RBBB (9.7 times higher) and of complete RBBB (4.8 times higher) in FSHD patients. This study in cardiac asymptomatic FSHD patients shows i) increased prevalence of incomplete RBBB in the absence of cardiomyopathy; ii) no progression of these abnormalities during eight years of follow-up. We conclude that FSHD patients without cardiac complaints do not need specific cardiac screening or surveillance. Furthermore, the increased prevalence of incomplete RBBB in the absence of cardiomyopathy suggests a selective involvement of the His-Purkinje system in FSHD. PMID:25473735

van Dijk, Gaby Pons; van der Kooi, Elly; Behin, Anthony; Smeets, Joep; Timmermans, Janneke; van der Maarel, Silvère; Padberg, George; Voermans, Nicol; van Engelen, Baziel

2014-01-01

205

Children's (Pediatric) Abdominal Ultrasound Imaging  

MedlinePLUS

... waves. Ultrasound imaging, also called ultrasound scanning or sonography , involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the ...

206

The association of direct thrombin inhibitor anticoagulants with cardiac thromboses.  

PubMed

Direct thrombin inhibitor (anti-factor IIa) anticoagulants, now established for treatment and prevention of cardiac thromboembolism and VTE, have been repeatedly associated with a significantly increased frequency of thrombosis on abnormal cardiac endothelium when compared head-to-head with indirectly acting therapeutic anticoagulants in studies of sufficient patient number and duration. Although there is uncertainty as to the mechanism, the weight of evidence as a class effect warrants prescribing effective anticoagulants other than direct thrombin inhibitors. PMID:25254608

Davidson, Bruce L

2015-01-01

207

EmergencyEmergency and Abnormal Situationsand Abnormal Situations  

E-print Network

SituationsAbnormal Situations Neil Johnston Aerospace Psychology Research Group Trinity College DublinEmergencyEmergency and Abnormal Situationsand Abnormal Situations in Aviation Symposiumin Aviation Symposium Santa Clara, June 2003 #12;Responding toResponding to Emergencies andEmergencies and Abnormal

208

Cardiac function in experimental uremia.  

PubMed

In acutely uremic animals, the contractile force of the heart is consistently increased; such an increase can be dissociated from changes of afterload or catecholaminergic drive. It is associated with diminished sarcolemmal Na,K-ATPase activity in the heart which, in turn, may be related to increased levels of endogenous digitalis-like substances (endigens) that have been postulated to represent a natriuretic factor. In patients with chronic uremia, myocardial contractility is usually normal, but occasionally there may be heart failure unrelated to pre-existing hypertension, coronary heart disease, anemia, fluid overload, or other recognizable factors. So far, the experimental basis for this clinical observation is uncertain. Possible causes for the clinical syndrome include an excess of parathyroid hormone or cardiodepressor substances. There is experimental evidence of impaired cardiac response to beta adrenergic agonists, e.g., decreased isoproterenol-dependent calcium uptake, diminished inotropic and chronotropic responses. In acutely uremic rats, cardiac cyclic AMP levels are high but can be reversed by beta blockers. Heart calcium content is variable and heart weight is constantly increased in acutely uremic rats, despite decreased skeletal muscle mass. The change in heart weight is not related to anemia, to an excess of parathyroid hormone, or to sympathetic activity; its cause remains unknown. Experimental studies to date have shown a variety of abnormalities, but do not provide a uniform concept of the mechanisms or an explanation for the cardiac dysfunction so often observed in patients with uremia. PMID:6368951

Kreusser, W; Mann, J; Rambausek, M; Klooker, P; Mehls, O; Ritz, E

1983-11-01

209

Cardiac late potential signals and sources  

PubMed Central

Most studies of cardiac late potentials (LPs) recorded from the body surface use signal processing definitions to characterize these abnormal ventricular potentials. For many years, the focus of the clinical studies have been on those signals that outlast the QRS complex; however, cardiac mapping studies have clearly identified that the such abnormal activation occurs during the QRS complex as well and can be distinguished from normal QRS potentials using advanced signal processing tools. Thus, both the abnormal intra-QRS potentials and the LP represent a continuum of the same signal sources. The electrogram recordings of these signals are often characterized as multiphasic with ambiguous/multiple depolarization times spanning tens of milliseconds within very short distances (<1.0 mm). The biophysical basis for these ambiguities does not fit conventional theories of cardiac propagation. This work examines the role that myofibroblasts (MFs) may play in facilitating conduction and producing very long conduction delays (10-30 milliseconds) between populations of close but isolated regions of normal cells. The prerequisite element of this hypothesis is that the MF can express gap junction proteins that align with the corresponding proteins in the myocardial cells. Membrane responsiveness studies of the MF did not detect, as expected, any ion channels capable of producing significant transmembrane currents or depolarizing potentials. However, in tissue-cultured preparations of neonatal mouse myocytes, a nonconducting gap (200-400 ?m) was seeded with MF, and this gap was electrotonically bridged by the MF resulting in conduction velocities of 0.1 m/s. Such passive cell mediation of cardiac conduction would provide a biophysical explanation of LP as well as forming the basis of several hypothesized mechanisms of cardiac arrhythmias, such as microreentry. A fiber model using a series of coupled Luo-Rudy cardiac cell models was interspersed with a simple resistor-capacitor model of the MF, which then demonstrated a range of conduction disorders including excessive delays (>30 milliseconds) and decremental conduction. Hence, the role of this passive cell coupling in the generation of abnormal patterns of conduction as well as arrhythmogenesis has yet to be fully determined but may in fact define another mechanism of cardiac conduction. PMID:20888006

Berbari, Edward J.; Vasquez, Carolina

2013-01-01

210

Half-dose Alteplase for Sub-massive Pulmonary Embolism Directed by Emergency Department Point-of-care Ultrasound  

PubMed Central

This report describes a patient with sub-massive pulmonary embolism (PE) who was successfully treated with half-dose thrombolytics guided by the use of point-of-care (POC) ultrasound. In this case, POC ultrasound was the only possible imaging since computed tomography was contraindicated. POC ultrasound demonstrated a deep vein thrombosis and evidence of cardiac strain. In situations or locations where definitive imaging is unobtainable, POC ultrasound can help diagnose submassive PE and direct the use of half-dose tissue plasminogen activator.

Amini, Richard; Panchal, Ashish R.; Bahner, David; Adhikari, Srikar

2015-01-01

211

Ultrasound image quality evaluation  

Microsoft Academic Search

The objective of this work was to evaluate the image quality of two different ultrasound image scanners before and after de-speckle filtering. The evaluation was made by statistical and texture analysis, as well as by optical perception by two vascular experts on 20 ultrasound images of carotid artery. The de-speckled filters used were based on: (i) local statistics, (ii) homogeneous

C. Loizou; C. S. Pattichis; R. Istepanian; M. Pantziaris; E. Kyriakou; T. Tyllis; A. Nicolaides

2003-01-01

212

Review What is ultrasound?  

Microsoft Academic Search

This paper is based on material presented at the start of a Health Protection Agency meeting on ultrasound and infrasound. In answering the question 'what is ultrasound?', it shows that the simple description of a wave which transports mechanical energy through the local vibration of particles at frequencies of 20 kHz or more, with no net transport of the particles

Timothy G. Leighton

213

What is ultrasound?  

Microsoft Academic Search

This paper is based on material presented at the start of a Health Protection Agency meeting on ultrasound and infrasound. In answering the question ‘what is ultrasound?’, it shows that the simple description of a wave which transports mechanical energy through the local vibration of particles at frequencies of 20kHz or more, with no net transport of the particles themselves,

Timothy G. Leighton

2007-01-01

214

Ultrasound Simulators In Obstetrics And Gynecology : State Of The Art.  

PubMed

Simulation and virtual reality have spread in various field of medicine, from anesthesiology to surgery and emergency care. In all medical fields, simulation offers the possibility of making errors without experiencing negative patient outcomes. Additionally, the negative emotions generated by failures or errors are critical to the medical learning process but are experienced more constructively in the context of simulation than in real life. Ultrasound is the primary method of imaging in obstetrics and gynecology and has become an essential part of practice. To date, ultrasound simulators have been mainly used to teach basic skills in cardiac ultrasound within emergency and internal care units. In the field of obstetrics and gynecology ultrasound, simulators have appeared at the beginning of this century and have led to only few studies. This field is developing and could bring several benefits into teaching, training and evaluation of ultrasound competency. We reviewed the existing literature to provide with an overview of the state of the art in the use of simulation in ultrasound in obstetrics and gynecology. PMID:25346451

Chalouhi, G E; Bernardi, V; Ville, Y

2014-10-27

215

Safety of Microbubbles and Transcranial Ultrasound in Rabbits  

NASA Astrophysics Data System (ADS)

The object of this study was to evaluate the safety of large doses of microbubbles and ultrasound administered to the head of rabbits as if they were receiving acute stroke therapy of a similar nature. Materials and Methods: Female New Zealand White rabbits were used, N=24, in three groups 1] n=4 control (no treatment), 2] n=10 bubble control (ultrasound plus aspirin), and 3] n=10 target group (ultrasound plus aspirin plus MRX-815 microbubbles). Group 3 was infused with IV bubbles over 1 hour at 0.16cc/kg. Ultrasound was delivered to the dehaired side of the head during bubble infusion and for 1 additional hour at 0.8 W/cm2 20% pulsed wave. Rabbits survived for 22 to 24 hours, were imaged with computerized tomography and 3 Tesla magnetic resonance imaging including contrast studies, and sacrificed. Tetrazolium (TTC) and Hematoxylin and Eosin (H&E) sections were made for pathological examination. Results: All 24 animals showed absence of bleeding, endothelial damage, EKG abnormalities, stroke, blood-brain-barrier breakdown, or other acute abnormalities. CT and MRI showed no bleeding or signs of stroke, but two animals had mild hydrocephalus. The EKGs showed normal variation in QTc. Rabbit behavior was normal in all. Minimal chronic inflammation unrelated to the study was seen in 5. Two animals were excluded because of protocol violations and replaced during the study. Conclusion: The administered dose of microbubbles and ultrasound demonstrated no detrimental effects on the healthy rabbit animal model.

Culp, William C.; Brown, Aliza T.; Hennings, Leah; Lowery, John; Culp, Benjamin C.; Erdem, Eren; Roberson, Paula; Matsunaga, Terry O.

2007-05-01

216

Abnormal Psychology Psychology 280  

E-print Network

1 Abnormal Psychology Psychology 280 1st Summer Session 2013 May 13June 27, 2013 Tuesday" Kalibatseva, M.A. Office: 127B Psychology Building Email: kalibats@msu.edu Phone Psychology PhD program at Michigan State University. I completed my bachelor's dual degree in psychology

Liu, Taosheng

217

The evaluation of cardiac biometry in major cardiac defects detected in early pregnancy.  

PubMed

The objective was to evaluate early cardiac biometry in fetuses with structural cardiac defects between 10 and 17 weeks of gestation using our normative data about fetal heart biometry. A retrospective case series, patients were selected from all cases with congenital heart disease diagnosed between 10 and 17 weeks of gestation in our prenatal unit between 1999 and 2000. A schematic sonographic examination, including nuchal translucency (NT) thickness measurements, was performed and was followed by fetal Doppler echocardiography. The transversal heart diameter, both ventricular dimensions, heart area, heart circumference, thoracic diameter, thoracic circumference, thoracic area, pulmonary trunk diameter and aortic diameter were measured and the cardiothoracic ratios were calculated. Doppler evaluation of the umbilical arteries, ductus venosus and umbilical vein was performed. Fetal karyotyping was obtained by amniocentesis or chorionic villous sampling. During the study period, 31 cases of congenital heart disease between 10 and 17 weeks of gestation were diagnosed. Of these, two fetuses presented with ectopia cordis and six with insufficient cardiac biometric measurements. In the remaining 23 fetuses, different complex abnormalities with a high rate of chromosomal abnormalities (91%) were present. Fetal heart biometry was normal in 22% and abnormal in 78%. NT thickness measurements were performed before 14 weeks of gestation and ten of 12 fetuses (83%) presented with an increased NT. Both fetuses with normal NT showed an abnormal fetal heart biometry. Venous Doppler evaluation was performed in 22 cases and 12 fetuses (55%) demonstrated an abnormal venous Doppler. There were ten fetuses (45%) with normal venous Doppler; in seven of these cases, fetal heart biometry was partly abnormal. This study shows the feasibility of first and early second trimesters' fetal echocardiography and the applicability of cardiac biometry in these instances. In this context, early fetal heart biometry and NT thickness measurements may be complementary methods for the prenatal diagnosis of some major congenital heart defects. In early pregnancy, some cardiac defects like tricuspid valve dysplasia, coarctation of the aorta, aortic stenosis, tetralogy of Fallot or pulmonary stenosis may already show similar changes in the relation of the diameters of the fetal heart and great arteries, as seen in the second trimester. Therefore, evaluating the different cardiac ratios may have a high diagnostic value in early pregnancy. PMID:12768297

Smrcek, J M; Gembruch, U; Krokowski, M; Berg, C; Krapp, M; Geipel, A; Germer, U

2003-06-01

218

Classification of rotator cuff tendinopathy using high definition ultrasound  

PubMed Central

Summary Background: ultrasound is a valid cost effective tool in screening for rotator cuff pathology with high levels of accuracy in detecting full-thickness tears. To date there is no rotator cuff tendinopathy classification using ultrasound. The aims of this study are to define a valid high-definition ultrasound rotator cuff tendinopathy classification, which has discriminate validity between groups based upon anatomical principles. Methods: 464 women, aged 65–87, from an established general population cohort underwent bilateral shoulder ultrasound and musculoskeletal assessment. Sonographer accuracy was established in a separate study by comparing ultrasound findings to the gold standard intra-operative findings. Results: there were 510 normal tendons, 217 abnormal tendons, 77 partial tears, and 124 full-thickness tears. There was no statistical difference in age or the proportion with pain between the abnormal enthesis and partial tear groups, however both groups were statistically older (p<0.001) and had a greater proportion with pain (p<0.001 & p=0.050) than normal tendons. The full-thickness tears were statistically older than normal tendons (p<0.001), but not abnormal/partially torn tendons. The proportion with pain was significantly greater than both groups (p<0.001 & p=0.006). Symptomatic shoulders had a larger median tear size than asymptomatic shoulders (p=0.006). Using tear size as a predictor of pain likelihood, optimum sensitivity and specificity occurred when dividing tears into groups up to 2.5cm and >2.5cm, which corresponds with anatomical descriptions of the width of the supraspinatus tendon. Conclusion: the classification system is as follows: Normal Tendons; Abnormal enthesis/Partial-thickness tear; Single tendon full-thickness tears (0–2.5cm); Multi-tendon full-thickness tears (>2.5cm). PMID:25489559

Hinsley, Hannah; Nicholls, Alex; Daines, Michael; Wallace, Gemma; Arden, Nigel; Carr, Andrew

2014-01-01

219

Analysis of left ventricular impedance in comparison with ultrasound images.  

PubMed

Cardiac monitoring of ventricular assist devices (VADs) is important for detecting heart failure risks, such as critical arrhythmia and ventricular fibrillation, and for supplying data that are useful for hemodynamic control. Specifically, impedance cardiograms (ICGs) are especially beneficial because they have no effect on the tissue or organs and can monitor various parameters simultaneously, including the heart rate and heart contractions. In this article, we measured impedance changes in porcine left ventricles using electrodes placed around the inlet and outlet cannulae of the VAD. The measured left ventricular impedance (LVI) waveform changes are caused by heart movements, such as cardiac muscle contraction and changes in blood volume as a result of heart filling and emptying. In contrast to other impedance measurements, LVI is less affected by the movement of other organs. Using a porcine model, LVIs were measured and compared with blood flow data measured with an ultrasound blood flowmeter. The ICG showed the same frequency as the animal's heart rate, and their amplitudes were closely related to cardiac output (CO). However, the waveform differed from other vital signs, such as CO, electrocardiogram, and blood pressure. Ultrasound images were used to explain the impedance waveform. In the ultrasound images, we obtained the shape and size of the animal's heart and calculated the predicted impedance data. We then compared these to the actual measured data. These results show that the impedance signal contains detailed information on heart rate and CO; these results were unaffected by the cannulae or VAD perfusion. PMID:22188560

Choi, Seong Wook; Park, Sung Min

2012-05-01

220

Ultrasound—biophysics mechanisms†  

PubMed Central

Ultrasonic biophysics is the study of mechanisms responsible for how ultrasound and biological materials interact. Ultrasound-induced bioeffect or risk studies focus on issues related to the effects of ultrasound on biological materials. On the other hand, when biological materials affect the ultrasonic wave, this can be viewed as the basis for diagnostic ultrasound. Thus, an understanding of the interaction of ultrasound with tissue provides the scientific basis for image production and risk assessment. Relative to the bioeffect or risk studies, that is, the biophysical mechanisms by which ultrasound affects biological materials, ultrasound-induced bioeffects are generally separated into thermal and nonthermal mechanisms. Ultrasonic dosimetry is concerned with the quantitative determination of ultrasonic energy interaction with biological materials. Whenever ultrasonic energy is propagated into an attenuating material such as tissue, the amplitude of the wave decreases with distance. This attenuation is due to either absorption or scattering. Absorption is a mechanism that represents that portion of ultrasonic wave that is converted into heat, and scattering can be thought of as that portion of the wave, which changes direction. Because the medium can absorb energy to produce heat, a temperature rise may occur as long as the rate of heat production is greater than the rate of heat removal. Current interest with thermally mediated ultrasound-induced bioeffects has focused on the thermal isoeffect concept. The non-thermal mechanism that has received the most attention is acoustically generated cavitation wherein ultrasonic energy by cavitation bubbles is concentrated. Acoustic cavitation, in a broad sense, refers to ultrasonically induced bubble activity occurring in a biological material that contains pre-existing gaseous inclusions. Cavitation-related mechanisms include radiation force, microstreaming, shock waves, free radicals, microjets and strain. It is more challenging to deduce the causes of mechanical effects in tissues that do not contain gas bodies. These ultrasonic biophysics mechanisms will be discussed in the context of diagnostic ultrasound exposure risk concerns. PMID:16934858

O'Brien, William D.

2007-01-01

221

Ultrasound-biophysics mechanisms.  

PubMed

Ultrasonic biophysics is the study of mechanisms responsible for how ultrasound and biological materials interact. Ultrasound-induced bioeffect or risk studies focus on issues related to the effects of ultrasound on biological materials. On the other hand, when biological materials affect the ultrasonic wave, this can be viewed as the basis for diagnostic ultrasound. Thus, an understanding of the interaction of ultrasound with tissue provides the scientific basis for image production and risk assessment. Relative to the bioeffect or risk studies, that is, the biophysical mechanisms by which ultrasound affects biological materials, ultrasound-induced bioeffects are generally separated into thermal and non-thermal mechanisms. Ultrasonic dosimetry is concerned with the quantitative determination of ultrasonic energy interaction with biological materials. Whenever ultrasonic energy is propagated into an attenuating material such as tissue, the amplitude of the wave decreases with distance. This attenuation is due to either absorption or scattering. Absorption is a mechanism that represents that portion of ultrasonic wave that is converted into heat, and scattering can be thought of as that portion of the wave, which changes direction. Because the medium can absorb energy to produce heat, a temperature rise may occur as long as the rate of heat production is greater than the rate of heat removal. Current interest with thermally mediated ultrasound-induced bioeffects has focused on the thermal isoeffect concept. The non-thermal mechanism that has received the most attention is acoustically generated cavitation wherein ultrasonic energy by cavitation bubbles is concentrated. Acoustic cavitation, in a broad sense, refers to ultrasonically induced bubble activity occurring in a biological material that contains pre-existing gaseous inclusions. Cavitation-related mechanisms include radiation force, microstreaming, shock waves, free radicals, microjets and strain. It is more challenging to deduce the causes of mechanical effects in tissues that do not contain gas bodies. These ultrasonic biophysics mechanisms will be discussed in the context of diagnostic ultrasound exposure risk concerns. PMID:16934858

O'Brien, William D

2007-01-01

222

Intracellular Aggregation of Multimodal Silica Nanoparticles for Ultrasound-Guided Stem Cell Implantation  

PubMed Central

The promises of cardiac stem cell therapy have yet to be fully realized, in part because of poor survival and engraftment efficacy of implanted cells. Cells die after implantation owing to ischemia, inflammation, immune response, as well as mis-injection or implantation into fibrotic tissue. Imaging tools can help implant cells in areas of the heart most receptive to stem cell therapy and monitor the efficacy of treatment by reporting the viability, location, and number of implanted stem cells. We describe a multimodal, silica-based nanoparticle that can be used for cell sorting (fluorescence), real-time guided cell implantation ultrasound, and high-resolution, long-term monitoring by magnetic resonance imaging (MRI). The nanoparticle agent increased the ultrasound and MRI contrast of labeled human mesenchymal stem cells (hMSCs) 700 and 200% versus unlabeled cells, respectively, and allowed cell imaging in animal models for 13 days after implantation. The agent had no significant impact on hMSC cell metabolic activity, proliferation, or pluripotency, and it increased the production of many paracrine factors implicated in cardiac repair. Electron microscopy and ultrasound imaging suggest that the mechanism of action is in vivo aggregation of the 300-nm silica nanoparticles into larger silica frameworks that amplify the ultrasound backscatter. The detection limit in cardiac tissue was 250,000 hMSCs via MRI and 70,000 via ultrasound. This ultrasound-guided cell delivery and multimodal optical/ultrasound/MRI intra-cardiac cell-tracking platform could improve cell therapy in the clinic by minimizing misdelivery or implantation into fibrotic tissue. PMID:23515077

Jokerst, Jesse V.; Khademi, Christine; Gambhir, Sanjiv S.

2013-01-01

223

Musculoskeletal interventional ultrasound.  

PubMed

Ultrasound is a nonionizing, low-cost, portable imaging technique for the evaluation of tendons, muscles, joints, soft tissue masses, and cysts, especially in patients unable to tolerate computed tomography or magnetic resonance imaging. These advantages make ultrasound an ideal modality for guiding musculoskeletal interventions. Its real-time capabilities allow continuous observation of needle placement into the targeted area and direct visualization of interventions such as injection of medication while avoiding other soft tissue structures or nearby neurovascular bundles. After a brief overview of the technical factors involved in performing ultrasound-guided musculoskeletal interventions, this article reviews commonly performed percutaneous procedures in the musculoskeletal system. PMID:18095250

Joines, Melissa M; Motamedi, Kambiz; Seeger, Leanne L; DiFiori, John P

2007-06-01

224

Intravascular ultrasound chirp imaging  

NASA Astrophysics Data System (ADS)

We demonstrate the feasibility of intravascular ultrasound (IVUS) chirp imaging as well as chirp reversal ultrasound contrast imaging at intravascular ultrasound frequency. Chirp excitations were emitted with a 34 MHz single crystal intravascular transducer and compared to conventional Gaussian-shaped pulses of equal acoustic pressure. The signal to noise ratio of the chirp images was increased by up to 9 dB relative to the conventional images. Imaging of contrast microbubbles was implemented by chirp reversal, achieving a contrast to tissue ratio of 12 dB. The method shows potential for intravascular imaging of structures in and beyond coronary atherosclerotic plaques including vasa vasorum.

Maresca, D.; Jansen, K.; Renaud, G.; van Soest, G.; Li, X.; Zhou, Q.; de Jong, N.; Shung, K. K.; van der Steen, A. F. W.

2012-01-01

225

Chapter 2 Background and Method Overview The cardiac left ventricle is one of the most crucial and thoroughly studied structures in the  

E-print Network

) ultrasound to measure geometric properties of the beating heart is therefore particularly exciting ultrasound to other imaging modalities. Given an RT3D image of the heart, analytical techniques chapters. 2A. Imaging of Cardiac Anatomy and Function RV and LV Anatomy and Function The primary function

Stetten, George

226

Abnormal pressures as hydrodynamic phenomena  

USGS Publications Warehouse

So-called abnormal pressures, subsurface fluid pressures significantly higher or lower than hydrostatic, have excited speculation about their origin since subsurface exploration first encountered them. Two distinct conceptual models for abnormal pressures have gained currency among earth scientists. The static model sees abnormal pressures generally as relict features preserved by a virtual absence of fluid flow over geologic time. The hydrodynamic model instead envisions abnormal pressures as phenomena in which flow usually plays an important role. This paper develops the theoretical framework for abnormal pressures as hydrodynamic phenomena, shows that it explains the manifold occurrences of abnormal pressures, and examines the implications of this approach. -from Author

Neuzil, C.E.

1995-01-01

227

Primary Cardiac Fibroma and Cardiac Conduction System Alterations in a Case of Sudden Death of a 4-month-old Infant  

PubMed Central

A 4-month-old female infant considered to be in good health died suddenly and unexpectedly. Post- mortem examination was requested, with clinical diagnosis of sudden infant death syndrome. At autopsy the infant was described in good health. Histo- logical examination of the heart found a cardiac fibroma compressing the atrio-ventricular node and the examination of the cardiac conduction system showed an accessory fiber of Mahaim (nodo-ventricular) and cartilaginous metaplasia of the cardiac fibrous body. Probably the concomitant presence of cardiac conduction system abnormalities and a septal fibroma, compressing the atrio-ventricular node, could have an important role in causing the sudden death. PMID:23847693

Mecchia, Donatella; Lavezzi, Anna Maria; Matturri, Luigi

2013-01-01

228

Thalassemia and abnormal hemoglobin  

Microsoft Academic Search

Thalassemia and abnormal hemoglobins are common genetic disorders in Asia. Thalassemia is not only an important public health\\u000a problem but also a socio-economic problem of many countries in the region. The approach to deal with the thalassemic problem\\u000a is to prevent and control birth of new cases. This requires an accurate identification of the couple at high risk for thalassemia.

Suthat Fucharoen; Pranee Winichagoon

2002-01-01

229

Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice  

PubMed Central

Dobutamine is a ?-adrenergic agonist with an affinity higher for receptor expressed in the heart (?1) than for receptors expressed in the arteries (?2). When systemically administered, it increases cardiac demand. Thus, dobutamine unmasks abnormal rhythm or ischemic areas potentially at risk of infarction. Monitoring of heart function during a cardiac stress test can be performed by either ecocardiography or cardiac catheterization. The latter is an invasive but more accurate and informative technique that the former. Cardiac stress test induced by dobutamine and monitored by cardiac catheterization accomplished as described here allows, in a single experiment, the measurement of the following hemodynamic parameters: heart rate (HR), systolic pressure, diastolic pressure, end-diastolic pressure, maximal positive pressure development (dP/dtmax) and maximal negative pressure development (dP/dtmin), at baseline conditions and under increasing doses of dobutamine. As expected, in normal mice we observed a dobutamine dose-related increase in HR, dP/dtmax and dP/dtmin. Moreover, at the highest dose tested (12 ng/g/min) the cardiac decompensation of high fat diet-induced obese mice was unmasked. PMID:23426115

Calligaris, Sebastián Dante; Ricca, Micaela; Conget, Paulette

2013-01-01

230

Anatomical Abnormalities in Autism?  

PubMed

Substantial controversy exists regarding the presence and significance of anatomical abnormalities in autism spectrum disorders (ASD). The release of the Autism Brain Imaging Data Exchange (?1000 participants, age 6-65 years) offers an unprecedented opportunity to conduct large-scale comparisons of anatomical MRI scans across groups and to resolve many of the outstanding questions. Comprehensive univariate analyses using volumetric, thickness, and surface area measures of over 180 anatomically defined brain areas, revealed significantly larger ventricular volumes, smaller corpus callosum volume (central segment only), and several cortical areas with increased thickness in the ASD group. Previously reported anatomical abnormalities in ASD including larger intracranial volumes, smaller cerebellar volumes, and larger amygdala volumes were not substantiated by the current study. In addition, multivariate classification analyses yielded modest decoding accuracies of individuals' group identity (<60%), suggesting that the examined anatomical measures are of limited diagnostic utility for ASD. While anatomical abnormalities may be present in distinct subgroups of ASD individuals, the current findings show that many previously reported anatomical measures are likely to be of low clinical and scientific significance for understanding ASD neuropathology as a whole in individuals 6-35 years old. PMID:25316335

Haar, Shlomi; Berman, Sigal; Behrmann, Marlene; Dinstein, Ilan

2014-10-14

231

Cardiac compression following cardiac surgery due to unrecognised hiatus hernia.  

PubMed

A 76-year-old man who had undergone a routine coronary artery bypass grafting operation developed severe haemodynamic instability in the early postoperative period in spite of multiple inotropic supports. Due to persistent instability of haemodynamics and worsening acidosis his chest was re-explored with detection of no obvious abnormality. An intra-aortic balloon pump (IABP) was inserted for additional support. The chest had to be left open overnight and closed formally next morning. A chest X-ray at that stage showed a large hiatus hernia with huge gastric dilatation compressing the heart. Decompressions of the stomach lead to dramatic improvement in his circulatory status with rapid weaning of inotropes and IABP and he could be extubated. This case illustrates the importance of recognising the presence of hiatus hernia in preoperative chest X-ray and prophylactic NG tube insertion at the time of cardiac surgery in these cases. PMID:17881242

Devbhandari, Mohan P; Khan, Mohammad Aamir; Hooper, Timothy L

2007-11-01

232

Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.  

ERIC Educational Resources Information Center

Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

Fernald, Charles D.

1980-01-01

233

Ultrasound: Head (For Parents)  

MedlinePLUS

... the head and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

234

Ultrasound: Infant Hip  

MedlinePLUS

... hip area, and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

235

Ultrasound: Bladder (For Parents)  

MedlinePLUS

... bladder area and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

236

Ultrasound: Pelvis (For Parents)  

MedlinePLUS

... pelvic area and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

237

Ultrasound: Abdomen (For Parents)  

MedlinePLUS

... abdominal area and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

238

Cardiac gated ventilation  

NASA Astrophysics Data System (ADS)

There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. We evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50msec scan aperture. Multislice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. We observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a nonfailing model of the heart.

Hanson, C. William, III; Hoffman, Eric A.

1995-05-01

239

Cardiac gated ventilation  

SciTech Connect

There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart.

Hanson, C.W. III [Hospital of the Univ. of Pennsylvania, Philadelphia, PA (United States). Dept. Anesthesia; Hoffman, E.A. [Univ. of Iowa College of Medicine, Iowa City, IA (United States). Div. of Physiologic Imaging

1995-12-31

240

Advanced breast biopsy instrumentation (ABBI) and management of nonpalpable breast abnormalities: a community hospital experience  

Microsoft Academic Search

A range of diagnostic techniques have been in use for determining the nature of non-palpable mammographic abnormalities over the last decade, these include stereotactic and ultrasound guided cytology, core biopsy and vacuum assisted core biopsy techniques as well as open surgical breast biopsy. Recently, a less invasive alternative has been investigated; the Advanced Breast Biopsy Instrumentation (ABBI) technique (U.S. Surgical

I. A. Jacobs; A. H. Chevinsky; W. Diehl; T. J. Smith

2001-01-01

241

Exercises to Improve Gait Abnormalities  

MedlinePLUS

... Home About Goals Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner ...

242

Abnormal human sex chromosome constitutions  

SciTech Connect

Chapter 22, discusses abnormal human sex chromosome constitution. Aneuploidy of X chromosomes with a female phenotype, sex chromosome aneuploidy with a male phenotype, and various abnormalities in X chromosome behavior are described. 31 refs., 2 figs.

NONE

1993-12-31

243

Persistent and reversible cardiac dysfunction among amateur marathon runners  

Microsoft Academic Search

Aims Transient systolic and diastolic abnormalities in ventricular function have previously been docu- mented during endurance sports. However, these described alterations may be limited by the tech- niques applied. We sought, using less load-dependent methods, to characterize both the extent and the chronology of the cardiac changes associated with endurance events. Methods and results Transthoracic echocardiography (TTE) was performed prior

Tomas G. Neilan; Danita M. Yoerger; Pamela S. Douglas; Jane E. Marshall; Elkan F. Halpern; David Lawlor; Michael H. Picard; Malissa J. Wood

244

Lung ultrasound in the critically ill.  

PubMed

Lung ultrasound is a basic application of critical ultrasound, defined as a loop associating urgent diagnoses with immediate therapeutic decisions. It requires the mastery of ten signs: the bat sign (pleural line), lung sliding (yielding seashore sign), the A-line (horizontal artifact), the quad sign, and sinusoid sign indicating pleural effusion, the fractal, and tissue-like sign indicating lung consolidation, the B-line, and lung rockets indicating interstitial syndrome, abolished lung sliding with the stratosphere sign suggesting pneumothorax, and the lung point indicating pneumothorax. Two more signs, the lung pulse and the dynamic air bronchogram, are used to distinguish atelectasis from pneumonia. All of these disorders were assessed using CT as the "gold standard" with sensitivity and specificity ranging from 90% to 100%, allowing ultrasound to be considered as a reasonable bedside "gold standard" in the critically ill. The BLUE-protocol is a fast protocol (<3 minutes), which allows diagnosis of acute respiratory failure. It includes a venous analysis done in appropriate cases. Pulmonary edema, pulmonary embolism, pneumonia, chronic obstructive pulmonary disease, asthma, and pneumothorax yield specific profiles. Pulmonary edema, e.g., yields anterior lung rockets associated with lung sliding, making the "B-profile." The FALLS-protocol adapts the BLUE-protocol to acute circulatory failure. It makes sequential search for obstructive, cardiogenic, hypovolemic, and distributive shock using simple real-time echocardiography (right ventricle dilatation, pericardial effusion), then lung ultrasound for assessing a direct parameter of clinical volemia: the apparition of B-lines, schematically, is considered as the endpoint for fluid therapy. Other aims of lung ultrasound are decreasing medical irradiation: the LUCIFLR program (most CTs in ARDS or trauma can be postponed), a use in traumatology, intensive care unit, neonates (the signs are the same than in adults), many disciplines (pulmonology, cardiology…), austere countries, and a help in any procedure (thoracentesis). A 1992, cost-effective gray-scale unit, without Doppler, and a microconvex probe are efficient. Lung ultrasound is a holistic discipline for many reasons (e.g., one probe, perfect for the lung, is able to scan the whole-body). Its integration can provide a new definition of priorities. The BLUE-protocol and FALLS-protocol allow simplification of expert echocardiography, a clear advantage when correct cardiac windows are missing. PMID:24401163

Lichtenstein, Daniel A

2014-01-01

245

Sudden cardiac death in athletes.  

PubMed

A 'paradox of sport' is that in addition to the undisputed health benefits of physical activity, vigorous exertion may transiently increase the risk of acute cardiac events. In general, the risk of sudden cardiac death (SCD) approximately doubles during physical activity and is 2- to 3-fold higher in athletes compared to nonathletes. The incidence of SCD in young athletes is in fact very low, at around 1-3 per 100,000, but attracts much public attention. Variations in incidence figures may be explained by the methodology used for data collection and more importantly by differences between subpopulations of athletes. The incidence of SCD in older (? 35 years) athletes is higher and may be expected to rise, as more and older individuals take part in organized sports. SCD is often the first clinical manifestation of a potentially fatal underlying cardiovascular disorder and usually occurs in previously asymptomatic athletes. In the young (<35 years), SCD is mainly due to congenital/inherited cardiac abnormalities, whilst coronary artery disease (CAD) is the most common cause in older athletes. Cardiac screening including family/personal history, physical examination and resting electrocardiogram (ECG) may identify individuals at risk and has the potential to decrease the risk of SCD in young athletes. Screening including the ECG has a high sensitivity for underlying disease in young athletes, but the specificity needs to be improved, whereas the sensitivity of screening without the use of ECG is very low. The screening modality recommended for young athletes is of limited value in older athletes, who should receive individualized screening with cardiac stress testing for patients with high risk of underlying CAD. As cardiovascular screening will never be able to identify all athletes at risk, adequate preparedness is vital in case of a potentially fatal event at the sporting arena/facility. Firstly, we will review the magnitude of the problem of SCD in athletes of different ages, as well as the aetiology. Secondly, we will focus on how to prevent SCD in athletes of all ages, reviewing cardiovascular screening recommendations as well as emergency preparedness and arena safety. PMID:24350833

Schmied, C; Borjesson, M

2014-02-01

246

Catheter Ultrasound Phased-Array Transducers for Thermal Ablation: A Feasibility Study  

E-print Network

Catheter Ultrasound Phased-Array Transducers for Thermal Ablation: A Feasibility Study KENNETH L for cardiac ablation has been shown previously. We describe the design and testing of catheter-sized linear phased arrays transducers for ul- trasound ablation. One array has 86 PZT-4 elements operating at 8 MHz

Smith, Stephen

247

Cranial Ultrasound Lesions in the NICU Predict Cerebral Palsy at Age 2 Years in Children Born at Extremely Low Gestational Age  

PubMed Central

Our prospective cohort study of extremely low gestational age newborns evaluated the association of neonatal head ultrasound abnormalities with cerebral palsy at age 2 years. Cranial ultrasounds in 1053 infants were read with respect to intraventricular hemorrhage, ventriculomegaly, and echolucency, by multiple sonologists. Standardized neurological examinations classified cerebral palsy, and functional impairment was assessed. Forty-four percent with ventriculomegaly and 52% with echolucency developed cerebral palsy. Compared with no ultrasound abnormalities, children with echolucency were 24 times more likely to have quadriparesis and 29 times more likely to have hemiparesis. Children with ventriculomegaly were 17 times more likely to have quadriparesis or hemiparesis. Forty-three percent of children with cerebral palsy had normal head ultrasound. Focal white matter damage (echolucency) and diffuse damage (late ventriculomegaly) are associated with a high probability of cerebral palsy, especially quadriparesis. Nearly half the cerebral palsy identified at 2 years is not preceded by a neonatal brain ultrasound abnormality. PMID:19168819

Kuban, Karl C. K.; Allred, Elizabeth N.; O’Shea, T. Michael; Paneth, Nigel; Pagano, Marcello; Dammann, Olaf; Leviton, Alan; Du Plessis, Adré; Westra, Sjirk J.; Miller, Cindy R.; Bassan, Haim; Krishnamoorthy, Kalpathy; Junewick, Joseph; Olomu, Nicholas; Romano, Elaine; Seibert, Joanna; Engelke, Steve; Karna, Padmani; Batton, Daniel; O’Connor, Sunila E.; Keller, Cecelia E.

2009-01-01

248

Prenatal screening for chromosome abnormalities  

Microsoft Academic Search

An abnormal chromosome complement (aneuploidy) contributes significantly to fetal loss during pregnancy, as well as to perinatal morbidity and mortality. The contribution of chromosomal abnormalities to fetal loss decreases as pregnancy continues with an estimated 50% of first trimester spontaneous abortions due to chromosomal abnormalities, but only 5% of stillbirths (after 28 weeks). Prenatal screening for aneuploidy (in particular Down

Lyn Chitty

249

Clinical utility of gray scale renal ultrasound in acute kidney injury  

PubMed Central

Background Acute kidney injury occurs commonly in hospitalized patients and is associated with significant morbidity and mortality. Although renal ultrasound is often performed, its clinical utility in determining of the cause of acute kidney injury, particularly the detection of urinary tract obstruction, is not established. Methods Retrospective cohort study of all adult inpatients that underwent renal ultrasound for acute kidney injury over a 3-year period at a large university teaching hospital. The frequency of renal ultrasound abnormalities and clinical characteristics that predicted the finding of urinary tract obstruction was determined. Results Over the 3-year period, 1471 renal ultrasounds were performed of which 55% (810) were for evaluation of acute kidney injury. Renal ultrasound was normal in 62% (500 of 810) of patients. Hydronephrosis was detected in only 5% (42 of 810) of studies and in only 2.3% (19 of 810) of the cases was obstructive uropathy considered the cause of acute kidney injury. The majority of these patients (14 of 19) had a medical history suggestive of urinary tract obstruction. Less than 1% of patients (5 of 810) had urinary tract obstruction on ultrasound without a suggestive medical history. Most other ultrasound findings were incidental and did not establish an etiology for the acute kidney injury. Conclusions Renal ultrasound for evaluation of acute kidney injury is indicated if there is medical history suggestive of urinary tract obstruction. Otherwise, renal ultrasound is unlikely to yield useful results and should be used more selectively based on patients’ medical history. PMID:24011084

2013-01-01

250

Potential role of ultrasound in anesthesia and intensive care  

PubMed Central

One of the most exiting recent technological advances in the field of anesthesia to track the region of interest is the introduction of anatomical evaluation by ultrasound imaging. Widespread use of this modality depends on its proven clinical efficacy, cost effectiveness, and practicality as it allows anesthesiologist to evaluate complex and varied anatomy prior to needle insertion. Sound used in medicine is not significantly transmitted by air or bone but through fluids which make up the larger part of soft tissues in the body. Ultrasound has been shown to offer excellent guidance for difficult venous access, epidural space identification in cases of difficult anatomy, delineating nerve plexuses for chronic nerve blocks, for regional anesthesia, and in transesophageal echocardiography for cardiac imaging with blood flows or in an otherwise high-risk patient where interventional procedure is required. It has special application to assess the narrowest diameter of the subglottic upper airway. A systemic literature search was performed in PubMed and the Cochrane library. The search strategy was set up using either single text word or combinations. We also included the studies where in these techniques were compared with conventional methods . Despite the initial excitement of this technique, ultrasound visualization is still indirect and images are subject to individual interpretation. It is gradually becoming routine in daily practice at our institution due to its reliability and safety. Though ultrasound is much safer, exposure in terms of intensity and time should be limited as far as possible, as high-energy ultrasound can cause heating and damage to tissues. In this review, we discuss established and future areas of ultrasound imaging and emphasize the use of B-mode ultrasound to improve the efficacy of interventional techniques. We have also illustrated potential uses with reference to cross-sectional B-mode images which visually represent a slice of tissues and are the easiest images for interpretation by clinicians.

Gupta, Prashant K.; Gupta, Kumkum; Dwivedi, Amit Nandan D.; Jain, Manish

2011-01-01

251

[A novel lamin A/C mutation in a family with dilated cardiomyopathy and a strong history of sudden cardiac death].  

PubMed

Diseases related to lamin A/C mutations (laminopathies) are extremely heterogeneous. The common cardiac phenotype is idiopathic dilated cardiomyopathy with atrioventricular block and/or arrhythmias. Moreover, patients with lamin A/C gene mutations are at increased risk for sudden cardiac death. Here we present a family with a strong positive history of sudden cardiac death in presence of idiopathic dilated cardiomyopathy and cardiac conduction abnormalities, related to a novel lamin A/C mutation in exon 3. PMID:20461955

Andreassi, Maria Grazia; Botto, Nicoletta; Vittorini, Simona; Pulignani, Silvia; Aquaro, Giovanni; Sicari, Rosa

2010-03-01

252

Towards ultrasound cardiac image segmentation based on the radiofrequency signal  

Microsoft Academic Search

In echocardiography, the radio-frequency (RF) image is a rich source of information about the investigated tissues. Nevertheless, very few works are dedicated to boundary detection based on the RF image, as opposed to envelope image. In this paper, we investigate the feasibility and limitations of boundary detection in echocardiographic images based on the RF signal. We introduce two types of

Igor Dydenko; Denis Friboulet; Jean-Marie Gorce; Jan D’hooge; Bart Bijnens; Isabelle E. Magnin

2003-01-01

253

Validation of four-dimensional ultrasound for targeting in minimally-invasive beating-heart surgery  

NASA Astrophysics Data System (ADS)

Ultrasound is garnering significant interest as an imaging modality for surgical guidance, due to its affordability, real-time temporal resolution and ease of integration into the operating room. Minimally-invasive intracardiac surgery performed on the beating-heart prevents direct vision of the surgical target, and procedures such as mitral valve replacement and atrial septal defect closure would benefit from intraoperative ultrasound imaging. We propose that placing 4D ultrasound within an augmented reality environment, along with a patient-specific cardiac model and virtual representations of tracked surgical tools, will create a visually intuitive platform with sufficient image information to safely and accurately repair tissue within the beating heart. However, the quality of the imaging parameters, spatial calibration, temporal calibration and ECG-gating must be well characterized before any 4D ultrasound system can be used clinically to guide the treatment of moving structures. In this paper, we describe a comprehensive accuracy assessment framework that can be used to evaluate the performance of 4D ultrasound systems while imaging moving targets. We image a dynamic phantom that is comprised of a simple robot and a tracked phantom to which point-source, distance and spherical objects of known construction can be attached. We also follow our protocol to evaluate 4D ultrasound images generated in real-time by reconstructing ECG-gated 2D ultrasound images acquired from a tracked multiplanar transesophageal probe. Likewise, our evaluation framework allows any type of 4D ultrasound to be quantitatively assessed.

Pace, Danielle F.; Wiles, Andrew D.; Moore, John; Wedlake, Chris; Gobbi, David G.; Peters, Terry M.

2009-02-01

254

Tuberous Sclerosis and Cardiac Tumors: New Electrocardiographic Finding in an Infant  

PubMed Central

Cardiac rhabdomyoma, the primary cardiac tumor most often diagnosed in children, is frequently present in patients with tuberous sclerosis. Most pediatric patients with rhabdomyoma are asymptomatic; however, various electrocardiographic abnormalities can be detected, such as Wolff-Parkinson-White syndrome, ectopic atrial tachycardia, and atrioventricular node dysfunction. We describe the case of a 10-month-old infant girl who had tuberous sclerosis and multiple cardiac rhabdomyomas. Her electrocardiographic presentation was notable for dome-shaped T waves and no ST segment in some leads. To our knowledge, this electrocardiographic finding has not been described in patients with tuberous sclerosis and cardiac masses. PMID:25425989

Sap, Fatih; Sert, Ahmet; Odabas, Dursun

2014-01-01

255

Tuberous sclerosis and cardiac tumors: new electrocardiographic finding in an infant.  

PubMed

Cardiac rhabdomyoma, the primary cardiac tumor most often diagnosed in children, is frequently present in patients with tuberous sclerosis. Most pediatric patients with rhabdomyoma are asymptomatic; however, various electrocardiographic abnormalities can be detected, such as Wolff-Parkinson-White syndrome, ectopic atrial tachycardia, and atrioventricular node dysfunction. We describe the case of a 10-month-old infant girl who had tuberous sclerosis and multiple cardiac rhabdomyomas. Her electrocardiographic presentation was notable for dome-shaped T waves and no ST segment in some leads. To our knowledge, this electrocardiographic finding has not been described in patients with tuberous sclerosis and cardiac masses. PMID:25425989

Aslan, Eyup; Sap, Fatih; Sert, Ahmet; Odabas, Dursun

2014-09-01

256

Medical ultrasound systems  

PubMed Central

Medical ultrasound imaging has advanced dramatically since its introduction only a few decades ago. This paper provides a short historical background, and then briefly describes many of the system features and concepts required in a modern commercial ultrasound system. The topics addressed include array beam formation, steering and focusing; array and matrix transducers; echo image formation; tissue harmonic imaging; speckle reduction through frequency and spatial compounding, and image processing; tissue aberration; Doppler flow detection; and system architectures. It then describes some of the more practical aspects of ultrasound system design necessary to be taken into account for today's marketplace. It finally discusses the recent explosion of portable and handheld devices and their potential to expand the clinical footprint of ultrasound into regions of the world where medical care is practically non-existent. Throughout the article reference is made to ways in which ultrasound imaging has benefited from advances in the commercial electronics industry. It is meant to be an overview of the field as an introduction to other more detailed papers in this special issue. PMID:22866226

Powers, Jeff; Kremkau, Frederick

2011-01-01

257

Cardiac involvement in idiopathic haemochromatosis and the effect of venesection  

PubMed Central

Eight patients with idiopathetic haemochromatosis have been followed up for 2-15 years to study their cardiac state and the effect of repeated venesection in treating their disability. Five of these patients had no clinical cardiac disability. Serial electrocardiographs were done in five patients and significant abnormality was seen in three of them at the time of admission. After removal of excess iron the cardiac disability progressed in two patients and regressed in one other. One of these presented with palpitations and was found to have Wolff-Parkinson-White syndrome. Not one of our patients developed cardiac failure and the two deaths which occurred were the result of hepatic failure. At autopsy one of them was found to have metastases in the myocardium from a hepatoma, a complication we have not encountered in previous reports. ImagesFig. 7

Jachuck, S. J.; Rai, G. S.; Fossard, C.

1974-01-01

258

Improving the diagnostic accuracy for detecting cardiac sarcoidosis.  

PubMed

Cardiac sarcoid is a potentially fatal condition that presents with a wide range of clinical manifestations including conduction abnormalities, tachyarrhythmias, congestive heart failure, cardiomyopathy and sudden cardiac death. Small observational registries and non-comparative studies have described clinical evidence of cardiac involvement in 5% of patients with systemic sarcoid, yet autopsy studies suggest prevalence as high as 79%. This suggests that cardiac sarcoidosis (CS) is underdiagnosed in everyday clinical practice. The scarcity of data and lack of consensus on the most appropriate methods for detecting, monitoring and treating CS presents a significant diagnostic and therapeutic challenge. This review explores the potential impact of novel strategies, including multimodality imaging, on the diagnostic accuracy for detecting CS and treatment. PMID:25600346

Wicks, Eleanor C; Menezes, Leon J; Elliott, Perry M

2015-02-01

259

A Rare Stapes Abnormality  

PubMed Central

The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50?dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively. PMID:25628909

Kanona, Hala; Virk, Jagdeep Singh; Kumar, Gaurav; Chawda, Sanjiv; Khalil, Sherif

2015-01-01

260

A rare stapes abnormality.  

PubMed

The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50?dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively. PMID:25628909

Kanona, Hala; Virk, Jagdeep Singh; Kumar, Gaurav; Chawda, Sanjiv; Khalil, Sherif

2015-01-01

261

Ultrasound of Peripheral Nerves  

PubMed Central

Over the last decade, neuromuscular ultrasound has emerged as a useful tool for the diagnosis of peripheral nerve disorders. This article reviews sonographic findings of normal nerves including key quantitative ultrasound measurements that are helpful in the evaluation of focal and possibly generalized peripheral neuropathies. It also discusses several recent papers outlining the evidence base for the use of this technology, as well as new findings in compressive, traumatic, and generalized neuropathies. Ultrasound is well suited for use in electrodiagnostic laboratories where physicians, experienced in both the clinical evaluation of patients and the application of hands-on technology, can integrate findings from the patient’s history, physical examination, electrophysiological studies, and imaging for diagnosis and management. PMID:23314937

Suk, Jung Im; Walker, Francis O.; Cartwright, Michael S.

2013-01-01

262

Renal ultrasound elastography.  

PubMed

Chronic kidney disease (CKD) incidence and prevalence are increasing in Western countries, due particularly to diabetes mellitus and hypertension-related nephropathies. CKD may lead to end-stage renal failure, with extensive morbidity, mortality and increasing health costs. Primary and secondary prevention requires a better knowledge of mechanisms underlying renal scarring, the development of specific therapies to slow down the progression of the disease and the development of non-invasive diagnostic tools to characterize the process. Ultrasound elastography is a new imaging technique under development that provides information about renal stiffness. Kidney elasticity measurements with ultrasound should be performed with a quantitative technique, such as Shearwave techniques. However kidney stiffness is not only related to fibrosis, as it also sensitive to mechanical and functional parameters such as anisotropy, vascularization, hydronephrosis and external pressure. This paper reviews the existing ultrasound elastography techniques. Elastography is a new tool under development for renal tissue characterization and needs further validation in clinical practice. PMID:23567180

Grenier, N; Gennisson, J-L; Cornelis, F; Le Bras, Y; Couzi, L

2013-05-01

263

Basic Principles of Ultrasound  

NSDL National Science Digital Library

Created by a team of medical professionals and health-care specialists, the main Echo Web site contains a wide range of resources dealing primarily with diagnostic ultrasounds, sonography, and the field of echocardiography. One of the most helpful of these resources is the Basic Principles of Ultrasound online course, which is available here at no cost. The course itself is divided into six different sections, along with a bibliography and FAQ area. Visitors can use the online course to learn about the basic principles of ultrasound, the basic science behind related devices and instruments, and the ways to use these devices safely. Instructors might also do well to use this website in conjunction with lectures on the subject, or as away to give students an additional resource to consult at their leisure.

2004-01-01

264

Mutations in the cardiac transcription factor NKX2.5 affect diverse cardiac developmental pathways  

PubMed Central

Heterozygous mutations in NKX2.5, a homeobox transcription factor, were reported to cause secundum atrial septal defects and result in atrioventricular (AV) conduction block during postnatal life. To further characterize the role of NKX2.5 in cardiac morphogenesis, we sought additional mutations in groups of probands with cardiac anomalies and first-degree AV block, idiopathic AV block, or tetralogy of Fallot. We identified 7 novel mutations by sequence analysis of the NKX2.5-coding region in 26 individuals. Associated phenotypes included AV block, which was the primary manifestation of cardiac disease in nearly a quarter of affected individuals, as well as atrial septal defect and ventricular septal defect. Ventricular septal defect was associated with tetralogy of Fallot or double-outlet right ventricle in 3 individuals. Ebstein’s anomaly and other tricuspid valve abnormalities were also present. Mutations in human NKX2.5 cause a variety of cardiac anomalies and may account for a clinically significant portion of tetralogy of Fallot and idiopathic AV block. The coinheritance of NKX2.5 mutations with various congenital heart defects suggests that this transcription factor contributes to diverse cardiac developmental pathways. J. Clin. Invest. 104:1567–1573 (1999). PMID:10587520

Benson, D. Woodrow; Silberbach, G. Michael; Kavanaugh-McHugh, Ann; Cottrill, Carol; Zhang, Yizhong; Riggs, Steve; Smalls, Octavia; Johnson, Mark C.; Watson, Michael S.; Seidman, J.G.; Seidman, Christine E.; Plowden, John; Kugler, John D.

1999-01-01

265

Live volumetric imaging (LVI) intracardiac ultrasound catheter.  

PubMed

The Live Volumetric Imaging (LVI) catheter is capable of real-time 3D intracardiac echo (ICE) imaging, uniquely providing full volume sectors with deep penetration depth and high volume frame rate. The key enabling technology in this catheter is an integrated piezoelectric micromachined ultrasound transducer (pMUT), a novel matrix phased array transducer fabricated using semiconductor microelectromechanical systems (MEMS) manufacturing techniques. This technology innovation may enable better image guidance to improve accuracy, reduce risk, and reduce procedure time for transcatheter intracardiac therapies which are currently done with limited direct visualization of the endocardial tissue. Envisioned applications for LVI include intraprocedural image guidance of cardiac ablation therapies as well as transcatheter mitral and aortic valve repair. PMID:23773496

Dausch, David E; Castellucci, John B; Gilchrist, Kristin H; Carlson, James B; Hall, Stephen D; von Ramm, Olaf T

2013-01-01

266

Are Electronic Cardiac Devices Still Evolving?  

PubMed Central

Summary Objectives The goal of this paper is to review some important issues occurring during the past year in Implantable devices. Methods First cardiac implantable device was proposed to maintain an adequate heart rate, either because the heart’s natural pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. During the last forty years, pacemakers have evolved considerably and become programmable and allow to configure specific patient optimum pacing modes. Various technological aspects (electrodes, connectors, algorithms diagnosis, therapies, …) have been progressed and cardiac implants address several clinical applications: management of arrhythmias, cardioversion / defibrillation and cardiac resynchronization therapy. Results Observed progress was the miniaturization of device, increased longevity, coupled with efficient pacing functions, multisite pacing modes, leadless pacing and also a better recognition of supraventricular or ventricular tachycardia’s in order to deliver appropriate therapy. Subcutaneous implant, new modes of stimulation (leadless implant or ultrasound lead), quadripolar lead and new sensor or new algorithm for the hemodynamic management are introduced and briefly described. Each times, the main result occurring during the two past years are underlined and repositioned from the history, remaining limitations are also addressed. Conclusion Some important technological improvements were described. Nevertheless, news trends for the future are also considered in a specific session such as the remote follow-up of the patient or the treatment of heart failure by neuromodulation. PMID:25123732

Mabo, P.

2014-01-01

267

Cardiac allograft vasculopathy: diagnosis, therapy, and prognosis  

PubMed Central

Development of cardiac allograft vasculopathy represents the major determinant of long-term survival in patients after heart transplantation. Due to graft denervation, these patients seldom present with classic symptoms of angina pectoris, and the first clinical presentations are progressive heart failure or sudden cardiac death. Although coronary angiography remains the routine technique for coronary artery disease detection, it is not sensitive enough for screening purposes. This is especially the case in the first year after transplantation when diffuse and concentric vascular changes can be easily detected only by intravascular ultrasound. The treatment of the established vasculopathy is disappointing, so the primary effort should be directed toward early prevention and diagnosis. Due to diffuse vascular changes, revascularization procedures are restricted only to a relatively small proportion of patients with favorable coronary anatomy. Percutaneous coronary intervention is preferred over surgical revascularization since it leads to better acute results and patient survival. Although there is no proven long-term advantage of drug-eluting stents for the treatment of in-stent restenosis, they are preferred over bare-metal stents. Severe vasculopathy has a poor prognosis and the only definitive treatment is retransplantation. This article reviews the present knowledge on the pathogenesis, diagnosis, treatment, and prognosis of cardiac allograft vasculopathy. PMID:25559827

Skori?, Boško; ?ikeš, Maja; Ma?ek, Jana Ljubas; Bari?evi?, Željko; Škorak, Ivan; Gašparovi?, Hrvoje; Bio?ina, Bojan; Mili?i?, Davor

2014-01-01

268

Non-Invasive Measurement of Intracranial Pressure Pulsation using Ultrasound  

NASA Technical Reports Server (NTRS)

Exposure to microgravity causes a cephalad fluid shift which may elevate intracranial pressure (ICP). Elevation in ICP may affect cerebral hemodynamics in astronauts during space flight. ICP is, however, a difficult parameter to measure due to the invasiveness of currently available techniques. We already reported our development of a non-invasive ultrasound device for measurement of ICP. We recently modified the device so that we might reproducibly estimate ICP changes in association with cardiac cycles. In the first experiment, we measured changes in cranial distance with the ultrasound device in cadavera while changing ICP by infusing saline into the lateral ventricle. In the second experiment, we measured changes in cranial distance in five healthy volunteers while placing them in 60 deg, 30 deg head-up tilt, supine, and 10 deg head-down tilt position. In the cadaver study, fast Fourier transformation revealed that cranial pulsation is clearly associated with ICP pulsation. The ratio of cranial distance and ICP pulsation is 1.3microns/mmHg. In the tilting study, the magnitudes of cranial pulsation are linearly correlated to tilt angles (r=0.87). The ultrasound device has sufficient sensitivity to detect cranial pulsation in association with cardiac cycles. By analyzing the magnitude of cranial pulsation, estimates of ICP during space flight are possible.

Ueno, Toshiaki; Ballard, R. E.; Yost, W. T.; Hargens, A. R.

1997-01-01

269

Intraoperative ultrasound-guided excision of nonpalpable breast lesions.  

PubMed

The methods commonly used to guide surgical excision of impalpable breast lesions include preoperative placement of hookwires, carbon injections, and, more recently, radioisotope injections. However, all of these techniques have disadvantages, not the least of which is subjecting the patient to an additional stressful and often traumatic procedure preoperatively. The use of intraoperative ultrasound to guide the excision of sonographically visible impalpable lesions is a new technique that avoids the need for a preoperative localization procedure. This report describes one of the author's (I.B.) personal series of ultrasound-guided breast excisions, collating data collected prospectively, and reviews the efficacy of this technique. Data in relation to 115 ultrasound guided breast excisions performed in 103 patients were reviewed. The technique of using a high-frequency real-time ultrasound probe intraoperatively to localize and guide excision of breast abnormalities is described. There were no failed excisions, as confirmed by specimen sonography, pathology findings, and/or follow-up ultrasound. Breast malignancies comprised 42% of all excised lesions, and of these, adequate margins of excision were achieved at the first operation in 93% of cases. Direct ultrasound localization of the lesion at the time of surgery allowed optimal placement of the incision and eliminated delays in operating time because specimens did not have to be sent to the Radiology Department for confirmation of excision. Intraoperative ultrasound-guided excision is a safe and efficient technique in the management of impalpable, sonographically visible breast lesions, and early reports in the world literature support the findings of this series, which show it to have significant advantages over other current methods, particularly with respect to a reduction in patient anxiety and improved surgical resection margins. PMID:15706446

Bennett, I C; Greenslade, J; Chiam, H

2005-03-01

270

Association of low-density lipoprotein oxidation to abnormal electrocardiographic late potentials.  

PubMed

In vivo oxidation of low-density lipoprotein is shown to be significantly related to another risk factor for coronary atherosclerosis, abnormal electrocardiographic late potentials, in clinically healthy pilots. Because both of these variables have been also associated with cardiac arrhythmogenic action, together they may improve the identification of patients at risk of ventricular tachyarrhythmias. PMID:10363876

Kääpä, P; Vihervaara, H; Ahotupa, M

1999-06-01

271

An Artificial Vector Model for Generating Abnormal Electrocardiographic Rhythms  

PubMed Central

We present generalizations of our previously published artificial models for generating multi-channel ECG to provide simulations of abnormal cardiac rhythms. Using a three-dimensional vectorcardiogram (VCG) formulation, we generate the normal cardiac dipole for a patient using a sum of Gaussian kernels, fitted to real VCG recordings. Abnormal beats are specified either as perturbations to the normal dipole or as new dipole trajectories. Switching between normal and abnormal beat types is achieved using a first-order Markov chain. Probability transitions can be learned from real data or modeled by coupling to heart rate and sympathovagal balance. Natural morphology changes from beat-to-beat are incorporated by varying the angular frequency of the dipole as a function of the inter-beat (RR) interval. The RR interval time series is generated using our previously described model whereby time- and frequency-domain heart rate (HR) and heart rate variability characteristics can be specified. QT-HR hysteresis is simulated by coupling the Gaussian kernels associated with the T-wave in the model with a nonlinear factor related to the local HR (determined from the last n RR intervals). Morphology changes due to respiration are simulated by introducing a rotation matrix couple to the respiratory frequency. We demonstrate an example of the use of this model by simulating HR-dependent T-Wave Alternans (TWA) with and without phase-switching due to ectopy. Application of our model also reveals previously unreported effects of common TWA estimation methods. PMID:20308774

Clifford, Gari D.; Nemati, Shamim; Sameni, Reza

2010-01-01

272

Cardiac Procedures and Surgeries  

MedlinePLUS

Cardiac Procedures and Surgeries Updated:Oct 24,2014 If you've had a heart attack, you may have already had certain procedures to ... artery disease (CAD) you have. Cardiac Procedures and Surgeries Angioplasty Also known as Percutaneous Coronary Interventions [PCI], ...

273

In vivo validation of cardiac output assessment in non-standard 3D echocardiographic images  

NASA Astrophysics Data System (ADS)

Automatic segmentation of the endocardial surface in three-dimensional (3D) echocardiographic images is an important tool to assess left ventricular (LV) geometry and cardiac output (CO). The presence of speckle noise as well as the nonisotropic characteristics of the myocardium impose strong demands on the segmentation algorithm. In the analysis of normal heart geometries of standardized (apical) views, it is advantageous to incorporate a priori knowledge about the shape and appearance of the heart. In contrast, when analyzing abnormal heart geometries, for example in children with congenital malformations, this a priori knowledge about the shape and anatomy of the LV might induce erroneous segmentation results. This study describes a fully automated segmentation method for the analysis of non-standard echocardiographic images, without making strong assumptions on the shape and appearance of the heart. The method was validated in vivo in a piglet model. Real-time 3D echocardiographic image sequences of five piglets were acquired in radiofrequency (rf) format. These ECG-gated full volume images were acquired intra-operatively in a non-standard view. Cardiac blood flow was measured simultaneously by an ultrasound transit time flow probe positioned around the common pulmonary artery. Three-dimensional adaptive filtering using the characteristics of speckle was performed on the demodulated rf data to reduce the influence of speckle noise and to optimize the distinction between blood and myocardium. A gradient-based 3D deformable simplex mesh was then used to segment the endocardial surface. A gradient and a speed force were included as external forces of the model. To balance data fitting and mesh regularity, one fixed set of weighting parameters of internal, gradient and speed forces was used for all data sets. End-diastolic and end-systolic volumes were computed from the segmented endocardial surface. The cardiac output derived from this automatic segmentation was validated quantitatively by comparing it with the CO values measured from the volume flow in the pulmonary artery. Relative bias varied between 0 and -17%, where the nominal accuracy of the flow meter is in the order of 10%. Assuming the CO measurements from the flow probe as a gold standard, excellent correlation (r = 0.99) was observed with the CO estimates obtained from image segmentation.

Nillesen, M. M.; Lopata, R. G. P.; de Boode, W. P.; Gerrits, I. H.; Huisman, H. J.; Thijssen, J. M.; Kapusta, L.; de Korte, C. L.

2009-04-01

274

Cardiac Resynchronization Therapy Upregulates Cardiac Autonomic Control  

PubMed Central

Objective: To determine the effect of cardiac resynchronization therapy (CRT) on sympathetic nervous function in heart failure (HF). Background: Neurohormonal dysregulation and cardiac autonomic dysfunction are associated with HF and contribute to HF progression and its poor prognosis. We hypothesized that mechanical resynchronization improves cardiac sympathetic function in HF. Methods: Sixteen consecutive patients receiving CRT for advanced cardiomyopathy and 10 controls were included in this prospective study. NYHA class, 6-minute walk distance, echocardiographic parameters, plasma norepinephrine (NE) were assessed at baseline, 3-month and 6-month follow-up. Cardiac sympathetic function was determined by 123iodine metaiodobenzylguanidine (123I-MIBG) scintigraphy and 24-hour ambulatory electrocardiography. Results: Along with improvement in NYHA class (3.1 ± 0.3 to 2.1 ± 0.4, P < 0.001) and LVEF (23 ± 6% to 33 ± 12%, P < 0.001 delayed heart/mediastinum (H/M) 123 I-MIBG ratio increased significantly (1.8 ± 0.7 to 2.1 ± 0.6, P = 0.04) while the H/M 123I-MIBG washout rate decreased significantly (54 ± 25% to 34± 24%, P = 0.01) from baseline to 6-month follow-up. The heart rate variability (HRV) measured in SD of normal-to-normal intervals also increased significantly from baseline (82 ± 30 ms) to follow-up (111 ± 32 ms, P = 0.04). The improvement in NYHA after CRT was significantly associated with baseline 123I-MIBG H/M washout rate (r = 0.65, P = 0.03). The improvement in LVESV index was associated with baseline 123I-MIBG delayed H/M ratio (r = ?0.67, P = 0.02) and H/M washout rate (r = 0.65, P = 0.03). Conclusion: After CRT, improvements in cardiac symptoms and LV function were accompanied by rebalanced cardiac autonomic control as measured by 123I-MIBG and HRV. PMID:18479331

CHA, YONG-MEI; OH, JAE; MIYAZAKI, CHINAMI; HAYES, DAVID L.; REA, ROBERT F.; SHEN, WIN-KUANG; ASIRVATHAM, SAMUEL J.; KEMP, BRAD J.; HODGE, DAVID O.; CHEN, PENG-SHENG; CHAREONTHAITAWEE, PANITHAYA

2009-01-01

275

Cardiac Hegemony of Senescence  

PubMed Central

Cardiac senescence and age-related disease development have gained general attention and recognition in the past decades due to increased accessibility and quality of health care. The advancement in global civilization is complementary to concerns regarding population aging and development of chronic degenerative diseases. Cardiac degeneration has been rigorously studied. The molecular mechanisms of cardiac senescence are on multiple cellular levels and hold a multilayer complexity level, thereby hampering development of unambiguous treatment protocols. In particular, the synergistic exchange of the senescence phenotype through a senescence secretome between myocytes and stem cells appears complicated and is of great future therapeutic value. The current review article will highlight hallmarks of senescence, cardiac myocyte and stem cell senescence, and the mutual exchange of senescent secretome. Future cardiac cell therapy approaches require a comprehensive understanding of myocardial senescence to improve therapeutic efficiency as well as efficacy. PMID:24349878

Siddiqi, Sailay; Sussman, Mark A.

2013-01-01

276

Cardiac Hegemony of Senescence.  

PubMed

Cardiac senescence and age-related disease development have gained general attention and recognition in the past decades due to increased accessibility and quality of health care. The advancement in global civilization is complementary to concerns regarding population aging and development of chronic degenerative diseases. Cardiac degeneration has been rigorously studied. The molecular mechanisms of cardiac senescence are on multiple cellular levels and hold a multilayer complexity level, thereby hampering development of unambiguous treatment protocols. In particular, the synergistic exchange of the senescence phenotype through a senescence secretome between myocytes and stem cells appears complicated and is of great future therapeutic value. The current review article will highlight hallmarks of senescence, cardiac myocyte and stem cell senescence, and the mutual exchange of senescent secretome. Future cardiac cell therapy approaches require a comprehensive understanding of myocardial senescence to improve therapeutic efficiency as well as efficacy. PMID:24349878

Siddiqi, Sailay; Sussman, Mark A

2013-12-01

277

History of intraoperative ultrasound.  

PubMed

Intraoperative ultrasound (IOUS) using A-mode or non-real-time B-mode imaging started in the 1960s; however, it was not widely accepted mainly because of difficulty in image interpretation. In the late 1970s, IOUS became one of the topics in the surgical communities upon the introduction of high-frequency real-time B-mode ultrasound. Special probes for operative use were developed. In the 1980s, all over the world the use of IOUS spread to a variety of surgical fields, such as hepatobiliary pancreatic surgery, neurosurgery, and cardiovascular surgery. IOUS changed hepatic surgery dramatically because IOUS was the only modality that was capable of delineating and examining the interior of the liver during surgery. After 1990, color Doppler imaging and laparoscopic ultrasound were incorporated into IOUS. Currently, IOUS is considered an indispensable operative procedure for intraoperative decision-making and guidance of surgical procedures. For better surgical practice, education of surgeons in the use of ultrasound is the most important issue. PMID:10385947

Makuuchi, M; Torzilli, G; Machi, J

1998-11-01

278

OPTIMISATION STRATEGIES FOR ULTRASOUND  

E-print Network

3D US screening methods, for example, with endoscopic, intravascular, trans-rectal, and trans-vaginal become increasingly common to produce intrinsically 3D ultrasound (US) probes. Volumetric imaging has now matured because of the possibility of capacitive micro- machined US transducers and 2D phased arrays

Drummond, Tom

279

Medical ultrasound with microbubbles  

Microsoft Academic Search

In the medical ultrasound applications, microbubbles are closely tied to the diagnostic\\/therapeutic uses. For diagnostic applications, their sound scattering properties yield improved imaging, when the microbubbles are used as contrast agents. The harmonics and subharmonics responses from the bubbles assist in distinguishing the acoustic scattering of blood from that of the surrounding tissue. The therapeutic use of microbubbles has recently

Yoichiro Matsumoto; John S. Allen; Shin Yoshizawa; Teiichiro Ikeda; Yukio Kaneko

2005-01-01

280

Bragg waveguide ultrasound detectors.  

PubMed

Polymer Bragg grating waveguides (BGWs) are demonstrated as ultrasound detectors. The device is fabricated by a direct electron beam lithography technique using an epoxy-based photoresist as the core material, with grating features fabricated on the side walls of the rib waveguide. The main motivation for this design is the linear geometry of the device, which can be used in a linear array, facilitating high-frequency ultrasound imaging. The fabricated BGW device has a cross-sectional area of 1.5 × 1.5 ?m and the grating length is 500 ?m. The optical resonance spectrum is measured and compared with a theoretical model. The BGW device is experimentally demonstrated for the detection of ultrasound waves emitted by a 25-MHz transducer. Detection sensitivity depends on optimal grating design for a steep resonance. The extension of a single-element BGW device to a linear array using optical wavelength division multiplexing is presented. The results demonstrate the potential use of BGW devices in highly compact array of optoacoustic detectors for high-sensitivity ultrasound detection and photoacoustic imaging. PMID:23143579

Govindan, Vishnupriya; Ashkenazi, Shai

2012-10-01

281

Ultrasound of the extrahepatic bile duct: issues of size.  

PubMed

Ultrasound is a pivotal study for evaluation of the biliary tree. In particular, the size of the extrahepatic bile duct is a critical measurement and has been a contentious issue since the early days of diagnostic ultrasound. This article reviews the history and ongoing issues regarding sonography of the normal-size duct and a variety of factors that may affect its size, including age, prior surgery, congenital abnormalities, anatomical variations, and medications. Other related sonographic issues are discussed including abnormal nondilated ducts and abnormal intraluminal contents such as sludge or air that make evaluation of the duct more difficult, particularly in patients with primary sclerosing cholangitis and prior liver transplantation. Ultimately, the luminal size of the extrahepatic duct should be considered as a single part of the entire assessment of the biliary tree that must also include the intrahepatic and pancreatic ducts, the pattern of dilatation (variable vs progressively dilated to a single point of obstruction), any wall thickening, intraluminal sludge, calculi or mass, and extraluminal compression. Clinical symptoms and abnormal laboratory values should prompt further evaluation despite a normal appearance of the bile duct, whereas pursuit of an isolated finding of an enlarged duct without supporting clinical data may not be warranted. PMID:20498562

Horrow, Mindy M

2010-06-01

282

Cardiac disease after radiation therapy for Hodgkin's disease: analysis of 48 patients  

SciTech Connect

Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluations were performed in 48 patients with Hodgkin's disease at risk a mean of 97 months after radiotherapy. The study protocol included echocardiography, gated radionuclide ventriculography, and cardiac catheterization. Cardiac disease was found in 46 patients (96%) and included constrictive or occult constrictive pericarditis (24 patients), an abnormal hemodynamic response to a fluid challenge (14 patients), coronary artery disease (6 patients), and left ventricular dysfunction (2 patients). Most patients (53%) had normal echocardiograms. Gated blood pool radionuclide angiocardiography was performed in 42 patients. Excluding patients with occlusive coronary artery disease, the left ventricular ejection fraction at rest (mean 59%) and during exercise (mean 69%) was within normal limits. Thus (1) delayed cardiac disease after radiotherapy is common, (2) chronic pericardial disorders are the most frequent manifestations of this disease, and (3) the prognosis for patients who have radiation-induced cardiac disease is generally favorable.

Applefeld, M.M.; Wiernik, P.H.

1983-06-01

283

Association between electrocardiographic findings and cardiac dysfunction in adult isolated traumatic brain injury  

PubMed Central

Introduction: Abnormal electrocardiographic (ECG) findings can be seen in traumatic brain injury (TBI) patients. ECG may be an inexpensive tool to identify patients at high risk for developing cardiac dysfunction after TBI. The aim of this study was to examine abnormal ECG findings after isolated TBI and their association with true cardiac dysfunction, based on echocardiogram. Methods: Data from adult patients with isolated TBI between 2003 and 2010 was retrospectively examined. Inclusion criteria included the presence of a 12-lead ECG within 24 h of admission and a formal echocardiographic examination within 72 h of admission after TBI. Patients with preexisting cardiac disease were excluded. Baseline clinical characteristics, 12-lead ECG, and echocardiogram report were abstracted. Logistic regression was used to identify the relationship of specific ECG abnormalities with cardiac dysfunction. Results: We examined data from 59 patients with isolated TBI who underwent 12-lead ECG and echocardiographic evaluation. In this cohort, 13 (22%) patients had tachycardia (heart rate >100 bpm), 25 (42.4%) patients had a prolonged QTc, and 6 (10.2%) patients had morphologic end-repolarization abnormalities (MERA), with each having an association with abnormal echocardiographic findings: Odds ratios (and 95% confidence intervals) were 4.14 (1.02-17.05), 9.0 (1.74-46.65), and 5.63 (1.96-32.94), respectively. Ischemic-like ECG changes were not associated with echocardiographic abnormalities. Conclusions: Repolarization abnormalities (prolonged QTc and MERA), but not ischemic-like ECG changes, are associated with cardiac dysfunction after isolated TBI. 12-lead ECG may be an inexpensive screening tool to evaluate isolated TBI patients for cardiac dysfunction prior to more expensive or invasive studies. PMID:25249741

Krishnamoorthy, Vijay; Prathep, Sumidtra; Sharma, Deepak; Gibbons, Edward; Vavilala, Monica S.

2014-01-01

284

Students' reactions to abnormal psychology  

Microsoft Academic Search

As a result of some concern about the effect of courses in abnormal psychology on students, a questionnaire was presented to several classes at the close of the course. The majority answering the questionnaire felt the course to be beneficial, giving evidence that the study of abnormal psychology need not be generally harmful, and may have a significant place in

W. S. Taylor

1932-01-01

285

abnormalities in infants and toddlers  

E-print Network

, Akshoomoff 2000). Similarly, patients with fetal alcohol syndrome (FAS) have decreased cerebellar volumesCerebellar abnormalities in infants and toddlers with Williams syndrome Wendy Jones* PhD, The Salk-mail: jones@crl.ucsd.edu One commonly observed neuroanatomical abnormality in adults with Williams syndrome

Bellugi, Ursula

286

Abnormal pressure in hydrocarbon environments  

USGS Publications Warehouse

Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

Law, B.E.; Spencer, C.W.

1998-01-01

287

Arterial-Cardiac Interaction: The Concept and Implications  

PubMed Central

Vascular stiffening of the large arteries is a common feature of human aging. Increased aortic stiffness with age may contribute to pathological changes in the left ventricle and this can induce ventricular stiffening. Vascular-ventricular stiffening combined with abnormal arterial-cardiac interaction is considered an important pathophysiology of heart failure with a preserved ejection fraction. Here, I briefly review the concept and implications of arterial-cardiac interaction and this will pave the way to understanding and controlling heart failure with a preserved ejection fraction, which is more prevalent in the elderly. PMID:21860718

2011-01-01

288

Cardiac Risks Associated With Marathon Running  

PubMed Central

Context: A recent cluster of sudden cardiac deaths in marathon runners has attracted considerable media attention and evoked concern over the safety of long-distance running and competition. This review discusses the acute and potential long-term risks associated with marathon running and puts these into perspective with the many health benefits afforded by habitual vigorous exercise. Evidence Acquisition: Data sources included peer-reviewed publications from 1979 to January 2010 as identified via PubMed and popular media. Results: Marathon running is associated with a transient and low risk of sudden cardiac death. This risk appears to be even lower in women and is independent of marathon experience or the presence of previously reported symptoms. Most deaths are due to underlying coronary artery disease. The value of preparticipation screening is limited by its insensitivity and impracticality of widespread implementation. Appropriate preparation and deployment of trained medical personnel and availability of automatic external defibrillators are expected to have a major impact on survival from cardiac arrests during marathons. Cardiac biochemical and functional abnormalities are commonly observed transiently following completion of a marathon, although their clinical significance is unknown. Conclusions: Sudden cardiac deaths associated with marathon running are exceedingly rare events. Prevention should focus on recognition and investigation of prodromal symptoms, if present, and access to rapid defibrillation and trained medical personnel. The robust association of endurance running with improved quality of life and longevity underscores the importance of putting risks into perspective with other well-established health benefits of regular vigorous exercise. PMID:23015951

Day, Sharlene M.; Thompson, Paul D.

2010-01-01

289

Cardiac involvement in Caucasian patients with pulmonary sarcoidosis  

PubMed Central

Background Cardiac sarcoidosis (CS) is a potentially life-threatening condition. At present, there is no consensus with regard to the optimal non-invasive clinical evaluation and diagnostic procedures of cardiac involvement in patients with sarcoidosis. The aim of this study in a large homogenous Scandinavian sarcoidosis cohort was therefore to identify risk factors of cardiac involvement in patients with sarcoidosis, and the value of initial routine investigation with ECG and cardiac related symptoms in screening for CS. Methods In this retrospective study a cohort of 1017 Caucasian patients with sarcoidosis were included. They were all screened with ECG at disease onset and investigated for CS according to clinical routine. Results An abnormal ECG was recorded in 166 (16.3%) of the 1017 patients and CS was later diagnosed in 22 (13.2%) of them, compared to in one (0.1%) of the 851 sarcoidosis patients with a normal ECG (p?cardiac related symptoms (11/40) (27.5%) compared to those with pathologic ECG changes without symptoms (11/126) (8.7%) (p?abnormal ECG and cardiac related symptoms at disease onset as powerful predictors of a later diagnosis of cardiac sarcoidosis. In contrast, CS is very rare in subjects without symptoms and with a normal ECG. This knowledge is of importance, and may be used in a clinical algorithm, in identifying patients that should be followed and investigated extensively for the presence of CS. PMID:24506975

2014-01-01

290

GPU Based Real-time Instrument Tracking with Three Dimensional Ultrasound  

PubMed Central

Real-time three-dimensional ultrasound enables new intra-cardiac surgical procedures, but the distorted appearance of instruments in ultrasound poses a challenge to surgeons. This paper presents a detection technique that identifies the position of the instrument within the ultrasound volume. The algorithm uses a form of the generalized Radon transform to search for long straight objects in the ultrasound image, a feature characteristic of instruments and not found in cardiac tissue. When combined with passive markers placed on the instrument shaft, the full position and orientation of the instrument is found in 3D space. This detection technique is amenable to rapid execution on the current generation of personal computer graphics processor units (GPU). Our GPU implementation detected a surgical instrument in 31 ms, sufficient for real-time tracking at the 25 volumes per second rate of the ultrasound machine. A water tank experiment found instrument orientation errors of 1.1 degrees and tip position errors of less than 1.8 mm. Finally, an in vivo study demonstrated successful instrument tracking inside a beating porcine heart. PMID:17681483

Novotny, Paul M.; Stoll, Jeff A.; Vasilyev, Nikolay V.; Del Nido, Pedro J.; Dupont, Pierre E.; Howe, Robert D.

2009-01-01

291

Molecular Basis of Cardiac Myxomas  

PubMed Central

Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis. PMID:24447924

Singhal, Pooja; Luk, Adriana; Rao, Vivek; Butany, Jagdish

2014-01-01

292

Ultrasound Characteristics of In Utero Infection  

PubMed Central

In utero infection of the fetus has become recognized as an important cause of fetal and neonatal morbidity and mortality. Since both anatomic and functional abnormalities have been described in the fetus related to various infections, ultrasonography may be a valuable diagnostic tool in this regard. A complete review of the current literature was undertaken to report available information on this topic. Common pathogens or clinical conditions were selected. The identified data were confounded by the way in which each case originally presented for study. Although certain anomalies were frequently associated with individual organisms, their incidence could not be determined, nor were most specific to that infectious agent. Representative ultrasound images are presented for common and unusual cases. PMID:18476148

Treadwell, Marjorie C.; Gonik, Bernard

1997-01-01

293

Fetal cardiac activity analysis during twin pregnancy using a multi-channel SQUID system  

NASA Astrophysics Data System (ADS)

The use of SQUID magnetometers for non-invasive in utero assessment of cardiac electrical disturbances has already been shown to be a valuable clinical tool. In this way, its applicability also for the complicated case of twin pregnancy, in which the proximity of the cardiac magnetic source of each fetus can hamper the individual analysis of cardiac electrical activity, is of clinical interest. In this paper, we present fetal magnetocardiography performed on a mother pregnant of twins with 26 weeks gestational age, measured inside a magnetically shielded room, by using two identical 31-channel low- Tc SQUID magnetometer systems. Each sensor array has been positioned over one of the fetuses, according to its heart position previously assessed with the aid of ultrasound measurements. The raw data is initially averaged in time and, afterwards, analyzed by means of time plots and isofield maps. The time recordings allow the study of the morphology of each fetus’ cardiac signal and the cardiac time intervals. The resultant equivalent dipole obtained from the isofield maps indicates the position and orientation of each fetus heart. The results agree with the ultrasound analysis performed immediately before the measurements and used to obtain the approximate location of the fetuses’ hearts. Since a distinct analysis of the cardiac electrical activity of each fetus could be achieved, the results indicate the potential of the fetal magnetocardiography in the individual antenatal diagnosis of each one of the fetuses of a twin pregnancy.

Costa Monteiro, E.; Schleussner, E.; Kausch, S.; Grimm, B.; Schneider, A.; Hall Barbosa, C.; Haueisen, J.

2001-05-01

294

Cardiac imaging and stress testing asymptomatic athletes to identify those at risk of sudden cardiac death.  

PubMed

Sudden cardiac death in young athletes is rare but tragic. The cardiology community is faced with the challenge of providing a sensible strategy for the prevention of SCD while simultaneously reaffirming that the benefits of regular exercise far outweigh potential risks. At present, there is a broad range of screening recommendations dependent upon country, sporting discipline, and competition level. While much recent debate has focused on the efficacy of screening with electrocardiography, a number of sporting bodies also mandate the inclusion of exercise testing and echocardiography in screening protocols. Cardiac magnetic resonance imaging, coronary calcium scoring and computed tomography coronary angiography have also been promoted as potentially valuable screening tools for competitive athletes. This review will examine the controversial topic of utilizing cardiac imaging for athlete pre-participation screening. Specifically, the limitations of screening for relatively rare disorders using imaging tools with uncertain or imperfect accuracy will be addressed. Current evidence suggests that the accuracy of all cardiac imaging modalities is insufficient to justify their use as primary screening modalities in athletes. Atypical findings such as marked cardiac dilation, reduced deformation, or small patches of delayed gadolinium enhancement may be commonly encountered in well-trained athletes, but, at present, the prognostic significance of such findings is unknown. Resulting uncertainty for the clinician and athlete has the potential for psychological stress, further testing, and unnecessary exclusions from competition. However, these concerns must not be confused with the extremely useful applications of cardiac imaging for the assessment of athletes with symptoms, an abnormal electrocardiogram or a positive family history. As modern imaging further enhances our understanding of the spectrum of athlete's heart, its role may expand from the assessment of athletes with suspected disease to being part of comprehensive pre-participation screening in apparently healthy athletes. PMID:24029371

La Gerche, Andre; Baggish, Aaron L; Knuuti, Juhani; Prior, David L; Sharma, Sanjay; Heidbuchel, Hein; Thompson, Paul D

2013-09-01

295

Agnathia-otocephaly: prenatal diagnosis by two- and three-dimensional ultrasound and magnetic resonance imaging. Case report.  

PubMed

A case of prenatally diagnosed otocephaly is reported. Otocephaly is an extremely rare malformation characterized by absence or hypoplasia of the mandible and abnormal horizontal position of the ears. 2D ultrasound performed at 25 weeks of gestation revealed agnathia, proboscis and hypotelorism. 3D ultrasound (rendering mode) and magnetic resonance imaging were used to evaluate the facial features, and were essential for characterization of facial malformations in otocephaly and for the demonstration and correct prenatal counseling of the couple. PMID:25463893

Hisaba, Wagner Jou; Milani, Hérbene José Figuinha; Araujo Júnior, Edward; Passos, Jurandir Piassi; Barreto, Enoch Quinderé Sá; Carvalho, Natália Silva; Helfer, Talita Micheletti; Pares, David Batista Silva; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

2014-12-01

296

Hypokalemia-Induced Abnormal Movements: Case Report  

PubMed Central

Introduction A sudden loss of consciousness followed by abnormal movements can be ictal or syncopal in origin. Transient response by the brain to sudden decrease of blood flow may cause sudden loss of consciousness followed by abnormal movements that mimic seizure. Dysrhythmia is one of the important and critical reasons of such events that should be differentiated from seizure. Case Presentation In this case report we describe a 55 year-old woman admitted to our emergency department first with the impression of seizure. Eventually, it was realized that she had suffered from brain hypo-perfusion secondary to hypokalemia induced arrhythmia. Her arrhythmia was managed by unsynchronized biphasic shock in acute phase and also potassium replacement. She was then admitted to the CCU (Coronary Care Unit) where she received further care for medical management and drug dose adjustment and was discharged 4 days later. Conclusions Syncope from arrhythmia most commonly results from ventricular tachycardia, which accounts for 11% of all cases of syncope. Torsades de point is a unique type of ventricular tachycardia, characterized by QRS complexes of changing amplitude proceeded by prolonged QT intervals and almost often followed by loss of consciousness and also seizure like movements. Prolonged QT interval which is an important provocative factor for torsades de point commonly results from interactions between drug therapy, myocardial ischemia, and electrolyte disturbances such as hypokalemia or hypomagnesaemia. Changes in the extracellular potassium level have predominant and profound influences on the function of the cardiovascular system that may provoke fatal demonstrations such as QT prolongation, ventricular arrhythmia and even cardiac arrest. Electrolyte assessment is particularly important in certain patient populations, such as the elderly in whom a variety of pathological states or conditions like dehydration or renal failure are more common. Early identification and correction of these disturbances are necessary to control either seizures or seizure-like movements and prevent permanent brain damage, as anticonvulsants alone are generally ineffective. PMID:24350174

Baratloo, Alireza; Rouhipour, Alaleh; Forouzanfar, Mohammadmahdi; Rahmati, Farhad; Hashemi, Behrooz

2013-01-01

297

Cardiac Risk Assessment  

MedlinePLUS

... helpful? Formal name: Cardiac Risk Assessment Related tests: Lipid Profile , VLDL Cholesterol , hs-CRP , Lp(a) Overview | ... on Coronary artery disease: Tests and diagnosis .) The lipid profile is the most important blood test for ...

298

Benign breast lesions: Ultrasound  

PubMed Central

Benign breast diseases constitute a heterogeneous group of lesions arising in the mammary epithelium or in other mammary tissues, and they may also be linked to vascular, inflammatory or traumatic pathologies. Most lesions found in women consulting a physician are benign. Ultrasound (US) diagnostic criteria indicating a benign lesion are described as well as US findings in the most frequent benign breast lesions. PMID:23396888

Masciadri, N.; Ferranti, C.

2011-01-01

299

Tissue identification by ultrasound  

NASA Technical Reports Server (NTRS)

The ultrasonic properties of animal and human soft tissue were measured over the frequency range of 1.5 to 10.0 MHz. The method employed a swept-frequency, coherent technique known as time delay spectrometry. Measurements of attenuation versus frequency on liver, backfat, kidney, pancreas, spleen, breast, and other tissue were made. Considerable attention was paid to tissue handling and in determining the effects of fixing on the attenuation of ultrasound in the tissue.

Lecroissette, D. H.; Heyser, R. C.; Gammell, P. M.; Wilson, R. L.

1978-01-01

300

Ultrasound in gynecology  

Microsoft Academic Search

.   This paper reviews the various examination thechniques, the clinical indications, and the imaging findings for US studies\\u000a of the female pelvis in patients with gynecological problems. Ultrasound, in fact, is the preferred imaging modality in the\\u000a study of the female pelvis, and provides information of basic importance in detecting and characterizing pelvic masses of\\u000a uterine, ovarian, or adnexal origin,

Lorenzo E. Derchi; Giovanni Serafini; Nicola Gandolfo; Nicoletta G. Gandolfo; Carlo Martinoli

2001-01-01

301

Clinical ophthalmic ultrasound improvements  

NASA Technical Reports Server (NTRS)

The use of digital synthetic aperture techniques to obtain high resolution ultrasound images of eye and orbit was proposed. The parameters of the switched array configuration to reduce data collection time to a few milliseconds to avoid eye motion problems in the eye itself were established. An assessment of the effects of eye motion on the performance of the system was obtained. The principles of synthetic techniques are discussed. Likely applications are considered.

Garrison, J. B.; Piro, P. A.

1981-01-01

302

Prenatal-postnatal correlations of brain abnormalities: how lesions and diagnoses change over time  

PubMed Central

A combination of prenatal ultrasound and MRI can be used to detect and characterize many primary and secondary CNS abnormalities in the developing fetus. While this information is useful in prenatal patient counseling, it is important to understand the factors that can influence change in diagnosis and prognosis over time. The etiology of the abnormality, the conspicuity of associated findings, the change in appearance over time, and the opinion of subspecialty experts all can influence the diagnosis. Additionally, technical factors of imaging acquisition may allow the detection of an abnormality in the postnatal period and not prenatally. Having an understanding of the normal fetal central nervous system anatomy at varying gestational ages will aid in the imaging detection and interpretation of CNS pathology. Understanding how these appearances and diagnoses can change over time will aid in the discussion of prognosis with expectant parents, which is crucial in fetal CNS abnormalities. PMID:24078783

Senapati, Gunjan; Levine, Deborah

2013-01-01

303

Hybrid imaging: integration of nuclear imaging and cardiac CT.  

PubMed

The integration of nuclear medicine cameras with multidetector CT scanners provides a unique opportunity to delineate cardiac and vascular anatomic abnormalities and their physiologic consequences in a single setting. By revealing the burden of anatomic coronary artery disease and its physiologic significance, hybrid imaging can provide unique information that may improve noninvasive diagnosis, risk assessment, and management of coronary artery disease. By integrating the detailed anatomic information from CT with the high sensitivity of radionuclide imaging to evaluate targeted molecular and cellular abnormalities, hybrid imaging may play a key role in shaping the future of molecular diagnostics and therapeutics. This article reviews potential clinical applications of hybrid imaging in cardiovascular disease. PMID:19306768

Di Carli, Marcelo F

2009-05-01

304

Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis  

PubMed Central

In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population. PMID:23653854

Huffman, Jeff C.; Celano, Christopher M.; Beach, Scott R.; Motiwala, Shweta R.; Januzzi, James L.

2013-01-01

305

Effects of Lifestyle Modification Programs on Cardiac Risk Factors  

PubMed Central

Medicare conducted a payment demonstration to evaluate the effectiveness of two intensive lifestyle modification programs in patients with symptomatic coronary artery disease: the Dr. Dean Ornish Program for Reversing Heart Disease (Ornish) and Cardiac Wellness Program of the Benson-Henry Mind Body Institute. This report describes the changes in cardiac risk factors achieved by each program during the active intervention year and subsequent year of follow-up. The demonstration enrolled 580 participants who had had an acute myocardial infarction, had undergone coronary artery bypass graft surgery or percutaneous coronary intervention within 12 months, or had documented stable angina pectoris. Of these, 98% completed the intense 3-month intervention, 71% the 12-month intervention, and 56% an additional follow-up year. Most cardiac risk factors improved significantly during the intense intervention period in both programs. Favorable changes in cardiac risk factors and functional cardiac capacity were maintained or improved further at 12 and 24 months in participants with active follow-up. Multivariable regressions found that risk-factor improvements were positively associated with abnormal baseline values, Ornish program participation for body mass index and systolic blood pressure, and with coronary artery bypass graft surgery. Expressed levels of motivation to lose weight and maintain weight loss were significant independent predictors of sustained weight loss (p?=?0.006). Both lifestyle modification programs achieved well-sustained reductions in cardiac risk factors. PMID:25490202

Razavi, Moaven; Fournier, Stephen; Shepard, Donald S.; Ritter, Grant; Strickler, Gail K.; Stason, William B.

2014-01-01

306

Diagnostic accuracy of the vertebral heart score and other radiographic indices in the detection of cardiac enlargement in cats with different cardiac disorders.  

PubMed

A retrospective search was conducted to evaluate the diagnostic accuracy of the vertebral heart score (VHS) and other related radiographic indices in the detection of cardiac enlargement associated with different cardiac disorders in the cat. One hundred and five cats with a complete echocardiographic examination and radiographic examination of the thorax with at least two orthogonal views were enrolled. Eighty-three cats had different cardiac disorders, 72 with left-sided cardiac disorders (LSCD) and 11 with right-sided cardiac disorders; 22 cats were free of cardiovascular abnormalities. Measurements of VHS and cardiac long and short axes on lateral (L) and dorsoventral or ventrodorsal radiographs were obtained. Receiver operating characteristic curves were calculated to evaluate the diagnostic accuracy of each radiographic index in differentiating between cats with cardiac disorders or cats with LSCD and cats without cardiac abnormalities and, among cats with LSCD, between those with no or mild left atrial enlargement (LAE) or those with moderate-to-severe LAE and healthy cats. The L-VHS at the cut-off of 7.9 had high diagnostic accuracy in distinguishing cats with LSCD and moderate-to-severe LAE from healthy cats, but all the other radiographic indices were moderately accurate in distinguishing between cats with overall cardiac disorders or LSCD, either with no or mild LAE and moderate-to-severe LAE, and healthy cats. The considered radiographic indices were also moderately accurate in predicting different degrees of LAE in cats with LSCD. Radiographic indices are reasonably specific, but less sensitive predictors of cardiac enlargement in cats with heart disorders. PMID:24518255

Guglielmini, Carlo; Baron Toaldo, Marco; Poser, Helen; Menciotti, Giulio; Cipone, Mario; Cordella, Alessia; Contiero, Barbara; Diana, Alessia

2014-10-01

307

Ultrasound mediated gene transfection  

NASA Astrophysics Data System (ADS)

Gene therapy is a promising modality for the treatment of a variety of human diseases both inherited and acquired, such as cystic fibrosis and cancer. The lack of an effective, safe method for the delivery of foreign genes into the cells, a process known as transfection, limits this effort. Ultrasound mediated gene transfection is an attractive method for gene delivery since it is a noninvasive technique, does not introduce any viral particles into the host and can offer very good temporal and spatial control. Previous investigators have shown that sonication increases transfection efficiency with and without ultrasound contrast agents. The mechanism is believed to be via a cavitation process where collapsing bubble nuclei permeabilize the cell membrane leading to increased DNA transfer. The research is focused on the use of pulsed wave high frequency focused ultrasound to transfect DNA into mammalian cells in vitro and in vivo. A better understanding of the mechanism behind the transfection process is also sought. A summary of some in vitro results to date will be presented, which includes the design of a sonication chamber that allows us to model the in vivo case more accurately.

Williamson, Rene G.; Apfel, Robert E.; Brandsma, Janet L.

2002-05-01

308

Autonomic cardiac innervation  

PubMed Central

Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.   Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory function, including in possible neurotransmitter changes. Certainly, neurotrophins and cytokines regulate transcriptional factors in adult autonomic neurons that have vital differentiation roles in development. Particularly for parasympathetic cardiac ganglion neurons, additional examinations of developmental regulatory mechanisms will potentially aid in understanding attenuated parasympathetic function in a number of conditions, including heart failure. PMID:23872607

Hasan, Wohaib

2013-01-01

309

Missed cardiac tamponade  

PubMed Central

Cardiac tamponade can have an insidious onset, becoming life threatening when an adequate cardiac output can no longer be maintained. This case provides an example of a presentation where all the classic signs were present but unfortunately they were missed, in this way providing good revision of what these signs are. It gives some anaesthetic and procedure based perspectives for this rare presentation. It is noteworthy for the speed at which symptoms and signs resolved after the tamponade was relieved. PMID:22679253

Thomson-Moore, Alexandra Louise

2011-01-01

310

Late cardiac, thyroid, and pulmonary sequelae of mantle radiotherapy for Hodgkin's disease  

SciTech Connect

Cardiac, thyroid and pulmonary function were evaluated in 25 patients aged 35 years or under, treated for Hodgkin's disease by mantle radiotherapy 5-16 years previously. No patient had symptoms of heart disease. Although thallium myocardial perfusion scintigraphy was normal in all patients, abnormalities of myocardial function were detected in 6 (24%) patients using gated equilibrium rest and exercise radionuclide ventriculography. Resting left ventricular ejection fraction (LVEF) was abnormal in 1 patient, and in 3 patients there was an abnormal LVEF response to exercise. All 6 patients had right ventricular dilatation. Apical hypokinesia was present in 4 of these patients. A small asymptomatic pericardial effusion was detected by M-Mode echocardiography in only 2 (8%) patients. Twenty-three (92%) patients had evidence of abnormal thyroid function. Two (8%) patients had become clinically hypothyroid. Serum TSH was elevated in 13 (52%) patients and TRH stimulation test was abnormal in a further 10 (40%) patients in whom TSH was normal. Pulmonary function studies showed a moderate decrease in diffusing capacity (72% of predicted) and a minor reduction in lung volume. Although a high incidence of cardiac, thyroid and pulmonary abnormalities was detected, only the 2 patients who had become hypothyroid were symptomatic. Modification of the irradiation technique may reduce the incidence of cardiac abnormalities, but is unlikely to alter significantly the thyroid or pulmonary sequelae.

Morgan, G.W.; Freeman, A.P.; McLean, R.G.; Jarvie, B.H.; Giles, R.W.

1985-11-01

311

Robotic ultrasound systems in medicine.  

PubMed

Robots ultrasound (RUS) can be defined as the combination of ultrasound imaging with a robotic system in medical interventions. With their potential for high precision, dexterity, and repeatability, robots are often uniquely suited for ultrasound integration. Although the field is relatively young, it has already generated a multitude of robotic systems for application in dozens of medical procedures. This paper reviews the robotic ultrasound systems that have been developed over the past two decades and describes their potential impact on modern medicine. The RUS projects reviewed include extracorporeal devices, needle guidance systems, and intraoperative systems. PMID:23475917

Priester, Alan M; Natarajan, Shyam; Culjat, Martin O

2013-03-01

312

Intra-beat Scaling Properties of Cardiac Arrhythmias and Sudden Cardiac Death  

NASA Astrophysics Data System (ADS)

We applied detrended fluctuation analysis (DFA) to characterize the intra-beat scaling dynamics of electrocardiographic (ECG) recordings from the PhysioNet Sudden Cardiac Death Holter Database. The main finding of this contribution is that, in such recordings involving different types of arrhythmias; the ECG waveform, besides showing a less-random intra-beat dynamics, becomes more regular during bigeminy, ventricular tachycardia (VT) or even atrial fibrillation (AFIB) and ventricular fibrillation (VF) despite the appearance of erratic traces. Thus, notwithstanding that these cardiac rhythm abnormalities are generally considered as irregular and some of them generated by random impulses or wavefronts, the intra-beat scaling properties suggest that regularity dominates the underlying mechanisms of arrhythmias. Among other explanations, this may result from shorted or restricted -less complex- pathways of conduction of the electrical activity within the ventricles.

Rodríguez, Eduardo; Lerma, Claudia; Echeverría, Juan C.; Alvarez-Ramirez, Jose

2008-02-01

313

Impact of obesity and weight loss on cardiac performance and morphology in adults.  

PubMed

Obesity, particularly severe obesity is capable of producing hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function. These include increased cardiac output, left ventricular hypertrophy and diastolic and systolic dysfunction of both ventricles. Facilitated by co-morbidities such as hypertension, the sleep apnea/obesity hypoventilation syndrome, and possibly certain neurohormonal and metabolic alterations, these abnormalities may predispose to left and right heart failure, a disorder known as obesity cardiomyopathy. PMID:24438730

Alpert, Martin A; Omran, Jad; Mehra, Ankit; Ardhanari, Sivakumar

2014-01-01

314

Abnormal echocardiography 7 days after stem cell transplantation may be an early indicator of thrombotic microangiopathy.  

PubMed

Cardiac complications after hematopoietic stem cell transplantation (HSCT) can lead to significant morbidity and mortality. Cardiac evaluation during the first 100 days after HSCT is usually performed only if clinically indicated, and no studies have examined whether routine screening is beneficial in this patient population at high risk for tissue injury. We conducted a single-center prospective clinical study to screen for cardiac complications in pediatric and young adult patients. One hundred consecutive HSCT patients underwent scheduled echocardiographic screening on day +7 after transplantation, independent of their clinical condition. At least 1 abnormality was identified in 30% of cases. Seventeen children had a pericardial effusion, 13 elevated right ventricular pressure, and 3 reduced left ventricular function. Survival was reduced in children with any echocardiographic abnormality at day 7 (67% versus 80% in those with and without, respectively, abnormality, P = .073). Moreover, raised right ventricular pressure at day +7 was significantly associated with transplant-associated thrombotic microangiopathy (TA-TMA; P = .004) and may indicate early vascular injury in the lungs. These data suggest that echocardiography 7 days after HSCT can detect early cardiac complications of HSCT and may identify early vascular injury associated with TA-TMA. PMID:25300868

Dandoy, Christopher E; Davies, Stella M; Hirsch, Russel; Chima, Ranjit S; Paff, Zachary; Cash, Michelle; Ryan, Thomas D; Lane, Adam; El-Bietar, Javier; Myers, Kasiani C; Jodele, Sonata

2015-01-01

315

American Institute of Ultrasound in Medicine  

MedlinePLUS

... In | My Account | Renew | Join About Us Leadership History Awards Committees Mission & Constitution Join/Renew Communities Basic Science and Instrumentation Cardiovascular Ultrasound Contrast-Enhanced Ultrasound Elastography ...

316

A case of ultrasound-guided prenatal diagnosis of prune belly syndrome in Papua New Guinea – implications for management  

PubMed Central

Background Prune belly syndrome is a rare congenital malformation of unknown aetiology and is characterised by abnormalities of the urinary tract, a deficiency of abdominal musculature and bilateral cryptorchidism in males. We report a case of prune belly syndrome from Papua New Guinea, which was suspected on pregnancy ultrasound scan and confirmed upon delivery. Case presentation A 26-year-old married woman, Gravida 3 Para 2, presented to antenatal clinic in Madang, Papua New Guinea, at 21+5 weeks’ gestation by dates. She was well with no past medical or family history of note. She gave consent to participate in a clinical trial on prevention of malaria in pregnancy and underwent repeated ultrasound examinations which revealed a live fetus with persistent megacystis and anhydramnios. Both mother and clinicians agreed on conservative management of the congenital abnormality. The mother spontaneously delivered a male fetus weighing 2010 grams at 34 weeks’ gestation with grossly abnormal genitalia including cryptorchidism, penile aplasia and an absent urethral meatus, absent abdominal muscles and hypoplastic lungs. The infant passed away two hours after delivery. This report discusses the implications of prenatal detection of severe congenital abnormalities in PNG. Conclusion This first, formally reported, case of prune belly syndrome from a resource-limited setting in the Oceania region highlights the importance of identifying and documenting congenital abnormalities. Women undergoing antenatal ultrasound examinations must be carefully counseled on the purpose and the limitations of the scan. The increasing use of obstetric ultrasound in PNG will inevitably result in a rise in prenatal detection of congenital abnormalities. This will need to be met with adequate training, referral mechanisms and better knowledge of women’s attitudes and beliefs on birth defects and ultrasound. National medicolegal guidance regarding induced abortion and resuscitation of a fetus with severe congenital abnormalities may be required. PMID:23651554

2013-01-01

317

Combined cardiological and neurological abnormalities due to filamin A gene mutation  

PubMed Central

Background Cardiac defects can be the presenting symptom in patients with mutations in the X-linked gene FLNA. Dysfunction of this gene is associated with cardiac abnormalities, especially in the left ventricular outflow tract, but can also cause a congenital malformation of the cerebral cortex. We noticed that some patients diagnosed at the neurogenetics clinic had first presented to a cardiologist, suggesting that earlier recognition may be possible if the diagnosis is suspected. Methods and results From the Erasmus MC cerebral malformations database 24 patients were identified with cerebral bilateral periventricular nodular heterotopia (PNH) without other cerebral cortical malformations. In six of these patients, a pathogenic mutation in FLNA was present. In five a cardiac defect was also found in the outflow tract. Four had presented to a cardiologist before the cerebral abnormalities were diagnosed. Conclusions The cardiological phenotype typically consists of aortic or mitral regurgitation, coarctation of the aorta or other left-sided cardiac malformations. Most patients in this category will not have a FLNA mutation, but the presence of neurological complaints, hyperlaxity of the skin or joints and/or a family history with similar cardiac or neurological problems in a possibly X-linked pattern may alert the clinician to the possibility of a FLNA mutation. PMID:20730588

de Wit, Marie Claire Y.; de Coo, Irenaeus F. M.; Lequin, Maarten H.; Halley, Dicky J. J.; Roos-Hesselink, Jolien W.

2010-01-01

318

Vasomotor responses to decreased venous return: effects of cardiac deafferentation in humans  

PubMed Central

We compared haemodynamic and peripheral vasomotor responses to lower body negative pressure (LBNP) in cardiac transplant recipients who had undergone bicaval anastomoses, involving right atrial deafferentation (?RA), and the conventional procedure in which some atrial baroreceptor afferents remain intact (+RA). We measured mean forearm blood flow (FBF) responses using Doppler/ultrasound during three randomised trials involving 0 (baseline), ?20 and ?40 mmHg LBNP in 15 transplant recipients (9 ?RA, 6 +RA) and in eight healthy matched controls. A significant effect of LBNP on FBF existed between control and transplant groups (P < 0.05; two-way ANOVA). Mild LBNP (?20 mmHg), significantly decreased FBF by 29.7 ± 10.0% relative to baseline in +RA subjects (P < 0.05), whereas the 17.7 ± 10.3% decrease in ?RA subjects was not significant. In response to ?40 mmHg LBNP, FBF significantly decreased in control (42.4 ± 4.6%, P < 0.05) and +RA subjects (33.3 ± 11.4%, P < 0.05) with no significant change in the ?RA group. The response of systolic blood pressure (SBP) to ?40 mmHg significantly differed between groups (P < 0.05): ?RA subjects decreased significantly (P < 0.05) whilst the decrease in SBP in +RA subjects did not achieve significance and control subjects exhibited an increase. The heart rate increase from baseline to ?40 mmHg was significantly attenuated in ?RA relative to controls and the +RA group (P < 0.05). The present study demonstrates that atrial deafferentation impairs reflex vasomotor control of the circulation in response to low- and high-level LBNP, indicating that atrial deafferentation may contribute to abnormal arterial pressure regulation. PMID:15331679

Weisbrod, Cara J; Arnolda, Leonard F; McKitrick, Douglas J; O'Driscoll, Gerard; Potter, Kathleen; Green, Daniel J

2004-01-01

319

Ultrasound Prenatal Diagnosis of Inguinal Scrotal Hernia and Contralateral Hydrocele  

PubMed Central

Fetal inguinal scrotal hernia is a rare condition resulting in an abnormal embryonic process of the tunica vaginalis. We report a case of ultrasound prenatal diagnosis of inguinal scrotal hernia associated with contralateral hydrocele in a woman at 37 weeks of gestation, referred to our clinic for a scrotal mass. Differential diagnosis includes hydrocele, teratoma, hemangiomas, solid tumours of testis, bowel herniation, and testicular torsion. Bowel peristalsis is an important ultrasound sign and it allowed us to make diagnosis of inguinal scrotal hernia. Diagnosis was confirmed at birth and a laparoscopic hernia repair was performed without complications on day 10. During surgery, a bilateral defect of canal inguinal was seen and considered as the cause of scrotal inguinal hernia and contralateral hydrocele observed in utero. PMID:24455356

Massaro, G.; Sglavo, G.; Cavallaro, A.; Pastore, G.; Nappi, C.; Di Carlo, C.

2013-01-01

320

Addressing Phonological Questions with Ultrasound  

ERIC Educational Resources Information Center

Ultrasound can be used to address unresolved questions in phonological theory. To date, some studies have shown that results from ultrasound imaging can shed light on how differences in phonological elements are implemented. Phenomena that have been investigated include transitional schwa, vowel coalescence, and transparent vowels. A study of…

Davidson, Lisa

2005-01-01

321

Safety of ultrasound contrast agents  

Microsoft Academic Search

The use of ultrasound contrast agents has increased over recent years. The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) decided to review the safety of ultrasound contrast agents in humans and to draw up guidelines. A comprehensive literature search and review was carried out. The resulting report was discussed by the CMSC of ESUR

Jarl Å. Jakobsen; Raymond Oyen; Henrik S. Thomsen; Sameh K. Morcos

2005-01-01

322

Optically guided ultrasound imaging system  

NASA Astrophysics Data System (ADS)

This study investigates the potential use of combining near infrared (NIR) diffuse light and ultrasound methods for early detection of small breast tumors. A novel imaging system which combines these two methods has been introduced. A NIR phased array positioner capable of providing the line-of-sight of a small heterogeneity in a scattering medium is incorporated into an ultrasound imaging system. This combined system has been tested using models consisting of few mm emulated tumors buried in a scattering phantom. In each test, the combined system was mechanically translated to scan for a small object. At each scanning position, optical amplitude and phase data and an ultrasound image were acquired. The object line-of- sight information was coded into ultrasound images after scanning. Ultrasound image without and with line-of-sight information were evaluated by two radiologists. ROC curves using ultrasound and combined methods are measured and the areas under the average ROC curves of ultrasound and combined methods are 49% and 82%, respectively. Thus the combined method affords a significant improvement in detection sensitivity and specificity compared with conventional ultrasound in this phantom study.

Zhu, Quing; Chance, Britton; Sullivan, Daniel

1997-08-01

323

Ultrasound image segmentation: a survey  

Microsoft Academic Search

This paper reviews ultrasound segmentation methods, in a broad sense, focusing on techniques developed for medical B-mode ultrasound images. First, we present a review of articles by clinical application to highlight the approaches that have been investigated and degree of validation that has been done in different clinical domains. Then, we present a classification of methodology in terms of use

J. Alison Noble; Djamal Boukerroui

2006-01-01

324

Despeckling of medical ultrasound images  

Microsoft Academic Search

Speckle noise is an inherent property of medical ultrasound imaging, and it generally tends to reduce the image resolution and contrast, thereby reducing the diagnostic value of this imaging modality. As a result, speckle noise reduction is an important prerequisite, whenever ultrasound imaging is used for tissue characterization. Among the many methods that have been proposed to perform this task,

Oleg V. Michailovich; Allen Tannenbaum

2006-01-01

325

Cardiac radiology: centenary review.  

PubMed

During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day. PMID:25340434

de Roos, Albert; Higgins, Charles B

2014-11-01

326

[Contribution of cardiac MRI in the etiologic diagnosis of chest pain syndrome with a normal angiographic aspect of the coronary arteries].  

PubMed

The etiologic diagnosis of chest pain with elevation of specific cardiac enzymes, repolarization abnormalities and a normal angiographic aspect of the coronary arteries is difficult. In this situation, the role of cardiac MRI is growing, frequently allowing to precise the etiology of the chest pain. We present a literature review concerning the semiology of the cardiac MRI in the three main involved etiologies: myocarditis, takotsubo syndrome, and myocardial ischemia with a normal angiographic aspect of the coronary arteries. PMID:18394586

Leurent, G; Langella, B; Boulmier, D; Larralde, A; Donal, E; Bedossa, M; Le Breton, H

2008-04-01

327

Cardiac transthyretin amyloidosis.  

PubMed

Cardiac amyloidosis of transthyretin fibril protein (ATTR) type is an infiltrative cardiomyopathy characterised by ventricular wall thickening and diastolic heart failure. Increased access to cardiovascular magnetic resonance imaging has led to a marked increase in referrals to our centre of Caucasian patients with wild-type ATTR (senile systemic) amyloidosis and Afro-Caribbean patients with the hereditary ATTR V122I type. Both subtypes present predominantly as isolated cardiomyopathy. The differential diagnosis includes cardiac amyloid light-chain (AL) amyloidosis, which has a poorer prognosis and can be amenable to chemotherapy. We review here the clinical features of cardiac ATTR amyloidosis and describe the diagnostic tests to determine ATTR type. Correct diagnosis is ever more crucial given that several novel therapies for ATTR amyloidosis are on the near horizon. PMID:22888163

Dungu, Jason N; Anderson, Lisa J; Whelan, Carol J; Hawkins, Philip N

2012-11-01

328

Characterization and Modeling of Capacitive Micromachined Ultrasound Transducers for Diagnostic Ultrasound  

E-print Network

, LDV, ultrasound 1 INTRODUCTION Diagnostic medical ultrasound requires arrays of ultrasound transducersCharacterization and Modeling of Capacitive Micromachined Ultrasound Transducers for Diagnostic Ultrasound C.B. Doody1 , J.S. Wadhwa2 , D.F. Lemmerhirt2 , and R.D White1 1 Tufts University, Medford, MA 2

White, Robert D.

329

Fetal abnormality: an audit of its recognition and management. Northern Regional Survey Steering Group.  

PubMed Central

A voluntary survey set up by local clinicians has documented all lethal abnormality in a geographically defined area of northern England where there were 361,037 registered births between 1982 and 1990, and monitored the incidence of all significant physical abnormality since January 1984. The survey aims to maintain a register of all pregnancies where an abnormality is suspected before birth, and those where an abnormality is only identified after birth, together with a record of how the diagnosis was established. Information on management and outcome a year after birth is also collected. Nearly half the total decline in perinatal mortality in the region between 1982 and 1990 is accounted for by an increase in the antenatal recognition of lethal abnormality, isolated hydrocephalus, or a neural tube defect and subsequent termination of pregnancy. Although the reporting of many non-lethal conditions was incomplete during the pilot study in 1984, it has become progressively more complete since then. The number of cases confirmed postnatally varied little between units between 1985-9, but audit showed that the proportion recognised antenatally varied fivefold for reasons unconnected with unit size or the amount of antenatal ultrasound work done. For a number of serious conditions more than 10% of all antenatal diagnoses were completely wrong. Survey data are, for the first time, making it possible to monitor the accuracy of the ultrasound-based screening and diagnostic services for identifying specific fetal abnormalities. They are also providing clinicians with an invaluable confidential database of a whole region's collective experience of dealing with complex fetal abnormality. PMID:1519973

1992-01-01

330

Cardiac Tumors: A Brief Commentary  

PubMed Central

Patients with cardiac tumors may present with cardiovascular related or constitutional symptoms, but more often than not a cardiac mass is discovered incidentally during an imaging examination performed for an unrelated indication. Cardiac myxoma is generally considered to be a surgical emergency. Echocardiography, including the transesophageal approach, is the most important means of diagnosis; computed tomography and magnetic resonance imaging. The clinical presentation has changed, and the management of cardiac myxoma now needs to be reviewed.

Roever, Leonardo; Casella-Filho, Antonio; Dourado, Paulo Magno Martins; Resende, Elmiro Santos; Chagas, Antônio Carlos Palandri

2014-01-01

331

Emergency Cardiac Care: An Update  

PubMed Central

The authors review the new guidelines for basic life support and advanced cardiac life support and the recommended changes to the standards. The changes recommended for basic life support will simplify the psychomotor skills required. The recommended changes to the guidelines for advanced cardiac life support, which include discontinuing the use of isoproterenol and limiting the use of sodium bicarbonate in cardiac arrest, are likely to improve survival rates. Controversies in the management of cardiac arrest are also discussed. PMID:21253157

Swanson, Richard W.

1988-01-01

332

Immune abnormalities in myelodysplastic syndromes.  

PubMed Central

The immune states of 52 patients with myelodysplastic syndromes classified according to the FAB criteria were studied. Serum electrophoresis and immunoelectrophoresis, direct Coombs test, and tests for organ and non-organ specific antibodies were performed. Twenty six patients had immunoglobulin abnormalities: six (11.5%) had monoclonal gammopathy; 17 (32.6%) had polyclonal increases in serum immunoglobulin; while in three (5.8%) immunoglobulin concentrations were decreased. The distribution of immunoglobulin abnormalities among the five myelodysplastic syndrome subtypes was fairly uniform. Results of direct Coombs test were negative in all cases. Organ specific antibodies were not detected in any of the patients tested, although two patients were found positive for antinuclear antibodies. The presence of immunoglobulin abnormalities indicates an involvement of the lymphoplasmatic system in myelodysplastic syndromes. PMID:3928701

Economopoulos, T; Economidou, J; Giannopoulos, G; Terzoglou, C; Papageorgiou, E; Dervenoulas, J; Arseni, P; Hadjioannou, J; Raptis, S

1985-01-01

333

Immune abnormalities in myelodysplastic syndromes.  

PubMed

The immune states of 52 patients with myelodysplastic syndromes classified according to the FAB criteria were studied. Serum electrophoresis and immunoelectrophoresis, direct Coombs test, and tests for organ and non-organ specific antibodies were performed. Twenty six patients had immunoglobulin abnormalities: six (11.5%) had monoclonal gammopathy; 17 (32.6%) had polyclonal increases in serum immunoglobulin; while in three (5.8%) immunoglobulin concentrations were decreased. The distribution of immunoglobulin abnormalities among the five myelodysplastic syndrome subtypes was fairly uniform. Results of direct Coombs test were negative in all cases. Organ specific antibodies were not detected in any of the patients tested, although two patients were found positive for antinuclear antibodies. The presence of immunoglobulin abnormalities indicates an involvement of the lymphoplasmatic system in myelodysplastic syndromes. PMID:3928701

Economopoulos, T; Economidou, J; Giannopoulos, G; Terzoglou, C; Papageorgiou, E; Dervenoulas, J; Arseni, P; Hadjioannou, J; Raptis, S

1985-08-01

334

High frequency ultrasound torturer.  

PubMed

The discernible aim of torture as everyone believes--and rightly so--is to destroy the personality of an individual in a way that would render his compliance in future. But to destroy a personality is easier said than done. It requires long sessions of detention and torture. The torturers risk themselves getting exposed. The Human Rights groups are active all around the world. Ultimately the personality may not be destroyed much to the chagrin of the torturers, and an unexpected resilient rebounding may take place. Therefore, with the repertoire of modern knowledge, the strategy may well change in the 21st century. Discreet methods may be employed to selectively destroy areas in brain by high dosage and high frequency ultrasound. It is completely a non-invasive technique that does not leave its fingerprint for painful, later denials of subornation. Nevertheless the personality will change--from rightful aggression to slavish submission. The aim of this article is to put forward the theoretical perspective and cofounded projection of the darker and menacing side of ultrasound technology so that future generation could be saved from sin of omission. PMID:20509473

Husain, Munawwar; Rizvi, Shameem Jahan; Usmani, Javed Ahmad

2009-12-01

335

Principles of Cerebral Ultrasound Contrast Imaging  

Microsoft Academic Search

Ultrasound contrast is gaining acceptance worldwide as an adjunct to conventional ultrasound imaging. It has clinical applications as diverse as liver disease detection and characterization, myocardial perfusion and wall motion studies, and cerebral vascularity and perfusion imaging. This paper will focus on imaging techniques used for transcranial ultrasound contrast imaging. The interaction of ultrasound with the microbubbles in the contrast

Jeff Powers; Michalakis Averkiou; Matthew Bruce

2009-01-01

336

Determining Directions of Ultrasound in Solids  

NASA Technical Reports Server (NTRS)

Ultrasound shadows cast by grooves. Improved method for determining direction of ultrasound in materials is shadow method using Scanning laser acoustic microscopy (SLAM). Direction of ultrasound calculated from dimensions of groove and portion of surface groove shields from ultrasound. Method has variety of applications in nontraditional quality-control applications.

Generazio, Edward R.; Roth, Don J.

1987-01-01

337

Abnormal Psychology, Spring 2008 1 Psychology 350  

E-print Network

Abnormal Psychology, Spring 2008 1 Psychology 350 Abnormal Psychology Spring 2008 N-101 Tuesdays 4 psychology. By the end of the semester, students will be able to: · Discuss extant models of abnormal in Foundation II.B., Social and Behavioral Sciences required." #12;Abnormal Psychology, Spring 2008 2 Course

Gallo, Linda C.

338

Impairment of cardiac function and energetics in experimental renal failure.  

PubMed Central

Cardiac function and energetics in experimental renal failure in the rat (5/6 nephrectomy) have been investigated by means of an isolated perfused working heart preparation and an isometric Langendorff preparation using 31P nuclear magnetic resonance (31P NMR). 4 wk after nephrectomy cardiac output of isolated hearts perfused with Krebs-Henseleit buffer was significantly lower (P < 0.0001) at all levels of preload and afterload in the renal failure groups than in the pair-fed sham operated control group. In control hearts, cardiac output increased with increases in perfusate calcium from 0.73 to 5.61 mmol/liter whereas uremic hearts failed in high calcium perfusate. Collection of 31P NMR spectra from hearts of renal failure and control animals during 30 min normoxic Langendorff perfusion showed that basal phosphocreatine was reduced by 32% to 4.7 mumol/g wet wt (P < 0.01) and the phosphocreatine to ATP ratio was reduced by 32% (P < 0.01) in uremic hearts. During low flow ischemia, there was a substantial decrease in phosphocreatine in the uremic hearts and an accompanying marked increase in release of inosine into the coronary effluent (14.9 vs 6.1 microM, P < 0.01). We conclude that cardiac function is impaired in experimental renal failure, in association with abnormal cardiac energetics and increased susceptibility to ischemic damage. Disordered myocardial calcium utilization may contribute to these derangements. PMID:8254048

Raine, A E; Seymour, A M; Roberts, A F; Radda, G K; Ledingham, J G

1993-01-01

339

IRF8 suppresses pathological cardiac remodelling by inhibiting calcineurin signalling  

PubMed Central

Interferon regulatory factor 8 (IRF8) is known to affect the innate immune response, for example, by regulating the differentiation and function of immune cells. However, whether IRF8 can influence cardiac hypertrophy is unknown. Here we show that IRF8 levels are decreased in human dilated/hypertrophic cardiomyopathic hearts and in murine hypertrophic hearts. Mice overexpressing Irf8 specifically in the heart are resistant to aortic banding (AB)-induced cardiac hypertrophy, whereas mice lacking IRF8 either globally or specifically in cardiomyocytes develop an aggravated phenotype induced by pressure overload. Mechanistically, we show that IRF8 directly interacts with NFATc1 to prevent NFATc1 translocation and thus inhibits the hypertrophic response. Inhibition of NFATc1 ameliorates the cardiac abnormalities in IRF8?/? mice after AB. In contrast, constitutive activation of NFATc1 nullifies the protective effects of IRF8 on cardiac hypertrophy in IRF8-overexpressing mice. Our results indicate that IRF8 is a potential therapeutic target in pathological cardiac hypertrophy. PMID:24526256

Jiang, Ding-Sheng; Wei, Xiang; Zhang, Xiao-Fei; Liu, Yu; Zhang, Yan; Chen, Ke; Gao, Lu; Zhou, Heng; Zhu, Xue-Hai; Liu, Peter P.; Bond Lau, Wayne; Ma, Xinliang; Zou, Yunzeng; Zhang, Xiao-Dong; Fan, Guo-Chang; Li, Hongliang

2014-01-01

340

Overcoming biological barriers with ultrasound  

NASA Astrophysics Data System (ADS)

Effect of ultrasound on the permeability of blood vessels and cell membranes to macromolecules and nanodroplets was investigated using mouse carotid arteries and tumor cells. Model macromolecular drug, FITC-dextran with molecular weight of 70,000 Da was used in experiments with carotid arteries. The effect of unfocused 1-MHz ultrasound and and perfluoro-15-crown-5-ether nanodroplets stabilized with the poly(ethylene oxide)-co-poly(D, L-lactide) block copolymer shells was studied. In cell culture experiments, ovarian carcinoma cells and Doxorubicin (DOX) loaded poly(ethylene oxide)-co-polycaprolactone nanodroplets were used. The data showed that the application of ultrasound resulted in permeabilization of all biological barriers tested. Under the action of ultrasound, not only FITC-dextran but also nanodroplets effectively penetrated through the arterial wall; the effect of continuous wave ultrasound was stronger than that of pulsed ultrasound. In cell culture experiments, ultrasound triggered DOX penetration into cell nuclei, presumably due to releasing the drug from the carrier. Detailed mechanisms of the observed effects require further study.

Thakkar, Dhaval; Gupta, Roohi; Mohan, Praveena; Monson, Kenneth; Rapoport, Natalya

2012-10-01

341

Computerized Ultrasound Risk Evaluation (CURE) System: Development of Combined Transmission and Reflection Ultrasound with New Reconstruction Algorithms for Breast Imaging  

SciTech Connect

Our Computerized Ultrasound Risk Evaluation (CURE) system has been developed to the engineering prototype stage and generated unique data sets of both transmission and reflection ultrasound (US). This paper will help define the clinical underpinnings of the developmental process and interpret the imaging results from a similar perspective. The CURE project was designed to incorporate numerous diagnostic parameters to improve upon two major areas of early breast cancer detection. CURE may provide improved tissue characterization of breast masses and reliable detection of abnormal microcalcifications found in some breast cancers and ductal carcinoma in situ (DCIS). Current breast US is limited to mass evaluation, whereas mammography also detects and guides biopsy of malignant calcifications. Screening with CURE remains a distant goal, but improved follow-up of mammographic abnormalities may represent a feasible breakthrough. Improved tissue characterization could result in reduction of the estimated one million benign biopsies each year in the United States, costing up to several billion dollars. Most breast calcifications are benign and comprise-80% of stereotactic biopsies guided by mammography. Ultrasound has the capability of finding some groups of calcifications, but further improvements in resolution should also address tissue characterization to define the soft tissue filling of ducts by DCIS. In this manner, CURE may be able to more accurately identify the malignant calcifications associated with progression of DCIS or early cancers. Currently, high-resolution US images of the breast are performed in the reflection mode at higher frequencies, which also limits depth of penetration. Reconstruction of reflection ultrasound images relies upon acoustic impedance differences in the tissue and includes only direct backscatter of the ultrasound signal. Resolution and tissue contrast of current US continues to improve with denser transducer arrays and image processing, but the operator dependent nature of using a moveable transducer head remains a significant problem for thorough coverage of the entire breast. We have therefore undertaken the development of a whole breast (i.e., including auxiliary tail) system, with improved resolution and tissue characterization abilities. The extensive ultrasound physics considerations, engineering, materials process development and subsequent algorithm reconstruction are beyond the scope of this initial paper. The proprietary nature of these processes will be forthcoming as the intellectual property is fully secured. We will focus here on the imaging outcomes as they apply to eventual expansion into clinical use.

Littrup, P J; Duric, N; Azevedo, S; Chambers, D; Candy, J V; Johnson, S; Auner, G; Rather, J; Holsapple, E T

2001-09-07

342

Safety Assurance in Obstetrical Ultrasound  

PubMed Central

Safety assurance for diagnostic ultrasound in obstetrics began with a tacit assumption of safety allowed by a federal law enacted in 1976 for then-existing medical ultrasound equipment. The implementation of the 510(k) pre-market approval process for diagnostic ultrasound resulted in the establishment of guideline upper limits for several examination categories in 1985. The obstetrical category has undergone substantial evolution from initial limits (I. e., 46 mW/cm2 spatial peak temporal average (SPTA) intensity) set in 1985. Thermal and mechanical exposure indices, which are displayed on-screen according to an Output Display Standard (ODS), were developed for safety assurance with relaxed upper limits. In 1992, with the adoption of the ODS, the allowable output for obstetrical ultrasound was increased both in terms of the average exposure (e. g. to a possible 720 mW/cm2 SPTA intensity) and of the peak exposure (via the Mechanical Index). There has been little or no subsequent research with the modern obstetrical ultrasound machines to systematically assess potential risks to the fetus using either relevant animal models of obstetrical exposure or human epidemiology studies. The assurance of safety for obstetrical ultrasound therefore is supported by three ongoing means: (I) review of a substantial but uncoordinated bioeffect research literature, (ii) the theoretical evaluation of diagnostic ultrasound exposure in terms of thermal and nonthermal mechanisms for bioeffects, and (iii) the skill and knowledge of professional sonographers. At this time, there is no specific reason to suspect that there is any significant health risk to the fetus or mother from exposure to diagnostic ultrasound in obstetrics. This assurance of safety supports the prudent use of diagnostic ultrasound in obstetrics by trained professionals for any medically indicated examination. PMID:18450141

Miller, Douglas L

2008-01-01

343

Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study.  

PubMed

Background: The mechanisms associated with the cardiovascular consequences of obstructive sleep apnea include abrupt changes in autonomic tone, which can trigger cardiac arrhythmias. The authors hypothesized that nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea. Objective: To analyze the relationship between obstructive sleep apnea and abnormal heart rhythm during sleep in a population sample. Methods: Cross-sectional study with 1,101 volunteers, who form a representative sample of the city of São Paulo. The overnight polysomnography was performed using an EMBLA® S7000 digital system during the regular sleep schedule of the individual. The electrocardiogram channel was extracted, duplicated, and then analyzed using a Holter (Cardio Smart®) system. Results: A total of 767 participants (461 men) with a mean age of 42.00 ± 0.53 years, were included in the analysis. At least one type of nocturnal cardiac rhythm disturbance (atrial/ventricular arrhythmia or beat) was observed in 62.7% of the sample. The occurrence of nocturnal cardiac arrhythmias was more frequent with increased disease severity. Rhythm disturbance was observed in 53.3% of the sample without breathing sleep disorders, whereas 92.3% of patients with severe obstructive sleep apnea showed cardiac arrhythmia. Isolated atrial and ventricular ectopy was more frequent in patients with moderate/severe obstructive sleep apnea when compared to controls (p < 0.001). After controlling for potential confounding factors, age, sex and apnea-hypopnea index were associated with nocturnal cardiac arrhythmia. Conclusion: Nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea and the prevalence increases with disease severity. Age, sex, and the Apnea-hypopnea index were predictors of arrhythmia in this sample. PMID:25252161

Cintra, Fatima Dumas; Leite, Renata Pimentel; Storti, Luciana Julio; Bittencourt, Lia Azeredo; Poyares, Dalva; Castro, Laura de Siqueira; Tufik, Sergio; Paola, Angelo de

2014-11-01

344

Detection rates of clinically significant genomic alterations by microarray analysis for specific anomalies detected by ultrasound  

PubMed Central

Objective The aim of this study is to understand the diagnostic utility of comparative genomic hybridization (CGH)-based microarrays for pregnancies with abnormal ultrasound findings. Methods We performed a retrospective analysis of 2858 pregnancies with abnormal ultrasounds and normal karyotypes (when performed) tested in our laboratory using CGH microarrays targeted to known chromosomal syndromes with later versions providing backbone coverage of the entire genome. Abnormalities were stratified according to organ system involvement. Detection rates for clinically significant findings among these categories were calculated. Results Clinically significant genomic alterations were identified in cases with a single ultrasound anomaly (n = 99/1773, 5.6%), anomalies in two or more organ systems (n = 77/808, 9.5%), isolated growth abnormalities (n = 2/76, 2.6%), and soft markers (n = 2/77, 2.6%). The following anomalies in isolation or with additional anomalies had particularly high detection rates: holoprosencephaly (n = 9/85, 10.6%), posterior fossa defects (n = 21/144, 14.6%), skeletal anomalies (n = 15/140, 10.7%), ventricular septal defect (n = 14/132, 10.6%), hypoplastic left heart (n = 11/68, 16.2%), and cleft lip/palate (n = 14/136, 10.3%). Conclusions Microarray analysis identified clinically significant genomic alterations in 6.5% of cases with one or more abnormal ultrasound findings; the majority were below the resolution of karyotyping. Larger data sets such as this allow for sub-stratification by specific anomalies to determine risks for genomic alterations detectable by microarray analysis. © 2012 John Wiley & Sons, Ltd. PMID:22847778

Shaffer, Lisa G; Rosenfeld, Jill A; Dabell, Mindy P; Coppinger, Justine; Bandholz, Anne M; Ellison, Jay W; Ravnan, J Britt; Torchia, Beth S; Ballif, Blake C; Fisher, Allan J

2012-01-01

345

Melatonin and cardiac pathophysiology  

Microsoft Academic Search

Melatonin, an indole produced in several organs but most notably in the pineal gland, has a variety of effects that influence cardiac pathophysiology. Herein, we summarize the findings that illustrate the ability of melatonin to attenuate the severity of hypertension, limit myocardial damage, improve the function of the ischemic-reperfused heart, protect the heart from the toxicity of anthracycline drugs and

Russel J. Reiter; Dun X. Tan

346

Cardiac fibroma in adults.  

PubMed

We present the case of a 61-year-old woman with nonspecific symptoms who on investigation and treatment had a fibroma of the right ventricular free wall. She underwent surgical resection of the mass and is doing well. The literature pertaining to cardiac fibromas in adults is reviewed and discussed. PMID:20934889

Nwachukwu, Harriet; Li, Alice; Nair, Vidhya; Nguyen, Elsie; David, Tirone E; Butany, Jagdish

2011-01-01

347

Cardiac function monitoring system  

Microsoft Academic Search

An IBM-PC controlled system has been developed to evaluate the cardiac function in the catheterization room. The system uses a multielectrode impedancimetric catheter to compute the instantaneous left intraventricular heart volume, through specially developed algorithms and calibration procedures, and a catheter tip micromanometer to measure the instantaneous left intraventricular pressure. With these two variables, and after a preload maneuver, the

J. C. Spinelli; M. C. Herrera

1988-01-01

348

[A boy with nail abnormalities].  

PubMed

A 12-year-old boy consulted the dermatologist for nail abnormalities. Three weeks earlier, he was treated with doxycycline 100 mg BID for 10 days because of erythema chronicum migrans. Following sun exposure, the patient had developed distal onycholysis surrounded by a hyperpigmented zone. He was diagnosed with doxycycline-induced photo-onycholysis. PMID:23838405

Atiq, Nasirah; van Meurs, Tim

2013-01-01

349

Ethical Issues in Cardiac Surgery  

PubMed Central

While ethical behavior has always been part of cardiac surgical practice, ethical deliberation has only recently become an important component of cardiac surgical practice. Issues such as informed consent, conflict of interest, and professional self-regulation, among many others, have increasingly attracted the attention of cardiac surgeons. This review covers several broad topics of interest to cardiac surgeons and cardiologists, and treats several other topics more briefly. There is much uncertainty about what the future holds for cardiac surgical practice, research, and culture, and we discuss the background of ethical issues to serve as a platform for envisioning what is to come. PMID:22642634

Kavarana, Minoo N.; Sade, Robert M.

2012-01-01

350

An unusual cause for a relatively common radiographic abnormality.  

PubMed

A 59-year-old Indian woman presented to the respiratory clinic with chest pains, long-standing swallowing difficulties and a chest radiograph, which was reported as showing a shadow in the right paratracheal region. A CT scan was obtained and was reported as demonstrating a right-sided paratracheal lymph node and varicosities adjacent to the inferior vena cava. Histology from an endobronchial ultrasound-guided biopsy revealed a heavily blood-stained sample but showed no evidence of granulomas or malignancy. Subsequently, the images were reviewed, with the conclusion that they were actually of an engorged azygos vein compressing the oesophagus. MRI confirmed the absence of mediastinal lymphadenopathy and the presence of a prominent hemiazygos vein compressing the oesophagus. This case highlights the importance of including anatomical abnormalities in the differential diagnosis and reassessing patients when the history and investigations do not correlate. PMID:25540206

Odedra, Anand; Farrugia, Mark; Babiker, Zahir

2014-01-01

351

Bench-to-bedside review: Mechanisms of critical illness – classifying microcirculatory flow abnormalities in distributive shock  

Microsoft Academic Search

Over 30 years ago Weil and Shubin proposed a re-classification of shock states and identified hypovolemic, cardiogenic, obstructive\\u000a and distributive shock. The first three categories have in common that they are associated with a fall in cardiac output.\\u000a Distributive shock, such as occurs during sepsis and septic shock, however, is associated with an abnormal distribution of\\u000a microvascular blood flow and

Paul WG Elbers; Can Ince

2006-01-01

352

Hypomelanosis of Ito with an unusual pulmonary abnormality in an infant  

PubMed Central

Hypomelanosis of Ito (HI) is a neurocutaneous syndrome characterized by hypopigmented cutaneous lesions and extracutaneous manifestations frequently affecting the nervous system and the musculoskeletal system. Dysmorphic features, dental, ophthalmic, gastrointestinal, cardiac, and renal abnormalities are described in a minority of patients. The authors describe a 4-month-old infant having HI with unusual pulmonary hypoplasia that has not been reported so far. PMID:24860762

Bhat, Ramesh Y.; Patra, Saikat; Varma, P.V. Chaitanya; Prakashini, K.

2014-01-01

353

Ultrasound in placental disorders.  

PubMed

The definition of placenta previa based on ultrasound findings is more practical, and the traditional definition (implantation of the placenta in the lower uterine segment) needs to be revised. The term 'placenta previa' should only be used when the placental edge overlaps or is within 2 cm of the internal cervical orifice in late pregnancy. If the placental edge is located further than 2 cm but within 3.5 cm from the internal cervical orifice, the placenta should be termed 'low-lying'. Unless the placental edge at least reaches the internal orifice at mid-trimester, symptomatic placenta previa in the third trimester will not be encountered. Caesarean section is the recommended mode of delivery for placenta previa at term. Attempt at vaginal delivery is appropriate for low-lying placenta, but the possibility of post-partum haemorrhage should be kept in mind. The incidence of invasive placentation, such as placenta accrete, has progressively risen in the past 3 decades, possibly as a consequence of increasing caesarean section rates. Ultrasound has a sensitivity of 91% and a specificity of 97% for the identification of all forms of invasive placentation. Chorioangiomas are benign non-trophoblastic placental tumours with excessive vascular proliferation within the stroma of chronic villi. They are usually asymptomatic, although occasionally can be associated with adverse fetal outcomes. Chorioangiomas usually appear as well-circumscribed, rounded, hypo-echoic lesions next to the chorionic surface. Iatrogenic delivery or prenatal intervention are two options, if fetal compromise is present. Prenatal detection leads to a dramatic increase in survival compared with those cases unsuspected antenatally. PMID:24461676

D'Antonio, Francesco; Bhide, Amar

2014-04-01

354

Long-term cardiac sequelae after treatment of malignant tumors with radiotherapy or cytostatics in childhood  

SciTech Connect

A series of 41 individuals were restudied after childhood cancer with a median follow-up time of 17 years after chest irradiation or treatment with cyclophosphamide or Adriamycin (doxorubicin). Radiotherapy of the chest had been used in 21 patients, and in 13 of these irradiation was also directed at the heart. Thirty-five patients received cyclophosphamide and five received Adriamycin therapy. All patients were investigated by a pediatric cardiologist. Investigations included an electrocardiogram (ECG), a chest radiographic film, an echocardiogram, an exercise test, and a 24-hour ECG. Altogether 20 patients (49%) showed some abnormality in cardiac tests. Each additional year of follow-up was associated with a 1.3-fold (95% confidence limits, 1.04-1.66; P less than 0.05) increase in the risk for pathologic cardiac findings. The risk for an abnormal cardiac test result in the 13 patients who had received cardiac irradiation was 12.8-fold (95% confidence limits, 1.8-90.8; P less than 0.02) that of the other patients. However, abnormalities in cardiac function were mild.

Maekinen, L.M.; Maekipernaa, A.R.; Rautonen, J.; Heino, M.; Pyrhoenen, S.L.; Laitinen, L.A.; Siimes, M.A. (Univ. of Helsinki Medical School (Finland))

1990-05-01

355

Fetal and umbilical Doppler ultrasound in high-risk pregnancies  

PubMed Central

Background Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible false positive Doppler ultrasound findings could encourage inappropriate early delivery. Objectives The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (September 2009) and the reference lists of identified studies. Selection criteria Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared to no Doppler ultrasound. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. Main results Eighteen completed studies involving just over 10,000 women were included. The trials were generally of unclear quality with some evidence of possible publication bias. The use of Doppler ultrasound in high-risk pregnancy was associated a reduction in perinatal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.52 to 0.98, 16 studies, 10,225 babies, 1.2% versus 1.7 %, numbers needed to treat = 203; 95%CI 103 to 4352). There were also fewer inductions of labour (average RR 0.89, 95% CI 0.80 to 0.99, 10 studies, 5633 women, random effects) and fewer caesarean sections (RR 0.90, 95% CI 0.84 to 0.97, 14 studies, 7918 women). No difference was found in operative vaginal births (RR 0.95, 95% CI 0.80 to 1.14, four studies, 2813 women) nor in Apgar scores less than seven at five minutes (RR 0.92, 95% CI 0.69 to 1.24, seven studies, 6321 babies). Authors’ conclusions Current evidence suggests that the use of Doppler ultrasound in high-risk pregnancies reduced the risk of perinatal deaths and resulted in less obstetric interventions. The quality of the current evidence was not of high quality, therefore, the results should be interpreted with some caution. Studies of high quality with follow-up studies on neurological development are needed. PMID:20091637

Alfirevic, Zarko; Stampalija, Tamara; Gyte, Gillian ML

2014-01-01

356

TWO CONSECUTIVE SETS OF TRANSRECTAL ULTRASOUND GUIDED SEXTANT BIOPSIES OF THE PROSTATE FOR THE DETECTION OF PROSTATE CANCER  

Microsoft Academic Search

PurposeWe investigated the role of performing 2 consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate in a single office visit as the protocol for detecting prostate cancer in men presenting for the first time with an abnormal digital rectal examination and\\/or elevated serum prostate specific antigen (PSA).

Michael A. Levine; Michael Ittman; Jonathan Melamed; Herbert Lepor

1998-01-01

357

Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS): a randomised controlled trial  

Microsoft Academic Search

BACKGROUND: Coronary Heart Disease and Cerebrovascular Disease share many predisposing, modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity and diabetes mellitus). Lifestyle interventions and pharmacological therapy are recognised as the cornerstones of secondary prevention. Cochrane review has proven the benefits of programmes incorporating exercise and lifestyle counselling in the cardiac disease population. A Cochrane

Olive Lennon; Catherine Blake

2009-01-01

358

Deferoxamine Improves Early Postresuscitation Reperfusion After Prolonged Cardiac Arrest in Rats  

Microsoft Academic Search

Summary: The no-reflow phenomenon and delayed hypoper- fusion after transient cardiac arrest (CA) impede postischemic recovery. Activation of lipid peroxidation (LPO) after ischemia and reperfusion is considered one of the mechanisms respon- sible for such abnormalities. The present study investigates the influence of iron-dependent LPO inhibitor deferoxamine (DFO) on the cerebral perfusion after prolonged CA and re- suscitation. Fourteen male

Serguei Liachenko; Pei Tang; Yan Xu

359

CARDIAC MOTION AND MATERIAL PROPERTIES ANALYSIS USING DATA CONFIDENCE WEIGHTED EXTENDED KALMAN FILTER FRAMEWORK  

E-print Network

of kinematic and mechanics abnormalities of the left ventricle (LV) [1]. Efforts using optimal filtering]. The key to our analysis framework is that stochastic differential equations of LV dynamics are com- binedCARDIAC MOTION AND MATERIAL PROPERTIES ANALYSIS USING DATA CONFIDENCE WEIGHTED EXTENDED KALMAN

Shi, Pengcheng

360

Trkb signaling in pericytes is required for cardiac microvessel stabilization.  

PubMed

Pericyte and vascular smooth muscle cell (SMC) recruitment to the developing vasculature is an important step in blood vessel maturation. Brain-derived neurotrophic factor (BDNF), expressed by endothelial cells, activates the receptor tyrosine kinase TrkB to stabilize the cardiac microvasculature in the perinatal period. However, the effects of the BDNF/TrkB signaling on pericytes/SMCs and the mechanisms downstream of TrkB that promote vessel maturation are unknown. To confirm the involvement of TrkB in vessel maturation, we evaluated TrkB deficient (trkb (-/-)) embryos and observed severe cardiac vascular abnormalities leading to lethality in late gestation to early prenatal life. Ultrastructural analysis demonstrates that trkb(-/-) embryos exhibit defects in endothelial cell integrity and perivascular edema. As TrkB is selectively expressed by pericytes and SMCs in the developing cardiac vasculature, we generated mice deficient in TrkB in these cells. Mice with TrkB deficiency in perivascular cells exhibit reduced pericyte/SMC coverage of the cardiac microvasculature, abnormal endothelial cell ultrastructure, and increased vascular permeability. To dissect biological actions and the signaling pathways downstream of TrkB in pericytes/SMCs, human umbilical SMCs were treated with BDNF. This induced membranous protrusions and cell migration, events dependent on myosin light chain phosphorylation. Moreover, inhibition of Rho GTPase and the Rho-associated protein kinase (ROCK) prevented membrane protrusion and myosin light chain phosphorylation in response to BDNF. These results suggest an important role for BDNF in regulating migration of TrkB-expressing pericytes/SMCs to promote cardiac blood vessel ensheathment and functional integrity during development. PMID:24498100

Anastasia, Agustin; Deinhardt, Katrin; Wang, Shiyang; Martin, Laura; Nichol, Donna; Irmady, Krithi; Trinh, Jasmine; Parada, Luis; Rafii, Shahin; Hempstead, Barbara L; Kermani, Pouneh

2014-01-01

361

Ultrasound-modulated bioluminescence tomography  

NASA Astrophysics Data System (ADS)

We propose a method to reconstruct the density of a luminescent source in a highly scattering medium from ultrasound-modulated optical measurements. Our approach is based on the solution to a hybrid inverse source problem for the diffusion equation.

Bal, Guillaume; Schotland, John C.

2014-03-01

362

Crystallization of glycine with ultrasound.  

PubMed

Sonocrystallization has proved to be an efficient tool to influence the external appearance and structure of a crystalline product obtained by various crystallization methods. The present work focuses on high intensity sonocrystallization of glycine by varying amplitude of ultrasound with an ultrasound frequency of 20kHz at two temperature ranges 40-50 and 20-30 degrees C in a jacketed 250-ml cooling crystallizer equipped with a stirrer. The polymorph composition of the obtained crystals was analyzed with a temperature variable X-ray powder diffractometer (XRPD). XRPD results showed that, besides the operating temperature, the glycine polymorphism was affected also by insonation. This was especially the case at the lower temperature range. Furthermore, based on the heat balance within the crystallizer, an increase in required cooling capacity was presented as a function of increasing ultrasound power. This study also showed, the higher the ultrasound amplitude the smaller the crystals obtained. PMID:16759826

Louhi-Kultanen, Marjatta; Karjalainen, Milja; Rantanen, Jukka; Huhtanen, Mikko; Kallas, Juha

2006-08-31

363

The Reveal LINQ insertable cardiac monitor.  

PubMed

Insertable cardiac monitors (ICMs) are leadless subcutaneous devices that continuously monitor the heart rhythm and record events over a timeframe measured in years, allowing for the diagnosis of infrequent rhythm abnormalities that can be the cause of palpitations, syncope and stroke. To date, ICMs have primarily been used in the work-up and management of syncope; however, their use in other areas of rhythm evaluation, particularly atrial fibrillation monitoring, is increasing. The Reveal LINQ™ is the smallest and most versatile ICM available and represents a dramatic leap forward in ICM technology that has the potential to transform patient care in a number of circumstances. Device miniaturization, simplified implant procedure and enhanced automation vastly increase physician and patient acceptance. The next 5 years can be expected to bring a greatly increased use of ICMs for disease diagnosis and management in a variety of clinical settings. PMID:25154970

Tomson, Todd T; Passman, Rod

2015-01-01

364

Fourier-domain beamforming: the path to compressed ultrasound imaging.  

PubMed

Sonography techniques use multiple transducer elements for tissue visualization. Signals received at each element are sampled before digital beamforming. The sampling rates required to perform high-resolution digital beamforming are significantly higher than the Nyquist rate of the signal and result in considerable amount of data that must be stored and processed. A recently developed technique, compressed beamforming, based on the finite rate of innovation model, compressed sensing (CS), and Xampling ideas, allows a reduction in the number of samples needed to reconstruct an image comprised of strong reflectors. A drawback of this method is its inability to treat speckle, which is of significant importance in medical imaging. Here, we build on previous work and extend it to a general concept of beamforming in frequency. This allows exploitation of the low bandwidth of the ultrasound signal and bypassing of the oversampling dictated by digital implementation of beamforming in time. By using beamforming in frequency, the same image quality is obtained from far fewer samples. We next present a CS technique that allows for further rate reduction, using only a portion of the beamformed signal's bandwidth. We demonstrate our methods on in vivo cardiac data and show that reductions up to 1/28 of the standard beamforming rates are possible. Finally, we present an implementation on an ultrasound machine using sub-Nyquist sampling and processing. Our results prove that the concept of sub-Nyquist processing is feasible for medical ultrasound, leading to the potential of considerable reduction in future ultrasound machines' size, power consumption, and cost. PMID:25073133

Chernyakova, Tanya; Eldar, Yonina

2014-08-01

365

Clinical course and medical management of neonates with severe cardiac failure related to vein of Galen malformation  

PubMed Central

Background: Neonatal presentation of vein of Galen aneurysmal malformations (VGAMs) with intractable cardiac failure is considered a poor prognostic sign. Interventional neuroradiology with embolisation has been shown to control cardiac failure, but there is a perception that neurological outcome in survivors is poor. Objective: To determine if aggressive intensive care and anaesthetic management of cardiac failure before urgent embolisation can influence morbidity and mortality. Patients: Nine newborns (four boys, five girls) were diagnosed with symptomatic vein of Galen malformations in the neonatal period during the period 1996–2001. Eight developed intractable high output cardiac failure requiring initial endovascular treatment in the first week of life. Results: The immediate outcome after a series of endovascular procedures was control of cardiac failure and normal neurological function in six (66%) patients, one death from intractable cardiac failure in the neonatal period, and two late deaths with severe hypoxic-ischaemic neurological injury (33% mortality). Clinical review at 6 months to 4 years of age showed five infants with no evidence of neurological abnormality or cardiac failure and one child with mild developmental delay (11%). Conclusions: Aggressive medical treatment of cardiac failure and early neurointervention combined with modern neuroanaesthetic care results in good survival rates with low morbidity even in cases of high risk VGAM presenting in the immediate perinatal period with cardiac failure. Systemic arterial vasodilators improve outcome in neonates with cardiac failure secondary to VGAM. Excessive ß adrenergic stimulation induced by conventional inotropic agents may exacerbate systemic hypoperfusion. PMID:12193525

Frawley, G; Dargaville, P; Mitchell, P; Tress, B; Loughnan, P

2002-01-01

366

The Welsh study of mothers and babies: protocol for a population-based cohort study to investigate the clinical significance of defined ultrasound findings of uncertain significance  

PubMed Central

Background Improvement in ultrasound imaging has led to the identification of subtle non-structural markers during the 18 – 20 week fetal anomaly scan, such as echogenic bowel, mild cerebral ventriculomegaly, renal pelvicalyceal dilatation, and nuchal thickening. These markers are estimated to occur in between 0.6% and 4.3% of pregnancies. Their clinical significance, for pregnancy outcomes or childhood morbidity, is largely unknown. The aim of this study is to estimate the prevalence of seven markers in the general obstetric population and establish a cohort of children for longer terms follow-up to assess the clinical significance of these markers. Methods/Design All women receiving antenatal care within six of seven Welsh Health Boards who had an 18 to 20 week ultrasound scan in Welsh NHS Trusts between July 2008 and March 2011 were eligible for inclusion. Data were collected on seven markers (echogenic bowel, cerebral ventriculomegaly, renal pelvicalyceal dilatation, nuchal thickening, cardiac echogenic foci, choroid plexus cysts, and short femur) at the time of 18 – 20 week fetal anomaly scan. Ultrasound records were linked to routinely collected data on pregnancy outcomes (work completed during 2012 and 2013). Images were stored and reviewed by an expert panel. The prevalence of each marker (reported and validated) will be estimated. A projected sample size of 23,000 will allow the prevalence of each marker to be estimated with the following precision: a marker with 0.50% prevalence to within 0.10%; a marker with 1.00% prevalence to within 0.13%; and a marker with 4.50% prevalence to within 0.27%. The relative risk of major congenital abnormalities, stillbirths, pre-term birth and small for gestational age, given the presence of a validated marker, will be reported. Discussion This is a large, prospective study designed to estimate the prevalence of markers in a population-based cohort of pregnant women and to investigate associations with adverse pregnancy outcomes. The study will also establish a cohort of children that can be followed-up to explore associations between specific markers and longer-term health and social outcomes. PMID:24884594

2014-01-01

367

Ultrasound Screening for Abdominal Aortic Aneurysm  

PubMed Central

Executive Summary Objective The aim of this review was to assess the effectiveness of ultrasound screening for asymptomatic abdominal aortic aneurysm (AAA). Clinical Need Abdominal aortic aneurysm is a localized abnormal dilatation of the aorta greater than 3 cm. In community surveys, the prevalence of AAA is reported to be between 2% and 5.4%. Abdominal aortic aneurysms are found in 4% to 8% of older men and in 0.5% to 1.5% of women aged 65 years and older. Abdominal aortic aneurysms are largely asymptomatic. If left untreated, the continuing extension and thinning of the vessel wall may eventually result in rupture of the AAA. Often rupture may occur without warning, causing acute pain. Rupture is always life threatening and requires emergency surgical repair of the ruptured aorta. The risk of death from ruptured AAA is 80% to 90%. Over one-half of all deaths attributed to a ruptured aneurysm take place before the patient reaches hospital. In comparison, the rate of death in people undergoing elective surgery is 5% to 7%; however, symptoms of AAA rarely occur before rupture. Given that ultrasound can reliably visualize the aorta in 99% of the population, and its sensitivity and specificity for diagnosing AAA approaches 100%, screening for aneurysms is worth considering as it may reduce the incidence of ruptured aneurysms and hence reduce unnecessary deaths caused by AAA-attributable mortality. Review Strategy The Medical Advisory Secretariat used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases to determine the effectiveness of ultrasound screening for abdominal aortic aneurysms. Case reports, letters, editorials, nonsystematic reviews, non-human studies, and comments were excluded. Questions asked: Is population-based AAA screening effective in improving health outcomes in asymptomatic populations? Is AAA screening acceptable to the population? Does this affect the effectiveness the screening program? How often should population-based screening occur? What are appropriate treatment options after screening based on the size of aneurysms? Are there differences between universal and targeted screening strategies? What are the harms of screening? Summary of Findings Population-based ultrasound screening is effective in men aged 65 to 74 years, particularly in those with a history of smoking. Screening reduces the incidence of AAA ruptures, and decreases rates of emergency surgical repair for AAA and AAA-attributable mortality. Acceptance rates decline with increasing age and are lower for women. Low acceptance rates may affect the effectiveness of a screening program. A one-time screen is sufficient for a population-based screening program with regard to initial negative scans and development of large AAAs. There is no difference between early elective surgical repair and surveillance for small aneurysms (4.0–5.4 cm). Repeated surveillance of small aneurysms is recommended. Targeted screening based on history of smoking has been found to detect 89% of prevalent AAAs and increase the efficiency of screening programs from statistical modeling data. Women have not been studied for AAA screening programs. There is evidence suggesting that screening women for AAA should be considered with respect to mortality and case fatality rates in Ontario. It is important that further evaluation of AAAs in women occur. There is a small risk of physical harm from screening. Less than 1% of aneurysms will not be visualized on initial screen and a re-screen may be necessary; elective surgical repair is associated with a 6% operative morality rate and about 3% of small aneurysms may rupture during surveillance. These risks should be communicated through informed consent prior to screening. There is little evidence of severe psychological harms associated with screening. Conclusions Based on this review, the Medical Advisory Secretariat concluded that there is sufficient evidence to determine that AAA screening using ultrasound is effective

2006-01-01

368

RECONSTRUCTION OF COMPRESSIVELY SAMPLED ULTRASOUND IMAGES USING DUAL PRIOR INFORMATION  

E-print Network

distributions, medical ultrasound 1. INTRODUCTION Recent developments in medical ultrasound (US) imaging haveRECONSTRUCTION OF COMPRESSIVELY SAMPLED ULTRASOUND IMAGES USING DUAL PRIOR INFORMATION Alin Achim a new technique for compressive sampling reconstruction of biomedical ultrasound images that exploits

Tsakalides, Panagiotis

369

Using ultrasound to quantify tongue shape and movement characteristics.  

PubMed

Objective : Previous experimental studies have demonstrated abnormal lingual articulatory patterns characterizing cleft palate speech. Most articulatory information to date has been collected using electropalatography, which records the location and size of tongue-palate contact but not the tongue shape. The latter type of data can be provided by ultrasound. The present paper aims to describe ultrasound tongue imaging as a potential tool for quantitative analysis of tongue function in speakers with cleft palate. A description of the ultrasound technique as applied to analyzing tongue movements is given, followed by the requirements for quantitative analysis. Several measures are described, and example calculations are provided. Measures : Two measures aim to quantify overuse of tongue dorsum in cleft palate articulations. Crucially for potential clinical applications, these measures do not require head-to-transducer stabilization because both are based on a single tongue curve. The other three measures compare sets of tongue curves, with the aim to quantify the dynamics of tongue displacement, token-to-token variability in tongue position, and the extent of separation between tongue curves for different speech sounds. Conclusions : All measures can be used to compare tongue function in speakers with cleft palate before and after therapy, as well as to assess their performance against that in typical speakers and to help in selecting more effective treatments. PMID:22117937

Zharkova, Natalia

2013-01-01

370

Normal and abnormal skin color.  

PubMed

The varieties of normal skin color in humans range from people of "no color" (pale white) to "people of color" (light brown, dark brown, and black). Skin color is a blend resulting from the skin chromophores red (oxyhaemoglobin), blue (deoxygenated haemoglobin), yellow-orange (carotene, an exogenous pigment), and brown (melanin). Melanin, however, is the major component of skin color ; it is the presence or absence of melanin in the melanosomes in melanocytes and melanin in keratinocytes that is responsible for epidermal pigmentation, and the presence of melanin in macrophages or melanocytes in the dermis that is responsible for dermal pigmentation. Two groups of pigmentary disorders are commonly distinguished: the disorders of the quantitative and qualitative distribution of normal pigment and the abnormal presence of exogenous or endogenous pigments in the skin. The first group includes hyperpigmentations, which clinically manifest by darkening of the skin color, and leukodermia, which is characterized by lightening of the skin. Hypermelanosis corresponds to an overload of melanin or an abnormal distribution of melanin in the skin. Depending on the color, melanodermia (brown/black) and ceruloderma (blue/grey) are distinguished. Melanodermia correspond to epidermal hypermelanocytosis (an increased number of melanocytes) or epidermal hypermelanosis (an increase in the quantity of melanin in the epidermis with no modification of the number of melanocytes). Ceruloderma corresponds to dermal hypermelanocytosis (abnormal presence in the dermis of cells synthesizing melanins) ; leakage in the dermis of epidermal melanin also exists, a form of dermal hypermelanosis called pigmentary incontinence. Finally, dyschromia can be related to the abnormal presence in the skin of a pigment of exogenous or endogenous origin. PMID:23522626

Ortonne, J P

2012-12-01

371

Glutamatergic Neurotransmission Abnormalities and Schizophrenia  

Microsoft Academic Search

\\u000a Schizophrenia affects approximately 1% of the adult population worldwide and requires lifelong therapy. Hyperfunction of the\\u000a dopaminergic system has long been hypothesized as the underlying cause of schizophrenia. However, this hypothesis explains\\u000a mostly the positive symptoms associated with schizophrenia. Several lines of evidence point to the glutamatergic system and\\u000a suggest that abnormalities in this system may play a crucial role

Yogesh Dwivedi; Ghanshyam N. Pandey

372

Regional Pericarditis Status Post Cardiac Ablation: A Case Report  

PubMed Central

Context: Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction. Case report: A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient's presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine. Conclusion: This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation. PMID:25317395

Orme, Joseph; Eddin, Moneer; Loli, Akil

2014-01-01

373

Clinical and echographic features of in utero cardiac dysfunction in the recipient twin in twin-twin transfusion syndrome  

Microsoft Academic Search

OBJECTIVE--Fetal twin-twin transfusion syndrome (TTTS) presenting in the second trimester has been associated with almost no perinatal survival until recently, when serial drainage of amniotic fluid has improved the prognosis to 70%-80%. Most recipient twins now survive but develop cardiac dysfunction. The study was undertaken to evaluate the abnormal echocardiographic features and clinical complications of cardiac disease in the recipient

N Zosmer; R Bajoria; E Weiner; M Rigby; J Vaughan; N M Fisk

1994-01-01

374

Cardiac arrhythmogenesis and temperature.  

PubMed

Fast processes in cardiac electrophysiology are often studied at temperatures lower than physiological. Extrapolation of values is based on widely accepted Q10 (Arrhenius) model of temperature dependence (ratio of kinetic properties for a 10 degrees C change in temperature). In this study, we set out to quantify the temperature dependence of essential parameters that define spatiotemporal behavior of cardiac excitation. Additionally, we examined temperature's effects on restitution dynamics. We employed fast fluorescence imaging with voltage-and calcium-sensitive dyes in neonatal rat cardiomyocyte sheets. Conduction velocity (CV), calcium transient duration (CTD), action potential duration (APD) and wavelength (W=CV*duration) change as functions of temperature were quantified. Using 24 degrees C as a reference point, we found a strong temperature-driven increase of CV (Q10=2.3) with smaller CTD and APD changes (Q10=1.33, 1.24, respectively). The spatial equivalents of voltage and calcium duration, wavelength, were slightly less sensitive to temperature with Q10=2.05 and 1.78, respectively, due to the opposing influences of decreasing duration with increased velocity. More importantly, we found that Q10 varies as a function of diastolic interval. Our results indicate the importance of examining temperature sensitivity across several frequencies. Armed with our results, experimentalists and modelers alike have a tool for reconciling different environmental conditions. In a broader sense, these data help better understand thermal influences on arrhythmia development or suppression such as during hibernation or cardiac surgery. PMID:17946861

Shah, Ujas; Bien, Harold; Entcheva, Emilia

2006-01-01

375

Quantifying skeletal muscle recovery in a rat injury model using ultrasound imaging.  

PubMed

Monitoring skeletal muscle health during recovery or degeneration is of great interest both clinically and in research settings. This type of monitoring requires health measurements be taken at multiple time points. Contraction strength is a commonly used metric for quantifying muscle health, but it requires invasive in vitro or in situ procedures that may further damage the tissue. Ultrasound imaging can be used to visualize muscle damage, and semi-quantitative grading scales have been shown to be effective at characterizing abnormalities. Using an established functional testing procedure in a rat model as a baseline measurement of muscle strength, we show that ultrasound imaging combined with a semi-quantitative grading scale can be used to monitor recovery after contusion injury. Although additional work is needed to refine the imaging and grading procedures, ultrasound promises a fast and non-invasive alternative to functional testing for characterizing skeletal muscle health. PMID:25529138

Leineweber, Matt; Gao, Yingxin

2015-01-21

376

[Prevention of gas microemboli during cardiac surgery. Numerical control of cardiac cavity purging by an ultrasonic detector].  

PubMed

Despite all precautions taken by cardiac surgeons to eliminate air remaining in the cardiac cavities and pulmonary veins at the end of cardiopulmonary bypass, many micro bubbles probably remain and pass into the systemic circulation with a risk of deteriorations of cerebral or myocardial function. Over the last four years we have used ultrasound to try to prevent the risk of preoperative gas microemboli: the machine is equipped with a detector (a quartz oscillator coupled to a piezoelectric transducer emitting a continuous beam of ultrasound at a frequency of 5 Mhz) which allows the following variables to be determined: the time interval from the onset of detection, the total quantity of bubbles (arbitrary units) in the examined regions, the quantity of bubbles detected over a given time interval which can be adjusted from 15 to 120 seconds. The passage of bubbles is also indicated by light and sound alarms. The smallest diameter of bubbles which can be detected is about 10 mu. There are periaortic probes adaptable to the calibre of the ascending aorta, transcutaneous probes for carotid artery detection and a left ventricular probe. In a preliminary series of 74 valve replacements in adults, this apparatus was used immediately after terminating cardiopulmonary bypass after we had thought that the cardiac cavities had been satisfactorily purged of air, and whilst active aspiration was continued in the ascending aorta distal to the periaortic probe: the total quantity of bubbles detected varied from less than 50 to more than 2000 AU, over a variable period of time which may exceed 20 min after termination of cardiopulmonary bypass. The total quantity of bubbles recorded after mitral valve (582 +/- 154 AU) or combined mitral and aortic valve replacement (685 +/- 167 AU) was generally greater than after isolated aortic valve replacement (335 +/- 126 AU). Therefore, after cardiopulmonary bypass, and despite all efforts at purging the air, we showed that numbers of microbubbles were ejected into the ascending aorta for a variable period of time: only some of them were eliminated by active aspiration through a trocar placed distal to the periaortic probe. The right coronary ostium was poorly protected against microbubbles because of its anatomical situation (6 cases in this series). We therefore established a protocol for the use of this apparatus to aid the purging of the cardiac cavities and pulmonary veins before stopping cardiopulmonary bypass: the manoeuvres, guided by the ultrasound probes, are performed before the left ventricle is allowed to eject blood into the ascending aorta.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6424617

Mikaeloff, P; Van Haecke, P; Girard, C; Tartulier, M; Devolfe, C; Guillaud, C; Lakestani, F; Roche, M; Guillerm, R; Masurel, G

1984-03-01

377

Early Blood Gas Abnormalities and the Preterm Brain  

PubMed Central

The authors explored associations between blood gas abnormalities in more than 1,000 preterm infants during the first postnatal days and indicators of neonatal brain damage. During 2002–2004, women delivering infants before 28 weeks’ gestation at one of 14 participating institutions in 5 US states were asked to enroll in the study. The authors compared infants with blood gas values in the highest or lowest quintile for gestational age and postnatal day (extreme value) on at least 1 of the first 3 postnatal days with the remainder of the subjects, with separate analyses for blood gas abnormalities on multiple days and for partial pressure of oxygen in the alveolar gas of <35. Outcomes analyzed were ventriculomegaly and an echolucent lesion on an ultrasound scan in the neonatal intensive care unit, and cerebral palsy, microcephaly, and a low score on a Bayley Scale of Infant Development at 24 months. Every blood gas derangement (hypoxemia, hyperoxemia, hypocapnia, hypercapnia, and acidosis) was associated with multiple indicators of brain damage. However, for some, the associations were seen with only 1 day of exposure; others were evident with 2 or more days’ exposure. Findings suggest that individual blood gas derangements do not increase brain damage risk. Rather, the multiple derangements associated with indicators of brain damage might be indicators of immaturity/vulnerability and illness severity. PMID:20807736

Leviton, Alan; Allred, Elizabeth; Kuban, Karl C. K.; Dammann, Olaf; O'Shea, T. Michael; Hirtz, Deborah; Schreiber, Michael D.; Paneth, Nigel

2010-01-01

378

Respiratory Hemodynamics in the Hepatic Veins-Abnormal Patterns.  

PubMed

The flow pattern in the hepatic veins (HVs) is dependent on the cardiac cycle and right heart hemodynamics and influenced by the respiratory cycle and the liver parenchyma. Most disease states that affect the right heart alter the HV Doppler in a manner independent of the respiratory cycle. Some diseases that typically involve the pericardium, right ventricular myocardium, or respiratory system confer characteristic changes to the HV flow in a manner dependent on the respiratory cycle. Analysis of the HV Doppler with assessment of the respiratory changes in flow and their timing helps to distinguish among the various disease states. In this manuscript, we discuss the effect of respiration on HV flow in patients with abnormal right heart function and illustrate the use of the respiratory changes in the HV Doppler as a tool for diagnosis. PMID:25252115

Fadel, Bahaa M; Alkalbani, Ahmad; Husain, Aysha; Dahdouh, Ziad; Di Salvo, Giovanni

2014-09-24

379

Cardiac Emergencies in Neurosurgical Patients  

PubMed Central

Perioperative safety concerns are a major area of interest in recent years. Severe cardiac perturbation such as cardiac arrest is one of the most dreaded complications in the intraoperative period; however, little is known about the management of these events in the patients undergoing elective neurosurgery. This special group needs further attention, as it is often neither feasible nor appropriate to apply conventional advanced cardiac life support algorithms in patients undergoing neurosurgery. Factors such as neurosurgical procedure and positioning can also have a significant effect on the occurrence of cardiac arrest. Therefore, the aim of this paper is to describe the various causes and management of cardiac emergencies with special reference to cardiac arrest during elective neurosurgical procedures, including discussion of position-related factors and resuscitative considerations in these situations. This will help to formulate possible guidelines for management of such events.

Petropolis, Andrea; Cappellani, Ronald B.

2015-01-01

380

How to Interpret Abnormal Pap Smear Results  

MedlinePLUS

... Cervical Cancer | How to Interpret Abnormal Pap Smear Results What does an abnormal Pap smear mean? A ... are located in your cervix or uterus. These results mean that some of your glandular cells are ...

381

Cardiac assessment of limb-girdle muscular dystrophy 2I patients: an echography, Holter ECG and magnetic resonance imaging study.  

PubMed

Mutations in the FKRP gene may be associated with cardiac involvement. The aim of our study was to assess myocardial involvement in patients with LGMD2I, using physical examination, echocardiography, resting and 24-h ambulatory electrocardiogram and cardiac magnetic resonance imaging, with particular attention to the detection of myocardial morphologic abnormalities. Patients were compared to matched controls. Twenty-three patients were enrolled (men 10--women 13; 32.3+/-9.5 years). Twenty-two had the C826A gene mutation (homozygous 12, heterozygous 10). Nine patients had severe muscle alterations, 10 had milder muscle involvement and 4 had isolated exertional myoglobinuria. When compared to controls, LGMD2I patients had reduced left ventricular ejection fraction (50.8+/-13.9 versus 66.6+/-3.8%, p<0.0001). Sixty percent of patients had reduced left ventricular ejection fraction, including 8% with severe reduced left ventricular ejection fraction <30%. None had significant arrhythmia. Gene mutation and the severity of the muscle disease were not predictive of cardiac involvement. Cardiac magnetic resonance imaging displayed a high prevalence of myocardial functional abnormalities, fatty replacement and fibrosis, among the 13 patients investigated. Reduced contractility and cardiac magnetic resonance imaging morphological abnormalities are highly prevalent in LGMD2I patients suggesting that all patients should be referred for cardiac evaluation. PMID:18639457

Wahbi, Karim; Meune, Christophe; Hamouda, El Hadi; Stojkovic, Tania; Laforêt, Pascal; Bécane, Henri Marc; Eymard, Bruno; Duboc, Denis

2008-08-01

382

Resonant ultrasound spectrometer  

DOEpatents

An ultrasound resonant spectrometer determines the resonant frequency spectrum of a rectangular parallelepiped sample of a high dissipation material over an expected resonant response frequency range. A sample holder structure grips corners of the sample between piezoelectric drive and receive transducers. Each transducer is mounted on a membrane for only weakly coupling the transducer to the holder structure and operatively contacts a material effective to remove system resonant responses at the transducer from the expected response range. i.e., either a material such as diamond to move the response frequencies above the range or a damping powder to preclude response within the range. A square-law detector amplifier receives the response signal and retransmits the signal on an isolated shield of connecting cabling to remove cabling capacitive effects. The amplifier also provides a substantially frequency independently voltage divider with the receive transducer. The spectrometer is extremely sensitive to enable low amplitude resonance to be detected for use in calculating the elastic constants of the high dissipation sample.

Migliori, Albert (Santa Fe, NM); Visscher, William M. (Los Alamos, NM); Fisk, Zachary (Santa Fe, NM)

1990-01-01

383

Simulation of Cardiac Action Potentials  

Microsoft Academic Search

\\u000a Simulation of cardiac action potentials offers a brief introduction to cardiac action potential modeling by examining the\\u000a history of the field and discusses experimental and modeling breakthroughs that have yielded today’s current models. The chapter\\u000a begins with an overview of the cardiac action potential and highlights the Hodgkin and Huxley formalism. The chapter then\\u000a highlights specific key models with a

Jonathan D. Moreno; Colleen E. Clancy

384

Partial rupture of the proximal Achilles tendon: a differential diagnostic problem in ultrasound imaging  

PubMed Central

Objectives: The aim of this study was to determine whether ultrasound can correctly visualise partial ruptures of the proximal Achilles tendon. Method: This was a prospective study in which all chronic Achilles tendon injury patients seen at three centres in Germany from 1998 to 2003 were screened. All patients with clinical and/or sonographic signs of abnormalities in the region of the proximal third of the Achilles tendon and tendomuscular junction were included in the analysis. Each of these cases was evaluated by ultrasound following an assessment protocol. Patients with ambiguous ultrasound findings and/or clinical signs were additionally assessed by magnetic resonance imaging (MRI). Results: Sonomorphologic changes suggestive of an abnormality in the proximal third of the Achilles tendon were detected in 13 out of 320 patients (4.2%) with recurring Achilles tendon complaints. Thirteen patients had clinical signs but no sonographic changes in the tendon. The sonographic diagnosis was correct in 19 cases. In six of the 26 cases studied, MRI was needed to establish the correct diagnosis of partial intratendinous rupture of the proximal Achilles tendon. Sensitivity was 0.5, specificity was 0.81, and the overall agreement of the ultrasound examination was 61.5%. All patients were asymptomatic at follow up at a mean of 14 months (range 12–17 months) after surgery. Conclusions: Ultrasound is a useful tool for evaluation of proximal Achilles tendon complaints. However, ultrasound is not sufficiently reliable for diagnosis of all pathologies, especially partial ruptures of the Achilles tendon. Thus, the definitive diagnosis must be established by MRI. PMID:16244194

Kayser, R; Mahlfeld, K; Heyde, C; Tschauner, C

2005-01-01

385

Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer  

Microsoft Academic Search

The purpose of this study was to examine the use of ultrasound (US)-guided core biopsy of axillary nodes in patients with operable breast cancer. The ipsilateral axillae of 187 patients with suspected primary operable breast cancer were scanned. Nodes were classified based on their shape and cortical morphology. Abnormal nodes underwent US-guided core biopsy\\/fine needle aspiration (FNA), and the results

A Damera; A J Evans; E J Cornford; A R M Wilson; H C Burrell; J J James; S E Pinder; I O Ellis; A H S Lee; R D Macmillan

2003-01-01

386

FUSBOTs: Image-guided Robotic Systems for FUS (Focused Ultrasound Surgery)  

Microsoft Academic Search

Minimally invasive and non-invasive surgical techniques remained a prime research focus in bio-medical arena in the past over two decades due to their numerous advantages over conventional surgery methods. Remote ablation of deep-seated abnormalities by various modalities such as the use of focused high intensity ultrasound can provide completely non-invasive procedures if the energy in the beam is carefully targeted.

Sunita Chauhan

387

Fibrolipomatous hamartoma and its ultrasound diagnosis: case series and review of the literature.  

PubMed

Fibrolipomatous hamartoma is a benign tumor mainly affecting peripheral nerves. It is characterized by abnormal growth of fibroadipose tissue within the nerve, leading to progressive compressive neuropathies. Carpal tunnel syndrome is the most frequent among them. Although it is considered an infrequent tumor, magnetic resonance imaging use has led to an increase in case reports. We present 3 clinical cases of fibrolipomatous hamartoma consulting due to soft tissue mass, which were diagnosed by ultrasound. PMID:25415865

Whittle, Carolina; Schonstedt, Valeria; Schiappacasse, Giancarlo

2014-12-01

388

Dentition abnormalities in a Timothy syndrome patient with a novel genetic mutation: a case report.  

PubMed

The purpose of this paper was to present the case of a two-year-old male diagnosed with Timothy syndrome who presented with generalized enamel defects in the primary dentition. Timothy syndrome is an autosomal dominant condition characterized by a de novo missense mutation in the Cav1.2 L-type calcium channel CACNA1C. Timothy syndrome patients present with multiple clinical manifestations, including: cardiac arrhythmias; syndactyly; immune deficiency; intermittent hypoglycemia; and neurologic issues, including seizures, mental retardation, hypotonia, and autism. Craniofacial abnormalities reported include: low-set ears; flat nasal bridge; small upper jaw; thin upper lip; round face; and baldness at birth. Abnormalities in the dentition have been reported, including small, misplaced teeth with poor enamel and severe caries. At present, there is no thorough description of the dental abnormalities seen in a patient with Timothy syndrome. PMID:24960393

Papineau, Scott D; Wilson, Stephen

2014-01-01

389

Programmable ultrasound imaging using multimedia technologies: a next-generation ultrasound machine  

Microsoft Academic Search

High computational and throughput requirements in modern ultrasound machines have restricted their internal design to algorithm-specific hardware with limited programmability. The authors have architected a programmable ultrasound processing system, Programmable Ultrasound Image Processor (PUIP), to facilitate engineering and clinical ultrasound innovations. Multiple high-performance multimedia processors were used to provide a computing power of 4 billion operations per second. Flexibility was

Yongmin Kim; Jin H. Kim; Christopher Basoglu; Thomas C. Winter

1997-01-01

390

Broadband miniature fiber optic ultrasound generator.  

PubMed

This paper presents the design, fabrication and characterization of a broadband miniature fiber optic ultrasound generator based on photoacoustic (PA) ultrasound generation principle for biomedical ultrasound imaging and ultrasound non-destructive test (NDT) applications. A novel PA generation material, gold nanocomposite, was synthesized by directly reducing gold nanoparticles within polydimethylsiloxane (PDMS) through a one-pot protocol. The fiber optic ultrasound generator was fabricated by coating the gold nanocomposite on the tip of the optical fiber. The efficiency of the PA generation using gold nanocomposite was increased 10(5) compared to using aluminum thin film and 10(3) compared to using graphite mixed within epoxy. The ultrasound profile and the acoustic distribution have been characterized. The amplitude of the generated ultrasound signal was as high as 0.64 MPa and the bandwidth was more than 20 MHz. This paper also demonstrated its capability for ultrasound imaging of a tissue specimen. PMID:25089431

Zou, Xiaotian; Wu, Nan; Tian, Ye; Wang, Xingwei

2014-07-28

391

Ultrasound probe localization by tracking skin features  

E-print Network

Ultrasound probe localization with respect to the human body is essential for freehand three-dimensional ultrasound (3D US), image-guided surgery, and longitudinal studies. Existing methods for probe localization, however, ...

Sun, Shih-Yu

2014-01-01

392

Contrast enhanced ultrasound (CEUS) in breast tumors.  

E-print Network

??Contrast-enhanced ultrasound or CEUS is a combination of the pharmacokinetics of contrast agents (or microbubbles-based ultrasound contrast agents), the signal processing of these agents and… (more)

Saracco, Ariel

2013-01-01

393

Ultrasound echoes as biometric navigators.  

PubMed

We demonstrate a new method of using ultrasound data to achieve prospective motion compensation in MRI, especially for respiratory motion during interventional MRI procedures in moving organs such as the liver. The method relies on fingerprint-like biometrically distinct ultrasound echo patterns produced by different locations in tissue, which are collated with geometrical information from MRI during a training stage to form a mapping table that relates ultrasound measurements to positions. During prospective correction, the system makes frequent ultrasound measurements and uses the map to determine the corresponding position. Results in motorized linear motion phantoms and freely breathing animals indicate that the system performs well. Apparent motion is reduced by up to 97.8%, and motion artifacts are reduced or eliminated in two-dimensional spoiled gradient-echo images. The motion compensation is sufficient to permit MRI thermometry of focused ultrasound heating during respiratory-like motion, with results similar to those obtained in the absence of motion. This new technique may have applications for MRI thermometry and other dynamic imaging in the abdomen during free breathing. PMID:22648783

Schwartz, Benjamin M; McDannold, Nathan J

2013-04-01

394

MRI assessment of cardiac tumours: part 1, multiparametric imaging protocols and spectrum of appearances of histologically benign lesions  

PubMed Central

Cardiac magnetic resonance imaging (MRI) is the reference standard technique for assessment and characterization of a suspected cardiac tumour. It provides an unrestricted field of view, high temporal resolution and non-invasive tissue characterization based on multi-parametric assessment of the chemical micro-environment. MRI exploits differences in hydrogen proton density in conjunction with T1 and T2 relaxation properties of different tissues to help differentiation normal from abnormal and benign from malignant lesions. In this article we review specific cardiac MRI techniques, tumour protocol design and the appearance of the spectrum of histologically benign tumours. PMID:25525581

Shahid, Muhammad; Ganeshan, Arul; Baijal, Shobhit; Simpson, Helen; Watkin, Richard W.

2014-01-01

395

Non-cardiac, non-oesophageal chest pain: the relevance of psychological factors  

PubMed Central

Background—No cause has been determined for chest pain that is neither cardiac nor oesophageal in origin. ?Aims—To compare the prevalence of lifetime psychiatric disorders and current psychological distress in three consecutive series of patients with chronic chest or abdominal pain. ?Patients—Thirty nine patients with non-cardiac chest pain and no abnormality on oesophagogastroduodenoscopy, oesophageal manometry, and 24 hour pH monitoring; 22 patients with non-cardiac chest pain having endoscopic abnormality, oesophageal dysmotility, and/or pathological reflux; and 36 patients with biliary colic. ?Methods—The Diagnostic Interview Schedule and the 28 item General Health Questionnaire were administered to all patients. ?Results—Patients with non-cardiac chest pain and no upper gastrointestinal disease had a higher proportion of panic disorder (15%), obsessive-compulsive disorder (21%), and major depressive episodes (28%) than patients with gallstone disease (0%, p<0.02; 3%, p<0.02; and 8%, p<0.05, respectively). In contrast, there were no differences between patients with non-cardiac chest pain and upper gastrointestinal disease and patients with gallstone disease in any of the DSM-111 defined lifetime psychiatric diagnoses. Using the General Health Questionnaire, 49% of patients with non-cardiac chest pain without upper gastrointestinal disease scored above the cut off point (that is, more than 4), which was considered indicative of non-psychotic psychiatric disturbance, whereas only 14% of patients with gallstones did so (p<0.005). The proportions of such cases were however similar between patients with non-cardiac chest pain and upper gastrointestinal disease (27%) and patients with gallstones. ?Conclusions—Psychological factors may play a role in the pathogenesis of chest pain that is neither cardiac nor oesophagogastric in origin. Keywords: chest pain;  oesophageal manometry;  gastro-oesophageal reflux disease;  oesophageal pH monitoring;  psychiatric illness PMID:9771413

Ho, K; Kang, J; Yeo, B; Ng, W

1998-01-01

396

Pathology Case Study: Sensory Abnormalities  

NSDL National Science Digital Library

The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in the medical/health science field. This particular case focuses on a 30-year-old man with a history of focal numbness, bladder and bowel dysfunction, and progressive sensory abnormalities. The patientâÂÂs history, images from an MRI, microscopic images of a specimen collected during his laminectomy, and final diagnosis are provided in this case for your review. Students will find this resource especially helpful, as it provides experience with patient history, lab results, and diagnostics.

Duggal, Neil; Hammond, Robert R.; Lownie, Steven P.; Smith, Sharyn

2007-12-10

397

Is ankle contracture after stroke due to abnormal intermuscular force transmission?  

PubMed

Contracture after stroke could be due to abnormal mechanical interactions between muscles. This study examined if ankle plantarflexor muscle contracture after stroke is due to abnormal force transmission between the gastrocnemius and soleus muscles. Muscle fascicle lengths were measured from ultrasound images of soleus muscles in five subjects with stroke and ankle contracture and six able-bodied subjects. Changes in soleus fascicle length or pennation during passive knee extension at fixed ankle angle were assumed to indicate intermuscular force transmission. Changes in soleus fascicle length or pennation were adjusted for changes in ankle motion. Subjects with stroke had significant ankle contracture. After adjustment for ankle motion, 9 of 11 subjects demonstrated small changes in soleus fascicle length with knee extension, suggestive of intermuscular force transmission. However, the small changes in fascicle length may have been artifacts caused by movement of the ultrasound transducers. There were no systematic differences in change in fascicle length (median between-group difference adjusting for ankle motion = -0.01, 95% CI -0.26-0.08 mm/degree of knee extension) or pennation (-0.05, 95% CI -0.15-0.07 degree/ degree of knee extension). This suggests ankle contractures after stroke were not due to abnormal (systematically increased or decreased) intermuscular force transmission between the gastrocnemius and soleus. PMID:25268148

Diong, Joanna; Herbert, Robert D

2015-02-01

398

Is ankle contracture after stroke due to abnormal intermuscular force transmission?  

PubMed

Contracture after stroke could be due to abnormal mechanical interactions between muscles. This study examined if ankle plantarflexor muscle contracture after stroke is due to abnormal force transmission between the gastrocnemius and soleus muscles. Muscle fascicle lengths were measured from ultrasound images of soleus muscles in five subjects with stroke and ankle contracture and six able-bodied subjects. Changes in soleus fascicle length or pennation during passive knee extension at fixed ankle angle were assumed to indicate intermuscular force transmission. Changes in soleus fascicle length or pennation were adjusted for changes in ankle motion. Subjects with stroke had significant ankle contracture. After adjustment for ankle motion, 9 of 11 subjects demonstrated small changes in soleus fascicle length with knee extension, suggestive of intermuscular force transmission. However, the small changes in fascicle length may have been artifacts caused by movement of the ultrasound transducers. There were no systematic differences in change in fascicle length (median between-group difference adjusting for ankle motion = -0.01, 95% CI -0.26-0.08 mm/degree of knee extension) or pennation (-0.05, 95% CI -0.15-0.07 degree/degree of knee extension). This suggests ankle contractures after stroke were not due to abnormal (systematically increased or decreased) intermuscular force transmission between the gastrocnemius and soleus. PMID:25580546

Diong, Joanna; Herbert, Robert D

2015-02-01

399

Cardiac PET perfusion: prognosis, risk stratification, and clinical management.  

PubMed

Myocardial perfusion imaging (MPI) with PET has expanded significantly over the past decade. With the wider availability of PET scanners and the routine use of quantitative blood flow imaging, the clinical use of PET MPI is expected to increase further. PET MPI is a powerful tool to identify risk, to quantify risk, and to guide therapy in patients with known or suspected coronary artery disease. A large body of evidence supports the prognostic value of PET MPI and ejection fraction in intermediate- to high-risk subjects, in women, in obese individuals, and in post-coronary artery bypass grafting individuals. A normal perfusion study indicates low risk (<1% annualized rate of cardiac events of cardiac death and non-fatal myocardial infarction), while an abnormal study indicates high risk. With accurate risk stratification, high-quality images, and quantitation, PET MPI may transform the management of patients with known or suspected coronary artery disease. PMID:25234079

Dorbala, Sharmila; Di Carli, Marcelo F

2014-09-01

400

Prevalence of cardiac arrhythmias in a community based chiropractic practice  

PubMed Central

Introduction: The prevalence of arrhythmias in chiropractic practice (the proportion of current patients who currently have arrhythmias) is unknown, but thought to be increasing. As arrhythmias influence management of chiropractic patients, the objective of this study was to determine the feasibility of screening for cardiac arrhythmias in a chiropractic clinic. Methods: With a convenience sample from one clinic, ECG data were recorded and analyzed to identify arrhythmias. Results: Seventy-six of ninety contacted patients participated in this study. Only 8 (?26%) of 31 patients with known or suspected cardiovascular abnormalities demonstrated arrhythmias versus 7 (?16%) of 45 subjects who were not previously aware of having an arrhythmia. Conclusion: The screening of patients for cardiac arrhythmias in a community based chiropractic clinic is feasible. A 3-minute recording of ECG activity at rest is not a highly sensitive method of identifying patients with previously recognized arrhythmias, but is capable of identifying previously undiagnosed arrhythmias. PMID:25202151

Padhi, Suzanne; Patel, Nasreen; Driscoll, Darcy; Budgell, Brian

2014-01-01

401

AUTOMATIC REGISTRATION OF 3D ULTRASOUND IMAGES  

E-print Network

AUTOMATIC REGISTRATION OF 3­D ULTRASOUND IMAGES R.N. Rohling, A.H. Gee and L. Berman CUED promising applications of 3­D ultrasound lies in the visualisation and volume estimation of internal 3­D structures. Unfortunately, the quality of the ultrasound data can be severely degraded by artifacts

Drummond, Tom

402

Portable Antenatal Ultrasound Platform for Village Midwives  

E-print Network

to appropriate medical facilities for delivery. Ultrasound is a common imaging modality for obstetrical (OBPortable Antenatal Ultrasound Platform for Village Midwives Waylon Brunette 1 , Wayne Gerard 1 University of Washington Seattle, WA USA 98195 ronathan@uw.edu ABSTRACT Ultrasound imaging is an effective

Anderson, Ruth

403

Medical Imaging with Ultrasound: Some Basic Physics.  

ERIC Educational Resources Information Center

Discussed are medical applications of ultrasound. The physics of the wave nature of ultrasound including its propagation and production, return by the body, spatial and contrast resolution, attenuation, image formation using pulsed echo ultrasound techniques, measurement of velocity and duplex scanning are described. (YP)

Gosling, R.

1989-01-01

404

[Probe design of ultrasound biomicroscopy in ophthalmology].  

PubMed

Ultrasound biomicroscopy is an important ultrasound medical instrument and primary used in ophthalmology.The article design a probe of ultrasound biomicroscopy which is Portable, Low power consumption and High performance. Which can be used when plug in the computer USB interface. PMID:25241515

Zhu, Mingshan; Chen, Hao; Qu, Jia; Xu, Liangyu

2014-05-01

405

Cardiac troponins: bench to bedside interpretation in cardiac disease.  

PubMed

Cardiac troponins are the preferred biomarkers for the determination of acute myocardial necrosis. The high sensitivity of the available assays has significantly increased the detection of microscopic amounts of myocardial damage. Although compelling evidence indicates that elevated cardiac troponins are markers of poor prognosis and increased mortality, irrespective of the clinical scenario, small elevations can be seen in protean conditions and may confound the diagnosis of acute coronary syndromes. Emerging evidence suggests multiple different cellular mechanisms leading to cardiac troponin release, which challenge long held paradigms such as equivalency between troponin release into the circulation and irreversible cell death. Hence, knowledge of the physiology and pathophysiology of these cardiac biomarkers is essential for their accurate interpretation and consequent correct clinical diagnosis. Herein, the current relevant information about cardiac troponins is discussed, with special emphasis on pathophysiology and clinical correlates. PMID:23656921

Muthu, Vasundhara; Kozman, Hani; Liu, Kan; Smulyan, Harold; Villarreal, Daniel

2014-04-01

406

Ultrasound: From Earth to Space  

PubMed Central

Ultrasonography is a versatile imaging modality that offers many advantages over radiography, computed tomography, and magnetic resonance imaging. On Earth, the use of ultrasound has become standard in many areas of medicine including diagnosis of medical and surgical diseases, management of obstetric and gynecologic conditions, assessment of critically ill patients, and procedural guidance. Advances in telecommunications have enabled remotely-guided ultrasonography for both geographically isolated populations and astronauts aboard the International Space Station. While ultrasound has traditionally been used in spaceflight to study anatomical and physiological adaptations to microgravity and evaluate countermeasures, recent years have seen a growth of applications adapted from terrestrial techniques. Terrestrial, remote, and space applications for ultrasound are reviewed in this paper. PMID:22399873

Law, Jennifer; Macbeth, Paul. B.

2011-01-01

407

Intracranial perfusion imaging with ultrasound.  

PubMed

In the last several years, great progress has been made in ultrasound perfusion imaging of the brain. Different approaches have been assessed and shown to be capable of the early detection of cerebral perfusion deficits in stroke patients. Real-time low-mechanical index imaging simplifies the acquisition of perfusion parameters and alleviates many of the previous imaging problems related to shadowing, uniplanar analysis, and temporal resolution. With the advent of this new, highly sensitive contrast-specific imaging technique, new possibilities of the real-time visualization of brain infarctions and cerebral hemorrhages have emerged. This review will detail the methodology of ultrasound perfusion imaging, discuss aspects of its safety and present the emerging clinical applications of brain perfusion assessment with ultrasound in acute stroke patients. © 2015 S. Karger AG, Basel. PMID:25531663

Meairs, Stephen; Kern, Rolf

2015-01-01

408

Ultrasound: from Earth to space.  

PubMed

Ultrasonography is a versatile imaging modality that offers many advantages over radiography, computed tomography, and magnetic resonance imaging. On Earth, the use of ultrasound has become standard in many areas of medicine including diagnosis of medical and surgical diseases, management of obstetric and gynecologic conditions, assessment of critically ill patients, and procedural guidance. Advances in telecommunications have enabled remotely-guided ultrasonography for both geographically isolated populations and astronauts aboard the International Space Station. While ultrasound has traditionally been used in spaceflight to study anatomical and physiological adaptations to microgravity and evaluate countermeasures, recent years have seen a growth of applications adapted from terrestrial techniques. Terrestrial, remote, and space applications for ultrasound are reviewed in this paper. PMID:22399873

Law, Jennifer; Macbeth, Paul B

2011-06-01

409

UPDATE: CARDIAC XENOTRANSPLANTATION  

PubMed Central

Purpose of review To review the latest development in cardiac xenotransplantation in small and large animal models and related in vitro studies. Recent findings With the recent introduction of ?1,3-galactosyltransferase gene-knockout (GT-KO) pig organs for xenotransplantation, improved cardiac graft survival has been obtained. However, this experience has demonstrated the importance of pig antigens other than Gal?1,3Gal (Gal) antigens (so-called nonGal antigens) as targets for primate anti-pig antibodies. Several in vitro studies have confirmed that, although the incidence and levels of anti-nonGal antibodies in non-human primates and humans are significantly less when compared with total anti-pig antibodies (i.e., anti-Gal + anti-nonGal), they can result in complement-mediated lysis of GT-KO pig cells. More recently, it has been demonstrated that regulatory T cells (Treg) suppress the cellular xenogeneic response, thus potentially preventing or reducing T cell-mediated rejection. The importance of thrombotic microangiopathy as a feature of the immune/inflammatory response and incompatibilities between the coagulation-anticoagulation systems of pig and primate are receiving increasing attention. Development of GT-KO pigs transgenic for one or more ‘anti-thrombotic’ genes, e.g., CD39 or tissue factor pathway inhibitor, may contribute to overcoming these problems. Summary Although GT-KO pigs have provided an advance over wild-type pigs as a source of Organs for transplantation into primates, further genetic modification of GT-KO pigs is required to overcome the remaining immune barriers before a clinical trial of cardiac xenotransplantation can be contemplated. PMID:19060538

Ekser, Burcin; Cooper, David K.C.

2009-01-01

410

Lower extremity abnormalities in children.  

PubMed

Rotational and angular problems are two types of lower extremity abnormalities common in children. Rotational problems include intoeing and out-toeing. Intoeing is caused by one of three types of deformity: metatarsus adductus, internal tibial torsion, and increased femoral anteversion. Out-toeing is less common than intoeing, and its causes are similar but opposite to those of intoeing. These include femoral retroversion and external tibial torsion. Angular problems include bowlegs and knock-knees. An accurate diagnosis can be made with careful history and physical examination, which includes torsional profile (a four-component composite of measurements of the lower extremities). Charts of normal values and values with two standard deviations for each component of the torsional profile are available. In most cases, the abnormality improves with time. A careful physical examination, explanation of the natural history, and serial measurements are usually reassuring to the parents. Treatment is usually conservative. Special shoes, cast, or braces are rarely beneficial and have no proven efficacy. Surgery is reserved for older children with deformity from three to four standard deviations from the normal. PMID:12924829

Sass, Pamela; Hassan, Ghinwa

2003-08-01

411

Disorders caused by chromosome abnormalities  

PubMed Central

Many human genetic disorders result from unbalanced chromosome abnormalities, in which there is a net gain or loss of genetic material. Such imbalances often disrupt large numbers of dosage-sensitive, developmentally important genes and result in specific and complex phenotypes. Alternately, some chromosomal syndromes may be caused by a deletion or duplication of a single gene with pleiotropic effects. Traditionally, chromosome abnormalities were identified by visual inspection of the chromosomes under a microscope. The use of molecular cytogenetic technologies, such as fluorescence in situ hybridization and microarrays, has allowed for the identification of cryptic or submicroscopic imbalances, which are not visible under the light microscope. Microarrays have allowed for the identification of numerous new syndromes through a genotype-first approach in which patients with the same or overlapping genomic alterations are identified and then the phenotypes are described. Because many chromosomal alterations are large and encompass numerous genes, the ascertainment of individuals with overlapping deletions and varying clinical features may allow researchers to narrow the region in which to search for candidate genes. PMID:23776360

Theisen, Aaron; Shaffer, Lisa G

2010-01-01

412

Abnormality on Liver Function Test  

PubMed Central

Children with abnormal liver function can often be seen in outpatient clinics or inpatients wards. Most of them have respiratory disease, or gastroenteritis by virus infection, accompanying fever. Occasionally, hepatitis by the viruses causing systemic infection may occur, and screening tests are required. In patients with jaundice, the tests for differential diagnosis and appropriate treatment are important. In the case of a child with hepatitis B virus infection vertically from a hepatitis B surface antigen positive mother, the importance of the recognition of immune clearance can't be overstressed, for the decision of time to begin treatment. Early diagnosis changes the fate of a child with Wilson disease. So, screening test for the disease should not be omitted. Non-alcoholic fatty liver disease, which is mainly discovered in obese children, is a new strong candidate triggering abnormal liver function. Muscular dystrophy is a representative disease mimicking liver dysfunction. Although muscular dystrophy is a progressive disorder, and early diagnosis can't change the fate of patients, it will be better to avoid parent's blame for delayed diagnosis. PMID:24511518

2013-01-01

413

The Importance of Screening and Prenatal Diagnosis in the Identification of the Numerical Chromosomal Abnormalities  

PubMed Central

ABSTRACT Background and aims: The obstetric care of a pregnancy, as it is practiced today, includes non-invasive screening approaches as well as invasive procedures for the definitive prenatal diagnosis of fetal disorders correlations between indications for prenatal cytogenetic diagnosis and results of the chromosomal analysis made upon fetal cells. The aim of our study was to evaluate the correlations between the screening test results and results of chromosomal analysis on fetal cells. Methods: Amniotic fluid samples from 1159 pregnant women were studied with the rapid FISH method and the cytogenetic analysis (karyotype). The results from both methods were compared. Results: The indications to perform prenatal cytogenetic diagnosis for numerical chromosomal abnormalities were: abnormal results of double or triple test, advanced maternal age, fetal abnormality detected through ultrasound examination, and positive family history for chromosomal anomalies. In our study we identified 30 cases with abnormal numeric chromosomes (18 cases of trisomy 21, 4 cases of trisomy 18, 3 cases of trisomy X, 1 case of monosomy, 2 cases of trisomy XYY, 1 case of trisomy XXY and 1 case of triploidy). Conclusions: This report confirms the importance of screening and the cytogenetic diagnosis in the identification of the numerical chromosomal abnormalities. PMID:22368694

NEAGOS, Daniela; CRETU, Ruxandra; SFETEA, Roxana Corina; BOHILTEA, Laurentiu Camil

2011-01-01

414

Ultrasound-Assisted Hip Arthroscopy  

PubMed Central

We describe the use of intraoperative ultrasound for the safe development of arthroscopic portals during hip arthroscopy without the requirement for fluoroscopy. We find this technique consistently accurate, allowing the safe introduction of arthroscopic instruments into the hip with a very low rate of iatrogenic injury. We have further developed the technique for application to both central- and peripheral-compartment procedures. We now have a total experience of more than 700 procedures to date. With the described technique of ultrasound guidance for portal placement, fluoroscopy is required in fewer than 2% of hip arthroscopy procedures at our institution. PMID:24904772

Weinrauch, Patrick; Kermeci, Sharon

2014-01-01

415

Enzyme activity determination using ultrasound  

NASA Astrophysics Data System (ADS)

Here are presented the results of a novel approach to the measurement of enzyme reaction rates in which ultrasound velocity measurement is used. Our results show enzyme activity is observable, in the acoustic context, and that furthermore this offers the potential to estimate the rate of reaction over different substrate concentrations and temperatures. Findings are corroborated with optical microscopy and rheological measurements. Ultrasound velocity measurement can be performed without the need for aliquot extraction and offers an efficient, non-invasive and dynamic method to monitor enzyme activity.

Holmes, M. J.; Southworth, T.; Watson, N. G.; Povey, M. J. W.

2014-04-01

416

Laparoscopic ultrasound and gastric cancer  

NASA Astrophysics Data System (ADS)

The management of gastrointestinal malignancies continues to evolve with the latest available therapeutic and diagnostic modalities. There are currently two driving forces in the management of these cancers: the benefits of minimally invasive surgery so thoroughly demonstrated by laparoscopic surgery, and the shift toward neoadjuvant chemotherapy for upper gastrointestinal cancers. In order to match the appropriate treatment to the disease, accurate staging is imperative. No technological advances have combined these two needs as much as laparascopic ultrasound to evaluate the liver and peritoneal cavity. We present a concise review of the latest application of laparoscopic ultrasound in management of gastrointestinal malignancy.

Dixon, T. Michael; Vu, Huan

2001-05-01

417

The synergistic effect of ultrasound and chemical penetration enhancers on chorioamnion mass transport.  

PubMed

In our previous study we proposed the use of chemical penetration enhancers for noninvasive detection of fetus abnormalities that can also be utilized for direct fetal drug delivery. In an attempt to further increase the mass transport rate across the amniotic membrane, thus shortening the procedure and improving the applicability of the proposed procedure, the effect and mechanism of combining ultrasound exposure with chemical penetration enhancers' application were assessed. The combined effect was evaluated in vitro on post-delivery human amniotic membrane and ex vivo on rat's whole amniotic sac. Ultrasound effect has been assessed by dye experiments using a customized image analysis program. Additional insights of ultrasound effect's mechanism on biological membranes are presented. Previously we have determined that chemical penetration enhancers affect the fetal membranes via two mechanisms termed as 'extractors' and 'fluidizers'. In this study, we found that combining ultrasound with a 'fluidizer' CPE (e.g. bupivacaine) results in a synergistic enhancement (90-fold) of fetal membrane's mass transport, while combining ultrasound with 'extractors' (e.g. ethanol and NMP) results in an antagonistic effect. The combined procedure is faster and gain greater accuracy than the applications of sole chemical penetration enhancers. PMID:25540905

Azagury, Aharon; Khoury, Luai; Adato, Yair; Wolloch, Lior; Ariel, Ilana; Hallak, Mordechai; Kost, Joseph

2015-02-28

418

Current perspectives on cardiac amyloidosis  

PubMed Central

Amyloidosis represents a group of diseases in which proteins undergo misfolding to form insoluble fibrils with subsequent tissue deposition. While almost all deposited amyloid fibers share a common nonbranched morphology, the affected end organs, clinical presentation, treatment strategies, and prognosis vary greatly among this group of diseases and are largely dependent on the specific amyloid precursor protein. To date, at least 27 precursor proteins have been identified to result in either local tissue or systemic amyloidosis, with nine of them manifesting in cardiac deposition and resulting in a syndrome termed “cardiac amyloidosis” or “amyloid cardiomyopathy.” Although cardiac amyloidosis has been traditionally considered to be a rare disorder, as clinical appreciation and understanding continues to grow, so too has the prevalence, suggesting that this disease may be greatly underdiagnosed. The most common form of cardiac amyloidosis is associated with circulating amyloidogenic monoclonal immunoglobulin light chain proteins. Other major cardiac amyloidoses result from a misfolding of products of mutated or wild-type transthyretin protein. While the various cardiac amyloidoses share a common functional consequence, namely, an infiltrative cardiomyopathy with restrictive pathophysiology leading to progressive heart failure, the underlying pathophysiology and clinical syndrome varies with each precursor protein. Herein, we aim to provide an up-to-date overview of cardiac amyloidosis from nomenclature to molecular mechanisms and treatment options, with a particular focus on amyloidogenic immunoglobulin light chain protein cardiac amyloidosis. PMID:22058156

Guan, Jian; Mishra, Shikha; Falk, Rodney H.

2012-01-01

419

Redox Control of Cardiac Excitability  

PubMed Central

Abstract Reactive oxygen species (ROS) have been associated with various human diseases, and considerable attention has been paid to investigate their physiological effects. Various ROS are synthesized in the mitochondria and accumulate in the cytoplasm if the cellular antioxidant defense mechanism fails. The critical balance of this ROS synthesis and antioxidant defense systems is termed the redox system of the cell. Various cardiovascular diseases have also been affected by redox to different degrees. ROS have been indicated as both detrimental and protective, via different cellular pathways, for cardiac myocyte functions, electrophysiology, and pharmacology. Mostly, the ROS functions depend on the type and amount of ROS synthesized. While the literature clearly indicates ROS effects on cardiac contractility, their effects on cardiac excitability are relatively under appreciated. Cardiac excitability depends on the functions of various cardiac sarcolemal or mitochondrial ion channels carrying various depolarizing or repolarizing currents that also maintain cellular ionic homeostasis. ROS alter the functions of these ion channels to various degrees to determine excitability by affecting the cellular resting potential and the morphology of the cardiac action potential. Thus, redox balance regulates cardiac excitability, and under pathological regulation, may alter action potential propagation to cause arrhythmia. Understanding how redox affects cellular excitability may lead to potential prophylaxis or treatment for various arrhythmias. This review will focus on the studies of redox and cardiac excitation. Antioxid. Redox Signal. 18, 432–468. PMID:22897788

Aggarwal, Nitin T.

2013-01-01

420

Optogenetic Control of Cardiac Function  

Microsoft Academic Search

The cardiac pacemaker controls the rhythmicity of heart contractions and can be substituted by a battery-operated device as a last resort. We created a genetically encoded, optically controlled pacemaker by expressing halorhodopsin and channelrhodopsin in zebrafish cardiomyocytes. Using patterned illumination in a selective plane illumination microscope, we located the pacemaker and simulated tachycardia, bradycardia, atrioventricular blocks, and cardiac arrest. The

Aristides B. Arrenberg; Didier Y. R. Stainier; Herwig Baier; Jan Huisken

2010-01-01

421

Correlation of cognitive function with ultrasound strain indices in carotid plaque.  

PubMed

Instability in carotid vulnerable plaque can generate cerebral micro-emboli, which may be related to both stroke and eventual cognitive abnormality. Strain imaging to detect plaque vulnerability based on regions with large strain fluctuations, with arterial pulsation, may be able to determine the risk of cognitive impairment. Plaque instability may be characterized by increased strain variations over a cardiac cycle. Radiofrequency signals for ultrasound strain imaging were acquired from the carotid arteries of 24 human patients using a Siemens Antares with a VFX 13-5 linear array transducer. These patients underwent standardized cognitive assessment (Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]). Plaque regions were segmented by a radiologist at end-diastole using the Medical Imaging Interaction Toolkit. A hierarchical block-matching motion tracking algorithm was used to estimate the cumulated axial, lateral and shear strains within the imaging plane. The maximum, minimum and peak-to-peak strain indices in the plaque computed from the mean cumulated strain over a small region of interest in the plaque with large deformations were obtained. The maximum and peak-to-peak mean cumulated strain indices over the entire plaque region were also computed. All strain indices were then correlated with RBANS Total performance. Overall cognitive performance (RBANS Total) was negatively associated with values of the maximum strain and the peak-to-peak for axial and lateral strains, respectively. There was no significant correlation between the RBANS Total score and shear strain and strain indices averaged over the entire identified plaque for this group of patients. However, correlation of maximum lateral strain was higher for symptomatic patients (r = -0.650, p = 0.006) than for asymptomatic patients (r = -0.115, p = 0.803). On the other hand, correlation of maximum axial strain averaged over the entire plaque region was significantly higher for asymptomatic patients (r = -0.817, p = 0.016) than for symptomatic patients (r = -0.224, p = 0.402). The results reveal a direct relationship between the maximum axial and lateral strain indices in carotid plaque and cognitive impairment. PMID:24120415

Wang, Xiao; Jackson, Daren C; Varghese, Tomy; Mitchell, Carol C; Hermann, Bruce P; Kliewer, Mark A; Dempsey, Robert J

2014-01-01

422

Spiral hypertrophic cardiomyopathy as detected by cardiac magnetic resonance.  

PubMed

Hypertrophic cardiomyopathy (HCM) is a genetically determined heart muscle disease; characterized by left ventricular hypertrophy (LVH). Spiral HCM is described as having a counterclockwise rotation pattern of hypertrophy along with variable degrees of fibrosis. A 34-year-old female presented with symptoms suggestive of heart failure. Echocardiography showed concentric LVH with normal contractility. Cardiac MRI showed asymmetric septal hypertrophy with mid-cavity obliteration and a spiral pattern of variably increasing wall thickness. Late gadolinium enhancement (LGE) demonstrated several areas of abnormal postgadolinium uptake. We report a case of spiral HCM. We should consider cardiovascular magnetic resonance (CMR) as the reference standard for diagnosing HCM. PMID:24749165

Amin, Nessim; Williams, Ronald B; Yarmozik, June A; Biederman, Robert W W

2014-03-01

423

The Chemotherapy of Cardiac Arrest  

PubMed Central

Direct-air ventilation, external cardiac compression, and external defibrillation are established techniques for patients who unexpectedly develop cardiac arrest. The proper use of drugs can increase the incidence of successful resuscitation. Intracardiac adrenaline (epinephrine) acts as a powerful stimulant during cardiac standstill and, in addition, converts fine ventricular fibrillation to a coarser type, more responsive to electrical defibrillation. Routine use of intravenous sodium bicarbonate is recommended to combat the severe metabolic acidosis accompanying cardiac arrest. Lidocaine is particularly useful when ventricular fibrillation or ventricular tachycardia tends to recur. Analeptics are contraindicated, since they invariably increase oxygen requirements of already hypoxic cerebral tissues. The following acrostic is a useful mnemonic for recalling the details of the management of cardiac arrest in their proper order: A (Airway), B (Breathing), C (Circulation), D (Diagnosis of underlying cause), E (Epinephrine), F (Fibrillation), G (Glucose intravenously), pH (Sodium bicarbonate), I (Intensive care). ImagesFig. 1Fig. 3Fig. 4 PMID:14216141

Minuck, Max

1965-01-01

424

Challenges in Cardiac Tissue Engineering  

PubMed Central

Cardiac tissue engineering aims to create functional tissue constructs that can reestablish the structure and function of injured myocardium. Engineered constructs can also serve as high-fidelity models for studies of cardiac development and disease. In a general case, the biological potential of the cell—the actual “tissue engineer”—is mobilized by providing highly controllable three-dimensional environments that can mediate cell differentiation and functional assembly. For cardiac regeneration, some of the key requirements that need to be met are the selection of a human cell source, establishment of cardiac tissue matrix, electromechanical cell coupling, robust and stable contractile function, and functional vascularization. We review here the potential and challenges of cardiac tissue engineeri